Heroin is an illicit substance produced from poppy seeds and sold as a powder or in a sticky or hard substance known as ‘black tar’. Black tar heroin is typically less pure than powdered heroin, although it possesses similar effects and risks. It can also cause a range of health risks that are prevalent specifically with this form of the drug.
- Black tar heroin is a form of heroin produced mostly in Mexico, as a black or brown sticky substance, commonly smoked or injected.
- Black tar heroin is often less pure than powder heroin, although its use carries a range of serious risks and addiction.
- People using black tar heroin can seek professional advice and support to help with safer drug use, withdrawal and detox, or recovery.
What is black tar heroin?
Black tar heroin is produced with crude processing methods, which leave behind an impure product in a dark, solid mass, often sticky or tar-like. [1] The main differences between black tar heroin and powder heroin are: [1][2]
- Appearance: Black tar heroin is a dark brown or black tar-like substance, while powder heroin is a white or off-white fine powder.
- Origin: Black tar heroin is produced primarily in Mexico, while powder heroin originates mostly from South America (particularly Colombia) or, less often, from Southeast Asia.
- Preparation and use: Black tar heroin is usually dissolved and injected or can also be smoked. Powder heroin is snorted, smoked, or injected.
- Purity: Black tar heroin is typically of lower purity than powder heroin, although powders are often mixed or “cut” with other substances.
How black tar heroin is used
Black tar heroin is either smoked or injected. When it is injected, it requires preparation, which typically involves mixing the drug with water and heating it to dissolve the drug in the water. [2]
Effects of black tar heroin
The effects of black tar heroin are reportedly similar to those of other forms of heroin. This can vary depending on the strength of the drug and the administration method. Short-term effects of black tar heroin include: [3][4]
- Sedation
- Euphoria
- Dry mouth
- Lethargy
- Itching
- Pinpoint pupils (unusually small pupils)
- Diarrhea
- Vomiting
- Runny nose
- Slowed breathing
Long-term effects of black tar heroin can include: [3][4]
- Lung and breathing problems
- Heart issues
- Risk of stroke
- Kidney and liver disease
- Increased risk of infectious diseases
- Skin damage at the injection site
- Chronic mental health issues (including changes in mood and psychotic symptoms)
Health risks specific to black tar heroin
There are reports of health risks associated specifically with black tar heroin, including injection-related skin infections and vein damage or loss. [5][6] Reports suggest that black tar heroin is likely to cause soft tissue infection at injection sites, particularly among those who inject intramuscularly or subcutaneously. These infections can result in skin abscesses, which are reportedly more likely to occur with black tar use than powder. [6][7]
Infections can then become severe and even fatal. For example, there are reports of black tar injection users experiencing wound botulism, a serious infection that causes paralysis and may lead to cranial nerve palsy. Similarly, reports indicate a prevalence among this group of necrotizing fasciitis, an infection that causes rapidly progressive tissue death. [5][6][8]
Another issue that is common among people who inject heroin is vein loss or collapse, which is reportedly more prevalent among people who use black tar heroin. [7]
The fentanyl contamination crisis
Fentanyl is increasingly being found in the illicit drug supply, cut with other drugs, as it is cheap to produce and can increase profits. [9] Reports suggest that fentanyl is commonly mixed with white powder heroin in Mexico. Black tar heroin may be less likely to be laced with fentanyl, as it is more difficult to mix with other substances. [9][10]
Addiction and dependence
Black tar heroin is as addictive as the powdered form, and carries the same risks of tolerance, dependence, and overdose. Prolonged and consistent use of black tar heroin can lead to the development of physical dependence, which can result in withdrawal symptoms if use is stopped. Black tar heroin withdrawal symptoms can include: [11]
- Nausea and vomiting
- Diarrhea
- Restlessness
- Aches and pains
- Cold and hot flashes
Addiction to black tar heroin can result in impairments in personal, social, and professional functioning, physical and mental health issues, and increased cravings and use.
Harm reduction strategies
Preparing black tar heroin for injection by using heat can reduce the risk of HIV, as the heat deactivates the virus. Some people reportedly dissolve the heroin in water only, which increases the risk of blood-borne viruses. [12]
Other possible harm reduction strategies available to people who use black tar heroin include: [7][12]
- Utilizing clean needles, which may be available at local needle exchange programs.
- Education around harm reduction and safer use.
- Using the drug at supervised injection facilities, where staff can monitor and treat any dangerous effects and offer other supportive services.
- Drug testing to check for any additional substances.
Evidence-based treatment approaches
Treatment for heroin use issues can include:
- Detox and withdrawal services: Heroin withdrawal can be dangerous and may require professional intervention throughout the process to avoid severe consequences.
- Rehabilitation services: Inpatient or outpatient services provide professional treatment and support, including medications, psychological intervention, holistic therapies, and group support.
- Opioid replacement medications: Commonly used opioid replacement medications include buprenorphine, naltrexone, and methadone, which can be used to help people during the withdrawal process and to help maintain abstinence and recovery.
