Smoking Heroin | Dangers, Risks, Effects Of Inhaling Heroin

Smoking heroin seems to have less of a stigma than injecting heroin. However, inhaling heroin is just as addictive as injecting it and is associated with additional risks.

Heroin reaches the brain quickly when it is smoked or injected. These methods of ingestion (injecting or smoking heroin) increase the likelihood that a person will become addicted to heroin.

Heroin can be smoked in both powder and tar form. Smoking heroin by placing it on foil, heating it from below, and inhaling the smoke/vapor is referred to as “chasing the dragon”. Heroin can also be smoked by placing it in a glass pipe, usually referred to as a “crackpipe.” Some also lace cigarettes and marijuana with heroin and smoke them.

Smoking heroin is dangerous and can lead to significant health risks in addition to addiction, withdrawal, and overdose.

A critical safety note for anyone using heroin today is that most of the current illicit heroin supply contains illicitly manufactured fentanyl, often without the user’s knowledge. Fentanyl is far more potent than heroin and dramatically increases overdose risk.

Fentanyl test strips can detect contamination before use and are available at many pharmacies and harm reduction organizations. Keeping naloxone on hand is strongly recommended.

Treatment for heroin addiction is available and can help a person achieve sobriety.

Short-Term Side Effects Of Smoking Heroin

The euphoric effects of heroin take about ten minutes to take effect when smoking heroin. These effects are a little slower than other methods of abusing heroin, such as injecting or snorting.

Some of the short-term effects of heroin include:

• itching
• flushed skin
• heavy limbs
• dry mouth
• confusion
• nodding out
• nausea

Long-Term Effects Of Smoking Heroin

The long term effects of smoking heroin are serious. Smoking heroin can result in brain damage as a result of white matter deterioration and serious lung problems. Additional long-term effects of heroin abuse include insomnia, constipation, depression, and other mental health issues.

Smoking heroin chronically can also result in hormone imbalances, which can affect sexual function in men and women, and menstrual cycles in women.

Smoking Heroin and Lung Issues

Smoking heroin can devastate lung function. Heroin on its own causes respiratory depression, and when a person smokes heroin, it increases the risk for pneumonia, tuberculosis, and other lung diseases.

Chronic Cough

When a person smokes heroin, they are inhaling the drug but also whatever the drug is cut with. These substances are not meant to be inhaled, and the body’s natural response is to cough in an attempt to get the toxic substance out of the lungs.

Additionally, if the heroin is being laced with cigarettes or marijuana, it can make the chronic cough associated with smoking heroin even worse.

Asthma and Smoking Heroin

Studies have shown that people who smoke heroin can develop asthma. People who already have asthma can experience a worsening of symptoms when they smoke heroin.

When a person has asthma and smokes heroin, it increases the risk of hospitalization, intubation, and ventilation. The asthma attacks associated with smoking heroin can be so severe that a person may die.

COPD and Heroin Smoking

Chronic Obstructive Pulmonary Disease (COPD) has been linked to smoking heroin. COPD is a progressive lung disease that places a person at higher risk for lung cancer and heart disease. There is also an increased risk for early-onset emphysema.

Smoking Heroin and Brain Damage

Chasing the dragon can result in a condition called toxic leukoencephalopathy. This condition causes severe damage to the white matter in the brain. Over time, with chronic heroin smoking, the damage may become permanent.

Toxic leukoencephalopathy can make a person forgetful and have trouble paying attention. However, there are severe effects that include personality changes, speech problems, dementia, coma, and even death.

Toxic leukoencephalopathy from heroin smoking, while serious, is considered rare. It has been most frequently associated with contaminants in the heroin supply rather than heroin itself.

As the illicit supply increasingly contains fentanyl and other adulterants, the risk of contaminant-related neurological damage remains a concern.

Smoking Heroin and Overdose

Heroin overdose is a risk factor regardless of how a person uses it. Because smoking heroin takes longer to produce the desired euphoric effect, a person may continue to smoke the drug, attempting to kickstart the euphoria.

Signs and symptoms of a heroin overdose include:

• pinhole pupils
• low blood pressure
• drowsiness
• blue lips, fingertips, or nailbeds
• weak pulse
• confusion
• loss of consciousness
• stroke
• coma
• death

If you suspect someone is overdosing on heroin, call 911 immediately. If naloxone is available, administer it right away. Because most of the current heroin supply contains illicitly manufactured fentanyl, you may need to use multiple doses of naloxone.

Place the person on their side in the recovery position to prevent choking, and stay with them until emergency services arrive. Most states have Good Samaritan laws that provide limited legal immunity to people who call for help during an overdose.

Addiction Treatment Options for Smoking Heroin

Effective treatment for heroin use disorder typically begins with medically supervised detox, followed by either inpatient or outpatient treatment.

Medications for opioid use disorder (MOUD), including buprenorphine, methadone, and naltrexone, are among the most evidence-based treatments available and significantly reduce the risk of relapse and fatal overdose.

Behavioral therapies such as cognitive behavioral therapy and contingency management address the psychological components of recovery. Many people benefit from long-term MOUD combined with ongoing therapy and peer support.

Browse our directory to find heroin use disorder treatment options near you, or call SAMHSA’s National Helpline at 1-800-662-4357 for free, confidential support available 24 hours a day, 7 days a week.

Written by the Addiction Resource Editorial Staff