Heroin is a potent opioid substance synthesized from morphine. It is typically found in illicit markets as a white or brown powder, or as a sticky, dark substance referred to as “black tar” heroin. The physical form of the drug, its purity, and the user’s familiarity with the substance influence the specific method chosen for its consumption. The way heroin is taken into the body determines how quickly it reaches the brain and the intensity of the resulting effects.
Administration by Insufflation
Insufflation, commonly known as snorting, involves inhaling powdered heroin through the nasal cavity. This method requires the heroin to be in a fine, dry powder form. The powder is typically arranged into thin lines and then drawn up one nostril.
Once inhaled, the fine particles adhere to the mucous membranes lining the nasal passages. The drug is then slowly absorbed into the bloodstream through the rich network of blood vessels beneath these membranes. Because the absorption process is gradual, the effects are delayed compared to other routes, often taking around 10 to 15 minutes to fully manifest.
The practice of snorting carries localized risks due to the caustic nature of the substance and its cutting agents. Chronic insufflation can lead to ulceration and irritation of the nasal septum and surrounding tissue. Prolonged damage may result in a perforated septum, which is a hole in the cartilage that separates the two nostrils. This route is typically chosen by users who seek to avoid injection.
Administration by Inhalation
Inhalation of heroin vapor, often referred to as “chasing the dragon,” is a method where the substance is heated to create a vapor that is then breathed into the lungs. This process involves placing the heroin onto a piece of heat-conductive material, such as aluminum foil, which is heated with a flame, causing the heroin to melt and vaporize without burning.
The user uses a tube or straw to inhale the resulting smoke as it trails across the foil. This route of administration is highly efficient because the lungs offer an immense surface area for gas exchange, allowing for very rapid absorption into the pulmonary circulation.
Despite the avoidance of needles, this practice carries significant respiratory risks due to the inhalation of hot, toxic fumes and potential contaminants. These risks can include lung function impairment and, in rare cases, a severe neurological condition known as toxic leukoencephalopathy, which damages the brain’s white matter.
Administration by Injection
Injection is a complex and high-risk route of administration that involves preparing a liquid solution of heroin for direct delivery into the body. The initial step requires dissolving the solid heroin in water, often in a small container like a spoon. Depending on the form of heroin, an acid like citric acid or vinegar may be needed to achieve solubility, and the mixture is frequently heated to aid in the dissolution.
After the heroin is dissolved, the solution is drawn into a syringe through a filter, which is meant to remove any insoluble particulate matter or cutting agents. Common makeshift filters include small pieces of cotton. This filtration step prevents foreign particles from entering the bloodstream, where they could potentially cause blockages in small blood vessels.
Intravenous (IV) Administration
The most common form of injection is intravenous (IV) administration, where the solution is delivered directly into a vein. This method provides the fastest and most intense onset of effects, known as “the rush,” because the drug immediately enters the systemic circulation and reaches the brain rapidly. However, IV injection carries the highest risk of blood-borne diseases, such as HIV and Hepatitis C, if needles or other injection equipment are shared.
Subcutaneous and Intramuscular Injection
Subcutaneous injection, often called “skin popping,” and intramuscular (IM) injection are less common alternatives that involve injecting the solution just under the skin or into a muscle, respectively. These routes are associated with a slower rate of absorption and a less intense effect than IV injection. However, they carry a high risk of localized infections, abscess formation, and serious bacterial infections like wound botulism and tetanus, particularly when non-sterile mixtures are deposited into the soft tissue.