Heroin Abuse & Addiction: Signs, Symptoms, and Treatment

Heroin is an opioid drug that’s made from opium poppy plants and morphine, a natural substance from the poppy seed pod. It is an illegal substance that has no approved use in medical settings. People who use heroin can take it by snorting, sniffing, injecting, or smoking it.

The National Survey on Drug Use and Health, an annual national survey, estimates that in 2018, around 808,000 people aged 12 and older used heroin in the past year.  An estimated 506,000 people misused heroin as well as prescription opioid pain relievers.1

Addiction is a treatable, chronic medical disease marked by the compulsive use of heroin and/or other substances despite negative consequences in a person’s relationships, career, and other aspects of their life.2 Aside from the risk of addiction, heroin use can alter how the brain works3 and have other long-term health consequences.

Heroin is often cut with other powder-like substances such as powdered milk, sugar, or even with cheaper and more powerful synthetic opioids similar to fentanyl,4 which increases the risk of a deadly overdose.5

Evidence-based treatment, both pharmacological and behavioral, based on years of research and treatment experience make it possible to recover from heroin addiction and lead a sober life. Detoxification, treatment, and a life free from the grip of heroin are all within reach.

What is Heroin Use Disorder?

When a person takes heroin, either by injecting, sniffing, snorting, or smoking, it attaches to opioid receptors in the brain that are involved in feelings of pleasure and pain. The more a person uses heroin, the bigger the chance is that they develop a tolerance of the substance. This means that they’ll continue to need more heroin to get the same high they had before.3

When a substance like heroin—and the compulsive use of the drug—interferes with a person’s day-to-day life or creates health issues, an individual may be diagnosed with a substance use disorder.3

For a medical or clinical professional to diagnose a heroin use disorder, a person must exhibit at least 2 of the following signs of heroin addiction in a 12-month period:6

  • Takes more heroin for longer than they intended.
  • Cannot control heroin use even if they want to.
  • Attempts to get, use, or recover from heroin regularly.
  • Constantly wants to use heroin.
  • Doing heroin interrupts their day-to-day life, including work, home, or school duties.
  • Continues to use heroin even though it causes issues with loved ones or colleagues.
  • Avoids activities they used to be passionate about due to heroin use.
  • Uses heroin in situations where it can be physically dangerous.
  • Realizes they are abusing heroin and continues to take it.
  • Tolerates larger quantities of heroin.
  • Experiencing withdrawal symptoms when stopping heroin use.

Signs of Heroin Use

While the diagnosis of an opioid use disorder should only be made by medical or clinical professionals, there are signs suggestive of heroin addiction or abuse that someone like a family member or friend might identify.


The signs suggestive of heroin use include:7

  • Marked drowsiness or sleepiness.
  • Slowed movement, breathing or cognition.
  • Decreased pupil size.
  • Marks on the skin, if the person injects heroin.
  • Itchiness.
  • Nervousness.
  • Insomnia.
  • Vomiting.

Physical Effects of Heroin

Some of the common health risks of abusing heroin can include:3

  • Nausea and vomiting.
  • Severe itchiness.
  • Clouded mental functioning.
  • Shifting between conscious and semi-conscious states.

When someone abuses heroin over the long-term, other health risks might present, including:3, 8

  • Constipation and stomach cramping.
  • Insomnia.
  • Lung problems.
  • Liver and kidney disease.
  • Poor cognition, including problems with decision-making, behavior regulation, and stress response.

Because heroin is an illicit substance and is not regulated, it often gets cut with other additives like powdered milk or sugar. When used intravenously, heroin with these additives may clog a person’s blood vessels and lead to further health complications that can cause permanent damage to the lungs, liver, kidneys, or brain.3

Those who inject heroin might also experience skin abscesses or boils, collapsed veins, an infection of the heart lining and valves, viruses like HIV or Hepatitis C from sharing needles.

Those who consume the substance nasally (i.e., “snorting”) might have damaged tissue in the nose which may even perforate the separation between the nostrils.

Mental health disorders such as depression may develop or worsen, and men may experience sexual disfunction while women might have irregular menstrual cycles.

Heroin Addiction Treatment

When a person enters an addiction treatment program to curb their heroin use, the likely first step will be detoxification, including medical management of uncomfortable, moderate to severe withdrawal symptoms.

Doctors may prescribe medication to help manage cravings and alleviate or stave off withdrawal symptoms, including:9

  • Buprenorphine, a weaker opioid that’s long-lasting.10
  • Methadone, which reduces opioid craving and withdrawal and blocks the effects of opioids.11

Naltrexone, which helps stop opioid drugs like heroin from attaching to the opioid receptors in the brain, is also sometimes prescribed to suppress heroin cravings, but it can’t be used until a person completed withdrawal.3

A qualified physician can dispense buprenorphine after an in-person physical examination and assessment at a doctor’s office without requiring attendance to a treatment facility.10 During COVID-19, the in-person requirement is waived and the assessment may be done via telemedicine.12

For many though, a heroin addiction treatment center has the tools a person will need to for more effective treatment leading to long-term recovery. Inpatient programs offer a sober environment where doctors and behavioral health professionals can monitor the patient, and the patient can relearn how to live life without heroin.3

Inpatient or intensive outpatient programs offer group or one-on-one cognitive behavioral therapy (CBT). CBT can help a patient shift the way they think about heroin and themselves, as well as teach ways to avoid relapse by managing stress and triggers that may make them want to start using again.3

Heroin Abuse Treatment at Recovery First

Recovery First Treatment Center offers safe medical detox from heroin and a number of other substances, as well as a full continuum of care for treatment of substance use disorders. From intensive medical rehab to telehealth addiction treatment, Recovery First can provide you with the medically validated help you need to reach sobriety and recovery. Call to talk to one of our compassionate, knowledgeable Admissions Navigators today. You can even see if your health insurance would cover treatment below.