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What Routes of Administration Can Be Used for Heroin?

Heroin use has become a major health problem in the United States over the past decade. Rates of heroin users and heroin-related overdoses continue to rise.

According to the National Institute on Drug Abuse (NIDA), nearly 950,000 Americans reported using heroin in 2016. Of these people, 170,000 used heroin for the first time compared to 90,000 new users in 2006. 

In addition to the rates of heroin use increasing, the rate of heroin use disorders has also steadily increased. In 2002, about 214,000 Americans met the diagnostic criteria for a heroin use disorder. This number rose to 626,000 in 2016.
Men and women of all ages and income levels in both urban and rural communities have demonstrated increased heroin use during the past several years.

Routes of Administration

There are many different ways to use heroin. The way it is used is determined by the user and what type of heroin they have.
Heroin typically comes in the form of white or brown powder, though it can be dark and gooey like tar in the case of black tar heroin. Black tar heroin can also be hard like black coal, and it may require different modes of use. 

Typical routes of heroin administration include:


Injecting heroin into the veins is the most commonly used method of taking the drug. Injecting it directly into the bloodstream guarantees a quick onset of effects. People have reported feeling the onset of euphoria within less than 10 seconds of injection.


With this method, users burn heroin and inhale the smoke. Users are less likely to feel a sudden rush of euphoria as they do when injecting the drug, but they do experience other high-related side effects within 10 to 15 minutes of smoking


Heroin can be snorted after it is ground down into a fine powder. The effects are likely felt within 10 to 15 minutes. Users who snort heroin often experience damage to the nasal passages.

No matter what route of heroin administration is being used, significant health risks and concerns are always posed. The high experienced may vary slightly between methods of use, but the risks of overdose and drug-related complications are present no matter how you take heroin.

Risks of Injection Heroin Use

With high rates of addiction to heroin and the many methods in which it can be used, researchers aim to gain an understanding of the risks associated with specific routes of administration. In a recent study, researchers examined the relationship between how someone used heroin their very first time compared to the likelihood of developing an addiction to the drug. 

Researchers compared the heroin use patterns of people who injected, inhaled, or snorted heroin for their first time. The study showed that people whose initial route of heroin administration was injection were nearly five times as likely to progress to daily heroin use within just one to three weeks as people who snorted or inhaled heroin initially. 

Heroin use tends to escalate so quickly with injection that the window of opportunity for an intervention to occur before this escalation is incredibly small. 

In addition to the likelihood of injecting heroin quickly leading to a drug use disorder, shooting up exposes the user to more risks. One study compared injection and non-injection routes of administration for heroin, methamphetamine, and cocaine.

Congruent with other studies, these researchers found that injection drug users exhibited higher rates of substance abuse and dependence, a greater need for addiction treatment, and more frequent co-occurring physical and psychological problems.

Stick figures pierced by a syringe for heroin use

Contraction of HIV and hepatitis B and C is a significant concern for injection drug users who share needles.

How to Minimize Risks

The best way to minimize risks associated with heroin use is not to use heroin at all. Every time you use heroin you expose yourself to the risk of overdose, contracting serious diseases, and experiencing severe physical and psychological side effects.
If you cannot abstain from heroin use, there are steps you can take to reduce your chances of encountering some of the worst problems related to heroin use. 

Substance abuse experts have recognized the following harm reduction techniques for people who use heroin:

  • Smoke or snort heroin rather than inject it.
  • If injecting heroin, always use a clean needle, and never share needles.
  • Don’t use heroin by yourself. This ensures someone is around to help you in case of an accidental overdose.
  • Only use low doses of heroin at any given time.
  • Keep use as infrequent as possible.
  • Avoid engaging in risky behaviors while under the influence.

In addition to following the above harm reduction techniques, consider seeking treatment for heroin use disorder. Detox services followed with behavioral therapy can help you address issues of substance abuse and mental health that are repeatedly exposing you to dangerous situations. Addiction treatment can greatly improve your ability to avoid risks associated with substance use.

What Indicates a Heroin Use Problem?

A heroin use disorder can occur in anyone who uses heroin in any capacity. Most users, however, begin using heroin by smoking it.

As tolerance builds and an addiction to the drug sets in, the methods of heroin use often progress to injection as it is a more efficient and powerful way to experience the drug. Injecting heroin, however, does not necessarily equate to addiction, though it can certainly be a red flag for a serious problem. 

In addition to an escalation of heroin use, signs of heroin addiction include the following:

  • Agitation and irritability
  • Slurred speech
  • Depression
  • Memory problems
  • Needle marks in people who inject heroin
  • Runny or sore nose in people who snort heroin
  • Constipation
  • Constricted pupils
  • Unexplainable changes in behavior
  • Changes in appearance
  • Neglect of personal hygiene
  • Problems at school or work and with relationships
  • An increase in risky or dangerous behavior

Someone with an addiction to any type of drug will be unable to stop using it even when they really want to. Addiction is a disease of the brain that leaves people unable to control their urges to use. Someone addicted to heroin will continue to use the drug despite experiencing the negative social, professional, legal, and health consequences of doing so.

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Getting Help for a Heroin Addiction

If you are struggling with heroin addiction, there are many types of treatment programs available throughout the country that specialize in heroin addiction treatment. NIDA explains that multiple forms of treatment, such as medication coupled with behavioral therapy, are usually necessary and highly effective in treating substance use disorders.

If heroin addiction is having an adverse impact on your life, begin exploring your treatment options today.


(July 2011). Comparing Injection and Non-Injection Routes of Administration for Heroin, Methamphetamine, and Cocaine Uses in the United States. Journal of Addictive Diseases. Retrieved January 2019 from

(December 2018). Harm Reduction Techniques for Heroin Users. Verywell Mind. Retrieved January 2010 from

(July 2018). Heroin Addiction: What You Should Know. Healthline. Retrieved January 2019 from

(September 2017). The Relationship Between Initial Route of Heroin Administration and Speed of Transition to Daily Heroin Use. Drug and Alcohol Review. Retrieved January 2019 from

(November 2018). The Various Ways Heroin is Taken. Verywell Mind. Retrieved January 2019 from

(June 2018). What is the Scope of Heroin Use in the United States? National Institute on Drug Abuse. Retrieved January 2019 from

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