You are currently viewing Can Heroin Damage the Brain? Are There Serious Heroin Effects on the Brain?

What does heroin brain damage look like?

While street heroin and fentanyl are dangerous drugs, pure pharmaceutical heroin was thought to be relatively safe. If a person were to use pure heroin with clean supplies and under supervision, experts believe that the illegal opioid did not typically cause permanent damage to the body.

More recently, studies show now that chronic, long-term heroin use may cause damage to the white matter of the brain. In fact, this damage is believed to be related to cognitive decline, with reduced cognitive impairment and reduced overall cognitive function.

Part of the difficulty with impulse control that leads a person back to heroin consumption may be related to heroin effects on the brain. Is there really a danger of brain damage from opioids?

Is heroin brain damage caused because heroin is an illegal street drug?

Before talking about the long-term effects of heroin, we should acknowledge that heroin is not a legal drug. It is rarely studied in controlled settings in humans.

If a study looks at changes in the brains of street heroin users, we must consider all of the factors involved in street drug use. Imagine if we accepted studies on other prescription drugs that used homemade street versions of those drugs?

Of course, it would be preposterous to look at a study on the cholesterol-lowering drug, Lipitor, if the study involved a street-cooked, back-alley version of the drug. How would we know if adverse effects were from the drug molecule itself, or from the clandestine manufacturing process and contamination?

Street heroin is not comprised of pharmaceutical grade heroin, produced in a world-class lab and delivered in certified vials to street dealers. It is extracted from poppy seeds in war-torn, undeveloped nations and then cut with various unknown substances before being delivered to the streets.

To further complicate matters, street heroin in recent years has also been contaminated with exotic fentanyl analogs from countries like China and Mexico. Fentanyl is a legal drug in the US, yet the fentanyl being added to heroin on the streets is not the same fentanyl.

In fact, street fentanyl is not even the same molecule. It is a different chemical altogether, and is more of a sibling or cousin to pharmaceutical fentanyl. Fentanyl analogs found in street heroin has different properties compared to legal fentanyl, and the effects on the brain and human body are not fully understood.

Can heroin damage the brain and cause Parkinson’s disease?

In the 1980s, there was an incident where a group of heroin users in California developed symptoms of Parkinson’s disease. It was due to a contaminant in the heroin known as MPTP.

MPTP caused interference in the mechanism of mitochondria in the neurons of the brain. The effect was similar to a toxic pesticide named rotenone which is known to have the same effect on rats, causing them to exhibit Parkinson’s-like symptoms.

The effects of the contaminated heroin were long-lasting. These heroin users suffered from permanent brain damage because they used heroin bought on the streets.

Parkinson’s disease is a terrifying condition in which the patient is essentially trapped in their own body. They lose much of the control of their movements that they previously took for granted.

While we are not seeing this type of damage currently, we cannot be completely certain what effect various designer fentanyl analogs will have on structures in the brain, including white matter microstructures and white matter pathways.

While a person injecting heroin may take comfort in the fact that other heroin users are not suffering from debilitating white matter disease of the brain at this time, we do not know what may occur long-term or what may come up at any time in the near future. Law-breaking chemists working in secret labs to cook up new versions of fentanyl to skirt local laws are not concerned about the white matter lesions they may cause.

What about morphine brain damage or oxycodone brain?

Since there are few, if any studies on the effects of pure, pharmaceutical heroin on the human brain, it will help to look at studies of other, legal opioids on the human central nervous system. After all, heroin is not so different from legal, prescription opioids.

In fact, heroin is converted in the human body to morphine. We can think of heroin as being essentially the same as morphine, and closely related to other prescription opioids, such as codeine, oxycodone, hydrocodone, hydromorphone, oxymorphone, and others.

Since these medications are prescribed by doctors on a regular basis and there are patients who have taken them for many years for the treatment of chronic pain, it is possible to study the long-term effects of these drugs on the brain. Of course, it is important to also account for the effects of chronic pain itself on the central nervous system.

Have studies demonstrated that there are changes to the myelin sheath, neuron and neuronal cell bodies, or other nerve cell structures? Brain studies looking for the long term effects of various drugs on the brain make use of magnetic resonance imaging, or MRI scan technology, in addition to direct study of the nerve fibers and nerve cells.

While studies that look at the brain on a large scale do not show major changes in most cases, when scientists took a closer look, looking at the synapses, the terminal regions where neurons communicate with each other do show changes in specific regions of the brain. In the reward centers, including the ventral segmental area (VTA), scientists have noticed strengthening of the connections that respond to opioid use with dopamine release.

What they have found, which is measurable changes in the chemical functioning of neurons in response to long-term opioid exposure, is a demonstration of what might be happening when a person becomes addicted to opioids or other substances. Addiction is more than just a bad habit or poor behavior. It is due to real changes in the brain.

Is the brain damage caused by heroin or fentanyl permanent?

If we are referring to the changes in brain cells as noted above, where the brain’s reward system is hijacked by an addictive substance, then this form of “brain damage” is likely partly reversible and partly permanent. A person can reach a state after discontinuing substance use, where they no longer have drug cravings.

Yet, a person who has been addicted to a substance in the past and has recovered from that addiction is still at risk for falling back into active addiction very easily. Some element of the reinforced pathways in the brain’s reward system remains and can be awakened with even minimal stimulation, if the person ingests the addictive substance again, even many years later.

Another form of brain damage that may occur is due to hypoxia when a person uses heroin or fentanyl and their breathing slows down. When mu opioid receptors are stimulated, one of the responses of the central nervous system is to slow down the respiratory rate.

A heroin user may experience a heroin overdose in which their brain does not get enough oxygen for a prolonged period. Afterwards, it is possible that the person will display mild cognitive impairment caused by the diffuse brain damage that results from hypoxia.

So, while this form of brain damage is not one caused by heroin effects directly, it is an indirect consequence of heroin abuse as a result of heroin addiction. A person engaged in substance abuse due to opioid addiction does not care about their physical health and physical consequences.

While high on heroin, the person may note that their breathing has slowed down and that they have little respiratory drive. It may even seem interesting to them that they can hold their breath for long periods of time without discomfort.

Why do young people use dangerous drugs such as heroin without fear of consequences?

One theory about why young people experiment with drugs is that their brains are not fully developed yet. Myelination of the neurons in the brain is the process in which a protective myelin sheath forms over the brain cells

The process, in which each neuron has a fully myelinated axon, does not complete until around the age of 25. Up until this time, young people have been more likely to engage in impulsive and dangerous behavior.

The fact that their brains are not finished developing may put their gray matter at more risk for harm from dangerous substances. While drug abuse is not safe at any age, it can be particularly dangerous for young adults and children.

Does Suboxone cause brain damage?

Is there such a thing as Suboxone brain? Do people who take Suboxone for medication assisted treatment have to worry about long-term, permanent changes to their brains due to Suboxone use? Heroin withdrawal is an intense, very unpleasant experience. Combined with cravings, the opioid withdrawal syndrome makes it very difficult for the heroin addict to quit. Suboxone can help by preventing ongoing opioid withdrawal symptoms and opioid cravings.

The current recommendation by experts is that Suboxone treatment should last for at least one year. In many cases, more than a year is ideal, and in some cases, treatment should be continued indefinitely.

Some patients are concerned about the long-term effects of Suboxone on the brain at the biochemical level, and how it may influence functioning of the brain’s reward centers and the normal release and re-uptake of neurotransmitters. Are there long-lasting changes to opioid receptors or other microstructures of neurons of the central nervous system?

One reason that people have this concern is that tapering off of Suboxone after long-term treatment can result in ongoing opioid withdrawal symptoms that can last for weeks, or even months. Some patients even complain of PAWS, or post-acute withdrawal syndrome, which means that they continue to experience periodic withdrawal symptoms for extended periods.

While it is clear that Suboxone does not cause damage to any brain region that can be seen on a brain MRI, diffusion tensor imaging, or similar scan, there may be changes on a microscopic scale that have not been discovered yet. As you can imagine, studying living human brains is not an easy task.

Are dopamine receptors affected by long-term Suboxone use?

Should addiction treatment specialists be concerned about recommending Suboxone therapy? Many medical therapies that are used on a large scale may have long-term consequences, and it is important to continue scientific studies and ongoing monitoring of patients who are prescribed life-saving medications, such as Suboxone. Yet, we must also consider the benefits vs risks.

Suboxone, and similar meds, such as ZubSolv, and Subutex, save lives. People with heroin use disorder are able to return to normal functioning, with a significantly reduced risk of relapse. The short-term effects of heroin can lead to accidental overdose and death.

Additionally, there are many patients who have discontinued Suboxone therapy and overcome post acute withdrawal symptoms. While these symptoms may persist long-term, they do eventually subside. It is possible to stop taking Suboxone and feel normal again.

Based on anecdotal reports from patients who have remained in recovery after completing Suboxone therapy, I believe that there is no lasting damage to microscopic brain structures, such as neurotransmitter receptors or related microstructures. Furthermore, the risk of brain damage from opioids of abuse is significant and can be prevented with Suboxone treatment.

Overdose on heroin or fentanyl leads to hypoxia, which can cause damage to white matter tracts and white matter microstructures. White matter injury (WMI) and damage to the gray matter of the cerebral cortex can seriously affect the brain function of an individual who has survived an overdose.

Is brain damage from drug use permanent?

Cerebral white matter damage can block connections between important brain structures, including the corpus callosum, basal ganglia and anterior cingulate, impacting thought processes, attention, perceptual awareness, memory, language and consciousness. Loss of brain function can lead to symptoms of dementia and mental health disorders.

Unlike progressive brain disorders such as Alzheimers disease and vascular dementia, it is possible for a person in recovery to have improved brain function over time. Lost brain function can be recovered, as the brain heals and finds new pathways around the neurological lesions which have formed.

Overcoming heroin dependence and drug addiction is essential, even if there has been damage to the brain’s gray matter. Short term effects of drug-related brain damage can be accommodated by the very flexible human central nervous system. Brain function improves with time after stopping opioid use, whether it is heroin, street fentanyl, or even prescription opioid use.

White matter change due to white matter lesion as a result of the short term effects of heroin and hypoxia can improve for many people recovering from opioid use disorder. While overcoming the issues of opioid physical dependence is not easy, it is possible, especially with the help of medication assisted treatment.