Heroin is the fastest-acting opioid drug.

It is extremely potent and considered highly addictive. The Drug Enforcement Administration, or DEA, classifies heroin as an illegal drug with no accepted medicinal uses within the United States. Called chiva, big H, smack, hell dust, negra, horse, black tar, and thunder on the street, heroin can be found as a white or brown powder or as a black sticky substance (black tar heroin). Generally, heroin is injected, smoked, or snorted.

Opioid drugs act on opioid receptors in the brain, causing a flood of dopamine, or “happy cells.” Opioids block feelings of pain and induce relaxation, producing an intense and mellowing “high.” Heroin takes effect quickly, within minutes after use, and wears off rather quickly as well. The National Highway Traffic Safety Administration (NHTSA) publishes that heroin’s effects generally peak in the first hour or so of use and wear off in about 3-5 hours. The drug’s quick method of action and the extreme euphoria it produces make it highly addictive.

Heroin is very dangerous, as it can easily reach toxic levels in the bloodstream, leading to a potentially fatal overdose in as little as one use. The DEA reports that heroin use, treatment admissions to substance abuse programs, and overdose deaths all increased in 2015. Heroin was seen as one of the biggest drug threats by almost half of all state, tribal, and local law enforcement agencies, according to the 2016 National Drug Threat Survey.

Behavioral Effects of Heroin

The negative repercussions of heroin can be experienced with just one use of the drug. Heroin causes a person to feel happy and relaxed, and impairs decision-making, concentration levels, and other cognitive abilities. It causes the skin to flush and become warm; arms and legs to feel heavy; and pupils to constrict. In addition, heroin can cause a dry mouth, and sometimes constipation, nausea, and itching.

  • While intoxicated by heroin, a first-time user may be less inhibited, take bigger risks, and therefore engage in behaviors that may be hazardous. Accidents, injuries, and high-risk sexual encounters may be typical. Unwanted pregnancy or the contraction of a sexually transmitted disease (STD) may result from heroin use and unsafe sexual practices. Heroin can cause spontaneous abortion in women who are pregnant. The diminished pain receptors caused by heroin abuse may lead to more serious injuries as well.
  • Moods are enhanced while using heroin, and when the drug wears off, a “crash” may occur, leaving individuals feeling depressed, anxious, fatigued, and “out of it.” Emotional distress may be more prominent if someone also battles a co-occurring mental health disorder, suffers from high levels of stress, or is predisposed to depression and/or anxiety. Medications, other substance abuse, or underlying medical conditions compound and heighten the potential risk factors of heroin abuse.

While long-term heroin use comes with a bevy of ill health effects, even first-time users of heroin run the risk of suffering from a range of potential side effects.

The most serious risk associated with first-time heroin use is fatal overdose.

Heroin Overdose

From 2002 to 2013, heroin overdose deaths almost quadrupled, the Centers for Disease Control and Prevention (CDC) reports and then tripled from 2010 to 2014, killing more than 10,000 people in 2014, the DEA publishes. Opioid drug use may start out with prescription painkillers, but as those become more difficult to obtain, people may switch over to heroin. The American Society of Addiction Medicine (ASAM) reports that four out of every five people who try heroin first abused prescription pain relievers. Heroin may be more potent than many prescription painkillers, and those making the switch may not recognize this when trying heroin for the first time. Close to 20 percent of heroin overdose deaths are due to first-time, or new, heroin users, CNN publishes.

Heroin is not regulated since it is an illegal drug, making it virtually impossible to know how pure it is and what exactly it might be “cut” with. This can make it extremely dangerous as the additives may cause a negative reaction, or individuals may inadvertently take too much heroin if one dose is purer than another.

Contaminants in heroin may block or congest some of the blood vessels leading to the lungs, liver, kidneys, and/or brain, and cause irreversible damage to these organs, the National Institute on Drug Abuse (NIDA) warns. Heroin may be “cut” with powdered milk, quinine, sugar, or starch, among other substances.

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    Heroin is a central nervous system depressant, as it slows down some of the body’s autonomic and life-sustaining functions. When heroin overwhelms the body by reaching toxic amounts in the bloodstream, users may forget to breathe. The following are signs of a heroin overdose:

    • Shallow or troubled breathing
    • Slow or weak pulse
    • Irregular heart rate
    • Bluish tinge to the lips, skin, or nails
    • Cold, clammy skin
    • Mental confusion
    • Nausea and/or vomiting
    • Extreme drowsiness and difficulty staying awake
    • Loss of consciousness
    • Tremors or seizures

    Heroin overdose can cause the brain to be deprived of oxygen for period of time, leading to hypoxia, which can result in permanent brain damage and coma as well as be potentially fatal. The Drug Abuse Warning Network (DAWN) reports that in 2011 heroin ranked third among drugs in emergency department (ED) visits for the abuse of an illegal drug. Over 20 percent of people seeking emergency medical treatment for abusing an illicit drug had used heroin.

When heroin is injected, it can cause skin abscesses and veins to collapse, and increase the risk for contracting an infectious disease, like HIV/AIDs or hepatitis, from sharing dirty needles. Smoking heroin may cause damage to lung tissue and burns to the hands and face. When someone snorts heroin, they may get nosebleeds and damage nasal and sinus cavities. Heroin disrupts normal blood pressure and heart rate, potentially creating cardiovascular issues like pulmonary edema, heart failure, arrhythmia, and also possible kidney failure.

Using heroin, even just one time, can be very hazardous to a person’s health and can even lead to death. Heroin can also lead to drug dependence and addiction, as ASAM warns that nearly a quarter of heroin users will suffer from an addiction involving opioid drugs. While many people think there’s no harm in trying anything once, heroin can be significantly dangerous to a first-time user.