By Shavonne Walker

shavonne.walker@salisburypost.com

The first time “Matt,” not his real name, injected heroin into his vein it was not only “euphoric” but he immediately felt the warm sensation of the drug coursing through his body.

“It was like taking a warm bath,” he said.

Matt, a Rowan County man in his mid-30s, would continue to chase that same feeling for the next decade or so. He began abusing prescription pills in the ’90s, specifically oxycontin. In the beginning, he’d consume about 5-to-10 mg at a time, but that amount grew.

Heroin use in the United States has increased 63 percent over the last decade and has more than doubled among adults ages 18-25, according to the Centers for Disease Control and Prevention.

Abusers of painkillers like those Matt consumed are turning to heroin in Rowan County and worldwide simply because the drug has a similar effect, is accessible and is cheaper.

Heroin was Matt’s way of “self-medicating.”

As a child Matt, was molested by a minister and over the years had a hard time coping with the abuse so he turned to pills to numb his feelings.

“Over the years, I tried to fight what happened, repress those memories,” he said.

His reliance upon pills turned into snorting the crushed pills and within two to three years, Matt was hooked on black tar heroin.

What is heroin?

Heroin is a semi-synthetic substance that is made from morphine, which comes from the dried milk or gum of the opium poppy plant. Opium is grown in Southeast Asia, Southwest Asia, Mexico, Guatemala, Colombia and Afghanistan. Heroin is more potent than morphine, according to the National Institute on Drug Abuse.

Heroin goes by many names including smack, brown sugar, skag and junk. It comes in different forms of a white or brownish powder or a black, sticky substance known commonly as black tar. The wide color range stems from the impurities left over from the manufacturing process or exists because of the additives present. However, it’s effects are all the same — euphoria, drowsiness, sweating and it can and does lead to addiction.

The white powder form of the drug is commonly referred to by its street name “China white,” but white heroin can have a slight pink hue or off-white color and “Mexican brown” or brown powder heroin can be light or a darker brown.

Heroin can be smoked, injected intravenously or intramuscularly, inhaled or snorted. The most common way users take in heroin is through a vein. The drug is essentially melted with water, typically on a metal spoon using an open flame.

Addiction

“Life back when I was an alcoholic was easier. I didn’t have to wake up chasing a high,” Matt said of the days he drank socially and smoked marijuana.

Matt then started with a bag or two of heroin, but “that didn’t cut it,” he said.

His heroin addiction began with sniffing the drug. He moved to sniffing three to four bags of heroin at a time, but that quickly turned to injecting it through his veins after a suggestion from a friend.

According to the National Institute on Drug Abuse, intravenous injections provides the most rapid onset of euphoria — 7 to 8 seconds while intramuscular injection produces a slower high of 5 to 8 minutes and the longest onset of euphoria is when heroin is smoked or sniffed, which takes 10 to 15 minutes to produce an effect.

Heroin “helped” Matt, temporarily, forget all of his problems.

He was happier and more energetic while on the drug, but he also didn’t care if he bathed or if anyone could see the needle marks all over his arms.

“Drugs took those senses away,” Matt said.

The married, father of two children under 12 said his addiction was a choice. He compares the choice to use drugs like any other decision in life.

“You choose to wake up and have a cup of coffee,” he said.

In order to maintain his heroin habit, Matt became a “middle man” and would “broker” drug deals. He estimates heroin dealers today make a 40 to 50 percent profit from the sale of the drug.

“It’s very lucrative,” he said.

Throughout the last five years, a pencil eraser-sized amount of heroin would cost about $20 and now half a gram costs about $50 to $60. The drug can be obtained from virtually anywhere, he said.

“It’s like going to the ABC store,” Matt said.

He recalled a time where he was on his way to buy heroin, knowing he had a light bill due the same day.

He bought a pack of cigarettes, a tank of gas and a gram of heroin.

“I was crying on the way to get the drugs” and because the addiction pulled at Matt so strongly, ultimately he didn’t care whether he spent his bill money.

Throughout the years Matt stole from family and friends to buy more heroin. Those closest to him still don’t quite trust him.

“That hurt,” he said, “you do things and every time you do something horrible, it would take something from you.”

He went from using heroin once a day, then moved to two or three times a day and later four times a day. Matt had built up a $250 a day heroin habit using about two grams of the drug.

“Heroin ruins your life,” he said.

Matt found that as an addict, no one expected anything from him.

“It’s hard to be sober with expectations,” he said.

If he disappointed his family, it would send him into a spiral and spur a relapse.

“They still see me as that junkie brother,” he said.

Of the adage that says once addicted, always addicted, Matt admits heroin does get into a person’s system.

“It’s tough, always. You have that in the back of your mind,” he said.

Relapse

He is currently a part of a methadone program, but admits to still occasionally using heroin. In fact, a lot of the people who are in the program are heroin abusers, he said.

Although some relapse, the program is helpful, Matt said.

“When I’m not using, I have my self respect back. I’m a son, a father, a brother, an employee. I become a human again. When I was using, I was none of those things,” he said.

He’s seen people come into the program “beaten up,” but after a few months with the program they are different — better.

The addiction, Matt said, is more than just the heroin. It’s the needle, buying the drug, cooking it on a spoon, drawing it into a syringe and forcing the drug into a vein as well as what you do afterward.

“Some people smoke a cigarette afterward or they just sit there and be high,” he said.

A relapse, Matt said, doesn’t just start with injecting the drug, it’s calling your dealer on the phone. It’s the mere act of trying to obtain your next high.

The body and heroin

Almost immediately after heroin is used, it begins to affect the body’s central nervous system. Users report feeling a rush or euphoric feeling and a warm flushing of the skin.

Heroin reduces a user’s emotional reaction to pain and can cause muscle spasms and slower breathing. It can also cause confusion, leaving the user in a mental fog.

“The major thing is it makes them feel a lot more mellow. They feel really good,” said Dr. Jack Byrnes, director of the Emergency Department at Novant Health Rowan Medical Center and chair of the Division of Emergency Medicine.

The drug slows down the part of the brain that keeps people awake and keeps them doing things, he said.

After the initial euphoria, the user alternates between a state of alertness and drowsiness.

Dr. Byrnes refutes the notion that a person can’t get addicted after one use. He said it’s simply not true.

Long term, heroin users often build a tolerance to the drug, leading them to crave and use more of the drug to achieve the same high.

Heroin abuse could also lead to HIV, hepatitis and AIDS from needle sharing as well as cause liver and kidney disease.

Byrnes said often users mix cocaine to get a buzz and then mix heroin to “chill them out.” Once the effects of the drug began to wear off is when a user wants another high.

In the emergency department, doctors have seen four times as many heroin overdoses as in the past. However, Byrnes suspects the number of overdoses are underreported.

Not all of the people actually make it to the hospital, Byrnes said.

He said the problem exists when what users are getting is 30 percent heroin mixed with another chemical or isn’t even heroin at all, which could be poisoning or a potential for an overdose.

Some emergency rooms that see heroin overdoses can potentially reach a person in time and “bring them back,” he said.

The use of Naloxone or Narcan, if given in time, can act as an antidote and reverse the effects of heroin or other opioids. Like an EpiPen used for allergic reactions, Narcan can be injected into the muscle and within 2 to 5 minutes it can restore a person’s breathing.

Organizations like North Carolina Harm Reduction Coalition are advocating for the use of Naloxone overdose prevention kits among the family members of regular heroin or opioid users and among first responders.

Contact reporter Shavonne Walker at 704-797-4253.