I. Introduction
II. DSM-5 and Substance Use Disorder
1. Developmental Factors
III. Heroin Use Disorder
1. History of Heroin: Properties and Use
2. Forms of Heroin
3. Prevalence of Heroin Use
4. International Use
5. A Deadly Epidemic
IV. Methods and Action of Heroin Use
1. Mechanism of Action
2. Physiological Effects
3. Short-term Effects
4. Long-term Effects
V. Prescription Opioid Use and Heroin Use
VI. Medical Complications
VII. Black Tar Heroin Use
1. History of Black Tar Heroin
2. Methods of Use
3. Drug Effects
4. Drug Use Risk
5. Signs of Black Tar Heroin Use
6. Physical Signs of Black Tar Heroin Use
7. Psychological and Behavioral Signs of Black Tar Heroin Use
8. Treatment
VIII. Role of Health Clinicians
IX. Treatment of Heroin Use Disorder
1. Principles of Effective Treatment
2. Treatment Stages
3. Medication Use in Treatment
4. Behavioral Therapies
5. Outpatient and Inpatient Treatment
6. Successful Treatment Steps
X. Heroin Toxicity
1. Causes of Heroin Overdose
2. Morbidity and Mortality
3. Clinical Presentation of Toxicity
4. Physical Signs/Symptoms
5. Differential Diagnoses
6. Physical Workup
7. Imaging Studies
8. Emergency Interventional Procedures
XI. Treatment for Heroin Toxicity
1. Special Populations
2. Pharmacotherapy
3. Surgical Treatment
4. Specialty Consultations
5. Healthcare Professional Attitudes in Treating Substance Use
XII. Drug Use in Health Professionals
1. Substance Use Triggers
XIII. Case Studies: Heroin Overdose
1. Case Study 1
2. Case Study 2
3. Case Study 3
XIV. Summary