Key points

  • Heroin is a highly addictive, dangerous opioid.
  • Using heroin with other drugs or alcohol increases the risk of an overdose, which can lead to coma or death.
  • While the number of heroin overdose deaths has increased since 2010, the rate is now decreasing.

What is heroin?

Heroin is a highly addictive, illegal opioid. The seed pods of opium poppy plants make morphine, which is used to create heroin. It is considered highly addictive because all the ways of taking heroin flood the brain very quickly.1

Drug overdose rates involving heroin

Over 7% of all opioid overdose deaths in 2022 involved heroin.2 Not only are people using heroin, but they are also using multiple other substances, including cocaine and prescription opioids.3

The number of heroin overdose deaths in 2022 was over 2 times the number in 2010.
Heroin overdose can lead to serious health issues and death.

However, from 2021 to 2022, the heroin overdose death rate decreased nearly 36%.2 Factors that may contribute to the decrease in heroin-involved deaths include fewer people initiating heroin use and, shifts from a heroin-based market to a fentanyl-based market.45

Learn more about Fentanyl Facts

How is heroin harmful?

Nearly 157,000 people died from an overdose involving heroin during 1999-2022.
Using heroin with other drugs increases the risk of overdose.

Heroin is typically injected but is also smoked and snorted. Persons who inject drugs are also at risk of getting a serious, long-term viral infections such as HIV, Hepatitis C, and Hepatitis B, as well as bacterial infections of the skin, bloodstream, and heart (endocarditis).

Repeated use of heroin can lead to tolerance. Opioid tolerance occurs when a person using opioids begins to experience a reduced response to medication or drug, requiring more opioids to experience the same effect. At higher doses over time, the body can experience opioid dependence. If someone who is dependent on heroin stops using it, they can have withdrawal symptoms.

Risks of Opioids Use Disorder (OUD) and Overdose

Opioids Use Disorder (OUD) often known as addiction is a problematic pattern of opioid use that causes significant impairment or distress. OUD is considered a medical condition that can affect anyone. Repeated use of heroin can lead to an opioid use disorder. This is more than physical dependence and it is a chronic (long-lasting) brain disorder.

A diagnosis is based on specific criteria such as unsuccessful efforts to cut down or control use, or use resulting in social problems and a failure to fulfill obligations at work, school, or home, among other criteria.

Like many other medical conditions, evidence-based treatments are available for OUD, but seeking treatment remains stigmatized. Stigma can be a major barrier to how well prevention and treatment programs work against the opioid crisis.

A heroin overdose can cause slow and shallow breathing, coma, and death. People often use heroin along with other drugs or alcohol. This practice is especially dangerous because it increases the risk of overdose.


Reversing an Opioid Overdose

Naloxone is a safe medication that can quickly reverse an overdose from opioids like heroin if it is given in time. It works by blocking the effects of the opioid on the body. Sometimes more than one dose of the medicine is needed. It can restore normal breathing within 2 to 3 minutes in a person whose breath has slowed, or even stopped, as a result of opioid overdose. Naloxone won't harm someone if they're overdosing on drugs other than opioids, so it's always best to use it if you think someone is overdosing.

There are two forms of naloxone, (pre-filled nasal spray and injectable) that anyone can use without medical training or authorization. Naloxone is easy to use and small to carry. People at risk of an overdose are encouraged to carry naloxone with them. They can buy naloxone over the counter at a pharmacy. 6

OUD Treatment

Treatments for OUD include medicines to treat withdrawal symptoms, medicine to block the effects of opioids, and behavioral treatments.

Opioid addiction treatment can vary depending the patient's individual needs, occur in a variety of settings, take many different forms, and last for varying lengths of time.

Evidence-based approaches to treating OUD include medications sometimes used in combination with behavioral therapy. People getting treatment for OUD can talk to their health care provider to come up with a treatment plan that fits their needs. A recovery plan that includes medication for opioid addiction increases the chance of success.6

Related pages

  1. Fareed A, Kim J, Ketchen B, Kwak WJ, Wang D, Shongo-Hiango H, Drexler K. Effect of heroin use on changes of brain functions as measured by functional magnetic resonance imaging, a systematic review. Journal of addictive diseases. 2017 Apr 3;36(2):105-16
  2. Spencer MR, Garnett MF, Miniño AM. Drug overdose deaths in the United States, 2002–2022. NCHS Data Brief, no 491. Hyattsville, MD: National Center for Health Statistics. 2024. DOI: https://dx.doi.org/10.15620/cdc:135849
  3. Jones CM, Logan J, Gladden RM, Bohm MK. Vital Signs: Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013. MMWR Morb Mortal Wkly Rep 2015; 64(26):719-725.
  4. Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report
  5. Department of Justice, Drug Enforcement Administration. 2020 national drug threat assessment. Washington, DC.2021.
  6. Substance Abuse and Mental Health Services Administration. Overdose Prevention and Response Toolkit.