Heroin Addiction: Signs, Symptoms, Risks, and Treatment Resources


Amanda Stevens, BS

Medical Review by:

Dr. Po Chang Hsu MD, MS

Updated On: Jan 13, 2024
Last Medical Reviewer On: April 29, 2024
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    Heroin is a powerful opioid with the potential to create a lifelong addiction. Chronic use of heroin can lead to changes in the brain’s white and gray matter, potentially impairing decision-making abilities, including impulse control related to drug-seeking behavior.

    Your body quickly builds up a tolerance to heroin, which means you will need increasingly potent doses to achieve the same high. The potential for overdose is very high, as is the necessity for heroin rehab.

    Key Points:

    • Heroin is a dangerously addictive Schedule I substance that has a high overdose potential.
    • Symptoms of heroin use include dry mouth, skin flushing, arms and legs feeling heavy, nausea and vomiting, uncontrollable itching, brain fog, and alternating between consciousness and unconsciousness.
    • Approximately 0.4% of the American population above 12 years of age have self-reported using heroin in the last 12 months (about 1.1 million people).
    • Signs of addiction to heroin could include recurrent use, avoidance of responsibilities, craving, interpersonal problems, tolerance, and withdrawal symptoms when not using.
    • Treatment for heroin use includes medical detox, inpatient treatment, and long-term aftercare interventions.

    What is Heroin?

    Heroin is a highly addictive drug made from the opium poppy plant. It was first synthesized by Bayer Pharmaceutical in 1898 and was meant to treat morphine addiction in Civil War Veterans. Unfortunately, these veterans soon developed a harmful tolerance to heroin.[1]

    The US delegates to the Geneva Limitation Convention in 1930 placed international limits on heroin production, and in 1970 it was put on the Schedule I Controlled Substances list in the US. This means heroin has no recognized medical purposes, has a high potential for abuse, and is illegal to possess.

    According to the 2021 National Survey on Drug Use and Health, a full 0.4% of Americans over the age of 12 have reported using heroin in the last 12 months.[2] That comes out to roughly 1.1 million people heroin users.[3]

    Heroin is derived from morphine and is widely available on the street. It goes by many slang names, such as “Dope,” “Smack,” and “Junk.” Heroin binds primarily to mu-opioid receptors, which are involved in the pain relief and reward pathways of the brain, not typically to receptors that directly receive dopamine.[4] It excites your central nervous system, which is why users experience a sensation of euphoria.

    Side Effects of Heroin

    The side effects of heroin are intense. Users crave the rush of sensations associated with the “high” heroin provides. These sensations are analgesia (inability to feel pain), euphoria, and alleviating opioid withdrawal symptoms.[5] However, there are also several common short-term side effects of heroin use, such as:[6]

    • Dry mouth
    • Skin Flushing
    • Arms and legs feel heavy
    • Nausea and vomiting
    • Uncontrollable itching
    • Brain fog
    • Alternating between consciousness and unconsciousness

    How is Heroin Taken?

    Heroin can be snorted, smoked, injected (intravenous, intramuscular, or subcutaneous), or taken orally. Heroin is highly lipid-soluble, allowing it to rapidly cross the blood-brain barrier and initiate its effects swiftly.

    Injecting heroin into veins is the most rapid method of administration, with effects typically occurring within seconds to a minute.[7] There is a risk of transmission of HIV, Hepatitis, or other infectious diseases via used needles.

    When smoking, snorting, or taking heroin orally, the effects will reach your brain in 3-5 minutes.[8] There is a risk of developing leukoencephalopathy, a spongiform degeneration of the white matter, by smoking heroin.[9] This is due to a product of the heating process.

    Heroin Quick Reference

    Drug Category Commercial & Street Names DEA Schedule Administration
    Opioid (No commercial names) Street names: Dope, Tar, Hell Dust, Dragon, Brown Sugar, Black Eagle, Scat, Mexican Mud, Smack, “H,” Junk, Skag, Snow, Horse, China White, Brown, Beast, and Hero. Schedule 1 Orally Intranasal Intravenous Intramuscular Subcutaneous

    Learn About Specific Opioids

    Heroin is part of the opioid drug family.[10] Some opioids, like heroin, have no legal uses. Others have narrowly defined legal uses. Legal uses of opioids could be for post-surgical pain (oxycodone), but illegal uses could be for the sensation of euphoria (heroin).

    Opioids can be natural (heroin, morphine, and codeine), semisynthetic (oxycodone, hydrocodone), and synthetic (fentanyl). All forms have a high potential for addiction.

    See additional resources to learn more about specific opioids:

    Statistics on Heroin Use, Misuse, and Addiction

    In 2021, approximately 9,173 people died from an overdose involving heroin.[11] Over 11% of all opioid-related deaths involved heroin in 2021.[12] Since 1999, nearly 150,000 Americans have overdosed on heroin.[13] The overdose death rate involving heroin in 2021 is nearly 4.5 times what it was in 1999.

    Right now, 0.4% of the American population above 12 years of age have self-reported using heroin in the last 12 months (about 1.1 million people).[14]

    Because of its incredibly high potential for addiction, there is a nearly equivalent percentage of the American population (0.4%) who reported having a heroin use disorder in the last 12 months (1.0 million people).[15]

    Effects of Heroin Abuse

    Can You Overdose on Heroin?

    Yes. You can overdose on heroin. A side-effect of heroin use is respiratory depression. Your breathing slows down as you experience the side effects of the drug. Your body also builds a rapid tolerance to heroin, which means you need more and more heroin to experience the same high.

    As you increase the size and potency of your dose, you put yourself at risk for death because your body will not be able to oxygenate enough blood since you aren’t breathing enough. Your brain might experience fatal hypoxia under the influence of heroin.[16]

    Signs and Symptoms of Heroin Overdose

    There is no single tell-tale sign that is present in all opioid overdoses. But the presence of one or more of these symptoms should be cause for opioid overdose alarm[17]:

    • Unconsciousness
    • Uneven or shallow breathing
    • Blue fingernails, lips, or skin
    • Constricted, tiny pupils
    • Choking
    • Limpness

    What to do if you suspect someone is overdosing on Heroin:

    If you find somebody who you suspect is overdosing on heroin, call 911 immediately. They need medical professionals to stabilize them. While you are waiting for help to arrive, administer naloxone, if available. Begin CPR if they’re unconscious and not breathing until emergency workers arrive.

    Dangers of Long-Term Heroin Use

    Physical complications of long-term heroin use include relatively minor gastrointestinal complications like constipation, serious side effects like deterioration of the brain’s white matter, and extremely serious effects like developing heroin use disorder, which is characterized by uncontrollable drug-seeking behavior no matter the consequences.[18][19][20]

    If you suffer from heroin use disorder, finding drugs will become the primary purpose of your life. You will engage in increasingly risky behaviors and activities to acquire heroin. Your quality of life will suffer, and your risk of death will skyrocket.

    Mixing Heroin with Other Drugs

    Mixing heroin with other drugs is dangerous because it intensifies the effects of both drugs on your body. Often heroin will already be cut with mystery agents by the time it reaches the drug buyer. No matter the kind, any other agent is extremely dangerous.

    Heroin is incredibly dangerous on its own and even more so with other drugs.

    Heroin Addiction and Abuse

    According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), heroin addiction is clinically referred to as an opioid use disorder.[21]

    To make a diagnosis, physicians use the criteria outlined in the DSM-5. An individual may be diagnosed with an opioid use disorder if they meet at least 2 of the following criteria in a 12-month period:[22]

    1. Taking more opioids than intended.
    2. A persistent desire or unsuccessful efforts to cut down or control opioid use
    3. Searching for more opioids or withdrawal from opioid use.
    4. Craving
    5. Failure to uphold professional, social, or familial responsibilities.
    6. Continued opioid use despite interpersonal problems caused by opioids.
    7. Important hobbies are curtailed because of opioid use.
    8. Putting yourself in a physically dangerous environment to use.
    9. Continued opioid use despite declining physical or mental health.
    10. Need to take more and more opioids to achieve the same effect.
    11. Not using the drug is painful.

    How Addictive is Heroin?

    Heroin is a Schedule I controlled substance, which means it has no medically acceptable uses but has a high potential for abuse and addiction. Heroin is also illegal to possess.

    Signs of Addiction to Heroin

    Signs of addiction to heroin could include recurrent use, avoidance of responsibilities, craving, interpersonal problems, tolerance, and withdrawal symptoms when not using.

    Heroin Addiction and Mental Health

    Oftentimes, substance use disorders co-occur with mental disorders. Heroin addiction can lead to the deterioration of mental health faculties, which could agitate other substance abuse issues in a vicious cycle.

    Eventually, opioid use disorder can lead to a loss in quality of life and greatly increase the chances of fatally overdosing.

    Cutting Agents Used for Heroin

    Cutting agents are additives mixed with pure heroin at various stages of the supply chain to increase the drug’s volume and thus enhance the dealer’s profit.

    Heroin often contains additives, such as sugar, starch, or powdered milk, that do not readily dissolve and can clog blood vessels leading to the lungs, liver, and kidneys, potentially resulting in serious organ damage.[23]

    Heroin Addiction Treatment

    The cost of heroin addiction treatment is highly variable. Between detox, inpatient, outpatient, 12-step programs, specific therapies, and aftercare, a full heroin addiction rehab can last 1 to 3 months. Many factors impact the cost, such as length of stay, intensity of care, prescribed therapies, and desired lifestyle.

    Heroin Addiction Treatment Levels of Care

    If you or someone you know is addicted to Heroin, it’s not too late to seek help. At Paramount Wellness, we have several different levels of heroin rehab that may be prescribed, depending on the severity of the substance use disorder:

    Therapies Used in Heroin Addiction Treatment

    If you or someone you know is addicted to Heroin, it’s not too late to seek help. At Paramount Wellness, we offer many different kinds of heroin rehab therapy that can be customized to fit your needs, history, and lifestyle:

    Co-Occurring Disorders

    Co-occurring disorders like mental disorders are common in patients who also exhibit a substance-use disorder. It’s a negative feedback cycle that is difficult to escape.

    In cases of co-occurring mental and substance use disorders, a dual-diagnosis treatment approach is often required. To avoid relapse, both substance use disorder and mental disorder need to be simultaneously addressed. This helps break the sobriety/addiction trigger/relapse cycle. Besides substance abuse, some other co-occurring mental disorders include:

    How to Find Heroin Addiction Treatment in Connecticut

    There are many resources dedicated to helping you find heroin rehab treatment in Connecticut. Guidance may include but isn’t limited to:

    • Finding treatment by checking if there are specifically approved providers and/or treatment modalities from your insurance company
    • Finding help through the “Behavioral Health Services Locator” tool offered by SAMHSA[24]
    • Reading reviews of local treatment centers

    Frequently Asked Questions

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