In the midst of the opioid crisis in the United States, heroin is quickly emerging as a bigger threat, with more people already dependent on prescription opioids turning to heroin as a cheaper and easier to source alternative.

And heroin is even more dangerous than ever before, as it is increasingly being cut with cheaper, easier to manufacture, and significantly more potent and deadly substances such as fentanyl and carfentanil. This creates a situation where heroin users are unaware of the fact that they’re buying heroin that’s partially or even sometimes mostly fentanyl and, since they’re taking it at the dosage they normally would for heroin, overdosing fatally in far greater numbers.

The serious health issues associated with heroin abuse have never been something to be trivialized, but this new danger only serves to highlight how vital it is to seek out treatment for heroin addiction and avoid becoming another statistic in the growing death toll created by the opioid epidemic.

What is Heroin?

Heroin is a substance known as an opioid. The term opioid used to only refer to synthetic drugs created to work the same way as naturally-derived “opiates” like morphine or codeine, which were themselves made from opium. Now though, opioid has become the umbrella term for the classification of all opiate drugs, both synthetic and natural.

Derived from morphine, heroin was originally created to be used as an over-the-counter cough suppressant in the late 1800s. It was marketed as a safer and less addictive alternative to morphine but quickly surpassed morphine in both addiction and overdose rates soon after being introduced.

It wasn’t until 1924 that the United States banned all sales, imports, and manufacturing of heroin. It is now classified by the DEA as what is known as a Schedule I substance, which means that because of its high potential for abuse and no recognized medical use.

It is illegal to either possess or manufacture. In its powdered form, heroin is either white or brown. It also comes in the form of a black tar-like substance. Heroin can be snorted, smoked, or injected and is known by street names such as junk, dope, smack, brown sugar, and horse. Apart from being cut with substances like fentanyl, it is also frequently combined with some of the following substances, including:

  • Cornstarch
  • Sugar
  • Caffeine
  • Acetaminophen
  • Strychnine, a pesticide
  • Quinine, an antimalarial medication
  • Phenobarbital

This is just a small sampling of the substances mixed with heroin either to lower the cost of manufacturing or to increase its potency.

How Does Heroin Work?

Heroin works by rapidly entering the body and activating the brain’s opioid receptors. Opioid receptors are what’s known as neurotransmitters, chemicals responsible for carrying out crucial tasks in the brain and central nervous system. Opioid receptors naturally produced by the body regulate stress levels and act as painkillers.

What heroin does is bind itself to these receptors and activate them by mimicking their molecular composition. The body cannot naturally produce enough neurotransmitters to block pain the way that heroin can, and so heroin overwhelms the system, creating a much stronger block against pain signals as well as depressing breathing and releasing feelings of relaxation.

On top of the effect of masking pain, heroin also creates a huge spike in feelings of euphoria by flooding the brain with increased levels of another neurotransmitter called dopamine. Dopamine is in control of what is commonly referred to as the brain’s “pleasure center,” regulating not just feelings of gratification, but also how the brain processes motivation and reward.

What that means is that the massive buildup of dopamine in the brain conditions an individual to associate heroin use with activating the “reward button” in the brain along with the pain-negating effects. As the brain stops making its own dopamine in order to compensate for the large amount provided by heroin, eventually the body and brain become dependent on heroin to provide enough dopamine and block out pain in order to continue functioning.

At the same time, the user begins to build a tolerance, requiring more heroin to achieve the same effects. This is why when someone who has become dependent on heroin for an extended period of time suddenly stops, their body “crashes” as its dopamine levels bottom-out, and the opioid receptors stop blocking pain signals.

The body and brain’s struggle to cope with this situation is what causes heroin withdrawal symptoms, and how misuse progresses to abuse and, eventually, addiction.

What are the Effects of Heroin?

The immediate short-term effects of heroin use include:

  • Pain relief
  • Euphoria
  • Dry mouth
  • Drowsiness
  • Warm flushing of the skin
  • Impaired thinking
  • “Heavy” feeling in arms and legs
  • Nausea
  • Itchiness

Sometimes, people will also experience less common, but still possible, reactions to heroin use, including:

  • Anxiety
  • Tremors
  • Chest pain
  • Heart palpitations
  • Migraines
  • Shortness of breath

The long-term effects of heroin addiction include:

  • Constipation
  • Insomnia
  • Abdominal cramping
  • Liver damage
  • Depression
  • Sexual dysfunction
  • Kidney disease

And in the case of intravenous use:

  • Collapsed veins
  • Infections
  • Abscesses
  • Lung complications
  • Increased risk of HIV and hepatitis

What are the Signs of Heroin Addiction?

When someone becomes dependent on heroin, their whole world shifts as obtaining and using heroin takes priority over everything else in their life. As heroin becomes the driving force behind their behaviors, the signs of heroin addiction will start to pile up and soon become apparent. Some common signs of heroin addiction that should act as an alert that this person is in need of treatment include:

  • Missing money or valuables
  • Lying or secretive behavior
  • Difficulty in performing daily tasks
  • Decline in personal hygiene
  • Significant worsening of performance
  • Visible track marks
  • Attempting to rationalize drug use
  • Legal problems
  • Lack of interest

If you’ve experienced these symptoms or seen it present in someone close to you, it is indicative of heroin addiction, and professional help should be sought out as soon as possible in order to have the best chance of preventing permanent mental and physical damage.

What is Involved in Heroin Addiction Treatment?

Treating addiction to opioids is never an easy process, and heroin is no exception. Because of this, the best course of action for ensuring successful heroin addiction treatment is to start with medical detoxification at a professional detox center.

Because heroin works so quickly, it does not stay in your body for very long, and withdrawal symptoms can start in as little as six hours after the last use. Heroin detox is rarely ever a life-threatening situation, but with symptoms that can range from uncomfortable, such as those associated with having the flu, to potentially dangerous, including convulsions, panic attacks, and suicidal behavior, it’s no wonder that heroin has such a high relapse rate.

At a medical detox facility, under the supervision of expert medical professionals, an individual will have a much better chance of completing a heroin detox safely and successfully, as they can set up a tapering schedule to slowly wean those dependent on heroin down to smaller dosages.

Many detoxification centers will also provide medications to decrease the amount of general discomfort caused by the symptoms of heroin withdrawal, as well as medical maintenance therapy to aid in the tapering process. These medications provide similar effects to heroin in order to decrease cravings, but are much weaker and have less risk of addiction.

The typical medications used to treat people with opioid dependency taper down their usage include:


A long-acting alternative for those with a history of heroin relapse, methadone lessens heroin cravings while also blocking its euphoric effects. However, methadone does still carry a risk of addiction and requires strict dosage monitoring.


While clonidine is primarily used to treat high blood pressure, it has found some success in helping to decrease drug cravings.


Commonly used to treat heroin addiction, buprenorphine is what’s known as a “partial opioid,” that works in the same manner as methadone but has less potential for addiction.


The name-brand mix of buprenorphine and another drug called naloxone that completely blocks the effects of heroin. Naloxone on its own is too strong to use in maintenance therapy.


Unlike the medications listed above, naltrexone is not addictive and carries no opioid qualities, instead completely negating the high from heroin. Naltrexone is also sold in the form of an extended-release injection called Vivitrol.

Once someone has finished detoxing from heroin, the next step in heroin addiction treatment is checking into an addiction rehabilitation treatment program. Recovery from heroin addiction is simply not possible without first detoxing, but if detox is not followed by a recovery treatment program or some kind of aftercare, relapse is all but guaranteed.

In fact, studies show that 91 percent of people who finished heroin detox but completed no follow-up treatment suffered a relapse, with 59 percent going back to using heroin just one week after being discharged. This also greatly increases the risk of an accidental overdose.

A recovery treatment program is crucial in order to gain the skills necessary to avoid returning to regular heroin abuse and successfully manage addictive behaviors. Typically, treatment programs will be customized based on what works best for a given individual, and there are many different kinds of recovery treatment programs available, including counseling, therapy, support groups, and even sober living communities.

How Dangerous is Heroin?

If the long-term side effects of heroin abuse are not enough of an illustration of the dangers inherent in heroin use, there are many other dangers associated with heroin abuse that is more than potentially life-threatening and can put lives other than just the users at risk.

The symptoms of a heroin overdose are only becoming more frequent due to the previously mentioned trend of illegal manufacturers cutting heroin with fentanyl as well as other poisons. However, it is just as possible to overdose on pure heroin if someone does a significant amount.

The common symptoms associated with a heroin overdose include the following:

  • Confusion and disorientation
  • Constricted pupils
  • Dangerously low blood pressure
  • Convulsions
  • Weak pulse
  • Difficulty breathing
  • Blue lips and nails from lack of oxygen
  • Drowsiness,
  • Coma
  • Permanent brain damage

In the case of an overdose, Narcan, the name brand of the previously mentioned anti-opioid medication naloxone, can be used to reverse the overdose and rapidly flush the opioids out of the overdosing individual’s system. It is; however, not a guaranteed solution, and needs to be administered as soon as possible.

Many people rationalize heroin addiction and other substance abuse by claiming that they’re only hurting themselves by using. However, in many instances, pregnant women who abuse heroin have an extremely high chance of not only giving birth to a baby that is itself already dependent on heroin, but also to have babies with congenital birth defects involving the spine, heart, or their vision.

The symptoms of NAS include:

  • Difficulty breathing
  • Trouble feeding properly
  • Difficulty gaining weight
  • Fever
  • Vomiting
  • Diarrhea
  • Seizures

Heroin Abuse Statistics

  • Overdose deaths from heroin have more than quadrupled since 2010.
  • People addicted to prescription opioids are 40 times more likely to also be dependent on heroin.
  • Roughly four in every five heroin users were first misusing prescription opioids.
  • In a 2014 survey of people in recovery treatment for opioid abuse, 94 percent of those surveyed said they started using heroin because prescription painkillers were significantly more expensive and difficult to obtain.
  • In 2016, at least 170,000 people tried heroin for the first time.
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