The Long- and Short-Term Effects of Heroin Use
Heroin is a highly addictive drug and rapidly acting opioid processed from morphine, the primary component of opium, a naturally occurring substance that’s extracted from the seedpod of the opium poppy.[1]
Available in white or brownish powders or a black, sticky substance known as black tar heroin, the drug can be injected, smoked, or snorted.[2] Heroin is highly addictive and produces a rush of euphoria, along with several side effects and risks.
Key Points
- Heroin is a highly addictive drug that’s derived from morphine, a component of opium.
- Heroin may be injected, smoked, or snorted.
- There are immediate and long-term effects and risks with heroin use, including health complications.
- In addition to the broad risks of heroin, certain methods of use carry specific risks.
- Heroin has indirect risks associated with it, including injuries from risk-taking behavior and bloodborne diseases from needle sharing.
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]
Frequently Asked Questions
Can You Overdose on Heroin?
Yes, you can overdose on heroin. This happens when you take enough of the drug to produce a life-threatening reaction. During an overdose, breathing slows or stops completely, decreasing the oxygen that goes to the brain.[15] If enough time passes, this can cause coma and permanent brain damage.
Can a Heroin Overdose Be Reversed?
With rapid medical intervention, a heroin overdose can be reversed with minimal effects. Naloxone, an opioid blocker, is essential in treating an opioid overdose and buying time for the person to get medical attention.[16]
Is Heroin Ever Safe?
Heroin is always dangerous, regardless of the dosage, frequency, or method of use. Although heroin is derived from morphine and is similar to prescription narcotic painkillers like oxycodone and hydrocodone, it is an illegal opioid with no approved medical use.[17] Even prescription narcotics are carefully monitored because of their abuse and addiction potential, and they’re without some of the risks and side effects associated with heroin additives or methods of administration.
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U.S. Department of Health and Human Services. (2021b, April 13). What are the long-term effects of heroin use?. National Institutes of Health. Retrieved from https://nida.nih.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use on 2023, July 10.
U.S. Department of Health and Human Services. (2021b, April 13). What are the long-term effects of heroin use?. National Institutes of Health. Retrieved from https://nida.nih.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use on 2023, July 10.
U.S. Department of Health and Human Services. (2021c, April 13). What are the medical complications of chronic heroin use?. National Institutes of Health. Retrieved from https://nida.nih.gov/publications/research-reports/heroin/what-are-medical-complications-chronic-heroin-use on 2023, July 10.
U.S. Department of Health and Human Services. (2021c, April 13). What are the medical complications of chronic heroin use?. National Institutes of Health. Retrieved from https://nida.nih.gov/publications/research-reports/heroin/what-are-medical-complications-chronic-heroin-use on 2023, July 10.
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U.S. Department of Health and Human Services. (2021, April 13). What are the treatments for heroin use disorder?. National Institutes of Health. Retrieved from https://nida.nih.gov/publications/research-reports/heroin/what-are-treatments-heroin-use-disorder on 2023, July 10.
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