Heroin slows and sometimes stops breathing, which can result in death.  In

2015, there were 2,343 deaths related to heroin or other illicit opiods among

people ages 15-24.

In 2019, that number was nearly tripled in California.












Heroin is a highly addictive opiate drug,  which is processed from morphine. It comes in several forms including a white powder, brownish powder, a black sticky substance knows as tar and liquid tar.  The substance is extracted from opium which is derived from certain poppy plants.  

For many people who take heroin, it is more about avoiding or numbing pain than feeling good.  It is used to self medicate and is often used by people with depression and anxiety.  After a hit of heroin, chemical changes in the brain give the user a feeling of intense pleasure, which is satisfying to those who do not feel good in the first place, despite the fact that it worsens unpleasant feelings over time.


Heroin can be injected with a needle, smoked, sniffed or snorted and those who inject it are at risk of infectious diseases such as HIV/AIDS, hepatitis and liver or kidney disease.  It is a myth that heroin is less dangerous if you snort or smoke it.  You can still die of an overdose or become addicted by snorting and smoking heroin.  There is no safe way of using it.


Heroin enters the brain rapidly and causes a fast, intense high.  Heroin use alters the brain circuits that control reward, stress, decision-making and impulse control making it more difficult to stop using even when it has negative consequences. Repeated use can lead to a tolerance and withdrawal, so you need more of the drug just to feel normal. As higher doses of the drug are used over time, physical dependence and addiction to the drug develop, leading to about 23% of individuals who use heroin becoming dependent on it.  



Heroin is an illicit opiod which enters the brain quickly.  It changes thoughts, feeling and sensations.  It slows down the way you think, reaction time and memory. Users often report feeling a surge of euphoria or “rush” followed by a twilight state of sleep and wakefulness.

Heroin is very addictive both psychologically and physically.  At lower doses, heroin can make a person feel calmer, less tense and more accepting of those around them.  It may help to reduce anxiety in certain settings.  While at higher doses, people often diconnect from those around them, experience a kind of floating or dream-like state, which can be a relief for those with a high level anxiety or depression or those who feel alienated from the world around them.




Heroin slows down the heart and breathing, sometimes so much that it can be life-threatening. It causes drowsiness, respiratory depression, constricted pupils, nausea, warm flushing of the skin, dry mouth,  and heavy extremities.  In addition, long term effects can include abscesses, itching, collapsed veins, damaged tissue, mental disorders, liver and kidney disease, infection of the heart lining and valves, constipation and reduced sex drive.

Heroin is often unpleasant the first time it is taken, which causes many people never to do it again.  The effects it has on the nervous system can cause immediate vomitting. When combined with supressed breathing and the coughing reflex it increases the risk of choking.  Heroin poses special problems to those who inject it because of the risks of HIV, hepatitis B and C, and other diseases that can occur from sharing needles.

Signs of a heroin overdose are slow and shallow breathing, blue lips and finger nails, clammy skin, convulsions, and coma.  When someone overdoses it causes lack of oxygen to the brain called hypoxia.  Hypoxia can cause long term effects on the nervious system, brain damage and death.




People selling heroin often mix in other substances, such as sugar, starch, powdered sugar and more dangerous chemicals like fentanyl.  These added substances can clog blood vessels leading to liver, lung, kidney and brain inflammation or infection, not to mention death.  Because these fillers are added the amount of actual heroin is unpredictable, so it is impossible to know if any given dose will be strong enough or too weak to provide a high, increasing the chances of an overdose.  Reactions depend on how pure it is or by what the drug dealer has mixed into it.


Heroin comes from the seed pods of various opium poppy plants grown in Southeast and Southwest Asia, Afgahnistan, Mexico and Columbia.

Mexico is the primary importer of heroin into the United States importing mainly black tar heroin.  Mexico previously specialized in producing the lowest quality of the drug, in a brown powder substance, but due to the U.S. markets demands over the last few decades they were forced to shift their focus.

With the white powder form that is produced in Afghanistan being in high demand Mexico had no choice but to improve its own product in order to survive. They did so by developing black tar which is comparable to white powder in its potency. However, black tar lacks purity and about three-quarters of the product containing toxic contaminants.  


Between 2002-2013 heroin use in the United States increased by 63% and has continued to increase sharply across the United States among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use, including women, people who are privately insured, and people with higher incomes.

Due to the availability and inexpensive prices on the streets for black tar heroin, it is a popular choice for many people addicted to opiates. According to the National Survey on Drug Use and Health (NSDUH), nearly 950,000 people in the United States used heroin in the past year and this number has been on the rise since 2007.

The number of first time users is high, with 170,000 people trying heroin in 2016, which nearly doubled the number of people in 2006.  Young people are especially susceptible to heroin use. Adults between the ages of 18 and 25 have the greatest increases.  The good news is we are not seeing the same trends with teenagers, as those aged 12 to 17.

The impact of heroin use is felt all across the United States, with heroin being identified as the most or one of the most important drug use issues affecting several local regions from coast to coast. Heroin-involved overdose deaths have increased by nearly 5 times since 2010 and use no longer predominates solely in urban areas. Several suburban and rural communities increasing amounts of heroin seized by officials as well as increasing numbers of overdose deaths.  

California’s overdose rate increased by 15.5 % between 2018 – 2019, which is credited to the introduction of fentanyl into black tar heroin.  In total there were nearly 12,000 overdose deaths in California alone.


People who are addicted to heroin and stop using abruptly may have severe withdrawal symptoms as soon as a few hours after the last dose.  Some of these symptoms include restlessness, sever muscle and bone pain, sleep problems, disarrhea, vomiting, cold flashes with goose bumps and uncontrollable leg movements.

Medication in combination with behavioral treatment can help people stop using heroin and recover from addiction.  Building a support system that helps people stop using is also important.  Medications such as methadone and naloxone greatly increase the chance of recovery and reduce the risk of overdose.


Black Tar Heroin – Everything You Need to Know.  werecover.com. April 2019. Web. 13 Aug. 2020.         

Drug Fact Sheet – Heroin. DEA.gov. April 2020. Web. 11 Aug. 2020.

Heroin Drug Facts. DrugAbuse.gov. November 2019. Web. 11 Aug. 2020

       Content source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human  Services.

Heroin Research Report. FDA.gov. Jama 2019. Web. 12 Feb. 2020.

Opiod Overdose – Heroin. CDC.gov. March 2020. Web. 13 Aug. 2020.

        Content source: Centers for Disease Control and PreventionNational Center for Injury Prevention and Control

The Feeling of Getting High on Heroin.  VeryWellMind.com. March 2020. Web. 12 Aug. 2020.

Tips for Teens: The Truth About Heroin.  SAMHSA.gov. April 2018. Web. 11 Aug. 2020.