Heroin Use

Why Do People Use Heroin?

Once heroin use leads to addiction (also called opioid use disorder or heroin use disorder), it’s easy to understand why people continue to use heroin.

That is, heroin use hijacks the brain and causes a mental reliance (addiction) and often a physical dependence on heroin.

However, you may want to better understand why people use heroin in the first place. It’s important to know that many avenues can lead to drug abuse and that these driving factors often contribute to continued use.

Some common reasons people cite for beginning drug use include:

• For the rush of pleasurable feelings it produces (heroin high)
• To manage the effects of health conditions, such as mental health disorders
• To avoid certain situations or people
• To avoid withdrawal symptoms or cravings once substance use disorders start

How People Use Heroin

People may snort, inject, smoke, or rectally insert (plugging/boofing) heroin. The method of use depends on the form of the drug.

Powder heroin is typically snorted or may be dissolved in liquid to inject or plug. Some people heat powdered heroin in a foil packet and inhale the vapors through a straw (chasing).

At first, people may be intimidated by the thought of injection drug use and may only snort the drug. With continued opioid misuse and the onset of addiction, they may start injecting heroin to seek a faster onset of effects.

Heroin is often used by people who first misused prescription opioids and sought heroin when their prescription ran out. This situation makes heroin a driving factor in the ongoing opioid crisis.

Why Is Heroin Use Dangerous?

Heroin use is dangerous for several reasons. First, heroin abuse often results from people seeking the drug after forming an addiction to prescription drugs, such as other opioids.

This transition often means they already had a chronic pain condition. Using heroin means they will now likely add an addiction.

Heroin is also considered one of the most dangerous drugs of abuse and a national and worldwide public health threat.

Other reasons why using heroin is dangerous:

• Risk of opioid overdose: Heroin has a high risk of overdose due to the drug’s ability to greatly reduce breathing and heart rates.
• May contain unknown substances: Drug dealers may cut heroin with (or add to heroin) other substances—which includes the highly potent fentanyl and substances not meant for consumption to increase the quantity of the drug, such as baking soda or talcum powder.
• Heroin addiction and dependence: Heroin drug addiction is one of the hardest substance use disorders to overcome without adequate healthcare.
• Risk of heroin charges: Even if people using heroin don’t form an addiction, the sale and possession of heroin is illegal and can result in hefty fines and long prison sentences.
• Host of side effects: Whether someone uses heroin for a short time or a long time, they may experience negative side effects, from memory issues to brain changes, weight loss, depression, contraction of diseases (like hepatitis C or HIV), and much more.

When Did Heroin Use Start?

Like most opioids, heroin began as a legal prescription medication (diacetylmorphine). In 1874, heroin use was reported in a hospital in London, according to the United Nations Office on Drugs and Crime.

Doctors prescribed heroin to treat chronic coughs and other respiratory illnesses like phthisis and tuberculosis.

Heroin got its official name and was first marketed in 1898 by Bayer. Healthcare providers hailed it as a ‘wonder drug’ and used it to replace codeine and morphine.

In just a couple of years, doctors began to realize the potential for addiction, the power of heroin, and the severity of withdrawal.

By 1900, most doctors using heroin as a treatment began reporting tolerance, decreased efficacy over time, and drug addiction caused by heroin use.

What Are the Legal Consequences of Using Heroin?

Even one instance of heroin use or sale comes with a risk of legal charges. Here are the laws on heroin and the charges a person could face if found with the drug.

Laws and Regulations for Heroin

International control of heroin began in 1912 when the drug was placed in the same category as cocaine and morphine by the Hague Opium Convention.

Similar international conventions restricted the sale and manufacture of heroin in 1925 and 1931.

Slowly, most countries established laws prohibiting the import of opium for heroin production, trade and preparation of heroin, exportation, drug possession, and more.

Heroin became illegal in the United States in 1924 due to the Anti-Heroin Act, which restricted the manufacture and possession of opium for use in producing heroin.

The drug has been regulated at federal, state, and local levels ever since.

Penalties for Heroin Use, Sale, and Possession

Heroin is currently a Schedule I drug under the Controlled Substances Act in the U.S. This means heroin has no medical use and a high potential for abuse and addiction.

Use, possession, and sale of heroin come with penalties as follows for first convictions:

• Heroin use: misdemeanor charge of up to $2000; up to one year in prison
• Heroin possession (100-999 grams): no less than 5 years/no more than 40 years prison time; up to $2 million fine
• Heroin possession (1 kilogram or more): no less than 10 years/up to life in prison; up to $4 million fine

Heroin Rates of Use in the United States

The following rates show the scope of heroin drug use in the United States:

• In 2019, 745,000 people used heroin (U.S. Department of Health & Human Services – HHS). This number includes adolescents ages 12 and older.
• The number of drug overdose deaths involving heroin steadily increased between 1999 to 2016 from 1,960 to 15,469 (National Institute on Drug Abuse – NIDA).
• After 2016, heroin overdose deaths began to decrease, with 13,165 heroin deaths reported in 2020 (NIDA).
• This rate equates to four heroin deaths per 100,000 Americans (Centers for Disease Control and Prevention – CDC).
• Heroin deaths in 2020 were seven times higher than in 1999, despite declining heroin-involved deaths from 2016-2020 (CDC).
• Almost 20% of all opioid deaths involve heroin (CDC).
• About 80% of heroin users report using prescription opioids prior to heroin use, according to data compiled from national surveys (National Institutes of Health – NIH).
• The rate of older adults using heroin doubled between 2013-2015, largely due to using opioids for chronic pain, forming an addiction, and later using heroin (NIH).

What Are Your Options for Quitting Heroin Use?

If you are concerned about a family member using heroin, know that recovery is possible.

Some treatment programs and therapies which can help people quit heroin use include:

• Detox programs: Detoxing from heroin and other drugs is an important first step in substance abuse treatment.
• Inpatient rehab programs: After drug detox, inpatient heroin rehab programs offer targeted behavioral health treatments, counseling, and therapy. This is where people learn to manage cravings and heroin use triggers they may experience during recovery.
• Medication-assisted treatment: MAT uses prescription medications like naltrexone (Vivitrol), buprenorphine (Suboxone), and methadone to address the heroin withdrawal symptoms that often get in the way of long-term recovery.
• Outpatient programs: Step-down levels of care following the initial rehab program help foster lasting sobriety. These can include partial hospitalization, intensive outpatient treatment, and more.
• 12-step support groups: Narcotics Anonymous and other support groups help people battling heroin use by offering a safe environment to share struggles.

Getting Help for Heroin Use for Yourself or a Loved One

Ready to help your loved one break free of heroin use? You can start today with several options.

Try taking a substance abuse assessment online, such as through the National Institute on Drug Abuse. While it doesn’t replace medical advice, it can help you understand whether you or your family member need to seek help.

From there, your healthcare provider may be able to suggest a rehab program that fits your needs. You can also search for quality treatment programs by using SAMHSA’s treatment locator.

Finally, to get support right away, search for a Heroin Anonymous program to be connected to other people in recovery who can offer a wealth of support and access to resources.