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Heroin and the brain
March 18, 2016

Heroin and the Brain: What Everyone Should Know about the Drug’s Scary, Long-Term Side Effects

Heroin and the brain

Heroin and heroin addiction are sweeping America pointing to an alarming surge in heroin-related overdoses and deaths. These numbers continue to rise along with the drug’s increasing popularity as a cheaper, more accessible high than other opiates, like painkillers requiring a doctor’s prescription. All signs now point to a rising heroin epidemic.

If that part is clear, what’s less widely known is how heroin changes the brain and hurts the body over the long haul. Here’s what everyone should know about the drug’s scary, long-term side effects.

How Heroin Affects the Brain

Recent advances in addiction science shed light on how heroin affects the brain over time, starting with that first hit.

Heroin, an opioid, traces its chemical lineage back to another opioid: morphine. The same opioid derived from the seedpods of the Asian opium poppy plant, which doctors administer to cancer patients, also produces heroin’s signature high. In fact, when heroin enters the brain, the brain’s first response is to recognize and encode this new substance as morphine. This translation process usually happens very quickly (although the time it takes will differ depending on whether heroin is smoked or injected). As with other painkilling opioids like hydrocodone and oxycodone, neural enzymes break heroin down into heroin’s main constituent, morphine. Morphine thus becomes the real molecular trigger of the brain’s ensuing response to heroin.

And what ensues is an especially powerful, dopamine-packed flooding of the brain’s pleasure circuits. “Aha!,” the brain says upon recognizing morphine, which then binds to so-called opiate receptors in the brain. These receptors function a bit like a very sophisticated UPS system: They are in just about every region of the brain and help receive and process the various chemically encoded messages that come their way.

Heroin Tolerance and Dependence can Lead to Dangerous Side Effects & Withdrawal Symptoms

Heroin tolerance and dependence can begin to develop as early as the first hit, with the result that quite early on in its interactions with heroin, the brain can experience potentially deadly side effects. When morphine binds to the brain’s receptors, these receptors sound the alarm to activate dopamine (a “neurotransmitter,” or chemical messenger, that in this context tells the brain to expect something really pleasurable on the way). With just one hit of heroin, all of these receptors all over the brain light up—as if in unison they all start madly cheering “Dopamine, Dopamine!” That cheering sets off other physical chain reactions.

Some of these reactions cause short- and long-term side effects that can be dangerous. A dopamine-cheering receptor in the brain stem area will set off automatic processes like blood pressure, arousal, and respiration, for example. The result can be a suppression of breathing that in turn reduces oxygen to the brain. “Hypoxia,” as it’s called, can be serious, causing short- and long-term effects that include coma and death.

After an explosive release of its own endorphins in the presence of heroin, the brain experiences a dramatic letdown once the drug has left the system. Now, in order to achieve the same intensity of pleasure, the brain starts craving more heroin, within as little as a few hours of its last injection. A PBS Frontline segment on heroin and the brain puts it this way: “A general hypothesis says that when the body’s chemical equilibrium is upset, as in habitual drug-taking, the body sets up oppositional processes to restore itself. More of the drug is needed to overcome these efficient corrective processes.”

Dependence occurs as the brain, now accustomed to receiving a steady and continuous supply of its pleasure fix, literally changes its own circuitry to accommodate an ongoing intake of heroin. Once that fix is taken away, the brain must again readjust by compensating for heroin’s absence. The resulting neurochemical imbalance sets off withdrawal symptoms that make heroin detox a difficult and medically risky process requiring oversight by trained addiction specialists.

Common heroin withdrawal symptoms include:

  • Nausea and vomiting
  • Muscle spasms
  • Muscle and bone pain
  • Cramps
  • Elevated anxiety and restlessness
  • Insomnia
  • Fever
  • Diarrhea
  • Cold flashes with goosebumps

Other Scary, Long-Term Changes in the Brain Caused by Heroin

Maybe it’s no surprise then that over time heroin changes both the physical wiring and chemical balance of the brain, according to studies. Neuroimaging of heroin-addicted brains has shown long-lasting changes in cerebral gray matter. This gray matter includes regions of the brain that determine muscle control, sensory perception (such as seeing and hearing), memory, emotions, speech, cognitive decision processes, and impulse control. Changes in the limbic system, (the area of the brain connected to the regulation of emotions associated with other pleasurable activities such as eating and sex), also occur.

Common symptoms of neurological damage cause my heroin use:

  • Impaired emotional processing
  • Impaired memory
  • Decreased decision-making ability
  • Heightened impulsiveness
  • Poor coordination
  • Drowsiness

Other Serious Physical Effects of Heroin

The brain is not the only organ to suffer from long-term heroin use. Other serious physical effects can include:

  • Kidney failure due to high levels of protein in the urine
  • Compromised functioning of the intestinal muscles, and, in turn, chronic constipation problems

How Heroin Detox and Treatment Can Help

Thankfully, for those trying to quit heroin, professionally supervised detox and treatment can help on the path toward recovery. Research shows that evidence-based substance abuse care, in the form of a plan of addiction treatment that combines both behavioral and pharmaceutical interventions, is most effective in treating heroin addiction.

Getting into rehab as soon as possible is critical in cases of heroin addiction. Seeking professional treatment early on can spare heroin users from the worst long-term side effects of their habit and can help them go on to lead healthy, normal lives. Freedom from heroin addiction really can happen, starting today.

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