How Does Heroin Affect the Brain?

Heroin has a significant and negative impact on almost every cell within your brain. The main complications include blood vessel damage, infections, metabolic disorders and damage to different tissues.[1]

Some types of heroin-related brain damage are permanent, while others can improve with time. No matter what type of damage has occurred, self-care can allow you to live with your new brain, make good choices and avoid further damage and complications. 

For the best possible outcome, heroin use must stop promptly, medical care must be given, and addiction treatment must begin.

Can Heroin Cause Brain Damage?

Researchers say heroin can cause brain damage, and some types of brain damage don’t require years of drug use to occur. Some people develop symptoms after their initial first few times using heroin. 

These are the three types of damage associated with heroin. 

Traumatic Injury 

Pure heroin is hard to find. Most street drugs are contaminated with heavy, solid substances like talc and chalk. Inject these items, and they can travel to brain tissues and clog delicate blood vessels. Brain tissues rely on oxygen, and when the delivery methods are blocked, they can starve and die. 

Heroin use can also cause low blood pressure, resulting in low oxygen levels reaching vital brain tissue. People who use high doses of heroin may float into and out of consciousness, and their brain cells may die with each episode.[2] 

A heroin overdose causes even more damage, as tissues can be deprived of oxygen and nutrients for long periods. Even if you survive an overdose, your brain may not be the same. 

Adjusted Neurotransmitters

Brain chemicals are profoundly changed by heroin.[3] Each dose produces a burst of dopamine, a natural substance that causes euphoria. In time, brain cells don’t produce sufficient amounts of dopamine unless potent drugs are used. Higher doses are required for the same effect.

Quit using heroin, and your brain cells need time to adjust. While you withdraw, you may feel deeply depressed, as your body struggles to produce dopamine without drugs. Strong cravings for heroin may develop as your brain calls out for the substance they’re accustomed to. These cravings make relapse likely if you don’t have proper help. 

Heroin & Your Brain’s Structure

Long-term use of drugs like opioids can change the shape and size of critical parts of your brain. 

The frontal cortex is responsible for logic, setting goals, planning and self-control. In people with longstanding drug use, this part of the brain is shrunken.[4] 

Researchers also discovered changes in these portions of your brain:[5]

• Prefrontal cortex
• Temporal lobe
• Insular regions

Researchers aren’t sure why vital brain tissues shrink after long-term drug exposure. It’s possible blood vessel damage and contaminants play a role. It is also theorized that some tissues may shrink due to the abundance of dopamine they’re exposed to with regular use. 

Symptoms of Heroin Damage on Your Brain

People with a longstanding heroin habit experience changes doctors may be able to see in brain imaging scans. But some types of brain changes can be hard to recognize. 

Neurotransmitter changes aren’t noticeable until you stop taking drugs. Only then will you have a deep craving for drugs that seems impossible to ignore. Adjustments your brain made due to drug use are to blame for these intense cravings. 

You may also feel a reduced ability to resist drug cravings. Tissue damage in the frontal cortex could make it hard for you to set solid plans and stick to them. Things that were easy before you started heroin use are suddenly very difficult. 

People with brain injuries caused by overdoses and oxygen deprivation can have trouble remembering information, including the following:[6]

• People’s names
• Appointment dates and times 
• When to take medications

Brain injuries can also cause difficulty in managing behavior and emotions. People may seem much more likely to get angry or upset than they did before the injury took place.[6]

Can Heroin Brain Damage Be Reversed?

Some types of heroin brain damage can heal with time and proper treatment. Other types are harder to address.

Neurotransmitter changes respond to Medication for Addiction Treatment (MAT) programs. Therapies like Suboxone (a buprenorphine and naloxone combination) can correct chemical imbalances and help people think clearly despite the damage done to their brain cells. 

But brain damage caused by trauma or vascular disease are harder to fix. Brain cells don’t regenerate like other tissues within the body. People can learn to make new connections and strengthen their remaining skills. But the tissues that died or shrank may never come back or heal fully. 

Treating Brain Damage Caused by Heroin

MAT programs are the best option for people with brain damage caused by heroin. Since this problem is so common among drug users, almost everyone with an opioid use disorder should consider therapy with MAT.

Buprenorphine, a key component in Suboxone, is a partial opioid agonist. It latches to the same receptors used by heroin, but it doesn’t trigger euphoria in people with opioid use disorder (OUD). Instead, it soothes their damaged brain cells and relieves symptoms like drug cravings and withdrawal symptoms. 

Naloxone, the second component in Suboxone, works as a misuse deterrent. It can’t correct brain cell damage, but it can work as a backstop against overdose if people take too much. 

Naloxone can kick opioids off their receptors and stop an overdose in progress. Since people with heroin-related brain damage struggle with self-control, this element is crucial. Relapse is more likely due to the brain damage heroin use can cause, but Suboxone acts as a safeguard against relapse.

Therapy provided in MAT programs can help people with heroin brain damage to find new ways to think and react. For example, people struggling with out-of-control emotions like anger might learn breathing exercises to prevent violent outbursts. They might learn how a good night’s sleep is crucial to keeping their symptoms in check. And they might uncover the triggers that lead to their difficult emotions, so they can learn how to avoid them and better cope with them when they can’t be avoided. 

The medication aspect of MAT programs is critically important to people with heroin-related brain damage. But therapy could be equally useful, especially during early recovery. 

In therapy, patients build skills that help them to better manage relapse triggers and life in general. Because of this work, they are better able to deal with tough circumstances without returning to heroin use, and they simply enjoy life more as they learn to better manage their thoughts and emotions.

If you’re using heroin now and aren’t sure how to stop, talk to your doctor about enrolling in an MAT program. You can also reach out to us here at Bicycle Health to learn more about our telehealth addiction treatment offerings. We make treatment for opioid use disorder accessible, so more people can leave heroin use in their past.