Heroin is typically sold as a white or brownish powder, or as the black sticky substance known on the streets as “black tar heroin.” Although purer heroin is becoming more common, most street heroin is “cut” with other drugs or with substances such as sugar, starch, powdered milk, or quinine.

Heroin can be injected, smoked, or sniffed/snorted. High purity heroin is usually snorted or smoked.

Because it enters the brain so rapidly, heroin is particularly addictive, both psychologically and physically. Heroin abusers report feeling a surge of euphoria or “rush,” followed by a twilight state of sleep and wakefulness.

One of the most significant effects of heroin use is addiction. With regular heroin use, tolerance to the drug develops. Once this happens, the abuser must use more heroin to achieve the same intensity. As higher doses of the drug are used over time, physical dependence and addiction to the drug develop. Physical symptoms of heroin use include: drowsiness, respiratory depression, constricted pupils, nausea, a warm flushing of the skin, dry mouth, and heavy extremities.

Other opioids such as OxyContin ® , Vicodin ® , codeine, morphine, methadone, and fentanyl can cause similar effects as heroin.