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Also known as: Black tar, Brown sugar, H, Horse, Junk, Ska, Skunk, Smack, and White Horse.
What is heroin?
Heroin is a very addictive drug made from morphine, a psychoactive (mind-altering) substance taken from the resin of the seed pod of the opium poppy plant. Heroin’s color and look depend on how it is made and what else it may be mixed with. It can be white or brown powder, or a black, sticky substance called “black tar heroin.”
Heroin is part of a class of drugs called opioids. Other opioids include some prescription pain relievers, such as codeine, oxycodone (OxyContin), and hydrocodone (e.g. Vicodin).
Heroin use and overdose deaths have dramatically increased over the last decade. This increase is related to the growing number of people misusing prescription opioid pain relievers like OxyContin and Vicodin. Some people who become addicted to those drugs switch to heroin because it produces similar effects but is cheaper and easier to get.
In fact, most people who use heroin report they first misused prescription opioids, but it is a small percentage of people who switch to heroin. The numbers of people misusing prescription drugs is so high, that even a small percentage translates to hundreds of thousands of heroin users.1 Even so, some research suggests about one-third of heroin users in treatment simply started with heroin. Maybe they were mistakenly told that only one use cannot lead to addiction. Both heroin and opioid pill use can lead to addiction and overdose.
How Heroin is Used
Heroin is mixed with water and injected with a needle. It can also be sniffed, smoked, or snorted. People who use heroin sometimes combine it with other drugs, such as alcohol or cocaine (a “speedball”), which can be particularly dangerous and raise the risk of overdose.
To learn more about the different types of opioids, visit our Prescription Opioids Drug Facts page.
1 Compton WM, Jones CM, Baldwin GT. Relationship between nonmedical prescription-opioid use and heroin use. The New England Journal of Medicine 2016;374:154-163.