How Is Heroin Used?

Heroin Use
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Question: How Is Heroin Used?

Answer: Heroin is used in various ways. It can be injected, snorted, sniffed and smoked, depending mainly on the purity of the drug and the preference of the user.

Heroin can be injected into a vein or a muscle. It can be smoked in a pipe or mixed with a marijuana joint or a regular cigarette. Its smoke can be inhaled through a straw, a process known as "chasing the dragon." As a powder, it can be snorted.

Users who inject heroin feel is effects the quickest. When heroin is mainlined, users can usually begin to experience a feeling of euphoria within 7 to 8 seconds. When it is smoked, the user will typically feel its peak effects in 10 to 15 minutes.

Rush Is Greater for Injection Users

Shortly after injecting heroin, users report that they feel a surge or "rush" of euphoria, dry mouth, a warm flushing of the skin, and heaviness in the extremities. After this initial euphoric feeling, users will enter a state that alternates between drowsiness and wakefulness, during with mental functioning becomes hazy.

Those who snort or smoke heroin may not feel the intense rush that injection users feel but will experience the same other effects.

Traditionally, the majority of people seeking treatment for heroin abuse were injection drug users, but the availability of pure heroin has created a shift toward sniffing and smoking the drug, particularly among young users.

The Ritual of Injecting Heroin

The preparation and process of getting heroin ready to inject can become like a ritual for those who choose to mainline the drug. Just as how they carry, light and hold their cigarette becomes a part of the ritual for tobacco users, getting ready to shoot heroin can also become a very ritualistic.

Heroin comes in a powder or tar-like form so in its natural state it cannot be directly injected into the body, it must be changed into liquid form first.

Typically, heroin is placed into a spoon and mixed with liquid and heated (see photo above). Citric acid is sometimes used because it helps break down the heroin. The heroin, citric acid, and water are heated in the spoon using a lighter or candle until it becomes liquefied.

Laying Out The 'Works'

Some users will place a cigarette filter or a tightly rolled up ball of cotton into the spoon and let it absorb the liquid. They will then draw the liquid into a syringe through the filter to eliminate impurities.

The user will then tie a belt or shoelace around the upper arm to cause their veins to stand out, just as phlebotomist does with a rubber tube when drawing blood for medical testing.

Many users for whom the process has become a ritual, will begin by laying out their "works"—the heroin, syringe, spoon, lighter, filter or cotton, belt, citric acid, water, and alcohol swabs—on display and placed in order or use.

The alcohol swab is used to clean the spoon and the place of injection on the body. Most users begin by injecting heroin in the arm because it is the easiest method, but as their veins collapse or become damaged, they will inject into other areas—behind the knees, between the toes, or in the neck.

Highly Addictive Drug

The higher purity heroin that can be snorted or smoked also appeals to new users, who may be leery of injection drug use, according to the National Institute on Drug Abuse.

Injection users of heroin generally have a higher rate of addiction or dependence on the drug, compared with those who snort or smoke it. Injection users tend to use more often and develop a tolerance to the drug more quickly.

No matter how heroin is used - injected, snorted or smoked - it is highly addictive for the user due in part to the development of tolerance to the drug which requires greater dosages to achieve the same results.

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National Institute on Drug Abuse. "Heroin." Research Report Series Updated January 2014

The Partnership at "Heroin." Drug Guide. Accessed March 2014.

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