Smoking Heroin: Dangers and Health Effects

Heroin is a dangerous and highly addictive illegal opioid that is derived from morphine.1 While it is often associated with needle drug use, heroin can also be snorted or smoked—methods that may be more attractive or less stigmatizing for people who are curious about trying the drug.2 However, any heroin use can cause serious harm or deadly overdose, regardless of the way it’s used.1 This page will discuss the dangers associated with smoking heroin.

What Are the Effects of Smoking Heroin?

Tired woman on bed

Immediately after smoking heroin, it is common for someone to experience:3

  • A rush of pleasure (i.e., euphoria).
  • Warm, flushed skin.
  • Heaviness in their arms and legs.
  • Dry mouth.
  • Very itchy skin.
  • Nausea and vomiting.

After the initial effects, the person may experience other effects that can last for hours, including:

  • Drowsiness.
  • Inability to think clearly.
  • Slowed heart rate.
  • Slowed or difficult breathing, which may be severe enough to cause coma or death.

Heroin use is also associated with many lasting physical and mental health problems, especially when misused chronically over a prolonged time period.4 These include:4

  • Difficulty sleeping.
  • Chronic constipation.
  • Depression, antisocial personality disorder, or other mood disorders.
  • Opioid use disorder (OUD).
  • Transmission of infectious diseases, including HIV.
  • Sexual dysfunction or irregular menstruation cycles.
  • Lung problems from poor general health and from repeated periods of slowed or irregular breathing.

Smoking heroin may introduce its own risks. Some studies have shown that smoking heroin may:5-8

  • Contribute to the onset of asthma or worsen asthma symptoms.
  • Worsen lung functioning in patients with chronic obstructive pulmonary disease (COPD).
  • Be associated with increased rates of rates of early, progressive emphysema.
  • Degeneration of the white matter in the brain likely due to chemical vapors formed when heating heroin on aluminum foil.

Can You Overdose from Smoking Heroin?

People that use heroin—no matter how they administer it—are at risk of overdosing.1,9 Opioid overdoses are emergencies that require immediate medical attention. Signs of a heroin overdose include:10

  • Very small pupils.
  • Loss of consciousness.
  • Slowed, shallow or stopped breathing.
  • Cold, pale, or bluish skin.
  • Choking or gurgling noises.

When someone experiences an opioid overdose, bystanders should call 911 immediately and, if it is available, administer naloxone (Narcan or Kloxxado) as soon as possible. Witnesses should stay with the overdose victim and, if possible, roll them on their side to prevent choking while waiting for emergency responders to arrive.10

There are many resources in Texas to get overdose-response training or to obtain naloxone, even without a prescription.

Is Smoking Safer than Injecting?

Heroin use, in any form, is unsafe and may be deadly. However, smoking heroin may help users avoid or minimize some of the very serious risks associated with needle drug use, such as:4

  • Collapsed veins and abscesses.
  • Clogged blood vessels.
  • Infected blood vessels and heart valves.
  • Transmission of bloodborne diseases (HIV, hepatitis) from needle-sharing.*

It is also increasingly common for heroin to be cut with other dangerous, potent opioids like illicitly manufactured fentanyl12—a significant risk factor for overdose no matter how heroin is taken.

Signs of Smoking Heroin

People who smoke heroin often carry or leave around certain paraphernalia, such as:13,14

  • Small plastic baggies.
  • Pipes.
  • Straws/tubes.
  • Aluminum foil.
  • Lighters.

Some behavioral signs of heroin addiction include:15

  • Skipping important work, school, or social obligations to seek or use heroin.
  • Using heroin in situations when it is dangerous to do so (e.g., driving).
  • Continuing to use heroin despite a negative impact on work or school performance.
  • Spending lots of time and money seeking and using heroin.
  • Expressing a desire to quit or trying and being unable to do so.

Heroin addiction can be a nightmare for both the person suffering from it and their loved ones. Fortunately, it is treatable.16

Getting Help for Heroin Addiction

group recovery

Addiction treatment is a very individualized process, meaning a form of treatment that works for someone may not work for someone else.16 That said, there are several proven approaches for treating heroin addiction.16,17 Treatment for opioid addiction often involves a combination of medication and therapy.16,17

For many patients, the very first step in treatment for a heroin use disorder is medical detox, or supervised withdrawal.18,19 Heroin withdrawal last about 3-5 days and can be physically and mentally distressing, bringing about flu-like symptoms such as vomiting and fever as well as anxiety and .15, 19 Typically, withdrawal from opioids is more uncomfortable than it is dangerous; however, in rare cases medical complications can arise, for example if the patient has an underlying cardiac illness.19 Medically assisted detox enables staff to supervise the patient, administer medication, and respond to emergencies when necessary.19

While making it safely through withdrawal is a crucial part of recovery, effective addiction treatment does not end with detox.16 Much of the important work is done in the next step—rehabilitation.16 Through various forms of therapy, patients learn to form positive coping mechanisms, repair negative thought patterns, and form and maintain healthy interpersonal relationships.20 It is also vital that patients are treated for any co-occurring disorders they may have.16

Medications such as methadone and buprenorphine (Suboxone) may be used in concert with behavioral therapies, an approach known as medication-assisted treatment, or MAT.21 Many rehab facilities offer MAT for patients in treatment for opioid use disorders. Medication can reduce cravings and withdrawal symptoms and use is associated with lower levels of relapse.18,21 It is common for people to stay on medication to treat heroin addiction or months or even years after they begin recovery.18

Recovery from addiction is a lifelong pursuit. Effective rehabilitation facilities will help patients make a plan for some form of aftercare or continuing care, which helps people in recovery avoid returning to heroin use. 22 or some, this may mean transitioning to an intensive outpatient program or moving into a sober-living facility, while for others it may be attending weekly therapy, regular support groups, or their rehab program’s alumni events.

What Type of Treatment Is Right for Me?

Not every person will follow the same treatment path. The appropriate setting for treatment, the medications used, and the length of treatment may vary depending on the patient’s individual needs and progress during treatment.16

If you or a loved one is struggling with addiction, please reach out to an admissions navigator to learn about treatment options and the care provided at Greenhouse Treatment Center.

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We are here to help you get clean and learn how to stay that way. Start your recovery at our spa-like facility in the Dallas-Ft. Worth area. Holistic therapies, chef-prepared meals, and LGBTQ+ support are among the many features of our premier drug and alcohol treatment program. Traveling for healthcare & essential services is permitted across the US. Addiction treatment is essential, and we are here for our patients in this difficult time. Greenhouse is taking every precaution to ensure patient and staff safety. We are able to test incoming patients and anyone feeling unwell to ensure peace of mind and focus on addiction treatment.