Heroin Addiction


Learn more about Heroin addiction

While the number of fentanyl-related deaths increased, Maryland saw a decrease in fatalities due to heroin-use. In 2019, through the second quarter, Maryland saw 414 deaths due to heroin overdose. The number of deaths in 2020 through the second quarter totaled 288. Education and rehabilitation are needed to help reduce the amount of opioid-related deaths in the state.

What is Heroin?

Heroin is an opioid made from morphine, a natural substance taken from the seed pod of the opium poppy plants grown in Southeast and Southwest Asia, Colombia, and Mexico. As a powder, heroin can be a white or brown powder, but a specific black sticky form of heroin is called black tar heroin. Unlike other drugs in the same opioid category, heroin is not a prescribed medication that can be abused. It is illegal in any form. Heroin is approximately twice as potent as morphine, making it easy to become addictive and easy to overdose on.

What Heroin looks, tastes, and smells like

Heroin often has a strong odor that smells of vinegar. The chemical process used to create heroin leaves it smelling like this and less so if washed at the end. The darker the heroin, the less processed and the more impurities, chemicals, and bacterias remain within it. Specifically, black tar heroin will have a strong smell of vinegar and an extremely bitter taste. As it gets lighter in processing, the less smell and bitter taste remain.

Understanding Heroin Addiction

Becoming addicted to heroin falls under the classification of Opioid Use Disorder (OUD). For a provider to determine if someone suffers from OUD, the DSM-5 Diagnostic Criteria for OUD is administered. The provider will confirm a diagnosis from the questionnaire if there is proof that two or more of the criteria have been observed within a 12-month period.

The DSM-5 criteria include the following:

  • The opioid was taken in larger amounts or longer than was intended
  • The persistent desire to use or unsuccessful effort to cut down is present
  • A majority of the time is spent in obtaining, using, or recovering from the opioid
  • Craving the opioid
  • Despite the persistent problems caused by the opioid, use continues
  • The use of the opioid results in the failure to fulfill major life roles
  • The things that once brought joy are given up because of opioid use
  • Use of an opioid despite the physically hazardous situations
  • Use of an opioid despite the harm or psychological effects
  • Signs of tolerance to the opioid
  • Experiencing withdrawal when not using the opioid

Effects of Using Heroin

Like any other opioid in the category, heroin affects the brain. The side effects of using heroin can be extreme and range in severity. Users can experience short-term and long-term effects up to and resulting in overdose or death.

Short-term effects of heroin include:

  • Dry mouth
  • Heavy feeling in the arms and legs
  • Warm flush to the skin
  • Severe itching
  • Nausea
  • Vomiting
  • Clouded mental state
  • Going back and forth between consciousness and unconsciousness

Long-term effects of heroin include:

  • Insomnia
  • Damaged tissue under the nose of those who snort the drug
  • Collapsed veins in those who inject the drug
  • Abscesses on the skin
  • Liver and kidney disease
  • Constipation
  • Stomach cramping
  • Lung problems
  • Irregular menstruation for women
  • Sexual dysfunction for men

Signs of Heroin Withdrawal

Depending on the intensity of the heroin use, withdrawal symptoms can range from mild to severe. These symptoms can begin up to a few hours after the last dose, which can make the user seek out the substance. Understanding the signs of withdrawal from heroin can help someone seek out the help they need.

Some of these symptoms include:

  • Restlessness
  • Sleep problems
  • Severe muscle and/or bone pain
  • Diarrhea
  • Vomiting
  • Cold chills with goosebumps
  • Uncontrollable leg movements
  • Severe cravings

FAQ About Heroin Addiction

Are there any factors that could increase developing an opioid or heroin addiction?

There are some risk factors that people may find increase the risk of addiction to heroin or any opioid:

  • Genetics
  • A family history of opioid use and abuse, previous addictions, or an experience with other drugs
  • Entering and maintaining a relationship with someone who is addicted to an opioid or another drug
  • Having a chronic disease or experiencing extreme pain that is not contained by prescription medications requiring patients to seek out something stronger

Why is heroin addictive?

Like other opioids, heroin attaches to the opioid receptors in the brain. These receptors are the brain’s reward receptors, and when an opioid binds with it, the euphoric reward is craved by the brain.

What can be done for a heroin overdose?

Naloxone, an opiate antagonist, can help reverse an opioid overdose’s effects by intruding the brain’s receptors on the opiates. Even with naloxone, it may take several doses, and it must be done early in the overdose to work. Overdose symptoms include a slowed heartbeat, shallow breathing, clammy skin, sleepiness, inability to walk or talk, and being unresponsive.

Always call 911 if you suspect a heroin overdose.

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Brooke Abner,

Motivational Coach