Author: Ruben Bermea, LPC

The harrowing effects of heroin use and addiction make this opioid one of the most concerning substances available in illicit markets. Known for its role in the deadly opioid overdose crisis, heroin use continues in communities around the world.¹ Due to its lack of medical value and a high potential for addiction, the United States Drug Enforcement Agency has classified heroin as a Schedule I narcotic, the highest and most restrictive classification of narcotic substances.²

Heroin use can cause many serious side effects, both short– and long-term, including the risk of overdose and addiction. The sooner you seek treatment for heroin use, the less likely you are to experience lasting effects on your physical and mental health.

Effects of Heroin Use

Heroin is an illegal opioid drug and central nervous system (CNS) depressant that’s about three times more potent than morphine, an opioid painkiller. It binds with the opioid receptors in your brain and produces a myriad of effects. Heroin use causes short-term effects like slowed breathing and heart rate and long-term effects like collapsed veins and liver damage.^2,3

Short-Term Side Effects

Short-term side effects of heroin use include:^2,3

• Pin-point pupils
• Drowsiness lasting hours
• Impaired mental functioning
• Problems urinating
• Itchiness
• Dry mouth
• Nausea
• Constipation
• Vomiting
• Reduced heart rate
• Slow breathing
• Heavy limbs

These heroin side effects can become dangerous and have long-term consequences, especially if your breathing becomes dangerously labored. Difficulty breathing can cause you to go into a coma or develop lasting brain damage from lack of oxygen.³

Heroin Overdose Risk and Effects

The most dangerous short-term effect of heroin is potential overdose, which occurs when someone has used a toxic amount of heroin that the body cannot handle. Heroin overdoses can be fatal or non-fatal, but even non-fatal overdoses can have long-term consequences on a person’s health.

Signs of a heroin overdose include:⁴

• Paleness
• Purple or blue lips and fingernails
• Limp legs and arms
• Unconsciousness
• Pinpoint pupils
• Slow or shallow breathing
• Faint heartbeat
• Vomiting
• Inability to speak

Using heroin with other CNS depressants, such as alcohol, benzodiazepines, barbiturates, and prescription opioids, can increase your risk of overdosing. Additionally, going through heroin withdrawal may increase your risk of overdose due to decreased tolerance. If you return to the same heroin dose you were previously using, your body may no longer be accustomed to that amount and it could result in a heroin overdose.

If you suspect that you or someone you know has overdosed on heroin, call 911 immediately. Depressed breathing can lead to hypoxia, a condition in which a person’s brain is not receiving enough oxygen. Hypoxia can cause permanent brain damage. Responding quickly to a heroin overdose can save someone’s life and potentially limit long-term damage from a heroin overdose.

Naloxone to Reverse the Effects of Heroin Overdose

If you have naloxone on you, administer it to the overdosing person immediately. Naloxone, which is sold under the brand name Narcan, is an opioid overdose antidote that rapidly reverses the effects of a heroin overdose.⁴

Narcan binds to opioid receptors to block heroin’s effects at the receptor site. Narcan comes as a nasal spray formulation so laypeople can easily administer naloxone at home or in the community. However, you should still seek emergency medical treatment since the life-saving effects of naloxone are only temporary.⁴

Signs of Heroin Intoxication

People misuse heroin for its relaxing and euphoric effects. Signs of heroin intoxication may include:^2,3,4

• Reduced sensitivity to pain
• An initial” rush” of pleasure
• Feeling peaceful and relaxed
• Slurred speech
• “Nodding” off to sleep while awake
• Impaired judgment
• Movement changes
• Apathy
• Feelings of unease or dissatisfaction
• Memory problems
• Reduced attention span

If you are concerned that someone you care about is using heroin, call our helpline at 800-934-1582(Who Answers?) to find a rehab that can help them stop using heroin.

Long-Term Side Effects

Chronic heroin use can lead to many long-term effects that are harmful to a person’s physical and mental health. Many of these long-term effects of heroin use depend on the method of administration, such as injecting or snorting.
Injecting heroin without sterile needles can increase the likelihood of becoming exposed to blood borne-illnesses, such as HIV and hepatitis.2 Snorting heroin can cause damage to your nose and the mucous membranes inside, sometimes causing holes, or perforations, to develop in your septum.⁵

Other long-term effects of heroin may include:^2,3,5

• Liver damage
• Kidney disease
• Pneumonia
• Skin infections
• Collapsed veins
• Infection of heart valves and lining
• Abscesses, or pus build-up
• Risk-taking behavior
• Mental health conditions
• Insomnia
• Sexual dysfunction
• Irregular menses

Heroin purchased from illicit sources can contain contaminants that may lead to further health complications.3 People who sell heroin may cut this illicit opioid with other substances or materials to increase profits. If a contaminant does not dissolve easily, it may cause blockages in your veins when injected. Other toxic drugs, such as fentanyl, may amplify the potency of heroin, raising the risk of adverse effects, including overdose.³

One of the most concerning long-term effects of heroin use is addiction or opioid use disorder.⁵

Chronic Heroin Use Can Lead to Addiction

Heroin addiction, also known as an opioid use disorder, is a chronic, relapsing condition characterized by uncontrollable heroin use regardless of negative effects on your life. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) describes the criteria for an opioid use disorder, which can range from mild to severe.⁵

Common signs of a heroin addiction include:⁵

• Cravings or urges to use heroin
• Taking more heroin for longer periods of time than you intended
• Failing to stop, cut down, or otherwise control your use
• Spending a large amount of time obtaining and using heroin
• Disengaging from important life activities because of heroin use
• Using heroin despite the damage it causes to your health
• Failing to meet responsibilities due to heroin side effects or use
• Experiencing relationship problems due to heroin use
• Using heroin in physically dangerous situations

Though these signs can indicate a heroin addiction, it’s important to remember that only a licensed treatment professional can diagnose an opioid use disorder. Treatment providers can then refer you to a treatment program that best suits your needs. If you need help finding a rehab, give us a call at 800-934-1582(Who Answers?) to speak to a treatment support specialist.

Resources

1. National Institute on Drug Abuse. (2021, March 11). Opioid Overdose Crisis.
2. Ciulla-Bohling, R. (2020). Heroin. Salem Press Encyclopedia of Health.
3. National Institute on Drug Abuse. (2021). Heroin DrugFacts.
4. National Institute on Drug Abuse. (2021). Naloxone DrugFacts.
5. American Psychiatric Association. (2013). Substance-related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).