Chronic heroin use can lead to medical consequences such as scarred and/or collapsed veins, bacterial infections of the blood vessels and heart valves, abscesses and other soft-tissue infections, and liver or kidney disease. Poor health conditions and depressed respiration from heroin use can cause lung complications, including various types of pneumonia and tuberculosis.
Addiction is the most detrimental long-term effect of heroin use because it is a chronic, relapsing disease characterized by compulsive drug seeking and use, as well as neurochemical and molecular changes in the brain.
Long-term effects of heroin use also can include arthritis and other rheumatologic problems and infection of bloodborne pathogens such as HIV/AIDS and hepatitis B and C (which are contracted by sharing and reusing syringes and other injection paraphernalia). It is estimated that injection drug use has been a factor in onethird of all HIV and more than half of all hepatitis C cases in the United States.
Heroin use by a pregnant woman can result in a miscarriage or premature delivery. Heroin exposure in utero can increase a newborns’ risk of SIDS (sudden infant death syndrome).
Street heroin is often cut with substances such as sugar, starch, powdered milk, strychnine and other poisons, and other drugs. These additives may not dissolve when injected in a user’s system and can clog the blood vessels that lead to the lungs, liver, kidneys, or brain, infecting or killing patches of cells in vital organs. In addition, many users do not know their heroin’s actual strength or its true contents and are at an elevated risk of overdose or death.
According to Drug Abuse Warning Network (DAWN) emergency department (ED) data, there were 93,064 reported mentions of heroin in 2001, an increase of 47.4% since 1994 (see table 2). Preliminary ED data for the first half of 2002 revealed that there were 42,571 mentions of heroin. A drug mention refers to a substance that was recorded (mentioned) during a visit to the ED. Heroin represented 15% of 638,484 total ED episodes in 2001. Approximately 56% of heroin ED mentions were for people ages 35 and older. Almost half (43%) of heroin ED mentions were for whites.
According to DAWN’s 2001 mortality data, of the 42 metropolitan areas studied, 19 areas saw a decrease in the number of heroin/morphine mentions, while 9 areas reported an increase in heroin/morphine mentions.