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Updated on September 26, 2022

Is Heroin a Stimulant or Depressant?

Key Takeaways

  • Heroin is an opioid and central nervous system depressant, not a stimulant. 
  • The drug works by depressing activity in the central nervous system.
  • Mental health issues like depression are risk factors for heroin abuse.
  • Other dangers of heroin abuse include addiction, overdose, disability, and death.
  • There are various effective treatments available for heroin addiction.

Is Heroin a Stimulant or a Depressant?

Heroin isn’t a stimulant. It’s a central nervous system (CNS) depressant. It slows down activity by binding to mu-opioid receptors in the brain. 

Heroin is a Schedule I illicit opioid that targets the brain’s reward system. This leads to a desire to take the drug, which can result in addiction.


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The Depressant Effects of Heroin

Opioids like heroin affect brain functioning by attaching to and activating mu-opioid receptors to regulate pain.

Receptors are also involved in:

  • Feelings of pleasure
  • Controlling heart rate, sleeping, and breathing

While heroin reduces pain and delivers a rapid and intense rush, it can also:1 

  • Impair cognitive functioning
  • Increase sedation
  • Slow autonomic functions like breathing

After an initial surge of euphoria or pleasure, heroin users often experience heaviness in their arms and legs. They may also have clouded mental functioning.

Another side effect of heroin is “going on the nod.” This is a back-and-forth state of consciousness and semi-consciousness.

Chronic heroin users can experience many adverse reactions that affect the body and mind. 

Can Heroin Cause Depression?

Long-term opioid use is closely linked to depression and higher rates of anxiety disorders.3 

Heroin use can cause:

  • Depression
  • Mood changes
  • Suicidal behavior and/or thoughts
  • Psychological dependence and addiction

Additionally, pre-existing mental health problems like depression are linked to substance abuse problems.4 

While various drugs can trigger depression, it doesn’t mean these substances are depressants. But when a person repeatedly uses heroin to achieve the same initial high, the brain quickly adapts to the drug. 

Many heroin users say the first use produced the most intense high. After this, they continue to use heroin again and again to try and achieve that same high. But it will never be as strong. 

When brain opiate receptors are stimulated by external drug use (like heroin), the internal neurotransmitters stop being made and released to normal stimuli. Users quickly feel like they need to use the drug to achieve regular levels of pleasure. 

If a person suddenly stops taking heroin, their brain can no longer produce the high levels of pleasure or feel-good signals it used to produce.

This can lead to depression symptoms as the brain struggles to adjust. Untreated depression can worsen or interfere with recovery efforts, such as detox.

Heroin users who suffer from depression also have a greater risk of overdose and suicide.2 

Symptoms of Depression

If you’ve experienced some of the following symptoms most of the day, nearly every day, for at least two weeks, you may have depression:5 

  • Persistent sad, anxious, or empty moods 
  • Feelings of hopelessness
  • Irritability 
  • Feelings of guilt, worthlessness, or helplessness 
  • Loss of interest in hobbies and activities 
  • Decreased energy or tiredness 
  • Moving or talking more slowly 
  • Feeling restless or having trouble sitting still 
  • Difficulty concentrating, remembering, or making decisions 
  • Difficulty sleeping, waking up, or oversleeping 
  • Appetite or weight changes 
  • Thoughts of suicide or suicide attempts 
  • Aches or pains
  • Headaches
  • Cramps or digestive problems

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Other Dangers of Heroin & Opioids

Repeated heroin abuse changes the physical structure and physiology of the brain. This creates long-term imbalances in neuronal and hormonal systems that aren’t easily reversed.

Studies have shown some deterioration of the brain’s white matter resulting from heroin use, which affects:

  • Decision-making abilities
  • The ability to regulate behavior 
  • Responses to stressful situations

Heroin use can also quickly lead to tolerance and physical dependence on the drug. Tolerance develops when more of the drug is needed for the same effects.

Regarding physical dependence, the body adapts to the drug’s presence. It depends on external sources (drug use) to perform its regular functions. Withdrawal symptoms occur if use is stopped abruptly.

Heroin overdose is a dangerous and deadly consequence of the drug’s use. A large dose of heroin depresses the autonomic nervous system (heart rate and breathing) to the extent that a person can’t survive without medical help.6

What is Speedballing?

Some heroin users also practice speedballing, which involves taking a mixture of heroin and cocaine.

Those who speedball typically experience a more intense, longer-lasting high than they would if they took either drug alone.

Speedballing is particularly risky because it forces the body to process different drugs simultaneously. Using a depressant and a stimulant together causes a push-pull reaction in the body that can be extremely dangerous.

Cocaine requires the body to take in and use more oxygen. Heroin, on the other hand, slows breathing. 

Combined, the two drugs strain overactive lungs, heart, and brain. Confusion and turmoil in the body occur.

Speedballing makes it more challenging for the body to receive enough oxygen to keep itself safe and balance the effects of cocaine. 

Additionally, cocaine wears off much faster than heroin. People who speedball tend to inject more often than people who use either drug separately.

Heroin Addiction (Signs of Opioid Use Disorder)

In 2016, about 948,000 Americans reported using heroin in the past year. This number has been on the rise since 2007.7 

Repeated heroin use often occurs in opioid or heroin use disorder. This is a chronic, relapsing disease that goes beyond physical dependence. It’s characterized by uncontrollable heroin-seeking, no matter the consequences.

Heroin is highly addictive. Injection and smoking, which are methods of administration that allow the drug to reach the brain fastest, increase the risk of developing an opioid use disorder.

Once a person has heroin use disorder, seeking and using the drug becomes their main life purpose. 

Addicts need repeated doses of heroin to avoid withdrawal symptoms like nausea, abdominal pain, sweating, shaking, muscle cramps and an overwhelming urge to use. Most don’t get the euphoria after injection that started their addiction. But they need to use it to feel ‘normal’ again.

Heroin initially delivers high levels of positive feelings, which increases the odds that someone will continue to use the drug despite its negative consequences. Once physical addiction takes hold, heroin makes a person feel ‘normal’ rather than high.

An opioid disorder has severe consequences, including:

  • Disability
  • Relapses
  • Death

Other symptoms that occur within 1 to 2 months include:

  • Taking larger amounts or consuming drugs over a longer period than intended
  • Consistent desire or unsuccessful efforts to reduce or control opioid use
  • Spending a lot of time seeking or using the opioid or recovering from its effects
  • Craving or having a strong desire to use opioids 
  • Issues fulfilling obligations at work, school, or home
  • Continued opioid use despite having recurring social or personal problems
  • Giving up or reducing activities because of opioid use
  • Using opioids in dangerous situations
  • Continued opioid use despite having an ongoing physical or psychological problem likely to have been caused or worsened by opioids
  • A developed tolerance to opioids
  • Experiencing opioid withdrawal symptoms

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Treatment for Heroin Abuse & Addiction

There are various effective treatments available for heroin abuse and addiction, including behavioral therapies and medications.8 

Both approaches help restore a degree of normalcy to brain function and behavior. 

Behavioral therapies and medication can be extremely useful when used alone. But for many, combining both types of treatments is the most effective approach.

Treatments options include:

  • Medications
  • Detox
  • Talk therapy
  • Cognitive-behavioral therapy (CBT)
  • Support groups
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  1. NIDA. "Heroin DrugFacts." National Institute on Drug Abuse, 1 Jun. 2021
  2. NIDA. "Suicide Deaths Are a Major Component of the Opioid Crisis that Must Be Addressed." National Institute on Drug Abuse, 19 Sept. 2019
  3. Martins, S S et al. “Mood and anxiety disorders and their association with non-medical prescription opioid use and prescription opioid-use disorder: longitudinal evidence from the National Epidemiologic Study on Alcohol and Related Conditions.” Psychological medicine vol. 42,6 : 1261-72
  4. Alcohol and Drug Use Prevention, State of Hawaii, Department of Health
  5. Depression, National Institute of Mental Health, Feb. 2018
  6. NIDA. "What can be done for a heroin overdose?." National Institute on Drug Abuse, 2 Jun. 2021
  7. NIDA. "What is the scope of heroin use in the United States?." National Institute on Drug Abuse, 13 Apr. 2021
  8. NIDA. "What are the treatments for heroin use disorder?." National Institute on Drug Abuse, 13 Apr. 2021

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