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Is Heroin Dangerous?

In nearly one-third of opioid overdose deaths, a dangerous opioid substance called heroin is to blame. People frequently question what heroin looks like and how to identify it because it is a deadly, addictive, and illegal substance. This is especially valid if you have reason to believe that a friend or family member is having problems with heroin addiction. Many people ask, “what does heroin look like?” To learn more, read ahead.

Is Heroin Addictive?

The abuse of drugs and alcohol is a significant problem worldwide, costing 250 billion dollars annually due to premature deaths, healthcare expenditures, reduction of productivity, lost earnings, and drug-related crime in the United States alone.

Drug Abuse and National Institute on Alcohol Abuse and Alcoholism). Drug addiction is considered to be a chronic, relapsing disorder characterized by compulsive drug-seeking, continued use despite serious negative socio-economic and health consequences, and loss of control over drug use [3].

Many drugs of abuse, including opioids, alcohol, and nicotine, can alter the levels of endocannabinoids in the brain. Recent studies show that the release of endocannabinoids in the ventral tegmental area can modulate the reward-related effects of dopamine and might therefore be an important neurobiological mechanism underlying drug addiction. There is strong evidence that the endocannabinoid system is involved in drug-seeking behavior (especially behavior reinforced by drug-related cues) and in the mechanisms that underlie relapse to drug use.

Heroin is very addictive because it causes changes in the brain that trick the parts responsible for motivation and pleasure into thinking heroin is desirable. The brain is programmed to remember experiences that cause happiness. It’s also designed to motivate us to repeat these experiences in the future. Addictive substances such as heroin trick the brain, encouraging us to seek drugs.

Heroin abuse and addiction are very difficult to overcome, and many addicts struggle with becoming clean and sober, and this is because of the addictive nature of the drug. Heroin causes an intense euphoria and trance-like state that will become addictive and habit-forming.

Heroin is a unique drug. It doesn’t cause a euphoric rush as intense as the rush caused by cocaine or crystal meth. It doesn’t last as long as many prescription drugs. But heroin is often described as one of the most addictive drugs because it creates a physical and psychological dependency.

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Heroin Drug Facts

Heroin

Heroin is an opioid drug made from morphine, a natural substance from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder or a black sticky substance known as black tar heroin.


How do people use heroin?

People inject, sniff, snort, or smoke heroin. Some people mix heroin with crack cocaine, a practice called speedballing.


What are the effects of heroin?

Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.

Short-Term Effects

People who use heroin report feeling a “rush” (a surge of pleasure or euphoria). However, there are other common effects, including:

  • dry mouth
  • warm flushing of the skin
  • heavy feeling in the arms and legs
  • nausea and vomiting

Long-Term Effects

People who use heroin over the long term may develop the following:

  • insomnia
  • collapsed veins for people who inject the drug
  • damaged tissue inside the nose for people who sniff or snort it
  • infection of the heart lining and valves
  • abscesses (swollen tissue filled with pus)
  • constipation and stomach cramping
  • liver and kidney disease

Heroin Statistics

In 2020, heroin-involved overdose death rates decreased by nearly 7% 2019 to 2020. However, more than 13,000 people died from a drug overdose involving heroin in the United States, a rate of more than four deaths for every 100,000 Americans. The number of heroin-involved overdose deaths was nearly seven times higher in 2020 than in 1999. Almost 20% of all opioid deaths involved heroin.


13,000

More than 13,000 people died from a drug overdose involving heroin in the United States.

Source: CDC

20%

Almost 20% of all opioid deaths involved heroin.

Source: CDC

What is Heroin?

Heroin, also known as diacetylmorphine, is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia [1]. What does heroine look like? And what does a gram of heroin look like? Heroin can be a white or brown powder or a black sticky substance commonly known as black tar heroin. People sniff, inject, snort, or smoke heroin. Some people mix heroin with crack cocaine, a practice called speedballing. Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.

Heroin is addictive, and there is a high risk of drug overdose and death from using it. What does pure heroin look like? Heroin also often contains additives, such as sugar, starch, or powdered milk, that can clog blood vessels leading to the lungs, liver, kidneys, or brain and cause permanent damage. In addition, sharing drug injection equipment and having impaired judgment from drug use can increase the risk of contracting infectious diseases such as HIV and hepatitis (see “Injection Drug Use, HIV, and Hepatitis”).

Heroin is a Schedule I drug under the Controlled Substances Act of 1970, with no approved medical use in the United States. What does a heroin overdose look like? A person can easily overdose on illegal drugs like heroin. A drug overdose occurs when a drug produces adverse severe effects and life-threatening symptoms. Death from an opioid overdose happens when the drug depresses the parts of the brain that control breathing.

Purity of Heroin

Street drugs such as heroin are rarely pure. It may be a white powder or dark brown. The purity can differ widely as many impurities may depend on the manufacturing process. Starches, sugar, powdered milk, and other drugs are often added as fillers. The unpredictable strength of heroin further complicates matters on top of the person’s addiction.

Many heroin overdoses are often accidental. Some individuals switch from a prescription opioid-based medication to a drug for various reasons. The problem is these prescription medications are supplied in known dosages and compositions, and heroin isn’t. Even if heroin may be easier to obtain, the purity can vary regardless of the source. There’s little or no regulation of dosage, so people often don’t know how much drug they are taking. Impurities or fillers are added by dealers to increase potency or cut production costs. 

In 2009, the United Nations Office on Drugs and Crime reported that Afghanistan had identified several chemicals used to cut heroin. Substances included caffeine and other compounds, such as chloroquine, phenolphthalein, and paracetamol. Caffeine makes heroin vaporize when exposed to lower temperatures. Chloroquine is a drug used to treat malaria. Chloroquine is widely available and low in price but does not change the properties or use of the drug. Some believe the additive may be sold as fake heroin in Southwest Asia.

Cutting agents used include:

  • Phenolphthalein: This substance has been used as an acid, base indicator, and laxative and is a known carcinogenic. However, the reasons for cutting heroin are not fully understood.
  • Paracetamol: An over-the-counter (OTC) painkiller, it has a mild analgesic effect and a bitter taste. It might be used to disguise poor-quality heroin and is commonly used in many countries.
  • Fentanyl: This narcotic pain medication is used as a cutting agent or sold as heroin. It is as much as 100 times more potent than morphine, which is why there was an increase in the penalty for trafficking heroin cut with this drug by up to five years. Fentanyl has been the reason for many drug-related deaths in the US.
  • Tylenol PM: Cutting black tar heroin with these tablets is more practical because of the cooking process used for creating what’s known as cheese heroin. Other medications with diphenhydramine and acetaminophen may be used as well.

Chalk, flour, talcum powder, starch, and more dangerous agents, such as methamphetamine, cocaine, alprazolam, ecstasy, and crack cocaine, are also been used. Therefore, street heroin’s purity can vary greatly, anywhere from 3-99 percent. One can easily see why the risk of overdose is so high.

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7 Types of Heroin

Heroin comes in many colors, forms, textures, and cuts; the most popular type of heroin can vary by region. Substances that manufacturers add and drug dealers to heroin also affect its texture and appearance.

Street heroin is almost always combined with “cutting agents,” or fillers, to increase profit and stretch the drug dealers’ supply. 

1 White Powder Heroin

What does powder heroin look like? White to off-white refined powder heroin, known as diacetylmorphine hydrochloride, is the purest form of heroin. However, it may be cut with other substances. Sometimes the color may be beige or pink, depending on the exact ingredients and the processing methods. Typically, the whiter the heroin, the purer it is, but white powder fillers can still cut it. Because it dissolves quickly, people inject this type of heroin, but the additives can sometimes cause problems. It’s not usually smoked because it burns at much higher temperatures than other forms of heroin.

2 Brown powder Heroin

Brown powder heroin is an increasingly common form of heroin. Brown powder used to be sold primarily in the western United States, but it also shows up in cities in the Midwest and along the East Coast.

Some brown powder is produced from black tar heroin that is crushed and laced with cutting agents to make it easier to snort. Others are produced as the result of the first stage of purification and may also be engraved with lactose. It has an appearance similar to sand but can vary in shade of brown depending on the additives.

Because brown heroin can be snorted or smoked and doesn’t require intravenous injection, it has gained popularity among suburban teenagers and others who might never before have considered using heroin due to a fear of needles, track marks, and blood-borne disease.

3 Black Tar Heroin

Black tar heroin is the most common form of heroin sold west of the Mississippi River. Black tar heroin can look drastically different from brown or white powder heroin. True to its name, black tar heroin typically comes in black chunks and may feel sticky. 

What does black tar heroin look like? Of all the different forms of heroin, black tar heroin is usually much less refined and has a lower purity. It also has a different and cheaper production process than other types of heroin, making it less expensive. Injecting black tar heroin can lead to many complications.

Black tar heroin also clogs needles, while white powder heroin does not. Despite its name, black tar heroin is not always black. The drug can also appear brown or reddish. It can be sticky like roofing tar or hard like coal. It can also look like melted licorice. 

4 China White

At one time, China White referred to pure white powder heroin manufactured in Southeast Asia. Today, the name is more commonly used as a slang term for powder heroin mixed with fentanyl or other analogs of fentanyl. China White can also refer to fentanyl sold as heroin or a heroin-like product.

Both China White and fentanyl have fearsome reputations, and fentanyl-laced heroin has been associated with the recent spike in opioid-related overdose fatalities.

5 Speedball

A speedball mixes heroin and a stimulant, such as cocaine, a central nervous system (CNS) depressant and an inspiration. Usually cocaine, but meth is also used, though not as frequently. When used in conjunction, these two drugs can create a dangerous tug-of-war effect on the body. 

While heroin acts on the CNS to slow breathing and induce drowsiness, cocaine (and meth) increase heart rate and blood pressure and can cause anxiety and agitation. Speedballing can cause a heart attack, stroke, aneurysm, or respiratory failure. Speedballs are also increasingly tainted with fentanyl, a potent synthetic opioid that can cause overdose and death.

6 Gun Powder Heroin

A reportedly more potent version of black tar heroin called gunpowder heroin has been popping up on the West Coast. Gunpowder heroin is a crumbly substance resembling dried coffee.

As the name would suggest, it often resembles gunpowder or coffee grounds. The color is usually dark grey or solid black but may also contain white or black specks. Because of its increased solubility versus black tar heroin, it is easier to inject, and its relatively lower cost may contribute to its popularity among some users.

7 Scramble

Scramble is a mixture of brown or white powder heroin and other substances packed into a gelatin capsule. It may contain many filters, including lactose, quinine, fentanyl, crushed opioid pills, and benzodiazepines. A scramble is a widespread form of heroin in Baltimore.

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Heroin Addiction

The specific causes of heroin addiction can vary from person to person. However, research has shown that a combination of dynamics can explain why a person becomes a heroin addict. Some of these causes may include the following:

Genetic: Researchers believe genetics contribute to whether or not a person is susceptible to drug addiction. Moreover, certain personality traits could render a person vulnerable to developing a substance abuse problem.

Physical: Because heroin quickly crosses the blood-brain barrier, a heroin addict’s brain functioning is at risk of impairment. The ability to process information, communicate effectively, and regulate impulses are all hindered when a person uses heroin. These hindrances put the addict at risk of compromising his or her safety and the safety of others.

Environmental: People with early exposure to drug addiction are at risk of learning that drug abuse is a way to cope with stress. Additionally, and for those without this exposure, traumatic life events can trigger a person to turn to drugs to manage stress.

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Treatment for Heroin Addiction

When people addicted to opioids like heroin first quit, they undergo withdrawal symptoms (pain, diarrhea, nausea, and vomiting), which may be severe.

Medications can be helpful in this detoxification stage. This is to ease craving and other physical symptoms that can often prompt a person to relapse.

Medication-assisted treatment (MAT) can be considered by all individuals seeking treatment for heroin addiction. Drugs such as Suboxone, Zubsolv, and Vivitrol may aid heroin addicts in their recovery.

  • Lofexidine. FDA-approved, a non-opioid medicine designed to reduce opioid withdrawal symptoms. It is the primary medication for detoxification and heroin withdrawal symptoms.
  • Methadone (Dolophine or Methadose) is a slow-acting opioid agonist. Methadone is taken orally to reach the brain slowly while preventing withdrawal symptoms. Methadone is only available through approved treatment programs, where it is dispensed to patients daily.
  • Buprenorphine (Subutex). FDA approved. Buprenorphine relieves drug cravings without producing the “high” or dangerous side effects of other opioids. Suboxone is a novel formulation of buprenorphine that is taken orally and contains naloxone (an opioid antagonist) to prevent attempts to get high by injecting the medication.
  • Naltrexone (Vivitrol). FDA approved. It is a medication primarily used to manage alcohol or heroin addiction by reducing cravings and feelings of euphoria associated with substance abuse. Heroin addicted person should not receive naltrexone before detoxification.
  • Naloxone should be given to anyone who shows signs of an opioid overdose or when an overdose is suspected. It can be given as a nasal spray or injected into the muscle, under the skin, or into the veins.

Behavioral Therapies

Behavioral therapies or Psychotherapies – Cognitive behavioral therapy (CBT) helps modify the patient’s expectations and behaviors related to drug use and increase skills in coping with various life stressors.

Detoxification

Many heroin-dependent individuals require detox as their first stop due to the withdrawal symptoms they experience when they cease using heroin. Detox consists of gradually tapering off the patient’s usual dosage of heroin while also shifting dependence from heroin to a drug with similar but less severe and addictive effects. The patient can then be weaned off the new medication, often avoiding the harmful results of prolonged heroin withdrawal. After detox, the patient enters inpatient rehab for an extended period based on how severe the addiction is.

If you or your loved one is suffering from heroin addiction, help is a phone call away. Professional heroin addiction treatment is necessary for fast and effective recovery. To help you answer the question “what does heroin look?”, contact us today at We Level Up NJ Treatment Facility. We provide the utmost care with doctors and medical staff available 24/7 for life-changing and lasting recovery. We offer an enhanced opportunity to return to a fulfilling and productive life.

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FAQs

What does someone on heroin look like? And what does a heroin addict look like?

This condition has a few distinctive characteristics, including bloodshot eyes, pinpoint pupils, and an out-of-focus or sleepy countenance.

What does a heroin pipe look like?

A heroin pipe could look like a small glass pipe similar to a “crack pipe” used to smoke crack cocaine or methamphetamine. It could also simply be a straw or another tube-like apparatus.

Sources

[1] NIDA. 2021, June 1. Heroin DrugFacts. Retrieved from https://nida.nih.gov/publications/drugfacts/heroin on 2022, November 16=

[2] [3] Huecker MR, Koutsothanasis GA, Abbasy MSU, et al. Heroin. [Updated 2022 Sep 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441876/

[4] Oelhaf RC, Azadfard M. Heroin Toxicity. [Updated 2022 May 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430736/