Heroin is an illegal opiate.  It’s both the most abused and the most rapidly acting of the opiates.  Heroin is processed from morphine, a naturally occurring substance extracted from the seedpod of certain varieties of poppy plants.  It is typically sold as white or brownish powder or as the black sticky substance known on the streets as “black tar heroin”.  It is highly addictive as users find that they have a need for persistent, repeated use of the drug (known as craving) and that their attempts to stop using the drug lead to significant and painful physical withdrawal symptoms.  According to the 1996 National Household Survey on Drug Abuse, an estimated 2.4 million people use heroin at some time in their lives. 

Why is Heroin So Highly Addictive?

Heroin is so addictive because it activates many regions of the brain particularly the regions that are responsible for producing both the sensation of “reward” and physical dependence.  Together, these actions account for the user’s loss of control and the drug’s habit-forming action.  

How is Heroin Used?

Heroin is usually injected, sniffed/snorted, or smoked.  Typically a heroin user may inject up to four times a day.  Intravenous injection provides the greatest intensity and most rapid onset of euphoria (7 to 8 seconds), while intra-muscular injection produces a relatively slow onset of euphoria (5 to 8 minutes).  When heroin is snorted or smoked, peak effects are usually felt within 10 to 25 minutes. 

What are the Short-Term Effects of Heroin Use?

Soon after injection (or inhalation), heroin crosses the blood-brain barrier.  In the brain, heroin is converted to morphine and binds rapidly to opioid receptors.  Abusers typically report feeling a surge of pleasurable sensation, a “rush”.  The intensity of the rush is a function of how much drug is taken and how rapidly the drug enters the brain and binds to the natural opioid receptors.  With heroin, the rush is usually accompanied with a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities, which may be accompanied by nausea, vomiting, and severe itching.  After the initial effects abusers usually will be drowsy for several hours.  Mental function is clouded by heroin’s effect on the central nervous system.  Cardiac functions slow; Breathing is also severely slowed, sometimes to the point of death. 

One of the most detrimental long-term effects of heroin is addiction itself.  Addiction is a chronic, relapsing disease, characterized by compulsive drug seeking and use, and neurochemical and molecular changes in the brain.  Heroin also produces profound degrees of tolerance and physical dependence, which are also powerful motivating factors for compulsive use and abuse.  As with abusers of any addictive drug, heroin abusers gradually spend more and more time and energy obtaining and using the drug.  Once they are addicted, the heroin abusers’ primary purpose in life becomes seeking and using drugs. 

 Medical consequences of chronic heroin abuse include scarred and/or collapsed veins, bacterial infections of the blood vessels and heart valves, abscesses (boils) and other soft-tissue infections and liver or kidney disease.  Lung complications (including various types of pneumonia and tuberculosis) may result from the poor health condition of the abuser as well as from heroin’s depressing effects of respiration.  Many of the addictives in street heroin may include substances that do not readily dissolve and result in clotting the blood vessels that lead to the lung, liver, kidneys, or brain.  Of course, sharing of injection equipment or fluids can lead to some of the most severe consequences of heroin abuse-infections with hepatitis B and C, HIV, and a host of other blood-borne viruses, which drug abusers can than pass to their sexual partner. 

How Does Heroin Abuse Affect Pregnant Women?

Heroin abuse can cause serious complications during pregnancy, including miscarriage and premature delivery.  Children born to addicted mothers are at greater risk of SIDS (sudden infant death syndrome), as well.  Pregnant women should not be detoxified from opiates because of the increased risk of spontaneous abortion or premature delivery; rather treatment with methadone is strongly advised by the National Institute on Drug Abuse.  Research has demonstrated that the effects of in utero exposure to methadone is relatively benign. 

Drug Slang Associated with Heroin:

These are just a few examples of slang used to describe heroin.

Atom Bomb – heroin mixed with marijuana