Short- and Long-Term Effects of Heroin Use

In 2020, more than 1.1 million people aged 12 or older reported using heroin within the past 12 months in the United States.¹ That same year, approximately 9,173 individuals died from an overdose involving heroin.¹ That number, however, has been decreasing slightly every year since 2017.²

People who use heroin are not only at risk of deadly overdose but of several other short- and long-term effects that can impact an individual’s health, including issues with several organ systems, life-threatening infections, and declining mental health. Regular heroin use can also lead to the development of a heroin use disorder, a diagnostic term for a heroin addiction.³

What is Heroin?

Heroin, an opioid, is an illegal, highly addictive drug derived from morphine, which is an opiate alkaloid extracted from poppy plants.³ Heroin is commonly encountered as a white or brown powder but can also be a black, sticky substance.⁵

Heroin is classified as a Schedule I controlled substance in the United States, which means heroin currently has no approved medical use and there is a high potential for misuse.^6,7

Typically injected, snorted, or smoked, heroin’s effects are felt almost immediately as the drug reaches the bloodstream quickly; binds to and activates opioid receptors in the brain; and delivers a rewarding surge of euphoria.³

Additionally, heroin can alter several physiological functions, including breathing and heart rate. Heroin use also increases dopamine activity in certain areas of the brain associated with reward and reinforcement.³

What Are the Short-Term Effects of Heroin Use?

Individuals who use heroin may experience varying degrees of side effects, depending on the amount used and whether the heroin was used with additional substances.⁹

People who use heroin commonly report feeling a pleasurable rush and a reduction in pain, but may also experience more adverse side effects soon after use, including.^3,9

• Drowsiness.
• Decreased mental functioning.
• Alternating states of being awake and asleep (nodding off).
• Limbs that feel heavy or weighted down.
• Dry mouth.
• Nausea.
• Vomiting.
• Itchy skin.
• Slowed heart rate.
• Slowed breathing.

Long-Term Effects and Dangers of Using Heroin

Chronic heroin use can have many long-term physical and mental health effects, including the development of significant opioid tolerance and physiological dependence. Repeated heroin use is associated with structural and functional brain changes, which can additionally result in neurochemical and hormonal imbalances. In fact, studies show that the brain’s white matter can deteriorate with long-term heroin use, which can affect a person’s decision-making capability, behavior regulation, and stress response.⁹ It can also lead to addiction.

Other long-term heroin side effects may include:^3,9

• Insomnia.
• Infections of the heart lining and valves (in association with non-sterile needle use).
• Abscesses (in association with non-sterile needle use).
• Chronic and severe constipation.
• Increased risk of pneumonia and other lung complications.
• Co-occurring mental health issues, such as depression and antisocial personality disorder.
• Sexual dysfunction for men.
• Irregular menstrual cycles for women.
• Addiction, or heroin use disorder.

The method or route in which heroin is used can impart its own risks. For instance, individuals who inject heroin increase the likelihood of local tissue infection, more widespread vascular inflammation, and other cardiovascular risks. Additionally, some heroin contains particulate contaminants that can irritate and/or block the tiny vessels that deliver blood to the kidneys, liver, lungs, and brain, causing permanent damage to those organs.⁹

Furthermore, sharing injection equipment increases the risk of contracting transmittable diseases, including HIV and hepatitis C.  And those who snort heroin risk mucosal inflammation and erosion of delicate tissues in the nose.⁹

Heroin Overdose

From 1999 to 2020, nearly 143,000 people died from heroin-related overdoses.¹⁰ A heroin overdose occurs when a person ingests enough of the substance to produce life-threatening effects or death.⁹ Overdose risks are further compounded by the fact that heroin is commonly combined with other drugs such as illicitly-manufactured fentanyl, a synthetic opioid that’s 50 times more potent than heroin.¹¹

Heroin overdose is very dangerous and potentially life-threatening. Symptoms may include:¹²

• Small, constricted, pinpoint pupils.
• Loss of consciousness.
• Slow, shallow breathing.
• Making choking or gurgling sounds.
• Having a limp body.
• Cold, clammy, pale, or bluish skin.

What Effects Does a Heroin Overdose Have on the Body?

A heroin overdose frequently involves significant respiratory depression, meaning an individual’s breathing becomes very slow, even stopped. Severely slowed or altogether stopped breathing can result in hypoxia, or compromised blood oxygen delivery to the brain and other tissues. Hypoxic brain damage can lead to lasting neurological injury, coma, and death.³

What to Do in Case of a Heroin Overdose

In the event of a heroin overdose, call 9-1-1 immediately and administer naloxone if it is available. Prompt medical intervention can be lifesaving for a person experiencing a heroin overdose.

Naloxone is a medication that can reverse some of the adverse effects of opioids, which can save the life of an individual experiencing heroin overdose. Naloxone is an opioid receptor antagonist that can reverse the effects of an opioid like heroin, allowing the person to breathe normally.¹³

Naloxone used to only be available to medical professionals. Now, it is often prescribed alongside prescription opioids and naloxone can be obtained over the counter.¹³

Heroin Addiction

Addiction refers to the compulsive, uncontrollable use of a substance despite the harm it causes.

Healthcare professionals use the criteria supplied by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition to diagnose an opioid use disorder (OUD). These symptoms include:¹⁴

1. Using heroin in larger amounts and/or for longer periods of time than intended.
2. Making one or more unsuccessful efforts to cut down or stop heroin use, despite the persistent desire to do so.
3. Spending a great deal of time obtaining, using, and recovering from heroin use.
4. Craving or having a strong urge to use heroin.
5. Failing to fulfill major responsibilities at work, home, or school because of recurrent heroin use.
6. Continuing to use heroin despite having persistent or recurrent social or interpersonal problems, which stem from or are worsened by heroin use.
7. Giving up important social, occupational, or recreational activities because of heroin use.
8. Using heroin in situations that are physically hazardous.
9. Continuing to use heroin despite the knowledge that it can cause or exacerbate physical or psychological problems.
10. Becoming tolerant to heroin, meaning it takes increased amounts of the substance to achieve the desired effect.
11. Experiencing withdrawal when heroin use is stopped or drastically reduced.

Heroin Dependence & Withdrawal Symptoms

Long-term heroin use puts a person at risk of becoming physically dependent on the substance.¹⁵ Dependence is a physiological adaptation of the body to a substance, meaning the body becomes so used to the heroin being present in the system that when an individual drastically reduces their dose or stops altogether, withdrawal symptoms emerge. With significant physiological dependence, an individual may continue to compulsively use heroin to avoid unwanted and unpleasant withdrawal symptoms.

The symptoms of heroin withdrawal—which can begin as early as a few hours after the last dose—may include:³

• Feeling restless.
• Pain in the muscles and bones.
• Diarrhea and vomiting.
• Chills and goosebumps.
• Insomnia.
• Involuntary, jerky leg movements.
• Severe heroin cravings.

Opioid withdrawal can be extremely uncomfortable but is generally not life-threatening and can be medically managed as a part of professional detoxification and treatment.

How to Get Help for a Heroin Addiction

While addiction is a chronic and relapsing disease, it can be treated. If you or someone you love is addicted to heroin, there are treatment options available, which may include:¹⁶

• Detoxification. Medically managed detox and withdrawal management allows your body to rid itself of heroin under the supervision of a healthcare provider, who keeps you safe and as comfortable as possible with medications and other supportive care.
• Inpatient rehab. Inpatient rehab requires you to remain at the facility—either a hospital or residential center—during treatment. Treatment generally includes counseling, behavioral therapy, education, and treatment for any co-occurring mental health issues.
• Outpatient rehab. Outpatient programs generally provide similar therapeutic interventions to inpatient care but allow you to live at home or in a sober living environment while participating in scheduled counseling and therapy sessions.
• Aftercare. Long-term follow-up care sets you up for lasting recovery with support and accountability after completing a formal treatment program and may include mutual-help groups, continued outpatient counseling and therapy, and/or sober living environments.

If you or a loved one are ready to get help for heroin addiction, we at American Addiction Centers (AAC) are here for you. Reach out to connect with one of our compassionate and knowledgeable admissions navigators to learn more about our treatment centers and programs and understand your options. We can help you get on the road to recovery.