Heroin Addiction, Health Effects, & Treatment

Heroin is a powerfully addictive and dangerous opioid drug.1 In addition to life-threatening overdose, heroin use is associated with serious physical and mental health problems.
Understanding Heroin

What is Heroin?

Heroin is an opioid that is derived from the opium poppy plant. Heroin elicits a powerful euphoric “high,” which can promote misuse and eventually lead to addiction.1

Heroin is classified as a Schedule I substance by the Drug Enforcement Administration (DEA), meaning it has a high abuse potential and no recognized medical benefits.

Is Heroin Addictive?

When opioids like heroin are used in high enough doses, they increase the dopamine activity in the brain. This helps produce the euphoric high, and also reinforces repeated drug use.3, 4

A person who regularly uses heroin will often develop a tolerance, meaning that they need higher and/or more frequent doses of the drug to feel the desired effects. Continuing to increase the amount of heroin just to feel its effects may lead to a life-threatening overdose as well as physiological dependence.

Dependence makes it especially difficult to quit, since the associated withdrawal symptoms are often painful and unpleasant. Experiencing heroin withdrawal often leads to relapse, since symptoms are minimized or disappear completely by taking heroin or another opioid.

A person who can no longer control their heroin use and subsequently experiences negative impacts in major areas of their life, such as school, work, or family life because of their drug use has developed an opioid use disorder, a chronic brain illness marked by a pattern of compulsive opioid use that leads to significant impairment and distress that may require medication and therapy to treat.5

In addition to the properties and subjective effects of heroin, other risk factors may contribute to the development of OUD. These factors include:6

  • Genetic predisposition.
  • Experiencing trauma, especially at a young age.
  • Presence of co-occurring mental health disorders.
  • Use of drugs at a young age.

How Common Is Heroin Addiction?

heroinAccording to data compiled in 2019, 438,000 Americans 12 years old or older met the criteria for heroin use disorder that year.7

Of the 2.1% (5.7 million) of Americans 12 years old or older that have used heroin in their lifetime:7

  • 7 million have administered heroin with a needle.
  • 6 million have smoked heroin.
  • 7 million have snorted heroin.

In 2019 alone, 745,000 (0.3%) Americans 12 years old or older used heroin.7

In that same year, 14,019 Americans died of a heroin-involved overdose.8

Health Risks

What are the Health Effects of Heroin?

When someone uses heroin, it is quickly converted to morphine and binds with opioid receptors. People report feeling an immediate pleasurable “rush” of euphoria and a warm flushing of the skin, dry mouth, and a heavy feeling in the arms and legs. This feeling may also be accompanied by other undesirable effects, like nausea, vomiting, and itching.9

Once the immediate sensation wears off, people may feel the following effects for several hours:9

  • Drowsiness.
  • Brain fog.
  • Decreased heartrate.
  • Slowed breathing.

Heroin’s depressive effect on the respiratory system may be serious enough to be fatal in some instances; a person may stop breathing completely. Reduced oxygen to the brain can also cause permanent brain damage.9

Heroin is sometimes cut with fentanyl, a very potent synthetic opioid that greatly increases the risk of overdose. The number of opioid overdoses that involved fentanyl multiplied nearly 12 times between 2013 and 2019.10

Long-Term Health Risks of Heroin Addiction

Prolonged use of heroin causes many serious negative effects on the brain and body.

Common physical effects of repeated heroin use include:11

  • Insomnia.
  • Constipation.
  • Pneumonia and tuberculosis may result from depressed respiration.
  • Mood disorders such as depression or antisocial personality disorder.
  • Sexual dysfunction in men.
  • Irregular menstruation cycles in women.

Repeatedly snorting heroin can damage nasal tissue and perforate the nasal septum.11

Prolonged needle drug use can also cause:11

  • Scarred and collapsed veins.
  • Abscesses.
  • Clogged blood vessels.
  • Arthritis caused by immune reactions to contaminants that may be present.
  • Bacterial infections in blood vessels or heart valves.
  • Infectious diseases such as HIV/AIDS and hepatitis B and C caused by shared needles.

In the brain, chronic heroin use causes hormonal and neuronal changes that are difficult to reverse. It can also have a deteriorative effect on the white matter in the brain, which researchers believe may affect the person’s judgement, behavior, and stress responses.5

Heroin use may also lead to opioid use disorder, also known as heroin or opioid addiction. Those who smoke or inject heroin are at increased risk of addiction, because those two routes of administration allow the drug to reach the brain the fastest.5

Signs of Addiction

What are the Signs of Heroin Addiction?

Opioid use disorder (OUD) is a is a treatable chronic disease that causes someone to compulsively use and seek heroin despite grave consequences. When diagnosing opioid addiction, medical professionals use the criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).12

Two or more of the 11 DSM-5 criteria experienced within a year can result in an OUD diagnosis. These criteria include:12

  1. Having a persistent desire to quit or reduce opioid use, but being unable to do so. They also may have tried to cease or reduce opioid use unsuccessfully.
  2. Often using opioids more often or in larger amounts than intended.
  3. Spending lots of time seeking opioids, using opioids, or recovering from opioid use.
  4. Feeling a strong craving to use opioids.
  5. Consistently failing to meet obligations to school, family, or their occupation due to opioid use.
  6. Continuing to use opioids despite problems in their home, school, or work life caused or worsened by opioid use.
  7. Giving up on or reduce social activities to use opioids.
  8. Using opioids in situations where it is dangerous to do so (e.g., while driving).
  9. Continuing to use opioids despite knowing they have physical or mental health conditions that are worsened by or caused by their opioid use.
  10. Having developed a tolerance of opioids.
  11. Suffering withdrawal symptoms when they don’t use opioids or continng to use opioids just to avoid withdrawal.

What are the Signs of a Heroin Overdose?

Opioids, including heroin, are involved in more fatal overdoses in the United States than any other class of drugs.8 Signs of an opioid overdose include:13

  • Constricted (“pinpoint”) pupils.
  • Pale, blue, or cold skin.
  • Vomiting and/or choking/gurgling sounds.
  • Loss of consciousness or falling asleep.
  • Limp body.
  • Shallow, slow, or stopped breathing.
Detox & Treatment

How Do You Treat Heroin Addiction?

Methods of effective addiction treatment vary greatly between patients, since addiction recovery is a highly individualized process. However, there are evidence-based approaches that can help to successfully manage addiction and promote recovery from a heroin use disorder.14

Treatment typically involves detoxification, followed by rehabilitation, which is then followed by aftercare.14

What are the Symptoms of Heroin Withdrawal?

People who chronically misuse heroin can quickly develop an opioid dependence.1 The severity of withdrawal hinges on many variables, such as the patient’s general health, for how long and to what degree they’ve been misusing heroin, and more. Common heroin withdrawal symptoms include:15

  • Rapid heart rate.
  • High blood pressure.
  • Insomnia.
  • Perspiration.
  • Anxiety.
  • Muscle spasms.
  • Stomach aches.
  • Diarrhea.
  • Muscle aches.
  • Nausea.
  • Vomiting.

Though heroin withdrawal is rarely life threatening, it can be painful and highly uncomfortable. Medically supervised detox can make the process less unpleasant.15

How Long does Heroin Withdrawal Last?

Heroin withdrawal usually begins between 8 and 12 hours after the last dose and eases in 3 to 5 days. Sometimes certain symptoms may linger.15

Like the severity of withdrawal symptoms, people may be affected differently in terms of withdrawal timeline. Post-Acute Withdrawal Syndrome (PAWS) is common in people that give up opioids after chronic abuse. PAWS generally lasts weeks or months and may include the following symptoms:16

  • Problems with cognitive tasks.
  • Irritability.
  • Anxiety or depression.
  • Drug cravings.
  • Social problems.
  • Obsessive-compulsive behavior.

Detox and Treatment for Heroin Addiction

group of men in therapyAt a medical detox facility, patients can withdraw under the supervision of medical professionals who can monitor them for safety and comfort and administer medication to ease withdrawal symptoms and cravings.15

Buprenorphine or methadone are opioid agonists that do not elicit a high in people with a high opioid tolerance—are often administered both during and after detox. Other medications like clonidine and lofexidine that ease certain withdrawal symptoms may also be used.17, 18

Following rehab, it’s important to maintain a positive network of peers that is conducive to sobriety. For some, aftercare means temporarily staying at a sober-living facility, while others may begin attending weekly or other regularly attended meetings with a mutual help program, such as Narcotics Anonymous or SMART Recovery. Recovery is not something that is simply achieved but is a life-long process.

sunrise house building

If you or a loved one is struggling with heroin addiction, Sunrise House Treatment Center can help. Please reach out to an Admissions Navigator at to learn all about care at the facility, treatment options, and specialized treatment tracks.

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