The History of Heroin (And What People Still Get Wrong)

By Kelly Burch 05/25/18

A recent "Rolling Stone" report walked through the turbulent history of the prolific opiate. 

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The current opioid crisis is no doubt tied to the proliferation of prescription opioid medications, but the factors that have contributed to the crisis began even further back, in the early days of the "War On Drugs."

According to a column by Jonathan Reiss of Rolling Stone, heroin use increased dramatically during the 1960s, as veterans returning from Vietnam brought demand for the opioid home with them.

When President Richard Nixon declared a War on Drugs in 1971, he pointed to New York City’s heroin markets as a big part of the nation’s drug problems. 

However, for federal agents enforcing the new hardline federal policies, it was easier to detect marijuana, which has a pungent smell and is transported in larger quantities. Because of this, Mexican drug cartels began to minimize their risk by shifting their product from cannabis to heroin.

At the same time, Asian suppliers began distributing heroin throughout the U.S. 

“Purity levels would soon skyrocket as the heroin market was about to become competitive,” Reiss writes. 

In fact, heroin on the streets became 10 times more pure between 1970 and 1990. Previously, the drug had to be injected, but the more powerful heroin meant that users could get high from snorting the drug, broadening its appeal to people who were already snorting cocaine. 

Even decades ago, there was a racial divide in who was using heroin. During the 1970s the drug devastated communities of color, so many people in those groups learned to stay away from heroin. 

"Young African Americans and young Latinos were not going into heroin because they saw the destruction that occurred in their families and in their neighborhoods and they didn't want to go down that road," said Philippe Bourgois, a cultural anthropologist and author of the book Righteous Dope Fiend. "It was seen as a loserly thing to do.”

That was when the drug became primarily associated with poor rural whites. 

The next big push for opioids came during the 1990s, when the pharmaceutical industry lobbied the Joint Commission, which accredits health facilities, to consider pain as a vital sign. When doctors around the country began prioritizing patients' treatment of pain, the sale of opioid painkillers skyrocketed, quadrupling over 10 years.

People became hooked on opioids, and when pills were unavailable they turned to heroin to meet their needs. 

Despite the nation’s long relationship with heroin, Reiss says that there are still many misconceptions about the drug. One of the most common is mistaking symptoms of withdrawal for signs of a user being high. 

“Dilated pupils, sweating, shaking, slurring and vomiting aren't signs of being high; they're signs of opioid withdrawal,” he writes. 

Another common misunderstanding is that people with heroin addiction can just stop using. Because of the powerful physical dependence that develops, medication-assisted treatment (MAT) is dramatically more effective at helping people quit opioids. Alternative treatments, like cannabis and Ibogaine, could also lead to better treatment options in the future, Reiss writes. 

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.