Heroin is an illegal opioid drug derived from morphine. Opioids are powerful pain-relieving medications that are sometimes referred to as depressants.

This is largely due to the discernable effects of the drugs on the body — including slowed breathing and heart rate. But the National Institute on Drug Abuse categorizes heroin and prescription opioids in a class of their own.

Opioids activate the opioid receptors in the central nervous system, which can cause respiratory depression. However, opioids act primarily as analgesics, or painkillers, and rarely have depressant effects unless taken at high doses or with other drugs that produce sedation, namely the classical CNS depressants, such as benzodiazepines and barbiturates.

The Drug Enforcement Administration classifies heroin as a Schedule I controlled substance in the United States — meaning it has no medical uses and a high potential for abuse and addiction. Conversely, most central nervous system depressants, such as Xanax and Ambien, have been approved by the FDA for medical use and scheduled according to their risk for abuse.

Various types of drugs can trigger depression, a mood disorder characterized by fatigue, hopelessness and suicidal thoughts, but that does not mean that these drugs are depressants. The National Institute on Drug Abuse explains that CNS depressants slow brain activity by increasing the activity of the chemical GABA, gamma-aminobutyric acid.

man experiencing depression after heroin use
Unlike benzodiazepines, barbiturates and other prescription sedatives used to slow brain activity in the treatment of anxiety and sleep disorders, opioids — including heroin — affect brain functioning by attaching to and activating opioid receptors to regulate pain.

In addition to blocking pain, opioid receptors are involved in feelings of pleasure and in controlling heart rate, sleeping and breathing. This means that while heroin dulls pain and offers a rapid and intense rush, it may also impair cognitive functioning, increase sedation, and slow certain autonomic functions, such as those that control a person’s respiratory rate. In other words, it acts as a depressant.

After an initial surge of pleasure or euphoria people who use heroin often experience heaviness in their arms and legs clouded mental functioning. Another side effect of heroin use is “going on the nod,” which is a back-and-forth state of consciousness and semi-consciousness.

People who use heroin chronically can experience many adverse reactions affecting the body and the mind. Mental disorders such as depression can occur with long-term heroin use.

Opioid abuse is closely associated with mood disorders such as depression and higher rates of anxiety disorders, research suggests. Heroin, particularly, can cause mood changes, suicidal behavior, psychological dependence and addiction.

About one-fourth of heroin users will eventually become addicted to the drug, according to the National Institute on Drug Abuse. And nearly one-half of people addicted to heroin will also suffer from depression.

When a person begins to use more and more heroin to achieve the same initial transient “high,” the brain quickly adapts to the constant presence of the drug.

If the person decides to stop taking the drug, the brain will fail to produce or trigger the high levels of pleasure or feel-good signals it was once accustomed to with the increased stimulation of the heroin. This can lead to symptoms of depression as the brain struggles to adjust.

Untreated depression can become worse or interfere with recovery efforts as a person detoxes. Research shows that heroin users who also suffer from depression have a greater risk of overdose, relapse and suicide.

Signs of depression include:

  • Low mood without reason
  • Irritability
  • Sleep problems
  • Change in appetite
  • Weight gain or loss
  • Extreme fatigue
  • Feelings of worthlessness and guilt
  • Trouble concentrating
  • Slowed or accelerated movements
  • Feelings of Hopelessness
  • Lack of enjoyment in usual activities or hobbies
  • Repeated thoughts of suicide or death

The important thing to remember is that the mood disorder depression is not the same as the depression of the central nervous system and not all drugs with depressant properties are classified as depressant drugs.

If you’re facing a heroin use disorder or depression, help is available for both. Do not wait to seek treatment because both of these disorders can lead to severe health consequences. With treatment centers across the country The Recovery Village can help you find effective treatment options for your mental health and substance use problems. To learn more about how treatment can help you heal, contact a representative at The Recovery Village today.

Centers for Disease Control and Prevention. (2017, August 24). Opioid Overdose. Retrieved from https://www.cdc.gov/drugoverdose/opioids/index.html

Darke, S., et al. (2009, March 31). Patterns of major depression and drug-related problems amongst heroin users across 36 months. U.S. National Library of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19215987

European College of Neuropsychopharmacology. (2007, October 15). How does the opioid system control pain, reward and addictive behavior? Science Daily. Retrieved from https://www.sciencedaily.com/releases/2007/10/071014163647.htm

Hasin, D.., et al. (2002, April). Effects of major depression on remission and relapse of substance dependence. U.S. National Library of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11926938

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Merrer, J. L., et al. (2009, October). Reward Processing by Opioid System in the Brain. U.S. National Library of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4482114/

National Institute on Drug Abuse. (2010, September). Comorbidity: Addiction and Other Mental Illnesses. Research Report Series. National Institutes of Health. U.S. Department of Health and Human Services. Retrieved from https://www.drugabuse.gov/sites/default/files/rrcomorbidity.pdf

National Institute on Drug Abuse. (2018, June). Heroin. Drug Facts. Retrieved from https://www.drugabuse.gov/publications/drugfacts/heroin

Nunes, MD, E. V. and Levin, MD, F. R. (2004, April 21). Treatment of Depression in Patients With Alcohol or Other Drug Dependence: A Meta-analysis. Journal of the American Medical Association. Retrieved from https://jamanetwork.com/journals/jama/article-abstract/198569

Scherrer, J.F. et al. (2016, January/February). Prescription Opioid Duration, Dose, and Increased Risk of Depression in 3 Large Patient Populations. Annals of Family Medicine: Volume 14, No. 1 54-62. Retrieved from http://www.annfammed.org/content/14/1/54

Substance Abuse and Mental Health Services Administration. (2013). Opioid Overdose Toolkit: Information for Prescribers. Retrieved from https://www.integration.samhsa.gov/Opioid_Toolkit_Prescribers.pdf

U.S. Food and Drug Administration. (2018, June 14). Opioid Medications. Retrieved from https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm337066.htm

U.S. National Library of Medicine. (2018, May 5). Depression – overview. National Institutes of Health. Retrieved from https://medlineplus.gov/ency/article/003213.htm

U.S. National Library of Medicine. (2018, May 5). Opiate and opioid withdrawal. National Institutes of Health. Retrieved from https://medlineplus.gov/ency/article/000949.htm

U.S. National Library of Medicine. (2017, May 14). Pain medications – narcotics. National Institutes of Health. Retrieved from https://medlineplus.gov/ency/article/007489.htm

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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