Heroin chest pain (chest pain during or after using heroin) can come from several places: low oxygen from slowed breathing, an infection of the heart or lungs, blood vessel damage from injecting, or other drugs mixed in, like cocaine or fentanyl. Some of these are emergencies. If chest pain comes with trouble breathing, confusion, a racing or irregular heartbeat, or fainting, call 911 right away.
Most people think of heroin as an overdose risk, and it is one. It also wears down the heart and lungs slowly, and chest pain is often the body’s way of telling you something’s wrong.
How Heroin Affects the Heart and Lungs
According to the National Institute on Drug Abuse (NIDA), heroin is converted to morphine in the brain and binds quickly to opioid receptors. Those receptors help control automatic functions like breathing and heart rate. After the initial rush, NIDA explains, breathing slows, sometimes enough to be life-threatening. Less oxygen reaches the body, which can lead to coma and permanent brain damage.
Common Causes of Heroin Chest Pain
Slowed breathing and low oxygen
When breathing slows, the heart and other organs get less oxygen. You might feel tightness, heaviness or pain in the chest, along with drowsiness, blue lips or confusion. It’s the same process that makes heroin overdose so deadly.
Infections of the heart
NIDA lists bacterial infections of the blood vessels and heart valves among the medical complications of chronic heroin use. Doctors call this endocarditis. It usually happens when bacteria get into the bloodstream through injection and settle on the heart valves. It can cause chest pain, fever, chills and exhaustion, and it needs urgent medical treatment.
Lung infections
NIDA also reports lung complications, including different types of pneumonia and tuberculosis, tied both to the poor health that often comes with heroin use and to heroin’s effect on breathing. Pneumonia can cause sharp chest pain, especially when you breathe in or cough.
Blocked blood vessels
Street heroin is rarely pure. NIDA notes that many additives don’t dissolve and can clog the blood vessels leading to the lungs, liver, kidneys or brain, which can kill cells in those organs. A blockage in the lungs’ vessels can cause sudden chest pain and shortness of breath.
Mixing heroin with stimulants
Some people combine heroin with cocaine or meth. NIDA warns that cocaine can cause chest pain that feels like a heart attack, as well as actual heart attacks and strokes. Put a stimulant and an opioid together and the heart takes strain from two directions at once.
Withdrawal and anxiety
In withdrawal, anxiety and a pounding heart can feel a lot like chest pain. It might not be dangerous on its own, but you can’t tell the difference by yourself, so get it checked.
When Chest Pain Is an Emergency
Call 911 if chest pain comes with any of these:
- Slow, shallow or stopped breathing, or gurgling sounds
- Blue or gray lips or fingertips
- A racing, pounding or irregular heartbeat
- Confusion, extreme sleepiness, or the person can’t be woken
- Fainting, sweating or pain spreading to the arm, jaw or back
- Fever with chest pain, especially in someone who injects drugs
If someone is unresponsive or breathing slowly, give naloxone (Narcan) if you have it. Be honest with emergency staff about what was used. They’re there to help, and knowing what’s in the person’s system can save their life.
Don’t wait out chest pain at home because you’re scared of getting in trouble. Emergency rooms see drug-related emergencies every day, and in that moment the only goal is keeping the person alive.
Fentanyl Has Raised the Stakes
The CDC warns that illegally made fentanyl is mixed into heroin, cocaine and meth, and that fentanyl is 50 to 100 times more potent than morphine. Many people who think they’re using heroin are actually using fentanyl, or a mix of the two, which makes breathing problems far more likely. The CDC also confirms that naloxone can reverse an overdose from opioids, fentanyl included.
Heroin’s Damage Beyond the Chest
Chest pain is only one sign of the damage. NIDA reports that chronic injection leads to scarred or collapsed veins and puts people at risk for hepatitis B and C and HIV. Over time heroin also changes the brain’s structure and chemistry, which is a big part of why stopping is so hard. Our post on opioids and the brain explains what happens there and how the brain heals in recovery.
Treatment for Heroin Addiction
Treating heroin addiction means treating the body and the person. That usually starts with medically supervised detox. NIDA notes that withdrawal symptoms peak between 24 and 48 hours after the last dose and mostly subside within about a week, though some people have lingering symptoms for months.
Medications for opioid use disorder can make a major difference. A StatPearls review notes that methadone treatment is associated with about a 50% reduction in deaths from any cause, so ask any treatment provider how they approach these medications. Beyond that, counseling, a structured program and ongoing support help people rebuild what heroin took. Learn more about our heroin addiction treatment.
Frequently Asked Questions
Why does my chest hurt after using heroin?
It could be low oxygen from slowed breathing, an infection of the heart or lungs, blood vessels blocked by additives, or other drugs like cocaine or fentanyl in the mix. Get medical care instead of guessing.
Can heroin damage your heart?
Yes. Injecting heroin can lead to bacterial infections of the heart valves and blood vessels, and heroin slows heart rate and breathing, which cuts the oxygen reaching your heart.
Is chest pain from heroin an emergency?
It can be. Call 911 if chest pain comes with breathing problems, an irregular heartbeat, confusion, fainting or fever.
Find Freedom at Covenant Hills
Your body’s telling you something, and you don’t have to keep ignoring it. At Covenant Hills, a Christian treatment center in Orange County, we help people get free from heroin with medical care, therapy and a community of faith. Call 800-662-2873 for a free, confidential assessment.
