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What is Heroin?

Heroin is a type of illegal drug derived from morphine, a naturally-occurring substance extracted from the opium poppy plant. Heroin belongs to a category of drugs called opiates or opioids, which treat pain. Heroin appears as a white or brownish powder that is "cut" with sugars, starch, powdered milk, or other substances. It can be snorted, smoked, or injected.

How Addictive is Heroin?

Heroin is highly addictive. Heroin users often develop a tolerance and need higher and more frequent doses of the drug to achieve the desired effects. Many heroin users develop a substance use disorder (SUD), which is when continued use of the drug causes issues in their lives. 

Heroin addicts who suddenly stop using the drug may experience severe withdrawal. Most of these symptoms feel like intense flu, complete with aches, chills, depression, exhaustion, nausea, and powerful cravings for the drug.

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What Does a Heroin High Feel Like?

Heroin users often describe feelings of warmth, relaxation, and detachment, and reduced anxiety. Heroin is a powerful sedative, and can diminish physical and emotional aches and pains. Heroin can also make people feel sleepy or feel like they're in a dream. When injected or smoked, heroin is quickly introduced into the bloodstream and leads to feelings of euphoria.

The effects of heroin appear quickly and can last for several hours, depending on the dosage and administration mode. 

Effects of Heroin High on the Mind

Repeated heroin use changes the brain, creating long-term imbalances in neurons and hormonal systems. Studies have shown a loss of the brain’s white matter is associated with heroin use, which may affect decision-making, behavior control, and stress response.

Heroin affects the opioid receptors, and the brain's risk/reward system. The more a person takes heroin, the less natural opioid the brain will produce. The brain also decreases how much dopamine, serotonin, and other neurotransmitters it produces due to heroin use.

If a person is not able to take heroin when experiencing cravings, they will experience withdrawal symptoms, which include:

  • Restlessness
  • Severe muscle and bone pain
  • Sleep problems
  • Diarrhea and vomiting
  • Cold flashes with goosebumps 
  • Uncontrollable leg movements 
  • Severe cravings

In addition, heroin is a depressant drug and can cause long-term negative impacts on the user’s emotional well-being, creating a psychological dependence, confusion, and mood swings.

Effects of Heroin High on the Body

Many people find heroin very unpleasant the first time they take it. The effects of heroin on the nervous system can cause vomiting, suppressed breathing, a coughing reflex, and constipation. Over time, as a user builds a tolerance, heroin creates a sensation of relaxation in the body and can cause the limbs to feel heavy.

Heroin is a depressant that slows down the body’s systems. It lowers blood pressure and reduces heart rate.

Physical signs that someone may be high on heroin include: 

  • Dry mouth
  • Flushed skin
  • Constricted pupils
  • Falling asleep suddenly
  • Slow breathing
  • Loss of self-control
  • Itching
  • Nausea
  • Vomiting
  • Constipation

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Risks & Dangers of Heroin Use 

Heroin use is associated with several severe health conditions, including fatal overdose, spontaneous abortion, and infectious diseases like hepatitis and HIV (transmitted through contact with blood or other bodily fluids, which can occur when sharing needles). Chronic heroin use leads to collapsed veins and bacterial infections of the heart and blood vessels. Heroin use can also cause health problems such as rheumatoid arthritis.

Heroin is often "cut" with such ingredients as sugar and powdered milk. Some of these ingredients do not dissolve well and, when injected, can form blood clots that can affect the brain, heart, and lungs. Heroin is also often cut with more potent opioids like fentanyl, which results in overdose deaths.

In the U.S., approximately 128 people die daily from opioid overdoses.

Symptoms of Heroin Addiction 

The symptoms that someone is addicted to heroin include:

  • Persistent hacking cough 
  • Dry mouth
  • Tiny pinpoint pupils 
  • Huge pupils (if withdrawing from heroin)
  • Eyelids and arms/legs appear to be heavy
  • Cuts, bruises, or scabs from skin picking 
  • Infections or abscesses from injecting
  • A strong smell of cigarette or marijuana smoke (heroin addicts often smoke both)
  • Lack of hygiene and disregard for physical appearance
  • Sores on nostrils or lips 
  • Nosebleeds
  • Burn marks on fingers or mouth
  • Dark circles or puffiness under the eyes
  • Flu-like symptoms: fever, achy, vomiting, always cold
  • Runny nose or constant sniffing 
  • Needle marks on arms or legs 

Treatment for Heroin Abuse & Addiction 

Opiates, mainly heroin, account for 18% of the admissions for drug and alcohol treatment in the United States.

A range of addiction treatments, including medicines and behavioral therapies, effectively help people stop heroin use. It's essential to match the best treatment approach to meet the particular needs of each patient.

Behavioral therapies for heroin addiction include cognitive-behavioral therapy (CBT) and contingency management (CM). 

Medicines help with the withdrawal process. The FDA approved lofexidine, a non-opioid drug designed to reduce opioid withdrawal symptoms. Other medications that help stop heroin use include buprenorphine, methadone, and naltrexone. However, unlike methadone and buprenorphine, naltrexone is not a controlled substance, and is not addictive as it's not an opioid.

Naloxone, sold under the brand name Narcan, is used to prevent opioid overdose in emergencies. 

Because of the high overdose rate, persons addicted to heroin should immediately seek medical treatment at an inpatient, outpatient, detox, or partial hospitalization rehab program.

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Resources

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“Fentanyl.” DEA.gov, United States 
Drug Enforcement Administration, www.dea.gov/factsheets/fentanyl

“Heroin Statistics - Facts About Heroin Addiction, Use & Death - Drug-Free World.” Drugfreeworld.org, Foundation for a Drug-Free World, www.drugfreeworld.org/drugfacts/heroin/international-statistics.html

“How Opioid Drugs Activate Receptors.” National Institutes of Health, U.S. Department of Health and Human Services, 5 June 2018, www.nih.gov/news-events/nih-research-matters/how-opioid-drugs-activate-receptors

NIDA. "Heroin DrugFacts." National Institute on Drug Abuse, 21 Nov. 2019, https://www.drugabuse.gov/publications/drugfacts/heroin Accessed 3 Jan. 2021.

NIDA. “Opioid Overdose Crisis.” National Institute on Drug Abuse, 10 June 2020, www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis

NIDA. "What are the long-term effects of heroin use?." National Institute on Drug Abuse, 28 May. 2020, https://www.drugabuse.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use Accessed 3 Jan. 2021.

NIDA. "What is heroin and how is it used?." National Institute on Drug Abuse, 28 May. 2020, https://www.drugabuse.gov/publications/research-reports/heroin/what-heroin Accessed 3 Jan. 2021.

“Signs of Heroin Use.” Easy Read, National Institute on Drug Abuse, 5 Sept. 2019, https://easyread.drugabuse.gov/content/signs-heroin-use

“Warning Signs That a Person Might Be Using Heroin.” 54 Heroin Abuse or Addiction Warning Signs, New Hope Recovery Center, www.nationwidechildrens.org/-/media/documents/151683

What Is Heroin and What Does It Feel like? https://drugpolicy.org/drug-facts/what-is-heroin

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