Medically Reviewed

Short- and Long-Term Effects of Heroin Use

3 min read · 4 sections

In 2020, more than 900,000 people aged 12 or older reported using heroin within the past 12 months in the United States.1 That same year, approximately 13,165 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

Long-Term Effects and Dangers of Heroin Use

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.

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.9  And those who snort heroin risk mucosal inflammation and erosion of delicate tissues in the nose.9

Take Our Substance Misuse Self-Assessment

Take our free, 5-minute substance misuse self-assessment below if you think you or someone you love might be struggling with substance misuse. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result.

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. 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.

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.

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.13 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, most first responders—including paramedics, firefighters, and police officers—carry it. Additionally, it is often prescribed alongside prescription opioids, and in some states, naloxone can be obtained over the counter.13

Heroin Withdrawal

Long-term heroin use puts a person at risk of becoming physically dependent on the substance.14 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.

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:15

  • Using heroin in larger amounts and/or for longer periods of time than intended.
  • Making one or more unsuccessful efforts to cut down or stop heroin use, despite the persistent desire to do so.
  • Spending a great deal of time obtaining, using, and recovering from heroin use.
  • Craving or having a strong urge to use heroin.
  • Failing to fulfill major responsibilities at work, home, or school because of recurrent heroin use.
  • Continuing to use heroin despite having persistent or recurrent social or interpersonal problems, which stem from or are worsened by heroin use.
  • Giving up important social, occupational, or recreational activities because of heroin use.
  • Using heroin in situations that are physically hazardous.
  • Continuing to use heroin despite the knowledge that it can cause or exacerbate physical or psychological problems.
  • Becoming tolerant to heroin, meaning it takes increased amounts of the substance to achieve the desired effect.
  • Experiencing withdrawal when heroin use is stopped or drastically reduced.
  • In the event of a heroin overdose, medical help must be sought as quickly as possible, as an overdose can result in death and other serious medical issues. When calling 911, it is helpful to provide information like the person’s age and weight, the amount of heroin they consumed, and in what manner they consumed it. Information on how long ago the person took the drug can also be helpful for medical professionals.

If you or a loved one are ready to get help for heroin addiction, we at American Addiction Centers (AAC) are here for you. Speak to one of our compassionate and knowledgeable Admissions Navigators to learn more about our facilities and programs and understand your options. We can help you get on the road to recovery. Call us .

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