Heroin and Blood Pressure: The Dangers of Hypotension

“One of the hardest things was learning that I was worth recovery.” – Demi Lovato

In 2022, thirty-two deaths were associated with heroin in Tampa County. Thirty-two lives ended too soon. Unfortunately, these recorded deaths are people who died with heroin in their system. We don’t know how many people in our community died from health problems related to long-term heroin use.

Opioid use disorder (OUD), is associated with many health conditions that affect everything from the brain to the lungs to blood vessels throughout the body. Because heroin and other opioids slow the heart, the effects of heroin on the cardiovascular system are of particular concern and can impact you in the long term.

At Real Recovery, we know that recovering from OUD is a commitment that takes time. That’s why we’re with you every step of the way, from your first night of inpatient care through your first year of sober living and beyond.

Now, let’s discuss the relationship between heroin and blood pressure.

How Heroin Affects Your Blood Pressure

Opioids like heroin are known to lower blood pressure. Blood pressure is the force that pushes blood through your arteries, getting oxygen and vital nutrients into your organs. Low blood pressure is also known as hypotension.

Heroin slows the heart considerably. When your heart slows down, it’s less effective at pumping blood through the body. This leads to low blood pressure. Heroin also causes the muscles in the walls of blood vessels to relax. This is known as vasodilation, and it causes your veins to widen. While this means more blood can travel through your veins, it also means your blood pressure is lower.

Heroin and other opioids also cause mast cells to release histamines. Mast cells are white blood cells that are stored in connective tissue near blood vessels. They work within the body’s immune system to protect it from harm, like bacteria, parasites, and viruses. Histamines are a signaling chemical your immune system uses to communicate between different cells. Histamines are commonly associated with allergies which cause the immune system to overreact to a substance. In addition to causing sneezing, itching, watery eyes, and a runny nose, histamines also cause a drop in blood pressure.

The Dangers of Heroin’s Effects on Blood Pressure

While low blood pressure might sound like a good thing on the surface, the hypotension caused by heroin is very dangerous.

Common symptoms of hypotension include:

• Dizziness or lightheadedness
• Difficulty concentrating
• Blurring or fading vision
• Fatigue or trouble staying awake
• Upset stomach, vomiting, or diarrhea
• Fainting

In the short term, falls and resulting injuries are a major concern for people experiencing hypotension. If you feel dizzy or faint, you should sit down. Falls resulting from hypotension can cause serious injuries like concussions or broken bones. If you are feeling faint, you also should not drive. If you faint while driving, you could seriously injure or even kill yourself or someone else.

In extreme cases, hypotension can lead to shock. Shock is the body’s natural response to a sudden drop in blood pressure. While it is treatable, it can quickly become deadly.

Symptoms of shock include:

• Pale, cold, and clammy skin
• Shallow, rapid breathing
• Weak, rapid heartbeat
• Dilated pupils
• Confusion
• Blue Lips and fingertips
• Profuse sweating

Shock is a medical emergency. If you or someone you know is experiencing symptoms of shock, you need to call for medical attention immediately. In the meantime, you should keep them warm, and loosen any tight clothing.

Remember that Florida has a good samaritan law. This means that you will not be charged, arrested, prosecuted, or penalized for drug possession while getting medical help for yourself or someone else.

Potential Long-Term Consequences of Low Blood Pressure Due to Heroin

The biggest concern with chronic low blood pressure is poor blood flow. Poor blood flow can cause or worsen many conditions. For one thing, poor blood flow leads to a weakened immune system. This makes it more difficult for the body to fight disease and infection. When you get sick, you stay sick for longer, and your symptoms are more severe than they are for people with strong immune systems.

Poor blood flow is also very hard on the brain. The brain is an important organ, which requires a lot of blood and oxygen to function properly. Over time, poor blood flow to the brain causes brain damage, leading to memory issues and impaired decision-making skills. Poor blood flow to the brain can also lead to stroke and vascular dementia.

It’s not just the brain that’s at risk. Poor blood flow has a severe effect on organs throughout the body. One major concern is tissue damage. When tissue is damaged repeatedly, it eventually will die. Tissue death due to a lack of blood flow, also known as gangrene, is irreversible.

If dead tissue is not removed, perforation (a tear or rip) in an organ occurs next. This is a life-threatening medical emergency. When an organ is torn it can no longer function properly.

How Heroin Interacts with Blood Pressure Medications

Generally, blood pressure medications and heroin both lower blood pressure, which can lead to an increased likelihood of hypotension and shock. Additional interactions depend on the specific blood pressure medication you are on.

ACE Inhibitors

Angiotensin-converting enzyme (ACE) Inhibitors are a very common tool used to treat high blood pressure. The medication has a complex set of interactions with opioids. Interestingly ACE Inhibitors may also be used to treat OUD. Studies have shown that ACE Inhibitors improve the production of natural opioids in the brain, and may reduce the preference for opioid substances, without being addictive.

Beta Blockers

Beta-blockers work by reducing the effects of adrenaline. Similar to heroin, they slow the heart and widen veins. This can compound the risk of hypotension. Some beta-blockers, like Propranolol, may be useful in reducing the euphoric effects of heroin, and cravings for heroin during withdrawal.

Calcium Channel Blockers

Calcium channel blockers work by preventing calcium from centering cells in the heart and arteries. Calcium causes the heart to squeeze more forcefully, so calcium blockers allow it to relax. Calcium channel blockers have been shown to increase the impact of morphine. Since heroin is broken down into morphine, this is dangerous. The increased effects could mean you don’t recognize that an overdose is happening until it’s too late.

Diuretics

Diuretics work by increasing the amount of water and salt your body expels through urine and lowering the amount of water in the blood. A common side effect of Diuretics is low potassium. Severely low potassium in the blood, known as hypokalemia, causes respiratory depression. This can worsen the respiratory depression caused by heroin, and lead to further complications.

Respiratory depression can lead to health issues including brain damage and cardiac arrest.

Other Ways Heroin Affects the Heart

Lowering blood pressure is not the only way that heroin affects the cardiovascular system. Injecting heroin causes endocarditis, which is when the valves of the heart become inflamed. In some cases, it causes infective endocarditis, which is a serious infection of those valves. This is often treatable with antibiotics but requires surgery in some cases.

Heroin is also known to cause arrhythmia or irregular heartbeats. If an arrhythmia goes untreated, it can cause heart attack or stroke, which are deadly. Cardiomyopathy is a serious condition that damages the heart’s ability to pump blood throughout the body and can result from taking heroin long-term. Cardiomyopathy, over time, leads to heart failure.

Heroin and the Veins

Intravenous heroin consumption is tough on the veins. If a needle has already been used, you could end up with bloodborne infections, such as hepatitis B, hepatitis C, or HIV. You could also get a fungal or bacterial infection located at the injection site. In rare cases, needles can break off and become lodged under the skin. If intravenous substance use continues long enough, it can result in scarring at the injection site or vein collapse.

Heroin Addiction Treatment in Tampa, Florida

The idea of starting treatment for OUD probably sounds overwhelming. Recovery is a big commitment, but if your heroin consumption is affecting your health, it is time to consider heroin rehab. It is never too late to start your best life. Recovery is always possible with the right support.

Real Recovery Solutions is a 12-step focused treatment program based in Tampa, Florida. In addition to treatment services, we also offer case management services to set you up for success. We’ll connect you with SNAP benefits, continuing education, work opportunities, gym memberships, and more. Ready to start your real recovery journey? Give us a call at 813-373-6762 today.

Real people. Real solutions. Real results.