It is common for conversations around heroin addiction to focus on how the drug impacts the body: the high infection risk due to sharps, the risk of blood clots, dramatic weight loss and the likelihood of overdose. However, being a psychoactive drug, heroin also ‘affects how the brain works and causes changes in mood, awareness, thoughts, feelings, or behaviour.’ The changes you may be able to identify when you use heroin are not the only changes that occur. When heroin is used consistently, it can lead to long-term alterations in the brain. These alterations to brain function and structure can impede quality of life. They can also make it harder for individuals to break out of cycles of heroin abuse, as these structural changes can act to reinforce drug use. For that reason, it is important to understand the cognitive and neurological symptoms of heroin addiction and to be aware of their associated long-term complications.
A quick guide to heroin
What is it?
Heroin is an opiate (a particularly strong type of painkiller). Whilst some opiates are manufactured and sold legally, heroin is an illicit drug and is categorised as a Class A under the UK’s 1971 Misuse of Drugs Act. A heroin high is typically associated with the following sensations:
- Happiness or euphoria
- Relaxation
- Drowsiness
How does it affect your body?
Initial uses of heroin can lead you to feel sick or dizzy. A lot of the time, users find that heroin promotes a general relaxation of the body, including a reduction in specific areas linked to pain. However, heroin has a high mortality rate. In England and Wales, opiates were involved in just under half (46.1% of drug-poisoning deaths registered in 2022.’ This can be linked to the mechanism and subsequent effects of the heroin high itself or can be linked to secondary health complications, such as:
- Accidental overdose (due to increased tolerance and dose)
- Accidental overdose linked to polydrug use
- Accidental overdose linked to inhaling vomit
- Respiratory depression
- Damage to veins
- Risk of infections and viruses (HIV, hepatitis B and hepatitis C)
- Risk of blood clots
- Risk of gangrene
- Severe weight loss
- Skin infections, abscesses and necrosis
- Change to the body’s ability to manage pain
Alongside these symptoms, you may also experience potent cravings and withdrawal symptoms from heroin in between cycles of use.
Heroin and the brain
Heroin can affect the way that the brain functions in several key ways. There is also clinical evidence to suggest that chronic heroin use can alter the physiological structure of the brain, indicating that heavy heroin use has the power to change the anatomy of the brain itself.
How does it get to the brain?
When we use drugs, they enter our bloodstream. This then allows the drug through our central nervous systems (a complex network made up of our brain and spine) until the blood that contains traces of heroin arrives in the brain.
What happens in the brain?
When it arrives in the brain, heroin is converted to morphine. These morphine molecules then bind to specific sites in our brain known as opioid receptors. This binding facilitates the intense ‘rush’ that characterises the initial feeling of a heroin high.
Heroin and Dopamine
Heroin-binding leads to an increase in dopamine activity. Dopamine is a neurotransmitter, a specific chemical in the brain that is linked with our reward systems. Because heroin increases dopamine activity, it can mean that, over time, we come to associate heroin with a sense of feeling good or even of achievement. This can act to reinforce drug-seeking behaviour as we try and replicate the feel-good rush of the early highs. Effectively, this can rewire our brains and lead to intense heroin cravings. However, repeat use can lead to the development of an addiction to heroin and can, therefore, cause permanent structural changes in the brain.
Management of pain
When heroin binds to our opioid receptors, it can lead to a reduction in pain (this is often why opioids are prescribed for individuals dealing with chronic pain). However, an overreliance on heroin can mean that the brain begins to struggle to manage pain without it. This can mean that our sensitivity to pain can increase, and we find ourselves needing to use more heroin to navigate physical discomfort.
Structural changes
Researchers have found that the brains of individuals with a history of heroin use had a reduction in the grey matter of particular areas of the brain. This reduction in brain matter can be linked with deficits in multiple types of function. These effects are sometimes called ‘cognitive impairments’ and can impact the way we:
- Assess risk
- Manage stress
- Control impulsivity
- Remember things
- Making decisions
It is not currently clear if these impairments can ‘recover after abstinence.’ This means that these reductions in function can potentially be life-long.
Recognising the need for heroin rehab
If you can identify signs of heroin addiction in yourself (or a loved one), it is important to access support. For many people, heroin rehab is a very positive first step in the journey towards a drug-free future. Acknowledging the need for help can be very daunting – however, those initial actions can allow you to unlock a new stage in your life. With a mixture of physical and psychological support, UKAT offers comprehensive rehab programmes to help you loosen the grip of heroin addiction. Contact us today and let us help you break free from heroin addiction.