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What You Need to Know About Heroin

Image of a woman looking into the camera with a concerned look upon her face.

Heroin, horse, smack, cheese, gum. By any name, it's a killer drug. Until recently, heroin was not thought to be a problem among children of middle-class parents. But lately, heroin has been showing up in new places. Today, the typical user could be the child, teen, or adult next door.

These younger addicts account for some dangerous new patterns in the way heroin is used:

  • It can be the child's first drug experience. Children do not always start with "gateway" drugs (drugs that lead to other drugs), like marijuana, and then move up. A gateway drug is one that leads to other drugs.

  • It's a social activity. Heroin used to be thought of as something done alone. Now it's not unusual to see it used in a group setting such as teen parties.

This social use increases the risks of spreading serious infections, such as HIV or Hepatitis C.  

New image, old danger

Heroin is made from morphine. Morphine is found in the seed pods of some varieties of poppy plants. It is a very addictive opiate.

Although purer heroin is becoming more common, most street heroin is "cut" with one or more other substances. These may include antihistamines to help control the stuffy nose and watery eyes that occur when snorting heroin. These can also include other white powdery substances likes sugar, starch, powdered milk, quinine, or even strychnine or other poisons. Other drugs like cocaine, methamphetamine, or other opiates may also be mixed in. It might be only a little heroin or even no heroin at all. And that can change with each dose a person gets. Heroin users don't know the actual strength of the drug or what substance was used to cut it. So they are at risk for overdose or death. Overdoses are common. It's easy to take a dose that had too much heroin. This can cause users to stop breathing or to suffocate in their own vomit.

Users get high by snorting, smoking, or injecting the heroin. Snorting and smoking have become more common because high-purity heroin is available. Smoking and snorting is also more common because users fear getting an infection by sharing needles.

In an addicted person, withdrawal occurs within a few hours after the last use. Symptoms of withdrawal can be drug craving, restlessness, muscle and bone pain, and vomiting. Symptoms peak between 48 and 72 hours after the last dose. They last about a week. Symptoms can be very intense. The addicted person may return to using again if he or she doesn't get treatment for withdrawal symptoms to help break the cycle of addiction.

Parents, take note

Drug use experts tell parents that their best strategy is to be involved in their children's lives and pay attention to everything that goes on.

They offer these specific suggestions:

  • Check out your children's friends. It's a red flag when children replace old friends with new ones who have bad reputations.

  • Learn the signs of heroin use. Look for runny noses and eyes, pinpoint pupils, and unusual amounts of sleep. Wearing long sleeves in summer could be a way to cover up needle marks on arms.

  • Pay attention to grades. A sudden drop in a child's grades could be a warning. Talk to the child's teachers to see if they have observed unusual behavior or other problems.

  • Look for clues. Syringes, tiny balloons or plastic bags, capsules and packaging material for antihistamines can be signs of heroin use. Check the coffee-bean grinder for unusual remnants.

  • Be sure to ask your child's healthcare provider about drug use prevention strategies. Some parents and schools have done urine or other drug testing on children and teens. It's an extreme measure, but if you believe one of your children is on heroin, it could be a lifesaver. Ask your healthcare provider to recommend a testing facility. Over-the-counter testing kits are also available from pharmacies or online. 

If you believe your child has a drug problem, take it seriously. Talk to a professional drug counselor to find out which resources are available for the child and the best way to get involved. Your child's healthcare provider or teacher may be able to recommend a counselor or substance use treatment program to contact. The Substance Abuse and Mental Health Services Administration has a drug abuse information and treatment resource locator available on its website.

Medical Reviewers:

  • Perez, Eric, MD
  • Walton-Ziegler, Olivia, MS, PA-C