Last updated : April 21, 2025
Heroin is a powerful narcotic classed as a Schedule 1 drug under the Drug Enforcement Administration’s (DEA) Controlled Substances Act. Drugs in this category have a high potential for addiction and abuse with no currently accepted medical use in treatment within the United States. It’s processed from morphine which is a naturally occurring substance extracted from certain varieties of the poppy plant. They grow naturally in Mexico, South America, Thailand, Laos, Myanmar, Afghanistan, and Pakistan.
Heroin is found in several forms. White powder heroin comes into the country from Mexico, Asia, and South America. Heroin coming into the country in the form of “black tar” or brown powder predominantly comes from Mexico as well.
People who use heroin are at high risk of overdosing on the drug because it’s impossible to gauge its strength. With regular use, the human body builds up a tolerance to the drug and when that happens the user must increase the dose to achieve the effects they want to experience. However, each increase puts the user at an increased risk of overdosing. Once the body develops a physical dependence on heroin, it leads to addiction.
Common Street Names
Once used as code amongst drug users, heroin has acquired a variety of street names over the years.
They include:
- Big H
- Black Tar
- Chiva
- Hell Dust
- Horse
- Negra
- Smack
- Thunder
Signs of Use
After ingesting heroin by either smoking, snorting, or sniffing it, the effects on the brain resemble those of prescription opioids, such as OxyContin, Vicodin, codeine, morphine, methadone, and fentanyl. It raises concern that people who become addicted to these prescription drugs may turn to heroin when they can no longer obtain the drugs through their physician. Heroin is generally less expensive on the street than what they would pay to stick with the medication that got them hooked.
Short-term side effects
Heroin enters the body rapidly and binds to the opioid receptors found on cells there. It especially likes to connect to those that involve feelings of pain and pleasure. This causes an intense surge of pleasure or even euphoria that is called a “rush.”
Other side effects include:
- Dry mouth
- Warm flushed skin
- Heavy feeling in the arms and legs
- Disorientation
- Nausea and vomiting
- Severe itching
- Inability to function mentally
- Slurred, slow, or incoherent speech
- Going “on the nod,” a term for drifting in and out of consciousness
These side effects can last between three to five hours. It’s important to note that while someone is nodding off, they experience slowed breathing and lowered pulse rate. If someone goes on the nod while standing, it may appear as if they are going to fall, but they usually don’t.
Long-term side effects
Using heroin over a long period of time has serious consequences attached, namely:
- Insomnia
- Collapsed veins for those who inject the drug
- Damaged tissue inside the nose associated with those who sniff or snort the drug
- Infection of the heart lining and valves
- Abscesses of the skin
- Constipation
- Stomach cramps
- Liver and kidney disease
- Lung complications which often include pneumonia
- Depression
- Antisocial personality disorder
- Sexual dysfunction for men
- Irregular menstrual cycles for women
Other serious risks
People who inject drugs into their skin put themselves at a higher risk of contracting HIV and hepatitis C (HVC) viruses. They’re transmitted through contact with blood or other bodily fluids which can occur when sharing needles or having unprotected sex.
Moreover, dealers often mix additives, such as sugar, starch, or powdered milk, into their goods to increase the amount they have for sale. These substances can clog blood vessels leading to the lungs, liver, kidneys, or brain causing permanent damage.
Signs of addiction
Heroin abuse alters a person’s behavior no matter how hard they try to hide their addiction. Eventually, though, the truth comes out.
Signs to watch for that indicate someone may be struggling with heroin abuse are:
- Poor performance at work or school
- Withdrawing from family and friends
- Secretive behavior
- Avoiding eye contact
- Lack of motivation
- Decreased interest in activities once enjoyed
- Arguing with friends, family, and co-workers
- Mood swings
- Trouble managing emotions
- Changes in sleep patterns
- Financial problems
- Legal troubles
Signs of overdose
Familiarizing yourself with the signs of a heroin overdose can make the difference between life and death.
The signs that someone is overdosing on heroin include:
- Shallow breathing
- No breathing at all
- Pinpoint pupils
- Cold, clammy skin
- Extremely low blood pressure
- Weak pulse
- Appears to be comatose
- Bluish-colored nails and lip
- Discolored tongue
- Delirium
- Drowsiness
- Uncontrolled muscle movements
If you suspect someone has overdosed on heroin, contact 911 immediately. Do you have access to Narcan? Then, by all means, use it! Narcan can temporarily reverse the effects giving first responders time to arrive.
Do you suspect an employee is using heroin or other drugs?
Using drugs in the workplace is unacceptable because when the mind is impaired it affects both thinking and fine motor skills. That puts the user at a higher risk of causing or being involved in an accident. Anyone who happens to be around them is unknowingly at risk as well.
As an employer, it’s your responsibility to make sure your work environment is as safe as it can possibly be. If you suspect someone of abusing drugs in the workplace, you must act upon it! If you don’t have a drug-free protocol in place, reaching out to the employee on a personal level and explaining your suspicion may be the catalyst to encourage them to seek help. Moreover, if the person realizes that you are aware of a problem and doesn’t decide to deal with it, they’re likely to quit their job—pronto.
If you do have a drug-free program in place, follow the procedure in place for Reasonable Suspicion drug testing immediately. The first step is probably documenting the signs and symptoms displayed—make sure the information is as detailed as possible. Management should, then, approach the employee and explain the suspicion. The individual should be referred immediately for drug testing. If that’s done on site, no worries, however, the employee should not be allowed to drive themselves to a testing facility.
Strictly following all drug-free procedures set in place guards you from being pulled into a future lawsuit brought by a disgruntled former employee.
