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Shooting Heroin (IV Use) | Side Effects & Dangers Of Injection

Published on December 29, 2020
young woman loading a syringe from a spoon shooting heroin

Intravenous heroin use is considered the riskiest and most harmful form of heroin abuse. Shooting or injecting heroin is associated with severe addiction, physical health problems, mental health disorders, and self-destructive behavior.

Why Is Heroin Injected?

Of all the different ways to take heroin, intravenous injection (or shooting) is the most direct, efficient, and dangerous. 

By liquefying the drug with paraphernalia like spoons and lighters, people can deliver the entire dose of the drug into the bloodstream at once. This yields a powerful rush of euphoria and pleasure known as a heroin high.

Intravenous injection delivers a high that hits faster and is more intense than snorting, smoking, and either subcutaneous or intramuscular injection (‘skin-popping’). And many who begin using heroin by smoking or snorting eventually graduate to injection as their addiction deepens.

Overdose Risk From Heroin Injection

Because so much narcotic is delivered at once, heroin injections are the most likely method of use to result in either an immediate or delayed overdose, often with tragic consequences.

This risk increases even more when heroin is taken with other drugs like benzodiazepines, alcohol, or prescription narcotics (especially fentanyl). 

Signs of a heroin overdose as a result of injection can include:

  • blue-tinted nails and lips
  • drowsiness
  • low blood pressure
  • pinpoint pupils
  • weak or fluttering pulse
  • weak, slow, or interrupted breathing

Tens of thousands of Americans die from preventable heroin overdoses each year. 

If you suspect an overdose has occurred, immediately call for emergency medical aid and administer the opioid overdose antidote naloxone if you have access to it.

Learn more about Heroin Overdose

Health Effects Of Shooting Heroin

The process of injecting heroin, often with re-used, shared, or non-sterile needles, can cause significant physical harm beyond that of the drug’s action on the body.

Some short-term heroin side effects can include:

  • clouded or slow thinking
  • dry mouth
  • intense itching
  • heavy arms and legs
  • nausea and vomiting
  • nodding-off between consciousness and semi-consciousness
  • warm, flushed skin

Physical Dependence & Tolerance

Dependence may occur as your body adjusts to the drug and relies on it for normal function and pleasure. Tolerance means the effects of the drug decrease over time, requiring you to take larger and more dangerous doses for the same effect.


  • skin and soft tissue infections
  • vein infections
  • infection of the heart lining and valves
  • bone infections
  • wound botulism
  • tetanus
  • hepatitis C and B
  • HIV/AIDs
  • necrotizing fasciitis/gangrene (flesh-eating disease, often leading to amputation of the infected limb)

Vein & Skin Trauma

  • abscesses
  • collapsed veins
  • varicose veins (spidery veins that form around injection sites)
  • hematomas (swelling clumps of clotting-blood outside your blood vessels)
  • permanent scarring and track marks
  • deep vein thrombosis/pulmonary embolism (a clot or blockage, often resulting from filler materials mixed into black tar heroin)

Mental Damage

  • deterioration of the brain’s white matter
  • reduced memory and intellect
  • worsening mental health, often in the form of antisocial personality disorder or depression
  • insomnia
  • behavioral and mood changes
  • needle fixation

Other Long-Term Health Effects

  • tooth and gum damage
  • weakening musculature
  • constipation
  • cold Sweats
  • chronic itching
  • liver damage
  • sexual and reproductive dysfunction, including impotence
  • unhealthy loss of appetite leading to weight loss and malnutrition
  • weakened immune function

Learn more about the Short & Long-Term Effects Of Heroin Abuse

Treatment For Heroin Addiction

The opioid crisis and heroin epidemic in the United States casts a long shadow, and breaking free from heroin’s physical and mental pull can be difficult and even dangerous without professional help and supervision.

This is why addiction treatment centers offer programs with services that include:

Medical Detox

Medical detox provides a safe and secure route through intense heroin withdrawal symptoms with the help of around-the-clock supervision from health care professionals.

Medication Assisted Treatment (MAT)

Buprenorphine, methadone, or naltrexone may be prescribed to ease your withdrawal symptoms or change how the drugs affect your brain. These medications are also combined with behavioral therapy and other treatment services.

Inpatient/Outpatient Treatment

Treatment methods are personalized to your condition and needs, and are available in both inpatient or outpatient settings:

  • Inpatient treatment is ideal for severe cases and takes place entirely within a comfortable rehab facility, with all the support you need located on-site.
  • Outpatient treatment gives you the option to travel to and from sessions while living at home and attending other responsibilities.

In either case, your substance abuse treatment may involve group therapy, behavioral therapy, education, and a variety of supportive programs like art therapy, yoga, counseling, and support group participation.

To learn more about personalized programs for heroin addiction and substance use disorder, please contact an Ark Behavioral Health specialist today.

Written by Ark Behavioral Health Editorial Team
This page does not provide medical advice.

Minnesota Department of Health - Opioids Injection Drug Use
National Drug Intelligence Center - Heroin Fast Facts
National Institute on Drug Abuse - Heroin Research Report Overview

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