BACHELOR IN PHARMACEUTICAL SCIENCE

& HEALTH SCIENCES (HONS)

BPS 4362

YEAR 4 SEMESTER 1

DRUG ABUSE AND SOCIETY

“ COCAINE AND HEROIN ”

GROUP ASSIGNMENT

Group Member : Afiq Azizoon ( 2061171108 )

Maha lakshmeeh a/p Ranggsamy ( 2061182004 )

Pesha a/p Kali Pan ( 2061182003 )

Lecturer In-charge : MDM. HALIMAH

1
 TABLE OF CONTENT

TITLE PAGE NO
Introduction of Cocaine
History of Cocaine
Physical and Chemical Properties of Cocaine
Principal Route
Street Names
Available form in Black Market
Affected Neurotransmitter
Tolerance
Dependece
Withdrawal Symptoms
What happen to your when use
What happen to body when use

2
 INTRODUCTION OF COCAINE

Cocaine is a powerfully addictive stimulant that directly affects the brain. Cocaine was
labelled the drug of the 1980s and 1990s because of its extensive popularity and use during
that period. However, cocaine is not a new drug. In fact, it is one of the oldest known
psychoactive substances. Coca leaves, the source of cocaine, have been chewed and ingested
for thousands of years, and the purified chemical, cocaine hydrochloride, has been an abused
substance for over 100 years. In the early 1900s, for example, purified cocaine was the active
ingredient in most of the tonics and elixirs that were developed to treat a wide variety of
illnesses.

Cocaine is generally sold on the street as a fine, white, crystalline powder known as coke, C,
snow, flake, or blow. Street dealers generally dilute it with inert substances such as
cornstarch, talcum powder, sugar, or with active drugs such as procaine (a chemically related
local anesthetic) or amphetamine (another stimulant). Some users combine cocaine with
heroin – in what is termed a “speedball.”

There are two chemical forms of cocaine that are abused: the water-soluble hydrochloride salt
and the water-insoluble cocaine base (or freebase). When abused, the hydrochloride salt, or
powdered form of cocaine, can be injected or snorted. The base form of cocaine has been
processed with ammonia or sodium bicarbonate and water, and then heated to remove the
hydrochloride to produce a substance that can be smoked. The term “crack,” which is the
street name given to freebase cocaine, refers to the crackling sound heard when the mixture is
smoked.

The National Survey on Drug Use and Health (NSDUH) estimates that in 2008, there were
1.9 million cocaine users and approximately 359,000 were current crack users. Cocaine use
has declined slightly. In 2013, the number of current cocaine users was 1.5 million. Adults
aged 18 to 25 years have a higher rate of current cocaine use than any other age group, with
1.5% of young adults reporting past month cocaine use. Overall, men report higher rates of
current cocaine use than women.

Users generally take cocaine in "binges," during which the cocaine is used repeatedly and at
increasingly higher doses. This can lead to increased irritability, restlessness, panic attacks,
and paranoia–even a full-blown psychosis, where the individual loses touch with reality and

3
experiences auditory hallucinations. With increasing dosages or frequency of use, the risk of
adverse psychological or physiological effects increases.

4
 HISTORY OF COCAINE

Three thousand years before the birth of Christ, ancient Incas in the Andes chewed coca
leaves to get their hearts racing and to speed their breathing to counter the effects of living in
thin mountain air. Native Peruvians chewed coca leaves only during religious ceremonies.
This taboo was broken when Spanish soldiers invaded Peru in 1532. Forced Indian laborers
in Spanish silver mines were kept supplied with coca leaves because it made them easier to
control and exploit.

Cocaine was first isolated (extracted from coca leaves) in 1859 by German chemist Albert
Niemann. It was not until the 1880s that it started to be popularized in the
medical community. Austrian psychoanalyst Sigmund Freud, who used the drug himself, was
the first to broadly promote cocaine as a tonic to cure depression and sexual impotence. In
1884, he published an article entitled “Über Coca” (About Coke) which promoted the
“benefits” of cocaine, calling it a “magical” substance. Freud, however, was not an objective
observer. He used cocaine regularly, prescribed it to his girlfriend and his best friend and
recommended it for general use.

While noting that cocaine had led to “physical and moral decadence,” Freud kept promoting
cocaine to his close friends, one of whom ended up suffering from paranoid hallucinations
with “white snakes creeping over his skin.” He also believed that “For humans the toxic dose
(of cocaine) is very high, and there seems to be no lethal dose.” Contrary to this belief, one of
Freud’s patients died from a high dosage he prescribed.

In 1886, the popularity of the drug got a further boost when John Pemberton included coca
leaves as an ingredient in his new soft drink, Coca-Cola. The euphoric and energizing effects
on the consumer helped to skyrocket the popularity of Coca-Cola by the turn of the century.

From the 1850s to the early 1900s, cocaine and opium-laced elixirs (magical or medicinal
potions), tonics and wines were broadly used by people of all social classes. Notable figures
who promoted the “miraculous” effects of cocaine tonics and elixirs included inventor
Thomas Edison and actress Sarah Bernhardt. The drug became popular in the silent film
industry and the pro-cocaine messages coming out of Hollywood at that time
influenced millions.

5
Cocaine use in society increased and the dangers of the drug gradually became more evident.
Public pressure forced the Coca-Cola company to remove the cocaine from the soft drink
in 1903. By 1905, it had become popular to snort cocaine and within five years, hospitals and
medical literature had started reporting cases of nasal damage resulting from the use of this
drug. In 1912, the United States government reported 5,000 cocaine-related deaths in one
year and by 1922, the drug was officially banned.

In the 1970s, cocaine emerged as the fashionable new drug for entertainers and
businesspeople. Cocaine seemed to be the perfect companion for a trip into the fast lane. It
“provided energy” and helped people stay “up.” At some American universities, the
percentage of students who experimented with cocaine increased tenfold between 1970 and
1980. In the late 1970s, Colombian drug traffickers began setting up an elaborate network for
smuggling cocaine into the US.

Traditionally, cocaine was a rich man’s drug, due to the large expense of a cocaine habit. By
the late 1980s, cocaine was no longer thought of as the drug of choice for the wealthy. By
then, it had the reputation of America’s most dangerous and addictive drug, linked with
poverty, crime and death. In the early 1990s, the Colombian drug cartels produced and
exported 500 to 800 tons of cocaine a year, shipping not only to the US but also to Europe
and Asia. The large cartels were dismantled by law enforcement agencies in the mid-1990s,
but they were replaced by smaller groups—with more than 300 known active drug smuggling
organizations in Colombia today. As of 2008, cocaine had become the second most trafficked
illegal drug in the world.

6
 PHYSICAL AND CHEMICAL PROPERTIES OF COCAINE

Cocaine is an alkaloid and a member of a broad group of plant substances that also includes
nicotine, caffeine, and morphine. The chemical name for cocaine is benzoyl-methyl-
ecgonine. Cocaine’s chemical structure consists of three parts: a lipophilic group, a
hydrophilic group, and an aliphatic group, which joins the first two groups.

On the street, cocaine comes in either of two forms: hydrochloride salt or "base." The
hydrochloride salt (powdered) form of cocaine can be administered intranasally (i.e.
snorted).  It can also be dissolved in water and injected.  The "base" forms of cocaine include
any forms that are not neutralized by an acid to make the hydrochloride salt. Depending on
the method of production, the base forms are called "freebase" or "crack."

The medical literature is often ambiguous when differentiating between "freebase" and
"crack," which are actually the same chemical form of cocaine. This notwithstanding, crack
and freebase are made using different techniques.  Freebase is produced by dissolving
cocaine hydrochloride in water, adding a base like ammonia, and then adding a solvent,
typically ether.  The cocaine base is dissolved by the ether and is extracted by evaporation. 
There is a chance that the ether, which is highly volatile, may remain in the mixture and
cause burns. Crack, on the other hand, is produced by dissolving cocaine hydrochloride in
water, mixing it with ammonia or sodium bicarbonate (baking soda), and heating this mixture
to remove hydrochloride. The remaining product is a soft mass that becomes hard when it
dries. The name “crack” comes from the crackling sound made when the mixture is smoked.

In its base form, cocaine can be smoked because it melts at a much lower temperature (80 °C)
than cocaine hydrochloride (180 °C). With the increased prevalence of crack, which is made
by a simpler and less dangerous process, the use of "freebase" has declined. Although crack
is typically smoked, some users dissolve it with lemon juice and inject it.

7
 Figure 1 : Cocaine Crack

Fig
ure 2 : Cocaine Powder

Figure 3 : Structure of Cocaine

8
 PRINCIIPLE ROUTE OF COCAINE

Users primarily administer cocaine orally, intranasally, intravenously, or by inhalation. When

people snort the drug (intranasal use), they inhale cocaine powder through the nostrils, where
it is absorbed into the bloodstream through the nasal tissues. Users also may rub the drug
onto their gums (oral use). Dissolving cocaine in water and injecting it (intravenous use)
releases the drug directly into the bloodstream and heightens the intensity of its effects. When
people smoke cocaine (inhalation), they inhale its vapor or smoke into the lungs, where
absorption into the bloodstream is almost as rapid as by injection. This fast euphoric effect is
one of the reasons that crack became enormously popular in the mid-1980s.

Cocaine use ranges from occasional to repeated or compulsive use, with a variety of patterns
between these extremes. Any route of administration can potentially lead to absorption of
toxic amounts of cocaine, causing heart attacks, strokes, or seizures—all of which can result
in sudden death.

Figure 4 : Principle route of cocaine

9
 STREET NAME OF COCAINE

As a popularly used illicit substance, cocaine has accumulated its fair share of aliases. Many
of the monikers or nicknames used to refer to cocaine and cocaine use are derived from
cocaine’s appearance or from popular methods of using cocaine. Those who use street names
and nicknames may be doing so in an attempt to make their cocaine use much less
conspicuous. Cocaine users may be able to get away with openly referencing their drug use
by using these words in everyday conversation dodging the scrutiny of authorities and family
members.

Their purpose toward these ends relies on non-drug users remaining unfamiliar with the oft-
changing designations. Inevitably, by the time that a slang drug reference has become a part
of our modern vocabularies, active drug users will have moved on to new ones to further
promote the deception.

It would be difficult to list all the street names and nicknames for cocaine since they often
vary by region or country and, furthermore, because users are constantly coining novel terms
to describe the drug.

COCAINE POWDER COCAINE CRACK MIXED

Mixing cocaine with other drugs including
amphetamine, heroin, and synthetic opioids
(such as fentanyl)
Flake Rocks Speedball
Snow Black Rocks Spaceball
Blow Nuggets Woo-Woo
Toot Gravel Cocoa puffs
Base Grit Woolies
Dust Hail Boy-Girl
White Candy Candy flipping
Pearl Chemical
Big Rush Cookies
Powder Dice
Coke Snow Coke

AVAILABLE FORM OF COCAINE IN BLACK MARKET

10
Figure 5 : Cocaine Powder

Figure 6 : Crack Cocaine

11
 PHARMACOLOGY OF COCAINE

The brain’s mesolimbic dopamine system, its reward pathway, is stimulated by all types of
reinforcing stimuli, such as food, sex, and many drugs of abuse, including cocaine. This
pathway originates in a region of the midbrain called the ventral tegmental area and extends
to the nucleus accumbens, one of the brain’s key reward areas. Besides reward, this circuit
also regulates emotions and motivation.

In the normal communication process, dopamine is released by a neuron into the synapse (the
small gap between two neurons), where it binds to specialized proteins called dopamine
receptors on the neighbouring neuron. By this process, dopamine acts as a chemical
messenger, carrying a signal from neuron to neuron. Another specialized protein called
a transporter removes dopamine from the synapse to be recycled for further use.

Drugs of abuse can interfere with this normal communication process. For example, cocaine
acts by binding to the dopamine transporter, blocking the removal of dopamine from the
synapse. Dopamine then accumulates in the synapse to produce an amplified signal to the
receiving neurons.

As a result, there is an accumulation of neurotransmitters causing continuous stimulation that

leads to the pleasurable effects reported by cocaine users. These effects include feelings of
euphoria which are associated with the excess presence of dopamine, feelings of confidence
which are associated with the excess presence of serotonin, and feelings of energy which are
associated with the excess presence of norepinephrine. The neural system most affected by
cocaine is called the ventral tegmental area (VTA) , which is central to positive reinforcement
aspects of addiction.

As with methamphetamine, cocaine’s fastest routes into cerebral circulation are smoking and
injecting, which take a matter of only seconds. In comparison, euphoria occurs one to five
minutes after cocaine is snorted. Smoking and injecting cocaine produces a rush and then a
high, whereas snorting cocaine produces only a high. This is due in part to the fact that the
amount of cocaine absorbed in the nasal mucosa has bioavailability of only 20 to 60%,
whereas the bioavailability of, for example, smoked cocaine is approximately 70%. Also,
snorting cocaine causes local vasoconstriction, therefore inhibiting faster absorption.

12
Benzoylecgonine and ecgonine methyl ester are the two inactive metabolites that account for
more than 80% of cocaine’s known metabolites.  The liver N-demethylates less than 10% of
cocaine into a toxic metabolite called norcocaine. Regardless of the route of administration,
cocaine and its metabolites present themselves in urine three to six hours after use. With a
half-life of about one hour, less than 5% of cocaine appears in urine unchanged. As a result,
benzoylecgonine is the major metabolite used in drug testing since its concentration in urine
is 50 to 100 times greater than that of cocaine.

Cocaine prevents conduction of sensory impulses by reacting with the neuron membrane to
block ion channels.  As a result of this block, the ion exchange which is normally responsible
for the electrical signals cannot be propagated along the axon, and the sensory messages are
not received in the central nervous system hence the anesthetic effect.

Figure 7 : The process of Cocaine in the Brain

13
AFFECTED NEUROTRANSMITTER

14
TOLERANCE

15
DEPENDENCE

16
WITHDRAWAL SYMPTOMS

17
 WHAT HAPPENS TO YOUR BRAIN WHEN YOU USE COCAINE ?

All drugs change the way the brain works by changing the way nerve cells communicate.
Nerve cells, called neurons, send messages to each other by releasing chemicals called
neurotransmitters. These neurotransmitters attach to molecules on neurons called receptors.

There are many neurotransmitters, but dopamine is the main one that makes people feels
good when they do something they enjoy, like eating a piece of chocolate cake or playing a
video game. Normally, dopamine gets recycled back into the cell that released it, thus
shutting off the signal. Stimulants like cocaine prevent the dopamine from being recycled,
causing a build-up of the neurotransmitter in the brain. It is this flood of dopamine that
reinforces taking cocaine, “training” the brain to repeat the behaviour.  The drug can cause a
feeling of intense pleasure and increased energy.

With repeated use, stimulants like cocaine can disrupt how the brain’s dopamine system
works, reducing a person’s ability to feel pleasure from normal, everyday activities. People
will often develop tolerance, which means they must take more of the drug to get the desired
effect. If a person becomes addicted, they might take the drug just to feel “normal.”

After the "high" of the cocaine wears off, many people experience a "crash" and feel tired or
sad for days. They also experience a strong craving to take cocaine again to try to feel better.

18
 WHAT HAPPENS TO YOUR BODY WHEN YOU USE COCAINE ?

 Short-Term Effects

Cocaine is a stimulant so it gives the body a feeling of stimulation and alertness, which can
be both pleasurable and harmful. Cocaine’s short-term effects appear quickly and disappear
within a few minutes to an hour. How long and intense the effects are depends on the method
of use. Here are some of the ways cocaine affects the body:

 extreme happiness and energy

 mental alertness

 sensitivity to sight, sound, and touch

 irritability

 paranoia (feeling that people are out to get you)

 constricted blood vessels and dilated pupils

 higher body temperature

 higher blood pressure and faster heartbeat, leading to higher risk of heart attack or
stroke

 feeling sick to the stomach

 restlessness

 decreased appetite and, over time, a loss of weight

 inability to sleep

 Long-Term Effects

The long-term effects of cocaine depend, in part, on the method of use and include the
following:

 snorting: loss of sense of smell, nosebleeds, nasal damage, and trouble swallowing

 smoking: cough, asthma, and lung damage

19
  consuming by mouth: damage to intestines (between the stomach and anus) caused by
reduced blood flow

 needle injection: higher risk for HIV and hepatitis (a liver disease) through shared
needles

 all methods: poor nutrition and weight loss

Can you overdose or die if you use cocaine ? Yes. In 2018, 859 people ages 15–24 died
from a cocaine overdose in the U.S.

Figure 8 : Victim of Cocaine Overdose

One of the most famous victims of cocaine overdose is Len Bias, a senior at the University of
Maryland, who had been drafted as the No. 2 pick by the Boston Celtics on June 17, 1986.
Just 2 days later, he died from a cocaine overdose.

Cocaine can be deadly when taken in large doses or when mixed with other drugs or alcohol.
Cocaine-related deaths often happen because the heart stops (cardiac arrest), then breathing
stops. Using cocaine and drinking alcohol or using other drugs increases these dangers,
including the risk of overdose.

For example, combining cocaine and heroin (known as a “speedball”) puts a person at higher
risk of death from an overdose. In rare instances, sudden death can occur on the first use of

20
cocaine or soon after. Among the deaths that occurred from cocaine use, most also included
misuse of an opioid of some form, either a prescription pain reliever, heroin, or man-made
opioids like fentanyl.

21
HEROIN

22
 INTRODUCTION OF HEROIN

Heroin is a powerful opioid drug made from morphine, a natural substance taken from the
seed pod of the Asian opium poppy plant. Use of heroin produces euphoria and feelings of
relaxation. Regular heroin use changes the functioning of the brain, causing tolerance and
dependence. Heroin can be a white or brown powder, or a black sticky substance known as
black tar heroin. Heroin can be pure or mixed with fillers or other drugs such as fentanyl.
Other common names for heroin include dope, horse, junk, and smack.

Heroin use has been increasing in recent years among both genders, most age groups and all
income levels. Some of the greatest increases have occurred in demographic groups with
historically low rates of heroin use: women, the privately insured and people with higher
incomes. In particular, heroin use has more than doubled in the past decade among young
adults aged 18-25 years. Heroin-related overdose deaths have more than quadrupled since
2010, with nearly 13,000 people dying in 2015. The rising rate of heroin use is attributed to
increased availability, relatively low price (compared to prescription opioids) and high purity
of heroin in the U.S. Past misuse of prescription opioids is the strongest risk factor for
starting heroin use.

In its purest form, heroin is a fine white powder. But more often, it is found to be rose gray,
brown or black in color. The coloring comes from additives which have been used to dilute it,
which can include sugar, caffeine or other substances. Street heroin is sometimes “cut” with
strychnine or other poisons. The various additives do not fully dissolve, and when they are
injected into the body, can clog the blood vessels that lead to the lungs, kidneys or brain. This
itself can lead to infection or destruction of vital organs. The user buying heroin on the street
never knows the actual strength of the drug in that particular packet. Thus, users are
constantly at risk of an overdose.

Heroin can be injected, smoked or sniffed. The first time it is used, the drug creates a
sensation of being high. A person can feel extroverted, able to communicate easily with
others and may experience a sensation of heightened sexual performance but not for long.

Heroin is highly addictive and withdrawal extremely painful. The drug quickly breaks down
the immune system, finally leaving one sickly, extremely thin and bony and, ultimately, dead.

23
 HISTORY OF HEROIN

Opium, the first opioid, is derived from the sap of opium poppies, whose growth and
cultivation dates back to the ancient civilization of Mesopotamia around 3400 BC.  Opium
was initially used by Egyptians and Persians, eventually spreading to various parts of Europe
and to India and China.  During the 18th century, physicians in the U.S. used opium as a
therapeutic agent for multiple purposes, including relieving pain in cancer, spasms from
tetanus, and pain attendant to menstruation and childbirth.  It was only towards the end of the
18th century that some physicians came to recognize the addictive quality of opium.

In 1805, morphine and codeine were isolated from opium, and morphine was used as a cure
for opium addiction since its addictive characteristics were not known.  Morphine’s use as a
treatment for opium addiction was initially well received as morphine has about ten times
more euphoric effects than the equivalent amount of opium.  Over the years, however,
morphine abuse increased.

Heroin was synthesized from morphine in 1874 by an English chemist, but was not produced
commercially until 1898 by the Bayer Pharmaceutical Company. Attempts were made to use
heroin in place of morphine due to problems of morphine abuse.  However, it turned out that
heroin was also highly addictive, and was eventually classified as an illegal drug in the
United States. Today, heroin in the United States comes mostly from Southeast Asia,
Southwest Asia, Latin America and Mexico. It is typically sold in a white or brownish
powder form or as a black sticky substance known as “black tar” heroin (black tar from
Mexico is the most common form of the drug in Arizona).  Heroin found on the streets is
usually mixed with other drugs or substances such as sugar, starch, powdered milk, talc,
baking soda, caffeine, cocaine, or quinine, though some reports indicate that pure forms of
heroin are becoming more widely available.

There have been at least two major heroin epidemics in the United States.  The first one
began after World War II and the second began in the late 1960s.  During the first epidemic,
the highest incidence of use occurred in the late 1940s and early 1950s; during the second,
the highest incidence occurred between 1971 and 1977.  Both epidemics appear to have
subsided due to lack of purity in the heroin that was available, and the increasing cost of
heroin.

24
At the time of the second epidemic, heroin use was prevalent among enlisted men serving in
Vietnam during the Vietnam War.  From 1969 to 1971, opiates were cheaply available in that
country.  Because most of the enlisted men were 18-20 years old and not allowed to buy
liquor on the base, they may have had an added incentive to try heroin as an available
alternative.  The most common way the enlisted men used heroin was by snorting it or
mixing it with tobacco or marijuana and smoking it.

Figure 1 : Asian Heroin

Figure 2 : Black Tar Heroin

25
Figure 3 : Heroin

26
 PHYSICAL AND CHEMICAL PROPERTIES

Heroin is an opioid, which is any drug, regardless of chemical structure, that produces effects
similar to those of opium and morphine. Heroin has the scientific name diacetylmorphine. 
Its chemical structure is similar to that of 6-acetyl morphine and morphine.

South-west Asian heroin is a brown powder usually in the form of the free base, which is
insoluble in water but soluble in organic solvents. The less common south-east Asian heroin
is usually a white powder in the form of the hydrate hydrochloride salt (CAS-1502-95-0),
which is soluble in water but insoluble in organic solvents.

Figure 4 : Structure of Heroin

Figure 5 : Metabolism pathway of heroin

27
 PRINCIPLE ROUTE OF HEROIN

Heroin from south-west Asia may be ‘smoked’ by heating the solid on a metal foil above a
small flame and inhaling the vapour. Those intending to inject this form of heroin must first
solubilise it with, for example, citric acid or ascorbic acid. Heroin from south-east Asia is
suitable for direct injection of a solution. A typical dose is 100 mg at street level purity.
Except when used therapeutically as an analgesic drug, ingestion of diamorphine/heroin is a
much less effective route of administration.

STREET NAMES OF HEROIN

 Big H
 Brown sugar
 Hell Dust
 Nose Drops
 Junk
 Horse
 H

28
AVAILABLE FORM OF HEROIN IN BLACK MARKET

Figure 6 : Pills or Tablet form of Heroin

Figure 7 : Powder form of Heroin

29
 PHARMACOLOGY OF HEROIN

The blood brain permeability of heroin is about 10 times that of morphine. Once heroin
crosses the blood brain barrier, it is hydrolyzed into 6-acetyl morphine and morphine, which
then quickly bind to opioid receptors. The “rush” felt by heroin users is the sensation caused
by the rapid entry of heroin into the brain and the attachment of 6-acetyl morphine and
morphine to opioid receptors.  Opioids in general can change the neurochemical activity in
the brain stem causing a depression in breathing.  In the limbic system opioids cause an
increase in feelings of pleasure, and have the ability to block pain signals sent through the
spinal cord.

When heroin is injected or smoked, users typically feel two types of euphoric effects–a
“rush” and a “high.”  The rush usually lasts one to two minutes and occurs right after the drug
is administered.  It is described as an intense orgasmic feeling that is felt throughout the body,
especially in the abdomen.  Following the rush is a high that can last four to six hours.  The
feeling is described as warm and pleasant, with indifference to internal and external stimuli. 
The following characterizations may occur during a high:

 “Go on the nod” – sitting in a chair or lying in bed, gazing at a newspaper or the
television while dozing and rousing alternatively

 “Drive” – talking constantly, boasting, and busying oneself with chores

 Alternately nod and drive

 Function normally – this may lead to an observer not detecting heroin use. 

Injecting heroin intravenously can produce a feeling of euphoria in seven to eight seconds. 
The peak effects of smoking heroin are similar to those obtained from intravenous injection.
In contrast, injecting intramuscularly, also known as skin popping, leads to a slower onset of
euphoria, taking five to eight minutes. The peak effects of snorting heroin occur in 10 to 15
minutes. Oral administration of heroin has little effect.

30
AFFECTED NEUROTRANSMITTER

31
TOLERANCE

32
DEPENDENCE

33
WITHDRAWAL SYMPTOMS

34
 WHAT HAPPENS TO YOUR BRAIN WHEN YOU USE HEROIN ?

When heroin enters the brain, it attaches to molecules on cells known as opioid receptors.
These receptors are located in many areas of the brain and body, especially areas involved in
the perception of pain and pleasure, as well as a part of the brain that regulates breathing.

Short-term effects of heroin include a rush of good feelings and clouded thinking. These
effects can last for a few hours, and during this time people feel drowsy, and their heart rate
and breathing slow down. When the drug wears off, people experience a depressed mood and
often crave the drug to regain the good feelings.

Regular heroin use changes the functioning of the brain. Using heroin repeatedly can result
in:

 tolerance: more of the drug is needed to achieve the same “high”

 dependence: the need to continue use of the drug to avoid withdrawal symptoms

 addiction: a devastating brain disease where, without proper treatment, people have
trouble stopping using drugs even when they really want to and even after it causes
terrible consequences to their health and other parts of their lives. Because of changes
to how the brain functions after repeated drug use, people that are addicted crave the
drug just to feel “normal.”

35
 WHAT HAPPENS TO YOUR BODY WHEN YOU USE HEROIN ?

 Short-Term Effects

Opioid receptors are located in the brain, the brain stem, down the spinal cord, and in the
lungs and intestines. Thus, using heroin can result in a wide variety of physical problems
related to breathing and other basic life functions, some of which may be very serious. Here
are some ways heroin affects the body:

 dry mouth

 warm flushing skin

 heavy feeling arms and legs

 feeling sick to the stomach and throwing up

 severe itching

 clouded thinking

 a temporary feeling of intense happiness

 going "on the nod," switching back and forth between being conscious and semi-
conscious

 increased risk of HIV and hepatitis (a liver disease) through shared needles and poor
judgment while “high” leading to other risky behaviours. (read more about the link
between viral infections and drug use)

When mixed with alcohol, short-term effects can include:

 coma—a deep state of unconsciousness

 dangerously slowed (or even stopped) breathing that can lead to overdose death

 Long-Term Effects 

 problems sleeping

 damage to the tissues inside the nose for people who sniff or snort it

36
  painful area of tissue filled with puss (an abscess)

 infection of the heart

 constipation and stomach cramping

 liver and kidney disease

 lung problems

 mental health problems, such as depression

 sexual problems for men

 changes in menstrual cycles for women

In addition to the effects of the drug itself, heroin bought on the street often contains a mix of
substances, including the dangerous opioid called fentanyl. Drug dealers add fentanyl
because it is cheap, and they can save money. Some of these substances can be toxic and can
clog the blood vessels leading to the lungs, liver, kidney, or brain. This can cause permanent
damage to those organs. Also, sharing drug injection equipment or engaging in risky
behaviours can increase the risk of being exposed to diseases such as HIV and hepatitis. 

Can you overdose or die if you use heroin ? Yes, because heroin can slow and even stop
a person's breathing. This is called a fatal overdose.

Deaths from drug overdoses increased from the early 1990s through 2017, fuelled by
increases in misuse of prescription opioids and, more recently, by a surge in heroin use.
Nearly 15,000 people died from heroin overdoses in 2018 (the latest year for which data is
available). The good news is that among young people ages 15 to 24, heroin overdoses
decreased by more than 20% between 2017 and 2018.

Signs of a possible heroin overdose are:

 slow breathing

 blue lips and fingernails

 cold damp skin

 shaking

37
  vomiting or gurgling noise

People who are showing symptoms of overdose need urgent medical help. A drug called
naloxone can be given to reverse the effects of heroin overdose and prevent death—but only
if it is given in time. It's available in an easy-to-use nasal spray or auto injector. Naloxone is
often carried by emergency first responders, including police officers and EMTs. In some
states, doctors can now prescribe naloxone to people who use heroin or prescription opioids
so they or their family members can have them available to use in the event of an overdose,
without waiting for emergency personnel (who may not arrive in time).

38
 THE RECENT CASE IN MALAYSIA

Penang police seize RM1.14mil worth of syabu, heroin; man arrested .

Published on 5 Aug 2019 2:06:45 PM

Penang police scored a major success in its fight against the drug menace with the arrest of a
54 years old local man and the seizure of an assortment of drugs worth RM1.14 million last
Wednesday at George Town, Penang. The old man is a hardcore addict to drugs and has a
police record of 9 drug-related and other offenses. During suspect, the old man urine test
shows positive results with methamphetamine. Deputy state police chief Datuk Roslee Chik
said among the drugs seized were 15,300gm of syabu (worth RM760,120), 12,650 ecstasy
pills (RM379,500) and 78.6gm of heroin (RM3,930). It is one of Penang police’s biggest
drug seizures of the year.

39
 Country's biggest drug bust: 12 tonnes of cocaine worth RM2.4bil seized in Penang

Published on Friday, 20 Sep 2019 5:33 PM MYT

GEORGE TOWN: In the biggest drug haul ever seen in Malaysia, police seized 12 tonnes of
cocaine worth RM2.4bil here.

The cocaine, which was mixed with 60 tonnes of charcoal, is believed to be from an
international drug syndicate using Penang as a transit point. Inspector-General of Police Tan
Sri Abdul Hamid Bador said this was the biggest haul in local history, which was a huge
cause for concern.

The operation was carried out under Ops Eagle which was launched on Sept 10 here. The
drugs were found in three containers filled with 60 sacks of coal at the Butterworth port on
Sept 10. The containers are believed to have arrived at the port on Aug 16. They used
advanced technology to make sure the drugs cannot be detected.

Even the canine unit could not detect the drugs. Normal drug detecting technology would not
be able detect it. (But) our chemistry department has advanced technology that was able to
detect the cocaine among the coal. The cocaine is valued at RM200,000 per kilo," he said at a
press conference held at the Bayan Baru police station here.

IGP Abdul Hamid said a 29-year-old suspect believed to be in charge of arrangements (for
the shipment) has been remanded for 14 days, which ends on Sept 23. The case is being
investigated under section 39B Dangerous Drugs Act 1952, which carries the death penalty.

This drug bust surpassed the previous record on Aug 20 this year when police seized 500kg
of ketamin and over 3.23 tonnes of cocaine worth over half a billion ringgit in Shah Alam.

40
 Bukit Aman makes first big drug bust of 2020

Published on Tuesday, 14 Jan 2020 5:50 PM MYT

SHAH ALAM: The first big narcotic bust of the year by Bukit Aman saw police seizing
around RM2.1mill worth of what is believed to be methamphetamine.

Bukit Aman Narcotics Crime Investigation Department (NCID) director Comm Datuk Mohd
Khalil Kader Mohd said in a press conference at the Selangor police contingent headquarters
on Tuesday (Jan 14) that the raid on Jan 12 was the result of police work following up on a
public tip-off.

The police stopped the suspects as they were transporting the drugs in cars."Four suspects
were arrested on Jalan Gasing, one of them from Thailand. They were in three cars at the
time and one of cars was found to had been carrying 40 packages (weighing a total of 42kg)
of suspected syabu.

"Malaysian and Thai currencies were also seized. We believe that the group were drug
distributors," he said. An investigation is underway to identify other members of the drug
syndicate, andit is known that the police have been trailing this group for around eight
months. The drugs would have been able to fuel the addiction of 84,000 drug users. Of the
four suspects, one had previous police records for gambling and drug-related offences. All
have been remanded till Jan 19," he said.

41
Malaysian Law Dangerous Drugs Act 1952

42
 TEST KIT FOR DRUG ABUSE

 5 in 1 multi-drugs panel dip card

Screen the 5 most commonly

used drugs in 1 time !

The NarcoCheck® multi-drug test is the ideal test for those who want to maintain a wide
vigilance without having any particular knowledge about narcotics. Whatever the drug that
could be consumed, this test would reveal it with a reliability of more than 99%!

Screening for the following 5 drugs:

 THC : Cannabis, Marijuana, hashish...

 MDMA : Ecstasy

 COC : Cocaine, Crack

 MOR : Morphine, Heroin, Opiates...

 AMP : Amphetamines

A single test to check everything at the same time.

Simple to use and very quick to carry out, this multi-drug test is the best way to quickly make
a first picture of the situation.

The NarcoCheck® test will allow you to:

 Prevent risky behavior by maintaining regular and deterrent vigilance.

43
  Be alerted from the first drug consumptions, in order to act before the addiction
settles, when it is still possible to backtrack.

 When running this test?

Generally, young people begin to use drugs with friends, in a recreational way. Risky
behaviors will thus have a better chance of being identified by a drug test if it is done in the
hours following the typical occasions of consumption (evenings, weekends with friends,
festivals, etc.).

 How often?

The frequency of testing must be sufficiently important to maintain a high level of dissuasion,
so that people who are tempted to cross the line are convinced that the game is not worth the
effort.

 Instructions

44
45
 REFERENCE

1. NIDA. 2020, October 7. Heroin. Retrieved from https://teens.drugabuse.gov/drug-

facts/heroin on 2020, November 9

2. NIDA. 2020, September 9. Cocaine. Retrieved from https://teens.drugabuse.gov/drug-

facts/cocaine on 2020, November 9

3. Penang police seize RM1.14mil worth of syabu, heroin; man arrested |

TheStarTV.com. TheStarTV.com. (2019). Retrieved 9 November 2020, from
https://www.thestartv.com/v/penang-police-seize-rm-1-14-mil-worth-of-syabu-
heroin-man-arrested.

4. Country's biggest drug bust: 12 tonnes of cocaine worth RM2.4bil seized in Penang.
The Star Online. (2019). Retrieved 9 November 2020, from

46
 https://www.thestar.com.my/news/nation/2019/09/20/country039s-biggest-drug-bust-
12-tonnes-of-cocaine-worth-rm24bil-seized-in-penang.

5. Bukit Aman makes first big drug bust of 2020. The Star Online. (2020). Retrieved 9
November 2020, from https://www.thestar.com.my/news/nation/2020/01/14/bukit-
aman-makes-first-big-drug-bust-of-2020.

6. Multi-Drug Test dip card (5 in 1) - Cannabis, Cocaine, Heroin, Ecstasy....

PharmaDrugTest.com. Retrieved 9 November 2020, from
https://www.pharmadrugtest.com/urine-drug-tests/12-multi-drugs-5-panel-dip-
card.html.

7. European Monitoring Centre for Drugs and Drug Addiction, “State of the Drug
Problem in Europe, 2008”

8. U.S. Drug Enforcement Agency Fact Sheet on Cocaine

9. National Institute on Drug Abuse: “NIDA Info Facts: Crack and Cocaine,” April 2008

10. “Cocaine Facts & Figures,” Office of National Drug Control Policy, 2008

11. King, L. A. and McDermott, S. (2004), ‘Drugs of abuse’, in: Moffat, A. C., Osselton,
M. D. and Widdop, B. (eds.), Clarke's analysis of drugs and poisons, 3rd edn, Vol. 1,
pp. 37–52, Pharmaceutical Press, London.

12. Moffat, A. C., Osselton, M, D. and Widdop, B, (eds.) (2004), Clarke's analysis of
drugs and poisons, 3rd edn, Vol. 2, Pharmaceutical Press, London.

47
13. Schiff, P. L. (2002), ‘Opium and its alkaloids’, American Journal of Pharmaceutical
Education 66, pp. 186–194.

14. United Nations (2006), Multilingual Dictionary of Narcotic Drugs and Psychotropic
Substances under International Control, United Nations, New York.

48