Heroin is a powerful opioid drug made from morphine, a natural substance taken from the seed pod of the Asian opium poppy plant.10,36 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 big H, hell dust, dope, horse, junk, and smack.36

Although nationwide heroin-involved drug use decreased by 4.1% from 2017-2018, heroin overdose remains a significant problem.13 In 2018, nearly 15,000 people died from an overdose involving heroin in the United States, a rate of almost 10 deaths for every 100,000 Americans.

It is estimated that nearly 808,000 people in the United States reported using heroin in 2018, this corresponds to about 0.3% of the population. 46,55

Heroin can be injected, smoked or snorted.36 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. In particular, heroin that is mixed with fentanyl or carfentanyl has a significantly increased risk of causing overdose or death.36,39