page_title: Heroin
section_title: Long term effects
hierarchical_section_title: Heroin / Adverse effects / Long term effects
caption_attribution_description: English: Main long-term effects of heroine, including the effects of the contaminants common in illegal heroin. (See Wikipedia:Heroin#Usage and effects). References: Office of National Drug Control Policy (ONDCP): Heroin Facts &amp; Figures Retrieved on 11 February, 2009 To discuss image, please see Template talk:Human body diagrams
context_page_description: Heroin, also known as diamorphine among other names, is an opioid most commonly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt which is distinguished from black tar heroin, a variable admixture morphine derivatives—predominantly 6-MAM, which is the result of crude acetylation during clandestine production of street heroin. Diamorphine is used medically in several countries to relieve pain, such as during childbirth or a heart attack, as well as in opioid replacement therapy. It is typically injected, usually into a vein, but it can also be smoked, snorted, or inhaled. In a clinical context the route of administration is most commonly intravenous injection; it may also be given by intramuscular or subcutaneous injection, as well as orally in the form of tablets The onset of effects is usually rapid and lasts for a few hours.
  Common side effects include respiratory depression, dry mouth, drowsiness, impaired mental function, constipation, and addiction. Side effects of use by injection can include abscesses, infected heart valves, blood-borne infections, and pneumonia.
context_section_description: Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of the brain's white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations. Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence, the body adapts to the presence of the drug, and withdrawal symptoms occur if use is reduced abruptly.
caption: Long-term effects of intravenous usage, including – and indeed primarily because of – the effects of the contaminants common in illegal heroin and contaminated needles.[60]
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