Heroin and Alcohol Consumption

heroin in a spoon
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Heroin is an opiate processed from morphine extracted from the seed pods of certain varieties of poppy plants. It is an illegal and highly addictive drug sometimes cut with other powder, including sugar, starch, powdered milk or quinine, to increase volume, which helps the person selling it make more money.

Between 1999 and 2019, the death rate from drug overdoses in the United States tripled. In that same timeframe, the rate of overdose deaths involving heroin increased six-fold, according to the Centers for Disease Control and Prevention.

Pure and Black Tar Heroin

In the United States today, you can buy two types of heroin: pure heroin and "black tar" heroin.

Pure heroin comes from South America and Southeast Asia and is a white powder with a bitter taste. Most of the heroin sold in the eastern United States is this form of heroin.

Black tar heroin comes from Mexico and is sold mainly in the states west of the Mississippi River. It is typically sticky like roofing tar or hard like coal and gets its dark color from the processing, which leaves behind impurities.

Injected, Snorted and Smoked

A user injects, snorts or smokes heroin to get their fix. All methods deliver this drug to the brain quickly.

For black tar heroin, an individual usually dissolves and dilutes the drug, then injects it. Heroin in its powder form, on the other hand, can be more desirable to new users not ready to begin injection drug use because they can snort it. You can smoke either kind.

How Heroin Affects the Brain

Once heroin enters your brain, the body converts it back to morphine and it binds to opioid receptors, located in many areas of your brain and body. The changes heroin causes in your brain causes its high risk for addiction and the chronic recurrence of addiction symptoms that may follow after treatment. 

Long-term effects of heroin addiction on the brain include:

  • Tolerance - over time you will need more of the drug to achieve the same effect
  • Dependence - you will need to use heroin do prevent withdrawal symptoms
  • Possible deterioration of the brain's white matter, which affects your ability to make decisions, regulate behavior, and appropriately respond to stressful situations

Alcohol and Heroin Is a Deadly Combo

A person who overdoses is likely to be under the influence of more than one substance. Studies show that 47% to 98% of overdose deaths involve multiple drugs (depending on the location and drugs being studied).

A combination of alcohol and heroin is especially dangerous because both substances suppress your ability to breathe. If you can't breathe properly, the lack of oxygen can cause hypoxia, which can result in short- and long-term effects, including coma and permanent brain damage. Respiratory failure is an overwhelmingly common cause of overdose deaths.

Effects of Heroin Treatment on Alcohol Consumption

Drinking alcohol is a suggested risk factor for heroin addiction. When someone with opioid addiction goes n into treatment, either methadone maintenance treatment (MMT) or heroin-assisted treatment (HAT), their alcohol consumption often goes down too, according to a study published in the journal Alcohol. Researchers found the HAT patients had a greater reduction in alcohol consumption.

7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute on Drug Abuse. Heroin DrugFacts.

  2. Centers for Disease Control and Prevention; National Center for Health Statistics. Drug overdose deaths in the United States, 1999–2019.

  3. National Institute on Drug Abuse. What is heroin and how is it used?.

  4. Gerber H, Borgwardt SJ, Schmid O, et al. The impact of diacetylmorphine on hypothalamic-pituitary-adrenal axis activity and heroin craving in heroin dependence. 2012;18(3):116-123. doi:10.1159/000334411

  5. Peppin JF, Raffa RB, Schatman ME. The polysubstance overdose-death crisis. J Pain Res. 2020;13:3405-3408. doi:10.2147/JPR.S295715

  6. Jolley CH, Bell J, Rafferty GF, Moxham J, Strang J. Understanding heroin overdose: a study of the acute respiratory depressant effects of injected pharmaceutical heroin. PLoS ONE. 2015;10(11):e0143672. doi:10.1371/journal.pone.0143672

  7. Haasen C, Eiroa-Orosa FJ, Verthein U, et al. Effects of heroin-assisted treatment on alcohol consumption: findings of the German randomized controlled trial. Alcohol. 2009;43(4):259-264. doi:10.1016/j.alcohol.2009.02.007

By Buddy T
Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.