Inter-subband laser performance can be critically dependent on the nature of the electron distributions in each subband. In these first Monte Carlo device simulations of optically pumped inter-subband THz lasers, we can see that there are two main causes of electron heating: intersubband decay processes, and inter-subband energy transfer from the ''hot'' nonequilibrium tails of lower subbands. These processes mean that devices relying on low electron temperatures are disrupted by electron heating, to the extent that slightly populated subbands can have average energies far in excess of the that of either the lattice or other subbands. However, although these heating effects invalidate designs relying on low temperature electron distributions, we see that population inversion is still possible in the high-THz range at 77 K in both stepped and triple-well structures, and that our 11.7 THz triple-well structure even promises inversion at 300 K.