Smoking Heroin

Smoking heroin is also known as "chasing the dragon." The first record of smoking heroin originated in Shanghai in the 1920s and involved the use of porcelain bowls and bamboo tubes. This method of heroin consumption eventually made its way across much of Eastern Asia and to the United States over the next decade.

"Chasing the dragon" was a later refinement of this form of smoking heroin, originating in or near Hong Kong in the 1950s, and refers to the ingestion of heroin by inhaling the vapors which result when the drug is heated-typically on tin-foil above a flame. Subsequent spread of 'chasing the dragon' to other parts of South East Asia during the 1960s and 1970s, to some parts of Europe during the late 1970s and early 1980s, and to much of the Indian sub-continent during the 1980s.

Many new and younger users begin by snorting or smoking heroin because they wish to avoid the social stigma attached to injection drug use. These users often mistakenly believe that snorting or smoking heroin will not lead to addiction. With regular heroin use, tolerance develops. This means the abuser must use more heroin to achieve the same intensity or effect. As higher doses are used over time, physical dependence and addiction develop. With physical dependence, the body has adapted to the presence of the drug and withdrawal symptoms may occur if use is reduced or stopped.

Many users who are smoking heroin often graduate to injection because as their bodies become conditioned to the drug, the effects it produces are less intense. They then turn to injection--a more efficient means of administering the drug--to try to attain the more intense effects they experienced when they began snorting or smoking heroin. It is important to note that snorting and smoking heroin poses the same risks of overdose and death as that of intravenous users.

But new evidence suggests that smoking heroin by "chasing the dragon" has its own hazards. The New York State Office of Alcoholism and Substance Abuse Services has prepared a memorandum to alert health agencies and drug treatment programs to the link between heroin smoking and an incurable neurological condition that can rob users of muscle coordination and speech, and if untreated can lead to paralysis and death.

Dr. Arnold R. Kriegstein, a neurologist at the Columbia-Presbyterian Medical Center, sounded the alarm after treating a Greenwich Village musician and his girlfriend whose coordination, gait and speech deteriorated after they had been smoking heroin. According to Dr. Kriegstein, who has since diagnosed a third case in a friend of the couple, the degeneration can be arrested but has no cure.

The medical condition caused by smoking heroin, called leukoencephalopathy, affects the part of the brain that controls motor skills. The disease takes at least two weeks to manifest itself, with a progressive loss of muscle coordination, a condition called ataxia. Afflicted heroin users become clumsy, their speech slurs and they wobble when they walk.

''They may not be able to coordinate muscles to perform everyday functions, let alone functions that demand a degree of skill or training such as playing a musical instrument,'' the memorandum reported. Without treatment, it said, they can lose the ability to talk, become paralyzed and die.

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