What Is Heroin?
Heroin is an illegal, highly addictive drug. It is both the most abused and the most rapidly acting of the opiates.
Heroin is typically sold as a white or brownish powder or as the black sticky substance known on the streets as "black tar heroin." Although purer heroin is becoming more common, most street heroin is "cut" with other drugs or with substances such as sugar, starch, powdered milk or quinine. Street heroin can also be cut with strychnine or other poisons.
Because heroin abusers do not know the actual strength of the drug or its true contents, they are at risk of overdose or death. Heroin also poses special problems because of the transmission of HIV and other diseases that can occur from sharing needles or other injection equipment.
Heroin has many street names including: Big H, Black, Black Eagle, Black Pearl, Black Stuff, Black Tar, Brown, Brown Crystal, Brown Sugar, Brown Tape, Brown Rhine, Chiba, Chieva, China White, Chiva, dope, Dragon, H, He, Heron, Herone, Hero, Hera, Horse, Junk, Mexican Brown, Mexican Mud, Mexican Horse, Mud, Sack, Scag, Scat, Ska, Skag, Skunk, Smack, Snow, Snowball, Tar, White, White Boy, White Girl, White Horse, White Lady, White Nurse, White Stuff.
How Is Heroin Consumed?
Heroin is usually injected, sniffed/snorted, or smoked. Typically, a heroin abuser may inject up to four times a day. Intravenous injection provides the greatest intensity and most rapid onset of euphoria (7 to 8 seconds), while intramuscular injection produces a relatively slow onset of euphoria (5 to 8 minutes). When heroin is sniffed or smoked, peak effects are usually felt within 10 to 15 minutes. Although smoking and sniffing heroin do not produce a "rush" as quickly or as intensely as intravenous injection, NIDA researchers have confirmed that all three forms of heroin administration are addictive.
Injection continues to be the predominant method of heroin use among addicted users seeking drug treatment; however, researchers have observed a shift in heroin use patterns, from injection to sniffing and smoking. In fact, sniffing/snorting heroin is now a widely reported means of taking heroin among users admitted for drug treatment in Newark, Chicago, New York, and Detroit.
With the shift in heroin abuse patterns comes an even more diverse group of users. Older users (over 30) continue to be one of the largest user groups in most national data. However, several sources indicate an increase in new, young users across the country who are being lured by inexpensive, high-purity heroin that can be sniffed or smoked instead of injected. Heroin has also been appearing in more affluent communities.
Short-term Effects of Heroin
Soon after injection (or inhalation), heroin crosses the blood-brain barrier. In the brain, heroin is converted to morphine and binds rapidly to opioid receptors. Abusers typically report feeling a surge of pleasurable sensation, a "rush." The intensity of the rush is a function of how much drug is taken and how rapidly the drug enters the brain and binds to the natural opioid receptors. Heroin is particularly addictive because it enters the brain so rapidly. With heroin, the rush is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities, which may be accompanied by nausea, vomiting, and severe itching.
Heroin Side Effects
After the initial effects, abusers usually will be drowsy for several hours. Mental function is clouded by heroin's effect on the central nervous system. Cardiac function slows. Breathing is also severely slowed, sometimes to the point of death. Heroin overdose is a particular risk on the street, where the amount and purity of the drug cannot be accurately known.
Although it is difficult to obtain an exact number of heroin users because of the transient nature of this population, several surveys have attempted to provide estimates. A rough estimate of the hardcore addict population in the United States places the number between 750,000 and 1,000,000 users.
The U.S. Department of Health and Human Services' National Household Survey on Drug Abuse found that, in 2001, approximately 3.1 million Americans (1.4%) 12 years old and older had used heroin at least once in their lifetime. Persons ages 18 to 25 reported the highest percentage of lifetime heroin use with 1.6% in 2001
According to the University of Michigan's Monitoring the Future Study in 2002, 1.6% of 8th graders, 1.8% of 10th graders, and 1.7% of 12th graders surveyed reported using heroin at least once during their lifetime. That study also showed that 0.9% of 8th graders, 1.1% of 10th graders, and 1% of 12th graders reported using heroin in the past year. Among college students surveyed in 2001, 1.2% reported using heroin during their lifetime and 0.1% reported using heroin in the 30 days before being surveyed. Of those young adults surveyed between ages 19 and 28, 2% reported using heroin during their lifetime and 0.3% reported using heroin within the 30 days before being surveyed.
In another study, of those high school students surveyed in 2001 as part of the Youth Risk Behavior Surveillance System, 3.1% reported using heroin at least once during their lifetime. Male students (3.8%) were more likely than female students (2.5%) to report lifetime heroin use.