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  • In the United States, a surge in heroin overdose deaths beginning in 2010 represented a new and deadly stage of the opioid epidemic.

    More than a decade later, heroin continues to be widely abused in communities across the United States. However, heroin is rarely taken orally and those who use heroin typically have certain items or tools, known as paraphernalia, which are used to take the drug.

    Note that many of the following examples of drug paraphernalia can be used to take any number of different illicit drugs, and not just heroin exclusively.

    Heroin Spoons

    Heroin comes in different forms, namely white powder heroin, brown powder heroin, and black tar heroin. Powder heroin is typically, though not always, used by injection or snorting, while black tar heroin is likely smoked.

    Injecting heroin involves using a metal surface, often a metal spoon or bottle cap, to hold the drug while it is heated and liquified.

    Spoons may go missing if they are being used to cook heroin, and if found these spoons will likely be tarnished or stained by the heating process.

    Heroin Needles

    Once powder heroin is liquified and mixed with water, the drug is loaded into hypodermic needles and syringes which are used to inject the drug, often through an improvised filter like a cigarette filter or cotton ball. This delivers the full dose of the drug directly into the bloodstream.

    A variety of different needles may be used to inject heroin, with varying measures taken to sterilize the equipment and prevent communicating diseases before or after use.

    Tinfoil Sheets

    Smoking heroin is sometimes called ‘chasing the dragon’, and instead of spoons or other implements, sheets of tin foil are used to hold the drug as it is heated, liquified, and then vaporized. 

    The fumes are then inhaled using a tube or straw, introducing the drug to the bloodstream through the lungs, resulting in a high.

    These tinfoil sheets, and sometimes foil gum wrappers, will be heavily worn and burned after use.

    Other Paraphernalia

    A wide variety of other items may be used to take heroin in one form or another. These items often include:

    • lighters, often several stored together
    • belts, shoelaces, or other cords used to tie off the arm prior to injection
    • cigarette pieces, used as a filter before injecting
    • cotton balls or Q-tips, used as a filter before injection
    • bowls, pipes, or cut up soda cans, which may be used to smoke the drug
    • cut up straws with burn marks and yellow tint, used to inhale heroin vapors
    • bottle caps, used to liquefy small doses of the drug
    • tinfoil folds or squares, used to hold small doses of heroin for sale
    • tied balloons, which are sometimes used to hold black tar heroin
    • small Zip-lock style bags, used to hold doses
    • razor blades, used to chop and divide powder heroin prior to snorting
    • rolled up dollar bills or rolling papers, used to snort powder heroin
    • gelatin capsules (pills), used to contain small doses of the drug for oral use
    • hidden lockboxes or safes
    • naloxone (Narcan) nasal spray, an opioid overdose antidote

    Other Signs Of Heroin Abuse

    Other physical or behavioral signs that a loved one is abusing heroin include:

    • burned fingers
    • wearing long sleeves to hide abscesses or puncture marks at injection sites
    • nosebleeds, if the drug is snorted
    • missing household items, often stolen and sold to generate funds for drug use
    • social withdrawal
    • failing grades or missed work or family engagements
    • poor mental function
    • nausea and vomiting
    • excessive itching
    • insomnia
    • depression
    • shifting states of consciousness and semi-consciousness
    • dangerously slowed breathing or coma

    Penalties For Distributing Heroin Paraphernalia

    While drug paraphernalia is not illegal to possess, providing or selling these items is illegal according to U.S. Code Title 21 Section 863.

    This code makes it “unlawful for any person to sell or offer for sale drug paraphernalia; to use the mails or any other facility of interstate commerce to transport drug paraphernalia; or to import or export drug paraphernalia.”

    While the penalties related to selling drug paraphernalia are generally less severe than for those associated with possessing or trafficking the drugs themselves, they can still amount to up to three years imprisonment and fines.

    Additional state laws and penalties may also apply.

    Treating Heroin Addiction

    If you or a loved one suffers from heroin use disorder or any other form of substance use, please contact Ark Behavioral Health today. 

    Our programs are designed to help you work through withdrawal symptoms and detox safely while making meaningful changes for long-term recovery.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Centers for Disease Control and Prevention (CDC) Injury Center - Understanding the Epidemic
    Drug Enforcement Agency (DEA) - Drug Fact Sheet: Heroin
    National Drug Intelligence Center - Drug Paraphernalia Fast Facts
    National Institute on Drug Abuse (NIDA) - Heroin DrugFacts

    Medically Reviewed by
    Lauren Weinand, M.D.
    on March 14, 2022
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