Heroin Effects: What Diacetylmorphine Addiction and Abuse Look Like

Few drugs have the same physical and psychological impact on a person as heroin.

In addition to the potentially lethal toxicity heroin has on the body, the intensity of diacetylmorphine addiction is largely unmatched by any other substance today.

That’s why it’s important that you know the ins and outs of heroin addiction and how you can spot its signs in the people you love. Being able to do so might just end up saving their lives.

What is Heroin Exactly?

Learning how to spot the signs of heroin addiction takes education. And while teaching yourself about the effects of heroin is an important part of that education, knowing what heroin really is can be just as beneficial.

Heroin, also known as diacetylmorphine, is an extremely addictive and dangerous narcotic. It’s currently classified as a Schedule I drug (the most hazardous) and is widely assumed by the public to be the most unsafe substance use disorder one can have, due in part to injection being its common method of abuse.

While most people abuse the drug through injection, heroin can also be smoked or snorted and comes in the form of a white or brown powder as well as a black sticky substance called “black tar heroin”.

There are a variety of street names for heroin including:

  • Brown sugar
  • China White
  • Dope
  • H
  • Horse
  • Junk
  • Skag
  • Skunk
  • Smack
  • White Horse

Heroin is made directly from the opioid analgesic morphine which comes from the opium poppy plant. This particular plant’s seed pods produce a unique latex byproduct that is extracted from incisions made in the pods. This latex is then dried to create opium. From this opium, a variety of opiates can be extracted like thebaine, codeine, and papaverine in addition to morphine.

By boiling a specific concoction of morphine with acetic anhydride for several hours, the chemical structure is altered to create diacetylmorphine. The resulting substance (heroin) has been shown to have an effect two to three times more intense than morphine.

How Does Diacetylmorphine Work in the Brain?

Chemically, heroin affects the brain by interacting with the body’s opioid receptors. These receptors help to regulate pain and pleasure as well as anxiety and euphoria. When heroin crosses the blood-brain barrier, it’s chemical structure binds with these receptors and, as a result, creates intense feelings of pleasure and euphoria.

With extended use, heroin causes physical changes in the structure of the brain to counteract the drug’s effects and try to return it to homeostasis. This is called tolerance. Once the habitual use of heroin stops completely, the brain struggles to change back to the way it was before, leading to a host of nasty withdrawal effects such as:

  • Agitation
  • Muscle Aches
  • Insomnia
  • Sweating
  • Vomiting
  • Nausea
  • Diarrhea
  • Cramping
  • Anxiety

That’s why heroin drug abuse results in addicts having such a hard time during the rehabilitation process – their body has become physically altered to reward drug seeking behaviors. This is one of the reasons that it’s so important to recognize that addiction isn’t merely a choice, it’s an actual disease.

History of Heroin

Heroin use, like many other substances of abuse, has a tumultuous history of use and acceptance in the medical field. In fact, the substance was one of the primary components of such unassuming medications as cough syrup and prescriptions to combat ailments like bronchitis and tuberculosis.

It’s first public distribution as such a remedy was brought about by the Bayer company in 1874. As usage across the country increased though, it eventually became obvious that heroin was actually an incredibly addictive compound.

It took four decades of public use of heroin products for something to finally be done about it and heroin was banned entirely in 1914 as part of the Harrison Narcotics Act. Since then, this highly addictive substance has been treated as a Schedule I narcotic, designating it as having no acceptable medicinal use with the highest potential for abuse and addiction.

One of the most interesting aspects of heroin’s history is that it was actually produced as a less addictive alternative to morphine, another opioid analgesic (pain reliever) from which heroin is derived from. Despite these origins though, heroin is now an entirely illegal substance while morphine is still used in the medical industry today.

The State of Heroin Abuse Today

For many people, heroin abuse remains one of the most stigmatized and dangerous substance use disorders they can imagine. The combination of its intensely addictive properties and the high potential to spread debilitating diseases like HIV and hepatitis through its use makes it an especially hazardous substance of abuse.

What makes heroin all the more dangerous is the fact that its use is increasing all across the country. We are now in what the Center for Disease Control and Prevention refers to as an “opioid epidemic.” Never before have so many people been addicted to opioids, and never before have so many people died from overdosing on these substances.

For example, since 1999 the number of opioid overdoses has risen by 400%. In 2015 alone over 33,000 people died from opioid related overdoses. What’s more, these numbers are only rising. Today, 91 Americans die every single day from an opioid overdose, making drug overdoses deadlier than guns and even cars in this country.

A large portion of this surge in substance abuse and overdose stems from an enormous increase in prescription opioid addiction. These pain relievers are synthesized to treat a wide variety of ailments and are often overprescribed. The result is patients that both willingly and unwillingly become hooked on the substances and eventually develop an addiction.

Recent studies have shown that prescription opioid abuse carries with it an increased chance of eventual heroin abuse as well. In fact, the National Institute on Drug Abuse reports that nearly half of young people who abuse heroin report that they had abused prescription opioids beforehand.

What’s more, many said they switched to heroin because it’s actually cheaper and easier to find.

The takeaway here is that prescription drugs are not only dangerous substances themselves, they’re also contributing to the rising instances of heroin addiction in America today. That’s why programs like National Prescription Drug Take-Back Day are so instrumental in combating the growing opioid epidemic.

Short and Long-Term Effects of Heroin

Like most substances, heroin abuse is accompanied by a range of short term effects that appear immediately after use as well as a host of long term effects the develop due to heroin addiction.

The short-term heroin effects include, of course, the “high” produced by the diacetylmorphine interacting with the body’s opioid receptors. This tends to leave the abuser feeling an intense rush of euphoria almost immediately. The euphoric effects will typically last only a few minutes but the drowsiness will persist for much longer.

Additional short-term effects of heroin abuse include:

  • Flushing of the skin
  • Dry mouth
  • Heavy-feeling hands and feet
  • Drifting in and out of consciousness, called going “on the nod”
  • Clouded mental functioning

The long-term heroin effects, of course, tend to be far more severe. These include:

  • Collapsed veins
  • Compromised internal organ health affecting the liver, kidney, lungs and heart
  • Pus-filled swollen tissue or abscesses
  • Persistent constipation or stomach cramping
  • Severe organ damage from other heroin additives resulting in permanent lung, liver, kidney, and brain damage

Another problem that typically goes hand-in-hand with extensive heroin addiction is the increased likelihood of engaging in high-risk behaviors, particularly sharing needles with other intravenous drug users. HIV and hepatitis B and C are all easily transmissible by sharing needles and many times users tend to sacrifice their own safety in order to feel heroin’s high.

Abusing heroin regularly, then, puts you at greater risk of coming in contact with blood-borne pathogens, many of which have permanent consequences.

5 Signs of Heroin Abuse to Watch For

Identifying the signs of heroin use and addiction is often the first step towards getting you or your loved one the help they need to recover. While moving towards a clean and sober life can be incredibly difficult, starting down this path is far better than consistent exposure to the risks of this dangerous drug.

Here are five signs to be on the lookout for when trying to spot a heroin addiction.

  1. Look for signs of intoxication. The short-term effects listed above are the best place to start. What’s more, if someone is consistently falling asleep during activities like watching TV or even during a conversation, they may have a heroin use problem.
  2. Know the physical indicators. Track marks, skin picking, visible abscesses, noticeable weight loss and sexual dysfunction could all point to heroin abuse.
  3. Watch for heroin paraphernalia. Pipes and needles are an obvious sign of a drug problem but more subtle hints at heroin abuse could include small baggies with a powdery residue, burnt spoons as well as rubber tubing.
  4. Learn to spot behavioral clues. A heroin addict is hardwired for drug-seeking behaviors. If someone you know is being increasingly secretive, avoiding social contact, and no longer participating in activities they used to enjoy, they may be hiding a heroin use problem.
  5. Identify the secondary signs. You may have noticed items going missing around the house or cash disappearing from your wallet. These could be signs of a growing drug habit in someone you live with. What’s more, they may have a hard time fulfilling obligations like work or school as well.

How to Spot a Heroin (diacetylmorphine) Overdose and What to Do

Heroin abuse is both highly dangerous and incredibly common. In addition to the toxicity of the diacetylmorphine itself, heroin is also often mixed with a variety of other potentially poisonous substances in a process known as “cutting”. Knowing how to identify and treat a heroin overdose, then, is incredibly important and very likely could end up saving a life.

Heroin has many sedative qualities and, as such, someone overdosing on it will likely become very tired or unconscious altogether. The following are other signs to watch out for when identifying a heroin overdose.

  • Slow, shallow breathing or no breathing at all
  • Dry mouth
  • Especially small pupils, sometimes as small as a pin point
  • Discolored tongue
  • Weak pulse and low blood pressure
  • Bluish nails and lips
  • Constipation
  • Stomach and intestine spasms
  • Drowsiness
  • Disorientation
  • Delirium
  • Coma
  • Uncontrolled muscle movements

If you think someone you know is going through a heroin overdose, it’s crucial to their safety that you seek help immediately. You can do so by calling 911 if the person has collapsed or has stopped breathing. You can also call the national Poison Help hotline at 1-800-222-1222.

A few things to note to make it easier to help:

  • Do NOT make the person throw up unless you’re instructed by emergency personnel to do so.
  • Try to figure out the person’s age, weight, and condition as well as how much heroin they took and when they took it.
  • Use CPR if the person has stopped breathing or if their breathing is dangerously weak.

One more point worth mentioning is that some people are frequently hesitant to contact emergency services due to the illegality of heroin abuse. However, it’s crucial to recognize that most people who overdose on heroin cannot survive without medical help. It is an incredibly dangerous drug. Do not hesitate. Do not simply hope for the best. They need medical help, plain and simple.

Getting Help for Heroin Addiction

Learning how to pick out the signs of heroin abuse and addiction is crucial to getting your loved one the help they need to overcome their substance use disorder. It may take a significant effort on your part as many abusers tend to be stuck in a state of denial. You may even have to set up an intervention to get them the help they need.

But rest assured that doing so may just end up saving their life from the clutches of this dangerous and incredibly debilitating substance.


Centers for Disease Control and Prevention (2017, April). Opioid Overdose. Retrieved from https://www.cdc.gov/drugoverdose/index.html

Center for Substance Abuse Research (2013, Oct.). Heroin. Retrieved from http://www.cesar.umd.edu/cesar/drugs/heroin.asp

MedlinePlus (2015, July). Heroin Overdose. Retrieved from https://medlineplus.gov/ency/article/002861.htm

MedlinePlus (2016, April). Opiate and Opioid Withdrawal. Retrieved from https://medlineplus.gov/ency/article/000949.htm

National Institute on Drug Abuse (2017, May). Commonly Abused Drugs Charts. Retrieved from https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts

National Institute on Drug Abuse (2017 Jan.). Heroin. Retrieved from https://www.drugabuse.gov/publications/drugfacts/heroin

Substance Abuse and Mental Health Services Administration (2016, Feb.). Opioids. Retrieved from https://www.samhsa.gov/atod/opioids

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