Side Effects of Heroin

Reviewed by Dr. Michael McGee - Board Certified Physician in General Psychiatry, Addiction Psychiatry, and Psychosomatic Medicine.

Heroin increases dopamine release in the brain’s motivation center, called the Nucleus Accumbens. It also dulls the body’s perception of pain by stimulating the brain’s endorphin receptors. One of the “side effects” of heroin from these actions on the brain is to create a sense of “euphoria,” or intense happiness.

Last updated: June 1, 2018
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The impact is immediate – occurring within minutes of being injected or snorted – and users experience a “rush” sensation.

One of the biggest problems with any kind of drug that unnaturally produces dopamine and stimulates endorphin receptors is it artificial reward response to something unnecessary. What this means is, your brain needs natural rewards for fulfilling needs such as getting sleep, sex, food, and water. Heroin artificially stimulates the brain’s reward system the same as natural rewards do, but to a much greater extent.

This is how addiction develops; your brain begins to crave heroin in the same way a starving person craves food. Heroin alters the brain’s drive-reward system in ways that compel the victim of addiction, who is now “starving” for heroin, to continue to use it.

Short Term Effects of Heroin

The short term effects of heroin include:

  • Euphoria
  • Intense rush
  • Nausea
  • Vomiting
  • Depressed breathing
  • Heaviness in appendages
  • Dry mouth

In addition to these, another symptom is “nodding.” Nodding is a big part of the high from heroin, as the user alternates between alertness and lethargy. The result is heroin users typically “nod” forward before catching themselves.

As heroin is a depressant that can cause sleepiness, many people combine it with cocaine or methamphetamine (stimulants) to “balance” the effects.

Long Term Effects of Heroin

The long term effects of heroin differ depending on how users consume the drug. Many users start using heroin in its powdered form– an indicator that it’s in a more pure state. However, black tar heroin (a black, sticky substance that’s a result of impurities left behind in the process) needs to be dissolved or diluted and injected. Intravenous use of heroin can cause a host of other long-term effects, such as increased risk of contracting a disease like HIV and hepatitis, as well as infections such as endocarditis—an infection of the heart valves.

Some of the long term side effects of heroin are as follows:

  • Change in brain structure
  • Deterioration of white matter
  • Imbalance (physically and hormonally)
  • Inability to regulate behavior
  • Decreased ability to make rational decisions
  • Poor executive functioning (inability to reason, plan, problem-solve, or multitask)
  • Infectious disease (HIV, hepatitis B & C)
  • Collapsed veins
  • Bacterial infections (fungal endocarditis & venous sclerosis)
  • Infection of heart lining and valves
  • Arthritis
  • Rheumatologic problems
  • Abscesses (swollen tissue filled with pus)
  • Liver disease
  • Kidney disease
  • Risk of overdose

In addition to these long term consequences, it’s possible to be affected by myriad others due to the additives and drugs that may be added to heroin. And, while some of these effects are treatable others are not reversible.

The most severe side effect is overdose, which often leads to death. Overdose occurs because one of the depressant’s side effects is slowed or depressed respiration. It’s possible to develop a condition called hypoxia, which decreases the amount of oxygen reaching the brain. This can result in permanent brain damage, coma, and death.

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