Soon after injection (or
inhalation), heroin crosses
the blood-brain barrier. In
the brain, heroin is converted to
morphine and binds rapidly to
opioid receptors. Abusers typically
report feeling a surge of pleasurable
sensation - a "rush." The
intensity of the rush is a function
of how much drug is taken and
how rapidly the drug enters the
brain and binds to the natural
opioid receptors. Heroin is
particularly addictive because
it enters the brain so rapidly.
With heroin, the rush is usually
accompanied by a warm flushing
of the skin, dry mouth, and a
heavy feeling in the extremities,
which may be accompanied by
nausea, vomiting, and severe
itching.
After the initial effects, abusers
usually will be drowsy for several
hours. Mental function is clouded
by heroin's effect on the central
nervous system. Cardiac function
slows. Breathing is also severely
slowed, sometimes to the point
of death. Heroin overdose is a
particular risk on the street,
where the amount and purity of
the drug cannot be accurately
known.
What are the long-term
effects of heroin use?
One of the most detrimental
long-term effects of heroin
use is addiction itself.
Addiction is a chronic, relapsing
disease, characterized by compulsive
drug seeking and use,
and by neurochemical and
molecular changes in the brain.
Heroin also produces profound
degrees of tolerance and physical
dependence, which are also
powerful motivating factors for
compulsive use and abuse. As
with abusers of any addictive
drug, heroin abusers gradually
spend more and more time and
energy obtaining and using the
drug. Once they are addicted,
the heroin abusers' primary
purpose in life becomes seeking
and using drugs. The drugs
literally change their brains and
their behavior.
Physical dependence develops
with higher doses of the drug.
With physical dependence, the
body adapts to the presence
of the drug and withdrawal
symptoms occur if use is
reduced abruptly. Withdrawal
may occur within a few hours
after the last time the drug is
taken. Symptoms of withdrawal
include restlessness, muscle and
bone pain, insomnia, diarrhea,
vomiting, cold flashes with goose
bumps ("cold turkey"), and leg
movements. Major withdrawal
symptoms peak between 24 and
48 hours after the last dose of
heroin and subside after about a
week. However, some people have shown persistent withdrawal
signs for many months. Heroin
withdrawal is never fatal to
otherwise healthy adults, but it
can cause death to the fetus of
a pregnant addict.
At some point during continuous
heroin use, a person can
become addicted to the drug.
Sometimes addicted individuals
will endure many of the withdrawal
symptoms to reduce their
tolerance for the drug so that they
can again experience the rush.
Physical dependence and
the emergence of withdrawal
symptoms were once believed
to be the key features of heroin
addiction. We now know this
may not be the case entirely,
since craving and relapse can
occur weeks and months after
withdrawal symptoms are long
gone. We also know that patients
with chronic pain who need
opiates to function (sometimes
over extended periods) have few
if any problems leaving opiates
after their pain is resolved by
other means. This may be because
the patient in pain is simply
seeking relief of pain and not
the rush sought by the addict.
| Short- and Long-Term Effects of Heroin Use |
Short-Term Effects |
Long-Term Effects |
- "Rush"
- Depressed respiration
- Clouded mental functioning
- Nausea and vomiting
- Suppression of pain
- Spontaneous abortion
|
- Addiction
- Infectious diseases, for example, HIV/AIDS and hepatitis B and C
- Collapsed veins
- Bacterial infections
- Abscesses
- Infection of heart lining and valves
- Arthritis and other rheumatologic problems
|
What are the medical complications
of chronic heroin use?
Medical consequences of
chronic heroin injection
use include scarred
and/or collapsed veins, bacterial
infections of the blood vessels
and heart valves, abscesses
(boils) and other soft-tissue
infections, and liver or kidney
disease. Lung complications
(including various types of
pneumonia and tuberculosis)
may result from the poor health
condition of the abuser as well
as from heroin's depressing
effects on respiration. Many of
the additives in street heroin may
include substances that do not
readily dissolve and result in
clogging the blood vessels that
lead to the lungs, liver, kidneys,
or brain. This can cause infection
or even death of small patches
of cells in vital organs. Immune
reactions to these or other contaminants
can cause arthritis or
other rheumatologic problems.
Of course, sharing of injection
equipment or fluids can lead
to some of the most severe
consequences of heroin abuse-
infections with hepatitis B and C,
HIV, and a host of other bloodborne
viruses, which drug
abusers can then pass on to their
sexual partners and children.
|
