Black Tar Heroin

Black tar heroin comes with its own set of unique health problems. Black tar users face an increased danger of developing venous sclerosis (hardened veins) and necrotizing fasciitis, a flesh-eating disease. Users often have difficulty with intravenous injection due to their damaged veins and arteries. This leads them to try “skin popping” or “muscling.” This is painful and can cause abscesses and other bacterial infections such as wound botulism.
Evidence Based
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What is Black Tar Heroin?

Black tar heroin is a dark-colored form of heroin that can be sticky like roofing tar or hard like coal. Its dark color is due to the crude processing methods that leave behind impurities. Black tar heroin is usually cut with other low-quality substances. 

Mexico produces most of this type of heroin. It gets smuggled over the border and distributed within the United States. It is more popular west of the Mississippi River and winds up on the streets of cities like Los Angeles. However, it has made its way to the northeast and is found in New York City, parts of Canada, and even Europe.

Black tar heroin is less refined and cheaper than other types of heroin, such as white powder and brown powder. Because of its low price and widespread availability it plays a substantial role in the current opioid epidemic. Most users inject black tar heroin after dissolving and diluting it, while some choose to smoke the substance.

Approximately 75 percent of black tar heroin is cut with toxic additives and contaminants, which give it the sticky, tar-like texture. This consistency clogs injection needles and users’ blood vessels, increasing the risk of damage to your kidneys, brain, liver, and lungs.

Graphic human body showing symptoms.

Health Effects of Black Tar Heroin

The euphoric effects of black tar heroin are similar to conventional powder heroin. Both substances have serious adverse impacts on your health. Heroin users have a high risk of the following side effects:

  • Dry mouth
  • Collapsed veins
  • Abscesses
  • Constipation
  • Gastrointestinal cramping
  • Liver disease
  • Kidney disease
  • Soft-tissue infections
  • Vascular sclerosis (hardened arteries)
  • Fatal Overdose

Heroin addiction and tolerance develop very quickly, even in short term users. Withdrawal symptoms begin 8 to 24 hours after the last use and can last 4 to 10 days. The withdrawal symptoms are so severe it often compels users to seek more of the drug to end their discomfort. 

However, black tar heroin also comes with its own set of unique health problems. Black tar users face an increased danger of developing venous sclerosis (hardened veins) and necrotizing fasciitis, a flesh-eating disease.

“Users interviewed with experience of both PH (powdered heroin) and BTH (black tar heroin) reported much more vein damage from black tar.”

Journal of Psychoactive Drugs

Black tar heroin users often have difficulty with intravenous injection due to their damaged veins and arteries. This leads them to try “skin popping” (injecting into the subcutaneous tissue, or the layer of tissue between the skin and muscle) or “muscling” (injecting into the muscle). This is painful and can cause abscesses and other bacterial infections. 

Wound Botulism

Multiple reports have linked black tar heroin to botulism. Botulism is a rare illness that develops from bacteria infecting a wound. The toxin attacks your body’s nerves, making it difficult to breathe and causing muscle weakness. 

In severe cases, people can die from wound botulism. Even if they are treated with antitoxin, they may need to stay in the hospital for weeks or months to recover.

Heroin Overdose

The rate of drug overdose deaths involving heroin raised from 0.7 to 1 percent in 2010, then increased enormously to 4.9 percent in 2016 and 2017.

Centers for Disease Control and Prevention, NCHS Data Brief

This staggering increase is due to several factors, including the rise in popularity of fentanyl. Fentanyl is an even more potent opioid linked to many heroin overdoses. Anyone who uses heroin is at risk for overdose. 

Signs of heroin overdose include:

  • Dry mouth
  • Small pupils
  • Drowsiness
  • Disorientation
  • Weak pulse
  • Blue nails, skin, or lips
  • Weak or shallow breathing
  • Coma

If you’re with someone who is overdosing on heroin, call 911 immediately. “Good Samaritan” laws protect people who call 911 to report an overdose in 40 states. Saving someone’s life is more important than criminal charges.

In the last two decades, heroin has played a significant role in the opioid crisis. Heroin overdoses have increased by nearly 500 percent over the previous ten years and now kill more people each year than traffic accidents. 

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Who Uses Black Tar Heroin?

Black tar heroin addiction is usually divided into two categories: heroin inhalers and injection drug users. According to a study published in Journal of Maintenance in the Addictions, inhalers typically have higher wages and less problems according to the Addiction Severity Index (ASI). Injection users typically are older, have experienced jail time, treatment episodes, and have been diagnosed with hepatitis C, HIV/AIDS, or gonorrhea.

“There were high levels of physical and mental problems and histories of traumatization as children and adults for almost all the respondents. Males were as likely as females to have been sexually abused as children or as adults.”

Journal of Maintenance in the Addictions 
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Addiction Treatment

Black tar heroin addiction treatment is similar to other opioid treatment approaches. Behavioral therapy is the foundation, and medication-assisted therapy often augments the treatment program.

Seeking help at a professional treatment center help will greatly increase your chances of recovery. Contact a local rehab center to find out about their services. If you have a history of mental health problems, be sure that they offer dual-diagnosis treatment. A comprehensive heroin recovery program should include:

  • Detox
  • Therapy
  • Medication options
  • Support groups
  • Aftercare planning

Heroin addiction causes extensive changes to the brain. Many heroin users do not believe that they can overcome their substance use disorder, and they are doomed to suffer from addiction for the rest of their life. However, with professional treatment, anyone can overcome their substance abuse problem and learn to live a sober life.


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Resources

Mars, Sarah G et al. “The Textures of Heroin: User Perspectives on "Black Tar" and Powder Heroin in Two U.S. Cities.” Journal of psychoactive drugs vol. 48,4 (2016): 270-8. doi:10.1080/02791072.2016.1207826

NIDA. "Heroin." National Institute on Drug Abuse, 8 Jun. 2018, https://www.drugabuse.gov/publications/research-reports/heroin.

Maxwell, Jane Carlisle, and Richard T Spence. “An Exploratory Study of Inhalers and Injectors Who Used Black Tar Heroin.” Journal of maintenance in the addictions vol. 3,1 (2006): 61-82. doi:10.1300/J126v03n01_06

“Injection Drug Use and Wound Botulism.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 Oct. 2018, www.cdc.gov/botulism/wound-botulism.html.

NIDA. "Overdose Death Rates." National Institute on Drug Abuse, 10 Mar. 2020, https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates.

“Drug Overdose Deaths.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 19 Mar. 2020, www.cdc.gov/drugoverdose/data/statedeaths.html.

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Updated on: June 24, 2020
Author
Michael Bayba
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Medically Reviewed: June 3, 2020
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Annamarie Coy

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