Is Heroin a Stimulant?

Key Takeaways

• Heroin binds to opioid receptors, reducing brain activity and pain - Jump to Section
• Heroin causes sedation and slows bodily functions - Jump to Section
• Heroin is highly addictive and can lead to severe addiction - Jump to Section
• Use disorder signs include uncontrollable urge to use and withdrawal symptoms - Jump to Section
• Treatment options for addiction include medical detox and therapy - Jump to Section
• Long-term heroin use is linked to depression and anxiety disorders - Jump to Section

Heroin isn’t a stimulant but rather a central nervous system depressant. As a depressant, it can cause a sedative effect and slow down brain activity.

On the other hand, stimulant drugs have the opposite effect. Stimulants speed up the sympathetic nervous system, increasing brain activity and alertness.

How Does Heroin Work?

Heroin is an opioid drug made from morphine, a natural substance taken from the seed of the various opium poppy plants. It binds to the mu-opioid receptors, slowing down brain activity and regulating pain.

Opioid receptors are also involved in:

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

Heroin targets the brain’s reward system, leading to a desire to take the drug. It’s classified as a Schedule I illicit opioid, meaning it has a high potential for drug abuse with no accepted medical use.

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The Depressant Effects of Heroin

After an initial surge of euphoria or pleasure, people often experience heaviness in their arms and legs. Other depressant effects include:¹ 

• Impair cognitive functioning
• Increase sedation
• Slow autonomic functions like breathing
• A dry mouth
• Warm, flushed skin
• Upset stomach and vomiting
• Clouded mental functioning
• Itching

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. 

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Heroin Use Disorder

Heroin is a highly addictive substance and one of the most commonly abused street drugs. It often leads to a severe heroin addiction known as opioid or heroin use disorder.

This is a chronic relapsing disease that goes beyond physical dependence. Heroin use disorder is characterized by an uncontrollable urge to seek heroin despite the consequences.

In 2016, about 948,000 Americans reported using heroin in the past year. This number has been on the rise since 2007.⁷ An opioid disorder has severe consequences, including:

• Disability
• Relapses
• Death

Signs of an Opioid Use Disorder

Symptoms can occur within 1 to 2 months. If you notice any of the following signs, seek treatment immediately:

• 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

The method of administration also affects the risk of developing an opioid or heroin use disorder. The faster it reaches your brain, the higher the risk. Smoking and injecting heroin reach the brain faster than other methods.

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Heroin Addiction Treatment Options

Several comprehensive treatment programs for heroin addiction exist.⁸ However, there is no one-size-fits-all treatment.

Talk to a healthcare professional about seeking treatment for heroin addiction. They can help you explore different options that cater to your needs.

Available treatment options include:⁸

• Medical detox: Medically supervised detox used to avoid withdrawal symptoms
• Inpatient treatment: Involves checking yourself into a rehab facility for 24-hour medical supervision
• Outpatient treatment: A treatment program where you are freely allowed to leave the rehab facility
• Cognitive-behavioral therapy: A short-term therapy technique that explores the link between thought patterns and addiction
• Medication-assisted treatment: Involves using medication, counseling, and therapy to treat addiction
• Dual diagnosis treatment: A treatment program that addresses co-occurring mental health conditions alongside addiction
• Individual or group therapy: Addiction therapies that are designed to help you develop skills to manage triggers and cravings
• Support groups: Groups like Narcotics Anonymous (NA) provide a much-needed community to help maintain sobriety after treatment

Heroin Dependence and Withdrawal

Once physical addiction occurs, heroin can make you feel ‘normal’ rather than high. Physical dependence happens when your body depends on external sources to function normally.

When this happens, you can experience withdrawal symptoms when you stop using the drug abruptly. Heroin withdrawal symptoms include:

• Gastrointestinal or abdominal pain
• Nausea
• Shaking
• Insomnia
• Agitation
• Sweating
• Anxiety
• Muscle aches
• Intense cravings for heroin

Heroin Tolerance and Overdose

The more you use heroin, the more you become tolerant of its effects. Once this happens, you’ll need higher and stronger doses of heroin to achieve the same effects. This leads to a serious risk of an overdose.

Heroin overdose is a dangerous and deadly consequence of drug use. A large dose of heroin depresses the autonomic nervous system, which is responsible for breathing and heart rate.

Heroin overdose symptoms include:⁶

• Uncontrolled vomiting
• Drowsiness and lethargy
• Weakness
• Loss of consciousness
• Unresponsiveness or inability to wake up
• Choking or gurgling noises
• Shallow breathing and other breathing problems
• Slowed pulse or heart rate
• Low blood pressure
• Pale or blue skin
• Cold and/or clammy to the touch
• Complete respiratory arrest

Like other drug overdoses, a heroin overdose requires immediate medical attention.⁶ Contact a healthcare professional if you notice any symptoms of an overdose.

Long-Term Side Effects Heroin use

Aside from the short-term side effects mentioned above, heroin also has long-term side effects. If you abuse heroin, the likelihood of experiencing adverse effects increases.

Long-term heroin use can cause:

• Collapsed veins
• Insomnia
• Increased risk of mental illness
• Heart lining and valve infection
• Skin infections like abscesses and cellulitis
• Weakened immune system
• Increased risk of HIV/AIDS, hepatitis B, and hepatitis C
• Liver disease and kidney disease
• Lung diseases like pneumonia and tuberculosis
• Menstrual problems and miscarriage

Heroin Drug Interactions

Many heroin users may combine this illegal opioid drug with other substances. This can lead to dangerous drug interactions, further increasing the risk of overdose and other serious complications.

The substances that can interact with heroin include, but aren’t limited to:

• Alcohol
• Other illicit drugs, such as cocaine and ecstasy (MDMA)
• Prescription opioids like Hydrocodone
• Stimulants
• Anti-seizure medications
• Certain antidepressants
• Sleep medications such as zolpidem
• Muscle relaxers
• Sedatives like Valium

What is Speedballing?

Combining depressant drugs like heroin with stimulants like cocaine is known as speedballing. People who speedball typically experience a more intense, longer-lasting high. 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. On the other hand, heroin slows down your breathing which can strain your heart, lungs, and brain.

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.

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 Long-term opioid use can increase the likelihood of a dual diagnosis, a condition where you simultaneously have a substance use disorder and a mental or mood disorder.

How Can Heroin Cause Depression?

When an external drug like heroin stimulates opioid receptors, the internal neurotransmitters stop responding to normal stimuli. This means your brain can no longer produce high levels of pleasure. This is also a sign of dependence.

As your brain struggles to function without heroin, you’ll start to feel symptoms of depression. This can worsen untreated depression or interfere with recovery efforts, leading to a relapse.

People who suffer from depression also have a greater risk of overdose and suicide.² It’s important to know that various drugs can trigger depression and isn’t exclusive to depressants. This is a result of your brain adapting to the effects of the drug.

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

If you or someone you know is experiencing these symptoms, consider contacting a medical professional. They’ll be able to give you tips and techniques on how to approach the condition.

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 show that heroin use can cause brain damage and deterioration of white matter. This can negatively affect:

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

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