Cocaine vs Heroin

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Cocaine and heroin are two widely used substances. In the United States, approximately 4.8 million individuals, over the age of 11, reported using cocaine within a 12 month period. (1) Approximately 1.4 million individuals were diagnosed with cocaine use disorder, or difficulties controlling their cocaine use. (2) In terms of heroin, approximately 1.1 million individuals, over the age of 11, reported engaging in heroin use within a 12 month period. (3) Approximately 1 million individuals were diagnosed with opioid use disorder, the term used to describe individuals who have difficulties controlling their heroin use. (4) Both substances are highly addictive and can lead to negative health effects.

If you suspect that you or a loved one are experiencing cocaine or opioid use disorder, Guardian Recovery can help. Here, we focus on evidence-based treatment options, such as therapeutic interventions, to help individuals break free from drug and alcohol dependencies. We offer various levels of care, ranging from inpatient residential to outpatient treatment programs. Reaching sobriety may not be an easy task, but our trained clinicians will help you, or a loved one, develop adaptive coping strategies and wellness techniques. Contact us today to begin your recovery journey.

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What Is Heroin?

Heroin is an illegal substance in the United States. Heroin is classified as a Schedule I drug by the Drug Enforcement Administration, meaning that it is not allowed to be used by the general population or for medical purposes. (5) Pure heroin has a bitter taste, and is usually sold as a white or off-white powder. Pure heroin is usually ingested by inhaling it through the nose or smoking it. Black tar heroin is a sticky substance that is darker than pure heroin. It is usually sold as a black, or dark orange pastelike substance. This difference in color is a result of how black tar heroin is made and processed. Black tar heroin is usually dissolved with water and injected intravenously. Pure heroin is sold mostly east of the Mississippi river, while black tar heroin is sold mostly west of the Mississippi river.

Drug Classification

Heroin belongs to the drug class known as opioids. The drug class opioids also includes other substances such as prescription pain relievers, and synthetic opioids, like fentanyl. (6)

Where Does Heroin Come From?

Heroin is processed from morphine, which is a natural substance that is found in various poppy plants. (7) Pure heroin originates from South America and Southeast Asia. Black tar Heroin is mostly produced in Mexico.

What Is Cocaine?

Cocaine is a dangerous, illegal substance that is classified as a Schedule II drug by the Drug Enforcement Administration. Schedule II drugs are not allowed to be used for recreational purposes, but can be used for certain medical reasons. (8) Cocaine can be ingested by smoking, snorting, or oral ingestion.

Drug Classification

Cocaine belongs to the drug class known as stimulants. (9) Stimulants speed up the central nervous system, which consists of the brain and spinal cord.

Where Does Cocaine Come From?

Cocaine is produced from the leaves of the coca plant. For centuries, those residing in South America chewed the coca leaves. The coca plant is found throughout South America in the countries of Bolivia, Peru, and Columbia. The leaves are harvested, soaked in various chemicals and agents, then dried and formed into cocaine.

Cutting Agents Used in the Production of Cocaine & Heroin

Cocaine and heroin are often cut with other agents by those who illegally sell the substances. Drug dealers cut the substances with other agents in order to sell more for a cheaper cost, and to intensify their effects. Adding cutting agents to substances increases their dangerousness as it is impossible to be able to know exactly what they are cut with. Adding cutting agents to cocaine and heroin increases the chances of individuals experiencing overdoses or death.

Common substances often used when cutting cocaine include:

  • Laundry detergent
  • Caffeine
  • Laxatives
  • Boric acid
  • Creatine
  • Marijuana
  • Fentanyl
  • LSD
  • PCP
  • Heroin

Common substances often used when cutting heroin include: (10)

  • Baking soda
  • Sugar
  • Starch
  • Crushed over the counter pain medications
  • Talcum powder
  • Powdered milk
  • Laundry detergent
  • Caffeine
  • Rat poison

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Heroin Side Effects & Withdrawal Symptoms

Engaging in heroin use can lead to both short-term and long-term side effects.

Common side effects associated with heroin use include: (11)

  • Dry mouth
  • Heavy arms and legs
  • Nausea or vomiting
  • Severe itchiness
  • Mental fogginess
  • Insomnia
  • Heart infection
  • Gastrointestinal issues
  • Liver and kidney disease
  • Depression
  • Anxiety

Withdrawal occurs when a substance is suddenly stopped or reduced. Heroin withdrawal can occur 6 hours after last use, and can last for months.

Common withdrawal symptoms associated with heroin use include:

  • Abdominal cramping
  • Sore muscles
  • Nausea
  • Diarrhea
  • Shakiness and chills
  • Mood swings
  • Anxiety
  • Depression

Cocaine Withdrawal & Side Effects

Due to how cocaine stimulates the brain, there are various side effects that can occur.

Common side effects associated with cocaine use include:

  • Anxiety
  • Panic attacks
  • Reduced blood flow
  • Weight loss
  • Nasal passageway damage
  • Malnourishment
  • Cognitive impairment
  • Heart damage
  • Stroke

Cocaine withdrawal can begin 12 hours after last use and can last for weeks, depending on the severity of use.

Common withdrawal symptoms associated with cocaine use include:

  • Restlessness
  • Mood swings
  • Fatigue
  • Insomnia
  • Nightmares
  • Depression
  • Increased appetite
  • Intense cravings

Common Effects on Dopamine & the Brain

Both cocaine and heroin flood the brain with the neurotransmitter dopamine, which is known as the pleasure chemical. As an individual continues to use cocaine or heroin, the brain no longer produces dopamine naturally, and only relies on the substance to manufacture it. This leads to the development of tolerance, or the need to use more cocaine or heroin to avoid any negative side effects or withdrawal symptoms. Heroin has also been found to destroy white matter in the brain. (12)

Links to Cardiovascular Blood Flow & Heart Problems

Both cocaine and heroin use can restrict blood flow to the heart, leading to cardiovascular problems and increasing the chances of an individual experiencing heart attack or stroke. (13)

Speedballing & The Effects of Mixing the Two

Speedballing, or mixing heroin and cocaine, can be extremely dangerous. This is because cocaine speeds up the body while heroin slows it down.

Side effects of mixing cocaine and heroin include: (14)

  • Uncontrolled motor skills
  • Aneurysm
  • Respiratory failure
  • Stroke
  • Heart attack

Is Cocaine or Heroin More Addictive?

In terms of cocaine vs heroin use, both substances are highly addictive. Severity of addiction depends on the individual, biological factors, and frequency of use.

Causes of Death in Overdoses

Overdose and death is possible with cocaine or heroin use. Approximately 19,447 individuals died from experiencing an overdose from cocaine use in 2020. (15) While approximately 13,165 individuals died from experiencing an overdose due to heroin use. (16) Seek immediate medical attention if you suspect that you or a loved one are explaining a drug overdose.

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Luckily, treatment is possible for both cocaine and heroin use. Here at Guardian Recovery, we offer comprehensive care and psychoeducation to help individuals learn to control their substance use. Contact us to learn more about our available treatment options. A free, no obligation insurance benefit check can be provided if requested. Our Treatment Advisors are ready to speak with you and to help you get started. Begin your recovery journey today with Guardian Recovery.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.


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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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