Smoking Heroin: Risks & Side Effects You Need To Know

Chasing the dragon. The phrase sounds poetic, but the reality is that smoking heroin is more risky than refined. The term is Cantonese slang, and it describes heating heroin (or other opioids such as morphine or opium) on something like aluminum foil and inhaling the resulting fumes, usually through a small tube.

Today, chasing the dragon has come to mean chasing an elusive heroin high.

What Does Heroin Feel Like?

Heroin is an opioid drug made from morphine, derived from the resin of the opium poppy plant’s seed pods. As an opioid, heroin is in the same family as prescription pain relievers such as codeine, oxycodone, and hydrocodone. All are very effective at blocking pain, but when misused, they can become addictive.

Because of the opioid epidemic, some people have turned to heroin as a cheaper and possibly easier-to-acquire fix than prescription opioids. In 2016 alone, nearly 1 million Americans reported using heroin in the past 12 months.

Heroin-linked overdose deaths have been on the rise in the last decade. In 2010, it was tied to 3,036 fatalities. By 2018, heroin factored into 14,996 deaths. People use the drug by injecting, smoking, or inhaling it.

When taken, users report that heroin causes a sort of rush of pleasure and warmth. Other side effects include:

  • Dry mouth
  • Heavy-feeling limbs
  • Nausea, vomiting
  • Itching
  • Brain fog
  • Going “on the nod,” a kind of drifting in and out of consciousness

How long a heroin high lasts depends on how much has been taken and if it’s been taken with other substances. On its own, a heroin high may last several hours, leaving the user feeling drowsy and a bit disconnected.

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Can You Smoke Heroin?

In a word, yes. Can you overdose from smoking heroin? In other words, yes. Smoking heroin or opium occurred in Asia in the 1920s (when the drugs were heated in porcelain bowls), and from there it spread globally, including to the United States.

Americans tend to smoke more cigarettes and cannabis, and with heroin use, puffing it was more a novelty. Heroin has long tended to be inhaled or injected, but more Americans have taken to smoking it in recent years.

Reasons why smoking has become more common, aren’t exactly clear. It could be that it’s just something new to do. It could also be a way to avoid contracting HIV or hepatitis or avoid contracting injection-site injuries and infections, which are more likely with needle use.

That’s not to say smoking heroin is a safer alternative. Needle-free usage minimizes some risks, but inhaling invites other problems. Smoking heroin or any other substance is definitely not a good practice when dealing with health conditions such as COPD (chronic obstructive pulmonary disease), which includes emphysema and chronic bronchitis.

The main cause of COPD is smoking tobacco, but one study found that smoking heroin (it should be noted a high number of the study’s heroin users also smoked tobacco) seems to increase the likelihood of these progressive lung diseases. Because heroin slows respiration and negatively impacts health overall, pneumonia and tuberculosis can result.

Heroin also has other effects on the body. Long-term use can lead to:

  • Endocarditis (an infection of the lining and valves of the heart)
  • Mental health problems, like depression or anxiety
  • Liver and kidney disease
  • Constipation, cramping
  • Sexual dysfunction, for men
  • Altered menstrual cycles for women

Other risks accumulate when using heroin if someone has altered an opioid (such as providing super-potent fentanyl, for example) unbeknownst to the user, the danger of overdose or even death skyrockets.

The same goes with intentional multiple drug use. When people pair heroin or fentanyl with cocaine, the result is a speedball. Many polydrug users take one substance to wipe out the undesirable side effects of another.

Cocaine as a stimulant can make users more jittery, and heroin as a depressant will act as a sedative. Combined, it’s kind of a Goldilocks goal: the too-hot cocaine meets the too-cold heroin and the desired result is a just-right buzz.

The problem is that by knocking out some of the unpleasant side effects, the user may have a false sense of just how much of the drugs they’ve taken, putting them at risk of an overdose.

Can You Overdose From Smoking Heroin?

Too much heroin, like other club drugs, taken on its own or combined with other substances, can be deadly. Because of the opioid slow breathing and heart rates, users put themselves in danger of coma and even dying.

Signs of an overdose include:

  • Slowed or stopped breathing or heartbeat
  • A bluish or purplish cast to lips and fingernails (due to lack of oxygen
  • Cold, pale, damp skin
  • Shaking
  • Vomiting, choking, or gurgling sounds
  • Limpness
  • Unconsciousness

If an overdose is suspected, it’s vital to call 911 immediately.

If Narcan (naloxone) on hand can reverse the effects of an overdose, administer that. It’s typically available as an easy-to-use injection or nasal spray.

It’s still important to call for help. Narcan/naloxone can save lives, but symptoms may return, and more doses and additional treatment may be needed.

Overcoming Addiction

Going into recovery is rarely easy, no matter what a person’s addiction is. Overcoming heroin addiction is possible, however.

Typically medication-assisted treatment (MAT) — medications such as methadone, buprenorphine, and naltrexone, which reduce the discomfort of withdrawal — paired with behavioral therapies can address the immediate pains of becoming drug-free and help people work on long-term strategies to achieve and maintain sobriety.


Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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