A Guide to Heroin Addiction and Abuse

Table of Contents

Common Questions

Is Heroin Addictive?

Yes, it’s an illegal, highly addictive drug that is dangerous and possibly life-threatening. In 2017, approximately 494,000 Americans (ages 12 years and older) reported using heroin in the past year.1

What is Its Drug Class?

Heroin is an opiate drug that is considered a narcotic.2 It’s made from certain poppy plants and morphine.

Where is Heroin on the Schedule of Drugs?

According to the DEA (Drug Enforcement Agency), heroin is a Schedule I drug.3 Schedule I substances are defined as having no currently accepted medical use and a high potential for abuse.

Is Heroin Safe?

No, it’s not safe in any form. Since it is made illegally, there is no quality control on what the substance contains. There could be caustic fillers (like rat poison) or other powerful, potentially deadly drugs mixed in (like fentanyl).

Street Names

Street names include:

  • Big H
  • Black Tar
  • Brown Crystal
  • China White
  • Chiva
  • Hell Dust
  • Horse
  • Mexican Mud
  • Negra
  • Smack
  • Thunder

How is It Used?

Heroin is abused by:

  • Injecting it with a needle
  • Smoking
  • Snorting

With high purity levels it’s usually smoked or snorted.2

Physical Effects of Heroin

Short-term Effects

The initial effects of taking heroin is a “rush” of euphoria that powerfully surges during the first few minutes. This is followed by a sleepy state and then wakefulness.

Long-term Effects

Physical effects after the rush can include:2

  • Sleepiness
  • Slowed breathing
  • Constricted pupils
  • Nausea
  • Warm skin flushes
  • Dry mouth
  • Heaviness in the arms and legs

Can You Overdose on Heroin?

Yes, it is very easy to overdose on heroin. During 2017, more than 15,000 Americans died from heroin-related drug overdoses.

Since the potency of a batch cannot be determined, there is no way to regulate how much to use, and how much might cause death due to overdose. Overdose symptoms include:2

  • Slow and shallow breathing
  • Clammy skin
  • Bluish fingernails
  • Convulsions
  • Coma
  • Possible death

What is Withdrawal Like?

After stopping use of heroin, the following withdrawal symptoms may happen within several hours:

  • Restlessness
  • Insomnia
  • Drug craving
  • Bone pain
  • Diarrhea
  • Muscle pain
  • Cold flashes with goosebumps
  • Involuntary leg movements

More serious withdrawal symptoms peak at 48 to 72 hours after the last dose. These more serious symptoms last approximately a week. Weakness and depression can settle in. Nausea and vomiting are common.

There are some people that experience withdrawal signs for many months or possibly years. There is a high degree of compulsive drug use when heroin is involved. Also, there is a high relapse rate for heroin use. Medication-assisted therapy (MAT) is available at treatment centers.  MAT helps with addiction issues, like, withdrawal, cravings and relapse prevention.

Treatment for Heroin Addiction

Strong compulsions to use heroin coupled with high rates of relapse makes it difficult (if not impossible) to stop taking heroin without help. Formal treatment is the best option to get and stay sober.

The two main options are inpatient or outpatient rehab for heroin addiction.

Inpatient rehab eliminates temptations and distractions of the outside world, especially those that contribute to addiction. The initial high risk of relapse is lowered with a residential setting with 24/7 monitoring.

Outpatient rehab is a good choice if you are ready to stop using substances, and you want the flexibility to handle responsibilities at home and work. Treatment schedules are flexible, letting you choose the time that best fits into your schedule.

Addiction is treatable. If you or a loved one is struggling with heroin abuse or addiction, talk with your doctor, counselor, or a treatment center for help.


  1. https://www.dea.gov/factsheets/heroin
  2. https://www.dea.gov/drug-scheduling

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