Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance is known as black tar heroin. Other common names for heroin include big H, horse, hell dust, and smack.
It can cause serious health problems and often causes death by overdose. Heroin is gradually absorbed through the bloodstream where it makes its way into the brain. Once in the brain, it is converted to morphine and then binds itself to receptors known as opioid receptors. These receptors are located in various areas of the brain, especially those involved in the perception of pain, pleasure and rewards. Opioid receptors are also located in the brain stem, an important area responsible for auto-processing, which is critical to maintaining life function. These functions include breathing, blood pressure and circulation and sexual arousal.
How do people use heroin?
People inject, sniff, snort, or smoke heroin. Some people mix heroin with crack cocaine, a practice called speed-balling.
What are the effects of heroin?
Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.
People who use heroin report feeling a "rush" (a surge of pleasure, or euphoria). However, there are other common effects, including:
warm flushing of the skin
heavy feeling in the arms and legs
nausea and vomiting
clouded mental functioning
going "on the nod," a back-and-forth state of being conscious and semiconscious
People who use heroin over the long term may develop:
collapsed veins for people who inject the drug
damaged tissue inside the nose for people who sniff or snort it
infection of the heart lining and valves
abscesses (swollen tissue filled with pus)
constipation and stomach cramping
liver and kidney disease
lung complications, including pneumonia
mental disorders such as depression and antisocial personality disorder
sexual dysfunction for men
irregular menstrual cycles for women
Other Potential Effects
Heroin often contains additives, such as sugar, starch, or powdered milk, that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage. Also, sharing drug injection equipment and having impaired judgment from drug use can increase the risk of contracting infectious diseases such as HIV and hepatitis (see "Injection Drug Use, HIV, and Hepatitis").
Can a person overdose on heroin?
Yes, a person can overdose on heroin. A heroin overdose occurs when a person uses enough of the drug to produce a life-threatening reaction or death. Heroin overdoses have increased in recent years.
When people overdose on heroin, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term mental effects and effects on the nervous system, including coma and permanent brain damage.
How can a heroin overdose be treated?
Naloxone is a medicine that can treat an opioid overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of heroin and other opioid drugs. Sometimes more than one dose may be needed to help a person start breathing again, which is why it’s important to get the person to an emergency department or a doctor to receive additional support if needed.
Naloxone is available as an injectable (needle) solution, a handheld auto-injector (EVZIO®), and a nasal spray (NARCAN® Nasal Spray). Friends, family, and others in the community can use the auto-injector and nasal spray versions of naloxone to save someone who is overdosing.
The rising number of opioid overdose deaths has led to an increase in public health efforts to make naloxone available to at-risk persons and their families, as well as first responders and others in the community. Some states have passed laws that allow pharmacists to dispense naloxone without a prescription from a person’s personal doctor.
Is heroin addictive?
Heroin is highly addictive. People who regularly use heroin often develop a tolerance, which means that they need higher and/or more frequent doses of the drug to get the desired effects. A substance use disorder (SUD) is when continued use of the drug causes issues, such as health problems and failure to meet responsibilities at work, school, or home. SUD can range from mild to severe, the most severe form being addiction.
Those who are addicted to heroin and stop using the drug abruptly may have severe withdrawal.
Withdrawal symptoms, which can begin as early as a few hours after the drug was last taken—include:
severe muscle and bone pain
diarrhea and vomiting
cold flashes with goosebumps ("cold turkey")
uncontrollable leg movements ("kicking the habit")
severe heroin cravings
Researchers are studying the long-term effects of opioid addiction on the brain. Studies have shown some loss of the brain’s white matter associated with heroin use, which may affect decision-making, behaviour control, and responses to stressful situations.
How is heroin addiction treated?
A range of treatments including medicines and behavioural therapies are effective in helping people stop heroin use. It’s important to match the best treatment approach to meet the particular needs of each individual patient.
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