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Side Effects of Heroin Abuse

a person sits on the floor with their head on their knees

A lingering danger during the country’s current opioid epidemic is heroin. Often, those who abuse opioid painkillers will eventually turn to heroin when they have run out of other options. The difference here is that heroin can only be acquired by illegal means, which adds another level of danger to this potent drug. Just like its other opioid counterparts, heroin is highly addictive and can lead to a number of physical, mental, and social issues if a person uses the drug continuously for a period of time. In this post, we’ll go over the many potential side effects of heroin abuse.

What Is Heroin

Heroin is a modified version of morphine, that will typically be found in a white powder form. However, heroin can often be mixed with other substances, which will sometimes give the powder a yellow or brownish color. Sometimes, it may even be black (black tar heroin). Heroin can be injected, smoked, or snorted, and will have a fast and dramatic effect on the user regardless of how it is taken. Because of how fast the drug acts, and how intense its effect on the body and mind can be, heroin is an extremely harmful and dangerous substance. Unfortunately, these factors are also what makes the drug so addictive.

How Harmful Is Heroin?

The level of harm heroin can cause a person will largely depend on their length and volume of usage. The prolonged abuse of heroin can cause serious physical and mental health issues, which may have some associated trickle-down side effects. Beyond its effects on a person’s mind and body, heroin abuse can also have several social and legal ramifications. It should also be noted that heroin comes with an extremely high risk of overdose. Because heroin is a street drug, there is no standard process by which the drug is created. It can be mixed with other substances and will vary widely in potency. Anyone, no matter their history with heroin or tolerance, is at risk for overdose any time they use, simply because there is often no way to know what you are putting into your body and how it will react. In fact, heroin is the main culprit when it comes to opioid deaths caused by overdose. Opioid abusers are often led to try heroin when they can no longer acquire their prescription drugs, or because they have built up such a high tolerance that they need something stronger to achieve the euphoric high opioids produce. Once heroin becomes their drug of choice, it will be difficult for them to go back to anything else that could compete with its intense high, paired with how readily available the substance has become, as well as the fact that heroin is relatively cheap to acquire. This all adds up to an extremely dangerous substance, that comes with the risk of death, as well as a host of other more minor side effects.

The Heroin High

Heroin is popular because of the intense, euphoric high it produces. The drug creates these feelings by binding to opioid receptors in the user’s body. This causes the affected nerve cells to release a neurotransmitter called dopamine, which regulates a person’s feelings of pleasure and reward. When a person takes heroin, they get a rush of dopamine in their body, which is what gives them the intense feeling of euphoria. This is how addiction starts and grows because the user will want to repeat the behavior to achieve the same sensation. While the euphoric high is the first main effect of heroin use, there are some other short-term effects that often come with a dose of heroin. Short-term effects will differ depending on how the person ingested the drug, but for the most part, they will feel warm and flushed during the dopamine rush an odd sensation of their extremities feeling heavy, as well as dry mouth. They may experience a few other pain-relieving and minor depressant effects. These may include a reduced sensation of pain, and a general drowsiness, sedation, and lethargy. The user may also “nod off” and rotate through being awake and asleep during their high. Another reason heroin is so highly addictive is that the dopamine rush and its associated feelings will only last for a few minutes, while the sedative effects may last for up to a few hours. The duration of the effects will depend on their method of ingestion, as well as the purity and dose of the drug. Of course, there are some negative side effects associated with the use of heroin as well.

Short-term Side Effects of Heroin Abuse

Once the initial effects of euphoria wear off, the user will still feel drowsy for several hours. This period can come with some much less enjoyable side effects, from minor nuisances to more difficult to deal with, and even some serious health risks. These side effects occur when the body adapts to the heroin in its system, attempting to counterbalance its effects and restore the affected parts of the body to their normal functions. These side effects may initially manifest as dry mouth, nausea, vomiting, and some severe itching. The person will feel groggy and be in a general haze, with slowed mental function putting them in a state of confusion. They are also likely to have constricted pupils that will make them extremely sensitive to light. Those are the easy/minor symptoms. However, the short-term side effects of heroin can be much more serious. Heroin also causes the body to lose temperature and slows the user’s heart rate. Their breathing may slow enough to become life-threatening or lead to coma and permanent brain damage. And of course, there is the risk for overdose. While death might not seem like a short-term effect, it is actually both. A heroin dose is impossible to measure because of the vast differences in purity, meaning it is never safe to use heroin. Long-time and first-time users alike overdose. It is certainly a substance best avoided altogether. The short-term side effects can be compounded if the person is using other substances along with heroin, especially other depressants like alcohol or other opioids. When combined, the user is at a very high risk for overdose, as the other more dangerous side effects will be compounded. Using substances in addition to heroin will cause dangerously slow breathing, a lack of oxygen in the brain, and more serious heart problems.

Long-term Side Effects of Heroin Abuse

Prolonged abuse of heroin will come with a long list of potential harmful side effects, many of which can have lasting consequences.

Addiction & Withdrawal

As we’ve mentioned, heroin is a highly addictive substance because of the quick, intense high it produces, coupled with how quickly the drug wears off. When a user loses their high, some of the negative short-term side effects we listed above start to creep in, leading them to use again to feel better. As the cycle continues the user will develop an addiction. Heroin is extremely addictive no matter how it is taken, but injection and smoking are the riskiest methods because of how quickly the drug reaches and affects the brain. Generally, once a person develops an addiction to heroin, it will take over their life — finding and using more of the drug will become their primary purpose, and all other responsibilities will be set aside. As the person uses more heroin, they will quickly develop a tolerance to the drug, as well as a physical dependence. This will require them to get more of the drug and use it more often to achieve the same effects. Their body adapts to the presence of heroin and will attempt to compensate. This is one of the most dangerous aspects of heroin abuse, especially because a user can become physically dependent in such a short period of time. Because their body has become so accustomed to having heroin in its system, they will feel nauseous and generally uncomfortable without it. When a person who has reached this level of abuse attempts to quit and suddenly stops taking heroin, they will encounter withdrawal. Withdrawal and detox can be very difficult for a long-time heroin abuser, and may set in as quickly as a few hours after the last time they take the drug. The symptoms often closely mimic flu symptoms, but can be much more severe. The user may encounter withdrawal symptoms such as restlessness, discomfort, anxiety, insomnia, a pounding or racing heartbeat, muscle and bone aches and pains, cold flashes with goosebumps, uncontrollable shaking and body tremors, sweating, diarrhea, and vomiting. These symptoms will peak within 24 to 48 hours after the person’s last dose and should lessen and go away in about a week. However, some users may have persistent withdrawal symptoms for months.

Physical Side Effects of Long-term Heroin Abuse

The physical side effects a heroin abuser can expect to see will vary from person to person depending on their length of usage and abuse, the volume and potency of heroin they were taking, if they were taking any other substances at the same time, and their individual make-up. However, the severity of symptoms they experience is closely connected to how long they abused the drug. The longer the abuse — the worse the symptoms. Those people who use heroin over an extended period of time can expect to see some changes to their physical appearance, as well as many ongoing harmful effects happening beneath the surface. Heroin abusers often suffer from poor dental health as their usage worsens, including damaged teeth and swollen gums. This is in part directly to the chemicals in the drug, but also because personal grooming will no longer be a priority. Their heroin use may also give them a poor appetite and a malnourished appearance.  Long-term abuse will cause the user’s muscles to weaken and keep them in a general sedated state. Because heroin can cause a user’s skin to itch, prolonged use can cause damaged skin due to excessive scratching. Pustules may also appear on the person’s skin, often on the face. Heroin abusers will often encounter insomnia as well as severe constipation, and will often experience sexual side effects, including impotence and the inability to achieve orgasm. The presence of heroin can also disrupt the female menstrual cycle. Other physical side effects can be much more destructive to the body. A person who frequently injects the drug may cause their veins to collapse, which can then lead to infections in their blood vessels and heart valves. They may encounter arthritis and tuberculosis because of the poor condition of their body. Bacterial infections are also common, as well as skin disease and abscesses around injection sites. Pregnant women are at high risk for miscarriage, as well as placing their child at risk for a communicable disease, in addition to being addicted to heroin from birth. The list of potential major-risk side effects is long but includes:

  • Liver disease
  • Infections of the valves and lining of the heart
  • HIV or Hepatitis B and C
  • Chronic pneumonia
  • Blood clots, leading to stroke, pulmonary embolism, and heart attack
  • Kidney disease
  • Risks of contracting chronic illnesses
  • Risks for blood-borne pathogens
  • Septicemia
  • Respiratory depression
  • Seizures
  • Overdose
  • Death

Mental Health Concerns

The prolonged abuse of heroin will change the physical structure and physiology of the user’s brain. This can cause long-term imbalances in their nervous system that may not ever return all the way back to normal. Heroin can deteriorate the brain’s white matter, which can have an effect on the person’s decision-making abilities, behavior, and response to stressful situations. Other mental health concerns include:  

  • Loss of memory and intellectual performance
  • Introversion
  • Depression
  • Anxiety

Co-occurring Disorders

A number of other mental illnesses and health conditions may co-occur with heroin abuse. These may include:

  • Bipolar disorder
  • Schizophrenia
  • Eating disorders
  • Post-traumatic stress disorder (PTSD)
  • Personality disorders
  • Other substance addictions, including alcoholism

Since heroin users often share needles, they put themselves at risk for developing AIDS and other infections, such as liver disease. Beyond health concerns, heroin abuse also causes side effects to the user’s personal life, including their finances, relationships with family and friends, trouble at school or their job, and of course, potential legal consequences from using the illegal drug.


This list barely scratches the surface of the many potentially damaging side effects of heroin abuse. It is a drug that wreaks absolute havoc on a person’s system, creating a ripple effect from their appearance to their physical and mental health, all the way down to their personal and professional lives. If you or a loved one is experiencing any side effects of heroin abuse or is suffering from heroin addiction, our heroin treatment center is here to help. Seek treatment today.

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