Heroin

Heroin is made from morphine, a naturally occurring substance that comes from the opium poppy plant. Pure heroin is a fine, white, bitter-tasting crystalline powder. Heroin sold on the street varies in colour and consistency depending on the way it is made and what other substances are added to it. It can look like a white powder, a brown grainy substance or a dark brown sticky gum. It can range in purity from 2 to 98 percent.

Sometimes quinine is added to imitate the bitter taste of heroin. (Quinine is a chemical found in some drugs to treat malaria.) This can fool a buyer into thinking he or she is getting a more pure form of heroin.

Heroin may be:

• dissolved in water and injected into a vein ("mainlining"), muscle, or under the skin ("skin-popping")
• smoked ("chasing the dragon")
• snorted

Also Known As: diacetylmorphine, diamorphine, black tar, dope (heroin), dust, H, horse, junk, smack, scag

Category: Central Nervous System (CNS) Depressants

On this page:

• How does Heroin Affect the Body?
• Can Heroin Harm a Developing Fetus or a Newborn Baby?
• Is Heroin Addictive?
• Heroin Withdrawal

How does Heroin Affect the Body?

After taking heroin, it travels through bloodstream and easily enters the brain. In the brain, heroin is converted back into morphine. Morphine interacts with specific proteins on the brain cells called opioid receptors. These opioid receptors send signals between brain cells (neurons) and ultimately change the way a person experiences pain.

How quickly heroin reaches the brain depends on how it is taken. When it is injected into the vein, it takes seconds for the drug to take effect. The effects after smoking or snorting are not as rapid and occur within 10 to 15 minutes. The effects heroin usually last for about three to five hours.

Will Heroin Always Produce the Same Effects?

The effects of heroin are unpredictable. It is different for everyone. The way a person feels after taking heroin depends on many factors:

• age and weight
• mood, expectations, and environment
• medical or psychiatric conditions
• the amount of heroin taken (dose)
• how it is used
• how often and for how long heroin has been used
• use of other drugs, including non-prescription, prescription, and street drugs

Short-Term Effects

Heroin is a dangerous drug whose effects are unpredictable, partly because the user does not know its purity or strength. A person on heroin may feel confused and dizzy. It may also temporarily relieve anxiety and depression.

When heroin is injected into the vein, heroin can produce a pleasurable sensation called a "rush" that lasts up to a few minutes. A "rush" is associated with a sense of relaxation, happiness and an absence of emotional and physical pain. After the initial feeling goes away, the user enters a tranquil phase ("on the nod") that can last for up to an hour.

Short-term use of heroin can produce many other effects:

• lack of emotion (apathy)
• nausea and vomiting
• reduced appetite
• decreased response to pain
• pinpoint pupils and impaired night vision
• constipation
• itching or burning sensation of the skin
• headaches

Heroin Overdose

An overdose of heroin can be deadly. The risk of overdose with heroin is high and unpredictable because users do not know the actual strength or the amount of drug that they are using. A person who has overdosed may have one or more of the following symptoms:

• pinpoint pupils
• cold clammy skin
• low blood pressure
• decreased and irregular heart rate
• slow and shallow breathing
• bluish skin (cyanosis)
• unconsciousness (a deep sleep that may develop into a coma)

Heroin affects the breathing centre in the brain. It can cause a person's brain to stop telling his/her lungs to breathe.

Heroin has a very rapid onset. A person who overdoses may fall unconscious very quickly after injecting the drug. An overdose is more likely if heroin is taken along with other depressants such as alcohol, benzodiazepines, or other opioids such as methadone.

There is an antidote called naloxone that can reverse the effects of heroin. If you think that a person has overdosed, contact emergency services immediately.

Some substances used to mix or dilute heroin may lead to problems. For example, strychnine and chalk are sometimes used. Strychnine is poisonous and chalk does not dissolve. If injected, chalk can block small blood vessels.

Long-Term Effects

Effects associated with long-term use of heroin include:

• an unstable mood
• constipation
• pinpoint pupils, which impair night vision
• loss of interest in sex (decreased libido)
• missed periods in women
• respiratory impairment

Using drugs by injection puts the user at risk for:

• skin infections
• blood poisoning (septicaemia)
• infection in the lining of the heart (endocarditis)

Sharing drug supplies, such as needles, pipes, and spoons, can spread tuberculosis, HIV, hepatitis B, and hepatitis C. Malnutrition, life on the street, untreated infectious diseases, and dependence on heroin and other drugs all contribute to a decreased resistance to disease and poor health.

Can Heroin Harm a Developing Fetus or a Newborn Baby?

Yes. Heroin can harm a developing fetus. Using heroin while pregnant is associated with:

• premature delivery
• low birth weight
• high infant mortality rates

These effects are also caused by poor nutrition, smoking, and inadequate prenatal care. Heroin withdrawal can be dangerous in a pregnant woman. It can lead to spontaneous abortion in the first trimester and premature labour in the third trimester.

The developing fetus is exposed to heroin in the womb. Babies born to regular heroin users may sometimes go into withdrawal. A baby in heroin withdrawal will be irritable, sweaty, and will shake. The baby will have trouble feeding, may vomit, and have diarrhea. Occasionally a baby in severe heroin withdrawal will develop seizures and die. Heroin withdrawal can be treated.

Is Heroin Addictive?

Yes. Heroin is a very addictive drug. The need for heroin develops from repeated use. Addiction, psychological and physical dependence can develop within two or three weeks of regular use. Regular users also become tolerant to heroin.

A person who is addicted to heroin finds it very hard to stop using the drug. Some people who are addicted no longer find the drug pleasurable but need to keep using heroin to prevent withdrawal.

People addicted to heroin must inject the drug every 6 to 12 hours to avoid withdrawal symptoms. Users may become so preoccupied by the powerful need to get heroin to prevent withdrawal that it takes over their daily life.

Heroin Withdrawal

The severity of symptoms of withdrawal from heroin depends on the:

• amount and frequency of use of heroin
• length of time a person has been a regular heroin user
• person's state of health
• conditions under which withdrawal occurs

Symptoms of withdrawal begin within 6 to 12 hours after the last use. It peaks over the next 24 to 48 hours and then subsides after about a week. During this period a person is extremely uncomfortable and has:

• intense and persistent cravings for heroin
• flu-like symptoms (runny nose and sneezing)
• frequent yawning
• sweating
• anxiety and restlessness
• a loss of appetite
• dilated pupils
• insomnia
• racing heartbeat and high blood pressure
• abdominal cramping
• nausea and vomiting
• diarrhea
• goose bumps
• involuntary jerking of the leg muscles
• depression
• dehydration and weight loss from not eating or drinking during the experience

Heroin withdrawal is rarely fatal.

Heroin addiction can be treated effectively with methadone, a long acting drug that is taken by mouth. Methadone maintenance treatment prevents heroin withdrawal and reduces or eliminates the cravings.