What Is Heroin?

Heroin is a type of Opioid made from the Opium poppy plant, commonly grown in Southeast and Southwest Asia, Mexico, and Columbia. It was first created by the German Bayer pharmaceutical company in 1895 and intended as a less-addictive alternative to Morphine. Following a refining process, Heroin can be a white, brown, beige, black, off-white, gray, or tan powder. Black Tar Heroin, however, is a dark brown or black substance similar in consistency to sticky stick roofing tar or resin.

As the United States learned of Heroin’s exceptionally addictive properties, its use spread across the country. Prior to its ban in 1924, an estimated 300,000 Americans were addicted to Opium. Nearly a century later in 2016, nearly 948,000 Americans reported using Heroin in the past year.

Today, due to fallout from the Opioid Epidemic, use of Heroin has increased among all age groups, genders, and income levels. Three of four current Heroin users reported first misusing prescription Opioids.

Street Names

  • Brown sugar
  • China White
  • Dope
  • H
  • Horse
  • Junk
  • Skag
  • Skunk
  • Smack
  • Boy

Is Heroin Addictive?

Heroin is an extremely addictive substance and the groundwork for an addiction can be laid from first use. Although some routes of administration allow Heroin to reach the brain faster (such as injection and smoking), all routes are considered dangerous and potentially addictive. Once an individual develops an addiction to Heroin, continuing use becomes their main focus despite any negative consequences they experience.

“21st-century dope — especially heroin spiked with synthetic opioids like fentanyl — is more addictive than anything before, according to narcotics experts. The highs are higher, as are the risks of lethal overdose.”

Nick Miroff
The Washington Post, 2017

Moreover, the body becomes dependent on Heroin quickly, relying on the drug instead of natural Opioids released by the body. Once the body develops a tolerance to Heroin, an individual will need to consume more and more of the substance to get the same effects. If an individual doesn’t get enough to sate their craving, or they reduce the amount they use, symptoms of withdrawal will kick in.

Heroin’s Effect on the Body

Once inside the body, Heroin is converted to Morphine and binds to Opioid receptors in the brain (known as mu-Opioid receptors). These cell receptors control feelings of pain and pleasure, and are responsible for regulating heart rate, sleep regularity, and breathing.

Immediate Effects of Use

  • A rush of “euphoria” or “high”
  • Dry mouth
  • Flushed skin
  • Feeling as if arms and legs are heavy
  • Itchy skin
  • Reduced mental performance
  • Floating in and out of consciousness
  • Pain relief
  • Slowed breathing and heart rate

Repeated and frequent use of Heroin causes alterations to certain brain cells and pathways that are not easily reversed and may be, in some cases, permanent. Furthermore, depending on how it’s administered, Heroin use can damage various areas around the body.

Long-term Effects of Use

  • Insomnia
  • Collapsed veins (from injections)
  • Damaged nasal passages (from snorting)
  • Infection in heart tissues
  • Skin abscesses
  • Constipation and digestive complications
  • Liver and kidney disease
  • Pneumonia
  • Depression
  • Antisocial personality disorder
  • Sexual dysfunction in men
  • Irregular menstrual cycles in women
  • Impaired decision-making
  • Inability to regulate emotional responses to stressful situations

Some of the health consequences of Heroin use stem from dangerous behaviors that individuals with a Heroin Use Disorder engage in. For instance, needle sharing can result in contracting diseases like HIV/AIDS and Hepatitis C.

What’s in Heroin?

Heroin is refined from seed pods of the Opium poppy plant using a number of chemicals and additives, many of which are harmful on their own. Lime (calcium hydroxide), commonly used to treat sewage, is used during the refining process as well as ammonia, which is notably caustic and hazardous in concentrated forms. Acids, chloroform, activated charcoal, and ethanol may also be used during this process.

Drug trafficking organizations and street dealers often “cut” their Heroin with sugar, starch, powdered milk, quinine, or deadlier Opioid analogs like Fentanyl.

Heroin may also be mixed with Cocaine, known as a Speedball. The addition of a stimulant does not cause the seemingly opposite symptoms of both drugs to negate each other but, instead, augments the effects of both. The effects of speedballing can be fatal.

Heroin Overdose and Withdrawal

Even if it’s an individual’s first time trying Heroin, they are at risk of experiencing an overdose. Overdose occurs due to the direct effects Heroin has on the Central Nervous System (CNS). Most typically, overdose causes an individual’s breathing is reduced to the point that their brain no longer receives a sufficient amount of oxygen. If this goes on too long (about six minutes), the brain begins to die. However, reported causes of death from Heroin overdose include cardiac arrest, respiratory failure, cardiorespiratory arrest, hyperkalaemia, pulmonary edema in lung tissue sections, rhabdomyolysis, coma, and convulsions. Heroin overdoses can be reversed with Naloxone (in the form of Narcan® nasal spray or Evzio® injections), but if these are not administered quickly enough, some brain damage may occur.

Naloxone works by binding to Opioid receptors in the brain and blocking Heroin from bonding with them. The effects of Naloxone typically begin between 2 – 5 minutes after it is administered. If there is any amount of Opioids in the person’s system, they will go into immediate withdrawal.

Symptoms of Withdrawal

  • Restlessness
  • Muscle and bone pain
  • Insomnia
  • Diarrhea
  • Sweating
  • Anxiety
  • Agitation
  • Nausea and vomiting
  • “Goosebumps”
  • Involuntary muscle movements
  • Gastrointestinal issues
  • Runny nose
  • Teary eyes
  • Irritability
  • Drug dreams

For most people, Heroin withdrawal begins within a few hours of their last dose. Symptoms worsen within 24 to 48 hours, feeling like the worst case of the flu the individual has ever had. After a week, most symptoms of withdrawal subside. However, some people may exhibit symptoms for months after quitting Heroin, known as Post-Acute Withdrawal Syndrome or PAWS.