Heroin ROA: Different Ways To Use Heroin

Medically Reviewed by Johnelle Smith, M.D on March 15, 2021

Heroin is an addictive opiate drug that can be injected, smoked, or snorted. Heroin can be dangerous no matter how it’s used. Recovering from heroin use may require treatment through a substance abuse treatment center or behavioral healthcare provider.

Medically Reviewed by
Johnelle Smith, M.D on March 15, 2021
Heroin Routes Of Administration

Heroin is an illicit opioid drug that can come in the form of a white powder, brown powder, or dark substance commonly referred to as black tar heroin.

Like many illicit drugs, heroin can be used in a few different ways.

Ways to use heroin include:

  • smoking
  • shooting (injection)
  • snorting (insufflation)
  • plugging (rectal use)

All forms of heroin use are dangerous. Chronic use of heroin can lead to drug dependence and addiction, which can be difficult to conquer alone and may require professional treatment.

Comparing Methods Of Use: Smoking, Snorting, Shooting, Plugging Heroin

Heroin can be injected into the veins or muscle, snorted up the nose, or smoked. Black tar heroin is usually smoked or injected. Powder forms of heroin can be snorted or injected.

How long it takes to feel the effects of heroin, as well as subsequent health consequences and risk of overdose, can be influenced by the way that heroin is used.

Dangers Of Smoking Heroin

Heroin can be smoked in a glass pipe, mixed with a joint, or rolled into a cigarette.

Smoking heroin may increase the risk of complications to the lungs and worsen respiratory conditions such as asthma. This can cause hacking coughs and potentially lead to lung disease.

Read more about the dangers of smoking heroin

Dangers Of Snorting Heroin

Heroin is one of several illicit drugs that can be snorted for its euphoric effects.

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Over time, snorting heroin may cause internal and external damage to nasal tissue, and can cause frequent nosebleeds, inflammation, and runny nose.

Read more about the dangers of snorting heroin

Dangers Of Shooting Heroin

Research shows that up to half of people who use heroin inject it. Injection drug use carries a higher risk of overdose and the transmission of bloodborne diseases such as HIV/AIDS, hepatitis B, and hepatitis C through sharing needles.

Over time, injecting heroin can also cause damage to the veins and blood vessels, which can lead to long-lasting health problems.

Read more about the dangers of shooting heroin

Dangers Of Plugging Heroin

Plugging is a term used to refer to the rectal administration of drugs. This is sometimes referred to as “butt chugging” or “boofing”.

Plugging heroin can damage rectal tissue and cause bloody stools, colonic perforation, and chronic bowel issues.

Administering heroin into the rectum is also a risk factor for overdose and sexually transmitted diseases (STDs) among people who engage in anal sex, due to plugging-related rectal damage.

Read more about the dangers of plugging heroin

Overdose Risk With Heroin

Drug overdose is a life-threatening condition that can be caused by taking too much of one or more drugs at once. Overdosing on heroin is possible no matter how you ingest it.

People who overdose on heroin may:

  • stop breathing
  • breathe very slowly
  • have cold, clammy skin
  • act very confused or out of it
  • have a very weak pulse
  • fall in and out of consciousness
  • begin seizing or convulsing

Injecting or plugging heroin has been associated with a higher risk of overdose compared to other routes of administration. Overdose can be deadly without quick treatment.

Heroin overdose can be treated with the drug Narcan, or naloxone—a life-saving drug that can be injected or sprayed up the nose to block the effects of heroin.

How To Know If Someone Is Using Heroin

Heroin is a powerful drug that can affect physical appearance, mood, and behavior. According to some research, people who inject heroin tend to be older, unemployed, and have co-occurring physical and mental health disorders.

Many people who use illicit drugs possess drug paraphernalia, such as spoons, syringes, and lighters used to smoke the drug.

Anyone who uses heroin will likely become very drowsy and become gaunt or disheveled in appearance.

Signs of heroin use by method of use:

  • injection: track marks on the arms, collapsed veins, bruising around common injection sites, abscesses
  • smoking: burned or cracked lips, burns elsewhere on the body, bloodshot eyes, hacking cough, sores on the lips
  • snorting: red or runny nose, nosebleeds, sniffling often, reduced sense of smell
  • plugging: persistent diarrhea, bloody stools, poor blood circulation

Chronic heroin use can cause changes in the brain over time that can affect how a person thinks and feels. People who abuse heroin may become depressed, agitated, and become hostile or aggressive towards others.

How To Stop Using Heroin

If you’ve been using heroin for some time, stopping heroin all at once—also known as going cold-turkey—can be dangerous.

For starters, this may trigger withdrawal symptoms such as vomiting, diarrhea, and strong drug cravings. This can be difficult to manage alone.

People who try to detox from heroin alone are also at a higher risk of relapse and overdose. The safest way to stop using heroin is to seek medical support through a professional detox program.

Detox programs for heroin users can offer medical supervision, support, and medication capable of curbing drug cravings and reducing the risk of overdose should someone relapse back into their drug use.

Finding Treatment For Heroin Abuse And Addiction

Recovering from an addiction to heroin isn’t easy, but it is possible. Across the United States, there are thousands of treatment options available to help people stop using heroin for good.

Treatment programs for heroin addiction include:

  • detox programs
  • inpatient rehab programs
  • outpatient rehab programs
  • medication-assisted treatment (e.g. methadone maintenance, buprenorphine therapy)
  • supportive housing programs

If you or a loved one is addicted to heroin, call our helpline today to learn more about available treatment options and how to find addiction treatment for heroin near you.

This page does not provide medical advice. See more

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