What Does Heroin Look Like? Signs of Use, Paraphernalia, Track Marks, and Nicknames

Much of New Jersey’s supply also carries xylazine or medetomidine, animal sedatives that naloxone does not reverse, so give the naloxone anyway.

What does heroin look like?

Heroin comes in three basic forms. In the words of the National Institute on Drug Abuse’s heroin page, it can be a white or brown powder, or a black sticky substance known as black tar heroin. Which one shows up depends on where it was made and where it is sold.

The first three rows come from a 2009 analysis of the US heroin market in the International Journal of Drug Policy. The fourth row is the part that matters, and it is covered in its own section below.

What color is heroin?

Anywhere from white to tan to dark brown, and black for tar. Color comes from how the drug was processed and what was added afterward. It is not a purity scale. More than 90 percent of drugs seized by New Jersey law enforcement over a recent two-year period tested positive for fentanyl, per the state’s Commission of Investigation, so assume a powder sold as heroin contains it. Powdered fentanyl, as the CDC puts it, looks just like many other drugs.

What is black tar heroin?

A cruder, less refined form, made mostly in Mexico and sold almost entirely in the western states. The 2009 market analysis describes it as dark brown to black, solid, and of lower purity, plateauing around 25 to 30 percent pure. It is sticky or rock-hard depending on moisture. Because it is less processed, it carries more of what came with it, and the same analysis ties it to wound botulism, tetanus, and severe soft-tissue infections in people who inject it under the skin. Black tar is uncommon in New Jersey. If you are on the East Coast and see something like it, do not assume you know what it is.

What does heroin smell like?

Often like vinegar. Heroin is made by treating morphine with acetic anhydride, and acetic acid left over from that step gives off the sharp, vinegar smell that a 2026 review of drug odor chemistry describes; it is one of the odor compounds that dogs trained to find heroin respond to. None of that helps with fentanyl, which, the CDC notes, you would not be able to see, smell, or taste.

What “dope” looks like in New Jersey now

In New Jersey, the word heroin on a bag no longer describes what is inside it. The state’s Commission of Investigation said it plainly in a December 2025 report: because fentanyl is so potent, a small amount of it can replace a larger quantity of heroin in drugs marketed as heroin, and a person who thinks they are buying heroin may be buying heroin mixed with fentanyl and xylazine. The same report cites 2,210 New Jersey residents who died of fentanyl-related overdoses in 2023.

Two veterinary sedatives now ride along with it. A New Jersey Department of Health alert found xylazine, or “tranq,” in one-third of suspected heroin and fentanyl seizures in 2022 and 45 percent in the first quarter of 2023, and 99 percent of seizures with xylazine also contained fentanyl. Then came medetomidine, a sedative the SCI report calls 100 to 300 times more potent than xylazine. It had not been seen in New Jersey seizures before 2024; from January 2024 to May 2025, New Jersey forensic labs found it in 910 cases of suspected heroin. Neither sedative is an opioid, and naloxone does not reverse either one.

What it looks like on the street in New Jersey is usually not loose powder. It is small glassine or wax-paper envelopes, sold singly or bundled, often stamped with a brand name or logo in ink. Those stamps are not quality marks. In a 2019 Irvington mill case, the Attorney General’s office linked the brand names stamped on the folds to 93 overdoses, including 33 deaths. A familiar stamp says nothing reliable about what is inside.

Heroin paraphernalia: needles, spoons, foil, and pipes

Heroin and fentanyl are injected, snorted, and smoked, and each route leaves different things behind. Smoking has overtaken injection. A 2024 CDC analysis of overdose deaths in 27 states and the District of Columbia found that, from early 2020 to late 2022, deaths with evidence of injection fell from 22.7 to 16.1 percent while deaths with evidence of smoking rose from 13.3 to 23.1 percent, making smoking the most commonly documented route by 2022. So a family looking only for needles may miss what is actually there.

Heroin needles and syringes

Usually small insulin-type syringes with thin needles and colored caps, sometimes loose, sometimes with the caps chewed or missing. Look also for small cotton balls or cigarette filters, alcohol pads, and a belt, shoelace, or rubber tube used as a tourniquet. Used needles are a hepatitis C and HIV risk to whoever picks them up; handle them with tongs or thick gloves and put them in a hard plastic bottle with a lid.

Heroin spoons and burnt spoons

A spoon with a black or brown burn mark on the underside and residue in the bowl is one of the most recognizable signs. Powder is dissolved in water and heated before it is drawn into a syringe, and the flame leaves the scorch. Bottle caps and the bottoms of soda cans serve the same purpose and are sometimes called cookers. Spoons disappearing from the kitchen drawer is a sign families often mention.

Heroin pipes, foil, and straws

Smoked heroin and fentanyl usually leave strips of aluminum foil with dark streaks or burn trails, plus a short straw, a hollowed-out pen, or a rolled bill used to inhale the vapor. Glass pipes are used too, though they are more often associated with crack and meth. Folded foil, lighters with no cigarettes, and cut straws in a car or bedroom are worth asking about.

Snorting

Cut straws, rolled bills, and powder residue on a flat surface. Snorting avoids needles, not overdose. With fentanyl in the supply, the dose is unknown by every route.

Track marks: what they look like and where

Track marks are the visible damage from repeated injection. They usually start as small puncture marks along a vein, often inside the elbow or on the forearm, then darken into lines of bruising and scar tissue as the same veins are used again. When the arm veins wear out, some people move to the hands, legs, feet, or neck. NIDA lists the long-term injection injuries as scarred or collapsed veins, abscesses, soft-tissue infections, and infections of the blood vessels and heart valves.

A “blown vein” is street shorthand for a vein that ruptures or leaks during an injection, leaving a painful, swollen, purple bruise. Long sleeves in hot weather, bandages that never come off, and bruises with no explanation are the signs people notice first.

Heroin street names and nicknames

NIDA’s drug chart lists Big H, Black Tar, Chiva, Hell Dust, Smack, and Thunder. In New Jersey the everyday word is dope, and it now means whatever is in the bag, heroin or fentanyl. The packaging has its own vocabulary: a bag or a fold is a single envelope, and bags are sold in larger groups called bundles and bricks. A brand name stamped on the fold is often what people ask for.

Bayer heroin: where the name came from

Heroin was a pharmaceutical product before it was a street drug. Bayer, the German company better known for aspirin, began manufacturing diacetylmorphine in 1898 and marketed it as a cough suppressant under the brand name Heroin, a history traced in a 2023 review in Frontiers in Pain Research. Its chemists believed it suppressed cough without depressing breathing. They were wrong, and slowed breathing is still how opioids kill.

Is heroin a depressant?

It is an opioid, and it depresses the central nervous system. NIDA’s chart lists drowsiness and confusion among its short-term effects, and the way it kills is respiratory depression: breathing that slows until it stops. It is not grouped with sedatives such as benzodiazepines in most drug classifications, but combined with them, or with alcohol, the breathing effects stack.

Signs of heroin use in a person

The drug itself produces a recognizable picture. NIDA’s chart lists euphoria, pain relief, drowsiness, and confusion as short-term effects, and nausea and constipation with regular use. What family members describe looks like this:

• Nodding: drifting in and out of sleep mid-conversation, head dropping, then snapping back
• Pinpoint pupils in normal light; our guide to what different drugs do to the eyes covers what pupils can and cannot tell you
• Slowed, slurred speech, heavy limbs, scratching
• Withdrawal between doses: NIDA describes restlessness, muscle and bone pain, sleeplessness, diarrhea, vomiting, and cold flashes with goose bumps; symptoms can start within a few hours and peak 24 to 48 hours after the last dose
• The pattern around it: money missing, constant “flu” that clears up suddenly, long sleeves, new friends, missing spoons

None of these alone is proof. Together, and with paraphernalia, they are a reason for a direct conversation, not a confrontation.

If you find paraphernalia or see the signs

Start with safety, then the conversation. Three things are worth doing this week, whatever the person says.

• Get naloxone into the house. It is free and anonymous at participating New Jersey pharmacies through the state’s Naloxone365 program. Our naloxone guide for families covers how to use it.
• Know that test strips are legal. Since January 2024, New Jersey’s P.L.2023, c.224 has kept drug-checking test strips, including strips for substances added to strengthen a drug, out of the drug paraphernalia law. The state Department of Health names fentanyl and xylazine strips as examples, and hospitals may hand them out along with sterile syringes. A strip can show fentanyl is present. It cannot show how much, and a negative strip does not make a bag safe.
• Make using alone less likely. Someone alone has no one to call 911 or give naloxone. The Department of Health alert lists the Never Use Alone line at 1-800-484-3731, a peer-run line, open around the clock, for people who use by themselves.

Then talk. Pick a time when they are not high and you are not angry. Say what you found and that you are scared for them. Ask, then listen longer than feels natural. You are not trying to win the first conversation; you are trying to make sure there is a second one. Tell them where the naloxone is. If they are willing to talk to someone, ReachNJ, the free state treatment line, is at 1-844-732-2465. The family guide covers how to open the conversation, and what if someone refuses detox covers what New Jersey law does and does not let you do.

What detox looks like for heroin and fentanyl

Opioid withdrawal is miserable and rarely fatal by itself. The danger is what comes after: tolerance falls within days, cravings do not, and a person who returns to the same bag at the old amount can stop breathing. That is why the standard of care is medication, not willpower. Buprenorphine or methadone, covered in the medication guide, cuts withdrawal and the risk of overdose death. With fentanyl in the picture, starting buprenorphine takes more care, because starting too early can trigger precipitated withdrawal; a clinician may use a low-dose start to lower that risk. Our opioid detox guide walks through the timeline, and Suboxone vs Subutex vs Sublocade covers the medication options. Tell the detox team if xylazine or medetomidine may be involved; withdrawal from those sedatives is a separate problem from opioid withdrawal and is managed differently.

In New Jersey

Under New Jersey law P.L.2017, c.28, fully insured New Jersey plans and the State Health Benefits and School Employees’ plans cannot require prior authorization for the first 180 days per plan year of in-network treatment your own physician, psychologist or psychiatrist finds medically necessary, or, during those same 180 days, for outpatient prescription drugs that treat substance use disorder, such as buprenorphine and naltrexone, when that clinician finds them medically necessary. Self-funded employer plans, Medicare and Medicaid are not covered by that rule, so verify with the plan. NJ FamilyCare covers buprenorphine, methadone, and naltrexone. Our insurance guides go plan by plan. ReachNJ, the free state treatment line, is at 1-844-732-2465. If someone is in crisis or thinking about suicide, call or text 988.

Periscope Behavioral Health, which publishes this site, is opening a medical detox in Hammonton, Atlantic County, expected Summer 2027. For help independent of us, the state’s IME Addictions Access Center at 1-844-276-2777 screens NJ FamilyCare and uninsured residents and refers them to treatment. Until the Hammonton detox opens, the admissions line of our publisher, Periscope Behavioral Health, at (888) 313-3583, can talk through options in New Jersey and Florida, including facilities Periscope operates. What a plan covers depends on the plan and the facility’s network status. Many emergency departments in the state can start buprenorphine the same day.

What none of this can tell you

A spoon, a stamp, a vinegar smell, and a nodding head can tell you someone is probably using an opioid. They cannot tell you whether the bag is heroin, fentanyl, or fentanyl with a sedative that naloxone will not touch. Assume the worst about the bag and the best about the person. Keep naloxone in reach. You do not need to be certain before you call.