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What Is Heroin?

Heroin is a highly addictive drug made from the seed pod of the opium poppy plant. Users take heroin because of the highs, but it can also have dangerous side effects, including death by overdose.

Heroin usually is a powder that can range in color from white to brown. Heroin also comes as a brown, sticky, tar-like substance known as "black tar heroin." The color of heroin powder is generally an indication of how pure it is. Off-white or brown heroin may have impurities or additives that can make it more dangerous.

Heroin is snorted through the nose, smoked, or injected with a needle.

Short-Term Effects

When heroin enters the body, it makes its way to the brain, where it is converted to morphine. The converted heroin affects parts of the brain and brain stem called opioid receptors. These receptors help control the way people sense pain and pleasure. Opioid receptors in the brain stem also help control vital functions such as breathing and blood pressure. Taking too much heroin (overdosing) often causes breathing problems that can be fatal.

The effects of heroin come on quickly, especially if it is injected, and can last anywhere from 3-5 hours. Soon after entering the brain, heroin causes a rush of euphoria, along with dry mouth and a warm flushing of the skin. The person's arms legs, hands, and feet can feel heavy.

After the initial rush goes away, users go back and forth between feeling awake and tired. They may have fuzzy or cloudy thinking. This stage (called going "on the nod") happens because of the drug's depressant effect on the brain and central nervous system.

Other short-term effects of heroin can include:

  • slowed or slurred speech
  • droopy eyelids, constricted pupils, and poor night vision
  • drowsiness
  • feeling disconnected from one's surroundings
  • delirium
  • nausea and vomiting
  • constipation
  • decreased breathing and heart rate
  • severe itching

Long-Term Effects

Long-term use of heroin can lead users to develop a tolerance to the drug. They need larger and larger doses to feel the same effects, and end up addicted to heroin.

Over time, people who inject the drug might get collapsed veins. This can cause problems with blood circulation in the affected parts of the body. Long-time heroin users aren't usually very healthy, so they're more likely to develop lung problems such as pneumonia or tuberculosis.

Other long-term effects include:

  • infection of the heart lining and valves
  • liver or kidney disease
  • large abscesses from infected injection sites

Other Possible Problems

Heroin is one of the easiest drugs to overdose on — it makes no difference if the drug is injected, snorted, or smoked. A heroin overdose can cause slow, shallow breathing; convulsions; coma; and death.

Users who inject heroin have a much greater risk of getting AIDS, hepatitis, and other viruses. This is especially true if users share needles with others.

People who buy heroin have no way of knowing how pure the drug is. Powdered heroin is often mixed with other things, including sugar, starch, quinine, and poisons like strychnine. These extra ingredients can increase the risk of overdose and cause permanent damage to the brain, lungs, kidneys, or liver.

Pregnant women who use heroin can have a sudden miscarriage or babies with a low birth weight. Babies of heroin users can be born addicted to the drug and suffer serious medical problems that may require hospital treatment.

Heroin is an illegal drug that's listed as a Schedule I substance in the United States. This means it has a high potential for abuse and serves no legitimate medical purpose. Possession or use of heroin is punishable by fines and jail time.

How Can Someone Quit?

When someone is addicted to heroin, it can be extremely hard to quit. Many users who try to give up heroin suffer through severe withdrawal symptoms.

Withdrawal symptoms can start as quickly as 6-12 hours after the last dose and can last 5-10 days. They include:

  • insomnia
  • depression
  • restlessness
  • muscle and bone pain
  • diarrhea
  • vomiting
  • alternating hot and cold flashes with goosebumps
  • kicking movements
  • severe cravings for the drug

Heroin users in poor health who quit the drug suddenly can die as a result of their withdrawal symptoms.

Heroin users who successfully quit can still have cravings for heroin years later, especially in situations that remind them of their drug use. People who've quit often end up back on the drug.

Treatments for heroin addiction include the use of medical drugs that help prevent withdrawal symptoms and ease users off heroin. These treatments are usually only given by medical professionals or in treatment centers.

There are also behavioral therapies designed to help people shake a heroin addiction, including group counseling or therapies designed around rewarding users for staying off the drug. Often, behavioral therapies are used along with medical treatments.

Avoiding Heroin

The chance of becoming addicted is higher with heroin than with most other drugs. Sadly, many people become addicted after only one use.

Because all it takes is one time to become addicted, and because that one time can kill you, it's important to avoid heroin at all costs. No amount of temptation (or peer pressure) is worth a life. Even if heroin doesn't end a life, it can definitely ruin one after only one use.

Reviewed by: Julia Brown Lancaster, MSN, WHNP-BC
Date reviewed: February 2014