5 Uncommon Forms of Heroin

FHE Blog - 5 Uncommon forms of heroin

Heroin is one of the common names for an opioid that’s also known as diamorphine, diacetylmorphine and morphine diacetate. Its scientific name given by the International Union of Pure and Applied Chemistry (IUPAC) is (5α,6α)-7,8-didehydro-4,5-epoxy-17-methylmorphinan-3,6-diol diacetate. The molecular formula for heroin is C21H23NO5.

Heroin is often used as a recreational drug due to its powerful euphoric effects. It has no accepted uses in the United States, although it’s also used as a powerful painkiller in other countries. About 1.9 percent of Americans have used heroin at least once as of 2017, according to the National Institute on Drug Abuse.

As a street drug, heroin is rarely sold in pure form since dealers routinely mix it with less expensive ingredients to increase their profit margin. Basic types of heroin are known by their most common color, such as white, brown and black heroin. However, other versions of heroin are less well known, even by those familiar with the drug.

Liquid Heroin

Uncommon Forms of Heroin - Liquid HeroinHeroin is most often available in powder form, but it can also be sold as a liquid. Liquid heroin is typically black tar heroin suspended in water. Black tar heroin is processed with crude methods that result in a high level of impurities that give it a dark color and sticky consistency. Dealers make liquid heroin by heating black tar heroin and mixing it with warm water. They then package the resulting solution in small vials, which are difficult for law enforcement officials to detect as heroin.

The use of liquid heroin is growing in the U.S., largely due to its high profit margin. A single gram of heroin can provide up to 100 doses of liquid heroin, which can be sold for between $5 and $10 depending upon the market. A dealer can therefore sell a gram of heroin for $5,000 to $10,000. Liquid heroin is also more appealing to new users, since it’s inhaled through the nose rather than injected.

Gunpowder Heroin

Gunpowder Heroin - an uncommon form of heroinGunpowder heroin is one of the more uncommon forms of heroin that has recently been appearing on the West Coast, according to a 2016 study in the Journal of Psychoactive Drugs. It’s a type of black tar heroin that first appeared on the streets of San Francisco in 2012. Gunpowder heroin probably originates from Mexico, which has historically been the primary source of black tar heroin on the West Coast.

Gunpowder heroin typically looks like gunpowder or dried coffee grounds. It may be a sticky powder or a solid that crumbles easily, but it can also be a mixture of powder and solid chunks. The color is usually a solid black or dark grey and may also contain white or black specks.

Users disagree as to whether gunpowder heroin is a distinct form of heroin or merely a modified version of it. However, they generally agree that it’s stronger than traditional black tar heroin, which is the primary reason for its growing popularity. Another advantage is that gunpowder heroin is more soluble than black tar heroin, making it easier to inject.


Uncommon forms of heroin - "Cheese" HeroinCheese is generally a combination of heroin and over-the-counter cold medication. It was first reported by The Dallas Morning News from 2005 to 2007 when it became responsible for a series of deaths in Dallas — mostly adolescents. As of 2012, cheese was primarily being used by people who were teenagers in this given historical period.

Users make cheese by crushing tablets of cold medication that contain acetaminophen or diphenhydramine. Acetaminophen is a painkiller that’s the active ingredient in Tylenol, while diphenhydramine is the antihistamine in Benadryl. They then add a street source of heroin such as black tar heroin and typically snort the resulting mixture.

Cheese contains between two and eight percent heroin as compared to the 30 percent concentration that’s typical for black tar heroin. The comparatively low level of heroin in cheese makes it seem like fatal overdoses would be less likely than with traditional forms of heroin. However, cheese is actually more dangerous because it also has very high levels of non-opiates, which emergency personnel must also address at the same time when deciding on a course of treatment.


Dealers often cut heroin with other drugs that are less expensive but still produce euphoric effects similar to that of heroin. Such is the case with fentanyl, which is up to 25 times stronger than heroin but easier to obtain. The use of heroin cut with fentanyl first came to the attention of the media in 2013, when The Boston Sun reported on over 300 deaths caused by fentanyl overdoses. This form of heroin is primarily found on the East Coast, primarily the northeastern United States.

Fentanyl was originally developed as a painkiller in 1959, but its availability as a street drug was greatly restricted until a slow-release patch was produced in the mid-1990s. The use of this patch grew rapidly among recreational users, and Fentanyl is now a well-known substitute for opiates like heroin. Fentanyl-cut heroin is most popular among long-term addicts who have greater difficulty in getting high. However, the greater potency of fentanyl also increases the risk of an overdose.


Carfentanyl is another rare additive in street heroin that has recently come to public attention. This analog of fentanyl was first produced in 1974 as a tranquilizer for elephants, but is now being used to increase the potency of street heroin. The medical examiner in Cuyahoga County, Ohio issued a public health warning advising residents that Carfentanyl was a contributing factor in that state’s high rate of opioid overdoses. Fortunately, the use of Carfentanyl as a heroin additive has remained restricted to a few specific areas.

Carfentanyl has no taste or color, so a typical user can’t detect it in a source of heroin. However, it’s about 2,500 times stronger than heroin, making it one of the most powerful opioids currently available. Carfentanyl’s extremely high potency greatly increases the risk of overdose, since a single drop of the pure drug can be lethal if it’s absorbed through the skin. A standard dose of naloxone will therefore be insufficient to reverse an overdose of Carfentanyl in most cases.

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At FHE Health (FHE), we understand how these forms of heroin can impact our patients’ lives. Our staff of medical professionals has all tools needed to help break the cycle of addiction, allowing patients to live fuller lives. Contact us today to find out how we can help you or your loved ones.

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