Heroin is a synthetic derivative of morphine. In the body, it is rapidly converted to 6-acetylmorphine, and then to morphine. The conversion to morphine occurs within minutes. In addition to the effects common to all opiates, there have been reports of acute rhabdomyolysis with myoglobinuria during heroin intoxication.
In some cases the patients have been comatose, lying with pressure on their muscles, but in other cases rhabdomyolysis occurred with alert patients, accompanied by muscle pains, weakness, and swelling. Chronic abuse of heroin has been associated with progressive nephrotic syndrome resulting in renal failure.
Heroin withdrawal normally begins within 6 to 8 hours of last use, symptoms of withdrawal peak at 2 to 3 days and have usually resolved within a week. Withdrawal from other opiates is similar but will exhibit different time scales and intensities, e.g., methadone withdrawal may last for several weeks and not commence for 36 to 48 hours. Opioid withdrawal can also be precipitated by an antagonist such as naloxone, which will produce a severe withdrawal with peak intensity about 30 minutes from administration.
The opiate withdrawal syndrome is very rarely life threatening and has been described as being simliar to having influenza. It is, however, experienced as sufficiently unpleasant for it to be avoided whenever possible by users and for its successful negotiation to be the necessary first step towards abstinence. For this reason it is important that it is properly managed by the clinician
The documentary describes how the drug comes from Afganistan and the lives of heroin addicts. Anyone who is interested in learning more about addiction, becoming homeless, hustling the streets for money every day, this is the film to watch.