The name heroin is infamous around the world for its potent qualities and devastating effects on humanity. For former addicts, the word alone can send shivers down their spines as they recall the strength the drug had over them. For users today, heroin is a drug that has them stuck in the cycle of addiction. While heroin is a common name, if you’re unfamiliar with its many forms, black tar heroin is another version of the drug that users can smoke or inject.
In 2019 alone, an estimated 50,000 people died from opioid-involved drug overdoses nationwide due to the misuse and abuse of drugs like heroin, prescription pain relievers, and synthetic opioids like fentanyl. While it’s hard to put a financial cost on life, the U.S.Centers For Disease Control and Prevention (CDC) estimates the economic burden of prescription opioid abuse costs the country $78.5 billion each year. This is due to addiction treatment, criminal justice involvement, healthcare, and lost productivity.
You might be wondering, how did this all happen? In the ‘90s, pharmaceutical companies approached doctors and assured them that their patients wouldn’t become addicted to their product. It subsequently led to widespread prescribing by doctors of potent narcotics for minor procedures. Despite government intervention that occurred when the problem became out of hand, once a person became addicted, they seemingly moved on to drugs like black tar heroin to get their fix.
The statistics show that an estimated 4% to 6% of people who misuse prescription opioids will move on to heroin. Nearly 80% of those who use heroin first misused prescription opioids. Despite the dramatic drop in prescribing across the country for several years in a row, all forms of heroin continue to flood their way from the southern border into the United States and cause havoc on communities across the country.
Let’s take a look below at what heroin is, how it’s used, and what the United States government is doing to curb the use of heroin and other opioids throughout the nation.
What Is Heroin?
In 2019, an estimated 19.8% of drug overdose deaths involved heroin. This potent drug is an opioid made from morphine, which is a natural substance from the seed pod of opium plants. These are grown in Southwest and Southeast Asia, Colombia, and Mexico. The drug comes in several forms, including a white or brown powder or a black sticky substance referred to as black tar heroin.
Heroin is most commonly used through injection, but others sniff, snort, or smoke the drug. In some cases, people may also use it with crack cocaine, which is known as speedballing. This can be extremely dangerous since heroin is a depressant drug and crack is a stimulant. Using stimulants with depressants can increase the odds of a fatal overdose because uppers like crack will cover the effects of heroin. This means a person could take more and more of each drug and overdose.
Effects of Heroin
Unless you’re an addict, it’s hard to understand how the effects of heroin can lure a person in and trap them until they’re close to death. Heroin addiction is extremely powerful and takes complete control of someone’s life until they reach out for professional treatment. However, until that time comes, heroin affects the body by rapidly binding to opioid receptors throughout our body. The result is total euphoria and pain relief that controls heart rate, sleep, and breathing.
Short-Term Heroin Effects
Those who use heroin report a rush of pleasure and euphoria. However, other effects include:
- Severe itching
- Nausea and vomiting
- Dry mouth
- Warm flushing of the skin
- A heavy feeling in the arms and legs
- Clouded mental functioning
- “Nodding,” or a back-and-forth state of consciousness
Those who inject drugs like heroin are at an increased risk of contracting hepatitis C (HCV) and HIV virus, which are transmitted through contact with bodily fluids or blood. This occurs when a person shares needles or other injection equipment. Hepatitis C is the most common bloodborne infection in the country. HIV can be contracted during both unprotected sex and sharing needles.
Other long-term effects include:
- Collapsed veins in intravenous drug users
- Infection of the heart lining and valves
- Liver and kidney disease
- Damaged nose tissue for those who sniff or snort it
- Abscesses (swollen tissue filled with pus)
- Lung complications, such as pneumonia
- Sexual dysfunction for men
- Mental health conditions, such as depression or antisocial personality disorder
- Irregular menstrual cycles for women
Putting anything into your nose or veins is dangerous, but heroin is commonly cut with additives like starch, sugar, or powdered milk. By injecting the drug, it can lead to an immediate clogging of blood vessels, leading to rapid kidney, liver, lung, or brain damage. In addition to this, sharing needles and being impaired increases the chances of developing long-lasting diseases like HIV and hepatitis c.
Heroin can also cause other health hazards that stem from the drug itself and the circumstances around using it. Research has found that long-term heroin abuse can lead to a deterioration of white matter in our brains, which is linked to decision-making capabilities, our ability to control behavior, and how we respond to stress. These changes in the brain lead to a greater likelihood of relapse in those who are attempting to stop using the drug. Even a person who achieves sobriety is likely to use heroin again over someone who doesn’t have a history of abuse.
The drug is also responsible for producing profound degrees of tolerance and physical dependence, meaning you’ll need to use much more of the drug to achieve the same effects after prolonged use. When a physical dependence occurs, our bodies adapt to the presence of heroin, leading to withdrawal symptoms upon abrupt cessation.
Withdrawal can occur in as little as a few hours after it was last taken. Symptoms of withdrawal include the following:
- Bone pain
- Muscle pain
- Restless leg syndrome
- Cold flashes
- A general feeling of malaise
Major withdrawal symptoms will peak anywhere from 24 to 48 hours after the last dose of heroin and will subside after a week. However, once acute withdrawals decrease, it’s common for long-term users to experience post-acute withdrawal syndrome (PAWS), which is when symptoms like anxiety, depression, and drug cravings persist for months or even up to a year after cessation.
Repeated heroin use will result in a heroin use disorder, a chronic relapsing disease that is beyond physical dependence. It’s characterized by uncontrollable drug-seeking behavior where consequences mean nothing. A person caught up in their heroin addiction will steal their parent’s last dollar without feeling bad about it. They’re so wrapped up in heroin that they don’t want to feel the sickness of withdrawal that they’ll do just about anything to stop it. When a person develops a heroin use disorder, getting more of the drug is their primary objective and purpose in life.
The effects of heroin cause havoc in both men’s and women’s lives, but abusing the drug can lead to infertility among women and disruptions in menstrual cycles. In other cases, pregnant women who use heroin will experience miscarriages, or their baby is born prematurely addicted to heroin. The drug also affects sexual function in both men and women in the form of a reduced sex drive. Men also experience erectile dysfunction or an inability to regain sexual interest on a long-term basis.
Eventually, it gets to a point where the person has become so stuck in the cycle of addiction they lose everything. The drug can be killing them, and they don’t care; they do what it takes to avoid the sickness. This means homelessness, family members cutting off all forms of communication, and having nothing in life except heroin. Addiction is a result of homelessness, and the challenging conditions of living on the street, having to find food, and struggling with poor health leads to a highly stressful state of being.
Black Tar Heroin
Black tar heroin appears much differently than the powder form of the drug, which is commonly white or brown in color. Black tar heroin is a dark, sticky substance, which is easily distinguishable from powder, even to the untrained eye. Black tar heroin received its name due to its resemblance to roofing tar.
All forms of heroin come from morphine, but black tar heroin is primarily produced in Mexico. However, some South American and Asian countries have been known to export the drug, although it’s much less common. Black tar heroin is prevalent on the West Coast of the U.S. because of the large Mexican supply available. Areas like Los Angeles see higher levels of black tar use than other parts of the United States.
Another factor that hasn’t been touched on is how heroin can lead to overdose. For those who are new to the drug and have low tolerance, heroin overdose is likely. However, even those who use the drug frequently risk overdosing. According to data compiled by the U.S. Centers for Disease Control and Prevention (CDC), fatal heroin overdoses have continually risen over the past several years.
Since 1999, 841,000 people have died from drug overdoses, and 70% of overdose deaths in 2019 involved an opioid. From 1999 to 2019, drug overdose deaths involving heroin shot up from 1,960 in 1999 to 15,469 in 2016. Although the numbers have been on a downward trajectory since 2016, there were still 14,019 deaths in 2019.
Similar to now, the 1960s and 1970s witnessed new levels in the battle against opioids in the United States. It led to significant outreach by the government to educate the public about the hazards of this potent opioid drug. Today there is still a general public awareness about the effects of heroin and its detriment to society. However, figures have reached all-time highs in the decades preceding.
While heroin overdoses can be fatal, it’s not always the reality. Heroin overdoses can be prevented. However, to do so, you must be familiar with the signs of a heroin overdose, which include the following:
- Spastic muscles
- Shallow breathing or an inability to breathe
- Low blood pressure or weak pulse
- Blue nails or lips
- Discolored tongue
- Mental disorientation
- Pinpoint pupils
If you witness any of these signs or believe that someone has overdosed on heroin, you must immediately call emergency services. In most cases, a person will succumb to a heroin overdose because someone was afraid to contact emergency services. Please, don’t gamble with someone’s life and call for help. In 2009 alone, an estimated 213,118 emergency department visits related to heroin use.
Unfortunately, there are some groups addicted to heroin more prone to experiencing an overdose, including the following:
- Those who reduce their tolerance to heroin, including someone who went through detox or rehab and relapsed.
- Those who inject heroin, especially when transitioning from other opioids like prescription painkillers.
- Those who suffer from depression.
- Those with medical conditions affecting the liver, such as individuals with hepatitis B or C or HIV.
- Those who take heroin in conjunction with other drugs, especially depressants like alcohol or benzos.
Although the majority of those who suffer from heroin use disorder are single, heroin overdoses commonly happen in front of at least one person, including family members or friends. We can’t stress this enough, but calling 911 can save lives if you witness a heroin overdose.
How to Treat a Heroin Overdose
As was mentioned above, the first thing you must do is reach out to emergency services if you believe someone is overdosing on heroin. An overdose is a dangerous and sometimes deadly consequence of heroin use. Significant doses of heroin depress heart rate and breathing to a point where someone can’t survive without medical intervention. Naloxone, also known as Narcan, is an opioid receptor antagonist medication that eliminates all signs of opioid intoxication and reverses an opioid overdose.
Narcan works by rapidly binding to opioid receptors and prevents heroin from activating them. Due to the significant increase in overdose deaths caused by opioids, the demand for Narcan has risen dramatically. It’s simple to use and can be administered by nonmedical personnel to prevent death. In 2015, the U.S. Food and Drug Administration (FDA) approved a higher dosage nasal spray that caregivers or family members can give to someone who might have overdosed on heroin, which vastly expands access to the drug.
Once a person reaches the hospital, medical professionals could use more naloxone to get the individual under control. Although it will take someone out of an overdose, there might be enough heroin in their system and cause them to overdose again later on. For this reason, medical monitoring is necessary, and other methods doctors might consider are induced vomiting or IV fluids to stabilize the individual. Heroin overdose should never be treated at home as conditions can deteriorate rapidly, especially if someone stops breathing.
Additional Risks of Heroin Use
Heroin is illegal, meaning that all use of the drug is illicit and always involves a criminal element. Exposure to drug dealers and other addicts leaves the individual vulnerable to fights, arrests, and a host of legal troubles that can follow them around for a lifetime. Since heroin is illegal both at the state and federal levels, apprehending a person involved with heroin sales, manufacturing, or possession could face criminal sanctions. There are various ways that heroin use can lead to lengthy prison terms.
Heroin use can also lead to a driving under the influence (DUI) charge, otherwise known as “drugged driving.” Those who drive under the influence of heroin exhibit symptoms similar to alcohol, including diminished vehicle control, delayed reaction times, weaving in the road, an inability to follow posted signs, and potentially falling asleep while driving.
Despite it being a stimulant, aggression is always a side effect of heroin, and someone who abuses the drug may become violent toward intimate partners, family members, children, or strangers. Unfortunately, the abuse could become sexual. Children are the most vulnerable to heroin-involved domestic abuse. When those who use the drug achieve sobriety, they’ll become aware of how heroin damages relationships with the people most important to them. The losses may lead to stress and long-term depression that can lead to suicidal thoughts. If you’re ever thinking about hurting yourself, please reach out for help immediately.
Heroin Addiction Treatment
The only way to gain meaningful sobriety and start imagining a life outside of heroin is to consider treatment. The withdrawal from heroin addiction is severe enough to cause someone to give up early on if they were to attempt doing so alone, which is why seeking out professional addiction treatment is the only option.
From what we’ve discussed above, it should be apparent the challenges of overcoming a heroin addiction. If you’ve been using black tar heroin and you’re ready to change your life, the first step in this arduous process is to check into medical detox. While stopping alone and without help isn’t necessarily dangerous, the withdrawal symptoms are likely to overpower you and lead you to relapse, which can be hazardous. When you stop, your tolerance naturally goes down, meaning if you use a dose you were accustomed to at the peak of using days or weeks after you’ve stopped, it could lead to a fatal overdose.
Medical detox will allow you to check into a facility where you’ll be held accountable and not have access to the outside world. You’ll be surrounded by caring professionals who will provide you with support and medication to overcome the worst of the withdrawals. Upon admission, you’ll be thoroughly assessed to determine if other co-occurring disorders are pushing you to use. Once you complete your stint in detox, you’ll move on to the next level of care, which is likely to be an inpatient treatment center if you’re a severe heroin addict.
An inpatient residential treatment center will last anywhere from 30 to 90 days, depending on the severity of your addiction and if other mental health problems are present. During your stay, you’ll attend various therapy sessions geared toward getting to the root of your addiction. Detox alone isn’t enough, and staying in this environment will retrain your mind to lead a life of normalcy without heroin.
Once you complete your stay, the journey has just begun. Fortunately, aftercare programs like 12-steps will connect you with others battling the same disease. Making friends and staying away from a solitary life is key to sobriety. While heroin addiction is tough to overcome, it is possible with the right help. Take the first step today toward a better life.