Heroin is well known for creating an intense high, particularly if it’s injected directly into the veins. It’s also known for being highly addictive and wrecking havoc on both the body and communities across the world. The fact that it works so fast and produces such a euphoric high is what makes it so addictive and dangerous, as the brain associates the action of injecting the drug with the reward of pleasure.

The drug also rapidly produces tolerance as the brain attempts to compensate for the unnatural release of pleasure-inducing chemicals. This results in an experience in which users find they cannot reach the same level of euphoria that they felt the first time they took heroin and end up using more or mixing drugs to “chase” that feeling.

The Rapid High of Injecting Heroin

Heroin is derived from morphine, which is made directly from the opium poppy. It’s one of the most potent opiates in existence and can be used as a painkiller or cough suppressant, though in the US, it’s considered to have no medical applications. Because of that and its addictive nature, it’s classified as a Schedule I drug under the Controlled Substances Act of 1970.

This drug can be snorted or smoked, but it’s most often associated with intravenous injection. This method is the most cost-effective and allows the maximum amount of heroin to rush to the brain for the most intense high. It’s also the most dangerous method of intake due to overdose risks and health issues associated with the frequent injection of this harsh chemical substance. According to the National Institute on Drug Abuse, heroin overdose rates have increased sixfold from 2001 to 2014.

The State of Heroin

The State of Heroin

In its most pure state, heroin comes in the form of a fine white powder or salt. It can be dissolved in water without the use of heat or acid when in salt form. The powder needs to be heated up to dissolve, which is often done on a spoon or aluminum foil. The liquid can then be collected into a syringe for injection.

Production of heroin starts with the collection of raw opium from the poppy, which is grown in countries like Afghanistan and Columbia for the purposes of heroin manufacturing. The plant material is crushed in a tub, and hot water is added and stirred. Plant material and other debris float to the top and are removed. More hot water is added along with calcium oxide (lime) until the pH level reaches an optimum state. This is then left to sit overnight and the opium, which now contains morphine, is siphoned out the next day.

At this point, the opium is in a dark brown liquid form. Impurities are further filtered out, often through cloth sacks, and ammonium chloride is added while stirring continuously. The liquid is then left to sit overnight again. After another filtering process, a morphine base is removed from the liquid and left to dry into a brown powder. Acetic anhydride is added to this and stirred until the base has dissolved once again. The resulting solution is heated for 30 minutes.

To turn the morphine into heroin, the heated liquid is filtered into a barrel with warm water, and baking soda is added. The reaction between these substances gives off carbon dioxide until the pH reaches 10. This solution is again filtered through a cloth, and the light brown heroin powder is collected. This is then dissolved in hydrochloric acid, and activated carbon is added. After a sitting period, the solution is again filtered to remove most impurities, and an ammonia solution is added.

After another dissolving and filtering process, using a combination of hydrochloric acid and acetone, the solution is left in the sun, so the liquid can evaporate, leaving behind a fairly pure and white powder: heroin.

The mixing of all of these volatile chemicals creates many dangers for those making the drug. Breathing in the fumes can cause health problems over time, and mixing the wrong chemicals can produce a toxic gas. The only reason deaths from this process aren’t reported is because the manufacturing of heroin takes place in the same countries that grow the opium poppy.

Various countries and manufacturers may have minor differences in the way they produce heroin, and there are different methods to produce lower quality versions of the drug, including “black tar heroin.” The US Department of Justice estimates that 26.6 metric tons of heroin were imported into the country from Columbia alone from 2002 to 2007.

Needles and Injection Sites

Needles and Injection Sites

It’s common for heroin users to use simple spoons to heat up the heroin with a lighter, and everyday syringes can be used to inject it. Some people use small pieces of cotton to absorb the heroin solution first, then put the tip of the syringe into the middle of the cotton and suck up the liquid from there. This helps to remove impurities, of which there are often many in any batch of heroin.

To inject the heroin, users may tie a rubber tube around their upper arm in order to make it easier to find a vein. The needle is then placed almost flat against the vein and inserted lengthwise to ensure that the solution goes into the vein and doesn’t end up outside. This method is referred to as intravenous drug use, and it is the most common injection method.

Some users may opt for intramuscular injection. This is injection of a substance directly into a muscle. This typically results in a slower high, though muscles have a lot of larger blood vessels so the absorption of the drug is still fairly rapid. Heroin may be injected into the deltoid muscle of the arm like a vaccine, the vastus lateralis muscle in the middle of the thigh, or the ventrogluteal muscle in the hip.

There are many risks associated with injecting heroin or any intoxicant. This includes the well-known risk of contracting life-threatening viruses, such as HIV and hepatitis C, due to needle sharing. Despite these threats, needle sharing remains common because of the cost of needles and the time it takes to sterilize them properly. According to the Centers for Disease Control and Prevention, around 10 percent of all new HIV cases between 2008 and 2011 were due to intravenous drug use and needle sharing.

In addition to this, frequent injection of heroin soon results in collapsed veins. Blood is easily diverted around individual collapsed veins, but after enough of them fail, a user can end up suffering from poor circulation that can lead to a number of health problems. Even worse, particles in the heroin solution can build up in arteries, including around the heart and brain. The harsh chemicals in the drug are also hard on the arteries around the heart and the heart muscle itself. This can end in sudden heart failure and death.

The Rapid High

After being injected into the vein or the muscle and absorbed into the bloodstream from there, the heroin travels to the lungs so the blood cells can be oxygenated, and then directly to the brain. This takes only around a single minute and the effects last around 15-20 minutes.

Heroin is an opioid agonist. It binds to the opioid receptors in the brain, resulting in a massive rush of endorphins that causes intense feelings of pleasure, not unlike a natural orgasm. This is followed by feelings of peace and relaxation. The sedation is severe enough that those high on heroin often alternately nod off and wake up, unaware that they had fallen asleep for a few seconds.

The Rapid High

Like all opioids, it also depresses the central nervous system. This slows essential bodily functions including the heart, the respiratory system, and the gastrointestinal system. This is why users of heroin often suffer from constipation. This is also what can lead to overdose death: Breathing can slow to the point that the brain can’t get enough oxygen.

The Low

Coming down from heroin can be rough. Withdrawal after developing a dependence on heroin is much worse, and addiction to this drug forms quickly thanks to the intense and rapid high. In 2012, approximately 467,000 people in the US were considered to be addicted to heroin.

The after effects of heroin depend on how much was taken at once and whether or not the person binged – taking more of the drug right after the effects start to wear off so that the high keeps going for hours. Coming down typically results in “opposite” effects of the heroin high, including increased heart and breathing rates, anxiety, and trouble sleeping. The same is true for withdrawal.

Heroin withdrawal symptoms include:

  • Yawning
  • Sweating
  • Runny nose
  • Increased eye tearing
  • Anxiety
  • Muscle aches
  • Insomnia
  • Agitation
  • Goosebumps
  • Dilated pupils
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal cramping

Though not dangerous aside from possible dehydration from vomiting, diarrhea, and sweating, heroin withdrawal is often described as an extremely intense flu that lasts around 7-10 days. It can also be very painful as the analgesic effects of the drug wear off, and the pain receptors start to be activated again.

The difference between the effects of coming down and actual withdrawal is the development of significant tolerance, resulting in changes in the brain. Tolerance happens when people regularly take a substance that affects the brain. The person’s brain attempts to compensate by altering itself to bring things back to normal. In the case of heroin, opioid receptors are made less sensitive or shut down to reduce the amount of endorphins released so the user has to take more to get the same effects.

Enough of this causes the brain to be significantly altered. A sudden absence of the drug means that an abnormally low amount of endorphins can be released, producing unpleasant symptoms. This lasts until the brain can bring itself back to normal.

Though this process is difficult, there are many services available across the US that treat heroin addiction. For opiates like heroin in particular, there are even medications available that directly treat this disorder. Fighting addiction takes more than detoxing and getting through withdrawal symptoms. Even after these symptoms calm down, cravings and temptations can continue for many years. Without rehabilitation and addiction education, addicted individuals are very likely to relapse after detox. Fortunately, with professional treatment, many people are able to spend the rest of their lives functioning without the need for drugs.