Heroin is an addictive, Schedule I narcotic drug synthetized from the opium poppy. The drug was initially created in 1874 to be a safer, less addictive alternative to morphine; however, it became illegal in 1914 in the United States after an epidemic of prescription abuse swept the country because heroin is so potent.

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Health Risks of Long-Term Heroin Abuse

  • Brain State Changes and Mental Health
  • Tolerance and Dependence
  • Chronic Infections
  • Cardiovascular Problems

Most people who struggle with addiction to heroin use the drug intravenously, but it can also be sniffed, snorted, or smoked. The drug takes effect within a few minutes after ingestion and induces an intense high. Signs of heroin intoxication include euphoria, sleepiness, and reduced sensations of pain. One of the most common effects of heroin is “nodding,” or a rapid cycling through consciousness and unconsciousness as heroin causes intense relaxation and fatigue.

Since heroin is so strong, it can be very addictive. Many people believe that one dose is enough to get many people hooked. The growing problem of prescription painkiller addiction, involving related but legal prescription opioids like oxycodone and hydrocodone, has led to an increase in heroin addiction, overdose, and death in the United States since 2000.

Heroin addiction and abuse can cause many short-term problems, including an increased risk of death from overdose, but people who abuse the narcotic for a long time can also experience long-term, and potentially permanent, effects on their health.

Brain State Changes and Mental Health

Long-term abuse of heroin changes the physical composition of the brain – neurotransmitters, hormones, and the physical structure of specific areas. White matter deteriorates over time, potentially affected the ability to make decisions and regulate behavior (especially impulsiveness) as well as stress responses. The brain is also less able to form new memories and recall existing memories. The individual may experience mood swings, mood disorders like depression or anxiety, and a lack of emotion, or apathy. Sleep cycles could change, and insomnia could become a long-term problem.

Chronic heroin abuse can cause blood clots due to many risk factors, such as disease, collapsed veins, and infections in the heart. These clots can travel to the brain and lead to a stroke, which can permanently change physical characteristics of the brain; these brain state changes can change motor skills, personality, and more.

Tolerance and Dependence

Addiction is tied to physical dependence and tolerance on drugs, but these are not the same problems. Addiction is a chronic disease involving compulsive ingestion of intoxicating substances to release dopamine and change mood or behavior; tolerance and dependence can occur in some people who take medications or other drugs, without addiction occurring. Tolerance occurs when the body is used to receiving a specific dose of a substance, so the brain stops adjusting neurotransmitters or hormones over time, requiring more of the chemical to create the same effects. Dependence occurs when the body needs a drug to hit a “normal” level of functioning.

Heroin use can quickly lead to both dependence and tolerance, meaning people who struggle with addiction to heroin escalate how much they take, and how often they take it, over a short period of time. This is dangerous, as it can cause an overdose, and it can also lead to harmful changes in the body much faster than other drugs.

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Liver and Kidney Disease

The liver and kidneys process a lot of toxins out of the body. When toxins like heroin enter the bloodstream at a high volume, or over a long period of time, it becomes more difficult for the liver to process this drug out of the blood and for the kidneys to filter it out through urine. Additionally, blood clots caused by collapsed veins, damage to the heart valves, and changes to the blood can prevent blood flow to the liver and kidneys, leading to further damage. Pulmonary edema prevents blood from circulating effectively in the body, and a lack of oxygenated blood will cause the liver and kidneys to shut down.

Chronic Infections

People who inject heroin are at risk of collapsed veins and blood clots, as well as infections from sharing needles. These infections include hepatitis B and C and HIV/AIDS. Heroin can also lead to bacterial infections, depending on how it is abused; for example, injection sites can become infected, while snorting the drug can damage the nose, throat, and upper respiratory system, which can make those areas more susceptible to infectious diseases. Lung problems can lead to pneumonia or bronchitis. Heart valves can become infected, leading to cardiovascular damage; abscesses can develop as areas fill with bacteria and puss.

Cardiovascular Problems

Infections can make their way into the heart’s valves, changing how often the heart beats and how effectively the organ pumps blood. Endocarditis is an infection of the heart, leading to heart attack, blood clots, and other cardiovascular failures that can cause death. People who abuse heroin for a long time are 300 times more likely to die from endocarditis.

Additionally, a dose of heroin reduces blood pressure; over time, consistent dips in blood pressure can lead to heart failure. Pulmonary edema is swelling caused by the heart’s inability to pump blood from the legs and feet back up into the rest of the body and into the lungs to get oxygen. A buildup of blood around the lungs and heart that fails to circulate through the body can cause pressure on these organs, further preventing the heart from pumping effectively and causing the person to feel like they are unable to breathe.

Treatment Is Necessary

People who abuse heroin need help to avoid overdose and chronic health problems like heart, lung, liver, and kidney disease. Although withdrawal from heroin can be uncomfortable, it is not fatal, and with medical oversight, withdrawal symptoms can be managed so they are less intense. Once a person has detoxed from heroin, it is essential to enter a rehabilitation program to get therapy and social support to overcome the addiction.