Medically Reviewed By: Kimberly Langdon M.D.
Even with the first use of heroin, there can be physical side effects of the drug. These can impact the person as quickly as 30 minutes after the initial high or “rush.”
Physical side effects of heroin abuse can vary by the type of heroin a person uses, the amount they use, the method of administration, and other factors.
The immediate side effects of heroin use are often perceived as pleasurable. Yet most physical side effects and effects on mental health are negative, uncomfortable, and may lead to more dangerous effects, such as lowered breathing rate and risk of overdose.
Immediate Physical Side Effects Of Heroin Use
Depending on the way a person uses heroin, they will typically feel its short-term effects right away, including some of the physical side effects.
The initial physical side effects of heroin can include:
- dry mouth
- warm flush
- heavy extremities
- itching
- nausea
- vomiting
Soon after these symptoms wear off a new set of side effects begins:
- drowsiness
- slowed heartbeat
- slowed breathing
- constipation
If respiratory function becomes depressed enough, it could lead to a coma or permanent brain damage.
Because withdrawal and cravings may begin as soon as heroin leaves your system, this can be a very unpleasant side effect.
Heroin withdrawal symptoms can include:
- nausea
- bone pain
- muscle spasms and cramping
- depression
Physical Effects Of Heroin By Method Of Administration
The physical side effects of heroin abuse can even change with how the drug is administered.
Heroin is typically thought of as injected, but it can be taken through other forms as well including snorting, smoking, and plugging (rectal administration).
Side Effects Of Injecting Heroin
When you inject heroin, the drug goes quickly to the brain and attaches to the opioid receptors. Heroin use by injection can lead to a number of side effects at the site of injection or associated with IV drug use.
Some of these include:
- risk of contracting infectious diseases: Hepatitis B, Hepatitis C, and HIV (from sharing heroin needles)
collapsed veins - other effects to the skin, such as scarring
- muscle tissue damage
- risk of infection at the injection site, or heroin abscesses
Side Effects Of Snorting Heroin
Snorting heroin is perceived as being less of a hassle because you need a syringe, but the immediate physical side effects can remain the same.
What does change is the amount of time it takes for the high to start. Also, the intensity and length of the high are less. For this reason, the side effects can seem less severe.
However, long-term side effects can include damage to the mucus membranes in the nose. Snorting heroin can also create small holes in the nasal septum.
Side Effects Of Smoking Heroin
Smoking heroin affects the brain nearly as quickly as injecting it does and the initial physical side effects can be very similar.
However, the long-term effects of smoking heroin can include damage to the lungs and chronic pneumonia.
Side Effects Of Plugging Heroin
Plugging heroin involves taking the drug rectally with a water solution. The short-term side effects can happen almost as quickly as smoking or injecting.
But the long-term problems caused by the drug remain the same. For example, heroin can affect the user’s nervous system creating damage to the brain’s white matter. It can also affect the body’s other internal organs like the liver and kidneys.
Physical Effects By The Type Of Heroin
Heroin abuse involves many different types of the drug sold illegally in the U.S.
Each of these can have slightly different or unique side effects:
- powder heroin: Powder heroin is often smoked and leads to effects such as lung damage over time. It can also be liquified and injected, leading to effects such as skin infection.
- black tar heroin: This version of heroin is often injected because it comes in a liquid form. This means users run the risk of collapsed veins and abscesses.
- synthetic heroin: This includes opioids that were created for prescription use, such as fentanyl, and comes with the risk of deadly overdose.
- china white heroin: Fentanyl can be used as a cutting agent in this type of heroin, which creates a high potential for a fatal overdose.
- pure heroin: Pure heroin does not have additives and also comes with the high risk of overdose if a person is used to taking a “diluted” form.
- cheese heroin: This kind of heroin is mixed with Tylenol PM, which is a respiratory depressant and can slow the user’s heart rate.
- blue heroin: Containing both fentanyl and cocaine, blue heroin comes with a high risk of overdose.
- pink heroin: Its pink hue comes from being mixed with other opioids, which further suppresses a user’s ability to breathe.
- hillbilly heroin: This is the term for prescription opiate abuse in certain areas of the nation, often which contain acetaminophen (which can damage the liver).
- liquid heroin: This is the kind of heroin that is injected and can result in collapsed veins over the long term.
- skunk heroin: Black tar heroin has been mixed with cannabis, this can lead to both effects of IV heroin drug use and cannabis effects.
Physical Long-Term Effects Of Heroin
There are many long-term effects on the body that come with physical dependence on heroin. These effects range from damage to internal organs to sexual side effects.
Sexual Side Effects
While this might not be the first side effect you’d expect, long-term heroin use can create sexual disinterest and arousal disorders in men and irregular menstrual cycles in women.
Learn more about the sexual side effects of heroin.
Risk Of Liver Disease
Heroin is often mixed with other additives which can cause health problems, because these additives do not dissolve easily.
This can create liver problems for the person who uses heroin regularly for long periods of time.
Risk Of Kidney Disease
The use of additives that do not easily dissolve can also create a problem for the kidneys, because they clog the blood vessels that lead to those organs.
Risk Of Skin Disease
Long-term heroin use can also create skin problems such as abscesses and boils that can bleed and become infected.
Contracting Chronic Illnesses
Heroin is often taken intravenously which creates an increased risk for such chronic diseases as:
- hepatitis B
- hepatitis C
- HIV/AIDS
These infectious diseases can be sexually transmitted as well.
Blood Clots
Clogging of the veins can create blood clots. When set loose in the bloodstream these clots can get lodged in the lungs.
Chronic Pneumonia
Because of the continual dampening of the long-term heroin user’s respiratory system, they can develop chronic pneumonia.
Heroin Overdose
The longer you use heroin, the higher risk you create of overdosing. A heroin overdose occurs when a person takes too much of the drug.
Shallow breathing and a dangerously low heart rate can result in death.
Find out more about heroin overdose.
Heroin Addiction
And of course, the longer you use heroin, the more addicted you become. It is a relationship of diminishing returns.
For the intense high, heroin users have to take more of the drug. This can, for a time, achieve the same high, but it increases the long-term effects.
Heroin addiction treatment can help reverse some of the long-term effects and immediately address the short-term effects, such as withdrawal symptoms, as well as foster lasting recovery.
Find Addiction Treatment At Bedrock Recovery Center
Heroin addiction and substance abuse are treatable, and at Bedrock Recovery Center, we have highly individualized treatment plans at our inpatient treatment center.
With many different medical treatment options available, such as the use of buprenorphine or methadone, you or your family member can get the help you need to quit using heroin.
- National Institute on Drug Abuse — Commonly Used Drugs Charts https://nida.nih.gov/drug-topics/commonly-used-drugs-charts#heroin
- National Institute on Drug Abuse — Heroin DrugFacts https://nida.nih.gov/publications/drugfacts/heroin
- National Institute on Drug Abuse — Research Report Series: Heroin https://nida.nih.gov/sites/default/files/heroinrrs_11_14.pdf