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NationalInstituteonDrugAbuse(NIDA)

Heroin

LastUpdatedMarch2018

https://www.drugabuse.gov

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TableofContents

Heroin

Overview

Whatisheroinandhowisitused?

WhatisthescopeofheroinuseintheUnitedStates?

Whateffectsdoesheroinhaveonthebody?

Whataretheimmediate(short-term)effectsofheroinuse?

Whatarethelong-termeffectsofheroinuse?

Howisheroinlinkedtoprescriptiondrugmisuse?

Whatarethemedicalcomplicationsofchronicheroinuse?

WhydoesheroinusecreatespecialriskforcontractingHIV/AIDSandhepatitisBandC?

Howdoesheroinuseaffectpregnantwomen?

Whatcanbedoneforaheroinoverdose?

Whatarethetreatmentsforheroinusedisorder?

WherecanIgetfurtherinformationaboutheroin?

References

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Overview

Heroinisahighlyaddictiveopioiddrug,anditsusehasrepercussionsthatextendfarbeyondtheindividualuser.Themedicalandsocialconsequencesofdruguse—suchashepatitis,HIV/AIDS,fetaleffects,crime,violence,anddisruptionsinfamily,workplace,andeducationalenvironments—haveadevastatingimpactonsocietyandcostbillionsofdollarseachyear.

Althoughheroinuseinthegeneralpopulationisratherlow,thenumbersofpeoplestartingtouseheroinhavebeensteadilyrisingsince2007. Thismaybedueinparttoashiftfrommisuseofprescriptionpainrelieverstoheroinasareadilyavailable,cheaperalternative andthemisperceptionthatpureheroinissaferthanlesspureformsbecauseitdoesnotneedtobeinjected.

Likemanyotherchronicdiseases,substanceusedisorderscanbetreated.Medicationsareavailabletotreatheroinusedisorderwhilereducingdrugcravingsandwithdrawalsymptoms,thusimprovingtheoddsofachievingabstinence.Therearenowavarietyofmedicationsthatcanbetailoredtoaperson’srecoveryneedswhiletakingintoaccountco-occurringhealthconditions.Medicationcombinedwithbehavioraltherapyisparticularlyeffective,offeringhopetoindividualswhosufferfromsubstanceusedisordersandforthosearoundthem.

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Whatisheroinandhowisitused?

Heroinisanillegal,highlyaddictivedrugprocessedfrommorphine,anaturallyoccurringsubstanceextractedfromtheseedpodofcertainvarietiesofpoppyplants.Itistypicallysoldasawhiteorbrownishpowderthatis"cut"withsugars,starch,powderedmilk,orquinine.PureheroinisawhitepowderwithabittertastethatpredominantlyoriginatesinSouthAmericaand,toalesserextent,fromSoutheastAsia,anddominatesU.S.marketseastoftheMississippiRiver.Highlypureheroincanbesnortedorsmokedandmaybemoreappealingtonewusersbecauseiteliminatesthestigmaassociatedwithinjectiondruguse."Blacktar"heroinisstickylikeroofingtarorhardlikecoalandispredominantlyproducedinMexicoandsoldinU.S.areaswestoftheMississippiRiver. Thedarkcolorassociatedwithblacktarheroinresultsfromcrudeprocessingmethodsthatleavebehindimpurities.Impureheroinisusuallydissolved,diluted,andinjectedintoveins,muscles,orundertheskin.

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WhatisthescopeofheroinuseintheUnitedStates?

AccordingtotheNationalSurveyonDrugUseandHealth(NSDUH),in2016about948,000Americansreportedusingheroininthepastyear, anumberthathasbeenontherisesince2007.Thistrendappearstobedrivenlargelybyyoungadultsaged18–25amongwhomtherehavebeenthegreatestincreases.Thenumberofpeopleusingheroinforthefirsttimeishigh,with170,000peoplestartingheroinusein2016,nearlydoublethenumberofpeoplein2006(90,000).Incontrast,heroinusehasbeendecliningamongteensaged12–17.Past-yearheroinuseamongthenation’s8th,10th,and12thgradersisatitslowestlevelssince1991,atlessthan1percentineachgradelevel.

Itisnosurprisethatwithheroinuseontherise,morepeopleareexperiencing

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Source:NationalSurveyonDrugUseandHealth:SummaryofNationalFindings,2016.

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negativehealtheffectsthatoccurfromrepeateduse.ThenumberofpeoplemeetingDiagnosticandStatisticalManualofMentalDisorders,4thedition(DSM-IV)criteriafordependenceorheroinusedisorderincreaseddramaticallyfrom214,000in2002to626,000in2016. ThefifthandthecurrentversionoftheDSM,DSM-5,nolongerseparatessubstanceabusefromdependence,butinsteadprovidescriteriaforopioidusedisorderthatrangefrommildtosevere,dependingonthenumberofsymptomsapersonhas. DataonthescopeandseverityofopioidusedisorderintheUnitedStatesarenotyetavailableforthesenewcriteria.

Fentanyl

Fentanylisasyntheticopioidthatis50to100timesmorepowerfulthanmorphine.Recently,tracesoffentanylhavebeenfoundinmanyotherillegaldrugs,includingheroin.Thisisapublichealthconcernbecausethestrengthoffentanylmakesoverdosingmorelikely.

TheimpactofheroinuseisfeltallacrosstheUnitedStates,withheroinbeingidentifiedasthemostoroneofthemostimportantdruguseissuesaffectingseverallocalregionsfromcoasttocoast.TherisingharmassociatedwithheroinuseatthecommunitylevelwaspresentedinareportproducedbytheNIDACommunityEpidemiologyWorkGroup(CEWG).TheCEWGiscomprisedofresearchersfrommajormetropolitanareasintheUnitedStatesandselectedforeigncountriesandprovidescommunity-levelsurveillanceofdruguseanditsconsequencestoidentifyemergingtrends.

Heroinusenolongerpredominatessolelyinurbanareas.SeveralsuburbanandruralcommunitiesnearChicagoandSt.Louisreportincreasingamountsofheroinseizedbyofficialsaswellasincreasingnumbersofoverdosedeathsduetoheroinuse.Heroinuseisalsoontheriseinmanyurbanareasamongyoungadultsaged18-25. Individualsinthisagegroupseekingtreatmentforheroinuseincreasedfrom11percentoftotaladmissionsin2008to26percentinthefirsthalfof2012.

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Whateffectsdoesheroinhaveonthebody?

Thegreatestincreaseinheroinuseisseeninyoungadultsaged18-25.

Heroinbindstoandactivatesspecificreceptorsinthebraincalledmu-opioidreceptors(MORs).Ourbodiescontainnaturallyoccurringchemicalscalledneurotransmittersthatbindtothesereceptorsthroughoutthebrainandbodytoregulatepain,hormonerelease,andfeelingsofwell-being. WhenMORsareactivatedintherewardcenterofthebrain,theystimulatethereleaseoftheneurotransmitterdopamine,causingareinforcementofdrugtakingbehavior.Theconsequencesofactivatingopioidreceptorswithexternallyadministeredopioidssuchasheroin(versusnaturallyoccurringchemicalswithinourbodies)dependonavarietyoffactors:howmuchisused,whereinthebrainorbodyitbinds,howstronglyitbindsandforhowlong,howquicklyitgetsthere,andwhathappensafterward.

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Whataretheimmediate(short-term)effectsofheroinuse?

Onceheroinentersthebrain,itisconvertedtomorphineandbindsrapidlytoopioidreceptors. Peoplewhouseherointypicallyreportfeelingasurgeofpleasurablesensation—a"rush."Theintensityoftherushisafunctionofhowmuchdrugistakenandhowrapidlythedrugentersthebrainandbindstotheopioidreceptors.Withheroin,therushisusuallyaccompaniedbyawarmflushingoftheskin,drymouth,andaheavyfeelingintheextremities.Nausea,vomiting,andsevereitchingmayalsooccur.Aftertheinitialeffects,usersusuallywillbedrowsyforseveralhours;mentalfunctionisclouded;heartfunctionslows;andbreathingisalsoseverelyslowed,sometimesenoughtobelife-threatening.Slowedbreathingcanalsoleadtocomaandpermanentbraindamage.

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OpioidsActonManyPlacesintheBrainandNervousSystem

Opioidscandepressbreathingbychangingneurochemicalactivityinthebrainstem,whereautomaticbodyfunctionssuchasbreathingandheartratearecontrolled.

Opioidscanreinforcedrugtakingbehaviorbyalteringactivityinthelimbicsystem,whichcontrolsemotions.

Opioidscanblockpainmessagestransmittedthroughthespinalcordfromthebody.

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Whatarethelong-termeffectsofheroinuse?

Repeatedheroinusechangesthephysicalstructure andphysiologyofthebrain,creatinglong-termimbalancesinneuronalandhormonalsystemsthatarenoteasilyreversed. Studieshaveshownsomedeteriorationofthebrain’swhitematterduetoheroinuse,whichmayaffectdecision-makingabilities,theabilitytoregulatebehavior,andresponsestostressfulsituations.

Heroinalsoproducesprofounddegreesoftoleranceandphysicaldependence.Toleranceoccurswhenmoreandmoreofthedrugisrequiredtoachievethesameeffects.Withphysicaldependence,thebodyadaptstothepresenceofthedrug,andwithdrawalsymptomsoccurifuseisreducedabruptly.

Withdrawalmayoccurwithinafewhoursafterthelasttimethedrugistaken.Symptomsofwithdrawalincluderestlessness,muscleandbonepain,insomnia,diarrhea,vomiting,coldflasheswithgoosebumps("coldturkey"),andlegmovements.Majorwithdrawalsymptomspeakbetween24–48hoursafterthelastdoseofheroinandsubsideafteraboutaweek.However,somepeoplehaveshownpersistentwithdrawalsignsformanymonths.Finally,repeatedheroinuseoftenresultsinheroinusedisorder—achronicrelapsingdiseasethatgoesbeyondphysicaldependenceandischaracterizedbyuncontrollabledrug-seeking,nomattertheconsequences. Heroinisextremelyaddictivenomatterhowitisadministered,althoughroutesofadministrationthatallowittoreachthebrainthefastest(i.e.,injectionandsmoking)increasetheriskofdevelopingheroinusedisorder.Onceapersonhasheroinusedisorder,seekingandusingthedrugbecomestheirprimarypurposeinlife.

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Howisheroinlinkedtoprescriptiondrugmisuse?

Harmfulhealthconsequencesresultingfromthemisuseofopioidmedicationsthatareprescribedforthetreatmentofpain,suchasOxycontin ,Vicodin ,andDemerol ,havedramaticallyincreasedinrecentyears.Forexample,almosthalfofallopioiddeathsintheU.S.nowinvolveaprescriptionopioid.Peopleoftenassumeprescriptionpainrelieversaresaferthanillicitdrugsbecausetheyaremedicallyprescribed;however,whenthesedrugsaretakenforreasonsorinwaysoramountsnotintendedbyadoctor,ortakenbysomeoneotherthanthepersonforwhomtheyareprescribed,theycanresultinsevereadversehealtheffectsincludingsubstanceusedisorder,overdose,anddeath,especiallywhencombinedwithotherdrugsoralcohol.Researchnowsuggeststhatmisuseofthesemedicationsmayactuallyopenthedoortoheroinuse.Somealsoreportswitchingtoheroinbecauseitischeaperandeasiertoobtainthanprescriptionopioids.

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Whatarethemedicalcomplicationsofchronicheroinuse?

Nomatterhowtheyingestthedrug,chronicheroinusersexperienceavarietyofmedicalcomplications,includinginsomniaandconstipation.Lungcomplications(includingvarioustypesofpneumoniaandtuberculosis)mayresultfromthepoorhealthoftheuseraswellasfromheroin’seffectofdepressingrespiration.Manyexperiencementaldisorders,suchasdepressionandantisocialpersonalitydisorder.Menoftenexperiencesexualdysfunctionandwomen’smenstrualcyclesoftenbecomeirregular.Therearealsospecificconsequencesassociatedwithdifferentroutesofadministration.Forexample,peoplewhorepeatedlysnortheroincandamagethemucosaltissuesintheirnosesaswellasperforatethenasalseptum(thetissuethatseparatesthenasalpassages).

Medicalconsequencesofchronicinjectionuseincludescarredand/orcollapsedveins,bacterialinfectionsofthebloodvesselsandheartvalves,abscesses(boils),andothersoft-tissueinfections.Manyoftheadditivesinstreetheroinmayincludesubstancesthatdonotreadilydissolveandresultincloggingthebloodvesselsthatleadtothelungs,liver,kidneys,orbrain.Thiscancauseinfectionorevendeathofsmallpatchesofcellsinvitalorgans.Immunereactionstotheseorothercontaminantscancausearthritisorotherrheumatologicproblems.

Sharingofinjectionequipmentorfluidscanleadtosomeofthemostsevereconsequencesofheroinuse—infectionswithhepatitisBandC,HIV,andahostofotherblood-borneviruses,whichdruguserscanthenpassontotheirsexualpartnersandchildren.

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WhydoesheroinusecreatespecialriskforcontractingHIV/AIDSandhepatitisBandC?

HeroinuseincreasestheriskofbeingexposedtoHIV,viralhepatitis,andotherinfectiousagentsthroughcontactwithinfectedbloodorbodyfluids(e.g.,semen,saliva)thatresultsfromthesharingofsyringesandinjectionparaphernaliathathavebeenusedbyinfectedindividualsorthroughunprotectedsexualcontactwithaninfectedperson.SnortingorsmokingdoesnoteliminatetheriskofinfectiousdiseaselikehepatitisandHIV/AIDSbecausepeopleundertheinfluenceofdrugsstillengageinriskysexualandotherbehaviorsthatcanexposethemtothesediseases.

Peoplewhoinjectdrugs(PWIDs)arethehighest-riskgroupforacquiringhepatitisC(HCV)infectionandcontinuetodrivetheescalatingHCVepidemic:EachPWIDinfectedwithHCVislikelytoinfect20otherpeople. Ofthe30,500newHCVinfectionsoccurringintheUnitedStatesin2014,mostcases

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occurredamongPWID.

HepatitisB(HBV)infectioninPWIDswasreportedtobeashighas25percentintheUnitedStatesin2014, whichisparticularlydishearteningsinceaneffectivevaccinethatprotectsagainstHBVinfectionisavailable.ThereiscurrentlynovaccineavailabletoprotectagainstHCVinfection.

Druguse,viralhepatitisandotherinfectiousdiseases,mentalillnesses,socialdysfunctions,andstigmaareoftenco-occurringconditionsthataffectoneanother,creatingmorecomplexhealthchallengesthatrequirecomprehensivetreatmentplanstailoredtomeetallofapatient’sneeds.Forexample,NIDA-fundedresearchhasfoundthatsubstanceusedisordertreatment,alongwithHIVpreventionandcommunity-basedoutreachprograms,canhelppeoplewhousedrugschangethebehaviorsthatputthematriskforcontractingHIVandotherinfectiousdiseases.Theycanreducedruguseanddrug-relatedriskbehaviorssuchasneedlesharingandunsafesexualpracticesand,inturn,reducetheriskofexposuretoHIV/AIDSandotherinfectiousdiseases.

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Howdoesheroinuseaffectpregnantwomen?

Heroinuseduringpregnancycanresultinneonatalabstinencesyndrome(NAS).NASoccurswhenheroinpassesthroughtheplacentatothefetusduringpregnancy,causingthebabytobecomedependent,alongwiththemother.Symptomsincludeexcessivecrying,fever,irritability,seizures,slowweightgain,tremors,diarrhea,vomiting,andpossiblydeath.NASrequireshospitalizationandtreatmentwithmedication(oftenmorphine)torelievesymptoms;themedicationisgraduallytaperedoffuntilthebabyadjuststobeingopioid-free.Methadonemaintenancecombinedwithprenatalcareandacomprehensivedrugtreatmentprogramcanimprovemanyoftheoutcomesassociatedwithuntreatedheroinuseforboththeinfantandmother,althoughinfantsexposedtomethadoneduringpregnancytypicallyrequiretreatmentforNASaswell.

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ANIDA-supportedclinicaltrialdemonstratedthatbuprenorphinetreatmentofopioid-dependentmothersissafeforboththeunbornchildandthemother.Onceborn,theseinfantsrequirelessmorphineandshorterhospitalstayscomparedtoinfantsbornofmothersonmethadonemaintenancetreatment.Researchalsoindicatesthatbuprenorphinecombinedwithnaloxone(comparedtoamorphinetaper)isequallysafefortreatingbabiesbornwithNAS,furtherreducingsideeffectsexperiencedbyinfantsborntoopioid-dependentmothers. ANIDA-fundedstudyfoundthattreatingNASbabieswithsublingualbuprenorphineresultedinashorterdurationoftreatmentthanoralmorphine,andalsoresultedinashorterlengthofhospitalstay,withsimilarratesofadverseevents.

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Mothers'BuprenorphineTreatmentDuringPregnancyBenefitsInfants

ANIDA-fundedclinicaltrial foundbuprenorphinetobeasafeandeffectivealternativetomethadonefortreatingopioiddependenceduringpregnancy.Buprenorphinewasalsofoundtobeeffectiveinreducingneonatalabstinencesyndromeinnewbornsborntoopioid-dependentmothers.

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Whatcanbedoneforaheroinoverdose?

Overdoseisadangerousanddeadlyconsequenceofheroinuse.Alargedoseofheroindepressesheartrateandbreathingtosuchanextentthatausercannotsurvivewithoutmedicalhelp.Naloxone(e.g.,Narcan )isanopioidreceptorantagonistmedicationthatcaneliminateallsignsofopioidintoxicationtoreverseanopioidoverdose.Itworksbyrapidlybindingtoopioidreceptors,preventingheroinfromactivatingthem. Becauseofthehugeincreaseinoverdosedeathsfromprescriptionopioidmisuse,therehasbeengreaterdemandforopioidoverdosepreventionservices.Naloxonethatcanbeusedbynonmedicalpersonnelhasbeenshowntobecost-effectiveandsavelives. InApril2014,theU.S.FoodandDrugAdministration(FDA)approvedanaloxonehand-heldauto-injectorcalledEvzio®,whichrapidlydeliversasingledoseofnaloxoneintothemuscleorundertheskin,buyingtimeuntilmedicalassistancecanarrive.In2015,theFDAapprovedaNarcan®nasalspraythatissprayeddirectlyintoonenostril.SinceEvzio®andNarcan®canbeusedbyfamilymembersorcaregivers,itgreatlyexpandsaccesstonaloxone.

Inaddition,theSubstanceAbuseandMentalHealthServicesAdministration(SAMHSA)continuallyupdatesitsOpioidOverdosePreventionToolkitthatprovideshelpfulinformationnecessarytodeveloppoliciesandpracticestopreventopioid-relatedoverdosesanddeaths.Thekitprovidesmaterialtailoredforfirstresponders,treatmentproviders,andindividualsrecoveringfromanopioidoverdose.LearnmoreaboutnaloxoneinNIDA’spolicybrief.

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Whatarethetreatmentsforheroinusedisorder?

Avarietyofeffectivetreatmentsareavailableforheroinusedisorder,includingbothbehavioralandpharmacological(medications).Bothapproacheshelptorestoreadegreeofnormalcytobrainfunctionandbehavior,resultinginincreasedemploymentratesandlowerriskofHIVandotherdiseasesandcriminalbehavior.Althoughbehavioralandpharmacologictreatmentscanbeextremelyusefulwhenutilizedalone,researchshowsthatformanypeople,integratingbothtypesoftreatmentsisthemosteffectiveapproach.

PharmacologicalTreatment(Medications)

Scientificresearchhasestablishedthatpharmacologicaltreatmentofopioidusedisorderincreasesretentionintreatmentprogramsanddecreasesdruguse,infectiousdiseasetransmission,andcriminalactivity.

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Whenpeopleaddictedtoopioidslikeheroinfirstquit,theyundergowithdrawalsymptoms(pain,diarrhea,nausea,andvomiting),whichmaybesevere.Medicationscanbehelpfulinthisdetoxificationstagetoeasecravingandotherphysicalsymptomsthatcanoftenpromptapersontorelapse.Whilenotatreatmentforaddictionitself,detoxificationisausefulfirststepwhenitisfollowedbysomeformofevidence-basedtreatment.

Medicationsdevelopedtotreatopioidusedisordersworkthroughthesameopioidreceptorsastheaddictivedrug,butaresaferandlesslikelytoproducetheharmfulbehaviorsthatcharacterizeasubstanceusedisorder.Threetypesofmedicationsinclude:(1)agonists,whichactivateopioidreceptors;(2)partialagonists,whichalsoactivateopioidreceptorsbutproduceasmallerresponse;and(3)antagonists,whichblockthereceptorandinterferewiththerewardingeffectsofopioids.Aparticularmedicationisusedbasedonapatient’sspecificmedicalneedsandotherfactors.Effectivemedicationsinclude:

Methadone(Dolophine orMethadose )isaslow-actingopioidagonist.Methadoneistakenorallysothatitreachesthebrainslowly,dampeningthe"high"thatoccurswithotherroutesofadministrationwhilepreventingwithdrawalsymptoms.Methadonehasbeenusedsincethe1960stotreatheroinusedisorderandisstillanexcellenttreatmentoption,particularlyforpatientswhodonotrespondwelltoothermedications.Methadoneisonlyavailablethroughapprovedoutpatienttreatmentprograms,whereitisdispensedtopatientsonadailybasis.

Buprenorphine(Subutex )isapartialopioidagonist.Buprenorphinerelievesdrugcravingswithoutproducingthe"high"ordangeroussideeffectsofotheropioids.Suboxone isanovelformulationofbuprenorphinethatistakenorallyorsublinguallyandcontainsnaloxone(anopioidantagonist)topreventattemptstogethighbyinjectingthemedication.IfapersonwithaheroinusedisorderweretoinjectSuboxone,thenaloxonewouldinducewithdrawalsymptoms,whichareavertedwhentakenorallyasprescribed.FDAapprovedbuprenorphinein2002,makingitthefirstmedicationeligibletobeprescribedbycertifiedphysiciansthroughtheDrugAddictionTreatmentAct.Thisapprovaleliminatestheneedtovisitspecializedtreatmentclinics,therebyexpandingaccesstotreatmentformanywhoneedit.Additionally,theComprehensiveAddictionandRecoveryAct(CARA),whichwassignedintolawinJuly2016,temporarilyexpands

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prescribingeligibilitytoprescribebuprenorphine-baseddrugsforMATtoqualifyingnursepractitionersandphysicianassistantsthroughOctober1,2021.InFebruary2013,FDAapprovedtwogenericformsofSuboxone,makingthistreatmentoptionmoreaffordable.TheFDAapproveda6-monthsubdermalbuprenorphineimplantinMay2016andaonce-monthlybuprenorphineinjectioninNovember2017,whicheliminatesthetreatmentbarrierofdailydosing.

Naltrexone(Vivitrol ) isanopioidantagonist.Naltrexoneblockstheactionofopioids,isnotaddictiveorsedating,anddoesnotresultinphysicaldependence;however,patientsoftenhavetroublecomplyingwiththetreatment,andthishaslimiteditseffectiveness.In2010,theinjectablelong-actingformulationofnaltrexone(Vivitrol )receivedFDAapprovalforanewindicationforthepreventionofrelapsetoopioiddependencefollowingopioiddetoxification.Administeredonceamonth,Vivitrol mayimprovecompliancebyeliminatingtheneedfordailydosing.

BehavioralTherapies

Themanyeffectivebehavioraltreatmentsavailableforopioidusedisordercanbedeliveredinoutpatientandresidentialsettings.Approachessuchascontingencymanagementandcognitive-behavioraltherapyhavebeenshowntoeffectivelytreatheroinusedisorder,especiallywhenappliedinconcertwithmedications.Contingencymanagementusesavoucher-basedsysteminwhichpatientsearn"points"basedonnegativedrugtests,whichtheycanexchangeforitemsthatencouragehealthyliving.Cognitive-behavioraltherapyisdesignedtohelpmodifythepatient’sexpectationsandbehaviorsrelatedtodruguseandtoincreaseskillsincopingwithvariouslifestressors.Animportanttaskistomatchthebesttreatmentapproachtomeettheparticularneedsofthepatient.

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WherecanIgetfurtherinformationaboutheroin?

Tolearnmoreaboutheroinandotherdrugsofmisuse,visittheNIDAWebsiteatwww.drugabuse.govorcontacttheDrugPubsResearchDisseminationCenterat877-NIDA-NIH(877-643-2644;TTY/TDD:240-645-0228).

What’sontheNIDAWebSite

Informationondrugsofmisuseandrelatedhealthconsequences

NIDApublications,news,andevents

Resourcesforhealthcareprofessionals

Fundinginformation(includingprogramannouncementsanddeadlines)

Internationalactivities

LinkstorelatedWebsites(accesstoWebsitesofmanyotherorganizationsinthefield)

NIDAWebSites

www.drugabuse.gov

www.teens.drugabuse.gov

www.drugabuse.gov/drugs-abuse/heroin

www.easyread.drugabuse.gov

OtherResources

InformationonheroinandsubstanceusedisordersisalsoavailablethroughtheseotherWebsites:

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Medication-AssistedTreatmentforOpioidAddiction

PrescriptionDrugs

ThispublicationisavailableforyouruseandmaybereproducedinitsentiretywithoutpermissionfromtheNIDA.Citationofthesourceisappreciated,usingthefollowinglanguage:Source:NationalInstituteonDrugAbuse;NationalInstitutesofHealth;U.S.DepartmentofHealthandHumanServices.

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Availableathttp://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm391465.htm.