Frequently Asked Questions About Heroin Usage

Cooking Heroin in a Spoon over a candle

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Although heroin abuse has trended downward for several years, it has regained popularity in the aftermath of the government's crackdown on prescription drug abuse.

When authorities began closing down the "pill mills" in Florida and other locations and set up prescription-tracking programs to prevent patients from "doctor shopping" to get more than one prescription for pain pills, it made obtaining painkillers more difficult and drove up the price on the black market.

Therefore, heroin became more available in some areas than OxyContin and was cheaper, the nation began to see a dramatic increase in heroin overdose deaths. An increase in the purity of heroin available on the market and a decrease in prices has created a concern for public safety.

Here are the most frequently asked questions about heroin, compiled by the National Institute on Drug Abuse.

What Is Heroin?

Heroin is a highly addictive drug that is processed from morphine extracted from the seed pods of poppy plants. In the eastern United States, most of the heroin sold on the street is white powder pure heroin, which is processed in South America and Southeast Asia. On the U.S. west coast, the main heroin sold is dark sticky "black tar" heroin which is produced in Mexico.

What Is the Scope of Heroin Use in the United States?

After years of declining use in the United States, in 2006 heroin use began a steady increase in usage across cultural and geographic lines throughout the country. The increase coincided with a nationwide crackdown on prescription drug abuse. Some observers believe the resulting declining supply and increasing prices of pain pills drove users to turn to more available and cheaper heroin.

How Is Heroin Used?

The pure heroin sold mostly in the eastern U.S. is usually a white powder that can be injected, snorted, sniffed or smoked. The black tar heroin popular in the western part of the country is usually dissolved and diluted then injected by the user. Many of the new users of heroin are smoking it, under the misconception that it is less addictive if smoked.

What Are the Immediate (Short-Term) Effects?

Whether heroin is injected, snorted or smoked, the user experiences an immediate "rush" followed by a feeling of euphoria as it is converted back to morphine in the brain. The only difference is the user experiences the rush more quickly if the heroin is injected or snorted than he does if the drug is smoked. The high is not only quicker, but it is also more intense.

What Are the Long-Term Effects?

Heroin users quickly build up a tolerance to the drug, meaning that they need more of it or need it more often to achieve the same effect that they felt when they first used it. Consequently, with the increased usage, they can become addicted very quickly. Heroin also can cause physical and physiological changes and imbalances in the brain that are very difficult to reverse, even when the user gets clean and sober.

What Are the Medical Complications of Chronic Use?

Because heroin use depresses respiration, many users develop lung complications, which along with the general poor health of the user can result in contracting tuberculosis and some types of pneumonia. There are many other negative medical consequences due to use of the drug itself and others related to how heroin is used and other substances mixed with the drug to increase the profits of dealers.

How Does Heroin Abuse Affect Pregnant Women?

If a woman uses heroin while she is pregnant, her unborn child can develop a dependence on the drug just as the mother does. When the baby is born and is no longer receiving a supply of heroin through the placenta, the child goes into a condition known as neonatal abstinence syndrome (NAS), requiring extensive medical treatment.

Why Are Users at Special Risk for Contracting HIV/AIDS and Hepatitis B and C?

Simply using heroin by itself does not increase the risk of contracting HIV or hepatitis. But, activities and behaviors associated with heroin use can increase the risk of being exposed to diseases and virus infections. Unprotected sex, using "dirty" needles, sharing needles and sharing other paraphernalia can increase the risks.

What Are the Treatments for Addiction?

Unlike some other drugs like methamphetamine, there are a variety of treatment options available to those who have a desire to stop using heroin. There are several medications available that help with quitting heroin that research has found to be effective if combined with other behavioral therapies.

What Are the Opioid Analogs and Their Dangers?

Chemical compounds that have similar effects of other drugs although different in the chemical structure are called drug analogs. Some of these are legitimate, produced by drug manufacturers for medical use.

Other drug analogs, however, are produced illegally and sometimes are more dangerous and potent than the original drug. These analogs are sometimes called designer drugs.

Two of the most well-known opioid analogs are fentanyl and meperidine (marketed under the brand name Demerol). Fentanyl was developed in 1968 as an analgesic during surgery because of its minimal effects on the heart.

Fentanyl is particularly dangerous because it is 50 times more potent than heroin and can quickly stop the person's breathing. In a surgical setting, that is not a problem because the patient is on a machine to help them breathe.

But when abused illegally, on the street, fentanyl can be deadly.

In early 2014, a rash of drug overdoses was reported as a result of heroin being sold on the street that had been mixed with fentanyl.

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  • National Institute on Drug Abuse. "Heroin." Research Report Series Updated January 2014

  • The Partnership at DrugFree. "Heroin." Drug Guide.