What Is Heroin?
Also known as: “Smack,” “Junk,” “H,” “Black tar,” “Ska,” and “Horse”
Heroin is a type of opioid drug that is partly manmade and partly natural. It is made from morphine, a psychoactive (mind-altering) substance that occurs naturally in the resin of the opium poppy plant. Heroin’s color and look depend on how it is made and what else it may be mixed with. It can be white or brown powder or a black, sticky substance called “black tar heroin.”
Heroin is becoming an increasing concern in areas where lots of people abuse prescription opioid painkillers, like OxyContin and Vicodin. They may turn to heroin since it produces a similar high but is cheaper and easier to obtain. Nearly half of young people who inject heroin surveyed in recent studies reported abusing prescription opioids before starting to use heroin.1
How Does Heroin Affect the Brain?
When heroin enters the brain, it is converted back into morphine. It then binds to molecules on cells known as opioid receptors. These receptors are in many areas of the brain and body, especially areas involved in the perception of pain and pleasure.
Short-term effects of heroin include a rush of good feelings and clouded thinking. For the first several hours after taking heroin, people want to sleep, and their heart rate and breathing slow down. When the drug wears off, people may feel a strong urge to take more.
Regular heroin use changes the functioning of the brain. Using heroin repeatedly can result in:
- Tolerance—more of the drug is needed to achieve the same “high”
- Dependence—the need to continue use of the drug to avoid withdrawal symptoms
- Addiction—a devastating brain disease where people can’t stop using drugs even when they really want to and even after it causes terrible consequences to their health and other parts of their lives
What Are the Other Effects of Heroin?
The changes that take place in the brain from heroin use have effects on the rest of the body. Some of these effects are quite serious. In 2011, more than 250,000 visits to a hospital emergency department involved heroin.2
Heroin use can cause:
- Feeling sick to the stomach and throwing up
- Severe itching
- Slowed (or even stopped) breathing
- Increased risk of HIV and hepatitis (a liver disease) through shared needles
- Coma—a deep state of unconsciousness
In addition to the effects of the drug itself, heroin bought on the street often contains a mix of substances, some of which can be toxic and can clog the blood vessels leading to the lungs, liver, kidney, or brain. This can cause permanent damage to those organs.
Can You Get Addicted to Heroin?
Yes, heroin is very addictive. It enters the brain quickly, causing a fast, intense high. Because users can develop a tolerance, people who use heroin need to take more and more of it to get the same effect, and eventually they may need to keep taking the drug just to feel normal. It is estimated that about 23 percent of individuals who use heroin become addicted.3 For those who use heroin repeatedly (over and over again), addiction is very likely. Once a person becomes addicted to heroin, seeking and using the drug becomes their main goal in life.
The number of people addicted to heroin doubled from 214,000 in 2002 to 467,000 in 2012.4
When someone is addicted to heroin and stops using it, he or she may experience:
- Muscle and bone pain
- Cold flashes with chills
- Throwing up
- Inability to sleep
- Kicking movements
- Strong craving for the drug
Fortunately, treatment can help an addicted person stop using and stay off heroin. Medicines can help with cravings that occur after quitting, helping a person to take control of their health and their lives.
Can You Die if You Use Heroin?
Yes, heroin slows, and sometimes stops, breathing, and this can kill a person. Dying in this way is known as overdosing. Deaths from drug overdoses have been increasing since the early 1990s—fueled most recently by a surge in heroin use. In 2011, 4,397 people died in the United States from a heroin overdose, an increase of almost 2.5 times compared to the 1,784 people who died from a heroin overdose in 2001. For young people (ages 15 to 24), the increase in the past 10 years has been about 4 times greater, with 809 young people dying from heroin overdose in 2011 compared with 212 in 2001.5 Signs of a heroin overdose are slow breathing, blue lips and fingernails, cold damp skin, and shaking. People who might be overdosing should be taken to the emergency room right away.
Treating Heroin Addiction
A range of treatments including behavioral therapies and medications are effective at helping patients stop using heroin and return to stable and productive lives.
Medications include buprenorphine and methadone, both of which work by binding to the same cell receptors as heroin but more weakly, helping a person wean off the drug and reduce craving; and naltrexone, which blocks opioid receptors and prevents the drug from having an effect (patients sometimes have trouble complying with naltrexone treatment, but a new long-acting version given by injection in a doctor’s office may increase this treatment’s efficacy). Another drug called naloxone is sometimes used as an emergency treatment to counteract the effects of heroin overdose.
1Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. CBHSQ Data Review. Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States. Rockville, MD, August 2013.
2Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. The DAWN Report, Highlights of the 2011 Drug Abuse Warning Network (DAWN): Findings on Drug-Related Emergency Department Visits. Rockville, MD, February 22, 2013.
3Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. CBHSQ Data Review. Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States. Rockville, MD, August 2013.
4Substance Abuse and Mental Health Services Administration. Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.
5Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2011 on CDC WONDER Online Database, released 2014. Available at http://wonder.cdc.gov.