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The Dangers of Black Tar Heroin

Heroin is a powerful opioid made from morphine, an opiate alkaloid substance extracted from poppy plants. There are several forms of heroin, ranging from white and brown powder to black tar heroin.1

Black tar heroin tends to be sticky like roofing tar or coal. Its color is a result of the relatively crude manufacturing processes that leave impurities in the final product. It is mainly produced in Mexico and found west of the Mississippi River.2

At purity levels typically no higher than 25-30%, black tar heroin is traditionally less pure than other forms of heroin.3   Impure heroin varieties such as black tar are most commonly injected.2

The use of black tar heroin is very dangerous and can lead to a number of health risks, including overdose and death.

Where Does Black Tar Heroin Come From?

Mexico is currently the main supplier of black tar heroin and other forms of heroin in the U.S.4

Mexico used to be known for brown powder heroin—which was low in purity and quality. The country also produced white powder heroin that was cheaper than that produced in Afghanistan, but inferior in quality. The cartels then moved to black tar heroin. However, in recent years, the cartels have learned how to create high-quality white powder heroin and export it to the United States.5

Mexican white powder heroin is mainly found in the eastern United States, while brown powder and black tar heroin are found in the western United States. However, Mexican white powder heroin is increasingly found in the western U.S. as well.4

Health Risks

Black tar heroin abuse is associated with serious health consequences—some of which are unique to the black tar variety, and some of which are shared with other types of heroin.

Special Health Risks

Some health risks when using black tar heroin include:

  1. Wound botulism: Wound botulism is a potentially life-threatening disease that can occur from injecting black tar heroin under the skin or into the muscle. A germ called Clostridium botulinum gets into a wound and creates a toxin that attacks the body’s nerves, which can make it hard to breathe and can cause muscle weakness and even death.6
  2. Venous sclerosis: Injection of black tar heroin can make the user vulnerable to venous sclerosis, a condition where one’s blood vessel walls become inflamed and gradually hardened. This results in significantly decreased blood flow and renders that vessel unusable as an injection site.7
  3. Tetanus: Tetanus is another toxic bacterial infection that can develop from injecting heroin contaminated with Clostridium tetani “spores.” It can result in spasms in the neck, jaw, chest, and back as well as fever, sweating, and ultimately death if the condition is not treated.8,9
  4. Necrotizing fasciitis: Necrotizing fasciitis is a flesh-eating tissue disease caused by injecting black tar heroin contaminated with certain types of bacteria.10
  5. Gas gangrene: Injection of black tar heroin can also make one vulnerable to becoming infected with Clostridium perfringens, another toxin-producing bacteria that causes life-threatening death of body tissue.11

Health Risks Common to Most Types of Heroin

Several risks common to all types of heroin, including black tar, include:12

  • Suppressed breathing.
  • Infectious diseasesfrom needle-sharing, such as hepatitis and HIV/AIDS.
  • Collapsed veinsfrom scarring and destruction of blood vessels.
  • Infections in the heartbacterial endocarditis is a life-threatening condition that can result from heroin use.
  • Abscessesin the skin, muscles, and other tissues where heroin was injected.
  • Severe constipation.

The User Experience

Users of black tar heroin dissolve the heroin, dilute it, and inject it into veins, muscles, or beneath the skin.2

When black tar heroin enters the brain, it attaches to opioid receptors involved in the perceptions of pain and reward, breathing, and heart rate. The euphoric rush that comes from black tar heroin is similar to that of other forms of heroin.1

After an injection, black tar heroin users may experience:1

  • Dry mouth.
  • Warm flushing of the skin.
  • Heaviness of the arms and legs.
  • Impaired mental functioning.
  • Alternating wakeful and drowsy states, a condition called “on the nod.”
  • Itching.
  • Nausea and vomiting.

Regular use of heroin can also lead to tolerance, dependence, and addiction. A user develops tolerance when they must take increasingly higher doses to achieve the effects they want. Dependence occurs when a user’s body becomes accustomed to the presence of the substance, and the user will experience withdrawal symptoms when they stop using. Addiction is when the user continues to abuse heroin despite negative effects on their health and personal life, such as problems with relationships, work, and school.1

Does Your Loved One Use Heroin?

If you are concerned that someone you care about may be abusing heroin, you can look for the following signs.

While these signs may indicate an addiction, remember that only a professional can diagnose a person with a substance use disorder.

Physical Signs of Heroin Abuse

  • Changes in appetite and sleep.
  • Sudden weight loss or gain.
  • Deterioration in appearance or grooming.
  • Frequently constricted pupils.
  • Consistently diminished levels of consciousness, drowsiness, and non-responsiveness.
  • Wearing long sleeves or hiding arms.13

Behavioral Signs of Heroin Abuse

  • Confusing changes in attitude or personality.
  • Sudden mood changes.
  • Absence from or poor performance at work or school.
  • Missing money or valuables; borrowing and stealing money.
  • Being isolated, withdrawn, or secretive.
  • Sudden changes in friends, activities, or hangouts.13

Help Someone with a Heroin Problem

If you believe someone you love has a problem with heroin, reach out for help today. There are many rehab centers across the country that can help your loved one with their addiction. Numerous options are available, and a large number of programs offer payment plans and sliding scale rates.

You can browse our directory for programs in your area.


  1. National Institute on Drug Abuse. (2018). DrugFacts: Heroin.
  2. National Institute on Drug Abuse. (2018). What is heroin and how is it used?
  3. Ciccarone D. (2009). Heroin in brown, black and white: Structural factors and medical consequences in the U.S. heroin marketInternational Journal of Drug Policy, 20(3), 277-282.
  4. S. Drug Enforcement Administration. (2017). 2017 National Drug Threat Assessment.
  5. Longmire, S. (2015). Middle America waking up to a Mexican Cartel Heroin Nightmare. Breitbart News.
  6. Centers for Disease Control and Prevention. (2017). Injection Drug Use and Wound Botulism.
  7. Sheehy, J. (2004). Black tar heroin use explains lower HIV levels among injection drug users in the Western U.S.University of California San Francisco News Center.
  8. Iqbal N. (2001). Tetanus in i.v. heroin users. Annals of Saudi Medicine, 21(5-6), 296-9.
  9. S. National Library of Medicine. Medline Plus. (2018). Tetanus.
  10. Kimura, A. et al. (2004). Outbreak of Necrotizing Fasciitis Due to Clostridium sordellii among Black Tar heroin users. Clinical Infectious Diseases, 38(9), e87-e91.
  11. Stevens, D. and Bryant, A. (2012). Life-Threatening Skin and Soft Tissue Infections. Netters Infectious Diseases, 94-101.
  12. American Psychiatric Association. (2013). Diagnostic and Statistical Manual Of Mental Disorders (5th Ed.). Arlington, VA: American Psychiatric Association Publishing.
  13. New York State Government. Recognizing the Signs of Addiction.

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