Heroin is among the most commonly used illicit drugs in the United States. In fact, it’s easiest to obtain after marijuana. Heroin has led to an increase in overdose deaths as the opioid epidemic rages across the country.
While overdose is often caused by slowed or stopped breathing, that’s not the only way that heroin can lead to dangerous medical complications. Heroin isn’t usually the first drug you think of when you hear about heart complications. Stimulants like cocaine and meth have a more direct role in heart attacks and cardiac problems, because of the way they tax your system after taking a high dose. However, heroin can also cause some serious heart-related problems.
Learn more about heroin, addiction, and heart diseases that may be avoided by seeking treatment.
Heroin use may not always have direct heart-related complications. In fact, pure heroin is like other opioids. In safe, controlled doses, it has very few severe side effects. Instead, heroin’s danger comes from its addictive potential, the likelihood of an overdose, and the use of illicit street heroin.
Heroin is bought and sold in a massive black market industry, controlled by transnational criminal organizations. Illicit heroin is shipped to the United States by boat and over the border. As it makes its way from the manufacturers to street-level dealers, it may go through several instances of adulteration. Adulteration refers to the addition of other substances to dilute the drug and spread profits. Heroin is cut with inert substances to act as filler, other chemicals for enhanced effects, and anesthetics for a unique numbing effect.
Inert fillers can include powdered milk, talc, cornstarch, sugar, and flour. These non-chemicals may seem like the safest heroin additives but even they can be dangerous. Powder substances like cornstarch and flour can coagulate and clump up. When they are injected into the vein along with heroin, they can cause blood clots, causing serious complications.
Clots can break off and travel to the heart or brain, causing cardiac arrest or stroke. They can also cause blood vessels to rupture, causing internal bleeding and a lack of blood to vital organs.
It can also cause deep vein thrombosis, which is when a clot forms in a major vein in your arms, legs, pelvis, lungs, or brain. In the extremities, a deep vein clot can cause weak limbs, pain, and other complications. If the vein ruptures or if the clot travels, it can be deadly.
Intravenous heroin use comes with its own set of risks and side effects. Repeated use of the same vein can cause it to collapse. Collapsed veins can cause poor circulation and even increase your risk of stroke and heart problems. In some cases, collapsed veins can heal as the swelling goes down. Collapsed veins can be caused by overuse of a vein, blunt needles, irritating contaminants, and poor injection technique.
Using dirty needles is often associated with contracting serious bloodborne diseases like HIV and hepatitis. However, it can also cause potentially deadly infections that affect the blood vessels and heart valves. These complications can also increase your risk of heart-related problems.
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Heroin can also be cut with other chemicals that are added during the refinement process or afterward. Chemicals like ammonia, chloroform, hydrochloric acid, acetic anhydride, and calcium oxide, have all been found in heroin. Some of these chemicals are extremely dangerous and may be cardiotoxic. In some cases, toxic chemicals like rat poison have also been found in heroin. Black tar heroin may also be cut with soil that can contain fecal matter, and a toxic bacteria called Clostridium botulinum, which is related to botulism.
Heroin abuse has also been associated with a rare but serious complication called myocardial infarction. Myocardial infarction is a blockage in the heart that damages it and can lead to heart failure.
In some cases of heroin use, patients present with chest pains and heart attacks after a night of heroin use. One 2012 case study reported a young man with no history of early heart disease came to the ER with chest pains and other heart attack symptoms. It was found that he had a myocardial infarction and that he had smoked heroin the night before. The study suspected that the heart complication was caused by heroin-induced cardiotoxic effects. However, the study also reports that the reason heroin causes cardiotoxic effects is unknown and can be due to systemic or direct toxic effects.
As an opioid, heroin slows down the nervous system in addition to its analgesic and euphoric effects. In pain relief, this can encourage relaxation and sedation. However, in high doses, this effect can be dangerous.
During an overdose, these depressant effects can slow down some of the automatic functions of your autonomic nervous system like breathing, heart rate, and blood pressure.
For the most part, deadly overdoses are caused by a lack of oxygen to the brain and body.
This is caused by slowed or stopped breathing, but your slowed heart rate also contributes to this danger.
The heart is responsible for pumping blood that has been oxygenated by your blood throughout the body.
As breathing and heart rate slows, less blood is being oxygenated and less oxygenated blood is making it to your brain and other body parts, resulting in coma and death.
Addiction is a chronic and progressive disease that can have serious consequences in your life. If it’s left untreated, heroin addiction can lead to health problems, strained relationships, and financial problems. Each day in active heroin addiction can lead to fatal complications. Addiction treatment can help avoid some of the serious issues that are associated with severe opioid use disorder. To start your road to recovery today, continue to learn about addiction and how it can be treated safely and effectively.
American Psychiatric Association. (2017, January). What Is Addiction? Retrieved from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
Hartney, E. (2019, July 8). It Is Hard to Know What May Have Been Added to a Batch of Heroin. Retrieved from https://www.verywellmind.com/what-is-in-heroin-22048#chemical-additives
Karoli, R., Fatima, J., Singh, P., & Kazmi, K. I. (2012, July). Acute myocardial involvement after heroin inhalation. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487283/
National Institute on Drug Abuse. (2018, June). What are the medical complications of chronic heroin use? Retrieved from https://www.drugabuse.gov/publications/research-reports/heroin/what-are-medical-complications-chronic-heroin-use
National Institute on Drug Abuse. (2019, June). Heroin. Retrieved from https://www.drugabuse.gov/publications/drugfacts/heroin