New Heroin Abuse Trend Leads to Deaths and Brain Damage

Brain examination after heroin use damage

A new report suggests that more heroin addicts are switching to smoking heroin instead of snorting it or injecting it. Smoking heroin is mistakenly viewed as a safer method of using heroin (compared to IV use). What the research is finding is that addicts are experiencing brain damage due to smoking heroin. And just because they smoke the drug instead of injecting it does not protect them from an overdose. That means users who smoke heroin are at risk for brain damage and overdose.

New Data Shows Yet Another Risk in Experimenting with Heroin

According to new data published in the Journal of the American Medical Association, opioid addiction affects about 2.4 million Americans. Almost one million of them (including 21,000 minors) abuse heroin. Heroin addiction costs the U.S. about $51 billion each year. And that’s just the tip of the iceberg on heroin’s harm.

The new research also shows that people who smoke heroin are at risk for brain damage. Citing the research, “Inhaled heroin use represents a global phenomenon and is approaching epidemic levels east of the Mississippi River as well as among urban youth. Chasing the dragon (CTD) by heating heroin and inhaling its fumes is particularly concerning because this method of heroin usage has greater availability, greater ease of administration, and impressive intensity of subjective experience (high) compared with sniffing or snorting. This is relevant owing to peculiar and often catastrophic brain complications.” According to the data, even if users who smoke heroin avoid an overdose, they run the risk of long-term side effects, including potentially permanent brain damage.

Without going too far into the biology and chemistry jargon, researchers found that drug users who administered heroin mainly by smoking it had unique associated health outcomes, mainly aggressive toxic leukoencephalopathy. Leukoencephalopathy is a disorder of the brain in which the brain’s white matter deteriorates, which is a critical issue as the brain’s white matter is partially responsible for both the motor and sensory systems. The researchers also reported that people who smoke heroin run the risk of stroke, seizure, and obstructive hydrocephalus, a serious condition in which the flow of fluid within the brain is blocked.

Heroin addict

In its mildest effects, smoking heroin was found to cause memory loss and long-lasting cognitive impairment. In more serious cases, the researchers found that regular inhalation of heroin led to the killing off of the brain’s white matter and the creation of sponge-like holes in the deteriorated areas. The result? Seizures, problems speaking, progressively worsening dementia, coma, and death.

The researchers hypothesized the reason why smoking heroin poses these unique risks (as compared to sniffing, snorting, or injecting) is because the high temperatures used to vaporize heroin converts the drug into a chemical that can cross the blood-brain barrier faster and more easily than in other methods of use. And because of how fast the drug gets to the brain, the chemicals are not metabolized by the body into a relatively less toxic substance. The result? A more potent and dangerous drug high delivered directly to the brain.

“’Chasing the dragon’ is not as safe as portrayed. And this isn’t something some doctor is saying to scare people away, it’s reality. It’s a heavy cost for patients, their families, and society itself.”

Sometimes addicts will justify inhaling heroin rather than injecting it because they believe that smoking the drug is “safer” than injecting it. If they inject, they run the risk of contracting diseases through contaminated needles. But the researchers said that smoking heroin is just as risky, but with different types of risks. Quoting one of the study authors, “’Chasing the dragon’ is not as safe as portrayed. And this isn’t something some doctor is saying to scare people away, it’s reality. It’s a heavy cost for patients, their families, and society itself.”

Understanding Heroin

Opium poppy plant

Heroin is an opioid drug made from morphine, which is synthesized from the seed pods of the opium poppy plant. Heroin usually appears in a white or brown powder or in the form of a black sticky substance known as black tar heroin. When heroin is used via smoking, sniffing, snorting, or injecting, the drug enters the body, makes its way to the brain, and rapidly binds with opioid receptors. Heroin acts as a depressant, eliciting a dulled, relaxed feeling of euphoria, along with slowed heart rate, slowed breathing, and general drowsiness. If too much heroin is consumed, the user overdoses, because the heroin causes such an extreme slowdown of breathing and heart rate that the heart stops and the user dies.

The Scope of Heroin Addiction and Overdoses in America

There is no doubt that heroin is a lethal substance. Unfortunately, the use of this substance has become more common in the United States. According to the National Institute on Drug Abuse, in 1999 there were 1,960 deaths from heroin-related causes. But in 2016, 15,469 people died from such overdoses, an 800% increase in deaths.

The Centers for Disease Control and Prevention studied the issue further. According to their findings, heroin-involved overdose deaths increased drastically from 2010 to 2019, going up over 500%. From the CDC’s findings, over 28% of opioid overdoses involved heroin.

In another report, researchers attempted to summarize the scope and effects of America’s growing heroin addiction crisis. “Heroin use has increased across the U.S. among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes. As heroin use has increased, so have heroin-related overdose deaths. Between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled, and more than 8,200 people died in 2013.”

Most researchers agree that heroin abuse took off in the mid-2000s not because the drug itself became suddenly popular or particularly desirable but because millions of Americans who had become hooked on opioid pain relievers needed an alternative to pain medication. Such individuals were finding it increasingly difficult to get ahold of pain meds, and the black market of heroin trafficking moved fast to meet the new demand. According to one NIDA report, “An estimated 4 to 6 percent who misuse prescription opioids switch to heroin and about 80 percent of people who used heroin first misused prescription opioids.”

There is Never a “Safe” Way to Use Heroin

Serious talk

Given the new findings, it becomes ever clearer that there is no such thing as “safe” heroin use. Even if an addict avoids overdose, the effects of heroin on the brain are such that users face serious lifetime complications, even from just one instance of using heroin.

If you know someone who is using heroin, please do everything you can to get them into a drug and alcohol addiction treatment center as soon as possible. Heroin use is a life-or-death crisis. Don’t wait another day, as another day may be too late. Help your loved one into a treatment center today.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP, LCDC



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.