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Common Effects of Opium and Heroin

The effects of heroin and opium in the short term are similar in many ways. They include a high or euphoria as well as other side effects such as nausea and slowed breathing. The euphoric effects are generally the reason why people use these drugs.

In the long term, users who inject heroin are at risk for many health problems, such as hepatitis and HIV. Longtime users of either drug can develop dependence and addiction, and they have a greater chance of overdosing.

Difference Between Opium vs Heroin

Heroin and opium are both opioids, a class of drugs that bind to opioid receptors in the brain and body and are used medically to relieve pain.1

Opium is a plant extract derived from the sap of an opium poppy’s seedpod. This sap can be dried, molded into bricks or balls, and sold for recreational use. In this raw form, opium can be smoked or eaten but should not be injected, as it may contain several impurities, including bacteria and fungi. Opium contains several opioid alkaloid substances, and it can serve as the raw material for processing into other drugs such as heroin, morphine, and codeine.2

Heroin is a highly addictive drug that can be smoked, snorted, or injected. It is often encountered as a white or brownish powder or a tar-like substance. Heroin is often cut with other substances such as sugar or powdered milk.3,4

The Drug Enforcement Administration (DEA) lists opium and most of its derivatives as Schedule II controlled substances, indicating that they have potential medical uses but also a high potential for abuse. Heroin, on the other hand, is considered a Schedule I substance, meaning it has no accepted medical use in the United States.5

Short-Term Effects

The short-term effects of opium and heroin include:

  • Relaxed feeling.
  • Relief from pain and anxiety.
  • Slowed breathing.
  • Impaired coordination.
  • Constricted pupils.
  • Nausea.
  • Constipation.


  • Initial euphoria or “rush.”
  • Twilight state of sleep and wakefulness (i.e., frequent nodding off).
  • Constricted pupils.
  • Warm, flushed skin.
  • Dry mouth.
  • Nausea.
  • Respiratory depression.
  • Heavy extremities.

Long-Term Impacts of Using

The long-term effects of opium and heroin will depend on the method of intake.

Intravenous heroin use is associated with HIV, hepatitis C, and other bacterial infections. In fact, some studies indicate that up to 90% of people who inject opioids will go on to contract hepatitis C. Those who inject heroin can also develop myocardial issues (e.g., heart valve infections), widespread vascular inflammation, collapsed veins, and peripheral edema (swelling from fluid build-up secondary to compromised cardiovascular function). Once veins become unusable for injection, people may inject directly into subcutaneous tissue, which can result in abscesses and cellulitis.6

People who snort heroin may develop irritation of the nasal mucosa and perforation of the nasal septum.6

Other long-term effects of heroin use include changes in neuronal and hormonal balances and deterioration of white matter in the brain, which can affect decision-making abilities and stress tolerance.7

Long-term effects of both heroin and opium include:6

  • Dry mouth and nose.
  • Severe constipation.
  • Poor vision from repeated pupil constriction.
  • Increased risk of accidents and injuries.
  • Erectile dysfunction in men.
  • Reproductive dysfunction and irregular menstrual cycles in women.
  • Neonatal abstinence syndrome in babies born to dependent mothers.
  • Tolerance, dependence, and addiction.
  • Prolonged risk of overdose.
  • Depression and increased risk of suicide.

The Risk of Overdose

As opioid drugs, both opium and heroin can lead to severe respiratory depression and overdose—an all-too-common outcome of the current opioid epidemic in the United States.

In 2016, 116 people died each day from opioid-related drug overdoses.8  Overdose deaths related to heroin increased fivefold from 2010 to 2016, and heroin overdose death rates increased by almost 20% from 2015 to 2016.9

Using heroin has grown increasingly risky in recent years as it is frequently “cut” with other substances, such the synthetic opioid fentanyl or one of its analogs, like carfentanil. Fentanyl, which can be up to 100 times more potent than morphine, is largely responsible for a fivefold increase in overdose deaths from synthetic opioids from 2013 (3,105 deaths) to 2016 (about 20,000 total deaths).10

If a person uses heroin laced with these substances, there is no way of knowing the actual strength, which increases the chance for overdose.


Symptoms of an opioid overdose include:11

  • Extreme drowsiness.
  • Slow or shallow breathing.
  • Blue or purple fingernails or lips.
  • Very small pupils.
  • Slow heart rate or blood pressure.

If you believe someone is overdosing, take the following steps:11 

  • Call 911 – give your address and a description of your location.
  • Check for signs of overdose – look for the symptoms listed above.
  • Support breathing – use rescue breathing by making sure the person’s airway is clear, placing one hand on the chin, tilting the head back, pinching the nose closed, and giving 2 slow breaths by placing your mouth over the person’s mouth to make a seal.
  • Administer naloxone, if available – naloxone is a medication that reverse the effects of a heroin or opium overdose and can be given via nasal spray or injection.
  • Monitor the person – watch them for at least 4 hours after the last dose of naloxone.

Signs of a Developing Addiction

The American Society of Addiction Medicine estimates that nearly a quarter of all people who use heroin develop an addiction.1 Though less commonly abused, opium is also an addictive substance, and long-term use can lead to serious problems for users.12

When a person is addicted to either drug, they may show signs such as:6

  • Great persistence and time being spent trying to obtain and use opium or heroin.
  • Using opium or heroin despite relational problems or conflicts.
  • Using opium or heroin in physically hazardous environments (driving, work).
  • Using opium or heroin despite legal, occupational, or academic consequences.
  • Desiring to quit using opium or heroin but being unable to do so.
  • Increased tolerance (needing more of the substance to achieve the desired effect).
  • Withdrawal symptoms when abstaining from opium or heroin.

Tolerance, Dependence, and Withdrawal

Opium and heroin use can both lead to tolerance and physiological dependence.

When a person’s tolerance to these drugs increases, the person may experience less of an effect from the usual dose and need to take more of the substance (or take it more frequently) to achieve the desired high.6 Some people may turn to more dangerous routes of administration (such as shooting intravenously) due to increased tolerance.

Dependence means that the person’s body becomes accustomed to the presence of the drug and will not function normally without it. When the person stops using the drug, they can develop withdrawal symptoms as their body readjusts to the substance’s absence.13

Withdrawal symptoms for both drugs can be highly unpleasant and distressing. Many heroin users will continue to use to avoid them.13

Opioid withdrawal symptoms can include:6

  • Depressed mood.
  • Muscle or body aches.
  • Nausea or vomiting.
  • Diarrhea.
  • Pupillary dilation.
  • Goose bumps.
  • Profuse sweating and fever.
  • Insomnia.
  • Runny nose.
  • Tearing of the eyes.

The fear of withdrawal can help maintain a vicious cycle of dependence and addiction. If you or someone you know needs help with a heroin or opium addiction, search our online directory for information on rehab centers across the U.S.

Many programs around the country treat these addictions. They can help you safely complete withdrawal and begin a successful recovery.


  1. American Society of Addiction Medicine. (2016). Opioid Addiction 2016 Facts & Figures.
  2. Columbia University. (2018). Opium.
  3. Get Smart About Drugs. (2017). Heroin.
  4. Partnership for Drug-Free Kids. Heroin.
  5. Drug Enforcement Administration Museum and Visitors Center. Cannabis, Coca, & Poppy: Nature’s Addictive Plants: The Origins of Opium.
  6. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  7. National Institute on Drug Abuse. (2018). What are the Long-Term Effects of Heroin Use?
  8. U.S. Department of Health and Human Services. About the U.S Opioid Epidemic.
  9. Centers for Disease Control and Prevention. (2017). Heroin Overdose Data.
  10. Centers for Disease and Control Prevention. (2017). Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700–10 States, July-December 2016.
  11. Substance Abuse and Mental Health Services Administration. (2016). Overdose Prevention Toolkit.
  12. Partnership for Drug-Free Kids. (2018). Opium.
  13. National Institute on Drug Abuse. (2007). Definition of dependence.

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