Black Tar Heroin; What is it?
“Since the 1990s, US heroin consumers have been divided from the full range of available products: east of the Mississippi River, Colombian-sourced powder heroin (PH) dominates the market, while to the west, Mexican-sourced “black tar” (BTH) is the main heroin available. 1” For many years Afghanistan was the largest producer of opium. In fact, prior to 1990, the only significant source of heroin was from Afghanistan. Myanmar was a major source in the 1970’s but demand was much lower and Afghanistan’s heroin eventually dominated the market. Reports seem to indicate that Afghanistan was a major producer globally until about 2009 except when the Taliban were able to shut down production in 2001. There are some who would dispute these numbers depending on the source of the intelligence and global politics. Production in other parts of the world have been steadily growing with increased demand. Increased sources of production have resulted in a wider variety of products, a wider range of quality from low to high, and distribution networks becoming more fluid. This could contribute to the increase in overdoses society is experiencing today.
Where does heroin come from today
Most heroin is produced today will come from South East Asia, South West Asia, Mexico and Columbia. The plants are grown in large quantities and it would be difficult to produce a domestic supply of the product in the United States. Domestic production is very dangerous (due to enforcement) and expensive for the producers who also face stiff competition with foreign sources where the drug is grown and harvested more freely and much cheaper. Large-scale production is now available in Mexico and Columbia. Other Asian countries are also increasing the supply in more recent times. Demand has increased, particularly in the last few years as pharmaceutical companies are wanting a more potent form of the product and the population of active drug users increases.
The drugs produced by pharmaceutical companies are finding their way into street level versions of the drug which increases the potency and effects of the drug. Street level drug producers are using fentanyl and carfentanil to increase the effects of the drug, but this is also increasing the dangerousness of the drug. Carfentanil is ten thousand times more potent than morphine and used by vets to treat large animals like bison. Vets are required to wear special equipment when handling the drug and are required to be licensed by the Drug Enforcement Agency (DEA).
Multiple forms of heroin – Prescription Opioids
The opium poppy (latin name; Papaver somniferum), can be used to harvest the opium, which is the dried latex produced by the seed pods. The flowers produce a milky white sap when damaged. This is converted into morphine from which opioids are manufactured. Morphine was first isolated in the 1800’s and is ten times more potent than opium. In 1874, chemists produced a heroin which they believed would be a less addictive form of morphine. Heroin can be smoked, injected or snorted. Some drug users will mix the drug with other drugs like cocaine which is known as speedballing.
Black Tar heroin or Mexican Black Tar heroin is mostly produced by the Mexican drug cartels. Some believe it is a less potent form of the drug than the powdered version from Columbia but that has proven to be a grave mistake for many users. When tar heroin is used, habitual drug users have a higher incidence of overdoses than other forms of the drug because of this belief. Tar heroin is generally thought to be cheaper and less refined than the powered form but in some cases is more potent due to additives.
The history of Black Tar Heroin
Since the 1990’s, Tar Heroin has been produced by the Mexican drug cartels. As production has shifted from Asia to South America, each producer has become known by the distinctive traits of the product they produce. Much of the heroin produced has been mixed with various substances that are available locally, which increases profits and reduces the risk of overdose. The fillers used can be common items like talc, flour, corn starch or strychnine. Manufacturers of street drugs may add other opioids (pharmaceutical sourced). Both fentanyl and carfentanil have been very popular since they also increase the effect of the drug and are cheap. Heroin in a pure form is very dangerous.
The pharmaceutical industry produces prescription medications from morphine including codeine, methadone, hydrocodone (Vicodin), hydromorphone (Dilaudid), meperidine (Demerol) and oxycodone (Percocet or Oxycontin), all of which have proven to be equally as addictive. Starting in the late 1960’s, fentanyl and then carfentanil were synthetic opioids that grew in popularity. In fact, research has shown that 80% of heroin users started their addiction with prescription forms of these drugs2. All of these products are available for the producers of tar heroin to increase the effects of the drug.
Multiple levels of pain relief are available
Pharmaceutical companies produce many forms of opioids to help patients who suffer from short term or long term (chronic) pain, particularly with cancer treatment. Fentanyl is popular with medical professionals and carfentanil are very popular as with vets. Both are synthetic opioids that are more rapidly absorbed by the body in treating pain, with reduced ill effects on other biological systems like the heart. These drugs will continue to evolve as they are easily produced and highly effective for pain management. It is estimated that between five hundred and six hundred billion dollars is the cost of lost productivity due to chronic pain, particularly in the last decade as the population ages.
As with illicit drug producers, Pharmaceutical companies cannot distribute a pure form of opiates because it would be difficult to distribute and administer. There is a wide array of products in various forms for distribution. There are many different forms of delivery including nasal sprays, injection, pills and even topical lotions. Increased usage and tolerances for the drug can cause patients to become reliant on the drug. Globally, many more countries are becoming increasing dependent on pharmaceutical companies to assist with pain management but the side effect of this is that there is an increase in people struggling with addiction. Low prices and wide availability increase the likelihood of recreational drug use by younger members of the population. Those who have become dependent on prescription drugs will eventually seek out illicit sources of the drug and turn to street level heroin dealers. East of the Mississippi River the common source is now tar heroin.
Effects of heroin use
Depending on the strength and delivery system, heroin is converted by the brain into morphine which reacts with the opioid receptors. The effects have been described as a ‘rush’ as the drug takes effect. Users will experience diminished brain function, decreases in respiration, more nausea, vomiting and dry itchy skin for several hours. Repeated use of the drug will physically alter the brain and physiology functions. Users will experience altered decision making and reduced ability to regulate themselves in stressful situations. Increased tolerance will require higher doses and dependance will require the user to become increasingly more and more reliant on the drug.
Long term users will experience heavy withdrawal symptoms within two days, and the effects can last for months. Symptoms include nausea, vomiting, aches, insomnia, shaking, diarrhea, cold flashes, goose bumps and involuntary leg movements. There are long term effects that are not reversable.
Heroin Use Disorder will result where those affected will experience chronic relapse, increasing dependency with little regard for any consequences. Those with Heroin Use Disorder will have a single purpose in life, the acquisition and use of the drug. The diminished capacity to self-regulate will result in higher levels of degradation and increased reliance on criminal activity to feed the drug users habit.
National Institute on Drug Abuse (NIDA)
NIDA is a federal government agency that promotes or uses research to study the effects of drug use and its consequences.
They work with other agencies and promote programs and research to assist societies, families, and drug users with the ongoing addiction crisis. NIDA was formed in 1974 but can trace its roots back to 1935. The population of heroin users in the United States is estimated at about one million today and has been steadily rising since 2007. The number of people starting heroin use in 2016 was estimated at 170,000, which is double the number from 2006. Heroin is highly addictive; the impurities are destructive and the transmission of diseases like Hepatitis C and HIV/AIDS are high (due to needle sharing). Overdoses are becoming increasingly higher over time as well. Treatment options for heroin addiction is combinations of behavioral and pharmacological (medications).
There are many therapies available to those who suffer from the disease of addiction. In addition to the long-term effects of drug abuse, there are social and economic impacts that effect each person differently. Some patients respond to outpatient services, but others require more intensive inpatient services. Many health professionals are turning to abundant evidence that shows that methadone, buprenorphine, and naltrexone all reduce opioid use and opioid use disorder-related symptoms. The belief is that in the long-term treatment of opioid abusers these drug replacement therapies (DRT, or Medically Assisted Treatment [MAT]) will allow users to improve their life skills without being involved in the illegal drug trade or lifestyle of an active drug user. This also reduces the side effects of the spread of disease and health issues related to the impurity of street products. There are a wide arrange of costs for treatment from free to tens of thousands of dollars per month.
Generally, treatment centers rely on proven scientific models of recovery and are attractive to insurance companies. There are a wide range of treatments available including Cognitive Behavioral Therapy(CBT), Contingency Management (CM), Motivational Interviewing (MI), Dialectal Behavioral Therapy (DBT), Rational Emotive Behavior Therapy (REBT), and 12-Step Facilitation. Most will use a combination of therapies depending on the facility and the staff experiences. Often treatment centers will have professional nurses and/or doctors. High end facilities offer massages, acupuncture, swimming pools, meditation, health food options and a resort-like experience.
These centers are usually started by people who have experienced issues with addition or alcoholism and have a desire to help others find a solution. They may be more open to using spiritual based practices and alternative therapies. These tend to be less attractive to insurance companies but can be significantly cheaper than treatment centers. Many non-profit rehab centers exist.
In response to the rising number of cases of overdose and the increasing number of people who are experiencing issues with addiction, the United States government, thru a number of agencies, has sought to standardize treatments, improve successful outcomes which allows insurance companies to be more open to funding treatment for the disease of addiction. Heroin users are thought to have a high likelihood of returning to active addiction, and obtaining insurance coverage for treatment can be difficult.
The Textures of Heroin: User Perspectives on “Black Tar” and Powder Heroin in Two US Cities Sarah G. Mars, Philippe Bourgois, George Karandinos, Fernando Montero, Daniel Ciccarone J Psychoactive Drugs. Author manuscript; available in PMC 2017 Sep 1. Published in final edited form as: J Psychoactive Drugs. 2016 Sep-Oct; 48(4): 270–278. Published online 2016 Jul 20. doi: 10.1080/02791072.2016.1207826 PMCID: PMC5027195
Centers for Disease Control and Prevention (CDC). Multiple Cause of Death, 1999-2015. CDC WONDER Online Database Accessed April 4, 2017.