Heroin Addiction: Effects, Withdrawal, and Recovery
What Is Heroin?
Heroin is an illegal and highly addictive opioid made from morphine. Heroin has several different forms. It may come as a:
- 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. 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.
What Is Heroin Cut With?
As heroin makes its way from the source of production, through dealers, to users, it is cut with adulterants and diluents.
Substances used to cut heroin include:
- Procaine (local anesthetic).
- Fentanyl (powerful opioid).
- Acetaminophen (pain reliever).
- Tramadol (pain reliever).
- Sucrose, lactose, dextrose (sugars).
- Quinine (antimalarial drug).
- Mannitol (diuretic, can also reduce pressure in the eyes and the brain).
- Inositol (used to treat mental health conditions and diabetes).
- Lidocaine (used to treat irregular heartbeat and relieve pain).
- Diacetamide.
- Lead.
Dealers use these substances for different reasons. Caffeine, for example, helps heroin to vaporize at a lower temperature to aid smoking. Tramadol shares many similar effects with heroin.
Sugar and lead are used to add bulk and dilute the heroin. And quinine has a bitter taste that can disguise poor quality heroin while also giving users a similar “rush”.
Other diluents are chalk, brick dust, powdered milk, and starch, which do not cause any noticeable effects in users but can cause health problems.
Like tramadol, fentanyl shares similar effects to heroin. But it is much more powerful. Fentanyl can be substituted for heroin or added to it, but this is extremely dangerous and often leads to overdose.
What Is the Difference Between Adulterants and Diluents?
The terms adulterants and diluents are often confused.
- An adulterant is an ingredient that has pharmacological effects and is added to either increase or decrease the effects or side effects of heroin.
- A diluent is a substance without any pharmacological effect that is added to bulk up the drug and stretch the amount of heroin in the batch.
- A contaminant is a byproduct of the heroin manufacturing process.
Some sources refer to both adulterants and diluents as adulterants. Even though they serve different purposes, they are both added to heroin on purpose or as a result of the production/distribution process.
Getting Help for Heroin Addiction
Heroin is dangerous regardless of whether it is pure or contaminated, and taking a step toward recovery from heroin use can feel overwhelming. But we are here to help.
Desert Hope Treatment Center—an inpatient rehab facility in Las Vegas, NV—offers a full continuum of care for drug and alcohol addiction including:
If you or someone you know is struggling with heroin addiction, please call to speak to one of our admissions navigators and start the rehab admissions process.
Our admissions navigators will walk you through the process and help you verify your insurance coverage. If using insurance to pay for rehab isn’t the best option for you, there are other ways to cover the cost of treatment.
Check your insurance coverage at Desert Hope by using the confidential verify your insurance benefits.
We make starting treatment at Desert Hope easy.
Weighing the Risks
It is very difficult to tell pure heroin from heroin that is contaminated with fentanyl or another harmful substance.
Dealers rarely disclose what they have put into their drugs during the production process. Test kits claim to be able to determine the purity of heroin, but even these are not 100% accurate.
Heroin is not only extremely addictive, but it is also incredibly dangerous.1 While some people may assume that avoiding injection use and only snorting heroin is safe, there is no safe way to use this illegal opioid.
Any use of heroin, including snorting, may result in a life-threatening heroin overdose, the primary signs of which include:
- Tiny pupils.
- Loss of consciousness.
- Problems breathing.
Other risks of snorting heroin include dependence, addiction, and numerous health problems.
Short-Term Effects of Snorting Heroin
Snorting heroin will produce a very rapid high (euphoria) with effects that include:
- Flushing/warmth of the skin.
- Heaviness in the extremities.
- Inability to think clearly.
- Itchiness.
- Nausea.
- Vomiting.
- Dry mouth.
- Nodding off (falling in and out of consciousness).
Long-Term Effects of Snorting Heroin
Snorting heroin may lead to a number of troubling long-term effects, including:
- Chronic runny nose.
- Nasal pain.
- Problems swallowing.
- Nasal tissue damage and ulceration.
- Holes in the nasal septum (the tissue separating the nostrils).
Other long-term effects of heroin that may occur with any method of use include:
- Insomnia.
- Severe constipation.
- Depression and other mental health disorders.
- Lung complications, including pneumonia.
- Irregular menstrual cycles (women)
- Impaired sexual functioning (men).
- Opioid dependence.
- Opioid use disorder (addiction).
Snorting vs. Injecting Heroin
Some individuals may snort heroin, believing that is a safer alternative to injecting the drug. It is true that injecting heroin or any other illicit drug, for that matter, does have some very serious unique risks, including:
- Scarred veins.
- Collapsed veins.
- Bacterial infections of the heart valves.
- Abscesses.
- Clogged blood vessels.
- Transmission of bloodborne diseases, such as HIV and HCV, through needle-sharing.
However, even snorting heroin has risks, including the risks of addiction, infection, and life-threatening overdose.
While snorting heroin may help users to decrease the level of risk associated with their heroin use, some people who begin by snorting heroin move on to injecting as their tolerance to heroin grows.
Also, arguably one of the most frightening risks of injection use, HIV and other infectious disease transmission, while lower, is still a risk for intranasal users. Heroin use decreases inhibition and impairs judgment, often resulting in risky sexual behaviors (such as unprotected sex), which increases a person’s risk for getting HIV or other infectious diseases.
Opioid overdoses have been growing significantly since the appearance of fentanyl and its analogues into the heroin market across the United States. It is not possible to detect fentanyl in heroin by smelling, tasting, or looking at the heroin powder, and heroin users may snort fentanyl-laced powder without realizing it. Unfortunately, it takes an extremely small amount of fentanyl to cause overdose and death, and with the ever-growing amount of this synthetic opioid in heroin all across the country, users put themselves at risk of overdose every time they snort heroin.
Heroin Addiction Treatment in Las Vegas, Nevada
If you are using heroin and you need help, we’re here to help you turn your life around. At our Las Vegas treatment center we help people get on the road to recovery from heroin addiction and back to living the lives they deserve.
Call our compassionate and helpful admissions navigators at to learn more about your treatment options, including everything from medical detox to help you withdraw from heroin safely to inpatient rehab to several forms of outpatient addiction treatment, or to start the rehab admissions process. We will help you find the path to recovery that works for you.
If you’re worried about covering the cost of rehab, most insurance policies offer addiction treatment insurance coverage.
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. When heroin reaches opioid receptors in the brain’s reward center, it stimulates the release of dopamine, which reinforces repeated use.
Someone who uses heroin repeatedly may quickly find they need to increase how much they take in order to achieve the high they want. This physiological adaptation to a drug is known as “tolerance.” Over time, repeated use may lead to dependence, which is a phenomenon marked by withdrawal symptoms when a person tries to quit or significantly reduce their use. Heroin withdrawal symptoms are intensely uncomfortable and can make attempts to stop using extremely difficult, physically speaking, and individuals may continue to use heroin to avoid withdrawal.
Chronic users, especially those who experience tolerance or withdrawal, are at increased risk of losing control of their use and unable to quit even when doing so is causing them numerous problems. Heroin use disorder, or addiction, is the continued compulsive use of the drug despite repeated negative consequences.
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. Some tips to help you start the conversation include:
- Take some time to understand addiction. This can help you to more easily empathize with what your loved one is going through.
- Avoid confrontations and confrontational language. Confronting someone and trying to force them into treatment is usually not successful and can decrease their motivation for change.12
- Encourage your loved one to see their doctor. 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
- 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 Effects of Heroin Use?
Heroin is a potent and highly addictive illicit opioid drug that is derived from morphine. It can be snorted, injected, or smoked, all of which present a risk of numerous short- and long-term effects of heroin.
This article will explain the effects of heroin misuse, including the specific heroin side effects associated with smoking, injecting, and snorting heroin and help you find treatment for yourself or a loved one living with heroin addiction.
Effects of Heroin
The short-term effects of heroin may include:
- Nausea.
- Vomiting.
- Skin flushing.
- Severe itching.
- Dry mouth.
- Heavy feelings in the extremities.
- Drowsiness.
- Clouded mental functioning.
- Slowed heart function.
- Slow and/or shallow breathing.
- Heroin Overdose
The use of opioids like heroin can also lead to overdose, which may be fatal. Signs of heroin overdose include:
- Loss of consciousness.
- Severely slowed or stopped breathing.
- Constricted “pinpoint” pupils.
- Discoloration of the lips and fingertips.
People who use heroin should be aware that it may be contaminated with illicit fentanyl, which has significantly impacted the rate of overdose associated with opioids. Nearly 88% of the overdose deaths related to opioids in 2021 involved synthetic opioids like fentanyl.
Long-Term Effects of Heroin Use
Over time, a person may develop tolerance – a state where they need increasing amounts of heroin and/or to use more frequently to feel normal – and dependence. When a person is dependent on an opioid like heroin, they may experience severe withdrawal symptoms when trying to cut back or stop using it.
Continued use of heroin can go beyond tolerance and dependence and lead to addiction. Addiction is characterized by the repeated compulsive use of heroin despite significant negative consequences.
The clinical term for heroin addiction is an opioid use disorder (OUD). Only a qualified healthcare professional can diagnose someone with an opioid use disorder, but understanding the criteria can help you get help for yourself or someone you love. Some of these criteria include:
- Using opioids in larger amounts or over a longer period than was intended.
- A persistent desire or repeated efforts to control or cut down opioid use.
- Spending a lot of time in activities necessary to obtain, use, or recover from opioids.
- Continuing to use opioids despite persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of opioids.
- Continuing opioid use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by opioids.
Continued use of heroin also significantly increases the risk of eventual overdose, particularly due to fentanyl and fentanyl analogues in the heroin supply.
Effects of Smoking, Injecting, and Snorting Heroin
People can use heroin in different ways, and each method of use carries specific risks. However, routes of administration that allow the drug to reach the brain fastest (smoking and injecting) increases the risk of developing an OUD.
Risks of Injecting Heroin:
- Scarred and/or collapsed veins.
- Bacterial infections.
- Soft tissue infections.
- Abscesses (boils).
- Clogged blood vessels that lead to the brain, lungs, liver, or kidneys due to contaminants.
- Infectious diseases like HIV, hepatitis B and C, and other blood-borne viruses.
Risks of Snorting Heroin:
- Perforated nasal septum.
- Damage to the mucosal tissue in the nose.
- Nasal pain.
- Purulent sputum (yellow or green phlegm).
- Dysphagia (problems swallowing).
Risks of Smoking Heroin:
- Lung damage.
- Increased risk of asthma and COPD.
- Severe early onset emphysema.
- Heroin-induced spongiform leukoencephalopathy. A rare but debilitating and potentially fatal neurological condition that affects white matter in the brain and causes impaired motor, speech, and cognitive function as well as reduced muscle strength.
Heroin Addiction Treatment in Las Vegas, NV
If you or a loved one are struggling with heroin use or addiction, we are here to help. Desert Hope, our inpatient rehab in Las Vegas, offers different types of rehab care and levels of addiction treatment to suit all needs. If you’re ready to regain control of your life, you can call us to learn more about your rehab options or to get admitted today.
What to Do During a Heroin Overdose
A heroin overdose is a medical emergency and one that can be fatal within minutes. Fentanyl is making the opioid epidemic ever more deadly. Now more than ever, it’s important to know the signs of an overdose and act fast, by calling 911 and administering naloxone (Narcan) as. quickly as possible.
It’s imperative that if you use heroin or other opioids, or know someone who does, to have Narcan, the opioid overdose reversal drug, on hand. Many states have enacted legislation that widens access to naloxone to friends, family, or anyone witness to a potential overdose situation. Using this medication immediately can save the life of an overdosing person.
Heroin Overdose Signs
An overdose can occur any time. With illegally manufactured fentanyl (IMF) consistently being added to other drugs, including cocaine and methamphetamine, more and more individuals are experiencing overdose.
Common signs of a heroin or other opioid overdose include:
- Pinpoint (extremely small) pupils.
- Extreme sleepiness or loss of consciousness.
- Slow, shallow, or stopped breathing.
- Gurgling and/or choking sounds.
- Limpness of the body.
- Pale or blue skin or fingernails.
Narcan for Overdose
Naloxone (sometimes referred to by the brand name Narcan) is a life-saving medication that can reverse the effects of an opioid overdose, when given in time. Naloxone is available in a nasal spray and injectable form and, in most states, you do not need a prescription to obtain it.
Naloxone will not harm a person if they’re overdosing on a drug other than opioids. So if you’re not sure if someone is experiencing an opioid overdose, you should still administer naloxone.
How to Help if Someone is Experiencing a Heroin Overdose
Even if you use Narcan, you must call 911 for emergency medical assistance. Narcan will eventually wear off, and the person will need medical care, or they could re-experience the symptoms of overdose.6
Here’s what to do after you’ve called 911:
- Give a dose of naloxone (Narcan). View our naloxone training video.
- Perform CPR if trained to do so.
- If there is no reaction to the naloxone within 2-3 minutes, administer another dose.
- Once the person has begun breathing again, prevent choking by placing them in the recovery position: Put them on their side with one hand under their head for support. Bend the knee of the topmost leg and pull both the leg and the top arm over the body to keep the person from rolling onto their back.
- Stay with the person until help arrives.
Laws Protecting Good Samaritans
If you’re worried about helping someone in an overdose situation because you fear legal trouble, don’t be. In many states, including Nevada, legal protections are in place for those who seek help for themselves or others in an overdose situation.
Per NV law, as long as you act “in good faith and with reasonable care,” you cannot be arrested for possessing controlled substances or drug paraphernalia or for being intoxicated by alcohol if you are underage.6
Legal protections don’t apply for charges related to intent to sell/distribute or for child neglect or endangerment. You are also not legally protected if you have an active warrant for your arrest.
Heroin Overdose Risk Factors
While anyone who uses heroin is at risk for overdose at any time, certain situations may make overdose more likely. Risk factors for heroin overdose include:
- Having an opioid use disorder.
- Injecting heroin.
- Using heroin again after an extended period of not using (for example, after completing a detox program).
- Using heroin in combination with alcohol or other substances that slow the breathing, such as benzodiazepines (e.g., Xanax) or sleep aids (e.g., Ambien).
- Having an additional medical condition such as HIV, liver disease, lung disease or concurrent mental health issues.
Opioid Overdose Deaths in the U.S.
The United States has been battling an opioid overdose epidemic for many years, especially with the increasing presence of fentanyl and fentanyl analogues in heroin and other illicit drugs.
The COVID-19 pandemic also seems to have worsened the crisis. Between the 12-months ending in June 2019 to the 12-months ending in May 2020:4
- The number of deaths resulting from opioid overdose increased more than 18%, totaling approximately 81,230.
- 25 states and the District of Columbia saw an increase of more than 20% in opioid overdose deaths.
- 11 states and New York City saw increases of 10-19% in opioid overdose deaths.
- Deaths resulting from synthetic opioids such as fentanyl increased by more than 38%.
- Whereas synthetic opioids were largely found in states east of the Mississippi prior to 2019, during this time period 10 western states saw a 98% increase in synthetic opioid-related deaths.
- Deaths involving cocaine rose nearly 27%, an increase largely associated with the co-use of cocaine and synthetic opioids.
With the opioid overdose crisis continuing to rage, it is crucial to know what to do in the event of an overdose. If you’re a regular opioid user or you love someone who is, you are very likely to witness an opioid overdose. Make sure you’ve familiarized yourself with the signs of an overdose, the steps to take, and how to get naloxone. Knowing what to do can save a life.
Heroin Addiction Treatment in Las Vegas, NV
If you or someone you love is struggling with addiction to heroin or other opioids, there is help. At our inpatient drug rehab in Las Vegas we use addiction-focused evidence-based healthcare to help people get on the road to recovery and living a life they deserve.
Contact our compassionate and knowledgeable admissions navigators at to learn more about your treatment options. Our navigators can also answer your questions about ways to pay for rehab, using insurance coverage for addiction treatment, and how to start treatment.
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
- Insomnia.
- Anxiety.
- Muscle aches and cramping.
- Runny nose.
- Sweating.
- Nausea/vomiting.
- Diarrhea.
- 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
Heroin Addiction Recovery
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.
Heroin Addiction Treatment in Las Vegas, NV
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 start treatment as soon as you’re ready.
Call us to learn more about drug addiction treatment in Las Vegas at Desert Hope. If you’re worried about covering the cost of rehab, our navigators can discuss the different ways to pay for treatment, including using insurance coverage for rehab.