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How does heroin abuse affect the brain?

Mina Draskovic, B.Psy., reviewed this content for accuracy on March 21, 2024

Heroin is an extremely addictive drug that binds to the brain receptors to produce that intense, euphoric high. Findings from NIDA show that heroin abuse can change the brain’s physical structure and physiology, causing long-term effects like dependence, increased tolerance, cognitive deficits, and hormonal imbalances.

Over time, repeated use destroys white matter, which can severely damage the overall health and function of your brain.

Table of Contents

At Ardu Recovery Center, we know battling heroin isn’t easy. With compassion and personalized care, our proven heroin addiction treatment programs will help you safely quit heroin and reclaim your health. 

What is heroin?

Heroin is an addictive illegal opioid drug. It is typically found in the form of a white or brown powder,  but it can also appear as a thick black substance called “black tar heroin.” Users inject, smoke, or snort heroin for its intense, euphoric high.

Heroin is one of the most dangerous and deadliest drugs in the world. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), over 500,000 people battled heroin use disorder in 2013, 84% of whom developed an addiction. 

Heroin triggers addiction by binding to opioid receptors in the brain.

What are the signs of heroin use?

You can recognize that someone is using heroin by the changes in their physical appearance and behavior. Some common warning signs of heroin abuse include:

  • Euphoria and drowsiness: the user may swing between sudden feelings of pleasure and relaxation followed by nodding off.
  • Nausea and vomiting: the body struggles to tolerate doses of heroin.
  • Constipation: opioids slow the muscular contractions of the bowels leading to severe backup.
  • Severe itching: histamine is released into the bloodstream causing itchiness.
  • Slowed breathing: potentially life-threatening respiratory depression and lack of oxygen.
  • Constricted pupils: heroin activates brain receptors which narrow pupil diameter.
  • Unkempt appearances: heroin addiction becomes all-consuming, causing users to neglect personal hygiene and grooming.
  • Sudden weight loss: heroin use and the money spent on drugs lead to poor nutrition and weight loss.
  • Track marks from intravenous injections: the user will likely wear long sleeves to hide them.
  • Withdrawal symptoms if heroin use stops.

It can be challenging to identify which substance someone is addicted to based on symptoms alone. Heroin shares many common indicators of addiction with other drugs such as ecstasy, cocaine, or prescription opioids.

If you notice any symptoms of substance use in your loved ones, contact Ardu today. 

I’ve been to many other treatment centers but none of them feel like Ardu. Ardu is such a loving, compassionate, and spiritual place! The staff truly cared about me and taught me so much about myself. They’ve made such a positive impact on my life…

Laskah Clarke


Does heroin damage the brain?

Heroin wreaks havoc on the brain. It floods the brain’s opioid receptors and disrupts brain chemistry. Here’s what happens in your brain when you start abusing heroin:

  1. Heroin enters the brain rapidly. When injected or smoked, it can reach the brain within seconds.
  2. In the brain, heroin binds to and activates mu-opioid (μ-opioid) receptors. They are normally activated by the brain’s natural opioids like endorphins to regulate pain and reward.
  3. Following the activation of μ-opioid receptors, heroin floods the brain with a sudden release of dopamine. Dopamine is a neurotransmitter and a “feel-good” hormone, responsible for signaling reward and pleasure pathways. When dopamine levels are high, you feel an intense rush of pleasure and euphoria.
  4. The brain tries to adapt to the overload of dopamine and opioids by reducing its normal production of these chemicals. Over time, this develops tolerance.
  5. As tolerance builds, more and more heroin is needed to achieve the desired high, establishing cravings and dependence.
  6. When heroin use stops, the downregulated dopamine system can no longer produce enough natural dopamine, leading to painful withdrawal symptoms.
  7. With long-term heroin use, heroin changes the brain structure—neural connections start to “rewire” as the brain’s reward and self-control circuits become hijacked.
  8. Brain regions most impacted by heroin use are the amygdala, prefrontal cortex, and nucleus accumbens, which  harms learning, motivation, and self-regulation. 
  9. Eventually, heroin addiction can lead to permanent brain damage.

The effects of heroin use aren’t detrimental only to the brain. Heroin takes its toll on nearly every organ system over time, leading to an array of health consequences. For example, long-term intravenous heroin use can lead to skin infections like abscesses or even collapsing veins. 

Heroin is also one of the major drugs that cause kidney damage.

With compassionate treatment tailored to your needs, recovery is possible. Our rehab center helps heroin users overcome physical and psychological addiction through medical detox, therapy, nutritional therapy, and more. 

What are the short-term effects of heroin on the brain?

Heroin triggers rapid changes in the brain within minutes of use. The short-term effects of heroin are the result of its rapid permeation of the blood-brain barrier. The blood-brain barrier is a protective membrane that filters out toxins and substances from reaching the sensitive neurons in the brain. Heroin quickly permeates this blood-brain barrier and binds to opioid receptors concentrated in areas that regulate pain, reward, heart rate, and more. This allows heroin to quickly alter brain communication and function and trigger short-term highs as well as some dangerous effects.

In the short term, the effects of heroin on the brain include:

  1. Euphoria
  2. Impaired brain function and inability to concentrate
  3. Slowed breathing regulation from the brain stem
  4. Disorientation, confusion, and clouded thinking
  5. Impulsiveness and loss of inhibition
  6. Distorted perception of time and space
  7. Diminished ability to make choices or use judgment

Without treatment, the physical and social spiraling of heroin addiction can ultimately claim your life through disease, violence, suicide, or an increased risk of overdose. But it doesn’t have to end that way. The expert staff at our heroin detox center helps you overcome addiction with therapy programs, guidance, medication, and around-the-clock supervision. 

How does heroin abuse affect the brain long-term?

With ongoing heroin abuse, the brain struggles to return to normal functioning between episodes of intoxicating highs. The result is changes that intensify with repeated heroin use, progressively harming brain communication, structure, and overall health.

The National Institute on Drug Abuse (NIDA) reveals that “repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed.”

A 2013 study showed widespread disruption and potentially permanent damage to myelin (which insulates neuron connections) primarily located in the frontal and upper brain regions of heroin users. This reveals how chronic heroin dependence can fundamentally undermine neural communication pathways in the brain over time.

Here are the long-term effects of heroin on the brain:

  1. Intense drug cravings and loss of control over ongoing use.
  2. Tolerance build-up, as the user needs larger doses to get high.
  3. Physical dependence and severe withdrawal when use stops.
  4. Numbed dopamine reward center and inability to feel pleasure.
  5. Impaired decision-making, judgment, and behavioral regulation.
  6. Memory problems that disrupt learning and cognition. Tamargo, et. al. found that people who used heroin had nearly three times higher adjusted odds for cognitive impairment compared to those misusing prescription opioids
  7. Slowed mental processing and cloudy thinking.
  8. Loss of gray and white matter density in the cortex and brainstem. Qiu, et. al. found that the severity of white matter integrity deficits in heroin addicts was associated with a longer length of heroin dependence, and these brain connectivity disruptions may correlate with impaired decision-making abilities.
  9. Worsening anxiety, depression, fatigue, and insomnia.
  10. Compromised stress system and impaired emotional health.

Those already battling mental health disorders often turn to the fleeting relief of heroin to self-medicate. They have impaired impulse control or judgment and may lack the inhibition to avoid experimenting with opioids despite the risks. Gould, Ph.D. suggests that heroin-induced changes to vital brain communication pathways undermine functioning in ways that exacerbate existing illnesses or trigger new ones. 

People with a dual diagnosis (those struggling with substance use disorder and co-occurring mental disorders) often tend to trade one addiction for another, sabotaging their progress through cross-addiction

At Ardu, we identify these patterns early by targeting the underlying traumatic roots and offering skill-building activities to cultivate new coping outlets for stress.

Is heroin addiction lethal?

Heroin addiction can be lethal. When taken in excessive amounts, heroin directly suppresses critical functions such as breathing, heart rate, and wakefulness. When you overdose on heroin, these effects can slow or stop breathing altogether, leading to coma or death in minutes. 

Here’s how to recognize a heroin overdose:

  • Small pupils
  • Weak pulse
  • Pale, bluish skin and fingers
  • Slow, irregular, or stopped breathing
  • Low blood pressure
  • Nausea, vomiting
  • Extreme drowsiness
  • Seizures
  • Coma

Heroin overdose can happen in the blink of an eye, often within minutes of taking too large a dose. That tiny window leaves little time to intervene, making overdose extremely hazardous and even fatal. If any signs of heroin overdose appear, immediately call 911. 

Get the right help with Ardu

Our heroin addiction treatment can pave the road to long-term recovery from heroin addiction. At our heroin rehab center, we provide compassionate care to help you reclaim your health and purpose. 

Our residential treatment provides round-the-clock structured support and intensive therapy daily. With constant medical supervision, structured routines centered on getting healthy, and a community of individuals with the same goals, our intensive inpatient program builds momentum toward sobriety. 

On the other hand, outpatient treatment tackles addiction with sessions that work around your life. Lower costs and flexibility allow for a recovery journey that can coexist with jobs, caregiving, or other responsibilities. Outpatient rehab works well for those with mild to moderate addictions who want help while preserving their routine. 

We also offer intensive outpatient programs and partial hospitalization programs and will work with you to find one that works best for you.

We use a wide range of therapies to understand and treat addiction’s underlying causes. Some of them are:

  • Cognitive-behavioral therapy helps identify negative thought and behavior patterns that contribute to substance abuse. 
  • Dialectical behavior therapy teaches distress tolerance, emotion regulation, and interpersonal skills to change addictive behaviors. 
  • Experiential therapies involve art therapy, music, or adventure therapy. They help you express emotions and build self-confidence through creative activities.

Before discharging you from our program, we develop a comprehensive aftercare plan outlining your next steps when you transition home. We are invested in your success for the long haul. Our aftercare services ensure you have all the resources and support needed to continue thriving in your recovery journey.

To enroll in an Ardu heroin treatment program, contact Ardu Recovery Center online or via phone (801-872-8480). We will work with you to find a recovery path that works for you during detox and beyond. 

Addiction FAQ

How does addiction affect the brain?

Addiction affects the brain by hijacking the reward pathways and flooding them with dopamine, the “feel good” neurotransmitter. Substances like opioids bind to opioid receptors in areas like the amygdala and nucleus accumbens, overstimulating the dopamine system over time and forming dependency. This drives compulsive drug-seeking behavior despite negative consequences. Addiction also impacts the prefrontal cortex, affecting self-control and decision-making processes.

How long does it take to rewire your brain?

The timeline for brain recovery and “rewiring” neural connections after addiction depends on many factors – genetics, age of exposure, substance used, and length of use all play a role. Generally, experts believe it takes a bare minimum of months to years for the brain to functionally heal after substance dependence. Detox clears drugs from the body, typically in a matter of days or weeks, but rewiring the brain is a longer process.

What part of the brain is targeted by addictive drugs?

The mesolimbic pathway, called the “reward circuit”, is often most directly targeted by addictive drugs. This pathway connects areas like the ventral tegmental area, nucleus accumbens, amygdala, and prefrontal cortex using dopamine signals. An influx of dopamine creates euphoric highs that reinforce addictive behaviors over time.

Do we have opioid receptors in the brain?

The human brain contains an abundance of opioid receptors, especially mu-opioid receptors that mediate pain, reward, and addiction pathways. Substances like heroin and prescription opioids activate these mu-receptors, initiating cascades of dopamine and effects downstream.

Which hormone is responsible for addiction?

Dopamine plays a central role in addiction by signaling pleasure, learning, and reinforcement of compulsive behaviors in the brain. Other neurotransmitters like glutamate and GABA also play roles. Chronic substance abuse can deregulate these chemical messengers.

How does addiction affect the developing brain?

Addiction during youth can severely disrupt healthy brain development, with impacts on maturation that last into adulthood. Structural changes are more severe when addiction occurs at a younger age since neural connections are still actively forming. Addiction changes these patterns, affecting learning, cognitive skills, emotional regulation, and impulse control.

How do prescription opioids impact the brain differently than heroin?

Prescription opioids and heroin both belong to the same class of drugs and interact with the brain’s opioid receptors in similar ways. They activate mu-opioid receptors and flood the brain’s dopamine reward pathway with euphoria-inducing chemicals. 

There are several key differences in how these substances impact the brain and the associated risks:

  1. Both prescription opioids and heroin can lead to long-lasting changes in brain structure and function, particularly in areas related to reward processing, decision-making, and emotional regulation. The unpredictable purity and additives in heroin may exacerbate these changes and cause more severe long-term consequences.
  2. Both heroin and prescription opioids increase dopamine levels in the brain. Heroin may cause a more significant release of other neurotransmitters, such as serotonin and norepinephrine, than prescription drugs.
  3. Heroin typically enters the brain more rapidly than prescription opioids, particularly when injected or smoked. This faster entry leads to a more intense and immediate “rush” of euphoria. Prescription opioids taken orally have a slower onset of effects.
  4. Heroin is generally more potent than prescription opioids. A smaller dose is required to achieve the desired effect. 
  5. Injecting or smoking heroin leads to a more rapid and intense high compared to taking prescription opioids orally. 


NIDA. 2021, April 13. What are the long-term effects of heroin use?. Retrieved from https://nida.nih.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use on 2024, February 28

NIDA. 2021, April 13. What are the long-term effects of heroin use?. Retrieved from https://nida.nih.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use on 2024, February 28

Li W, Li Q, Zhu J, Qin Y, Zheng Y, Chang H, Zhang D, Wang H, Wang L, Wang Y, Wang W. White matter impairment in chronic heroin dependence: a quantitative DTI study. Brain Res. 2013 Sep 19;1531:58-64. doi: 10.1016/j.brainres.2013.07.036. Epub 2013 Jul 27. PMID: 23895765.

Tamargo, J. A., Campa, A., Martinez, S. S., Li, T., Sherman, K. E., Zarini, G., Meade, C. S., Mandler, R. N., & Baum, M. K. (2021). Cognitive Impairment Among People Who Use Heroin and Fentanyl:

Findings from the Miami Adult Studies on HIV (MASH) Cohort. Journal of Psychoactive Drugs, 53(3), 215. https://doi.org/10.1080/02791072.2020.1850946

Qiu, Y., Jiang, G., Su, H., Lv, X., Zhang, X., Tian, J., & Zhuo, F. (2013). Progressive White Matter Microstructure Damage in Male Chronic Heroin Dependent Individuals: A DTI and TBSS Study. PLoS ONE, 8(5). https://doi.org/10.1371/journal.pone.0063212

Gould, T. J. (2010). Addiction and Cognition. Addiction Science & Clinical Practice, 5(2), 4-14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120118/

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