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Doing Smack: Is It Worth It?

Smack is a slang name for heroin. 

The drug, which is processed from morphine, which is extracted from opium poppy plants, is generally manufactured into a white or brownish powder (or sometimes into black tar heroin, which is black and sticky) that is then snorted, injected, or smoked. It is classified as a Schedule I Controlled Substance and has no approved medical use in the United States.
The U.S. Drug Enforcement Administration (DEA) warns that heroin is often cut with other potentially toxic products before being sold on the street as an illegal drug. Smack is therefore highly unpredictable. The product is not regulated, so there is no way to be sure exactly what might be in the heroin that is ingested.
Heroin used in the U.S. generally originates in Mexico or South America. It is also called Chiva, Hell Dust, China White, Thunder, Negra, Big H, Snow, and Horse in addition to smack.
Heroin can cause an intense and rapid-onset high, but it is extremely dangerous. Its use comes with a high risk for overdose, drug dependence, difficult withdrawal symptoms, and addiction.

The Highs and Lows of Smack 

Smack is a very fast-acting drug that enters the bloodstream rapidly, causing a flood of dopamine in the brain as it binds with opioid receptors. This causes an intense rush of euphoria. The high from smack can cause intense pleasure.
Smack can also cause a person to appear to be “on the nod,” alternating between consciousness and semi-consciousness, as opiates are central nervous system depressants. Smack lowers body temperature and blood pressure, and it slows one’s heart rate and breathing rate. It can leave a person feeling mellow, sluggish, or sedated, and with a heavy feeling in the arms and legs.
Smack can cause dry mouth and flushed skin as well as itching and possible nausea and vomiting. A smack high impairs one’s thinking, concentration, memory, and decision-making processes, making it hard for a person to make informed choices or think through possible consequences. This can make it more likely for someone under the influence of smack to act irrationally, unpredictably, and in ways that are out of character and potentially hazardous. Accidents, injuries, and even criminal behaviors can result from the lack of inhibitions and poor judgment that can accompany smack use.
A smack high happens quickly, and it also burns out fast. But the sluggishness, mental cloudiness, and drowsiness can persist for a few hours, the National Institute on Drug Abuse (NIDA) explains. When smack wears off, emotional lows are common.

Overdose Possibility 

One of the biggest immediate risks of smack use is the possibility of a life-threatening overdose. NIDA publishes that every day in the United States, about 115 people die from  opioid overdose.
Between 2010 and 2017, overdose deaths involving heroin quadrupled, the U.S. Centers for Disease Control and Prevention (CDC) reports, and more than 15,000 people from heroin-related overdose in 2017. Almost half a million Americans reported past-year heroin use in 2017, and there were more than 80,000 visits to U.S. hospital emergency departments (EDs) in 2015 for heroin-related poisonings, the CDC publishes.
A heroin overdose can lead to coma or brain damage due to a lack of oxygen to the brain. The most common symptom of a heroin overdose is decreased respiration, struggling to breathe, shallow breathing, or stopped breathing. Additional signs of a heroin overdose include cold and clammy skin that appears bluish in color, tremors or shakes, pinpoint pupils, mental confusion, drowsiness, and a possible loss of consciousness.

When heroin is mixed with other drugs or alcohol, the risk for overdose is amplified. Since heroin is manufactured illegally, it is often laced or cut with other products that can prove toxic as well. Fentanyl, an even more potent synthetic opioid that can cause an overdose in even lower doses, is often used to stretch heroin without the user’s knowledge.
An overdose on smack is a medical emergency. It requires immediate intervention and the administration of Narcan (naloxone), an opioid antagonist overdose-reversal drug that is carried by many first responders.

Depressed Man Looking Out a Window

Tolerance and Dependence With Regular Use

Heroin impacts the physical structure and chemical makeup of the brain. NIDA publishes that regular use of the drug can cause imbalances and changes that can take some time to overturn.
Regular smack use can cause tolerance to certain levels of the drug, and more will be needed to get the same high or desired effects. This type of dose escalation can rapidly lead to physical and psychological dependence on smack.
Dependence forms when the brain expects heroin and has made physical changes to its structure as a result. The natural chemical balance of the brain is disrupted, and without heroin, neurotransmitters (the brain’s chemical messengers) do not function in the same way.
Physical and emotional withdrawal symptoms are the result of this imbalance. Flu-like symptoms, including pain, loss of appetite and stomach upset, nausea, vomiting, diarrhea, yawning, teary eyes, dilated pupils, tremors, restlessness, cold flashes, and insomnia, are the usual symptoms of smack withdrawal. Emotionally, smack withdrawal can leave a person feeling depressed, agitated, irritable, and anxious. Drug cravings can be intense during smack withdrawal.
The intensity of withdrawal is determined by how significant the level of dependence on smack is. Stopping smack cold turkey after dependence has formed can be intense and is typically not recommended. Medical detox will wean the drug safely out of the body, often by replacing it with other substitution medications that are then tapered off slowly.

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Hazards of Long-Term Smack Use

Drug tolerance, dependence, and withdrawal symptoms are all signs of smack addiction.
Heroin is considered to be an extremely addictive drug. The American Society of Addiction Medicine (ASAM) reports that close to a quarter of all people who use heroin will struggle with addiction involving an opioid drug.
Other possible hazards of long-term smack use include:

  • Heightened risk for stroke and heart attack
  • Heart infections
  • Increased risk of contracting an infectious disease, such as HIV/AIDS or hepatitis through shared needles or unsafe sexual encounters
  • Constipation
  • Insomnia
  • Lung infections, including pneumonia and tuberculosis
  • Depression
  • Increased risk for developing antisocial personality disorder
  • Decreased white matter in the brain that can impair cognitive functions
  • Depressed or weakened immune system
  • Collapsed veins, scarring and “track marks,” skin infections, abscesses, and infections of the lining of the heart related to injecting smack
  • Sexual dysfunction in men
  • Disrupted menstruation or miscarriage in women
  • Damage to the mucosal tissues and nasal septum that can harm the sense of smell and lead to chronic runny nose from snorting smack
  • Chronic cough and respiratory distress from smoking smack
  • Stomach ulcers
  • Anorexia and unhealthy weight loss due to decreased appetite
  • Clogged blood vessels, leading to kidney, liver, brain, or lung infection or complications related to additives in heroin
  • Possible increased risk of arthritis or additional rheumatologic issues

Using smack can be highly dangerous. The highs of use are not worth the lows that follow or all the possible complications that can arise from using the drug just one time.

Repeated use of smack greatly increases the odds for more serious and potentially fatal complications, such as toxic overdose and addiction.


(2017). Drugs of Abuse A DEA Resource Guide. Drug Enforcement Administration. Retrieved January 2019 from

(June 2018). What are the Immediate (Short-Term) Effects of Heroin Use? National Institute on Drug Abuse. Retrieved January 2019 from

March 2018). Opioid Overdose Crisis. National Institute on Drug Abuse. Retrieved January 2019 from

(December 2018). Today's Heroin Epidemic. Centers for Disease Control and Prevention. Retrieved January 2019 from

(December 2018). Heroin Use. Centers for Disease Control and Prevention. Retrieved January 2019 from

(September 2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Retrieved January 2019 from

(2016). Opioid Addiction 2016 Facts & Figures. American Society of Addiction Medicine. Retrieved January 2019 from

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