Heroin is an opioid drug made from naturally-occurring morphine taken from opium plants in warm climates around the world. It’s usually distributed as a powder, white or pale brown, or as sticky, dark, “black tar” heroin. Heroin use has rapidly risen in the United States over the past decade, with over 800,000 people reported using the drug in 2018.
Heroin is most commonly taken intravenously. Because it comes as a powder, the drug must be mixed with a liquid, such as citric acid, which helps break it down. Users heat the mixture, then use a syringe to inject it into a vein or muscle. Users commonly wrap a belt or necktie around their limb to make their veins stand out in order to more easily inject the needle in the correct spot. While many begin by injecting heroin into their arms, those veins can collapse with repeated use, forcing a user to choose other injection sites across the body.
Other methods for ingesting heroin include smoking and snorting it. Heroin can also be combined with cocaine in what is called a “speedball.” Users inject or snort both drugs at once for a more intense, more dangerous high. Heroin is a strong depressant or ”downer,” and cocaine is a powerful stimulant or “upper.” Using both at once produces an extreme high which can cause lasting physical and mental damage. Speedballing also presents a significantly higher risk of overdose.
Injecting heroin leads to a rapid high within seconds. When smoked or snorted, it can take several minutes longer for the drug’s effects to peak. The initial high can last from 10-60 minutes, followed by a prolonged comedown period of up to several hours.
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