Once heroin enters the brain, it is converted to morphine and binds rapidly to opioid receptors.11 People who use heroin typically report feeling a surge of pleasurable sensation—a "rush." The intensity of the rush is a function of how much drug is taken and how rapidly the drug enters the brain and binds to the opioid receptors. With heroin, the rush is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities. Nausea, vomiting, and severe itching may also occur. After the initial effects, users usually will be drowsy for several hours; mental function is clouded; heart function slows; and breathing is also severely slowed, sometimes enough to be life-threatening. Slowed breathing can also lead to coma and permanent brain damage.12
Opioids Act on Many Places in the Brain and Nervous System
- Opioids can depress breathing by changing neurochemical activity in the brain stem, where automatic body functions such as breathing and heart rate are controlled.
- Opioids can reinforce drug taking behavior by altering activity in the limbic system, which controls emotions.
- Opioids can block pain messages transmitted through the spinal cord from the body.