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Whether you buy it as a white powder, a brown powder or a sticky tar-like substance, the high associated with heroin is what drives heroin use, abuse and ultimately, addiction.
How People Get Heroin Highs
Heroin may be used in a variety of ways in order to get high, which determine the onset of the drug’s desired effect.2
- Intravenous Injection – 7 to 8 seconds until effects felt. White powdered heroin may be combined with water to create a solution that can be injected directly into the vein ("shooting up" or "digging").
- Intramuscular Injection – 5 to 10 minutes until effects felt. Similar to the intravenous, a solution made from white heroin powder can be injected directly into the muscle.
- Subcutaneous Injection – About 20 minutes until effects felt. Heroin powder can also be injected under the outer layer of the skin ("skin popping").
- Nasal Insufflation – 10 to 15 minutes until effects felt. Powdered heroin can be administered through the nose ("snorting," "banging" or "railing"). Absorption is rapid through the nasal mucous membrane and in the bloodstream.
- Smoking/Inhaling – 10 to 15 minutes until effects felt. A freebase form of the drug may be created from white powdered heroin and then heated on aluminum foil to create smoke and vapors. The vapors may be inhaled. Alternatively, the drug may also be rolled into a cigarette and smoked with tobacco.
- Rectal – 10 to 15 minutes until effects felt. While it is not very common, white powdered heroin can be inserted into the rectum where it is absorbed through the rectal membrane. This is known as "plugging" and is regarded as a safe alternative to injecting the drug.
- Oral – More than 30 minutes until effects felt. White powdered heroin can be taken orally in the mouth. However, there are individuals who report that they do not get an intense rush from the high with this method of administration.
What Happens in the Brain on a Heroin High
Endorphins are naturally-occurring chemicals found within the brain and are associated with the body's response to pain or stress – by delivering pain-relieving effects to the affected neurons.
When used recreationally, heroin produces changes in brain function that can lead to various alterations in mood, perception or consciousness.
Upon entering the brain, the drug heroin is converted back to morphine, which then binds rapidly to opioid receptors, producing a surge of intense sensations of euphoria and pleasure.3
The rush that results from an initial hit of heroin generally only lasts a few minutes – but the high is more persistent.2 Once this sense of euphoria begins to dissipate, the individual will begin to feel very drowsy. They may even slip in and out of consciousness (also referred to as "nodding off"), which is generally most evident shortly after usage.
This state of drowsiness following the heroin high can also be characterized by mental sluggishness, slow or slurred speech and confusion, and may last for several hours.4 Individuals describe feeling warm, cozy and relaxed with a profound sense of fulfillment and satisfaction.
How Heroin Causes Addiction and Withdrawal
Heroin is strongly associated with the development of dependence. As described above, individuals who use heroin experience intense sensations of relief from physical aches and pains, as well as psychological distress.3 Therefore, they are more likely to seek out heroin in the future because of the drug’s potential to provide them with immediate relief.
With repeated use, however, the body will begin to believe that it no longer needs to produce its own chemicals for pleasure or to relieve pain. This leaves the individual to be physically dependent on using the drug in order to get relief. This physical dependence to heroin can lead to severe discomfort and pain when the drug is removed. This uncomfortable stage after drug removal is known as withdrawal. Individuals who have become dependent upon heroin are likely to experience symptoms of withdrawal approximately 10 hours following their last heroin use.2
Withdrawal symptoms can include:
- Drug cravings.
- Stomach cramps.
- Sweating and runny nose.
- Fever and chills.
- Muscle spasms.
- Nausea and vomiting.
- Increased heart rate and blood pressure.
Other Physical & Emotional Effects from Heroin
As the heroin user comes down from the high, sensations of drowsiness are also accompanied by clouded mental function, slowed heart rate and suppressed breathing.2,3
Repeated heroin use can lead to permanent alterations within the brain.2 ,4 Previous studies have found that chronic heroin use is associated with deteriorations in the white matter within the brain, which may lead to impairments in decision-making, self-regulation and the ability to respond to stress.2
Profound degrees of tolerance and physical dependence are also significant long-term risks that accompany heroin use.
The Heroin High: Is It Worth It?
For instance, what might have begun as recreational use of heroin has the potential to very quickly lead to a costly addiction, as repeated use is associated with tolerance and, thus, the need for more and more amounts of the drug in order to feel its effects.
Moreover, heroin use is often accompanied by potential for profound socio-behavioral ramifications – including increased problems at work, in school and in relationships with friends and family.
- Stephens RC. The street addict role: A theory of heroin addiction. 1991 Suny Press. Albany, NY.
- Zacny JP. A review of the effects of opioids on psychomotor and cognitive functioning in humans. Ex Clin Psychopharmacol 1995;3(4):432-466
- National Institute on Drug Abuse: Heroin.