Heroin Addiction: Symptoms, Side Effects, and Recovery
What Is Heroin?
- White powder.
- Brown powder.
- Black sticky substance (“black tar heroin”).
Heroin is typically smoked, injected, sniffed, or snorted. High purity heroin (typically the white powder version) is often snorted or smoked.3 However, it is increasingly difficult for users to discern the purity of heroin by looking at it due to the fact that other drugs, such as fentanyl, are now regularly added to it.4
Heroin acts quickly on the body’s opioid receptors to produce a surge of pleasure and euphoria often described as a “rush.”5 Other effects that come on quickly include:5,6
- Warm, flushed skin.
- Dry mouth.
- Heaviness in the arms and legs.
- Nausea and vomiting.
- Problems thinking clearly.
- Drowsiness and “nodding off” (going back and forth between being awake and semi-conscious).
- Slowed breathing.
How Does Heroin Addiction Start?
Heroin causes a powerful euphoric high that varies in intensity related to the amount taken and how quickly the drug enters and then binds to opioid receptors in the brain. Opioid receptors throughout the body regulate pain, hormone release, and feelings of pleasure and well-being. When heroin reaches opioid receptors in the brain’s reward center, it stimulates the release of dopamine, which reinforces repeated use.5,7
Someone who uses heroin repeatedly may quickly find they need to increase how much they take in order to achieve the high they want.5 This physiological adaptation to a drug is known as “tolerance.” With repeated use and increasing doses, heroin users may be hindered by painful withdrawal symptoms when they try to quit or significantly reduce their use.8 This physiological adaptation to a drug is known as “dependence.” Heroin withdrawal symptoms are intensely uncomfortable and can make any attempt to stop using extremely difficult, physically speaking. Trying to stay well, or avoid withdrawal, can perpetuate the ongoing cycle of heroin abuse.9
Chronic heroin users, especially those who experience tolerance or withdrawal, are at increased risk of eventually losing control of their use and finding themselves unable to quit even when doing so is causing them numerous problems.10 This inability to control or quit using despite significant negative consequences is the hallmark of a heroin use disorder.11
What Are the Signs of Heroin Addiction?
There are many physical and behavioral signs that a person may be using heroin; however, the criteria doctors and treatment professionals to diagnose someone with a heroin use disorder are very specific. A person may be diagnosed with a heroin use disorder if they meet 2 or more of the following criteria in a 12-month period:11
- Using increasing amounts of heroin or using it more often than intended.
- Wanting to quit using heroin but failing in attempts to do so.
- Putting a lot of time into getting, using, or recovering from heroin.
- Failing to meet personal, professional, or domestic obligations due to recurrent heroin use.
- Continuing to use heroin even when it causes or worsens social or interpersonal problems.
- Giving up hobbies and occupational activities in favor of using heroin.
- Using heroin when it can be physically hazardous, such as prior to driving.
- Continuing to use heroin knowing that it has likely caused or worsened a physical and/or mental health problem.
- Needing to increase the dose to feel the desired effects and/or experiencing a very diminished effect with the regular dose.
- Experiencing withdrawal symptoms when cutting back or trying to quit heroin and/or taking heroin to relieve or avoid these symptoms.
What to Do if You Suspect a Loved One is Addicted to Heroin
Heroin addiction is a medical disease, and chronic heroin use can lead to many devastating health and psychological effects. It impacts not only the addicted person but their loved ones as well. Addiction has the potential to cause long-lasting damage to families.
If you know of a loved one who is suffering from heroin addiction, talking to them about their addiction can be difficult. Often, it takes more than one conversation with your loved one to get them to accept that they need help. Try and keep these conversations supportive and non-confrontational. While you may feel that you need to hold a dramatic intervention like those you see on TV, there is no evidence that confrontational interventions with loved ones work. Confronting someone and trying to force them into treatment is usually not successful and can decrease their motivation for change.12 Rather, the National Institute on Drug Abuse advises incentivizing your loved one to see a doctor, as people are often more likely to listen to professionals than family or friends.13
To help your loved one, you can educate yourself on addiction and what treatment entails. You can emphasize that evidence shows that treatment works and that recovery really is possible, even if they currently feel hopeless. You can also research treatment programs so that you are ready with some options if they do agree to accept help.14
In the meantime, don’t forget about taking care of yourself. When you love someone struggling with addiction, it is all too easy to put your entire focus into their addiction. However, you will be able to better support your loved one if you are healthy. Carve out some time for your own hobbies, make sure to try to eat and sleep well, and think about attending some support groups like Nar-Anon for families of addicts.
What Are the Long-Term Effects of Heroin Use?
People who use heroin for prolonged periods may develop numerous health problems. Long-term opioid use is associated with:5,15
- Severe constipation and stomach pain.
- Lung problems, including various types of pneumonia.
- Changes in menstrual cycle (in women).
- Problems with sexual functioning (in men).
- Mental health disorders, including depression.
- Nasal tissue damage, which may lead to holes in the nasal septum (from snorting).
- Collapsed, scarred, or clogged blood vessels(from injecting).
- Abscesses and other skin infections (from injecting).
- Bacterial infections of the heart valves and blood vessels (from injecting).
Heroin users are also at risk of becoming infected with HIV, HCV, and other bloodborne diseases, especially if they share needles. Non-injection users are also at heightened risk for HIV and other sexually transmitted diseases due to the fact the heroin may inhibit judgment and lead people to engage in risky behaviors such as having unprotected sex.15,16
Heroin Addiction Treatment & Detox
Treatment for heroin addiction often begins with medical detoxification before moving on to the next stage: rehabilitation.8,17
How to Detox from Heroin
According to the Substance Abuse and Mental Health Services Administration, a detox environment that provides 24-hour medical supervision is preferable for heroin withdrawal due to the painful and distressing withdrawal symptoms that may include:11,18
- Muscle aches and cramping.
- Runny nose.
- Goosebumps and fever (rare and associated with more severe withdrawal).
In a medical detox program, medications and support are provided to ease patients through the withdrawal process and prepare them for rehabilitation.18
Recovering from Heroin Addiction
Heroin addiction treatment can occur in a variety of settings, such as inpatient rehab or an outpatient program. Inpatient and outpatient programs at Desert Hope offer many of the same elements of treatment, including behavioral therapies, mutual support groups, drug education, and medication-assisted treatment (MAT), which is the use of medications such as Suboxone in combination with therapy.
Inpatient programs offer a very intensive and supportive treatment experience, where patients can put all their attention on their recovery as they reside at our facility. Outpatient programs, which don’t require patients to live and stay at Desert Hope, come in several forms: partial hospitalization is similar in treatment intensity to an inpatient program, with treatment most days per week for many hours per day.17 Intensive outpatient programs are still very supportive but involve fewer treatment hours per week. Standard outpatient programs are the least intensive outpatient programs and are commonly used as a step-down treatment for those who have completed another program.20
How Long is Rehab for Heroin?
Treatment length may depend on many factors, such as how severe the substance use disorder, the patient’s insurance coverage, the treatment team’s recommendations, etc. There is no standard amount of time that a person must attend drug treatment.
The National Institute on Drug Abuse states that better outcomes are linked to longer durations of treatment.21 While you may have some limitations on how long you can stay in an intensive program—due to insurance, professional obligations, etc.—treatment facilities will often work with you to keep you on the path to recovery and ensure you have the best chances of success. This may mean setting you up with weekly outpatient therapy after an inpatient stay, linking you to community meetings, transitioning you to sober living, etc.
Get Help Today
If you are ready to stop using heroin, we are here to help you. You can speak to us day or night, confidentially, at . We understand what you’re going through, and we are ready to work with you to get you into treatment as soon as you’re ready.