Font size Font size smaller Font size normal Font size bigger

Heroin

Heroin (diacetylmorphine) is a semi-synthetic derivative of morphine, which is obtained from the opium poppy. [1] [2] Heroin is used by smoking, snorting, or injecting intravenously. [3] The purity of heroin varies over time and by country of origin. [1]

Legal status: Heroin is classified as a narcotic in Finland. Its use, purchase, sale, and possession are prohibited. [4] [5] The Supreme Court has ruled that heroin is an extremely dangerous narcotic. [6]

How does it work?

Heroin has a depressant effect on the central nervous system. [7] It binds to opioid receptors in the same way as naturally occurring endorphins in the brain. [8] Heroin is highly fat-soluble, which allows it to enter the body rapidly. [1] [7] When injected, the effects of heroin begin within a few minutes and last for 3–5 hours. [1] The effects depend on the dose, the user’s tolerance, and the method of use. [1] [2]

Desired effects: Like other opioids, heroin relieves pain. It also usually induces euphoric feelings of well-being. [2] In addition to physical pain, heroin relieves emotional suffering. [2] [7] For dependent users, avoiding withdrawal symptoms may become the primary reason for using heroin. [2]

Side effects: Unpleasant effects of heroin can include constipation, nausea, vomiting, dizziness, and itchy skin. [2] [7] Heroin also impairs memory and concentration. After the effect wears off, feelings of anxiety and depression are common. [2]

Key risks

Acute risks: Heroin carries a risk of life-threatening overdose. The substance depresses central nervous system function and, in high doses, can lead to respiratory depression and oxygen deprivation. [1] [7] Deaths related to heroin are mainly due to overdose. [9] An overdose does not always result in death, but can cause, for example, intense nerve pain or lung damage. [1]

Polydrug use risks: Heroin and alcohol amplify each other’s effects, increasing the risk of poisoning. [1] Sleeping pills and tranquilizers, such as benzodiazepines, also potentiate the sedative effects of heroin. [1] [14]

Heavy use risks: In long-term use, heroin can damage the kidneys. [1] However, the most significant long-term harm is the development of strong dependence. [7]

Dependence: Heroin and other opioids are among the most addictive substances. [2] [7] Actual withdrawal symptoms develop after several weeks of use. Heroin withdrawal symptoms are more intense than those of long-acting opioids such as buprenorphine. They may include irritability and depression, as well as clear physical symptoms like sweating, tearing, nausea, and severe runny nose. A dependent person may struggle to think about anything other than the substance. [1] [2] [7]

With repeated use, tolerance to heroin and other opioids develops. [1] [2] [7] However, tolerance can quickly return to normal after discontinuing use. [2] Therefore, overdoses are very common among people who resume use after a break.

Injecting heroin carries the risk of serious infectious diseases, such as HIV and hepatitis C. [10] [11] Hepatitis C infection is the most common injection-related harm: in Finland, approximately 75% of people who inject drugs have contracted the virus. [17] [19] Injection can also cause local infections. It is also possible for fungi or bacteria to enter the bloodstream during injection. [13]

Use during pregnancy: If heroin is used during pregnancy, the risks to the fetus are significant. Heroin use during pregnancy is associated with miscarriage, stillbirth, fetal growth retardation, bleeding during pregnancy, and premature birth. The newborn is likely to suffer from withdrawal symptoms, although usually milder than those caused by buprenorphine. Heroin is not known to cause fetal malformations. [1] [15]

How can risks be reduced?

Substance use is always risky. Risk-reduction strategies never eliminate the risks completely.

Some risks associated with heroin use can be avoided by not injecting the substance. However, if it is injected, it is crucial to always use only one’s own clean injection equipment and preparation containers. This is the best way to prevent infectious disease risks associated with intravenous drug use. [16] Used needles and syringes can be exchanged for clean ones at health counseling centers.

Overdose cases require immediate medical attention.

Different people react very differently to the same substances and doses. This should be kept in mind with heroin as well.

Sources

[1] Barceloux, Donald G. (2012): “Medical Toxicology of Drug Abuse. Synthesized Chemicals and Psychoactive Plants”. John Wiley & Sons, Inc., Hoboken, New Jersey.

 

[2] Koob, George F.; Arends, Michael A. & Le Moal, Michel (2014): “Drugs, addiction, and the brain”. Elsevier Science Publishing Co, Inc, San Diego.

 

[3] EUDA (2024): “European Drug Report 2024: Heroin and other opioids – the current situation in Europe”. The European Union Drugs Agency, Lisbon. Katsottu 17.2.2025.

 

[4] Valtioneuvoston asetus huumausaineina pidettävistä aineista, valmisteista ja kasveista (543/2008). Finlex verkkosivut, katsottu 24.3.2025.

 

[5] Huumausainelaki (373/2008). Finlex verkkosivut, katsottu 24.3.2025.

 

[6] Korkeimman oikeuden päätös KKO:2004:73. Finlex verkkosivut, katsottu 24.3.2025.

 

[7] Kalso, Eija & Rauhala, Pekka (2024): “Opioidien vaikutukset ja niiden mekanismit”. Sivut 516-521. Teoksessa “Lääketieteellinen farmakologia ja toksikologia” (toim. Ruskoaho, Heikki). 7 painos, Duodecim, Helsinki. Verkkoaineisto. Painettu versio julkaistu 2024.

 

[8] Kalat, James (2013): “Biological psychology”. 11. painos, Wadsworth Publishing, Boston.

 

[9] Degenhardt, Louisa; Bucello, Chiara; Mathers, Bradley; Briegleb, Christina; Ali, Hammad; Hickman, Matt & McLaren, Jennifer (2011): “Mortality among regular or dependent users of heroin and other opioids: a systematic review and meta-analysis of cohort studies.” Addiction, vol. 106:1, 32-51.

 

[10] Aalto, Mauri; Alho, Hannu & Niemelä, Sonja (2018): “Huume- ja lääkeriippuvuus Suomessa”. Sivut 11-12. Teoksessa “Huume- ja lääkeriippuvuudet” (toim. Aalto, Mauri; Alho, Hannu & Niemelä, Sonja). 1. painos, Duodecim, Helsinki.

 

[11] Tavitian-Exley, Isabel; Vickerman, Peter; Bastos, Francisco I. & Boily, Marie-Claude (2014): “Influence of different drugs on HIV risk in people who inject: systematic review and meta-analysis”. Addiction, vol. 110, 572–584, DOI: 10.1111/add.12846

 

[12] THL (2024): ”Tartuntataudit Suomessa 2023”. Terveyden ja hyvinvoinnin laitos, Helsinki.

 

[13] Kivelä, Pia (2018): “Huumeiden pistämiseen ja ulkoisiin olosuhteisiin liittyvät infektiot”. Sivut 210-211. Teoksessa “Huume- ja lääkeriippuvuudet” (toim. Aalto, Mauri; Alho, Hannu & Niemelä, Sonja). 1. painos, Duodecim, Helsinki.

 

[14] Lindsey, Wesley T.; Stewart, David & Childress, Darrell (2012): “Drug Interactions between Common Illicit Drugs and Prescription Therapies”. American Journal of Drug & Alcohol Abuse, vol. 38:4, 334-343.

 

[15] Kahila, Hanna (2018): “Huumeiden vaikutuksesta raskauteen ja vastasyntyneeseen”. Sivu 275. Teoksessa “Huume- ja lääkeriippuvuudet” (toim. Aalto, Mauri; Alho, Hannu & Niemelä, Sonja). 1. painos, Duodecim, Helsinki.

 

[16] THL (2016): ”Päihdetilastollinen vuosikirja 2016. Alkoholi ja huumeet”. Terveyden ja hyvinvoinnin laitos, Helsinki.