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Understanding the Dangers of Smoking Heroin

Heroin is a dangerous and very addictive narcotic drug made from morphine. It is usually injected but can also be smoked.  Smoking heroin produces physical and psychological dangers.

No Medical Use

Some of the strictest drug laws in the United States were passed due to problems with heroin, including the Controlled Substances Act (CSA) in the 1970s when the last heroin epidemic was raging.
The  U.S. Drug Enforcement Administration (DEA) listed heroin as a Schedule I drug, meaning there is no medical use for this opioid drug, and it is a harmful substance of abuse. Other opioids, including morphine, are usually placed on Schedule II because they have valid medical uses to treat pain, but they must be tightly controlled due to addiction risks.
Heroin was initially designed to be a medication. The chemical was synthesized in the 19th century because morphine, the original synthetic opiates, proved to be problematic and led to addiction.
Doctors believed that if they could find an opioid drug that worked quickly to kill pain and the high from it did not last long, then the painkiller would be more effective. The opposite turned out to be true.

Heroin Abuse in the United States

The current epidemic of heroin addiction and overdose is associated with the rise of newer prescription painkillers in the late 1990s. As those have become more regulated due to addiction risk since 2010, many people turn to heroin. It is less expensive, easier to get, and more potent than many prescription drugs.

As drug abuse becomes a more severe problem in the U.S. — on average, about 130 Americans die from opioid overdoses every day — drugs are abused in different ways. For example, someone who has orally consumed prescription narcotics to get high may begin crushing and snorting these pills. When they move to heroin, they may snort, smoke, or inject it.
While injecting a drug intravenously is the fastest method of getting high, smoking a substance also rapidly introduces the drug to your brain. This means that smoking substances like heroin cause an intense high, triggering the reward system.

What Happens When You Smoke a Drug?  

There is a misconception that smoking heroin is less addictive than injecting it.
Heroin itself, regardless of how it is consumed, is very potent and habit-forming. Abusing the drug in any way can lead to compulsive behaviors associated with addiction. Smoking is a method of rapid drug delivery to the body, so abusing any substance by smoking it can lead to addiction.

Drug delivery methods can affect how quickly you become addicted to a substance.
For instance, if you eat a cannabis-laced cookie, the drug will enter your blood slowly as it is digested. It will bind to your brain for longer, but the high will come on more slowly. When you smoke cannabis, the substance enters your lungs and attaches to blood cells along with oxygen, so it is then rapidly sent through your body, including your brain.
The faster a drug reaches your brain and causes intoxication, the sooner you may develop compulsive behaviors around it, which define addiction.

zippo lighter under a smoking spoon of heroin

Smoking Heroin

Smoking heroin leads to intoxication within 10 to 15 minutes. Eating heroin takes longer, leading to a high after about 30 minutes to an hour. Injecting the drug causes a high in just a few seconds.
Getting high faster causes side effects from the drug to occur faster too. The euphoria from intoxication will wear off faster.
Side effects of heroin abuse include: 

  • Going “on the nod,” or falling asleep and waking up in rapid cycles
  • Passing out
  • Slowed, irregular, or depressed breathing
  • Stopped breathing

Smoking and injecting heroin leads to surges or spikes of intoxication, which can lead to compulsive behaviors to take more since those spikes dip quickly.
Drugs like heroin cause surges of dopamine, a neurotransmitter that elevates mood and is also associated with managing the reward system. For example, eating something sugary and exercising for 30 minutes can both trigger small releases of dopamine. You will feel good, and you will associate these activities with feeling good, so you will do them again. You may crave exercise or sweets because your reward center is used to teaching you that these behaviors lead to positive outcomes.
Addictive drugs like heroin trigger the reward center with a huge rush of dopamine and other neurotransmitters. The faster drugs hit the brain, the faster this dopamine surge occurs.

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Quit Smoking Heroin With Help

Smoking heroin is not a common practice. According to one survey of heroin, methamphetamine, and cocaine users, about half of those struggling with heroin addiction injected the drug.
However, injecting drugs has also been reported as psychologically different than other forms of abuse, which may be associated with the false belief that smoking heroin is safer than injecting it.
There are several health risks of injecting drugs, like a higher risk of contracting hepatitis C or HIV from sharing needles. There are also risks associated with smoking any drug, including heroin, such as: 

  • Cardiovascular disease including blood clots, stroke, and heart damage
  • Lung diseases, including greater risk of pneumonia and tuberculosis
  • Emphysema, bronchitis, and chronic obstructive pulmonary disease (COPD)
  • High risk of cancer, including breast, colon, bladder, and lung cancer

Quitting heroin reduces your risk of overdose death due to slowed or stopped breathing, and it lessens your risk of any long-term harm associated with abusing the drug, including lung and heart damage. Get help with evidence-based treatment, starting with detox, to overcome compulsions and stay healthy. 


(October 29, 2013). Heroin. Center for Substance Abuse Research (CESAR). Retrieved February 2019 from

Heroin: What is It? Drug Enforcement Administration (DEA). Retrieved February 2019 from

(December 19, 2018). Opioid Overdose: Understanding the Epidemic. Centers for Disease Control and Prevention (CDC). Retrieved February 2019 from

(June 2018). What is Heroin? National Institute on Drug Abuse (NIDA). Retrieved February 2019 from

(September 2, 2015). Snorted, Injected, or Smoked? It Can Affect a Drug’s Addictiveness. The Conversation. Retrieved February 2019 from

(July-September 2011). Comparing Injection and Non-Injection Routes of Administration for Heroin, Methamphetamine, and Cocaine Uses in the United States. Journal of Addictive Disorders. Retrieved February 2019 from

(January 17, 2018). Health Effects of Cigarette Smoking. Centers for Disease Control and Prevention (CDC). Retrieved February 2019 from

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