Stuck on Opioids? Learn About Telemedicine Suboxone - Insurance Accepted.

Learn More

Does Heroin Cause Hallucinations? How & Why

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Apr 29, 2023 • 7 cited sources
woman suffering from hallucinations

Heroin use does not usually in and of itself cause hallucinations. 

Hallucinations are a type of perceptual disturbance in sight, hearing, feeling, smelling or tasting. These disturbances cause the person to perceive things and feelings that are not real. 

Hallucinations can range from mild and brief to intense and persistent. They can sometimes be a sign of a more serious condition, such as delirium or psychosis.

Heroin is an opioid medication. Opioid medications do not routinely or usually cause hallucinations. 

There have been reports of opioid-induced hallucinations in rare circumstances, particularly in relation to severely ill patients during end-of-life care. [1] However this is likely due to a combination of factors including severe illness or concurrent use of other substances.

If hallucinations are plaguing someone you love for any reason, it is important to reach out for help. There may be another medical issue at play. 

What Are Hallucinations?

Hallucinations are perceptual experiences that occur in the absence of any external stimuli.[2] They can involve seeing, hearing, feeling, smelling or tasting things that are not actually there but that feel very real to the individual experiencing them. 

The exact mechanisms that cause hallucinations are not fully understood, but they are thought to involve a complex interaction of various brain regions, including the visual and auditory cortex, the thalamus and the limbic system. [3] 

Why Might Hallucinations Occur When Using Heroin? 

Heroin is a powerful opioid that can have profound effects on the central nervous system, including altering the perception of sensory information and behavioral responses to stimuli.[4] While heroin alone does not usually cause hallucinations, it might do so for the following reasons: 

  1. If a person has a severe underlying illness, they may become delirious after using heroin, which may cause hallucinations 
  2. If a person has an underlying mental health condition that causes hallucinations such as schizophrenia, use of heroin may stimulate hallucinations in these individuals because of a predisposing susceptibility. 
  3. If a person is combining heroin with other drugs that cause hallucinations, this may be the cause. For example, there are classes of medications called hallucinogens such as PCP, magic mushrooms, or ecstasy that may prompt hallucinations, particularly if combined with heroin. 
  4. If a person uses alcohol or withdraws from alcohol, they may experience visual hallucinations.  This may or may not be exacerbated by concurrent opioid/heroin use. 
  5. If a person uses cocaine, they may experience tactile hallucinations, such as the sensation of “bugs crawling on the skin”. This may or may not be exacerbated by concurrent opioid/heroin use. 

What Can Hallucinations Associated With Heroin Use Also Indicate? 

While hallucinations might occur while taking heroin (usually in the context of one of the scenarios listed above), hallucinations are not commonly a side effect of heroin alone. Therefore, if you are using heroin and having hallucinations, you should most certainly reach out to your doctor, as there may be another underlying medical or psychological reason for your symptoms. New onset hallucinations can be serious, and you should seek medical attention if they occur.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More

  1. "Opioid-induced Hallucinations: A Review of the Literature, Pathophysiology, Diagnosis, and Treatment." International Anesthesia Research Society. April 2019. Accessed January 2023.
  2. "On the Neurobiology of Hallucinations." Journal of Psychiatry and Neuroscience. July 2009. Accessed January 2023.
  3. "Reality" Is Constructed by Your Brain. Here's What That Means, and Why It Matters." Wu Tsai Neurosciences Institute, Stanford University. June 2020. Accessed January 2023.
  4. "What Are the Long-Term Effects of Heroin Use?" National Institute on Drug Abuse June 2018. Accessed January 2023.
  5. "Psychotic Symptoms in Heroin Withdrawal: A Case Report." Cureus. January 2021. Accessed January 2023.
  6. "Prevalence and Classification of Hallucinations in Multiple Sensory Modalities in Schizophrenia Spectrum Disorders." Schizophrenia Research. October 2016. Accessed January 2023.
  7. "Traumatic Brain Injury and Neuropsychiatric Complications." Indian Journal of Psychological Medicine. March 2017. Accessed January 2023.
Safe, effective Suboxone treatment from home. Learn More

Imagine what’s possible on the other side of opioid use disorder.

Our science-backed approach boasts 95% of patients reporting no withdrawal symptoms at 7 days. We can help you achieve easier days and a happier future.