Heroin is usually a mixture of diacetylmorphine, the active ingredient that produces the drug effects, and a variety of filler ingredients. Some of these fillers are other opiates, and share some of the psychoactive effects of heroin. Others are simply powders that share the appearance of the form of heroin they are cut with. And in some cases, the add-ins are toxins that can cause deadly side effects.
Psychoactive Ingredients
Diacetylmorphine, or diamorphine, is a highly potent painkiller that is synthesized from the latex sap of the seed pod of the opium poppy, known as opium. The opium poppy grows in many parts of the world, including Asia, Australia, some parts of Europe, Turkey, Afghanistan, Colombia, and Mexico. For more mental health resources, see our National Helpline Database. This opiate is the main psychoactive ingredient in heroin, which produces the euphoric heroin high. It is also what gives heroin its addictive qualities and creates a state of physical dependence among its users; the more someone uses, the more they need to avoid withdrawal symptoms. Research shows that drug users are concerned about fentanyl in their heroin, and most are open to using rapid test strips, which can be used to detect the presence of fentanyl in drug samples (before use) or urine (after use) and can help inform people about their exposure risk. In addition to diacetylmorphine and fentanyl, street heroin may contain a variety of other street and prescription drugs, including methamphetamine. Although meth is a stimulant and heroin a relaxant, both produce feelings of euphoria. A drug dealer can often get away with mixing any euphoria-producing psychoactive drug with heroin if it is available at a cheaper price. Meth carries its own risks and typically contains toxic chemicals. That makes it particularly unsafe to inject directly into the bloodstream.
Black Tar Heroin
Black tar heroin looks like a sticky chunk of blackish brownish substance. It is produced by a very crude process in which the opiate that is produced is relatively unrefined compared to white powder heroin. Although black tar heroin has been around for over 100 years, its popularity in the United States began in the 1970s because it is cheaper and easier to make than white powder heroin.
Brown or White Powder Street Heroin
Further processing of black tar heroin, and cutting with lactose, can produce brown powder heroin. White powder heroin in its purest form is a salt form of the drug, known as diacetylmorphine hydrochloride, although it will typically be mixed or “cut” with other white powders. These reduce the potency and increase the risk of contamination and vein damage if the drug is injected.
Chemical Additives
The process of making heroin from opium varies, depending on the methods used and the facility in which it is made. These facilities might be state-of-the-art, legitimate laboratories run by fully qualified chemists. They might be clandestine labs run by illicit drug manufacturers. Or they might be makeshift spaces run by local growers with little or no education in chemistry. Sometimes heroin is manufactured in home labs by people attempting to convert prescription painkillers, such as oxycodone, into street heroin. There is no way to know the point of origin or additional ingredients of heroin purchased on the street. It may contain contaminants that are by-products of the manufacturing process, such as calcium oxide, ammonia, chloroform, hydrochloric acid, and acetic anhydride.
Anesthetics
Street heroin may contain local anesthetics, such as xylocaine. Although anesthetics are legally used for medical and dental purposes, they do carry risks, can have side effects, and are also potential allergens, carrying additional risks of adverse health effects. These may not be recognized or properly treated by users or dealers.
Fillers
Filler ingredients are added to bulk up heroin so that dealers can increase their profit margins. Some of these are benign substances, such as talc, flour, cornstarch, powdered milk, and various sugars. Other fillers are harmful. For example, black tar heroin may be diluted with black shoe polish or dirt. Quinine is sometimes added to white powder heroin for its bitter flavor.
Potential Toxins
It’s also possible for poisons to be cut into heroin. Strychnine, which is used as a pesticide used in rat poison, is one toxic ingredient sometimes mixed with heroin. Psychological symptoms of strychnine poisoning include anxiety, restlessness, agitation, and an increased startle response. Physical symptoms include jaw tension, muscle pain and spasms, rigidity of the arms and legs, and arching of the neck and back. Black tar heroin may be cut with soil, which can contain the spores of a toxic contaminant called Clostridium botulinum. This bacteria causes a potentially fatal kind of food poisoning called botulism. If the spores get into a wound, they can cause a rare infection known as wound botulism. Even though the wound may appear small, the infection is extremely serious. Although not actually an ingredient in heroin, people who burn heroin on aluminum foil to inhale the fumes—a practice known as “chasing the dragon”—may have elevated levels of aluminum in their urine. Aluminum is known to be a neurotoxin, although the long-term effects on heroin users still need to be established.
