Heroin is an extremely potent opioid that was derived from morphine and initially synthesized in an attempt to create a less addictive morphine substitute. However, the opposite proved to be true, and heroin addiction quickly became a widespread problem that, more than a century later, has yet to go away.
In the United States, heroin was involved in nearly 16,000 overdose deaths in 2017 alone, and according to the Substance Abuse and Mental Health Services Administration (SAMHSA), roughly 900,000 people age 12 and older reported using heroin in 2017, with more than 650,000 of them meeting the criteria for heroin use disorder.
While new restrictions have helped to lower overdose rates caused by prescription painkillers, it has had the unfortunate side effect of driving people already addicted to prescription opioids to heroin use instead, as it is now cheaper and easier to obtain in comparison.
Heroin is the fastest-acting opioid, as the general means of administration sends it directly into the bloodstream, where its effects rapidly take hold and can get someone addicted in just a single use. It can cause an overdose nearly just as fast.
How Does Heroin Work?
Heroin, as a central nervous system (CNS) depressant, works in the same way as other opioids. It blocks pain signals from reaching the brain by slowing down activity in the central nervous system, which also produces intense feelings of sedation.
This is something that is, to a much lesser degree, already regulated by your body through naturally produced opioids, which help you manage pain and stress. What heroin does is mimic these opioids to enter the brain and bind with what are known as opioid receptors.
Heroin then activates these receptors over and over to stimulate them into overproduction until the brain and nervous system are flooded with an excess of opioids, causing intense feelings of sedation and pain relief.
A secondary effect of heroin is that it also creates a surplus of a different brain chemical called dopamine. Dopamine is involved in regulating several key brain functions, including emotion, cognition, and how we process pleasure as a reward.
This is extremely important because it’s the burst of excess dopamine that causes the feelings of intoxication and euphoria that people associate with the “high” of heroin abuse. Repeated use of heroin rewires how the brain produces dopamine, creating the association between the action of using heroin with the reward of getting dopamine, kickstarting the addiction process.
What Are the Short-Term Effects of Heroin?Heroin does all of the aforementioned work in the brain and central nervous system extremely quickly, with users reporting an almost immediate “rush” of pleasure and warmth. Other short-term effects of heroin use include:
- Pain relief
- Heavy feeling in the limbs
- Slowed reflexes
- Nausea and vomiting
- Dry mouth
- Itchy skin
- Light sensitivity
- Slowed breathing
The rush will usually only last a few minutes, with the feelings of sedation and other effects generally lasting between three and five hours afterward. A user who is dependent on heroin can expect withdrawal symptoms to start within about six hours of the last dose.
The Exact Duration Of Heroin’s Effects Will Depend On Several Different Factors, Including:
- The size of the dose
- The purity of the heroin
- Whether it was snorted, smoked or injected
If someone takes a significant amount of heroin, the high will last longer. The same is true for purity, the effects of pure heroin are going to take longer to fade. Heroin that is cut with different, unknown additives, which is frequently the case, can cause significant variation in the duration of the effects.
When it comes to how fast-acting heroin is, injection is the quickest route, sending the opioids directly into the bloodstream, as opposed to a pill like OxyContin that must first be digested. Someone injecting heroin will feel its effects in as little as a minute.
Snorting heroin also rapidly brings on the drug’s effects, as it is absorbed as a powder through the mucous membranes in the nose and from there into the bloodstream, generally taking effect in anywhere from two to five minutes.
Smoking heroin, while still a very quick method of administration, is the slowest of the three to take effect, burning it to inhale the smoke through the lungs and can take around 10 to 15 minutes to take effect.
How Long Does Heroin Stay In Your System?
Along with quickly taking effect, heroin also has an extremely short half-life, which means it leaves the body nearly as fast, typically in about 30 minutes. However, just like there are multiple factors that contribute to how long you feel the effects, there are even more that determine how long it stays in your system.
Apart From The Amount And Purity Of The Heroin, The Length Of Time That Heroin Remains In Someone’s System Is Affected By:
- How often they have been using
- How heavily they have been using
- Their age
- Their weight and body mass
- The rate of their metabolism
- The health of their liver and kidneys
- Their body’s fat content
Even if in the case of heroin, which does not have to deal with being digested, if someone has been chronically abusing heroin for a significant period, the level of opioids in their system will still have built up in their fatty tissue.
In that same vein, much like alcohol, a person’s size will impact how long heroin will remain in someone’s system. The same sized dose is going to affect a smaller, thinner person more than someone larger and heavier. The lighter and smaller a person is, the longer it will take for their body to process an average dose of heroin.
People who are older and also have less healthy kidneys or liver will also take longer to process a given dose of heroin. Finally, the faster someone’s metabolism is, the quicker it will process heroin and cause it to dissipate from the body.
How Quickly Can You Overdose On Heroin?
While all of the previously mentioned factors play a role in the exact timing, especially the dosage and purity, a heroin overdose can occur within as little as 10 minutes of having taken it. The common symptoms of a heroin overdose include:
- Dangerously shallow and slow breathing
- Extremely weak pulse
- Blurred vision and pinprick pupils
- Blue skin around lips and fingernails
- Nausea and vomiting
- Unable to remain conscious or responsive
A lack of oxygen can quickly lead to major organ and brain damage as well as total shutdown and death if not treated soon enough. If someone is exhibiting the signs of a heroin overdose, it is vital that they receive emergency medical attention as quickly as possible.
Heroin overdose is generally treated by administering the overdose-reversal drug naloxone, also known by its brand name Narcan, which will rapidly flush the opioids of out someone’s system.