Although rates of heroin use are relatively low as compared to rates for other drugs, the impact of heroin use is devastating. Heroin users face health and social consequences that also affect society as a whole and cost billions of dollars each year. Since 2007, the number of people who use heroin has steadily risen, causing concern for many communities.
What is Heroin?
Heroin is a highly addictive opioid drug made from morphine, a substance extracted from the poppy plant. The milky, thick opium is first extracted from the pod of the poppy flower and then further refined to produce various forms of heroin. Heroin appears most commonly in the form of a white or brown powder and is also called “big H,” “hell dust,” and “smack.” The drug has received increasing media coverage because of its rise in popularity and sometimes fatal consequences.
Types/Forms of Heroin
The drug known as heroin is a mixture of diacetylmorphine and other filler ingredients. Heroin is sold in three different forms:
- Brown powder heroin
- Black tar heroin
- White powder heroin
The differences in consistency and color are due to the addition of filler ingredients that affect the potency of the drug. In many cases, the additives make the heroin drug more potent and more dangerous to use. Street heroin may contain fillers that are made from other drugs, such as methamphetamine. The presence of fentanyl in heroin is concerning for heroin users, as the chances of overdosing or having a fatal reaction increase when other psychoactive ingredients are added to the heroin.
Common Forms of Substance
Black tar heroin comes in the form of a hard, black chunk. This form of heroin is the least refined and still contains partially processed forms of opiate. Black heroin use increased in the 1970s in the United States, mostly because the cost was lower and the accessibility greater.
When black tar heroin is further processed and cut with lactose, brown powder heroin is produced. White powder heroin is the most pure, although it is typically mixed with other white powders to improve profitability, which increases the risk factor. Chemical additives and fillers increase the chances of side effects and adverse health risks.
In its purest form, heroin can look similar to cocaine or amphetamines. The more shiny the white powder appears, the more pure it is. When the powder appears to be dull, it has been cut with another white substance. Brown powder or black tar-like heroin is a sign that the drug is not very pure.
Since heroin can be ingested by smoking it, snorting it, or injecting it, different paraphernalia is associated with it and can help with identifying whether the drug is heroin.
What Are the Effects of Heroin
The heroin drug binds to and activates the mu-opioid receptors (MORs) in the brain. These receptors are designed to regulate pain and feelings of well being. MORs are located in the reward center of the brain and when they are stimulated, they release dopamine, which provides a euphoric feeling.
Short-Term Heroin Use
Heroin causes an intense rush or quick surge of pleasure. Typically the user’s skin will become flushed, their mouth becomes dry and their arms and legs may feel unusually heavy. Several hours of drowsiness may follow, as well as slowed cognitive function, heart rate and respiration.
Long-Term Heroin Use
When a person uses heroin for an extended period of time, the actual structure of the brain is changed. Deterioration of the brain can occur, causing imbalances that affect decisionmaking and the ability to regulate your behavior. Chronic heroin users are known to develop severe tolerance and physical dependence. This means that while the body demands the drug, it takes increasingly more of the substance to achieve the same “high.” Symptoms of withdrawal may also develop within a few hours of consuming the drug.
Health Concerns of Heroin Use and Pre-Existing Conditions and Complications
Regardless of the purity of the drug or how it is administered, heroin users are prone to several medical complications. Insomnia and chronic constipation are two of the most common side effects of heroin use. Lung and heart complications including pneumonia and heart failure may result from extended use. Mental disorders, such as depression and a variety of personality disorders, may also result from chronic heroin use.
Other common medical concerns are:
- Nasal complications
- Collapsed veins
- Bacterial infections of the blood
- Hepatitis B and C
People who have pre-existing conditions, such as asthma or compromised immune systems, experience a higher risk of severe health complications and possibly even death.
Heroin Vs. Other Drugs of Abuse
Oftentimes when people have experimented with other drugs, they have an urge to know what the “heroin high” feels like. In many instances, the heroin high is an escape from physical and emotional pain: Its users take it to numb painful or difficult feelings and sensations. This dynamic can also explain why people take other drugs of abuse, such as alcohol and marijuana, but these other drugs are recreationally used much more commonly than heroin.
History of This Drug
First produced in 1898, heroin was first manufactured by the Bayer pharmaceutical company primarily as a treatment for tuberculosis. Ironically, it was also marketed as a treatment for morphine addiction. Beginning in the 1850s, opium was commonly used both as a painkiller and for recreational purposes in the United States.
Morphine was introduced as a less addictive alternative to opium, but soon grew to become a larger problem than opium addiction. In the late 1800s, heroin powder was prescribed to combat morphine addiction. Once again, heroin escalated into a more problematic addiction than morphine.
By the late 1990s, heroin addicts were estimated to be on average 20 times more likely to experience an untimely death than the rest of the population. High rates of mortality plague heroin addicts today in what is now called an “opioid epidemic.”
Heroin Combined with Other Substances
A great many heroin users also use at least one other drug. When combined with other substances, heroin can become more risky than when taken alone. Consuming alcohol along with heroin can lead to intensely shallow breathing and low blood pressure which can result in a drug overdose. Benzodiazepines are used to treat anxiety and insomnia. When used in conjunction with heroin, the chances of overdose increase. Additionally, the combination of drugs also renders naloxone, the overdose reversal drug, ineffective. The most common combination is when heroin is mixed with cocaine. Known as a “speedball,” the use of heroin and cocaine together both depresses and stimulates the central nervous system, leading to breathing difficulties and heart palpitations.
How Heroin Is Addictive
Physical dependence on heroin can occur after repeated use. However, even just one-time use of the drug can create mental and psychological dependence, compelling the user to use more frequently to achieve the euphoria they desire. The initial decision to take heroin is voluntary, but repeated use can change the brain in ways that compromise an addicted person’s self-control. Their ability to resist taking more of the drug soon diminishes. Meanwhile, the resulting brain changes are persistent, which is why drug addiction is an uncurable, “relapsing” disease. Once in recovery from heroin drug use, you are still at increased risk for returning to heroin use. The fact that heroin is so habit-forming, and can unleash mechanisms of addiction that are extremely hard to break, makes early intervention and treatment for the drug of urgent importance.