Heroin is an illicit and potent opiate drug that is a significant drug of abuse. 

Users commonly inject the drug, resulting in an increased potential to develop a physical dependence on it quickly and to contract numerous blood-borne diseases or other infections. 

Injection use also worsens the negative effects of the drug due to its being delivered directly into the bloodstream.

Status of Heroin

Heroin was originally developed as a non-addictive alternative to morphine. It was believed to be a miracle drug that was aggressively marketed by the Bayer Company in the late 1800s and early 1900s. 

It soon became apparent that the drug was extremely addictive. It was a dangerous drug of abuse, resulting in it eventually being illegal to possess or use heroin. 

Today, heroin is classified as a Schedule I controlled substance. It cannot be obtained legally without special permissions from the federal government. It is believed to have no medical uses.


Mechanism of Action

Heroin is a derivative of opium that is processed from the Asian poppy plant. When an individual takes heroin, it is converted to morphine and then binds to the mu, kappa, and delta opioid receptors in the brain — specialized neurotransmitter receptors that have an affinity for endogenous substances that are chemically similar to opiates. 

Like opiates, these endogenous opioids produce a reduction in the subjective experience of pain, stress, and anxiety. 

Injecting heroin results in quicker delivery of the substance to the brain that would be accomplished by other methods, such as snorting the drug or taking it orally.  

Immediate Effects Of Injecting Heroin

When a person injects heroin, they will typically experience:

  • A sudden feeling of euphoria (often referred to as “the rush”)
  • A feeling of warmth all over the body
  • Heaviness in the legs and arms
  • Flushing of the skin
  • A reduction in feelings of pain and stress
  • Dry mouth
  • Decreased breathing rate

After the immediate effects of the drug occur, other sensations may take over including drowsiness, nausea, itching, and problems with reasoning or even confusion.

Dangers Of Injecting Heroin

Although injecting drugs is an efficient way to deliver them to the brain, there are many dangers associated with injecting an illicit drug like heroin. People who chronically abuse heroin by injecting it may experience some specific physical dangers.

  • There will be obvious puncture or track marks on the skin where a person has injected the drug. 
  • Repeatedly injecting heroin can lead to abscesses of the skin and a condition called necrotizing fasciitis where tissues under the surface of the skin begin to die and rot.
  • Wound botulism is a serious and life-threatening infection that can occur as a result of injecting heroin. 
  • Other potential infections, including gangrene or tetanus, can occur.
  • Chronically injecting heroin can lead to inflamed veins, blockages in the veins, or even collapsed veins.
  • Damage to the veins can lead to issues with blood flow that can result in reduced blood flow to the extremities (most often in the feet and legs). Individuals may suffer extreme swelling in their legs or feet due to reduced blood flow.
  • The user will increase their risk of developing cardiovascular infections, such as inflammation of the heart valve (endocarditis).
  • There is an increased risk of blood-borne infections in individuals who share needles. These infections can be dangerous and even fatal, such as HIV or hepatitis.
  • Complications associated with injecting heroin can lead to damage to other organs, including the brain, liver, and kidneys.

Other Medical Complications Of Heroin Injection

Chronic abuse of heroin by any mode of administration can lead to many serious medical issues

  • Serious respiratory issues, due to chronically suppressed breathing associated with heroin, can range from an increased potential for infections like pneumonia to tuberculosis or even cancer.
  • An increased burden on the liver occurs because more of the drug is delivered into the system via injection. This can lead to the potential for liver damage.
  • Respiratory depression and reduced blood flow as a result of injecting heroin can affect multiple organ systems. 
  • Most often, the brain suffers significant damage as a result of reduced oxygen delivery due to decreased blood flow and respiratory suppression.
  • Repeated use leads to rapid development of tolerance to the drug, which is a result of the body’s attempt to counterbalance heroin’s effects. 
  • Rapid tolerance to heroin can lead to a shorter road to addiction and physical dependence.


Exacerbation of Other Physical Issues

Opiate abuse is associated with several other physical side effects that can be exacerbated as a result of injecting heroin. The side effects can include constipation, sexual dysfunction, menstrual problems in women, prolonged lethargy and drowsiness, and a lack of attention to personal hygiene that can lead to other physical issues.

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Increased Risk for Overdose

Because injecting heroin results in more of the drug being delivered directly into the bloodstream and entering the brain, there is an increased potential for overdose compared to other modes of ministration. 

The brain is very sensitive to oxygen deprivation, and the effects of a disruption of blood or oxygen to the brain can be serious. 

A heroin overdose can be potentially fatal. Large amounts of heroin affect and even shut down areas of the brainstem that are involved in controlling life-sustaining functions, such as respiration and heart rate. 

When these areas of the brain are incapacitated, the person can experience significant brain damage or even brain death via cerebral hypoxia (significantly decreased oxygen to the brain) or cerebral anoxia (a complete cutoff of oxygen to the brain). 

The Necessity of Treatment

People who regularly inject heroin or other drugs are serious drug abusers who need professional help. An opiate use disorder as a result of heroin abuse is a treatable condition, but it requires treatment. 

Anyone who is injecting heroin should consult with a health care professional, such as a physician, psychologist, therapist, or social worker. With assistance, they can stop injecting heroin and start to recover from the damage the drug has caused.

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