Heroin is one of the most addictive and harmful illicit drugs and is widely abused in the US. More people die each year from overdosing on opioids (like heroin) than any other type of drug. Treatment helps many people overcome heroin addictions and begin the process of recovery.
- The National Institute on Drug Abuse reports that nearly one in four people (23%) who try heroin will become addicted.
- Last year, over 105,000 people died from a fatal drug overdose, and the vast majority of these deaths were caused by an opioid drug like heroin.
- People who overdose on heroin need immediate medical attention to prevent death from hypoxia (lack of oxygen). Certain medications like naloxone can help to reduce the effects of a heroin or opioid overdose, potentially saving lives.
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Understanding heroin
Heroin is a powerful opioid drug derived from the poppy seed, which is used to create opium and other prescribed painkillers like OxyContin, morphine, and Vicodin. All drugs made from processing poppy seeds (including heroin) belong to a class of drugs called opiates. These drugs are used medicinally to relieve pain but are also widely abused for their euphoric effects.[2]
Heroin can be taken in many forms, but is most commonly injected into the veins through a syringe. In 2022, over 100,000 people died from a fatal drug overdose, and the vast majority of these deaths were caused by opioid drugs like heroin.[1]
Recently, the black market supply of heroin has been contaminated with fentanyl, a deadly synthetic opioid that is 50-100 times more powerful than heroin. This is believed to cause the vast majority of fatal heroin overdoses and is often sold as heroin to unsuspecting buyers.[1]
Other names for heroin
Heroin has many street names, some that date back decades, as well as modern iterations, such as using emojis that represent the drug (e.g., dragons or brown shapes). Heroin has nicknames based on its appearance, effects, origins, and wordplay around heroin. Some of these terms are intended to deceive law officials, while others are used as common vernacular amongst abusers and addicts. Some of the most common land names for heroin include:
- Horse.
- H (or 'Big H').
- Black tar.
- Skag.
- Smack.
- Dr. Feelgood.
- Bart Simpson.
- Antifreeze.
- Tootsie roll.
- D.O.A. (dead on arrival).
- Brown (or 'golden brown').
- The Witch.
The cost of heroin
As a collected average of all states, the most common street price for a gram of heroin is around $307, according to the United Nations Office on Drugs and Crime.[8] As with all substance abuse, the cost of supporting addiction always outweighs that of receiving treatment.
The cost of heroin varies greatly across the United States. There are many reasons for variation in heroin cost between states, including the purity of the drug, the socioeconomic status of the area, the popularity of the substance, and the presence of crime.
Heroin use disorder
Heroin is a highly potent opiate depressant that affects the brain's opioid receptors and limbic reward system in a similar way to prescription painkillers. Like other opioids, heroin floods the brain with endorphins, a chemical that occurs in the brain to cope with pain. The high levels of endorphins produced when taking heroin overwhelm the brain and create intense feelings of pleasure and euphoria.
As the limbic reward system is effectively ‘hijacked’ by heroin use, it builds up a tolerance to it rapidly, meaning users feel like they have to take the drug again frequently. This drive and repeated use are what cause heroin dependence to form quickly, and what eventually lead to heroin addiction. The National Institute on Drug Abuse reports that nearly one in four people (23%) who try heroin will become addicted.
Signs and symptoms of heroin use disorder
Heroin abuse or addiction will always be diagnosed by licensed mental health, addiction, or medical professionals. During a clinical assessment, these professionals will determine if someone has a heroin use disorder (the clinical term for heroin addiction) based on whether they have two or more of the following indicators: [3]
- Hazardous heroin use.
- Social or interpersonal problems related to heroin use.
- Neglected major responsibilities to use heroin.
- Experiencing heroin withdrawal symptoms.
- Developing a tolerance.
- Using larger amounts.
- Repeated attempts to quit or control heroin use.
- Excessive time spent using heroin.
- Physical or psychological problems related to heroin use.
- Activities replaced by heroin use.
- Heroin craving.
These criteria are measured on a spectrum of mild, moderate, and severe. Meeting 1-2 criteria is defined as mild, 3-5 moderate, and 6+ severe.[3]
Effects of heroin use
The initial high tends to be the most powerful, and many users will try to ‘chase’ this feeling, but because tolerance develops quickly, the drug can lose its pleasurable effects rapidly. Many people up their dose to chase this initial high, but this greatly increases the risk of addiction and accidental overdose.
Related: How long does heroin stay in your system?
The initial effects of heroin appear harmless; even those experiencing dizziness and tiredness describe the sensation as enjoyable. It also has no immediate comedown or hangover, which may appeal to new heroin users. Still, heroin is highly addictive and can quickly lead to addiction.
Once addicted, the user is unable to feel normal without the drug and can quickly spiral into a pattern of problem use that begins to impact their physical and mental health, relationships, and ability to function.
Heroin overdose
The most dangerous risk associated with heroin use is that of fatal overdose, which is often accidental in nature. Because users may receive heroin that is of varying purity and because of the increasing use of fentanyl being sold as heroin, the risk of overdose is high.[4] People who overdose on heroin need immediate medical attention to prevent death from hypoxia (lack of oxygen). Certain medications like Naloxone can help to reduce the effects of a heroin or opioid overdose, potentially saving lives.
The signs of overdose on heroin or other opioids are:
- Shallow breathing.
- Small pinpoint pupils.
- Extreme drowsiness.
- Loss of consciousness.
- Slow or weak pulse.
- Bluish lips or nails.
- Dizziness or confusion.
Help overcoming heroin addiction
Heroin is a highly potent and addictive drug. Those suffering from a heroin use disorder often find it extremely hard to overcome without help. Fortunately, there are heroin addiction treatment and rehab centers up and down the country that offer medical and psychological support to those suffering from addiction.
If you or someone you know is suffering from heroin addiction, talking to a licensed professional can help you determine treatment options and which may be the best for you.
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