Heroin

Heroin

Heroin is an opioid drug made from a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.

Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.

Short-Term Effects

People who use heroin report feeling a "rush" (a surge of pleasure, or euphoria). However, there are other common effects, including:

• dry mouth
• warm flushing of the skin
• heavy feeling in the arms and legs
• nausea and vomiting
• severe itching
• clouded mental functioning
• going "on the nod," a back-and-forth state of being conscious and semiconscious

Long-Term Effects

• insomnia
• collapsed veins for people who inject the drug
• damaged tissue inside the nose for people who sniff or snort it
• infection of the heart lining and valves
• abscesses (swollen tissue filled with pus)
• constipation and stomach cramping
• liver and kidney disease
• lung complications, including pneumonia
• mental disorders such as depression and antisocial personality disorder
• sexual dysfunction for men
• irregular menstrual cycles for women

Other Effects

Heroin often contains additives, such as sugar, starch, or powdered milk, that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage. Also, sharing drug injection equipment and having impaired judgment from drug use can increase the risk of contracting infectious diseases such as HIV and hepatitis (see "Injection Drug Use, HIV, and Hepatitis").

Heroin is regularly mixed with fentanyl or carfentanyl to increase potency.  Due to improper and inexpert mixing, the amount of fentanyl per heroin dose can vary widely from hardly any to a fatal dose.  

Addiction

Heroin is highly addiction.  Users develop tolerance quickly, necessitating larger doses to get the same effect.  Substance use disorder can occur when a user continues to take the drug despite negative health or social consequences.  

Those addicted to heroin who stop abruptly may have severe withdrawal.  Symptoms can begin as early as a few hours after the last dose and can include:

• restlessness
• severe muscle and bone pain
• sleep problems
• diarrhea and vomiting
• cold flashes with goose bumps ("cold turkey")
• uncontrollable leg movements ("kicking the habit")
• severe heroin cravings

Researchers are studying the long-term effects of opioid addiction on the brain. Studies have shown some loss of the brain’s white matter associated with heroin use, which may affect decision-making, behavior control, and responses to stressful situations.

Heroin addiction is a treatable medical condition.  Medications can be given to reduce withdrawal symptoms and improve comfort while psychological therapy can help with cravings, anxiety, and depression.

Overdose

A heroin overdose occurs when a person uses enough of the drug to produce a life-threatening reaction or death. Heroin overdoses have increased in recent years.

When people overdose on heroin, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term mental effects and effects on the nervous system, including coma and permanent brain damage.

Naloxone is a medicine that can treat an opioid overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of heroin and other opioid drugs. Sometimes more than one dose may be needed to help a person start breathing again, which is why it’s important to get the person to an emergency department or a doctor to receive additional support if needed. 

California has passed laws that allow pharmacists to dispense naloxone without a prescription from a person’s personal doctor.