Understanding Heroin Abuse & Addiction

Heroin is a powerful semi-synthetic opiate derived from morphine most often used as a recreational drug. Heroin delivers and intense “rush” and is more powerful than most opioid analgesics because it crosses the blood-brain barrier more rapidly. Use of heroin leads quickly to dependence and has a high potential for addiction.

Heroin is known to cause “blissful apathy” along with its painkilling effects.

The type of available heroin and strength may vary based on the geographical location. Different areas produce various forms of the drug. The black tar version is usually found on the West Coast while the white is usually found on the East Coast.  

There are a number of names used then referring to the drug, according to the location and local trends. However, some are relatively well known across at different locations and with different age groups:

heroin addiction treatment

Nicknames and Street Names for Heroin

  • Big H
  • Black
  • Black Eagle
  • Black Pearl
  • Black Stuff
  • Black Tar
  • Boy
  • Brown
  • Brown Crystal
  • Brown Rhine
  • Brown Sugar
  • Brown Tape
  • Chiba
  • China White
  • Chiva
  • Dope
  • Dragon
  • H
  • He
  • Hera
  • Hero
  • Heron
  • Herone
  • illnesses
  • Junk
  • Mexican Brown
  • Mexican Horse
  • Mexican Mud
  • Number 3
  • Number 4
  • Number 8
  • Sack
  • Scag
  • Scat
  • Skunk
  • Smack
  • Snow
  • Snowball
  • Tar
  • White
  • White Boy
  • White Girl
  • White Horse
  • White Lady
  • White Nurse
  • White Stuff

What is Heroin?

Heroin is a highly addictive illegal drug that is processed from morphine and extracted from certain varieties of the poppy plants. It is usually found as a white or brownish powder and processed or “cut” with an additive agent such as sugars, starch or quinine, so the final product remains between white and brown.  The white powder forms have a bitter taste and predominantly originates from South America and the Southeast Asia. This almost pure form of heroin can be snorted and smoked what is more appealing to new users because it eliminates a bit of a stigma associated with injecting the drug.

The so-called black tar is as sticky as roofing tar, hard like coal and mostly produced in Mexico. The dark brownish color is mostly associated with the results from crude processing methods; that leaves behind impurities. This type of heroin is usually dissolved, diluted, and injected into veins, muscles, or under the skin.

Heroin was first synthesized from morphine in 1874. Until 1910, it was marketed as a non-addictive cough suppressant and substitute for morphine. The Harrison Narcotics Tax Act, passed in 1914, was meant to control the sale of heroin and other opiates. Heroin could be prescribed for medical purposes until 1924, when Congress banned the sale, import or manufacturing in the U.S. Most of it consumed in the U.S. comes from Colombia, Mexico, Canada, Afghanistan, and China. Other top-producing countries include Thailand, Vietnam, and Laos.

Heroin Uses

Regular heroin use – especially at high doses – often results in physical dependence, psychological addiction, or both. Heroin can be taken orally, snorted, smoked or injected. Some users inhale the vapors when it is heated. Often, is “cut” with other substances to dilute it or add bulk. A mixture of heroin and cocaine, known on the street as a “speedball,” can be fatal. A heroin/fentanyl mix caused an outbreak of overdoses in several American cities in 2006.

Dangers of intravenous use include transmission of hepatitis and HIV from contaminated needles and syringes, abscesses, chronic constipation and poisoning from ingredients and other drugs used to dilute it. Injection poses the greatest risk for overdose as this administration route allows for large amounts of heroin to enter the bloodstream at one time. It is possible, however, to overdose while sniffing or smoking heroin. This is especially true when taking large doses or combining heroin with other depressants, including alcohol.

Some countries provide needle exchange programs to provide users with clean supplies. While some argue this helps cut the transmission rate of infectious diseases, others say it amounts to governments’ acceptance of heroin use.

Heroin Side Effects

The addictive nature of heroin is reinforced by its powerful abilities in creating pleasurable feelings such as “rush” which is described as a strong euphoric feeling. As people use heroin for a period, the pleasurable effects start becoming overshadowed by numerous unwanted physical side effects once tolerance sets in. Usually, the system is taking action to counter-balance the impact of the drug.

Heroin binds to opioid receptors sites in the body. Once a chemical interaction happens, the affected nerve cells start releasing dopamine, a particular molecule responsible for mediating certain feelings of pleasure that can be extremely rewarding to the user. As the user continue to seek these pleasurable feeling, they tend to repeat the behavior – in this case, heroin use – what leads them to dependence and addiction.

Common Short Term Side Effects

The most common immediate short term analgesic and central nervous system depressant side effects are:

heroin withdrawal
  • The rush or euphoric feelings
  • Feelings of being warm and flushed  
  • Heavy sensation in the body extremities.
  • Nodding (periods of being awake and asleep)
  • Reduced sensation of pain
  • Drowsiness
  • Sedation
  • Lethargy
The intense euphoric effects will only last for a few minutes while the feeling of sedation can persist for a few hours. The duration and intensity of these side-effects can be dependent on the purity of the drug, dose usually taken, and route of administration.

Physical Dependence Side Effects

As physical dependence sets in, the side effects become less pleasurable and more damaging to the individual. Some of these side effects include:

  • Nausea and vomiting
  • Grogginess
  • Confusion
  • Dry mouth
  • Itchy skin
  • Constricted pupils
  • Light sensitivity
  • Lower than average body temperature
  • Slowed respiration
  • Slowed heart rate
  • Cyanotic (bluish) hands, feet, lips, etc
The euphoric effects of heroin abuse will decrease with continued use as the user becomes increasingly tolerant of the drug.

The practice of sharing needles to inject heroin increases the risk of contracting infectious diseases, especially HIV, Hepatitis B, and Hepatitis C. Injecting heroin and exchange needles increases the risk for other illnesses, such as endocarditis, blood clot, botulism, tetanus, and flesh-eating bacteria. Injecting heroin may also lead to painful abscesses that may result in blood poisoning.

Serious Physiological Side Effects

There is a broad range of serious physiological side effects can affect the long-term heroin user:

  • Dental and gum damaged
  • Excoriated skin from scratching
  • Opioid-Induced Constipation (OIC)
  • Diminished immune system
  • Susceptibility to diseases
  • Poor appetite and malnutrition
  • Heart and Valve Disease
  • Sleeping issue
  • Sexual Dysfunction
  • Pulmonary issue
  • Liver Damage
  • Kidney Damage
  • Infectious disease
  • Even Coma or Death
Additionally, some may experience numerous personal consequences, such as financial and relationship turmoil and or legal issue.

Mental Health Side Effects

Because heroin impacts the structure of the brain, mental health is also compromised with continued use.  Some of the symptoms might be:

  • Depression
  • Isolation
  • Memory Problems
  • Anxiety
  • Physical Dependence and Addiction

Abuse & Signs of Heroin Abuse

Heroin abuse as an illegal act, with no accepted medical use.  Because all use of heroin can be considered recreational, addiction is almost a certainty with repeated use.  Regular use can cause a person to develop a tolerance, requiring them to increase continually the dose to feel the desirable effects. Over time, the escalation of doses and abuse produces a physical dependence and addiction.

Once addicted, users become preoccupied with getting the drug and using it. The need to use quickly becomes overwhelming and all-consuming. This can lead people down a path of risky behavior in their quest to get a “fix” and avoid the sickness withdrawal creates.  In combination with its euphoric effects, and almost immediate addiction potential, this causes many users extreme difficulties when attempting to curtail the use on their own.

Heroin abuse can ruin relationships, destroy careers and lead to serious legal problems. The societal impacts of heroin abuse are astounding. The fallout impacts the medical establishment, criminal justice system, and courts.

Addiction & Signs of Heroin Addiction

Heroin addiction is described as a compulsive need to use the drug despite its risks and adverse consequences.

Signs of heroin addiction can be noticed by the presence of paraphernalia:

  • Missing shoelaces
  • Straws with burned residuals
  • Small containers, with white powdery residue or sticky brown substance.
  • Water pipes or another type of smoking devices
  • Aluminum foil with burn marks
  • Needles or syringes  
  • Burned spoons
heroin abuse and addiction
Other signs of addiction include sudden behavioral changes such as:
  • Lying or other deceptive behavior
  • Avoiding eye contact
  • Increased sleeping
  • Slurred or incoherent speech
  • Stealing or borrowing money from loved ones
  • Unexplained absence of valuables
  • Hostile behavior
  • Wearing long pants and/or long sleeves even in warm weather
  • Performance decline in school or work
  • Decreased attention to hygiene and appearance
  • Loss of motivation
  • Apathy toward future goals
  • Social withdrawal
Or noticeable physical symptoms like:

  • Weight loss
  • A frequent runny nose
  • Needle track marks  
  • Infections or abscesses  
  • Uncontrollable feelings of itching
  • For women, loss of menstrual cycle

Overdose & Avoiding Heroin Overdose

A heroin overdose can be fatal, so it’s important to know the signs to watch for. The illegal opiate is a central nervous system depressant and can be deadly when mixed with other substances that have the same effect. Depending on the purity of the heroin and the user, lethal doses can range, and no one can be sure about the purity of heroin as it can be mixed with other dangerous substances such as Fentanyl. There is no safe dose of heroin. The user’s tolerance, the amount taken and the purity are all factors that determine whether someone will have a bad reaction to heroin.

As with all opiates, tolerance can build with heroin use, even when it’s relatively short term. This requires users to take more and more to experience the effects they desire, whether it’s euphoria or to stave off withdrawal. There is no exact way to avoid and overdose when using heroin, an average amount for a regular user can result in a deadly overdose of a first-time user.

Heroin is very addictive and can dramatically slow the heart rate and breathing. The signs of an overdose occur quickly after an individual takes the substance. Some can have a conversation or do other things before the symptoms appear. Others may begin exhibiting overdose symptoms within minutes after taking the last dose. Other signs and symptoms of a heroin overdose can include:

  • Awake but not able to speak
  • Limp body
  • Pinpoint pupils
  • Breathing slow, shallow or none
  • Cold and clammy skin
  • Blue or grayish lips
  • Choking sounds, or a snore-like gurgling noise
  • Weak pulse, constipation
  • Low blood pressure
  • Disorientation
  • Extreme drowsiness, confusion, and delirium
  • Unresponsive to outside stimulus
If you feel an overdose is occurring, you must call 911 and get medical help immediately, as death could be a serious possibility.

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