Heroin FAQs

What Is Heroin?

• Heroin is an illicit opiate drug, derived from morphine. It is sold as a white or brown powder, or as a black/brown tarry substance
• It is a very potent analgesic substance that works very fast and produces a powerful euphoria and sense of well being
• It is very addictive – the regular use for only a week or so can result in a physical dependence

How Is Heroin Administered?

Heroin users administer the drug in one of three ways, by:

• Snorting in intranasaly
• Smoking it
• Injecting it into a vein, or less commonly, into a muscle

Who Uses Heroin?

The National Survey on Drug Use and Health conducted in 2007 reveals that 3.8 million Americans have tried heroin at least once and 366 000 had used it in the past year. In 2007, more than 100 000 people tried heroin for the first time.

How Does Heroin Affect the Brain?

Heroin is an opiate drug, able to directly stimulate the opiate receptors in the brain. When a person takes heroin, the drug passes through the blood brain barrier and suffuses the brain with opiates. These opiates activate neurotransmitter receptors in areas of the brain responsible for regulating pleasure and pain. Once heroin activates the brain’s opiate receptors, a person feels significant analgesia, as well as euphoria and contentment. 

Regular use of heroin over time leads to physical changes in the brain. With chronic use, heroin causes a reduction in the numbers of opiate receptors in the brain. Once these receptors are reduced in number, a person needs a greater amount of heroin to feel the same high (tolerance) and the person will feel symptoms of withdrawal when not using heroin (physical dependence).

The brain adapts easily and quickly to heroin use, becoming physically dependent on the powerful substance after only a short time of regular use. This easy development of physical dependence is one primary reason why heroin is so addictive and so tough to quit.

What Are the Characteristics of a Heroin High?

There is no denying that using heroin makes a person feel very good. It produces an intense high, that depending on the route of administration, can induce a minute or two long rush that users describe as almost “orgasmic’ in nature. Other characteristics of a heroin high include:

• A powerful sense of well being, free from worry
• A sleepy drowsy sedation
• Nodding, an awake but dreamlike state
• A feeling of warmth
• Slowed breathing

A heroin high lasts for up to 5 hours.

What Are the Short Term Health Consequences of Heroin Use?

Heroin can cause feelings of nausea and induce vomiting when taken by inexperienced users or when taken in large doses. Other medical consequences of acute heroin use can include:

• Mental confusion and slurred speech
• Analgesia
• Decreased respiration and heart rate
• Sweating
• Itchiness
• Constricted pupils
• A reduced cough reflux

The most significant acute consequence of heroin use is overdose, which can easily be fatal. Symptoms of heroin overdose include:

• Very shallow breathing or no respiration
• Convulsions
• Coma
• Cold and clammy feeling skin
• Extremely constricted pupils (pinpoint)

A heroin overdose is easily countered with a dosage of naloxone, a heroin antidote. Unfortunately, many people who overdose die before health care workers can administer an injection of the life-saving drug.

What Are the Long Term Heath Consequences of Heroin Use?

The chronic use of heroin can lead to devastating health consequences. Although heroin in itself is not a particularly toxic substance, the means of administration, the lifestyle associated with heroin use and the impurities present in street level heroin all combine to put chronic heroin users at great risk of a number of medical conditions and the risk of an early death.

Health consequences of chronic heroin use can include:

• HIV or hepatitis B or C infection - Injecting heroin (or even sharing straws) transfers blood born infectious disease between users. IV drug users face an extremely high risk of hepatitis C and a high risk of HIV.
• Cognitive impairments – long term heroin use seems to cause reduced cognitive functioning
• Skin infections – unsanitary injection practices can lead to skin abscesses and even gangrene
• Track marks – injection scars
• Botulism – users of black-tar heroin are at an elevated risk of very toxic botulism spores
• Bacterial infections – resulting from poor injection practices; these can lead to cardiac infections that increase the risk of heart failure
• Collapsed veins – frequent injections can lead to vein scarring or collapsed veins
• Malnutrition – heroin suppresses appetite and chronic users are sometimes more likely to spend money on drugs, than food
• Organ damage – resulting from a reduction in blood flow as a consequence of vein damage
• Pneumonia – The heroin lifestyle reduces the overall health of the addict, increasing susceptibility to pneumonia and even tuberculosis

Put simply, people using heroin are far more likely to die an early death than people not using heroin.

What Are the Withdrawal Symptoms of Heroin?

Heroin addiction perpetuates itself in part due to the intense withdrawal symptoms that occur with abstinence. Also known as “dope sickness”, heroin withdrawal symptoms begin within about a half day after last use, peak after 2 or 3 days and continue for between 4 days and a week with severity.

Symptoms of heroin withdrawal can include:

• Nausea
• Vomiting
• Headache
• Muscle aches and pains
• Yawning
• Diarrhea
• Runny sinuses
• Depression
• Anxiety
• Restlessness
• Sweating
• Restless legs or “kicking”
• Stomach cramps

Heroin withdrawal symptoms can be very unpleasant, yet unlike alcohol withdrawal symptoms, they are rarely dangerous.

Fortunately, medications exist that can greatly diminish the intensity, or even eliminate, withdrawal symptoms.

Heroin and Pregnancy

Pregnant women should not use heroin. Using heroin while pregnant can:

• Lead to miscarriage or obstetric complications
• Cause abnormal fetal growth
• Cause low birth weights
• Cause a  syndrome of infant opiate addiction
• Increase the risks of transferring HIV or hepatitis C to the baby

Pregnant women addicted to heroin should not try to detox “cold turkey” from the drug, as the severe withdrawal symptoms can induce miscarriage. Methadone opiate replacement therapy is currently the recommended treatment of choice for pregnant heroin using women.

Heroin Treatment Options

Heroin treatment options include

• Opiate replacement medications, such as methadone or Suboxone (buprenorphine)
• Medical detox and psychosocial addiction treatment
• 12 steps support groups

Please read heroin addiction treatment for a complete overview of treatment options.