The United States Drug Enforcement Administration (DEA) classifies heroin as a Schedule I drug. Schedule I drugs are the most dangerous of all substances listed by the DEA because they have a high potential for abuse and produce severe physiological and psychological side effects.
Despite the side effects, heroin continues to be abused. According to the National Institute on Drug Abuse (NIDA), in recent years, the incidence of heroin use has increased most in young adults aged between 18 and 25 years.
Right after taking it, heroin reaches the brain and produces feelings of euphoria—the characteristic “high” that users crave and one that motivates them to take more of the drug. Heroin affects almost major every organ of the body. Long-term heroin use damages the brain, kidneys, heart, lungs, and liver.
What are the side effects of heroin abuse?
The side effects of heroin abuse include:
- High degree of drug tolerance and drug dependence
- Infection of the heart lining and valves
- Collapsed veins
- Fatal overdose
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Short-Term Effects of Heroin
Immediate effects of heroin use include:
- Warm skin flush
- Dry mouth
- Feeling of heaviness in the extremities
- Fuzzy thinking
- Slow breathing
- Shallow heart rate
- Muscular weakness
The surge of euphoria is almost immediate, and its intensity depends on the quantity of the drug taken and the route of administration. Heroin is usually injected, inhaled, or smoked. According to this study, taking heroin intravenously delivers a large quantity of the drug directly to the blood of the user. Furthermore, this heroin reaches the brain quicker than when it is smoked or inhaled. When it is smoked or inhaled, it has to be filtered first by the lungs and/or kidneys before it can be absorbed by the brain.
The “high” is followed by warm flushes of the skin, dry mouth, a feeling of heaviness in the extremities, and fuzzy thinking. Some users also experience nausea, vomiting, and itches in the arms and legs. After the initial rush, the user slips into a state where he is alternately drowsy and awake. This “on the nod” state is also characterized by a shallow heart rate and slow breathing because heroin is a respiratory depressant that acts on the brainstem, a region that controls automatic physiological functions like breathing.
Sometimes, especially in the case of an overdose, breathing may even stop or slow down enough to induce coma or cause permanent brain damage. Taking heroin with alcohol or benzodiazepines (tranquilizers like Xanax and Valium) can turn fatal when breathing stops altogether.
Heroin intake is also known to numb pain in the short term by blocking the transmission of pain messages from the body to the brain through the spinal cord.
Long-Term Effects of Heroin
Some of the most severe long-term effects of heroin are the development of a high degree of drug tolerance and drug dependence.
Chronic users of heroin gradually become desensitized to the effects of small doses of the drug. They need progressively higher doses to achieve the same degree of high that they previously experienced with a lesser amount of the drug.
Increased drug tolerance is known to lead to fatal overdoses in chronic and long-time users.
The desire to experience the high of heroin and an aversion to go through the unpleasant withdrawal symptoms intensify compulsive drug-seeking behavior. Users feel “compelled” to seek and take heroin even if they are aware of its adverse side effects.
How Heroin Affects the Brain
Chronic heroin abuse causes damage to the medial temporal lobe, which results in rapid brain aging. Prolonged use of heroin can cause cognitive functional deficiencies, depression, anti-social personality disorder, and irrational thinking.
Heroin dependence is the result of the drug’s actions on the brain. Heroin is known to alter brain chemistry and functionality.
Heroin damages the prefrontal cortex (PFC) region of the brain. This region is involved in logical thinking, judgment, planning, impulse control, and other executive functions. Damage to this region impairs a person’s ability to think rationally and regulate his impulses based on his judgments. So, chronic users who are aware of the long-term and harmful effects of heroin still find themselves engaging in drug-seeking behavior.
Damage to the PFC region of the brain also impairs cognitive abilities. According to these research findings, chronic heroin use leads to deficits in cognitive skills like verbal fluency, pattern recognition, and the ability to control and shift attention from one task to another. Heroin users have clouded thinking and hence, are unable to perform tasks or hold on to jobs that demand higher-level cognitive abilities.
Chronic heroin abuse accelerates brain aging by damaging the PFC and the medial temporal lobe (MTL). These two regions of the brain are associated with the aging process. Even young heroin users exhibit deficits in cognitive functionalities like performing memory-related tasks that are usually associated with aging.
Heroin users often experience depression when the initial feelings of euphoria die down after the effects of the drug wear off or during a period of abstinence.
Chronic heroin abuse increases the risk of developing anti-social personality disorder. Damage to the PFC region of the brain impairs the ability to think rationally and control impulses. This makes a heroin user prone to anti-social behavior.
We also suggest to check out this video from CNN on how does your brain react to heroin:
The Physiological Effects of Heroin
Chronic heroin abuse damages every major organ of the body by accelerating the aging process at the cellular level:
- According to this study, after incidences of overdose, immunological conditions like liver and heart diseases are the second and third most significant causes of heroin-related mortality. In fact, the prevalence of these two conditions is significantly greater in people who abuse heroin than non-users.
- Heroin abuse is known to induce stress by raising the level of the stress hormone cortisol, according to this study. This study reports that heroin users are more vulnerable to stress than the general populace, and they react to stress by taking more of the drug. This increases stress, and thus begins a vicious cycle.
- The findings from various studies indicate that chronic heroin abuse damages the liver and the heart. For instance, this study conducted amongst intravenous heroin addicts shows that prolonged use of the drug damages the liver. It is also worth noting that the National Institute on Drug Abuse reports that heroin users who share needles are at an increased risk of contracting hepatitis B and C infections. The presence of chronic hepatitis increases the risk of developing cirrhosis and other liver diseases in heroin users.
- Chronic heroin use can cause abnormal heart rhythms and pulmonary edema, the latter being a condition where fluid accumulates in the lungs and causes shortness of breath. Heroin abuse also impairs cardiac functionality.
- Chronic heroin abuse is associated with severe kidney damage. Heroin users have three times more risk of kidney dysfunction than non-drug users. Taking heroin for even a few months can impair kidney functionality. Chronic heroin usage is associated with hypertension, a risk factor for kidney disease. This report by PubMed suggests that even a single exposure to heroin can trigger acute kidney damage that is severe enough to require dialysis.
- Although rare, but one reason for acute renal failure requiring dialysis or kidney transplant in heroin addicts is rhabdomyolysis. Rhabdomyolysis is a condition where muscle tissues break down and release certain substances into the bloodstream that damage the kidneys. Heroin overdose may cause rhabdomyolysis.
Long-Term Effects of Heroin on Bone and Teeth
Although not as widely reported as damage to the brain and other major organs of the body, the effects of heroin abuse on bone and dental health are still serious. According to this study, chronic heroin use can decrease bone mass and make bones brittle.
This PubMed report highlights the long-term effects of heroin abuse on oral and dental health. Chronic heroin users tend to exhibit more decayed, missing, filled teeth, and a greater incidence of dental caries and periodontal problems than the general population. This could be due to poor oral hygiene and/or chronic malnourishment.
It is also believed that because heroin dulls the sensation of pain, users tend to ignore the telltale signs of dental decay. Heroin reduces the production of saliva (the dry mouth symptom). Saliva is known to protect against dental decay and periodontal problems.
Long-Term Effects of Heroin Depending on the Route of Administration
It may not be widely known, but long-term heroin usage causes some unique side effects depending on how the drug is taken.
Many heroin users inject the drug because this method produces an almost instantaneous and intense high. But according to NIDA, sharing needles and other injection paraphernalia transmits body fluids, and this can cause hepatitis B and C, HIV, and many other blood-borne diseases. Users might then unknowingly pass on these infections to their sexual partners and children.
NIDA has published some grave statistics: injection drug users constitute a staggering 53 percent of hepatitis C infection cases reported in the U.S. in 2010. About 20 percent of hepatitis B infection cases are found amongst injection drug users.
Injecting heroin can also cause scarred and/or collapsed veins at the site of administration, boils, and a host of soft-tissue infections.
Often the heroin sold on the streets is adulterated and the contaminants can cause bacterial infection in the blood vessels and heart lining and valves. Sometimes these adulterants are not readily dissolved; these can then go on to clog the blood vessels of major organs, resulting in severe damage often with fatal consequences.
Many heroin users, especially those who are aware of the risks that come with injecting the drug, smoke it. But this route of administration too is not without its risks. Smoking heroin can damage the lungs and increase the risk of developing respiratory diseases like bronchitis and pneumonia. Heroin use depresses respiration and increases the risk of tuberculosis.
Snorting heroin, on the other hand, damages the mucosal tissue in the nose and can even rupture the nasal septum, which is the tissue that separates the two nasal pathways.
Effects of Heroin on Pregnant Women and the Fetus
According to this PubMed report, about 90 percent of all women who abuse drugs in the U.S. are in the reproductive age bracket. Heroin is a much-abused drug in this group of women.
Pregnant women who abuse heroin tend to exhibit poor obstetric history characterized by inadequate prenatal care, nutritional deficiency, positive HIV serology test, infection, and pre-eclampsia, which is a potentially dangerous pregnancy complication that can damage vital organs of the mother and sometimes necessitate pre-term delivery. Heroin abuse also increases the risk of developing antepartum hemorrhage or genital bleeding, which is one of the significant causes of perinatal and maternal morbidity and mortality.
Heroin metabolites pass through the placenta and are absorbed by fetal tissues. Pregnant women who abuse heroin increase the chances of their baby being born already physically dependent on heroin. This condition, called neonatal abstinence syndrome (NAS), triggers symptoms like fever, seizures, excessive crying, irritability, diarrhea, vomiting, tremors, and low birth weight, the latter being a primary risk factor for developmental delays later in life. A severe onset of NAS can also lead to sudden infant death syndrome. NAS requires the baby to be hospitalized. The outcome is usually favorable, and the infant becomes drug-free.
But the long-term effects of prenatal exposure to heroin may continue through childhood and into adolescence.
Long-Term Effects of Heroin Abuse on Children and Teens
According to this report, prenatal exposure to heroin can damage the central nervous system (CNS) of the fetus, the effects of which can last through the infant, childhood, and adolescence stages.
CNS damage usually manifests as behavioral complications. The study mentions that children who were exposed to heroin in utero are more likely to develop ADHD and/or other disruptive behavioral patterns than children of non-drug using mothers. Heroin-exposed children with behavioral complications usually cannot function in society as responsible adults, hold on to jobs, or form meaningful, nurturing relationships.
Prenatal exposure to heroin also increases the risk of cognitive deficits in children. These children may exhibit low verbal skills and impaired reading and arithmetic abilities. The lack of these skills affects the academic potential of children and teens, which in turn, reduces their chances of thriving and prospering in their chosen vocations.
Children born to mothers who abuse heroin also face developmental and adjustment challenges in indirect ways. Women who abuse heroin may falter as caregivers. Additionally, their drug-seeking and drug-trading activities may expose the children to high-risk environments and even, violence. Heroin-abusing mothers may often suffer from psychopathological conditions and lead chaotic lives.
Along with cognitive and learning difficulties, these maternal and environmental factors add to the stress levels of children and teens. This increases their risks of abusing drugs themselves, psychopathology, and committing crimes.
Chronic heroin abuse not only damages the brain and the vital organs of the body but also wastes talent, kills potential, and stifles lives and relationships.