Mark Ashby | Guest columnist | Executive director, LEAD Impairment Training

When digested, heroin quickly metabolizes into opioid agonists that produce an intense “rush.” Heroin can cross the blood-brain barrier very quickly because it is more soluble in water. (Shutterstock.com)

Heroin, or diacetylmorphine, has been around for a long time. It was first discovered by C.R. Alder Wright in 1874 by working with the chemical structure of morphine.1 As many of you already know, we get morphine from the opium poppy. The complete manufacturing process is outlined in the National Geographic Special titled “Drugs Inc. — Heroin.” The 46-minute program can be viewed on-line at nationalgeographic.com. 2

According to the North Metro Drug Task Force, there has been a substantial increase in heroin seizures just over the last two years. In 2010, approximately 62 seizures were completed. By September 2012, the seizures rose to 185 in a single year. That is a 200 percent increase just in this one enforcement area. 3

So what is heroin? How does it work? Why is it so addictive? Finally, how does it present itself in a person contacted for driving under the influence?

Heroin is one of the most commonly abused forms of narcotics. Narcotic analgesics are often referred to as pain killers. Heroin is a morphine derivative. Morphine is opium’s most active ingredient. Heroin was widely used as medication in the early 20th Century.

When the dangerous addiction properties were recognized in 1924, the Heroin Act made it illegal. 4 Afghanistan produces the majority of the world’s supply of heroin; however, Mexico’s production levels have increased 600 percent over the past four years putting it in second place.

Heroin is known by many names, including dope, junk, smack and H. It is classified as a Schedule 1 drug by the Drug Enforcement Administration.

Heroin itself is believed to be inactive, but when it is ingested, it quickly metabolizes into opioid agonists that produce an intense “rush.” Heroin can cross the blood-brain barrier very quickly because it is more soluble in water. It also forms a more concentrated solution than other drugs like morphine.

It is reported that most users prefer to inject the drug because of the direct route the chemical takes to the brain. When smoked, users report a rapid delivery but with a lower high. When injected into a muscle — IM — or snorted, there is a slower onset and less intense high. 5 The onset of the high is approximately three to five seconds when intravenous injection is used. When smoked, heroin can take five to 15 seconds with a milder onset. When intra-muscular injections are used, the onset can take five to 10 minutes. When heroin is snorted, the time increases to two to 10 minutes. 6 The duration of heroin can last between two to four hours. 7

Heroin has been reported as a drug that is immediately addictive to some users. Heroin works by flooding the brain’s opioid receptor sites. This “flooding” action causes the brain to release chemicals that provide us with “reward.” This same action also produces a high level of physical dependency.

Delayed responses or movements, facial itching, appearing to fall asleep, significant psycho-motor impairment and constricted pupils can all be signs of a heroin impairment. (Shutterstock.com)

The positive effects include feelings of euphoria and well-being, relaxation, sedation and pain relief. Negative effects can include nausea or vomiting, constipation, dizziness and blackouts. Heroin causes rapid tolerance and physical dependence. When the euphoric effects are added, this leads many people to become addicted. The subject is required to use more and more of the drug to produce the same effects.

How do people under the influence of heroin act like? Heroin is a narcotic analgesic.

It affects the autonomic nervous system or involuntary nervous system. It causes a person’s heartbeat to slow, body temperature to drop and blood pressure to become lowered. Breathing will become slower as will all physical movements.

Many of the body’s muscles will become affected, too. These include the digestive system and the pupils. When you look at a person under the influence of heroin, one of the possible observations will be very constricted pupils. With narcotics it isn’t unusual to see a person with their pupils around 1 millimeter in size with little to no reaction to any light.

In a workplace setting these are the most likely signs of impairment that you will see:

• Delayed responses or movements. I have had a man suspected of being under the influence take almost four minutes to respond to my question, “What is your name?”

• Facial itching. Many narcotics release histamines into your body. These are the same histamines that cause your eyes to itch from allergies. Typically, you can see a person scratching their face when this is occurring.

• “On the Nod.” Subjects will appear to fall asleep. This often occurs while they are in mid-sentence or even standing. During roadsides, I had a man go “on the nod” for almost 90 seconds while performing the finger to nose maneuver.

• Significant psycho-motor impairment displayed during the contact.

• Constricted pupils. As explained above, many subjects will have very constricted pupils that are not or are very slightly reactive to light. This occurs no matter if it’s bright or dark outside. 8

If you suspect that someone may be under the influence of heroin, it is best to always establish impairment by following your training.

If you want or need training on how to identify employees who are under the influence of alcohol or other chemicals, contact Mark Ashby at mark@ileadit.net.

Mark Ashby is a retired 24-year veteran police officer who specialized in the detection of drug-impaired persons. Ashby is the executive director of LEAD Impairment Training, offering training and oral fluid random testing programs for corporate companies

1. http://en.wikipedia.org/wiki/Heroin
2. http://channel.nationalgeographic.com/channel/videos/heroin/
3. North Metro Drug Task Force, October
4. American Council for Drug Education, http://www.acde.org/common/Heroin.htm
5. Heroin Basics, http://www.erowid.org/chemicals/heroin/heroin_basics.shtml
6. Tennessee Association of Alcohol, Drug and Addiction Services, http://www.taadas.org/factsheets/heroinFacts.htm
7. Heroin Basics, http://www.erowid.org/chemicals/heroin/heroin_basics.shtml
8. NHTSA Drug Classication and Evaluation Program,