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Heroin: Effects, Overdose Risk and Treatment in Florida

Addiction is not a life sentence. There is hope, and recovery is possible.

Heroin is an illegal, highly addictive opioid made from morphine. Its greatest danger is overdose: heroin slows breathing, and today it is often mixed with fentanyl, a far stronger opioid, so any use can be deadly. Opioid addiction is treatable, and medication is the standard of care.

What Heroin Is

Heroin is made from morphine, a natural substance taken from the seed pod of opium poppy plants grown in Southeast and Southwest Asia, Mexico and Colombia. It is sold as a white or brown powder or as a black, sticky substance known as black tar heroin. It can be injected, smoked or snorted.

Heroin belongs to the opioid family, which also includes prescription pain medicines such as oxycodone, hydrocodone and morphine and synthetic opioids such as fentanyl. Unlike those medicines, heroin has no accepted medical use in the United States.

Fentanyl in the heroin supply

NIDA reports that most recent overdose deaths in the United States involved illegally made fentanyl and other potent synthetic opioids. Fentanyl is often mixed into heroin and other drugs without the buyer knowing. A very small amount can stop someone’s breathing, and an overdose involving fentanyl may need more than one dose of naloxone to reverse.

How Heroin Affects the Brain and Body

Heroin attaches to opioid receptors in the brain and body. People typically report a surge of pleasure, followed by several hours of drowsiness and clouded thinking. Other common effects include warm, flushed skin, dry mouth, heavy-feeling arms and legs, nausea, vomiting and severe itching. Heart rate slows.

The most dangerous effect is on breathing. Opioids act on the brain stem, which controls breathing, and heroin can slow breathing enough to be life-threatening. Too little oxygen reaching the brain can cause coma and permanent brain damage.

Short- and Long-Term Risks

Repeated heroin use changes the brain’s structure and chemistry, creating imbalances that are not easily reversed. Studies show some loss of the brain’s white matter, which may affect decision-making, the ability to control behavior and how a person responds to stress.

NIDA lists these medical complications of long-term use:

  • insomnia and constipation
  • lung problems, including pneumonia and tuberculosis
  • scarred or collapsed veins, infections of the blood vessels and heart valves, abscesses and other skin and soft-tissue infections from injecting
  • damage to the lungs, liver, kidneys or brain when additives that don’t dissolve clog small blood vessels
  • arthritis and other immune reactions to contaminants
  • hepatitis B and C, HIV and other bloodborne infections spread through shared injection equipment

Overdose: Signs and What to Do

Signs of an opioid overdose include:

  • being unconscious or impossible to wake
  • slow, shallow or stopped breathing
  • very small pupils
  • purple or bluish lips and fingernails and pale skin
  • vomiting, a faint heartbeat, limp arms and legs or being unable to speak

Call 911 immediately. Then give naloxone (Narcan) if you have it. Naloxone is a nasal spray or injection that can reverse an opioid overdose, and NIDA notes it is now available over the counter, without a prescription. Stay with the person and keep watching them until emergency help arrives. Naloxone works for about 30 to 90 minutes, which can be shorter than the opioid stays in the body, so breathing can slow again after it wears off. A person who has been revived still needs emergency medical care.

If someone in your life uses opioids, keep naloxone where you can reach it quickly. NIDA says many pharmacies carry it, and it is also given out free by community programs and local health departments. Naloxone only works on opioids: it will not reverse an overdose caused only by cocaine, methamphetamine or alcohol, so calling 911 is always the first step.

Is Heroin Addictive? Dependence and Withdrawal

Yes. Repeated heroin use often leads to opioid use disorder, a chronic, relapsing condition in which a person keeps seeking and using the drug despite serious harm. Over time the body builds tolerance, so more is needed for the same effect, and becomes dependent on the drug to feel normal.

When someone who is dependent stops or cuts back, withdrawal can begin within a few hours of the last dose. Symptoms include restlessness, muscle and bone pain, trouble sleeping, diarrhea, vomiting and cold flashes. They typically peak 24 to 48 hours after the last dose and ease after about a week, though some people have lingering symptoms for months.

How heroin enters the body matters too. NIDA notes that injecting or smoking it delivers the drug to the brain fastest, which raises the risk of developing a use disorder.

Withdrawal is painful and is one of the main reasons people return to using. After a period without opioids, tolerance drops, so going back to a previous amount carries a high risk of overdose. That is why withdrawal is safer with medical support: medications can ease symptoms and cravings, and a care team can start ongoing treatment right away. A Florida detox center can manage this stage.

If Someone You Love Won’t Accept Help

Watching someone you love struggle with heroin is frightening, and many families don’t know where to start. A first step is to talk with a doctor, counselor or the SAMHSA National Helpline about options for your situation. In Florida, the Marchman Act allows a family member or other concerned person to petition a court for involuntary assessment and stabilization of a person with a substance use problem. It is a serious legal step, so it helps to learn how it works before you need it.

Heroin and the Law

Heroin is a Schedule I controlled substance under federal law, the category for drugs with a high potential for misuse and no accepted medical use. Making, selling or possessing it is a crime.

Treatment for Heroin Addiction in Florida

Medication is the standard of care for opioid use disorder. The FDA has approved three medications: methadone, buprenorphine and naltrexone. NIDA reports that research shows these medications lower the risk of returning to drug use and of dying from an overdose. They are usually combined with counseling and behavioral therapies that help people rebuild routines, relationships and coping skills.

In Florida, this care is offered at outpatient opioid treatment programs, in office-based practices and in residential programs. Our guide to medication-assisted treatment in Florida explains how each medication works and what to expect. If you need a structured setting to get through the early weeks, read about inpatient and residential rehab, or search licensed Florida rehabs near you.

Getting Help Now

  • Emergency: call 911 for any sign of overdose, a seizure, trouble breathing or someone who cannot be woken.
  • SAMHSA National Helpline: 1-800-662-4357. Free, confidential, 24/7, in English and Spanish, for treatment referrals and information.
  • Crisis: call or text 988 (Suicide & Crisis Lifeline) if you or someone you love is in emotional crisis or thinking about suicide.
  • Poison Control: 1-800-222-1222 for questions that are not emergencies.

Sources

Frequently Asked Questions About Heroin: Effects, Overdose Risk and Treatment in Florida

What is heroin?

Heroin is an illegal, highly addictive opioid made from morphine, which comes from the opium poppy. It is sold as a white or brown powder or as a black sticky substance called black tar heroin. It can be injected, smoked or snorted. Today heroin is often mixed with fentanyl, a far stronger synthetic opioid, which makes every use riskier.

What are the effects of heroin?

Heroin causes a rush of pleasure followed by several hours of drowsiness, clouded thinking and a slowed heart rate. Common physical effects include flushed skin, dry mouth, heavy arms and legs, nausea, vomiting and severe itching. The most dangerous effect is slowed breathing, which can become life-threatening and lead to coma or permanent brain damage.

How can you tell if someone is overdosing on heroin?

Signs of a heroin overdose include being unconscious or unable to wake, slow or shallow breathing, bluish or purplish lips and nails, and tiny pupils. Call 911 right away. Give naloxone (Narcan) if you have it; it is available over the counter as a nasal spray and can reverse an opioid overdose. Stay with the person and try to keep them breathing until help arrives.

Why is fentanyl in heroin so dangerous?

Fentanyl is a synthetic opioid far more potent than morphine, so even a tiny amount can stop someone's breathing. NIDA reports that illegally made fentanyl is involved in most recent opioid overdose deaths, and it is often mixed into heroin and other drugs without the buyer knowing. If you think someone is overdosing, call 911 and give naloxone (Narcan) if you have it.

What are heroin withdrawal symptoms?

Heroin withdrawal can cause muscle aches, cramps, anxiety, nausea, vomiting, chills and diarrhea when someone who is dependent stops or cuts back. It is very uncomfortable and often leads people back to using. Medications can ease withdrawal and cravings, so it is safer to go through it with medical help; you can find a Florida detox center in our directory.

What treatment works for heroin addiction in Florida?

Medication is the standard of care for heroin addiction. Methadone, buprenorphine and naltrexone are FDA-approved; they reduce cravings and the risk of overdose death, and they work best combined with behavioral therapy. Florida has outpatient clinics and residential programs that provide this care. Our guide to medication-assisted treatment in Florida explains your options.