The Long- and Short-Term Effects of Heroin Use

Short-Term Effects of Heroin

Once heroin enters the brain, it’s converted to morphine and binds to opioid receptors. Heroin varies in purity and may be used with additional substances, creating a range of different short-term side effects.

The short-term effects of heroin use include:[3]

• Drowsiness
• Twilight sleep
• Alternating states of wakefulness and drowsiness
• Decreased mental functioning
• Heavy extremities
• Nausea
• Vomiting
• Dry mouth
• Itchy skin
• Depressed heart rate and breathing

If the side effects are severe, breathing and heart rate can slow to the point of coma and potentially permanent brain damage.

Long-Term Effects of Heroin

Aside from immediate risks, chronic heroin use can have many long-term effects, including the risk of increased tolerance and addiction. Perhaps the most concerning risk is structural and functional brain changes that can cause long-term imbalances in neuronal and hormonal systems, some of which can’t be reversed.[4]

Chronic heroin use also deteriorates the brain’s white matter, which may impact the response to stress, the ability to regulate behavior, and decision-making abilities.[5]

No matter how the drug is used, heroin’s long-term effects may include medical complications like:[6]

• Insomnia and constipation
• Lung complications
• Mental disorders like depression and antisocial personality disorder
• Sexual dysfunction
• Menstrual irregularities

There are several effects related to the method of use, including damage to the nasal passages from snorting heroin and collapsed veins, infections, abscesses, and immune problems. Some of the greatest risks come not from the drug itself but from bloodborne diseases like hepatitis and HIV.[7]

Heroin may also be smoked, which is becoming popular among younger users to avoid the stigma associated with IV drug use.[8] Some believe it’s less addictive and risky to smoke heroin, but it’s just as dangerous.

Smoking heroin symptoms include slow and shallow breathing, anxiety, depression, euphoria, and mood swings.[9] Black tar heroin, a lower-quality and cheaper form of heroin produced in Mexico, is often smoked. Though the effects are similar to powder heroin, the side effects of smoking black tar heroin include:[10]

• Lethargy
• Runny nose
• Pinpoint pupils
• Diarrhea
• Vomiting

Black tar heroin has additional risks of heroin-related injuries or medical complications, including stroke, lung problems, and general poor 
health.[11]

Heroin Addiction and Treatment

Addiction is the compulsive and uncontrollable use of a substance despite negative effects on health and well-being. Heroin falls under the classification of an opioid use disorder (OUD), which is defined by the following criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):[12]

• Using heroin for longer periods or in larger doses than intended
• Trying to reduce or stop heroin use unsuccessfully
• Spending a lot of time sourcing, using, or recovering from heroin
• Experiencing intense cravings for heroin
• Falling behind on responsibilities at work, home, or school
• Continuing to use heroin despite problems with life or health
• Giving up activities once enjoyed to use heroin
• Building a tolerance to heroin’s effects
• Experiencing withdrawal from stopping or reducing heroin use
• Using heroin in dangerous situations

If you or a loved one is addicted to heroin, help is available. Because opioid withdrawal can be intense – possibly life-threatening – medical detox is often the first step. Detox provides round-the-clock medical care and supervision to minimize withdrawal symptoms and ensure you’re safe and comfortable.

Detox is an important step, but it’s not enough. Addiction treatment programs are important for addressing the underlying causes of addiction and reducing the risk of relapse for long-term abstinence.

Addiction treatment for heroin may include a combination of behavioral and medication (pharmacological) therapies in an inpatient or outpatient program. These approaches can help restore normalcy to brain function and improve behaviors.

Several medications may be used for OUDs, including:[13]

• Methadone, a long-acting opioid agonist that reduces withdrawal symptoms and promotes abstinence.
• Buprenorphine, a partial opioid agonist, can relieve drug cravings without producing euphoria.
• Naltrexone, an opioid antagonist that blocks the action of opioids without addiction potential.

Behavioral therapies like cognitive behavioral therapy (CBT) and contingency management are often combined with pharmacological therapy to address the behaviors and thought patterns that contribute to drug use and addiction.[14]