The Various Ways Heroin Is Taken

Hand cooking heroin on a spoon over a candle flame
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Heroin is a highly addictive drug that is used in various ways. In addition to the classic injection method, it can be snorted, sniffed, and smoked, depending mainly on the purity of the drug and the preference of the user.

Heroin can be injected into a vein or a muscle. It can be smoked in a pipe or mixed with a marijuana joint or a regular cigarette. Its smoke can be inhaled through a straw, a process known as "chasing the dragon." As a powder, it can be snorted.

People who inject heroin feel the effects the quickest. When heroin is mainlined, people can usually begin to experience a feeling of euphoria within seven to eight seconds. When it is smoked, people will typically feel its peak effects in 10 to 15 minutes.

Research suggests that injection is the route of administration chosen by about half of people who use heroin.

Heroin Is a Highly Addictive Drug No Matter How It's Taken

The higher purity heroin that can be snorted or smoked also appeals to people who have just started taking heroin and who may be leery of injection drug use, according to the National Institute on Drug Abuse.

Injection users of heroin generally have a higher rate of addiction or dependence on the drug compared with those who snort or smoke it. Injection users tend to use more often and develop a tolerance to the drug more quickly.

No matter how heroin is used—injected, snorted, or smoked—it is highly addictive, due in part to the development of tolerance to the drug which requires greater dosages to achieve the same results.

The Rush Is Greater for Injection Users

Shortly after injecting heroin, people report that they feel a surge or "rush" of euphoria, dry mouth, a warm flushing of the skin, and heaviness in the extremities. After this initial euphoric feeling, people will enter a state that alternates between drowsiness and wakefulness, during which mental functioning becomes hazy.

Those who snort or smoke heroin may not feel the intense rush that injection users feel but will experience the same other effects. Traditionally, the majority of people seeking treatment for heroin abuse were injecting the drug, but the availability of pure heroin has created a shift toward sniffing and smoking the drug, particularly among young people.

The Ritual of Injecting Heroin

The process of getting heroin ready to inject can become a ritual for those who choose to mainline the drug. Just as how carrying, lighting, and holding a cigarette becomes a part of the ritual for people who use tobacco, getting ready to shoot heroin can also become very ritualistic.

Heroin comes in a powder or tar-like form so in its natural state it cannot be directly injected into the body, it must be changed into liquid form first. Typically, heroin is placed into a spoon and mixed with liquid and heated. Citric acid is sometimes used because it helps break down the heroin. The heroin, citric acid, and water are heated in the spoon using a lighter or candle until it becomes liquefied.

Some people will place a cigarette filter or a tightly rolled up ball of cotton into the spoon and let it absorb the liquid. They will then draw the liquid into a syringe through the filter to eliminate impurities.

People will then tie a belt or shoelace around the upper arm to cause their veins to stand out, just as phlebotomist does with a tourniquet when drawing blood for medical testing. When the process has become a ritual, people will begin by laying out their "works" on display—the heroin, syringe, spoon, lighter, filter or cotton, belt, citric acid, water, and alcohol swabs—and placed in order of use.

The alcohol swab is used to clean the spoon and the place of injection on the body. Most people begin by injecting heroin in the arm because it is the easiest method, but as their veins collapse or become damaged, they will inject into other areas—behind the knees, between the toes, or in the neck.

Consequences of Using Heroin

Heroin overdoses depress heart rate and breathing. People who have overdosed must be rescued by medical personnel or they may die. Tolerance and physical dependence on the drug develop swiftly, with withdrawal symptoms when the drug is not taken. Addiction can follow, with seeking and using the drug becoming the primary focus of an individual's life.

People who inject drugs, including heroin, are at high risk for HIV, hepatitis B, and hepatitis C. But those who smoke or snort heroin are also at increased risk of HIV/AIDS and hepatitis because they are more likely to have unprotected sex while under the influence.

Women who use heroin during pregnancy pass the drug to their fetus through the placenta, causing the baby to be born dependent on the drug and resulting in neonatal abstinence syndrome (NAS). They also have a risk of spontaneous abortion during pregnancy.

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