What Are the Long Term Effects of Heroin?

There are numerous severe physical and mental side effects of heroin. 

While many people only associate heroin effects with illnesses related to unsafe injections, it’s important to consider the risks of other administration methods and health issues caused by the drug itself. 

This article touches on the side effects of heroin abuse, but its main focus is breaking down the drug’s long-term effects—physical and mental symptoms that could persist even after someone starts opioid treatment. We’ll provide a brief overview of the drug before exploring long-term effects of heroin on the body, long-term effects of heroin on the mind, impacts on babies of heroin users, and common signs of heroin addiction. 

What Is Heroin?

Heroin is an opioid drug derived from morphine, a naturally-occurring substance found in the seedpods of poppy plants. Heroin can take one of two physical forms:

1. A powder (typically white or brown)
2. A sticky substance (typically brown or black)

In many cases, heroin is mixed (“cut”) with other substances, like:

• Other drugs, including:
  • Fentanyl
  • Cocaine
  • Benzodiazepines
  • Quinine
• Harmful substances like:
  • Strychnine
  • Dyes
• Everyday ingredients, including:
  • Powdered milk
  • Starches
  • Sugar

Heroin is commonly injected into veins, but it can also be smoked or snorted through the nose. Because it’s an opioid, users can quickly build up a tolerance to heroin drug use, and it’s highly addictive. 

The Long-Term Physical Effects of Heroin

What are the effects of heroin? Let’s begin by breaking down some of the long-term physical heroin effects. 

Gastrointestinal (GI) Symptoms

While heroin use can cause nausea and vomiting in the short-term, gastrointestinal (GI) symptoms are common for long-term users, too—even during withdrawal and recovery. Over time, heroin can also cause constipation and stomach cramping. 

Medical experts recognize opioid-induced bowel dysfunction (OIBD) as one of the most common effects of heroin (and other opioid drugs), and it most commonly presents opioid-induced constipation (OIC).

Constipation might sound benign, but severe constipation can cause a host of additional health issues like:

• Stercoral colitis (fecal hardening that causes colon distention)
• Colon wall necrosis
• Colon ulcers
• Colon perforation (tearing)

Physical Intimacy Issues

Males chronically using opioids are more likely to present erectile dysfunction symptoms at younger ages. 

Current studies suggest that between 18 and 52% of opioid users experience some level of erectile dysfunction—and, unfortunately, these symptoms persist when former users switch to maintenance drugs like methadone and buprenorphine. 

Multiple studies also show that heroin (and opioids in general) can cause low sex drives in male and female users.^, 

Since heroin is a nervous system depressant, it significantly impacts users’ responses to both pain and pleasure. Nervous system suppression could be to blame for sexual dysfunction in heroin users. 

Physical Damage Related to Administration

Many negative effects of heroin are associated with administration methods—the different ways users introduce heroin into their system:

• Smoking heroin can cause lung damage and infections like pneumonia.

• Snorting heroin can severely damage sinus and nose tissues, potentially creating abscesses. 

• Injecting heroin can put users at a higher risk for numerous infectious diseases (which we’ll discuss in more detail below) and cause vein collapse—a condition called venous sclerosis.

Venous sclerosis is one of the most critical long-term effects of heroin. It can cause additional health issues like deep vein thrombosis and skin infections like cellulitis and abscesses. 

Severe Illnesses Related to Unsafe Injections

Injection drug users (including people who inject heroin) are at an increased risk for several blood-borne infections. Unsafe injections can increase heroin users’ risks of contracting:

• Hepatitis B and C – Both hepatitis B and hepatitis C are potentially fatal liver infections spread via blood contact. Hepatitis B typically subsides on its own, but it can cause long-term (chronic) infections. There are numerous treatments for hepatitis C, but the most common is an oral medication. Past patients of either strain can be reinfected—a major concern for repeat injection drug users. 

• Human Immunodeficiency Virus (HIV) – HIV is a blood-borne illness, and injection drug users are at significant risk of exposure via unsafe injection. Approximately one in ten new HIV diagnoses in the US are attributed to injection drug use, perhaps because HIV can survive in a used syringe for as long as 42 days. While there is currently no cure for HIV, people who contract the disease can take post-exposure prophylaxis (PEP) drugs to reduce their risk of transmitting the virus to someone else. 

• Endocarditis – Infective endocarditis (IE) is caused by a blood-borne bacteria called Methicillin-sensitive Staphylococcus aureus (MSSA). Injection drug users’ IE risks are amplified by potential HIV infections, which would suppress their immune systems. IE can be fatal if left untreated. 

The Long-Term Mental Effects of Heroin

What are the effects of heroin on users’ mental health and brain function? Four long-term mental effects may impact heroin use. 

Decreased Ability to Process New Information

One of the most salient long-term effects of heroin is its ability to decrease brain processing power—in both the short and long term. Why does heroin impact users’ abilities to process new information (or think critically)? 

• Drugs (heroin included) interfere with neurons and neurotransmitters—the parts of our brain that send and receive signals. 

• Some drugs (like heroin) closely mimic neurotransmitters in their chemical structure. So, they have the power to latch onto and activate neurons.

• While they might look like neurotransmitters, drugs don’t behave like neurotransmitters. Once they bind to and activate neurons, they can cause abnormal messaging that alters brain functions. 

• Heroin performs this exact task in the prefrontal cortex—the part of our brain partially dedicated to (among other things) thinking critically, solving problems, and processing new stimuli. 

Lower Impulse Control

Another one of the prefrontal cortex’s many roles is exerting self-control over impulses. Since heroin can interfere with neuron and neurotransmitter activity in the prefrontal cortex, it can also interfere with impulse control.

But signal disruption in the prefrontal cortex isn’t solely responsible for heroin users’ diminished impulse control. Heroin’s interference in the extended amygdala and the basal ganglia regions in the brain (both of which we’ll break down in more detail below) will also prevent heroin users from resisting impulses. 

Disruption of the Brain’s Reward Circuit

Heroin interferes with neuron and neurotransmitter function in the basal ganglia, the region responsible for:

• Motivation
• Forming habits and routines
• Inducing pleasurable effects of healthy activities like:
  • Sex
  • Socializing
  • Eating

These functions play a key role in the brain’s “reward circuit,” or the series of processes that motivates us to do things that feel pleasurable—signals in the reward circuit motivates us to perform actions that induce pleasure. 

Heroin can overwhelm the reward circuit, producing a deceptive euphoria. While heroin gives users a rush of pleasure, it also diminishes the sensitivity of the reward circuit, reducing its ability to send pleasure signals for anything except the presence of the drug. 

Simply put, heroin can retrain users’ brains to only produce “reward” signals while they’re using. 

Impacts on Stress Response

The extended amygdala helps humans manage feelings closely related to stress, including:¹⁶

• Anxiety
• Agitation
• Irritability

The euphoric state of a heroin high temporarily alleviates these emotions, which only makes the extended amygdala’s job harder—as it grows accustomed to relief, the amygdala becomes more sensitive to disruptions. 

The stress-inducing emotions above are some of the most common feelings heroin users experience during withdrawal. But since their extended amygdala functions are diminished, these feelings brought on by heroin withdrawal symptoms easily become unmanageable, producing a level of stress that can only (temporarily) be relieved by using again. 

The mental health effects of heroin described above paint a clear picture of why it’s so hard to recover from severe addictions. By disrupting key brain functions, heroin limits users’ abilities to think critically, resist cravings, and manage negative emotions associated with heroin withdrawal symptoms. 

The Long-Term Effects of Heroin on Babies

Heroin (or other opioid) use during pregnancy leads to significant impacts on babies. 

When people use heroin during pregnancy, the drug can pass through the placenta to the fetus, which may lead to it developing dependence even in utero. This can cause neonatal abstinence syndrome (NAS) once a baby is born. 

Symptoms of NAS include:

• Fever
• Excessive crying
• Slow weight gain
• Diarrhea and vomiting
• Irritability
• Seizures and tremors

NAS can be fatal. Luckily, it’s treatable—in a hospital setting, doctors can administer morphine, methadone, or buprenorphine to slowly wean babies off of opioids. Fortunately, this method often results in a full recovery. 

Signs of a Heroin Addiction

If you suspect that a loved one is suffering from heroin addiction, look for one or more common signs:

• Physical signs – Physical signs like drowsiness, loss or increase in appetite, significant weight loss or gain, small pupils, flu-like symptoms, or non-responsiveness could indicate a struggle with heroin use.

• Behavioral changes – Heroin users often self-isolate, stop engaging in their usual hobbies or activities, stop performing well (or at all) in school or at work, and experience frequent and severe mood swings.

• Evidence of using – You might come across physical evidence that someone you know is using heroin. Some examples include burnt spoons, discarded syringes, or bags with powder residue. If you notice medications, shoelaces, or spoons are missing, these could provide additional evidence that someone is using. 

Start Recovering from Heroin Addiction at Elevate Rehab

The long-term effects of heroin tend to be life-altering for people struggling with addiction—and, if they’re pregnant, their baby. But increased awareness of potential effects and the common signs of using can help you support a loved one struggling with heroin addiction. 

When it’s time to get help, and you’re looking for a heroin addiction treatment program, turn to Elevate Rehab’s California detox centers. We offer holistic rehab and recovery solutions that treat the whole person, not just their addiction. 

If you or a loved one are ready to rise above heroin addiction, contact us to start your recovery journey with the help of a heroin addiction treatment program. 

Sources: 

1. National Institute on Drug Abuse. Heroin DrugFacts. https://nida.nih.gov/publications/drugfacts/heroin 
2. Medline Plus. Heroin. https://medlineplus.gov/heroin.html 
3. US Drug Enforcement Agency. Heroin. https://www.getsmartaboutdrugs.gov/drugs/heroin 
4. Cureus Journal. A Local Epidemic of Laced Heroin Causing Skin Necrosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6666922/ 
5. New York City Department of Health. Heroin. https://www.nyc.gov/site/doh/health/health-topics/heroin.page 
6. Cureus Journal. Spontaneous Recurrent Pneumoperitoneum Due to Opioid-Induced Constipation: A Case Report. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303506/  
7. Journal of Addictive Diseases. Erectile Dysfunction in Opioid Users: Lack of Association with Serum Testosterone. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951625/ 
8. PLOS. Sexual Dysfunction Improved in Heroin-Dependent Men After Methadone Maintenance Treatment in Tianjin, China. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919724/ 
9. PLOS. Sexual Dysfunction in Heroin Dependents: A Comparison Between Methadone and Buprenorphine Maintenance Treatment. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0147852 
10. International Journal of Drug Policy. Fire in the Vein: Heroin Acidity and Its Proximal Effect on Users’ Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5152678/ 
11. US Centers for Disease Control and Prevention. People Who Use or Inject Drugs. https://www.cdc.gov/hepatitis/populations/idu.htm 
12. US Centers for Disease Control and Prevention. Viral Hepatitis – Hepatitis B. https://cdc.gov/hepatitis/hbv/bfaq.htm 
13. US Centers for Disease Control and Prevention. Viral Hepatitis – Hepatitis C. https://www.cdc.gov/hepatitis/hcv/cfaq.htm 
14. US Centers for Disease Control and Prevention. HIV and Injection Drug Use. https://www.cdc.gov/hiv/basics/hiv-transmission/injection-drug-use.html 
15. Journal of Community Hospital Internal Medicine Perspectives. Acute Endocarditis in Intravenous Drug Users: A Case Report and Literature Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714084/ 
16. National Institute on Drug Abuse. Drugs and the Brain. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain 
17. National Institute on Drug Abuse. How Does Heroin Use Affect Pregnant Women?. https://nida.nih.gov/publications/research-reports/heroin/how-does-heroin-abuse-affect-pregnant-women 
18. New York State Office of Addiction Services and Supports. Signs of Opioid Overdose.https://oasas.ny.gov/warning-signs