How Is Heroin Taken and Used?

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Heroin is an illicit drug commonly used for its euphoric and relaxing effects. It can be administered using several methods, the most common being intravenous (IV) injection. Although heroin is a potent painkiller, recreational use is often associated with psychological self-medication and a desire to numb emotions. In addition, those who become dependent are further motivated to continue using to avoid unpleasant withdrawal symptoms and intense drug cravings.

Regardless of how heroin is administered or for what reasons, it’s an extremely dangerous drug that can result in detrimental short- and long-term health effects, dependence, and overdose. Users are urged to seek integrated addiction treatment to address all aspects of their health and wellness, including the emotional factors contributing to their initial and ongoing drug misuse. At Guardian Recovery, we are dedicated to helping each individual overcome addiction and cultivate a healthy, drug-free life.

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What Are Common Cutting Agents & Contaminants in Heroin?

Because drug manufacturing is illegal, governments don’t oversee production and regulate heroin’s purity and contents. As such, heroin purchased off the street can have hazardous, sometimes deadly additives and contaminants. Some adulterants are deliberately added by manufacturers or dealers, while others are contaminants that end up in the drug unintentionally during production. Heroin manufacturers often adulterate or “cut” their products with various other substances. Reasons for this include increasing volume and weight and modifying its potency and effects, usually to increase profits.

Common Heroin Cutting Agents Include:

  • Caffeine Powder — Caffeine is one of the most common additives. Because it is a stimulant, it is added to reduce heroin’s sedative effects and improve the overall high the drug elicits.
  • Acetaminophen — Tylenol’s active ingredient. This over-the-counter pain reliever is cheap and widely available. It is commonly used to bulk the product because it has a similar melting point to heroin.
  • Bulking Agents — These are usually cheap white or off-white filler materials used to bulk up the drug and increase profits. Bulking agents include sugar, starches, salt, baking soda, calcium carbonate, chalk, talc, and laundry detergent.
  • Fentanyl — Fentanyl is a synthetic opioid up to 50 times more potent than heroin. (1) Even tiny amounts can rapidly cause a fatal overdose. Fentanyl is cheaper to manufacture, so it is often used to increase heroin’s potency.

Common Contaminants Found in Heroin Include:

  • Bacteria and Mold — Throughout manufacturing and distribution, unsanitary conditions sometimes allow bacteria and fungi to find their way into the product.
  • Heavy Metals — Heavy metals are dense, metallic substances. (2) Although some heavy metals—calcium, aluminum, and iron, for example—are relatively harmless, some are toxic or deadly. Toxic heavy metals found in heroin can include lead, chromium, cadmium, arsenic, and mercury.

Other Chemicals — Without government regulation, heroin can be contaminated with hundreds of additional chemicals used throughout the manufacturing process. These include toxic or caustic solvents that can lead to severe tissue damage or death.

Intravenous Heroin Use

IV injection is the most common technique used to administer recreational heroin and is a widespread practice among people who use illicit drugs in general. This method of administration involves dissolving heroin in water and injecting it directly into a vein using a hypodermic needle. Injected heroin rapidly enters the bloodstream and crosses the blood-brain barrier, resulting in an intense high within seconds.

Unfortunately, IV heroin use increases the risk of many other serious diseases and health complications, especially when needles are reused many times or shared between users. For example, injecting heroin can lead to HIV/AIDS, hepatitis B and C, endocarditis, tetanus, and other viral infections. (3) Moreover, damage caused at injection sites can cause collapsed veins, bacterial abscesses, skin infections, tissue necrosis, and scarring.

Smoking or Inhaling Heroin

This method of administration also called “chasing the dragon,” involves inhaling heroin smoke or vapor directly into the lungs. (4) Those who inhale heroin typically heat it in a glass pipe or on a piece of aluminum foil. Although not as fast as injecting, smoking heroin causes it to enter the bloodstream quickly, so it can also cause a rapid, intense high. However, this route of administration dramatically increases the risk of respiratory issues and lung damage, and it can also lead to dependence, addiction, and overdose.

Snorting Heroin

Snorting (nasal insufflation) is a method of administering heroin into the bloodstream through nasal mucosal tissue. Compared to injecting or smoking heroin, snorting is less common. Snorting heroin increases the risk of damage and infections in the nasal passages and lungs.

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Paraphernalia Associated With Using Heroin

Heroin users often employ a variety of tools, utensils, and equipment while preparing and consuming heroin. Paraphernalia left over from heroin use depends on the administration method used. Note that almost all heroin paraphernalia, not just syringes, can carry diseases.

Common Paraphernalia Associated With Heroin Use Include:

  • Hypodermic needles — Syringes are used for injecting heroin directly into the bloodstream. Once used, the sharp ends pose a high risk of transmitting diseases if not disposed of properly.
  • Spoons or cookers — Heroin typically requires heat to dissolve fully in water. Containers or vessels used to cook heroin, or “cookers,” are typically metal. (5) The most common cooking containers are spoons and aluminum foil.
  • Cotton balls — Cotton balls are frequently used to filter the heroin-water solution prior to injection to remove impurities. Sometimes cotton ball filtration can lead to “cotton fever,” an illness caused by bacteria that live on cotton plants. (6) Cotton balls are also commonly used to soak up any blood that leaks from injection sites.
  • Tourniquets — A tourniquet is a band or strap used to constrict blood flow and make veins more prominent and easier to inject. Common tourniquets include belts, stretchy rubber straps or hoses, handkerchiefs, and strips of cloth.
  • Glass pipes or water bongs — These may be used to smoke or inhale heroin.

Glass or plastic tubes — A glass or plastic tube may be used to snort heroin. Rolled up dollar bills are also commonly used.

Why Do People Use Heroin?

One of the main reasons people use heroin is to escape from the struggles and pains of life. So naturally, its rewarding and euphoric effects are a large part of the appeal, but there are other less harmful and more productive ways to achieve these feelings. Moreover, heroin is more potent than many alternatives and particularly adept at producing profound sedation allowing users to free themselves of all their problems entirely and predictably.

Pain relief is another desired outcome for users, as strict regulations placed on prescription opioids in the last few years have forced many patients to seek a substitute to maintain their dependence. However, because heroin is highly-addictive, those who become dependent continue to use it to thwart potential withdrawal symptoms. It is this chemical reliance on a drug that explains why addicted people engage in active drug use for so long.

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Heroin addiction is a severe, life-endangering condition that often results in many detrimental effects, including severe health complications, social and financial issues, and relationship difficulties. Although addiction is a chronic, relapsing brain disease, it is treatable, and countless individuals have developed the ability to refrain from drug use and focus on their health and wellness instead.

Reach out to Guardian Recovery to speak with an experienced Treatment Advisor and receive a free, no-obligation assessment, and health insurance benefits check. Learn more about our comprehensive programs and how we can provide you with the tools, support, and resources you need to break free from your physical and emotional dependence on heroin for the rest of your life.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

(1)https://www.cdc.gov/stopoverdose/fentanyl/index.html#:~:text=Fentanyl%20is%20a%20synthetic%20opioid,100%20times%20stronger%20than%20morphine. (2)https://epi.dph.ncdhhs.gov/oee/docs/HeavyMetalsInfo.pdf (3)https://harmreduction.org/issues/safer-drug-use/injection-safety-manual/potential-health-injections/ (4)https://pubmed.ncbi.nlm.nih.gov/9246796/ (5)http://www.bccdc.ca/resource-gallery/Documents/Educational%20Materials/Epid/Other/CookersQA_Mar182010_.pdf (6)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803705/

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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