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Signs of Heroin Abuse and Addiction

Heroin is a powerful and addictive illicit opioid drug that is derived from opium, a chemical found in the seed pod of the opium poppy plant. In 2021, more than 1.1 million people used heroin and about 1.0 million had a heroin use disorder.[1] These numbers demonstrate just how addictive heroin really is, as nearly everyone who tries it ends up becoming addicted to it.

Today, much of the heroin found on the streets contains fentanyl, another opioid that is 50-100 times stronger than heroin and morphine and the drug that is responsible for the majority of overdose deaths in the United States. Heroin is dangerous enough–but fentanyl makes abusing heroin even more hazardous. As a result, it is important to be able to identify the signs of heroin abuse and addiction in yourself or a loved one. The sooner you recognize someone has a problem, the faster you can get them the help they need.

Signs and Effects of Heroin Abuse

Like other opioids, heroin is a central nervous system (CNS) depressant that slows down breathing and heart rate by acting on the mu-opioid receptors in the brain, changing the way the body responds to pain.

When heroin enters the brain, it is converted to morphine and binds to opioid receptors that are located throughout the brain and body. Opioid receptors are responsible for perceiving pain and reward, so heroin increases pleasurable feelings and decreases pain sensations.

Heroin can be smoked, snorted, or injected, but regardless of the method of administration, the same physical side effects will be apparent. Side effects of heroin include:

  • Slowed breathing
  • Dry mouth
  • Nodding off
  • Flushed skin
  • Itching
  • Nausea
  • Vomiting
  • Slurred speech
  • Impaired coordination
  • Pain relief
  • Lethargy

Heroin abuse can also cause cognitive symptoms, such as:[2]

  • Clouded thinking
  • Poor decision-making
  • Short-term memory impairment
  • Difficulty paying attention
  • Reduced self-control
  • Relaxation
  • Euphoria
  • Sudden mood swings
  • Lack of motivation
  • Anxiety
  • Depression

As one of the most addictive drugs, many people use large amounts of heroin for long periods of time, placing themselves at risk for a variety of long-term side effects. Long-term effects of heroin abuse and addiction may include:[3]

  • Respiratory issues such as pneumonia and other pulmonary diseases
  • Infections of the skin at the injection site
  • Bloodborne infections such as HIV/AIDS and hepatitis
  • Cardiac issues such as pericarditis, endocarditis, and atherosclerosis
  • Coma
  • Overdose and death

Heroin addiction can also destroy a person’s social and work life as it affects your ability to make healthy choices, foster positive relationships, and be productive in work settings.

Signs of Heroin Addiction

Heroin addiction, formally diagnosed as heroin use disorder, is a complex condition characterized by loss of control over drug use, physical and psychological dependence, and psychosocial challenges. The exact symptoms may vary from one person to the next, but common signs of heroin addiction are as follows.

Physical symptoms:

  • Developing tolerance (needing to increase one’s dose of heroin to feel the same effects as before)
  • Withdrawal symptoms (flu-like symptoms that appear when someone stops taking heroin)
  • Changes in eating patterns
  • Constipation
  • Weight loss
  • Dry mouth
  • Runny nose
  • Itching the skin
  • Bruising, scabbing, or track marks on the skin

Behavioral symptoms:

  • Frequent work absences
  • Social withdrawal and isolation
  • Lying, stealing, or manipulating
  • Ignoring one’s responsibilities
  • Wearing long-sleeved shirts to hide track marks
  • Poor personal hygiene
  • A decline in work or school performance

Emotional, social, and cognitive symptoms:

  • Anxiety
  • Depression
  • Frequent mood swings
  • Hostility
  • Excitability
  • Loss of interest in things once enjoyed
  • Difficulty concentrating
  • Poor impulse control
  • Poor decision-making
  • Disorientation

Heroin Withdrawal Symptoms

If you have been abusing heroin and are wondering whether or not you are addicted, an easy way to tell is to ask yourself if you experience withdrawal symptoms if you stop taking the drug. Heroin withdrawal can resemble a moderate to severe case of the flu, consisting of symptoms like:[4]

  • Runny nose
  • Watery eyes
  • Yawning
  • Sweating
  • Chills
  • Goosebumps
  • Body and muscle aches
  • Abdominal pain
  • Nausea
  • Vomiting
  • Cramping
  • Insomnia
  • Diarrhea
  • Fever
  • Drug cravings

Although heroin withdrawal is typically not life-threatening, it can be severe. It is always important to seek help from a medical provider or heroin detox center to discuss your treatment options. Self-detox from heroin is often unsuccessful.

Spotting Heroin-Related Paraphernalia

Another sign of heroin abuse and addiction is the presence of hidden drug-related paraphernalia. Since heroin can be smoked, snorted, or injected, users may have a variety of paraphernalia. Paraphernalia is often hidden in one’s personal belongings or in a safe place that is out of plain sight.

Types of paraphernalia related to heroin abuse are:

  • Spoons that are bent at the base and have burn marks on the bottom
  • Small, clear plastic baggies with white or brown residue
  • Small glass pipes
  • Cut straws
  • Razor blade with sticky brown or white powder residue

How is Heroin Addiction Treated?

Heroin addiction can be treated through a combination of medical and behavioral approaches. The specific treatment options may vary depending on the individual’s needs, but some common approaches used in the treatment of heroin abuse and addiction are:

  • Detoxification – While under medical supervision, medications may be administered to manage withdrawal symptoms and cravings.
  • Medication-Assisted Treatment (MAT)MAT involves the use of medications, such as methadone, buprenorphine, or naltrexone, along with counseling and behavioral therapies to help reduce cravings, alleviate withdrawal symptoms, and block the effects of opioids.
  • Behavioral Therapies – Various behavioral therapies, such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are used to address the underlying causes of heroin addiction and promote healthy coping skills as well as long-term recovery.
  • Support Groups – Participation in support groups, such as Narcotics Anonymous (NA) or SMART Recovery, can offer a sense of community, peer support, and a platform for sharing hope, experiences, and strategies for overcoming heroin addiction.
  • Aftercare – After rehab, aftercare services are crucial for maintaining recovery. Aftercare includes ongoing counseling, support groups, recovery coaching, and sober living.

Find Help for Heroin Abuse and Addiction Today

At Next Step Recovery, we offer a private and convenient solution for you to take control of your heroin abuse and achieve long-term recovery.

When you receive treatment from Next Step Recovery, you are taking the most important step to stay sober and break free from heroin addiction.

Our team of qualified addiction specialists can help you verify your insurance coverage and answer any additional questions you may have. Contact us today to learn more about our heroin rehab programs in North Carolina.


  1. National Institute on Drug Abuse (NIDA): What is the scope of heroin use in the United States? Retrieved May 2023 from
  2. National Institute on Drug Abuse (NIDA): Heroin DrugFacts, Retrieved May 2023 from
  3. National Institute on Drug Abuse (NIDA): What are the long-term effects of heroin use?, Retrieved May 2023 from
  4. National Library of Medicine: Opioid withdrawal, Retrieved May 2023 from

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