Heroin is an extremely addictive illegal street drug that belongs to the opioid family of substances. It is synthesized from morphine, which is an opiate chemical derived from the opium poppy.1 It generally comes in the form of a white or brown powder, but can also be purchased as “black tar heroin,” a black, sticky substance.1
Heroin can be cut, or diluted, with inert substances such as sugar or starch, but unscrupulous dealers may use harmful substances, even including poisons such as strychnine or more potent prescription opioids like fentanyl to cut heroin. The unwitting use of these adulterant substances can prove to be even more dangerous than abuse of heroin alone.
Recreational drug users inject, smoke, or snort it. Once the heroin enters the bloodstream and travels to the brain, users begin to experience its effects. Intravenously injecting it can produce effects almost instantly, whereas smoking or snorting the drug may take as long as 15 minutes to produce any effects.2
Heroin is metabolized to morphine in the brain, which then interacts with opioid receptors to diminish the perception of pain, as well as influence our natural reward systems. When certain drug thresholds are reached within the brain, various vital life functions such as breathing and heart rate will also be negatively impacted.3 The surge of opioid receptor activity that results from heroin use produces a few minutes of intense pleasure, or euphoria, followed by an hour or so of relaxation.2 Beyond the euphoric high, other commonly encountered short-term effects include nausea, vomiting, and skin itching.2
Almost half a million people aged 12 or older were current heroin users in 2014.4 In 2011, 20.6% of all emergency department visits related to illicit drug use involved the use of the drug.5 Still, while undeniably dangerous, heroin does not affect everyone in the same way. The age and weight of a user, as well as the use of other drugs, the presence of other medical conditions, tolerance, and even mood at the time of use, are all factors that can affect the severity of the short-term effects experienced.
Since the physical and psychological heroin side effects may be dangerous and unpredictable, the drug is not legal for any purpose in the United States. Even the short-term effects of using it as a recreational drug can include permanent disability or death.
Dependency, or addiction, is the most common of long-term heroin effects—it is often considered one of the most addictive substances that is commonly abused for its mind-altering effects.
Short-Term Side Effects of Heroin
The immediate and short-term effects of heroin use will vary by how much is taken and the method of use.6 Injecting generally produces a faster, more intense high, while snorting or smoking has a relatively delayed, less-intense onset of effects.2
Beyond the user’s subjective euphoria, heroin’s short-term side effects may include the following:6
- Sense of heaviness in arms and legs
- Dry mouth
- Skin flushing
- Intense itching
- Slow cardiac system function
- Slow breathing
Heroin’s effects that involve the cardiac and respiratory systems may be extremely serious or even fatal. They are among the reasons that heroin use can lead to medical emergencies that require immediate treatment, including overdose death. More than 10,000 people died of heroin overdose in the U.S. in 2014.7
Short-term and immediate adverse effects of heroin may require treatment with a medication called naloxone that blocks the interaction of the drug with opioid receptors.8 As an emergency antidote to an overdose, naloxone has the potential to rescue people from the brink of respiratory failure and consequently save lives.
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What are the Long-Term Side Effects?
In addition to drug dependence, long-term heroin use is associated with a number of potentially severe illnesses and addiction development. Anoxic brain damage can result from repeated use, resulting in long-lasting imbalances in brain and hormone systems.6 Injection users who share needles also run an increased risk of contracting blood-borne pathogens, such as HIV and hepatitis B and C.2
Beyond brain damage and disease contraction, the following long-term effects of heroin use are often observed:2, 3
- Collapsed veins
- Infection of the heart lining and valves
- Pus-filled infections (i.e., abscesses)
- Liver or kidney disease
- Pulmonary complications
- Spontaneous abortion
- Gastrointestinal problems (e.g., chronic constipation, bowel obstruction)
Infections are usually caused by sharing needles, but even users who do not inject the drug are at risk for many of the complications of long-term heroin use.
Treatment Options for Addiction
Heroin abuse doesn’t have to ruin a person’s life. Seeking treatment, no matter what stage of abuse or addiction the user is in, can provide invaluable help for a person who wants to recover from addiction, dependency, or abuse. Treatment begins with detox, which is a sustained period of abstinence to clear all of the drug from a user’s body. The detox stage of recovery can involve unpleasant withdrawal symptoms such as:
- Bone and muscle pain.
- Cold flashes.
- Involuntary leg movements.
Withdrawal symptoms can begin as early as a few hours after last use and peak within 24 to 48 hours.6 Most withdrawal symptoms will subside within a week, but sometimes users experience symptoms lasting for months after their last use,6 so medical monitoring during detox is very important.
Once acute treatment of the physical withdrawal effects has progressed, rehabilitation counselors help patients overcome the factors that caused them to fall victim to heroin addiction. Heroin treatment programs help a recovering user analyze their own motivations for drug use through therapy and counseling sessions. Therapy often involves relapse prevention training, addiction education, and learning new coping strategies for dealing with cravings and temptations.
Inpatient treatment programs offer an escape from the stress and temptations of everyday life since the recovering user engages in treatment while staying at a sober treatment facility, allowing the patient to focus entirely on their recovery.
Outpatient treatment is another effective option for many recovering users. In an outpatient program, the patient continues to live at home, going to work or school as usual, and they check in for treatment sessions at the treatment facility on a regular basis, and undergo therapy and counseling to help them work toward recovery.
Throughout treatment, medications may be prescribed to help ease the discomfort of cravings and prevent abuse. Buprenorphine and methadone help reduce cravings by exerting similar, but much less intense, effects as the drug.3 Naltrexone is another medication used to treat heroin addiction and dependence. It works by blocking the opioid receptors so continued the drug has no effect on the user.3
Teens who commit to their heroin abuse recovery may benefit most from therapeutic communities, or sober living, and methadone maintenance therapy.9 Living in a sober community free of triggers to use may strengthen adolescents’ ability to remain abstinent. Medication therapy may be especially helpful in reducing cravings and external temptations as they cope with bodily changes and teen-specific social struggles such, as self-esteem and peer influence.
If you or a loved one is ready for heroin abuse or addiction treatment, we are here to help you find the treatment you need. Please call our 24-hour, toll-free addiction recovery hotline at , and we will direct you to professional resources.
- National Institute on Drug Abuse. (2016). Heroin.
- Center for Substance Abuse Research. (2013). Heroin.
- National Institute on Drug Abuse. (2014). DrugFacts: Heroin.
- Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health.
- Substance Abuse and Mental Health Services Administration. (2013). Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits.
- National Institute on Drug Abuse. (2014). Heroin.
- National Institute on Drug Abuse. (2015). Overdose Death Rates.
- Substance Abuse and Mental Health Services Administration. (2016). Naloxone.
- Hopfer, C. J., Khuri, E., Crowley, T. J., & Hooks, S. (2002). Adolescent heroin use: a review of the descriptive and treatment literature. Journal of Substance Abuse Treatment, 23(3). 231-237.