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https://americanaddictioncenters.org/opioids/heroin/effects-and-dangers

"...studies show that the brain’s white matter can deteriorate with long-term heroin use, which can affect a person’s decision-making capability,..."

Other long-term heroin side effects may include:

●Insomnia.
●Infections of the heart lining and valves (in association with non-sterile needle use).
●Abscesses (in association with non-sterile needle use).
●Chronic and severe constipation.
●Increased risk of pneumonia and other lung complications.
●Co-occurring mental health issues, such as depression and antisocial personality disorder.
●Sexual dysfunction for men.
●Irregular menstrual cycles for women.
●Addiction, or heroin use disorder.

The method or route in which heroin is used can impart its own risks. For instance, individuals who inject heroin increase the likelihood of local tissue infection, more widespread vascular inflammation, and other cardiovascular risks. Additionally, some heroin contains particulate contaminants that can irritate and/or block the tiny vessels that deliver blood to the kidneys, liver, lungs, and brain, causing permanent damage to those organs.9