Heroin belongs to a class of drugs that scientists call opioids. People who use the drug may be at risk of developing certain infections, such as wound botulism, infective endocarditis, and tetanus.

Heroin is an illegal opioid. When someone uses it, they may experience a rush of pleasure or euphoria. However, the drug can cause a range of health issues, including potentially life threatening conditions.

This article discusses heroin and the risk of infection in more detail, including some types of infections a person may experience due to heroin use and tips to help prevent them.

A row of syringes with different levels of liquid inside 1Share on Pinterest

A person may take heroin intravenously. This means they inject the drug into their veins. A study from 2018 noted that people who inject heroin are at higher risk of infection than people who inject certain other substances.

There are various factors associated with taking heroin intravenously that may increase a person’s chances of developing an infection. These factors include:

  • reusing or sharing needles or injection equipment
  • unintentionally using water that contains pathogens to dissolve the heroin
  • using a cigarette filter or reusing filters and cottons to filter the drug
  • taking heroin that contains contaminants
  • not cleaning the skin properly before injecting the drug
  • injecting heroin into muscle or other body tissues instead of a vein, either intentionally or unintentionally
  • “booting” or “jacking,” which is repeatedly drawing blood and heroin back out and then back into the vein

The type of heroin a person injects may also increase their risk of infection. A review of research from 2021 noted that a dark, sticky form of heroin, which people may call black tar heroin, could carry a higher risk of infection.

Heroin use may also expose a person to situations where the risk of infection is increased. This can include:

  • experiencing homelessness
  • becoming incarcerated
  • engaging in sexual activity without using barrier methods

Wound botulism is a rare but serious condition. The Centers for Disease Control and Prevention (CDC) state that a person is at an increased risk of developing wound botulism if they inject drugs such as black tar heroin into their skin or muscle.

The condition develops when a type of bacteria called Clostridium botulinum gets into a wound, such as an injection site. Over the next few days or weeks, it multiplies and makes a toxin that attacks a person’s nerves. This may cause:

Without treatment, wound botulism can be fatal. A person should seek immediate medical attention if they develop any symptoms of wound botulism.

Infective endocarditis is an infection of the inner lining and valves of the heart that bacteria, fungi, or other microbes may cause. Injecting heroin may allow these microbes to enter a person’s bloodstream through the injection site.

Infective endocarditis can weaken parts of a person’s heart, which may cause them to develop a heart murmur. It can also cause flu-like symptoms in its early stages.

Other signs of infective endocarditis include:

Infective endocarditis can be fatal without treatment. A person should speak with their doctor urgently if they experience any symptoms of the condition.

Tetanus occurs when Clostridium tetani bacteria enter a person’s wound. It affects the nerves and muscles, causing symptoms including:

Research from 2022 suggests that people who inject drugs have a higher risk of developing tetanus. Similarly, the National Harm Reduction Coalition states that people who inject drugs into their skin or muscle are at increased risk of tetanus.

Tetanus can be fatal without treatment. A person should seek immediate medical attention if they have any symptoms of tetanus.

HIV is a virus that affects a person’s immune system. This can cause them to have higher risk of infections and illness.

The virus spreads when people exchange certain bodily fluids, such as blood and semen. If a person shares needles with a person who has HIV, they are at risk of infection. A person may also contract HIV by having sex with a person who is HIV positive without a condom or other barrier method.

The CDC notes that people who injected drugs accounted for 10% of new HIV cases in 2018.

Early symptoms of HIV include fever and fatigue. Without treatment, a person may go on to develop certain infections, cancers, or other conditions as a result of a weakened immune system.

A person should speak with their doctor as soon as possible if they believe they may have HIV.

Doctors call damage and inflammation of the liver due to infection “viral hepatitis.” A person who injects drugs may be at risk of developing multiple forms of hepatitis, with the most frequent types being hepatitis B (HBV) and hepatitis C (HCV). These two forms of the condition spread through blood-to-blood contact.

A person may contract HBV or HCV by sharing needles and other injection equipment. These viruses can also spread through sex without condoms or other barrier methods.

Individuals who have HBV or HCV may not experience symptoms. If symptoms or other health complications do occur, they can include:

People should speak with a healthcare professional if they think they may have viral hepatitis.

Cellulitis is a bacterial skin infection. In people who inject drugs, the bacteria may enter the skin through an injection site. This can cause pain, skin discoloration, and swelling.

Research from 2020 found that cellulitis is common among people who inject drugs.

It is best to consult a doctor if a person develops cellulitis, as it requires treatment with antibiotics.

The best way to prevent infection from heroin use is to stop using it completely.

However, if a person is unable to stop using heroin, they may reduce their risk of infection by:

  • not sharing needles or other equipment
  • sterilizing needles
  • getting tested and treated for infections
  • always using condoms or other barrier methods when engaging in sexual activities
  • getting vaccinated against tetanus and HBV
  • using a syringe service program to receive free sterile needles
  • taking medications, under a doctor’s guidance, to help prevent or treat HIV
  • cleaning the skin properly before injecting heroin

People who use heroin should speak with a healthcare professional. They can provide guidance for stopping heroin use and treating substance use disorder (SUD).

Help is available

Seeking help for addiction may feel daunting or even scary, but several organizations can provide support.

If you believe that you or someone close to you is showing signs of addiction, you can contact the following organizations for immediate help and advice:

Was this helpful?

If a person uses heroin, they are at risk of developing various infections, including viral hepatitis, wound botulism, and HIV.

The best way to help prevent infection is to stop using the substance completely. If a person cannot stop using heroin, they should consider taking protective measures to reduce their risk of infection. Individuals who use heroin should speak with a doctor who can provide guidance for stopping heroin use and treating SUD.