Heroin addiction is a serious medical problem that can lead to deadly consequences. Fortunately, treatment is available and recovery is possible.

Heroin is a highly addictive and illicit opioid drug that claims thousands of lives every year. The country has been in the midst of an opioid crisis for decades now, and it’s only grown worse in response to the ongoing COVID-19 pandemic (See: Is COVID-19 Fueling the Next Opioid Epidemic?).

Heroin addiction impacts people from all backgrounds and walks of life; it can affect you, your friends, your family members and your loved ones. To support those you care about when they need it the most, it’s important to understand the dangers surrounding this drug and the types of life-saving treatment available.

Article at a Glance:

  • Heroin is an opiate that is made from morphine and can be snorted, smoked, or injected.
  • Heroin commonly comes in powder form or is a black, sticky substance.
  • Heroin is very addictive, but recovery is possible.
  • Treatment for heroin addiction involves detoxification, rehabilitation, and therapy.
  • Anyone can get addicted to heroin, regardless of who they are.

Is Heroin Addictive?

Yes, heroin is highly addictive. Heroin works in the same way as other opioids: it increases the amount of dopamine released to the limbic reward system, a part of the brain responsible for feeling pleasurable feelings related to eating, drinking and sex.

When a person uses heroin, large amounts of dopamine create a rush of pleasure and euphoria. After this experience, many people report feeling like they need to seek out the drug again and again. This repeated heroin use is what drives heroin dependence very quickly and contributes to heroin addiction.

Heroin is addictive, but recovery is possible. However, it can be a very difficult process, so improving the chances of recovery typically requires the assistance of a professional heroin addiction treatment program. Additionally, heroin detox and withdrawal can be extremely uncomfortable and potentially harmful to the body if not done under proper guidance, so it’s important to seek the help of experienced rehab professionals.

Can You Get Addicted to the First Time?

Heroin Treatment Options

It can be extremely difficult for people with heroin addiction to quit the drug on their own. This is because heroin affects parts of the brain that control judgment, planning and organization, and it also hijacks the brain’s memory and motivational systems.

Fortunately, help for heroin addiction is available and recovery is possible. Treatment strategies include detox and rehab, which help get the drug out of your system and support your mental and physical health while you heal. Medications that help keep you sober and therapy that helps you live a life without heroin are also important cornerstones of treatment.

Heroin Rehab

Heroin rehab is an important step in recovery. When recovering from heroin addiction, it is important to explore why you started using the drug in the first place. Further, you will need to develop coping strategies and mechanisms to avoid falling back into heroin use.

Having a support system and treatment can help reverse the hijacking effects heroin has on the brain and allow you to begin living a sober life. Rehab helps you accomplish all of this, with an emphasis on therapy and self-awareness.

Heroin Addiction Detox vs. Rehab

Although there is a misconception that detoxification and rehabilitation are the same, they are distinct steps in the recovery process. Detoxification — the act of getting off of heroin — is the first step in recovery. Detox is followed by rehab, which consists of talk therapy, teletherapy and ongoing support. These are all important tools that help people recover from heroin addiction.


In some cases, medications can be used to help clients stop using heroin and stay sober. As an extremely addictive opioid, heroin often gives people a euphoric high. Longer-acting opioids like methadone and buprenorphine can be used to prevent withdrawal symptoms without the risk of causing euphoria. In addition, non-opioid medications can be used during the detox and rehab process to help treat other withdrawal symptoms, such as muscle aches or diarrhea.

Behavioral Therapy

It is important to understand why you began to rely on heroin and to develop coping mechanisms to help you avoid heroin in the future. Therapy helps to achieve this. In rehab, you may work with a therapist in one-on-one sessions or in groups to help you explore the underlying causes of your addiction.

Continue reading at Substance Abuse Treatment Programs or Verify Your Insurance Benefits 

Heroin Addiction Demographics

About 745,000 Americans — about 0.3% of the population — used heroin in 2019. Heroin use impacts younger people as well: in 2020, around 0.4% of high school seniors said that they had a history of heroin use, with 0.3% stating they’d used it in the past month. A survey from The Recovery Village on past and present opioid users also found that around 25% of respondents used heroin. Further, one in three respondents started with a legitimate opioid prescription but later began abusing heroin or other prescription opioids.

Heroin increased across most demographic groups in the United States through 2013, the most recent year for which demographic data is available. This includes increases among both men and women, different age groups, races and income brackets.

Chris’ Story: Beginning of A Heroin Addiction

Related Topic: Survey Finds New Stats & Trends in the Opioid Epidemic

Immediate Effects of Heroin

Heroin is a derivative of the drug morphine. When heroin enters the brain, the body converts it to morphine. The morphine binds to opioid receptors and triggers the areas of the brain responsible for pleasure and mood. This includes the brain stem, which is responsible for controlling important autonomic bodily functions like blood pressure, breathing and arousal.

Long-Term Effects of Heroin

Heroin abuse and addiction can cause permanent changes to the body over the long term. This is one of the reasons why it is so important to avoid using heroin and to seek help as early as possible if you realize you struggle with heroin abuse.

Long-term changes can include

  • Imbalances in neurotransmitters and hormones
  • Deterioration in the brain’s white matter
  • Problems with decision-making, emotions and stress response

Overdose Risk

The opioid epidemic has taken the United States by storm, and many people are dying from heroin overdoses every day. In 2019 alone, heroin was responsible for more than 14,000 overdose deaths in the United States, over seven times the number of deaths in 1999.

A heroin overdose is a medical emergency. If you believe that someone is overdosing on heroin, it is important to administer naloxone if it is available. Naloxone is an opioid reversal agent that can temporarily block the effects of opioids like heroin and save someone’s life. Because naloxone can wear off, you should call 911 immediately so the overdose victim can receive medical help.

Signs of a heroin overdose include:

  • Shallow or slow breathing
  • Small pupils
  • Weak pulse
  • Bluish tint to the nails and lips
  • Confusion
  • Drowsiness
  • Coma
  • Death

Related Topic: Heroin Overdose 

Prescription Opioids and Heroin

Prescription painkillers have become a gateway drug to heroin, so anyone who has been prescribed opioid medications can be susceptible to heroin use and addiction. The risk is greatest among those who have become dependent on prescription opioids or abused them. Prescription opioid abuse often starts about two years before a person turns to heroin.

People who are unable to finance their prescription opioid addiction or whose prescriptions have been cut off may resort to heroin use. This is because heroin produces a more distinct high for less money and is readily available. Due to its availability, affordability and link to prescription opioids, heroin addiction affects people from many backgrounds.

What Does Heroin Look Like?

Heroin is available in multiple forms, which can make it more difficult to identify. Forms of heroin may also vary depending on the availability in your area. Two of the most common forms of heroin include a powder form as well as a solid, sticky form.

Powder Form

Heroin is commonly available in a white or brown powder form. The whiter it is, the purer and more potent it is compared to off-white or brown heroin. Typically, there are more impurities in brownish heroin powder. The color usually varies based on geographic location in the U.S. For example, white or off-white powdered heroin is commonly seen in the eastern part of the U.S. Some powdered heroin may also be found in the western part of the U.S., but it’s typically the brown variety that is less pure.

Solid, Sticky Form

Some heroin is sold as a solid, sticky substance that is typically black in color. Known as black tar or sticky tar, this substance can be hard to the touch.

The purest forms of heroin are white, powdered and odor-free. However, the darker, impure forms of powdered heroin have a slight pungent smell similar to vinegar. Similarly, black tar heroin also has a smell slightly resembling vinegar. If both black tar and off-white heroin are smoked, the smell will intensify and the vinegar scent will be even stronger.

Heroin Cut With Other Drugs

Pure heroin does exist in the drug marketplace. More often than not, however, it’s cut with other drugs and substances. In other words, drug dealers mix in different ingredients with heroin so they can sell more of the drug and make a larger profit. While this process does dilute it, it also makes consuming the drug more dangerous because it can cause a variety of effects.

Some substances that heroin is cut with include:

  • Sugar
  • Starch
  • Powdered milk
  • Quinine
  • Fentanyl

Mixing heroin and other drugs can be dangerous. For example, mixing stimulants like cocaine with heroin can mask signs of overdose, causing people to think they should take more.

Heroin Paraphernalia

Sometimes, a person may not be aware that their loved one is struggling with heroin until they come across paraphernalia. Some of the most common things you may find if a person is struggling with heroin include:

  • Needles used to inject heroin
  • Tinfoil used to heat heroin
  • Pipes used to smoke heroin
  • Plastic pen cases or cut up drinking straws used to snort or sniff heroin
  • Small spoons used to heat heroin for injection
  • Cotton balls used to remove impurities from liquid heroin
  • A tie-off, such as a shoestring, used to help with heroin injection

Find the Help You or Your Loved One Needs

If you or someone you love struggles with heroin abuse and addiction, The Recovery Village is here to help. Our multidisciplinary team of addiction experts can help you address your addiction and begin the road to a healthier, heroin-free life. Contact us today to learn more about heroin treatment programs that can work well for your needs.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more


What is heroin?

Heroin is an opiate, meaning it is naturally derived from the opium poppy plant. When used, heroin creates feelings of elation and pleasure (a “high”) that people get addicted to. However, heroin use and addiction can quickly lead to life-threatening consequences, such as respiratory depression and overdose.

How is heroin used?

Heroin can be abused in several ways. Most commonly, it is injected, smoked, sniffed or snorted. The highest-purity heroin is typically snorted or smoked.

Paraphernalia is not required to snort or sniff heroin. However, injected heroin requires tools like a syringe, and smoked heroin needs to be heated, which often requires a spoon.

What are some common street names for heroin?

Heroin has many street names to mask its unlawful sale and purchase. Knowing the street names could help identify if a loved one is misusing heroin. Some of the most common street names people might hear or read on the Internet include:

  • Big H
  • Black Tar
  • Boy
  • Brown Sugar
  • China White
  • Dope
  • Dragon
  • H
  • Horse
  • Junk
  • Mexican Brown
  • Mud
  • Scag
  • Skag
  • Skunk
  • Smack
  • Thunder

Related Topic: Street Names for Drugs


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U.S. National Library of Medicine. “Heroin Overdose.” MedlinePlus, September 1, 2021. Accessed October 4, 2021.

Centers for Disease Control and Prevention. “Heroin Overdose Data.” March 25, 2021. Accessed October 4, 2021.

National Institute on Drug Abuse. “Overdose Death Rates.” January 29, 2021. Accessed October 4, 2021.

National Institute on Drug Abuse. “A subset of people who abuse prescriptio[…]ogress to heroin use.” January 2018. Accessed October 4, 2021.

Florida Alcohol and Drug Abuse Association. “Speed-balling.” Accessed October 4, 2021.

Boeree, C. George. “The Emotional Nervous System.” 2009. Accessed October 4, 2021.

Get Smart About Drugs. “How to Identify Drug Paraphernalia.” March 8, 2021. Accessed October 4, 2021.

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indi[…] Drug Use and Health.” September 2020. Accessed October 4, 2021.

National Institute on Drug Abuse. “Monitoring the Future Study: Trends in P[…]nce of Various Drugs.” December 17, 2020. Accessed October 4, 2021.

Centers for Disease Control and Prevention. “Vital Signs: Demographic and Substance U[…] States, 2002–2013.” July 10, 2015. Accessed October 4, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.