Opiates

Wat zijn opiaten?

Opiaten (morfine, heroïne, opium) zijn pijnstillers, als medicijnen worden door artsen voorgeschreven tegen hevige (chronische) pijn. Deze pijnstillers vaak voor als tabletten. Sommige opiaten (zoals heroïne) komen voornamelijk van buiten de medische markt. Heroïne ziet eruit als een korrelig (wit, grijs of bruin) poeder. Een straatnaam voor heroïne is ‘bruin’ verwijzend naar die bruine poeder.

Er is een verschil tussen opiaten en opioïden. Opiaten zijn stoffen die uit de papaver gehaald kunnen worden. Voorbeelden hiervan zijn codeïne, morfine, heroïne en opium. Opioïden zijn stoffen die een vergelijkbare werking in de hersenen hebben als opiaten, maar niet in de papaver voorkomen.  Voor het gemak noemen we beiden hier opiaten.


Effecten heroïne

Opiaten zijn pijnstillers met een sederende werking.

Het effect van een middel wordt bepaald door eigenschappen van het middel zelf, maar ook door de set en setting van de gebruiker. Hier beschrijven we welke effecten opiaten over het algemeen hebben.

Morfine en heroïne hebben ongeveer hetzelfde effect, alleen is heroïne sterker. Welk effect heroïne heeft hangt af van de dosis, de zuiverheid en de wijze van gebruik. Ook de ervaring en de lichamelijke conditie van de gebruiker spelen een rol.

Positieve effecten (negatieve) Bijwerkingen

Relaxation

Reduction of stress, uneasiness, sadness, panic, and feelings of depression.

Head ache

Head ache

Euphoria, feelings of love

This substance can make you feel euphoric, like you are in love. You feel comfortable in your own skin and can experience things as pleasant more quickly.

Nausea/vomiting

An uneasy and tense feeling in the abdomen, which may cause discomfort. Nausea often precedes vomiting.

Mood swings

Using this drug may cause mood swings in users. These mood changes may be either positive or negative, and often alternate between extremes.

Constricting of the pupils

Some drugs constrict the pupils.

Reduction of worries

You can experience (strong) feelings of satisfaction and safety. Stress and/or worries that keep you busy on a daily basis are placed in the background a bit more, which can be pleasant.

Itch

Some drugs can cause ichting.

More intense music experiences

Music can be experienced louder or more intense. For example, it can feel as if you are completely ‘absorbed’ in the music or that you feel the low tones from the music go through your body more intensely.

Decreased appetite

Stimulation of the fight-or-flight response in the body can suppress appetite.

Pain reduction

You feel pain stimuli less. People sometimes use drugs to ease certain complaints they are experiencing. This can provide some relief.

But because of the inhibitory effect of the drug, you will, for example, feel less of a collision or fall or of too much movement. This can cause extra physical damage, for example, because you continue to dance when you should have rested. For example, you may not realize that a bruised ankle hurts.

Difficulty urinating

Your body releases a lot of antidiuretic hormone (ADH) causing you to retain more fluids. There is also more tension in the muscles in your urinary tract, which makes relaxing (and therefore urinating) more difficult.

More intense dreaming

You may start dreaming more actively and/or more intensely than usual. The dreams can then be a lot more vivid, more intense or weirder. This can be an interesting and fun, but also scary and unpleasant at times. The effect can therefore work both positively and negatively for you. You may also wake up less refreshed in the morning as a result.

Sedation

Decreased energy level

Reduction of cough stimulus

You are less bothered by the feeling that you have to cough.

Decrease in libido

Reduced sexual lust

Slowed breathing

Slowed breathing

Decreased body temperature

Some drugs cause a decrease in body temperature.

Double vision

Not being able to focus your eyes properly.

Craving

Feeling a (strong) need to take more when the effect wears off.

Lowered blood pressure

Some drugs can lower the blood pressure in your body.

Constipation

Some drugs can cause a constipation of the intestines.

Dry mouth

Stimulation of sympathetic pathways decrease saliva production, this causes the mouth to feel dry.

Increased sweating

In response to the increased stimulation and changes in body temperature, the skin will start to secrete sweat to cool the body temperature back to normal levels.

Dulling of emotions

Dulling of your emotions, apathy.

Irregular or absent period

Menstruation may become irregular or even stop entirely.


Dosering en gebruikswijze

Heroïne kun je snuiven, roken en spuiten

Heroïne kun je chinezen of spuiten. Bij chinezen (“chasing the dragon”) wordt de heroïne op een stukje aluminiumfolie gelegd en verhit. De dampen worden via een kokertje geïnhaleerd. Bij spuiten wordt de heroïne op een lepel gelegd en vermengd met water en citroensap of ascorbine. Vervolgens wordt het mengsel verhit en wordt de opgeloste heroïne in een injectiespuit opgetrokken en direct in een ader gespoten. Via het bloed bereikt heroïne snel de hersenen.

In Nederland wordt heroïne meestal gebruikt door te chinezen. Vroeger werd het ook vaak gespoten, maar mede door de angst voor aids is die groep gebruikers in Nederland kleiner geworden: de spuitende gemeenschap bestaat voornamelijk uit oudere (langgebruikende) gebruikers en gebruikers uit landen waar nog wel veel gespoten wordt.

Je kunt heroïne ook snuiven of roken, vermengd met tabak, maar dit doen maar weinig gebruikers. Oraal gebruiken kan ook (opeten of in een drankje oplossen) maar dat geeft een veel minder intense ‘flash’ en is om die reden niet erg populair.

De sterkte van de heroïne kan sterk verschillen. Om te weten hoe sterk jouw heroïne is kun je het laten testen bij de testservice.  Ook de dosis om het gewenste effect te bereiken loopt sterk uiteen en is zeer afhankelijk van de gebruiker en dan met name de mate van tolerantie (gewenning)!

Heroïne doseringen bij spuiten
Gemiddelde dosis (geen tolerantie) 5 – 10 mg
Gemiddelde dosis (grote tolerantie) 20 mg
Zeer hoge dosis (grote tolerantie) 60+ mg
Heroïne dosering bij chinezen 15 – 25 mg

Werkingsduur

Bij spuiten beginnen de effecten na zo’n 10 tot 20 seconden en houden ongeveer vier uur aan. Bij het chinezen beginnen de effecten na 5 tot 10 seconden en houden ook ongeveer 4 uur aan.


Risico’s heroïne

Heroïne zelf is nauwelijks schadelijk voor het lichaam. De manier van leven die vaak gepaard gaat met gebruik is wel schadelijk voor het lichaam. Veel heroïne gebruikers leven op straat, eten slecht en sommigen gebruiken besmette injectienaalden. De sterfte onder heroïnegebruikers neemt sneller toe dan onder de algemene bevolking. Naast overdosis en aids zijn doodsoorzaken levercirrose, kanker, longproblemen, hart – en vaatziekten, zelfdoding, ongevallen en geweld.

Risico’s op korte termijn

HIV and hepatitis infection (only with injecting)

When injecting drugs you run an increased risk of HIV, hepatitis and other blood-borne infections. Injecting is strongly discouraged for this reason. If you do decide to inject, make sure you don’t share equipment such as needles with others and that you use a clean needle every time.

Overdose heroin

The narcotic effect of heroin can cause breathing to stop completely. Overdose users appear pale and limp, breathe shallow or not at all, sometimes foam at the mouth and may vomit or have seizures.

Overdose – too high a dose and possibly fatal, can happen to a user if he:

  • Is a new user that is not used to the strength.
  • Stops for a while and takes this ‘regular’ dose again.
  • Uses aldulterated heroin.
  • Uses heroin that’s stronger than he thought.
  • Combines several drugs.
  • Uses in case of fatigue or low resistance.

Risico’s op lange termijn

Unnoticed pregnancy

Female heroin users often have irregular menstrual cycles or absence of their period. This does not prevent them from becoming pregnant, however. The inconsistency of menstrual cycles often causes these pregnancies to only be discovered in advanced stages of pregnancy.

Physical dependence in babies

A newborn baby of someone with heroin addiction is physically dependent on opioids and will develop withdrawal symptoms. After birth, the baby cries a lot, is easily startled, and has trouble sleeping. There is also a risk of developmental disorders. Medical supervision is necessary.

Diseases go unnoticed

Heroin suppresses pain which could lead to certain complaints to go unnoticed or that they are felt too late and therefore worsen.

Physical addiction

Regular use of this drug can lead to physical addiction. This means that in addition to the psychological urge to take more, withdrawal symptoms arise when using is interrupted or stopped. Withdrawal symptoms include but are not limited to: poor sleep, sweating and becoming restless.

Withdrawal symptoms are often a reason to start drinking or using again. In actuality, those phenomena are only temporarily  suppressed.

Tolerance or habituation also occurs. That means if you use it regularly, you need more to feel the same effect.

Tolerance and stimulants

With stimulant use, tolerance will build-up for both the mental changes and appetite-suppressing effect, but not for cardiovascular effects. The higher your dose, the higher your blood pressure.

Social isolation

Chronic and habitual use may cause users to spend less time maintaining friendships, relationships, and family bonds. Over time, they may start to reject any forms of social interaction, isolating them from their social circles.


Combinatiegebruik

Het combineren van verschillende soorten drugs kan riskant en onvoorspelbaar zijn. Als je medicijnen combineert, kan je een hoger risico op gezondheidsproblemen hebben. In de volgende paragrafen lees je over de effecten en risico’s van een aantal veel voorkomende combinaties en ook enkele die extra gevaarlijk kunnen zijn. Zie ook het thema drugs combineren.

Opiates and alcohol

Opiates and alcohol are both downers. They slow down activity in your nervous system. This has several risks. First, they both cause your breathing to slow down and become shallower. This can cause you to pass out faster than if you only take 1 drug.

Especially if you first drank alcohol and then take opiates, this increases the chance of passing out. If you first take opiates and then drink (some) alcohol, you are less likely to drink a lot. But of course it is better not to combine. This combination can cause serious physical risks.


Unitytips heroïne

Het is heel erg moeilijk om heroïne op recreatieve basis te consumeren. We raden consumptie van heroïne dan ook af. Als je toch heroïne gebruikt, kun je de risico’s beperken door:

Unity tips for using drugs

  • When using a drug for the first time, take only a small dose to see how your body reacts to the substance
  • Only use drugs when you are feeling well
  • Use drugs recreationally, not to combat psychological issues like fatigue
  • Avoid using drugs if you have (had) psychological afflictions or if you have a family history of psychological diseases (such as depression) in your family
  • Test your drugs before use at a drugs-testing service
  • Make sure to prepare a good set and setting for drug use
  • Only use drugs sparingly. Keep track of your use over time.
  • Decide in advance how much you are planning to use over the evening, and stick to that. 
  • Do not combine drugs with other substances or medicines
  • Do not participate in traffic after drug use
  • Prevent infectious diseases; Use your own snorter/sniffer and do not share paraphernalia with others
  • After insufflating, rinse your nose well with lukewarm saline water (for example, by using a nasal spray or nasal douche)
  • Are you, or one of your friends not feeling well? Keep an eye out for one another, take care of each other and visit the first aid (if one is available)
  • Call 112 in a life-threatening situation
  • Eat healthy before and after drug use. In particular, foods with lots of antioxidants and vitamins (blueberries, raspberries, blackberries, grapes, raisins, oranges, kiwi, broccoli). This is perhaps the most important tip! It can be difficult to eat during and after drug use, but make sure to try to eat something anyway. Eating well is a great way to reduce the hangover! If you can’t hold in solid foods, try juices, breakfast drinks, and smoothies.

Unity tips for using sedatives

  • Do not use sedatives (downers) in combination with other sedatives (alcohol, GHB, sleeping pills, opiates) or ketamine. This is dangerous because you can fall unconscious and suffocate on your vomit.
  • Write down the time of intake and your dose, text the dose and time to each other or put it in your phone to keep track of it yourself.
  • If you feel that you are getting falling asleep, you can try to keep moving to avoid falling asleep. But beware; if moving takes a lot of effort, there is a chance that you may fall or trip, so be careful.
  • An overdose is more likely on an empty stomach, a full stomach increases the chance of vomiting.
  • Less is more; taking a small, extra dose later because you did not feel anything after your first dose is better than taking too much and having an overdose.
  • Ensure that the people around you are aware of what you are going to use and have been using.
  • nooit alleen te gebruiken in verband met het risico op overdosering
  • jezelf een ijzeren zelfdiscipline toe-eigenen en met mate gebruiken
  • de heroïne te chinezen en niet te spuiten
  • je bewust te zijn van het gevaar op een overdosis
  • als je spuit, altijd een schone spuit te nemen

FAQ

How did the use of morphine start and how does it relate to heroin?

In 1803, a German pharmacist discovered how to make morphine from opium. Morphine, like opium, was used as a remedy for chronic pain and insomnia, but it was also taken by people who were addicted to laudanum (tincture of opium) and wanted to get rid of it. This didn’t work as morphine is even more potent and addictive than opium. Just how addictive morphine was was revealed when 45,000 soldiers returned addicted from the American Civil War.

Heroin was discovered in 1898 by a German company. It is made from morphine. The effect of this discovered new drug heroin turned out to be much stronger than that of morphine. For that reason, the drug was also called “heroin,” which means heroic or powerful in German. Where people used morphine to get rid of an opium addiction, they started using heroin to get rid of that morphine addiction. A vicious circle was the result. It was only too late to realize how addictive heroin was.

Heroin entered the drug market in 1972. The price was very low at first and before long all opium users switched to heroin and the same happened to the people who used other drugs. For years, the opiate problem has been the main drug problem in our country. This has now been reversed and there are relatively few heroin addicts.

How about the law and opiates?

In 1919 the Dutch Opium Act was passed. This determined that heroin was a hard drug from then on: possession, production, import, export and trade are punishable by law. Morphine, codeine and heroin may be used for medical purposes. People who own user amounts are not actively prosecuted. However, the heroin and the syringe attributes can be confiscated. Opiates such as morphine and codeine are mainly used in medicine. Morphine as a heavy painkiller and codeine as a cough suppressant. In that context, they are legal.
Check the theme Drugs and the law  for more info.

I am planning to combine opiates with other drugs. What are the consequences?

Combining different drugs can be risky and unpredictable. If you combine, you are more likely to have problems with your health. For more information, check the theme Drugs and combination use.

Heroin is regularly used in combination with other substances, for example with alcohol or cocaine. The combination with other downers is extra risky. For example, the respiratory inhibiting effect of opiates is enhanced by the use of alcohol. A combination with MAO inhibitors can lead to high blood pressure.

The combination with uppers such as cocaine gives your body different signals. Your body needs extra oxygen because of the cocaine, but gets it less because the heroin makes you breathe less.

How long are opiats detectable in the body?

How long a drug is detectable in your blood or urine depends on a number of factors. How often and how much you use and your personal metabolism (the speed at which the breakdown substances of a substance are broken down by your liver, in particular) influence how long it is detectable. Drugs are longer detectable in your urine than in your blood.

Heroin itself is usually detectable up to 8 hours after use. Tests usually look at the metabolite of heroin and these are detectable 3 to 5 days after use.

How are opiates made?

Opiates

Opiates are produced from the poppy plant. These plants grow in Central Asia and Southeast Asia (eg Iran, Iraq, Afghanistan, Burma and Thailand), but also in South America. Opium is obtained by making an incision in the seed bulb of the poppy plant. The seed bulb excretes a milky substance. When this dries up, a dark brown substance is formed, the raw opium. This raw substance can be smoked. Morphine can be made from the raw opium, and codeine can be made from morphine. Compared to morphine, codeine is a weak analgesic and a powerful anti-cough suppressant. By chemically processing the morphine, the heroin can eventually be created.

Opioids

Substances that have a similar effect in the brain as opiates, but do not occur in the original poppy bulb, are called opioids.

What if I have medical complaints after the use of partydrugs?

Some complaints after using drugs can last longer, A medical explanation or even treatment may then be necessary. The Brijder has set up a national consultancy for party drugs related medical complaints. If you have medical complaints after the use of party drugs, you can call the consultancy: 088 – 358 29 40. This service is only available in the Netherlands.

 

How addictive is heroin actually?

Heroin is highly addictive. Few people manage to control the use of the drug. The body quickly gets used to heroin. You then need more and more to still feel the desired effect of euphoria. It is striking that the withdrawal symptoms also occur very quickly; after only two or three weeks of use. A user feels sick, clammy and cold, perspires, has goosebumps, a runny nose, diarrhoea, abdominal cramps and muscle pain in arms and legs. These symptoms disappear when heroin is taken again. But the withdrawal symptoms only get worse every time. In addition, due to the euphoric and analgesic effect, a user continues to long for the drug. He/she puts everything aside and does everything (including stealing) just to be able to use. The mental dependence is especially great.

How did the use of opiates begin?

The history of opiates goes back a long way, about 4000 to 6000 years. Even then, people wrote about the poppy plant. Egyptians and many other peoples of the early Middle East used it. In the 7th century, opium arrived in China via Arab traders, where it was initially used to cure diarrhea. Later, under the influence of the Dutch settlers, opium became a remedy for malaria and it was used as a drug. China became obsessed with opium. The result was that many users became addicted and the then rulers announced a ban. This ban gave rise to two opium wars in which the English ensured that the opium from their colony of India could be sold in China. They wanted to keep selling this because they made a lot of money with it.

How did opium come to Europe?

In Europe, opium was not introduced as a medicinal drink until 1525. The drink was called ‘laudanum’ and was made from alcohol and opium. It was used by both adults and children as a sleep and pain reliever. The drink was quite popular. There was almost no disease in which opium was not seen as some sort of panacea. During the 19th century, opium was freely available in drugstores in both the US and England.

The use of opium as a drug in Europe dates back to the end of the eighteenth century. It was used by all walks of life, but at that time it didn’t cause too many problems: it was cheap and not yet illegal. There was hardly any knowledge about the negative effects and the risks.


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