Smoking Heroin

This is the history of smoking heroin, also known as "chasing the dragon". The first heroin smoking originated in Shanghai in the 1920s and involved use of porcelain bowls and bamboo tubes, thereafter spreading 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 heroin smoking, 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' included spread 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.

Smoking heroin off aluminum tied to deaths
Mar. 14, 2003 10:15 AM

VANCOUVER, British Columbia - Smoking heroin off aluminum is suspected in three recent deaths and at least seven cases of serious brain damage in the metropolitan area, Royal Canadian Mounted Police say.

"Don't smoke heroin, period - but if you do, don't smoke it off aluminum," said Wayne Jeffrey, a police toxicologist. "There seems to be an interaction between some of the things heroin is cut with and the aluminum foil that causes a toxic reaction."

The unusually large cluster of deaths and brain damage reported in heroin smokers is the largest ever seen in North America, health officials say, and the source remains unclear.

"We haven't confirmed exactly what's going on," said Derek Daws, managing director the British Columbia Drug and Poison Information Center. "It's unusual that there is such a cluster that has occurred in this area in such a short period of time."

The first sign of trouble, officials say, is slurred speech and a wobbly walk, followed by an inability to speak and paralysis. Authorities say the signs can take weeks to develop.

Pathology tests to check for contamination in the body will take weeks to complete, officials said.

In warning of the danger, Dr. Diane Rothon, director of health services for the Corrections Branch, said irreversible brain damage has been "identified in the drug-using population in provincial correctional centers, the Drug Treatment Court and in methadone maintenance treatment clinics, among others."

Many of the survivors are too damaged to describe what happened, but Daws said investigators believe they all smoked heroin that was resting on aluminum foil and may have filtered the smoke through steel wool.

Regional coroner Jeanine Robinson said her staff has confirmed that one user died after smoking heroin from aluminum foil, "holding tin foil over a flame." The other deaths have not been definitely linked to the aluminum.

The latest cases date from last fall. Over the last 20 years cases have also been reported in Amsterdam, the United States, Taiwan, China and the rest of Canada.

SMOKING HEROIN DANGEROUS

The city's chief medical health officer is investigating why three Vancouver residents have died since last fall and seven others suffered varying degrees of brain damage from smoking heroin.

Dr. John Blatherwick said the 10 cases comprise the largest group of toxic heroin reactions in such a short time period ever in North America, and he's worried more people could die or fall ill before the cause is determined.

His investigation, however, is hampered by the difficulty of getting solid information from the living victims, who either can't speak or have irreversible brain damage. The victims are all adults, seven of whom live outside the Downtown Eastside.

"This is just not a Downtown Eastside story," Blatherwick said. "This is nice upper middle class people having drugs brought to their house, and this is destroying their brains for the rest of their lives."

Called "heroin-induced toxic leukoencephalopathy," the condition involves alteration of the white matter of the brain through exposure to a toxin or poison. Blatherwick believes the heroin, its cutting agent or possibly the aluminum foil used in smoking the drug is responsible for the damage.

Heroin is smoked by heating the powder on a piece of tin or aluminum foil over a flame. The resulting white smoke is inhaled, sometimes using a tube or rolled foil cylinder. The practice is often called "chasing the dragon."

Since brain damage is usually permanent, early detection of the condition and immediately eliminating exposure to heroin smoke is essential, said Blatherwick, noting the 10 cases were reported at Vancouver General Hospital and St. Paul's Hospital.

The condition was first reported in Amsterdam in 1982. In the past 20 years, sporadic cases have appeared in Europe, the United States, Canada, Taiwan, China and Lebanon.

Det. Robb McLaren is investigating the cases on behalf of the Vancouver police drug unit, which recently conducted a covert "dial-a-dope" investigation to catch dealers delivering drugs to peoples' homes.

Buys were made across the city, resulting in the arrest of 34 suspected dealers. McLaren said many customers outside the Downtown Eastside prefer smoking instead of injecting heroin to conceal the fact they are addicts.

"You don't have to worry about cooking it, sticking it in a needle, stick it in your arm, find a vein-all that ugly stuff," said McLaren, noting, however, that both methods of abusing the drug are equally addictive.

Traditionally, heroin is cut with glucose-which is harmless and often used for children who are lactose intolerant-to decrease the purity and spread out a dealer's drug supply. But McLaren has also heard of cases where heroin was cut with caffeine and even strychnine.

Dean Wilson, president of the Vancouver Area Network of Drug Users, suspects the victims may not have been smoking heroin at all. He believes it could be fentanyl, a synthetic narcotic whose biological effect is indistinguishable from that of heroin, except that fentanyl may be hundreds of times more potent.

Fentanyl is most commonly used intravenously, but like heroin, may be smoked or snorted.

Smoking heroin is not a new phenomenon, McLaren said, pointing to the Opium Wars in the early 1800s, when the English shipped tons of opium-from which heroin is derived-from India into China in exchange for manufactured goods and tea.

This trade produced a country filled with drug addicts, as parlors for smoking opium proliferated throughout China in the early part of the 19th century.