Also known as dope, junk, horse and smack among, other slang terms, heroin is a white to dark brown powder or tar-like substance. It used in a variety of ways, often injected into a vein or muscle, placed on tinfoil and inhaled as smoke through a straw or snorted as powder.

Heroin causes a surge of euphoria (rush) accompanied by a warm flushing of the skin and heavy limbs. Following this initial euphoria, a person goes “on the nod,” an alternately wakeful and drowsy state.

Long-term effects of heroin appear after repeated use for some period of time. Chronic use may lead to collapsed veins, infection of the heart lining and valves, abscesses (swollen tissue with pus), constipation and gastrointestinal cramping, and liver or kidney disease. Pulmonary complications, including various types of pneumonia, may result from the poor health of the person using heroin as well as from the drug’s effects on breathing. In addition to the effects of the drug itself, street heroin may have additives that do not really dissolve and clog the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs. With regular heroin use, tolerance develops.

As higher doses are used over time, physical dependence and addiction develop. With physical dependence, the body has adapted to the presence of the drug and withdrawal symptoms may occur if use is reduced or stopped. Withdrawal, which in people who use heroin regularly may occur as early as a few hours after the last administration, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps (cold turkey), kicking movements (kicking the habit) and other symptoms. Major withdrawal symptoms peak between 24 and 48 hours after the last dose and subside after about a week.

Medications can make it easier to wean your body off heroin and reduce cravings. Buprenorphine and methadone work in a similar way to heroin, binding to cells in your brain called opioid receptors. These medicines are safer and longer-lasting than heroin. Naltrexone blocks those receptors so opioids like heroin don’t have any effect. This makes using them less enjoyable.

Cognitive behavioral therapy helps you pay attention to the things you think and do when it comes to drug use. It gives you ways to better cope with stress and other triggers. Another type of therapy called contingency management offers rewards such as vouchers or money if you can stay drug-free.

The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains a Web site (findtreatment.gov) that shows the location of residential, outpatient, and hospital inpatient treatment programs for drug addiction and alcoholism throughout the country.

The National Suicide Prevention Lifeline offers more than just suicide prevention it can also help with a host of issues, including drug and alcohol abuse, and can connect individuals with a nearby professional. People can also find more information about how to treat Heroin in Treat OUD.

When people addicted to opioids like heroin first quit, they undergo withdrawal symptoms (pain, diarrhea, nausea, and vomiting), which may be severe. Medications can be helpful in this detoxification stage to ease craving and other physical symptoms that can often prompt a person to relapse. The FDA approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms. While not a treatment for addiction itself, detoxification is a useful first step when it is followed by some form of evidence-based treatment.

Medications developed to treat opioid use disorders work through the same opioid receptors as the addictive drug, but are safer and less likely to produce the harmful behaviors that characterize a substance use disorder. Three types of medications include: agonists, which activate opioid receptors: partial agonists, which also activate opioid receptors but produce a smaller response; and antagonists, which block the receptor and interfere with the rewarding effects of opioids. A particular medication is used based on a patient’s specific medical needs and other factors.

The many effective behavioral treatments available for opioid use disorder can be delivered in outpatient and residential settings. Approaches such as contingency management and cognitive behavioral therapy have been shown to effectively treat heroin use disorder, especially when applied in concert with medications. Contingency management uses a voucher based system in which patients earn points based on negative drug tests, which they can exchange for items that encourage healthy living. Cognitive-behavioral therapy is designed to help modify the patient’s expectations and behaviors related to drug use and to increase skills in coping with various life stressors. An important task is to match the best treatment approach to meet the particular needs of the patient.

Heroin is an illegal, highly addictive drug processed from morphine, a naturally occurring substance extracted from the seedpod of certain varieties of poppy plants. It is typically sold as a white or brownish powder that is cut with sugars, starch, powdered milk, or quinine. Pure heroin is a white powder with a bitter taste. Important: Just because a drug is pure does not mean that it is healthy or good for you. It can be toxic or poisonous to your body. Highly pure heroin can be snorted or smoked and may be more appealing to new users because it eliminates the stigma associated with injection drug use. "Black tar” heroin is sticky like roofing tar or hard like coal. Its dark color results from crude processing methods that leave behind impurities. Impure heroin is usually dissolved, diluted, and injected into veins, muscles, or under the skin.

According to the Drug Enforcement Agency, opium poppy flowers flourish best when grown in arid, warm climates. Too much moisture during the growing process can affect the chemical dilution of the sap, leading to a less potent end product.

The flower is grown wherever is possible due to the lucrative nature of poppy cultivation, but the majority of large-scale production occurs throughout much of Central Asia as well as in the drier regions of the Middle East. We also see an influx of opium poppies grown in Central America and Colombia.

Long-Term Effects

Sometimes, heroin is combined with illicit stimulants like cocaine and taken as a speedball. A person may mix the two so that the cocaine combats the sedating effects of heroin.
Heroin is a central nervous system depressant. Like other opioids, it slows down, or depresses, activity in the central nervous system.

The drug achieves its effects by binding to mu-opioid receptors in the brain. It also targets the brain’s reward system, leading to a compulsion to take the drug, which can result in addiction.

Drug treatment can include behavioral therapy such as cognitive-behavioral therapy or contingency management, medications, or their combination. The specific type of treatment or combination of treatments will vary depending on the patient's individual needs and, often, on the types of drugs they use.