Though it was first synthesized in the late 19th century, heroin has roots that go back thousands of years to the use of opium in ancient civilizations. Despite its bad reputation now, people weren't always aware of heroin's dangers, and it wasn't always illegal. In fact, pharmaceutical companies initially marketed it as a wonder drug that could cure many ailments. Today, however, heroin is known as a very hazardous, addictive drug.
What Is Heroin?
Heroin is an illegal and addictive opioid drug derived from morphine, which, in turn, is extracted from the opium poppy plant. Classified as a Schedule I substance, heroin has no currently accepted medical use, but does have a high potential for abuse.1
People use heroin to feel a euphoric high. Most people inject heroin intravenously but, depending on the form of the drug, some also snort or smoke it.1 Some people who are addicted to painkillers begin using heroin because it is cheaper and easier to obtain .2
People have used opium—a raw, narcotic substance extracted from the opium poppy—since ancient times. The earliest known use of opium goes back to ancient Mesopotamia and Sumeria.1 A 6,000-year-old Sumerian tablet has an ideograph for the poppy that translates into "'joy' plus 'plant,'" which likely indicates that people used opium for many thousands of years.3
These ancient cultures then passed on the use of opium to other civilizations, including the Assyrians, Babylonians, and Egyptians.1 In fact, the ancient Egyptians included opium on a list of commonly used medicinal compounds. The use of opium eventually spread to other regions, with Arab traders introducing it to areas such as India and China during the Dark Ages.3
The medieval Chinese developed a particularly serious problem with opium. In the late 1600s, the Chinese used opium extensively for recreational purposes, which led to widespread addiction. The Chinese government declared the sale of opium illegal in 1729. Those who broke this law were subject to death by strangulation or decapitation. Nonetheless, the Chinese persisted in their addiction, even after the Chinese government then made the importation of opium from India illegal.3
On the other hand, the British East India Company, one of the largest trading organizations in the region, actively encouraged the growth of opium. Through covert methods, they managed to continue smuggling thousands of pounds of opium into China through a variety of means. This eventually led to the Opium Wars of 1839 and 1856. In the end, the British won the struggle and continued to import opium through Hong Kong into China throughout the early 20th century.3
The use of opium wasn't limited to China during this time, though. Early 19th century British poets popularized and romanticized its use. Thomas De Quincey was perhaps the most well-known. He wrote the 1821 piece, Confessions of an English Opium-Eater, an account of his addiction and pleasurable experiences with opium.4
The History of Other Drugs
18th and 19th Centuries
Opium became a commonly used therapeutic agent in the 18th century in the United States. Doctors prescribed it for a wide range of medical complaints, such as cancer pain, tetanus spasms, and the pain associated with menstruation and childbirth. However, toward the end of the century, doctors became aware of opium's addictive potential.5
The problem was further compounded by the development of the hypodermic needle in 1853 by Alexander Wood. People began injecting morphine, which led to increased potency and dependence.3
Intravenous morphine was used to treat pain, dysentery, and fatigue in Civil War soldiers, which ultimately led to widespread morphine addiction. This addiction became known as the "soldier's disease." Around the same time, the opium problem continued to worsen due to Chinese railroad laborers bringing opium to the U.S. to smoke.3
In 1900, around 300,000 Americans were dependent on opiates. Many of them were white women who purchased opium or morphine legally through mail-order catalogues or at local stores.3 Opium dens became common during this time. San Francisco became the first city to ban the smoking of opium within city limits in an attempt to stop the spread of opium dens.9
Heroin was first synthesized in 1874.5 But it was not produced commercially until 1898, when the Bayer Company began promoting it as a safer alternative to morphine as well as a cough suppressant.3,5 It was available in a variety of forms, including lozenges, tinctures, and pills, and was seen as a sort of "wonder drug." In fact, in 1900, the Boston Medical and Surgical Journal wrote that " [heroin] possesses many advantages over morphine. It's not hypnotic, and there's no danger of acquiring a habit ."4
Despite the misguided claims of safety and decreased abuse potential, heroin addiction rose throughout the early 1900s.6
Racial stigmas and hostilities to immigrants grew during the early 20th century. In an attempt to crack down on narcotics, Opium Commissioner Hamilton Wright, as well as others, tried to focus on and increase public fears that opium-addicted white women would start trading sex for drugs with Asian men.4 Tabloids in the 1890s fueled these fears by publishing "stories of white women being seduced by Chinese men and their opium to invoke fear of the 'Yellow Peril.'"6
The U.S. started taxing opium in 1890.9 In 1906, the Pure Food and Drug Act was passed, which required manufacturers to list the active ingredients contained in their products so that people would know whether opium or other addictive or dangerous drugs were present.4
Then, in 1909, Congress passed the Opium Exclusion Act, which banned the importation, possession, and use of opium for smoking. Global attempts to regulate narcotics ultimately led to the Harrison Narcotic Act of 1914, which taxed and more tightly regulated opium and cocaine-based products. Finally, in 1924, the Heroin Act was passed, which prohibited the manufacture, importation, and possession of heroin, even for medicinal purposes.8
1950s, 1960s, and 1970s
A heroin epidemic developed in the United States shortly after World War II. Heroin became more widely used among hipsters involved in the Harlem jazz scene in the 1930s and 1940s, and then again in the 1950s among members of the Beatnik subculture. During this time, much of the heroin used in the United States was supplied via the "French Connection," a scheme in which heroin was smuggled through a partnership between Corsican gangsters in Marseille, France, and the Sicilian Mafia.6
During the Vietnam War, up to 40% of the U.S. soldiers serving in Southeast Asia were estimated to have used heroin, though some reports say that only around 7% were estimated to have continued using after returning home.3 However, these statistics may be higher, as some estimates show a post-war addiction rate of around 10-15%.6
Around 750,000 people were addicted to heroin by the early 1970s. Much of the heroin used in the U.S. during the early to mid-1970s came from the "Golden Triangle" of Southeast Asia, which was a major source of raw opium. However, after the fall of Saigon in the mid-1970s, the search for a new source of raw opium led suppliers to Mexico. "Mexican Mud" heroin (or black tar heroin) replaced "China White" until 1978, when the trade moved to the Middle East.9
In 1970, the Controlled Substances Act was passed.8 Under this act, heroin was classified as a Schedule I drug. Schedule I drugs are considered the most dangerous and addictive substances and have no recognized medical use.1
1980s and 1990s
During the 1990s, heroin use increased significantly. Estimates in 1999 showed about 3 million Americans over 12 years of age had used heroin at least once in their lifetime; 403,000 people reported using heroin in the past year. Also, in the same year, the number of new heroin users was estimated to be 104,000.11
Due to shifting political climates, the heroin used today in North America often comes from Latin America and Mexico, with Mexico being the main supplier to American users.3
Heroin differs by region in terms of production, color, and form. It is generally sold as white, brown, or black tar.
White heroin is generally from Southeast Asia. It is relatively pure, white in appearance, water soluble, powdered, and acidic.12
Brown heroin often also comes from Southeast Asia. It is usually sold as a coarse brown powder, is not very water soluble, and is heat stable.12
Black tar heroin comes from Mexico. It is sold in solid form, has a lower purity, and is heat stable.12
Heroin is often cut with other substances. Some of these substances include:3
Quinine. Pure heroin tastes bitter. If heroin is mixed with other substances, this taste may be altered. Quinine, an anti-malaria drug that also has a bitter taste, may be added to mask the flavor of reduced heroin content. However, quinine itself can cause coma and respiratory depression in sufficiently high doses.
Mannitol. Because heroin can cause constipation, mannitol (an osmotic laxative) may be added to counter this effect.
Fentanyl. This is a manmade opioid painkiller that is 50-100 times more potent than morphine. It is sometimes partially or entirely substituted for heroin. It can be especially dangerous and deadly because it dramatically slows down bodily processes, such as respiration, and can lead to breathing difficulty and even death. People who use heroin may not be aware that the drug they're using contains fentanyl, so there can also be an increased risk of overdose.13
Carfentanil. This is a synthetic opioid that is 100 times more powerful than fentanyl . It may be cut into heroin to increase potency and addictiveness. Just a few grains the size of table salt can be deadly. It is typically used as a sedative for elephants.14
Heroin use and overdose rates have increased significantly worldwide over the past decade, due in part to the rising number of people who abuse prescription drugs and then switch to heroin. According to Yury Fedotov, the executive director of the UN Office on Drugs and Crime, "heroin continues to be the drug that kills the most people."15
In the U.S. alone, heroin use rates are rising, with 828,000 people aged 12 and older reporting use of heroin in 2015 compared with 948,000 in 2016.16 One study published in May 2017 in JAMA Psychiatry reports that "the prevalence of heroin use (1.61% vs 0.33%) and heroin use disorder (0.69% vs 0.21%) was significantly higher in 2012-2013 than in 2001-2002." The study also found that the greatest increase in heroin use occurred among whites.17
Correspondingly, the number of overdose deaths due to heroin has also risen sharply over the past decade, with around 13,000 deaths in 2015, compared with around 2,000 in 2006.18
Alarmingly, the opioid crisis (which includes the misuse of drugs such as heroin as well as prescription painkillers like OxyContin) continues to grow. Media reports as recently as October 2017 have quoted President Donald Trump, who has said that he will declare the crisis a national emergency.19
- University of Maryland Center for Substance Abuse Research. (2013). Heroin .
- National Institute on Drug Abuse for Teens. (2016). What's the Connection Between Prescription Pain Pills and Heroin?
- Hanson, G., Venturelli, P., & Fleckenstein, A. (2017). Drugs and Society . Burlington, M.A.: Jones & Bartlett Learning.
- Miroff, N. (2017). From Teddy Roosevelt to Trump: How drug companies triggered an opioid crisis a century ago . The Washington Post.
- University of Arizona: MethOIDE. (N.D.) Heroin Overview: Origin and History .
- PBS Frontline. (N.D.) A Social History of America's Most Popular Drugs .
- U.S. Food and Drug Administration. (2009). Federal Food and Drugs Act of 1906 .
- The National Alliance of Advocates for Buprenorphine Treatment. (2016). Laws .
- PBS Frontline. (1998). The Opium Kings: Opium Throughout History .
- Brookman, F., Maguire, M., Pierpont, H., and Bennet, T. (Eds.). (2010). Handbook on Crime . Cullompton, Devon: Willan Publishing.
- Tonkovich, R. (2004). Glamorization or Condemnation: The Accuracy of Hollywood's Portrayal of Heroin Use in Motion Pictures in the 1990s . LEDA at Harvard Law School.
- Ciccarone, D. (2009). Heroin in Brown, Black and White: Structural Factors and Medical Consequences in the US Heroin Market . The International Journal on Drug Policy, 20(3), 277-282.
- National Institute on Drug Abuse. (2016). DrugFacts: Fentanyl .
- Sanburn, J. (2016). Heroin Is Being Laced With a Terrifying New Substance: What to Know About Carfentanil . Time.
- United Nations. (2016). Record 29 Million People Drug-Dependent Worldwide; Heroin Use Up Sharply - UN Report .
- Center for Behavioral Health Statistics and Quality. (2017). Results from the 2016 National Survey on Drug Use and Health: Detailed Tables . Substance Abuse and Mental Health Services Administration: Rockville, MD.
- Martins, S.S., Sarvet, A., Santaella-Tenorio, J., Saha, T., Grant, B.F., and Hasin, D.S. (2017). Changes in US Lifetime Heroin Use and Heroin Use Disorder: Prevalence From the 2001-2002 to 2012-2013: National Epidemiologic Survey on Alcohol and Related Conditions . JAMA Psychiatry, 74(5), 445-455.
- National Institute on Drug Abuse. (2017). Overdose Death Rates .
- Rhodan, M. (2017). President Trump Is 'Looking Into' Report That His Drug Czar Pick Made the Opioid Crisis Worse . Time.