In addition to the illegal activity resulting from the criminalization of heroin, the ban has resulted in varying degrees of end product purity. This results in many addicts overdosing, and sometimes dying, because they underestimate the potency of their product (Faupel et al., 2010). Regardless of the negative societal consequences of heroin use, its use in the United States is becoming more pervasive each year. Our policy of strict deterrence against heroine is failing. It is important then to reevaluate the history, treatment, pharmacology, and societal consequences of heroin use to better understand how to more effectively deal with it.
Heroin's Roots: From Mesopotamia to Morphine
Heroin's roots can be traced back to the beginning of recorded history with the Sumerians, who invented cuneiform, the first known system of writing, at about 3400 BC (Fernandez & Libby, 2011). The Sumerians are also credited with starting the world's first civilization. A constituent of being a civilization is the technology to farm. Coupled with irrigation from the Tigris and Euphrates rivers, this allowed the Sumerians to support a large population, and allowed that population time to pursue other interest beyond the search for food (Cantor & Werthman, 1972) . The opium poppy (Latin: Papaver somniferum), which is the strain of poppy from which opium is derived, was among the plants they cultivated (Fernandez & Libby, 2011). Since farming allowed the Sumerians time to pursue interest beyond basic survival, they began to explore and trade the poppy plant with the Persians (now Iran) to the East (Fernandez & Libby, 2011).
The role that the opium poppy plant played in Sumerian society can be summarized in their own description of it. They described it as "the plant of joy" (Fernandez & Libby, 2011). A prescription of joy may have been precisely what they needed because despite their successes, they still lived between a very unpredictable Tigris and Euphrates rivers. Both rivers frequently inundated their land, swept away their cattle, destroyed their crops, and claimed their people and belongings (Roux, 1992). These hardships they faced were mirrored in their religious beliefs. They believed in gods who were selfish, not concerned with them, and who only created humanity to be slaves (Rosenberg, 1999). It is not surprising then, given the strain upon their society, that they used the poppy plant as a relief.
In 973 A.D, the poppy trade made its way to China. It was not long before China succumbed to its addictive powers. Such a problem it became for the Chinese that they eventually banned all importation of the opium in 1790, but this did not stop traders from smuggling opium into the country (Fernandez & Libby, 2011). Byreached a zenith and the Chinese emperor seized all opium cargo from British merchants at port and destroyed of opium. This sparked and Britain, and later France, both of which China lost (Fernandez & Libby, 2011). As a result, China was forced to legalize opium imports and their population, consequently, suffered with prevalent opium addiction that afflicted up to 27% of the male population in 1906 (Fernandez & Libby, 2011).
The next evolution on the way toward heroin was the discovery and isolation, by Friedrich Sertürner in 1804, of the primary active ingredient in opium which resulted in the far more potent morphine (Morphine History, n.d.). By this time, opium had made its way into the USA. Chinese immigrants, at around this time, were coming to the USA to work on the railroad and set up opium dens (Thio, 2010). The USA soon developed an opium addiction, but the USA's addiction to opium, by the 1850's, had little to do with Chinese immigrants. It was actually white middle to upper class women that were addicted to elixirs like Mrs. Winslow's Soothing Syrup and tins of laudanum obtain from the mail, both of which contained opium, which accounted for the bulk of the USA's opium addiction (Fernandez & Libby, 2011). Well known poets such as Edgar Allan Poe were also addicted to opium in the form of Laudanum (Neurotic Poets, n.d.). Nevertheless, because the Chinese were associated with opium dens, and were accused of taking jobs away from white labor, the Chinese were demonized and blamed for America's opium issues, and the war on opium began in San Francisco in 1875; a year after the discovery of heroin (Thio, 2010).
Pharmacology: Morphine and Endorphins
Before delving into the history of heroin, it is important to understand the pharmacology of morphine, since heroin is its derivative. As mentioned before, morphine is as much asopium. What makes it so addictive is, in part, its chemical structure which mimics endorphins endogenous to humans (Faupel et al., 2010; Lakasing, Isaacson, & Mirza, 2009). Endorphins are actually considered to be a type of endogenous opioid. These natural endorphins have receptors located in and around the hypothalamus inside the brains limbic system in concentrated quantities (Self, 1999; Lakasing, Isaacson, & Mirza, 2009). Here inside the limbic system is where the brain modulates human emotions and likely where endorphins and opiates produce a sense of euphoria (stedwards.edu, n.d.). Endogenous and exogenous endorphins also have the effect of mitigating pain by inhibiting the spinal cords pain transmitter (stedwards.edu, n.d.). Morphine, because it has endorphin like qualities, does all that endorphins do, but unlike endogenous endorphins, morphine is highly addictive.
Heroin History and Pharmacology
Inafter Alder Wright, a British chemist, combined morphine by boiling them together (Faupel et al., 2010). The result was diacetylmorphine; the pharmaceutical name for heroin. These similar properties to vinegar, and like vinegar, they are lipid soluble (NYUSteinhardt, n.d.). This lipid solubility allows heroin to pass the blood brain barrier faster than morphine; thereby delivering more morphine to the brain before the body breaks it down (NYUSteinhardt, n.d.). Resultantly, heroin is far more addictive than morphine.
At the time heroin was first marketed in 1898, heroin was believed to be a wonder drug. Scientist did not fully understand the chemical processes that made it more addictive than morphine, and in fact, heroin was proclaimed to be a cure for opiate addiction, as well as an aspirin replacement. It was even sold in children's cough medicine until 1910 (NYUSteinhardt, n.d.). Because of all these seemingly heroic powers of diacetylmorphine, it was given the name heroin (Fernandez & Libby, 2011).
Not long after heroin was marketed, it was discovered that heroin broke down into morphine in the body. This discovery led to the Harrison Narcotics Tax Act in 1914, which sought to control the sale of heroin and other opiates in the USA (NYUSteinhardt, n.d.). Bywere banned in the USA (NYUSteinhardt, n.d.). This had the effect, after weeding out various narcotic scandals and creating the Federal Bureau of Narcotics in 1930, of reducing the drug addicted population as a whole from1945 (Fernandez & Libby, 2011). Heroin addiction was on the verge of extinction.
World War II and the Sinaloa Drug Cartel
There were a variety of conditions that lead to the rise of heroin addiction in the USA after 1945. of World War II. During the war the USA lost its opium supplies in Asia to Japan (Bergman, n.d.). As a result the USA turned to Mexican and South American sources in efforts to keep a Morphine supply for its soldiers (Bergman, n.d.).
The control of opium, during this period of time was very relaxed. Government officials ofthemselves to distribute, and soldiers could be seen in Sinaloa, where the Sinaloa drug cartel has its roots, cultivating the poppy plants (Bergman, n.d.). Many Sinaloans during this time made huge profits. In 1945, however, all this came to a stop when the war ended. The USA no longer needed opium supplies from the South when it could once again acquire the superior opium strain from Asia (Bergman, n.d.).
As a consequence of the abrupt change in demand the Sinaloans, and other opium suppliers from the South, were left with an infrastructure of opium supply that was no longer needed. Resultantly, many of them turned to deviant methods to sell their product; they smuggled opium into the USA and built black market trade routes throughout the country (Bergman, n.d.). This set up an infrastructure that would lead to the dominance of 's most feared and successful drug cartels; the Sinaloa Cartel. Consequently, by 1956, the population of narcotic addicts increased to over 60,000 (Fernandez & Libby, 2011). Among these, the famous jazz musician who spent in jail in(Dr. H, 2004).
Vietnam and the CIA
Another contributory factor that led to the rise of heroin addiction in the USA was the CIA's role in Vietnam (McCoy, 2003). In order to gain military alliances, and to arm those alliances, the CIA transported opium in exchange for help against the Communists thereby increasing the availability of heroin in the area. This allowed easy access for American soldiers who, because of heavy anti-marijuana campaigns, turned to heroin in increasing numbers (Brush, 2002). They called them OJ's, for opium joints, since they smoked it like a joint by emptying out half of a cigarette and inserted heroin in its place (Brush, 2002). By the end of the 1960's, the USA's population of heroin addicts reached 500,000, and by the end of the Vietnam War, the heroin labs that were previously supported by the CIA, through transport, were exporting their product directly to the USA (Fernandez & Libby, 2011). Since the 1960's, the rise and fall of the heroin addict population can be, in some way, connected with covert CIA actions supporting the drug trade in exchange for political advantage. This includes operations in Afghanistan where the Taliban was heavily involved with the heroin trade (Fernandez & Libby, 2011).
Theoretical Explanations for Addiction
The history explored thus far shows a very close link between politics and heroin supply. The desire to control the supply of opiates came only after the Caucasian work force feared displacement to Chinese immigrant workers. Because the Chinese were heavily associated with opium, them was to demonize their way of life; this included their opium habit. Then, once opiate addiction approached extermination, the CIA undermined this success on several occasions by aiding in heroin trafficking to achieve their political goals of arming foreign forces in efforts to combat communism. Some of these forces, including the Taliban, later turned against the USA. Supply, however, is only half the economic equation supporting addiction. Demand is the other half.
Several theories attempt to comprehend human demand for drugs that result in addiction. Some of the oldest of these theories are the natural theories. These theories suggest that humans have an inherent desire to alter their states of consciousness (Faupel et al., 2010). Thinking over the history of opiates, there may be something to this. The Sumerians, Earths first known civilization, as we previously discovered, cultivated the poppy plant. Their own description of the plant indicated it was used to alter their state of consciousness from joy. Since the time of the Sumerians and most likely even before them, virtually every known civilization has used substances to enhance or change cognition (Faupel et al., 2010).
Biological theories, more specifically the neurochemical explanations of drug addiction, seem to corroborate with the natural view. As we have already discovered, opiates imitate the neurochemical endorphins in both the spinal cord (to block pain transmitters) and the brain. When a drug abuser develops a tolerance to heroin, the body stops producing its own natural endorphins (Faupel et al., 2010). Subsequent cessation from heroin causes physiological withdrawal symptoms that persist until these natural endorphins once again are produced, or until another heroin hit is acquired (Faupel et al., 2010). This natural system, which provides mind altering neurochemicals, could very well be the root of the Natural theories idea of an inherent need to alter consciousness; the human body has evolved a natural mechanism to do this already.
It is quite interesting to mention sociological concepts in reference to the drug abuse and the drug war as the drug war, set in motion by Nixon, is an affront to sociology as a whole. An example of the attitude of the war on drugs can be found in 's own quotes as recorded in Readers Digest in 1969: "The country should stop looking for root causes of crime and put its money instead into increasing the number of police" (as cited in Baum, 1997). In other words, Nixon was putting the responsibility of drug abuse squarely on drug abuser shoulders, while ignoring societal causes. In his rigidity he tried to stamp out various supply sources only to be faced with others. He also viewed all drugs in black in white terms; marijuana, to Nixon, was just as bad as heroin (Fernandez & Libby, 2011). In his efforts to stop marijuana, as we previously mention about the soldiers in Vietnam, drug abusers turned to a more dangerous drug; heroin. This same rigid stance against drugs and the focus of blame laying on the individual, rather than society, still exist today. This is precisely why the war on drugs has failed.
Anomie-Strain Theory. contributing to America's drug abuse issues is explained by a theory proposed by Robert Merton. He suggested that individuals within a society experience strain when that society, such as ours, emphasizes the acquisition of material goods and ambitious goals without providing its population with the means to achieve (Thio, 2010). When they cannot reach their goals through legitimate means, a percentage of that population will turn to deviant means to achieve (Thio, 2010). Society, according to Merton, actually encourages deviance, including drug abuse (Thio, 2010).Examples of anomie-strain theory can be seen clearly on the supply end of drug abuse. As mentioned before, the USA during World War II resorted to using opium directly to its south (Bergman, n.d.). Although many of the traffickers in this drug trade made fortunes, the average farmer producing the poppy plant was still poor and scratching out a living on the land (Faupel, Horowitz, & Weaver, 2010). These farmers invested their land and harvest on reliance of the USA's demand for their product. After the war, the USA suddenly no longer needed their opium (Bergman, n.d.). This must have caused a strain on their society, and tons of wasted crops. The ambitions of many must have been devastated; however, they had an easy alternative to legitimate means to achieve their goals. Many resorted to deviance to sell their product thereby creating drug cartels; the Sinaloa Cartel.
Conflict Theory. Another societal factor driving drug use in the USA is the inequality found between various social groups. A prime example of this inequality can be found in the arrest rates between poor and rich in Brooklyn and Manhattan in New York City. According to the New York Times, per caught with pot, only from East Manhattan, where a very affluent community lives, were arrested (Dwyer, 2010). Those from the poor areas of Brooklyn by contrast, out of caught with pot, overfor the same crime (Dwyer, 2010). Furthermorearrested were Latin or African American when White pot smokers in that area are more prevalent (Dwyer, 2010). Thorough history, inequality just like this, has spurred Karl Marx like conflicts between rich and poor, and peasants and nobles, resulting in societal fractures and political uprisings that are of(Kagan, Ozment, & Turner, 2010; Brym & Lie, 2010).Conflict theorist also note that the very nature of capitalistic societies, such as ours, lack social cohesion (Rohall, Milkie, & Lucas, 2007). Individuals in such a society ofalone. In such a dynamic it seems inevitable that American society would develop sub-cultural methods to cope with this alienation. Since drugs are readily available despite attempts to shut down supply, and according to natural theories, humans already have an innate need to alter their consciousness, a sub-culture of drug abuse fills otherwise unmet needs for human connection and individual transcendence that capitalistic societies of.
Heroin in the Media
Another influence on heroin addiction is the media. The media ofwhen it comes to heroin. In the 1990's, for example, a fashion photographer named David Sorrenti created the "Heroin Chick" look (Spindler, 1997). The look featured sunk-eyed pale and anorexic models that became very fashionable and popular. Everyto computer commercials cashed in on the look (Spindler, 1997). At the same time, in the media, commercials were being aired as scare tactics exaggerating the ill effects of heroin (Spindler, 1997). Such ads still continue, while at the same time other narcotics are glamorized on TV shows such as "House."
Heroin Addiction Treatment
The traditional view about heroin addiction is that it is very difficult to treat. For the hard-core addict this can be true. A large portion of the heroin addict population, however, actually mature out of heroin addiction on their own (Faupel, et al., 2010). Among those who break addiction on their own are a couple of common correlations. First they have, or are able to acquire, an alternative social group comprising non-addict friends or family that support their attempt to break free. Secondly, they generally choose to stop associating with their addicted friends (Faupel et al., 2010). These , which correlate with individuals who successfully self-treat, hint at the social nature of drug addiction.
Self-Help, Residential, and Out-Patient Treatment
Self-help treatment such as provided by NA (Narcotics Anonymous), and residential based programs such as Hazeldon which embrace NA like values, do well in part, because they offer a social structure, which is of, in which heroin addicts can recover. The same process of differential identification that helped initiate and acclimate the addict to the heroin culture is used to promote values that resist that culture. A belief in a higher power is also encouraged, which, from a completely objective point of view, helps remove the negative effects that anonymity has on accountability (Faupel et al., 2010). The long term consequences of this approach is debatable on a societal level.
Pharmacological methods in treatment are based on substitution and chemical antagonization. Substitution involves replacing the drug of which the addict is addicted to with a less dangerous maintenance drug. The most common drug used for maintenance today is methadone. Doctors who subscribe to metabolic form of methadthat abstaining from narcotics is unrealistic for their patient (Faupel et al., 2010). They believe that there is permanent metabolic damage to the individual and that removing narcotics completely poses more risk than it solves. Other doctors use methadpsychotherapy with hopes to provide the patient with the mental stability to eventually become narcotic free (Faupel et al., 2010).
Methadone. The success of methadone's ability to treat heroin addiction stem from the fact that it too has endorphin like properties. Unlike heroin, however, Methadan entire day and the euphoric effects stop after tolerance has been reached (Faupel et al., 2010). Additionally, since Methadof the same neurochemical receptors as heroin, heroin becomes far less effective while Methadbody; thus reducing the likelihood that heroin addicts will relapse (Faupel et al., 2010).
Chemical Antagonist. A pharmacological method of threating heroin abuse involves prescribing a chemical antagonist. , Naltrexone, works by attaching to the mu opioid receptor; the same receptor for which heroin has a high affinity (Fernandez & Libby, 2011). Once attached, subsequent use of heroin while the antagonist is in the body will actually cause withdrawal, instead of euphoria. Resultantly, operant conditioning, the heroin addict's craving is reduced (Fernandez & Libby, 2011).
Alternative and Controversial Treatments
Ibogaine. There are a few treatments that show promise which are currently illegal in the USA. Currently controversial is the application of the hallucinate Ibogaine. Its heroin thwarting effects were discovered by accident by Howard Lotsof in 1962; a former heroin addict (Fernandez & Libby, 2011). He was actually looking for a new type of high and discovered after using Ibogaine he had no desire for heroin. The experience lead him to research the drug and its effects on addiction. Subsequent research shows that Ibogaine reduces withdrawal symptom for opiate addicted rats and removes their desire to self-administer narcotics (Fernandez & Libby, 2011). Another clinical study, this time on humans, showed that two-thirds of those treated with Ibogaine remained drug free after (Fernandez & Libby, 2011). Despite the fact that this seems a fantastic treatment, and no occurrences of Ibogaine addiction has been reported, Ibogaine treatments remain illegal in the USA due to political and monetary issues (Fernandez & Libby, 2011).
Heroin Maintenance. Another treatment that has showed promise on the most hard-core heroin addicts, but remains illegal in the USA, is using heroin itself as a maintenance drug. This method of treatment has been used in various European countries and is referred to as HAT (heroin-assisted treatment). The goal of HAT is not necessarily heroin abstention, but to promote good health, and to reduce criminal activity. Netherlands showed that participants in HAT, after of treatment, vastly improved their health on physical, mental, and social health scales (Blanken, Hendriks, van Ree, & Wim, 2010). Criminal behavior was also reduced which indicates that the correlation between criminal behavior and drug use may be spurious; the stigma of being a drug addict, may itself be a cause of crime.
The treatment for drug addiction has mostly been conducted at an individual pharmacological/behavioral level. Some therapies incorporate group therapies or try to include a sense of social structure to treat addiction. Our society, however, has ddrugs on a systemic/societal level. This conclusion can be substantiated by Nixon's own words that suggest we should ignore societal addiction causes and focus instead on the individual (Baum, 1997). By ignoring societal causes, I would assert, that although American treatment has a level of success at treating the individual addiction issues, those who do escape addiction are quickly replaced by new drug culture inductees. Treatment then, for drug addiction, must also take place at the societal level, as well as the individual level. In other words, society itself must be treated.
Hints of the systemic error within our society can be found in a variety of places; all with . is in our economic polarization. The top 20% of the population, in the USA, earn over 50% of the income while the bottom 20% only earn 3% (Bade & Parkin, 2011). In terms of wealth, the top 1% have 35.7% of the nation's wealth. The top 20% have around 90% of the nation's wealth. Polarization is also evident in the justice system. The New York Times, for example, as we have already mentioned, has a polarized arrest rate between the minority poor and the white rich for crimes of pot possession despite the fact that white individuals statistically smoke pot more often (Dwyer, 2010). Even gender is polarized in our country, and homosexuals are discriminated against as a result (Kimmel, 2011).
The unifying concept of all above paragraph is polarization. Just like the suns magnetic polarized forces build tension resulting in a massive coronal ejection, our society is suffering from these polarized tensions. The stress fractures that result are manifested through crime, drug addiction, and other negative societal problems. According to Karl Marx, and other conflict theorist, these tensions generated in capitalistic societies such as ours, if not negotiated, could end in a climatic war between the rich and poor; a sun like explosion (Brym & Lie, 2010).
The primary ingredient in heroin has roots that go back as far as the first human civilization where it existed in a mild form that mimicked our own natural endorphins. Since then technology has allowed it to morph into an ever more potent form for which humankind has not evolved. The result of this increased potency is that it floods the mind with powerful euphoric effects that compel the user find again. There can be no doubt that heroin is a tempting yet dangerous prospect.
Compounding this temptation is a society that preaches equality, ambition, and the American dream, while failing to provide much of its population an equal environment or a means to achieve their dreams. Additionally, because of capitalistic influences, the American population is predisposed to a lack of social cohesion. This causes some to fill the resulting void with deviant subcultural alternatives such as the heroin subculture. Fixing America's drug addiction, in conclusion, must involve a change at the societal level. Citizens must feel like they are active and valued participants of American society while having the means to achieve their dreams. So long as the rich are favored and the poor are shunned, and the gulf between then increases, this ideal cannot be achieved. We must renegotiate the underlying issues that polarize us.
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