Heroin is an incredibly dangerous and highly addictive street drug. Because so many people started to become addicted and die from taking the drug, heroin was banned in the 1920s. However, the drug continued to be illegally produced and sold on the street. (1)
The physical and mental side effects of heroin use are extremely harmful. Sharing dirty needles can lead to lifelong, bloodborne infections. In areas where heroin addiction is rampant, there are increased incidences of HIV infections.
How Heroin Works
Heroin, a potent opioid derived from morphine, induces its effects by interacting with opioid receptors in the brain, primarily the mu-opioid receptors. (2) Upon entering the brain, heroin is metabolized back into morphine, its active form, intensifying its influence. The binding of heroin to these receptors triggers the release of neurotransmitters, such as dopamine, which plays a key role in pleasure and reward.
The impact of heroin extends beyond pleasure, however, as it also depresses central nervous system functions. This results in a slowing of vital processes, including respiration and heart rate, contributing to the sedative effects associated with opioid use. (3)
The dual action of enhancing pleasure while suppressing critical physiological functions creates a high risk of heroin overdose and underscores the intricate and perilous nature of how heroin interacts with the brain and nervous system.
What Are the Signs of Heroin Use?
There is a massive stigma associated with heroin use. Roughly 75% of people who take heroin did not start their drug addiction with it. Instead, three-quarters of people addicted to heroin became addicted to legal, prescription opioid drugs initially, such as naloxone, fentanyl, Vicodin, or OxyContin. (4) People also rarely start out injecting the drug but start by snorting or smoking the substance.
Tolerance to the drug will quickly build, and users will need to take more and more of the substance to get the same, intense effects and prevent withdrawal symptoms. At this point in the drug addiction process, users will start to inject the drug to get a more powerful, longer-lasting high.
The signs of heroin abuse and addiction are similar to those often found in addictions to other substances. (5) For example, addiction will take center stage in a person’s life. They will become secretive and isolate themselves.
Addicts will often miss work or school because they are too high or drunk to attend, and constantly thinking about how to obtain drugs, get high, or recover from drugs leaves room for little else in a person’s life.
For heroin addiction, and even opioid overdose, some telltale signs are particular to this type of substance dependency. (6)
- Glassy-eyed appearance
- Small pupils
- Flushed skin
- Drowsiness
- Track marks from injecting the drug
- Cloudy thinking
- Slurred speech
- Stumbling
- Itchiness
- Slowed breathing and heart rate
- Appearing or acting high
- Stomach upset and constipation
Since heroin is a street drug, manufacturers sometimes don’t know what’s in the mixture and will often mix the drug with other chemicals. These “bad batches” can have atypical effects on users.
Some of the atypical impacts of heroin use include:
- Anxiety and restlessness
- Tremors
- Headaches
- Chest pain
- Palpitations
- Shortness of breath
What Are the Short-Term Effects of Heroin Use?
The short-term effects of heroin use are characterized by a rapid and intense series of physiological and psychological changes. (7) When heroin is ingested, it swiftly enters the bloodstream and crosses the blood-brain barrier, where it is converted into morphine.
This conversion leads to the binding of morphine to opioid receptors in the brain, triggering a powerful and immediate euphoric sensation commonly known as a “rush.”
As the rush takes hold, individuals often experience a profound sense of warmth and detachment from both physical and emotional pain. The drug induces a state of bliss and tranquility, providing a temporary escape from stress and reality.
Users may also encounter a heavy sensation in their extremities, accompanied by mental cloudiness and a slowed heart rate and breathing.
However, the euphoria associated with heroin use is counteracted by several immediate risks. Respiratory depression, where breathing slows down significantly, is a critical concern and can lead to life-threatening consequences. Nausea and vomiting are common side effects, adding to the discomfort experienced during heroin use.
Moreover, the heightened potential for heroin overdose poses a severe threat, as the fine line between achieving the desired effects and succumbing to the dangers of excessive heroin intake is perilously thin.
What Are the Long-Term Effects of Heroin Use?
Unfortunately, heroin use comes with a high risk of overdose and death. Users can take a dose of heroin that is mixed with other chemicals and substances, increasing the chances of fatal heroin overdose and organ damage.
Illegal manufacturers sometimes put chemicals in heroin that do not dissolve as well as the pure drug as a way to pad their profits and get people hooked more easily. (7) (8)
These chemicals can clog arteries, and blood vessels, which can kill off vital organ cells and cause long-term damage or even lead to organ failure. (7)
Injecting heroin is also associated with an increased risk of bloodborne illnesses, such as HIV and hepatitis B and C. Injecting heroin can also cause skin infections and collapsed lungs. Using the drug is associated with an increase in respiratory infections like pneumonia and tuberculosis.
Heroin use disorder is also associated with infections of the heart valves, fertility problems, and sexual dysfunction. (9)
Even if a person does not inject heroin, snorting or smoking the drug will cause physical problems, too. Snorting heroin will wear down the nasal passages, leading to:
- Chronic sinus infections
- Dry mouth
- Heroin withdrawal
- Perforated septum in extreme cases
A perforated septum can cause permanent disfigurement and can only be fixed with expensive and invasive surgery. Smoking heroin will lead to permanent lung damage, shallow breathing, and scarring as well. (7)
Can Heroin Use Be Mistaken for Something Else?
Heroin comes in a powder form, and the color of the drug can vary. Most heroin is brown or tan in appearance, but some types of heroin can be white.
In some cases, heroin can be mistaken for cocaine and vice versa. In these instances, users can accidentally overdose on heroin they thought was cocaine or cocaine that turned out to be heroin.
Because heroin can give someone slurred speech or a flushed appearance, and make them uncoordinated, loved ones may mistake heroin use for alcohol use. This may cause loved ones to overlook a friend or family member’s heroin use when they think it’s “just alcohol.”
However, alcohol use will not leave a user with small or pinprick pupils, which is usually the biggest indicator that a person has taken heroin, not alcohol. The physical effects of heroin are almost identical to the side effects present with other opioid derivative drugs.
The Complex Impact of Opioids on the Brain and Nervous System
The use of opioids for pain relief uses a complex interplay with the intricate networks of the brain and nervous system. Below are some of the many health problems heroin users could experience: (10)
- Targeting Mu-Opioid Receptors: Opioids, such as morphine and oxycodone, primarily act on mu-opioid receptors located in the brain and spinal cord. This modulation of receptors helps manage pain signals and reduce pain perception. The activation of these receptors initiates a cascade of events that not only alleviate pain but also impact various aspects of the nervous system. The mu-opioid receptors play a central role in mediating the analgesic effects of opioids.
- Reward System Activation: Opioids stimulate the brain’s reward system, triggering the release of neurotransmitters like dopamine. This activation leads to feelings of euphoria, reinforcing the desire to continue opioid use and contributing to the development of dependence and addiction. The complex interplay within the reward system highlights the multifaceted nature of opioid impact on brain function, causing brain damage. Over time, repeated activation of the reward system can lead to neuroadaptive changes, reinforcing the cycle of opioid use.
- Depressant Effect on CNS: Opioids have a depressant effect on the central nervous system (CNS). This results in sedation, drowsiness, and an overall calming effect. Excessive opioid use can lead to respiratory depression, a serious concern associated with the risk of respiratory failure and overdose. Understanding the CNS depressant effects is essential for healthcare providers to ensure patient safety during opioid therapy. Monitoring patients for signs of CNS depression is essential, especially in situations where opioid doses may need adjustment.
- Respiratory Effects: Opioids influence the brainstem’s respiratory centers, impacting respiratory drive. The suppression of respiratory function is a central factor in opioid-related fatalities, emphasizing the need for monitoring respiratory function in clinical settings. This intricate involvement with respiratory regulation underscores the potentially life-threatening consequences of opioid misuse. Respiratory depression is a critical concern, and healthcare providers must educate patients about the signs of respiratory distress and the importance of seeking immediate medical attention. (11)
- Gastrointestinal Impact: Opioids affect the gastrointestinal tract, causing constipation due to decreased bowel motility. Opioid-induced constipation is a prevalent side effect that often requires additional medications for management. Understanding the gastrointestinal impact is essential for healthcare providers to address this common issue and improve the overall quality of life for individuals on opioid therapy. Educating patients about lifestyle modifications, dietary changes, and the use of stool softeners can help alleviate opioid-induced constipation.
- Neurotransmitter Modulation: Opioids modulate various neurotransmitters, including serotonin and norepinephrine, contributing to their overall effects. This modulation extends beyond pain relief, influencing mood, arousal, and emotional states. (12)
Understanding the intricate impact of opioids on the brain and nervous system is vital for healthcare professionals and individuals prescribed these medications. Responsible use, open communication with healthcare providers, and a comprehensive approach to pain management are essential to mitigate potential risks associated with opioid medications.
Other Effects Of Heroin On the Human Body
While the primary focus of heroin’s impact often revolves around its profound effects on the brain and nervous system, its influence extends to various other vital organs and physiological functions throughout the body.
Here are some key areas where heroin exerts its influence in substance use disorders:
- Cardiovascular System: The cardiovascular system is not immune to heroin’s effects. Heroin use can cause a range of cardiovascular issues, including low blood pressure, collapsed veins (commonly associated with intravenous use), and an increased risk of infections affecting the heart lining and valves. (9)
- Liver Function: Heroin abuse may result in liver damage, either directly from the drug or indirectly due to contaminants in illicitly manufactured heroin. Hepatitis and other infectious diseases transmitted through shared needles can further exacerbate liver issues.
- Immune System: Heroin use can compromise the immune system, making individuals more susceptible to infections and illnesses. This weakened immune response can hinder the body’s ability to fight off diseases effectively.
- Reproductive System: For individuals of reproductive age, heroin use poses risks to both male and female reproductive systems. In males, it can lead to hormonal imbalances and reduced fertility, while females may experience disruptions in menstrual cycles and an increased risk of complications during pregnancy. (13)
- Skin and Veins: Intravenous heroin use is associated with significant damage to the skin and veins. Skin abscesses, infections, and collapsed veins are common issues among individuals who inject the drug.
- Weight Loss and Malnutrition: Chronic heroin use can contribute to weight loss and malnutrition. Individuals may neglect nutritional needs, leading to a range of health issues associated with inadequate nourishment.
Mental Disorders and Heroin Use
The relationship between mental disorders and heroin use is complex, with each influencing the other in intricate ways. Individuals grappling with mental health challenges may turn to heroin seeking relief from emotional pain or distress. Conversely, prolonged heroin use can contribute to the development or exacerbation of mental health issues and physical dependence.
The co-occurrence of these challenges, known as dual diagnosis, underscores the importance of integrated treatment approaches that address both substance use disorders and mental health conditions concurrently.
Addiction Treatment Options For Heroin Use
Addressing heroin addiction involves a multifaceted approach, considering the complexity of its impact on individuals.
Here are the various treatment options available for those struggling with heroin use:
- Medication-Assisted Treatment (MAT):
- Methadone: A long-acting opioid agonist, methadone helps reduce cravings and withdrawal symptoms, providing a stable foundation for recovery.
- Buprenorphine: A partial opioid agonist, buprenorphine alleviates withdrawal symptoms and cravings, promoting a controlled transition away from heroin use. (14)
- Naltrexone: As an opioid antagonist, naltrexone blocks the effects of opioids, acting as a deterrent by preventing euphoria and cravings.
- Behavioral Therapies:
- Cognitive-Behavioral Therapy (CBT): CBT targets thought patterns and behaviors associated with heroin use, fostering healthier coping mechanisms and decision-making skills. (15)
- Contingency Management: This approach reinforces positive behaviors by offering tangible rewards for milestones achieved in recovery.
- Motivational Enhancement Therapy (MET): MET focuses on enhancing motivation for change, aligning personal goals with the desire to overcome heroin addiction.
- Support Groups:
- 12-Step Programs: Groups like Narcotics Anonymous (NA) provide a supportive environment for individuals to share experiences, receive guidance, and work through the 12 steps toward recovery.
- SMART Recovery: This science-based program empowers individuals to build self-reliance and address addictive behaviors through practical tools and strategies at a treatment center.
- Residential Treatment Programs:
- Inpatient Rehabilitation: Comprehensive, immersive programs offer 24/7 support, medical care, and therapy in a structured environment, promoting a focused commitment to recovery.
- Outpatient Treatment:
- Intensive Outpatient Programs (IOP): Suitable for those with a stable living situation, IOPs provide rigorous therapy schedules while allowing individuals to reside at home.
- Standard Outpatient Programs: These offer flexibility for individuals with less intensive needs, combining therapy with daily life responsibilities.
- Dual Diagnosis Treatment:
- Addressing co-occurring mental health conditions alongside heroin addiction is crucial. Dual diagnosis programs provide integrated care, recognizing the interplay between mental health and substance use.
- Family Therapy:
- Engaging families in the recovery process fosters a supportive network, addressing family dynamics and providing education on addiction and its impact.
- Aftercare and Relapse Prevention:
- Establishing a robust aftercare plan, including ongoing therapy, support groups, and relapse prevention strategies, is vital for sustained recovery. The Substance Abuse and Mental Health Services Administrationcan be of great assistance to ensure a lasting recovery.
What Should Someone Do if They Suspect a Loved One Is Using Heroin?
It is imperative that a person who uses heroin gets help immediately for the addiction. Heroin use will cause permanent, lifelong damage if it is not stopped quickly. Although it is a highly addictive substance, it is possible to achieve and maintain sobriety with detox, rehab, and aftercare programs.
Loved ones need to educate themselves on the physical and mental health processes involved in the disease of drug addiction. Speaking to an experienced drug addiction counselor on how to communicate with an addicted loved one can also give someone the tools they need to talk to a loved one about getting help.
Even if a loved one is not ready to go to treatment, attending addiction counseling as a friend or family member of an addicted person can offer some relief and support for this challenging situation.
Are you concerned about a family member or friend’s drug use? The counselors at Zinnia Health have helped hundreds of concerned family members find encouragement and support for these situations. Contact Zinnia Health at (855) 430-9439 today to learn more about addiction counseling and rehabilitation.
Citations
- https://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1953-01-01_2_page004.html
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590096/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/
- https://nida.nih.gov/publications/drugfacts/prescription-opioids
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/
- https://www.webmd.com/mental-health/addiction/signs-of-drug-addiction
- https://nida.nih.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use
- https://www.webmd.com/mental-health/addiction/heroin-use
- https://www.medicalnewstoday.com/articles/heroin-heart-attack
- https://americanaddictioncenters.org/heroin-treatment/physical-dangers
- https://www.ncbi.nlm.nih.gov/books/NBK470309/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9180936/
- https://americanaddictioncenters.org/health-complications-addiction/reproduction
- https://www.ncbi.nlm.nih.gov/books/NBK459126/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714654/
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