Heroin is a dangerous and illegal drug with a high addictive potential. It is also an effective painkiller.
Heroin belongs to the opioid family of drugs. Also in the opioid family are the “opiates,” such as morphine and codeine, which
are natural compounds found in the opium poppy; and “synthetic” opioids, such as Demerol (meperidine) and methadone, which
are chemically manufactured. Heroin is a “semi-synthetic” opioid: it is made from morphine that has been chemically processed.
It enters the brain quickly and produces a more immediate effect. Heroin is converted back into morphine in the brain.
When heroin was first introduced in the late 19th century, it was promoted as a pain reliever and cough suppressant. By the
early 20th century, the dangers of heroin were recognized. Laws were introduced throughout North America and Europe to restrict
the production, distribution and use of heroin. In some countries, there are circumstances where heroin may be prescribed
by physicians. In the United Kingdom, for example, doctors may prescribe heroin for extreme pain. This treatment is usually
reserved for patients who are terminally ill. In the United Kingdom, the Netherlands, Switzerland, Germany, Spain and Denmark,
a small number of people who are addicted to heroin, and who have not responded to other treatments, receive heroin by prescription
in carefully monitored maintenance programs.
| Street names: |
junk, H, smack, horse, skag, dope |
What does it look like and how is it used?
In its pure form, heroin is a fine, white, bitter-tasting crystalline powder that dissolves in water. When it is sold on the
street, its colour and consistency vary, depending on the manufacturing process and what additives it has been mixed, or “cut,”
with. Street heroin may come in the form of a white powder, a brown and sometimes grainy substance or a dark brown sticky
gum. The purity of heroin varies from batch to batch, and can range from two to 98 per cent.
Some additives, such as sugar, starch or powdered milk are used to increase the weight for retail sale, or other drugs may
be added to increase the effects of the heroin. Quinine may be added to imitate heroin's bitter taste, making it difficult
to determine the purity of the drug.
The most common ways of using heroin are:
• injection—either into a vein (“mainlining,” intravenous or IV use), into a muscle (intramuscular or IM use) or under the
skin (“skin-popping” or subcutaneous use)
• snorting—inhaling the powder through the nose (also called sniffing)
• inhaling or smoking—this method is also referred to as “chasing the dragon,” and involves gently heating the heroin on aluminum
foil and inhaling the smoke and vapours through a tube.
Injection may be chosen because this method gives the greatest and most immediate effect for the least amount of drug. People
who are addicted to heroin may inject two to four times a day. The drug is more likely to be snorted or smoked when heroin
of high purity is available, or by occasional users who prefer not to inject.
Most heroin is produced in Asia and Latin America, where opium poppies are grown. Morphine is extracted from the opium gum
in laboratories close to the fields, and then converted into heroin in labs within or near the producing country.
How does heroin make you feel?
The way heroin, or any drug, affects you depends on many factors, including:
• your age
• how much you take and how often you take it
• how long you've been taking it
• the method you use to take the drug
• the environment you're in
• whether or not you have certain pre-existing medical or psychiatric conditions
• whether you've taken any alcohol or other drugs (illegal, prescription, over-the-counter or herbal).
When heroin is injected into a vein, it produces a surge of euphoria, or “rush.” This effect is felt in seven or eight seconds,
and lasts from 45 seconds to a few minutes. The initial effect with snorting or smoking is not as intense. Following the rush
comes a period of sedation and tranquility known as being “on the nod,” which may last up to an hour. When heroin is injected
under the skin or into a muscle, the effect comes on more slowly, within five to eight minutes.
New users often experience nausea and vomiting. The desired effects include detachment from physical and emotional pain and
a feeling of well-being. Other effects include slowed breathing, pinpoint pupils, itchiness and sweating. Regular use results
in constipation, loss of sexual interest and libido, and an irregular or stopped menstrual cycle in women.
Heroin use causes changes in mood and behaviour. People who are addicted to heroin may be docile and compliant after taking
the drug, and irritable and aggressive during withdrawal.
How long do the effects last?
Regardless of how it is used, the effects of heroin generally last for three to five hours, depending on the dose.
People who use heroin daily must use every six to 12 hours to avoid symptoms of withdrawal. The initial symptoms are intense,
and include runny nose, sneezing, diarrhea, vomiting, restlessness and a persistent craving for the drug. Also associated
with withdrawal are goosebumps and involuntary leg movements, leading to the expressions “cold turkey” and “kicking the habit.”
Withdrawal symptoms peak within a couple days, and usually fade within five to 10 days. Other symptoms, such as insomnia,
anxiety and craving, may continue for some time. Heroin withdrawal is not life-threatening, but can be extremely uncomfortable.
Is heroin dangerous?
Yes. Heroin is dangerous in a number of ways. The most immediate danger is overdose. In an overdose, breathing slows down,
and may stop completely. A heroin overdose can be treated at a hospital emergency room with drugs such as naloxone.
The risk of overdose is increased by the unknown purity of the drug, injecting the drug, and combining heroin with other sedating
drugs, such as alcohol, benzodiazepines or methadone.
Is heroin addictive?
Yes. Regular use of heroin, whether it is injected, snorted or smoked, can lead to addiction within two to three weeks. Signs
of addiction include strong cravings for the effects of the drug, taking more of the drug than intended and continuing to
use the drug despite the problems it may cause. Addiction may develop with or without physical dependence.
Not all people who experiment with heroin become addicted. Some use the drug only on occasion, such as on weekends, without
increasing the dose. With regular use, however, tolerance develops to the effects of the drug, and more and more heroin is
needed to achieve the desired effect. Continuous use of increasing amounts of the drug inevitably leads to physical dependence.
Once dependence is established, stopping use can be extremely difficult. People who have used heroin for a long time often
report that they no longer experience any pleasure from the drug. They continue to use heroin to avoid the symptoms of withdrawal
and to control the powerful craving for the drug, which is often described as a “need.” Cravings may persist long after they
stop taking the drug, which makes it difficult to avoid relapse, or beginning to use again.
What are the long-term effects of using heroin?
Addiction, and the medical, social and legal complications that often result from heroin use, can be devastating to the lives
of the people who use the drug.
Research using brain scans has revealed that long-term regular use of heroin results in changes in the way the brain works.
While the effect of these changes is not fully understood, this research has shown that it may take months or years for the
brain to return to normal functioning after a person stops using heroin.
Methadone maintenance treatment, which prevents heroin withdrawal and reduces or eliminates drug cravings, is the most effective treatment
for heroin addiction currently available.
Mental Health and Addiction 101: Introduction to Addiction
Addiction: An Information Guide
Methadone Saves Lives
Check our Research Studies and Recruitment page
Personal Stories of living with heroin addiction
Read stories of hope and recovery
Centre for Addiction
