Heroin is a powerful opioid drug made from morphine, a natural substance taken from the seed pod of the Asian opium poppy plant.27 Use of heroin produces euphoria and feelings of relaxation. Regular heroin use changes the functioning of the brain, causing tolerance and dependence. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin. Heroin can be pure or mixed with fillers or other drugs such as fentanyl. Other common names for heroin include dope, horse, junk, and smack.29

Heroin use has been increasing in recent years among both genders, most age groups and all income levels. Some of the greatest increases have occurred in demographic groups with historically low rates of heroin use: women, the privately insured and people with higher incomes. In particular, heroin use has more than doubled in the past decade among young adults aged 18-25 years. Heroin-related overdose deaths have more than quadrupled since 2010, with nearly 13,000 people dying in 2015. The rising rate of heroin use is attributed to increased availability, relatively low price (compared to prescription opioids) and high purity of heroin in the U.S.6,10 Past misuse of prescription opioids is the strongest risk factor for starting heroin use.6

Heroin can be injected, smoked or snorted.27 Because heroin is so rapid acting and users do not know the actual strength or purity of the drug, uses face a high risk of overdose or death.29