Heroin Abuse, Addiction, Overdose, Withdrawal – Symptoms, Side Effects

What Is Heroin?

Heroin is a highly addictive opiate drug (strong painkiller) causing initial euphoria followed by profound relaxation, so it is considered as a ‘downer’ drug. It is synthesized from morphine, a substance obtained from seed pods of an opium poppy plant. Chemically, heroin is diamorphine (diacethylmorphine). It has a quicker and stronger effect than morphine.

Most of heroin is said to be produced in Afghanistan.

What is ‘synthetic heroin’?

‘Synthetic heroin’ is an informal term used for completely human-made, non-opium based narcotics, like methadone, oxycontin, phentanyl, pethidin.

Heroin Name

Heroin got its name because of its supposedly ‘heroic’ effects upon a user (as advertised by its first producer on the end of the 19th century). It was synthesized as an alternative for morphine, and should have less side effects and be less addictive than morphine, but it has appeared that just the opposite is true.

Heroin Forms and Uses

Heroin Powder

Pure heroin powder is white, and when mixed (cut) with other substances (quinine, starch..), light to dark brown, and of bitter taste. The purity of heroin may vary a lot. Chemically, heroin is a salt, diacethylmorphine hydrochloride. Heroin powder can be snorted (sniffed) or heated on a foil and inhaled by mouth, using a straw – (chasing the dragon), smoked in a water or standard pipe, ingested, or dissolved in water and injected into a vein (shooting) under the skin or into a muscle (skin popping).

Street names (nicknames) for heroin powder: boy, brown sugar, gear, H, horse, Mexican brown, mud, skag, smack, white junk.

Heroin powder is often mixed with other drugs:

  • Heroin + benzodiazepins or amphetamins (ingested)
  • Heroin + cocaine = speedball (injected) or moonrock (smoked), belushi, boy-girl, he-she, dynamite (snorted)
  • Heroin + fentanyl (legal narcotic) = China white
  • Heroin + LSD = beast
  • Heroin + marijuana (smoked) = atom bomb

Black Tar Heroin

Black tar heroin is a sticky black substance. It is a base (freebase) that is non-salt form of heroine. It is usually diluted (cut) with other substances to increase bulk. It is usually dissolved in water an acid, like citric acid powder, lemon juice, heated and injected into a vein.

Street names for black tar heroin: ash, black clown, capital B, negro, pigment.

Heroin as a Legal Drug

Heroin is available as a prescribed painkiller (under a name diamorphine) in certain countries (not in US) to relieve strong pain, like in heart attack or terminal stage of cancer. In US, heroin is a schedule I substance, meaning it is highly addictive and not allowed for any use (including medical use).

How Does Heroin Work?

Heroin slows down several body functions and reduces physical and psychological pain.

Heroin enters the brain where it is converted to morphine. Morphine acts on opioid receptors in the brain and thus reduces the feeling of pain. It stimulates opiate receptors in the brainstem resulting in respiratory depression. In the bowel it slows down gastric emptying and intestinal transit time.

Short-Term Heroin Effects

The onset of heroin effects is:

  • 7-8 seconds after injecting into a vein
  • 5-8 minutes after injecting into a muscle
  • 10-15 minutes after snorting
  • 30 minutes after ingestion

Short-term effects of heroin last for few hours and usually include:

  • Initial euphoria and intense pleasure (‘rush’), lasting for few minutes (mostly after injecting)
  • Relaxation, lasting for about one hour
  • Analgesic effect lasts for 3-5 hours
  • Dry mouth and dry, warm skin (hot flushes)
  • Heavy limbs
  • Alternating between alert and drowsy state (being on the nod)
  • General slowness: cloudy thinking, drowsiness, slurred speech, slow gait, slow breathing, slow heart rate
  • Dizziness or vomiting (in first time users or after a large dose)
  • Muscle weakness
  • Itchy skin (due to histamine release)
  • Narrowed, pinpoint sized pupils, droopy eyelids, impaired night vision
  • Constipation

Possible Dangers After a Single Heroin Dose

  • Overdose (see below)
  • Poisoning from substances added to heroin
  • Blood clots formation, leading to permanent damage of kidney, brain or other organs
  • Bacterial or fungal endocarditis (inflammation of the heart lining and valves)
  • Hepatitis B or C, or HIV/AIDS if sharing a contaminated needle

Heroin Overdose Symptoms

First time users usually use 5-20 mg of heroin, while an addict may use several hundreds mg per day, so an overdose is more likely in addicts. A deadly overdose may occur when a heroin bag ruptures inside the body of a ‘body packer’. Symptoms of heroin overdose may include:

  • Narrowed pupils, slow breathing, comma – this is a typical triad of symptoms of heroine overdose
  • Weak pulse
  • Muscle spasms
  • Death due to respiratory failure (stopping breathing) or blocked airways from inhaled vomit. The risk of death increases with combining heroin with alcohol, benzodiazepins or other ‘downer’ drugs.

Long-Term Heroin Side Effects

Prolonged heroin taking may cause:

  • Skin infection (cellulitis) at the site of heroin injecting, track marks from inflamed veins (usually on the forearms)
  • Chronic constipation
  • Collapsed veins resulting in a finger or limb gangrene (tissue death) due to inflammation of vessels (after injecting)
  • Pneumonia or other respiratory infection due to depressed breathing
  • Liver or kidney disease
  • Hepatitis B or C, or HIV/AIDS due to sharing contaminated needles
  • Spontaneous abortion
  • Children of addicted mothers may have low birth weight and delayed development
  • Psychological and physical addiction

How Addictive Is Heroin?

Heroin is a highly addictive drug, causing both psychological and physical addiction. With repeated use, a tolerance may develop, resulting in a need for a higher dose to achieve the same effect.

Heroin Withdrawal Symptoms

Few hours after the last heroin dose, withdrawal symptoms may appear, peak between 48-72 hours and last for about a week (but sometimes for months). Symptoms, collectively called heroin withdrawal syndrome may include:

  • Restlessness
  • Anxiety
  • Cold sweat with goose bumps (cold turkey)
  • Excessive salivation, tearing and runny nose
  • Yawning, sneezing
  • Painful erection (priapism) in men and increased genital sensitivity in females
  • Muscle spasms – kicking movements (“kicking the habit”)
  • Insomnia
  • Malaise, nausea, vomiting or diarrhea
  • Chills, fever
  • Sudden withdrawal may be deadly for a heavy user
  • Craving for heroine may persist for years after withdrawal

Related Articles:


  1. Heroin is illegal in US (justice.gov)
  2. Heroin facts: short-term and long-term effects, signs and symptoms (drugabuse.gov – National Institute of Drug Abuse – NIDA)
About Jan Modric (209 Articles)
Health writer

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