2023 Guide to the Deadly Heroin Epidemic

2023 Guide to the Deadly Heroin Epidemic

What is Heroin?

Heroin is a highly addictive substance that belongs to a group of drugs called narcotics, opiates, or opioids.  Opioids are used for relieving severe pain. Heroin is naturally extracted from a plant known as opium poppy, which mostly grows in Mexico, Colombia, and South Asia. Heroin is synthesized from morphine and much more effective. Heroin is around 8.3 times more effective than morphine.9 While it is currently illegal in the US, there was a time when heroin was legal, acceptable, and medically prescribed not only for adults but also for children. So, what happened?

History of Heroin

A deep look at heroin’s history can help to better understand why it has become illegal and is strongly prohibited worldwide nowadays.

Heroin Abuse After Prescriptions

Heroin used properly is still addictive and has serious effects. Patients who were being treated developed a tolerance quickly, which made them continuously need to take increasingly higher doses, even when it was hurting them.

Even after the treatment course of heroin, the majority of patients continued to take it, even though it is not necessary medically. Patients reported experiencing serious withdrawal symptoms whenever they tried to quit, making them unable to beat the addiction.

Heroin Street Names

Being a street drug, heroin is known by many different names. It is important to know all the names so that you can clearly identify what you or a loved one are actually taking.


Hell Dust

The Dragon

Dr. Harry

China White



Big H



Black Tar



Morphine Diacetate





White Dynamite


Chinese H

How is Heroin Used

As a street drug, dealers sell heroin in many different forms to make it easy to use and increasing its demand, e.g., white powder; brown powder; and a black, sticky substance known as black tar heroin.

Heroin is commonly taken as follows:

Myths and Misconceptions About Heroin

Heroin is Too Expensive for Kids to Get

One of the most common misconceptions about heroin is that it is too expensive for kids to get. Actually, children from ages 12 and up are part of the 652,000 Americans who used heroin in 2017.10 The majority of teens taking it tend to buy a certain type that is only snorted, which is much cheaper to manufacture and sell.

Prescription Opioids Don’t Cause Addiction

Even is prescribed Opioids can become addictive.  Once you are hooked to the prescription, it is much easier to start using illegal heroin.

People Take Heroin Because They Don’t Have Morals

Heroin abuse is not directly related to morals. People from all cultural and religious backgrounds are likely to develop addiction.  Often, addiction starts by accident, not by choice.

Only Impaired People Use Heroin

It is true that some people with impaired judgment become addicted; that is not the case for all heroin users.  Many users are highly-educated people whose judgment is not impaired.

Heroin is Only Common in the Poor and Big Cities

Heroin usage is common in all people, including in women, high-income classes, big cities, and rural areas as well.

Recovery From Addiction is Rare

Some misconceptions cause more pain than others, such as thinking that heroin recovery is impossible or rare.  High mortality rates lead people to believe that an addict would get treatment if treatment worked.  That is not the case many people recover from heroin safely and successfully with medical treatment.

What Causes Heroin Addiction?

Three Leading Causes of Addiction

Using Opioids for Recreational Purposes

Mental Health

Using Prescription

According to NBC Universal & World report, every day, 650,000 opioid prescriptions are being dispensed. 3,900 Americans start using opioids for non-medical purposes and 580 Americans start using heroin.

Opioid medications are prescribed to relieve pain, namely Oxycontin®, Vicodin®, Fentanyl®, and Demerol®. In many cases, opioid medications are misused for their mood-changing effects, which can lead to abuse.15

Thinking that prescription opioids are not as risky as illicit drugs make some people take analgesic opioids more than they should, mistakenly assuming they are safe.

Prescription opioids are sometimes taken by persons other than those for whom they are prescribed, thinking that they are just analgesics. This results in opioid side effects, including dependence and overdose.

Opioid dependence and addiction causes some people to switch to heroin because compared to prescription opioids, it is cheaper and easier to get.

Heroin Addiction Symptoms and Effects

Once heroin has been administered, it binds to certain receptors in the brain known as opioid receptors. This is how it relieves pain, affects pleasure, heart rate regulation, sleeping, and breathing.

Heroin affects people differently, based largely on how it was taken; e.g., mixing fentanyl and heroin is dangerous; but affects are also based individual factors, such as age, weight, health status, and dosage.

Short-Term Effects

Heroin short term effects refer to the symptoms noticed on those who take heroin only once, a few times, or for a short duration. Within 3 to 5 hours after administration, you may notice one or more of the effects below:

Desirable Effects

Quick pain

Feeling a rush or high 

High sense of

Undesirable Effects

Dry mouth

Nausea and vomiting

Inability to identify whether you are conscious or semiconscious

Tiny pupils

Flushed, warm skin

Severe itching

Drowsiness and clumsiness

Slower than normal breathing

Low libido or sex drive

Heaviness, especially in the arms and legs

Confusion or inability to think clearly

Slurred, slower speech

Slower than normal heartbeat

Long-Term Effects

Heroin’s long-term effects are appear after taking it frequently, heavily, or over a long duration.16

Heroin Withdrawal Symptoms

Quitting heroin is always associated with a group of withdrawal symptoms that can be the worst in the first hours or days. Withdrawal symptoms can start around 6 hours or less since the last dose and can continue for 10 days, 2 to 4 weeks, or even longer.  

Withdrawal symptoms include:

If heroin is taken during pregnancy, it will pass the placenta to the fetus, causing both the mother and fetus to be heroin-dependent, which is called neonatal abstinence syndrome (NAS). If left untreated quickly, it may result in fetus death.17

An addiction treatment program should be considered as soon as possible to cure the fetus and mother. Treatment may include taking either buprenorphine and methadone during pregnancy, after delivery, or both.

Other Effects

Heroin may also cause a person to be unable to breathe normally. It may decrease the amount of oxygen going to the brain, resulting in a condition called hypoxia. This can, in some cases, be severe enough to cause brain damage.

Some also wonder why heroin is associated with an increased risk of hepatitis B, C, and HIV/ AIDS. This is because of unsafe sex and sharing needles.  Impaired judgment causes heroin users to not mind sharing needles or having unprotected sex.  Because of these risky behaviors,  all blood-borne diseases are common in heroin users.18

Other substances included in heroin preparations can cause adverse effects. Injections containing sugar, milk, and starch can block blood from getting to vital organs such as lungs, liver, kidneys, and brain; causing permanent damage to these organs.

Can a Person Overdose on Heroin?

Deaths because of heroin overdose rose 22.4% between 1999 and 2007, for 2,399 deaths.  Since 2007 those deaths have risen 689.9%, for 15,482 deaths.21

In 2017, the deaths resulting from opioid overdose rose by 12% from 42,249 deaths in 2016 to 47,600 deaths; 67.8% of all overdose deaths in the US.22 

An overdose of heroin is typically any dose that can cause a person to experience life-threatening symptoms. Therefore, any dose can be an overdose for you, but not for another. This all depends on individual factors such as your age, the efficiency of your kidney and liver, and your health status overall. The strength of the heroin is also a factor.

What if a Person Overdoses on Heroin?

If a person overdoses on heroin, they may experience the following effects:


Heroin dependence

Feeling cold and


An urge to urinate