Heroin is a Schedule I controlled substance per the Drug Enforcement Administration (DEA), meaning that it is considered to be an illegal drug in the United States. It is sold on the streets as a sticky, brown substance called black tar heroin, or as a brown or white powder, known by the following names:
How Heroin Is Abused
Heroin may be dissolved in liquid and injected, smoked, or snorted. All three methods send heroin quickly into the blood stream for a rush of euphoria, or a “high” that is almost instantaneous and short-lived. The heroin high from smoking or snorting typically lasts 3-5 hours, according to the National Highway Traffic Safety Administration (NHTSA).
Perhaps because of its rapid onset and short duration of effect, heroin is considered to be highly addictive, as individuals often want to take more in order to keep the pleasant feelings rolling. Heroin is an opioid drug, filling up opioid receptors in the brain and throughout the central nervous system, slowing down heart rate, respiration levels, blood pressure, and body temperature. Anxiety is dispelled, pain sensations are blocked, and people using heroin may feel relaxed, drowsy, mellow, and happy. Users will likely not be able to think clearly or make sound decisions. Individuals may be at a higher risk of contracting sexually transmitted diseases, such as hepatitis or HIV/AIDS, after engaging in questionable sexual practices while abusing heroin.
With regular use, individuals can build up a tolerance to heroin and will need to take more of the drug each time in order to feel its pleasurable effects. Levels of dopamine, one of the brain’s natural chemical messengers that signals happiness, are impacted with heroin abuse. Repeated interference of heroin in the brain can actually alter the reward and motivation circuitry, and impact the natural production of neurotransmitters like dopamine. A dependence is formed as the brain does not function normally now without heroin. If the user attempts to stop using the drug, withdrawal symptoms that are physically and emotionally difficult can take hold.
Individuals may lose control over their heroin use, as well as suffer from mood swings and a shift in behaviors and actions that characterize addiction. The American Society of Addiction Medicine (ASAM) reports that nearly a quarter of all people who abuse heroin will develop an addiction to opioids. The National Survey on Drug Use and Health (NSDUH) reports that in 2014, almost 600,000 American adults (aged 12 and older) battled a heroin use disorder.
Overdose and Long-term Effects of Heroin Abuse
Smoking and snorting heroin can not only lead to addiction to the powerful narcotic drug, but they can also cause a deadly overdose. Heroin may be “cut” or mixed with other potentially toxic substances that can increase the odds for a negative reaction as well. Heroin slows down a person’s breathing, and a fatal overdose is generally caused when respiration rates slow down too much or stop altogether. That being said, low blood pressure and heart rate can also contribute to a heroin overdose death.
Heroin overdose in 2013 resulted in over 8,000 fatalities, more than quadrupling the amount of heroin overdose deaths in 2002, the Centers for Disease Control and Prevention (CDC) reports. When including prescription opioid painkillers as well, one person in the United States dies from an opioid overdose every 19 minutes, CNN publishes.
Heroin abuse is not only fatal in the short-term however, as chronic abuse can also cause a multitude of health and emotional issues that can increase mortality as well. CNN also reports that 16 percent of heroin abusers die after 30 years of regular use. Prolonged heroin abuse may also increase the risks for developing, and dying from, cancer, the Australian and New Zealand Journal of Public Health publishes.
Heroin withdrawal can cause potentially dangerous symptoms, with intense flu-like physical symptoms, including insomnia, and irregular heart rate and blood pressure, as well as significant emotional disturbances like depression and increased anxiety. The Drug Abuse Warning Network (DAWN) publishes that in 2011, heroin was the third most common illicit drug to be involved in emergency department (ED) visits that year, as over 20 percent of ED visits related to illicit drug use involved heroin (over 250,000 ED visits).
Snorting heroin can damage the tissues in the nose and mouth, causing chronic nosebleeds or even a perforated nasal septum. Smoking the drug can further damage lung tissue that may already be compromised due to heroin’s effects on respiration in general. Smoking heroin may cause individuals to burn their hands or mouths as well. The National Institute on Drug Abuse (NIDA) reports that heroin abuse can lead to the contraction of pneumonia or tuberculosis or other respiratory issues and/or disease related to the lungs. These effects can be even more pronounced if the drug is smoked.
Sexual dysfunction in men and disturbances to a female’s menstrual cycle may also occur with regular heroin use and dependence. NIDA also publishes that long-term heroin abuse may cause the potential depletion of gray matter in the brain, resulting in memory or cognitive decline.