Heroin: Health Effects, Withdrawal & Treatment
What Is Heroin?
Heroin is a powerful illegal opioid substance made from morphine, a natural opioid derived from opium poppies.2,3
Forms of heroin include:2,3
- White powder.
- Brown powder.
- Black sticky substance (“black tar” heroin).
Heroin is commonly used via several means:1,4,5
- Snorting or sniffing the powder (also called “insufflation”).
- Heating the heroin and smoking the fumes (inhaling it).
- Dissolving the heroin in water and injecting it intravenously.
Is Heroin Addictive?
Yes, heroin can be a very addictive drug. It acts on the opioid receptors in the body and both suppresses pain and elicits pleasure. At higher doses users typically experience a pleasurable rush of euphoria (a high).1 These pleasurable feelings can lead a person to want to repeat taking heroin.
A person can quickly build up a tolerance to heroin and may find they either need to increase the amount or frequency of their dose or change their method of use (e.g., from snorting to injecting) to get the effects they want.1,6
With continued heroin use, a person may quickly develop a physiological dependence. Dependence makes it especially difficult to quit, since the associated withdrawal symptoms are often painful and unpleasant characterized by symptoms that mimic an awful flu.1,7
Both tolerance and dependence are physiological signs that the body has adapted to heroin. Becoming increasingly tolerant to or dependent on heroin does not alone mean a person is addicted; however, both are signs of an opioid addiction, or opioid use disorder (OUD).7
An OUD is characterized by the compulsive seeking of heroin or other opioids despite the damage it causes to a person’s relationships, physical health, and other important areas of their life.7,8
What Are the Signs of Heroin Abuse?
Some signs that a person may be abusing heroin include:1,9,10
- Nodding off (alternating between wakefulness and semi-unconscious).
- Seeming out of it (spaced-out).
- Small pupils, if intoxicated.
- Large pupils, if in withdrawal.
- Slow and uncoordinated movements.
- Constant scratching/picking of the skin leading to cuts, bruises, or scabs.
- Constantly runny nose.
- Nosebleeds (from snorting heroin).
- A hacking cough (from smoking heroin).
- Sores on lips or the nostrils (from smoking heroin).
- Burns on the fingers or lips (from smoking heroin).
- Skin infections or abscesses (from injecting heroin).
- Needle marks/track marks (from injecting heroin).
- Changes in sleeping patterns (such as sleeping more of falling asleep suddenly).
- Neglect of personal hygiene.
- Decreased motivation.
- Increasingly secretive behavior.
- Personality changes and/or mood swings.
- Risk-taking (driving while high, having unprotected sex, etc.).
- Ignoring personal responsibilities/obligations.
- Wearing long sleeves even in warm weather (to hide needle marks).
What Are the Signs of Heroin Addiction?
As a person develops an opioid use disorder, they will begin to display signs that they are losing control over their heroin use, such as:7
- Using more heroin or using it more often than intended.
- Using heroin despite it causing social or interpersonal problems.
- Failing to fulfill obligations at home, school, or work due to heroin use.
- Using heroin when doing so can be physically hazardous, for example before getting behind the wheel.
View the full list of diagnostic criteria for an opioid use disorder.
Short-Term Effects of Heroin
When someone uses heroin, they may feel a near-immediate and very powerful high. Other short-term effects of heroin include:1,11
- Warm, flushed skin.
- Heaviness in the extremities.
- Dry mouth.
- Severe itchiness.
- Impaired mental functioning.
- Drowsiness/nodding off.
- Slowed breathing.
Heroin overdose occurs when a person uses too much heroin or uses heroin that contains another drug, such as a more powerful opioid like fentanyl. With fentanyl-containing heroin on the rise, overdoses have grown significantly in number in recent years.12,13
What to Do in Case of a Heroin Overdose
If you believe someone has overdosed, call 911 right away.14 Do not delay calling for emergency medical assistance, and don’t worry about getting in legal trouble. Most states have Good Samaritan laws that provide certain legal protections for those who call for help in an overdose emergency or otherwise try to help, for example, by administering naloxone, the opioid overdose reversal drug.15
If you have naloxone, administer it right away, even if you’re not sure if the person is overdosing. Someone not overdosing on opioids will not experience adverse effects as a result of receiving naloxone.12
If the person does not begin breathing within 2-3 minutes, administer another dose of naloxone.16 Stay with the person until medical assistance has arrived and position them on their side to prevent choking should they vomit.14
What Are the Long-Term Effects of Heroin?
Heroin is a powerful drug capable of causing a great deal of harm over time. Someone who uses heroin long-term may experience numerous medical and mental health issues, including:17
- Chronic constipation.
- Lung problems (e.g., pneumonia, tuberculosis).
- Sexual dysfunction (in men).
- Irregular menstrual cycles (in women).
- Deterioration of the brain’s white matter, which may lead to problems making decisions, regulating behavior, and controlling impulses.
- Opioid use disorder.
Injection users may experience a whole list of unique health risks, including clogged blood vessels, serious soft tissue infections, and collapsed veins.17 Those who snort heroin may also suffer several unique health problems, including nasal pain and holes in the nasal septum.17,18
Heroin users are also at increased risk of bloodborne diseases such as HIV or HCV from sharing drug paraphernalia (needles, straws) as well as by engaging in risky sexual behaviors.17,19
Heroin Addiction Treatment & Detox
Heroin addiction is treatable. If you or a loved one is suffering from an opioid use disorder and you don’t know where to turn, we can help.
Detoxing from Heroin
The treatment path for heroin addiction often begins with medical detox.20,21 In a medical detox program, the patient’s withdrawal symptoms are managed safely under the careful supervision of medical staff.21 Heroin withdrawal can be immensely uncomfortable and may include symptoms like:7,21
- Muscle and bone pain.
- Nausea and vomiting.
At AdCare, we have two inpatient detox programs, one detox center in Rhode Island and one drug detox center in Massachusetts where you or a loved one can detox in a sober, medically monitored inpatient environment.
Heroin Addiction Treatment Options
Treatment for heroin addiction should continue after detox, either in an inpatient or outpatient environment. Inpatient and outpatient programs will utilize many of the same core treatment elements, including counseling, group therapy, medications (e.g., methadone, buprenorphine or naltrexone), drug education, and mutual support groups (e.g., Narcotics Anonymous or SMART Recovery) to help people address their addictions and learn new coping skills to bolster their recovery.20
Inpatient/residential programs offer around-the-clock care and the chance to put all of your focus on your recovery. These programs can be a great starting point for those with moderate to severe opioid use disorders who need intensive support as they begin their treatment journey.20
Outpatient programs vary in intensity. The most intensive outpatient program, partial hospitalization, is similar to inpatient programs; however, you do not live at the facility. Intensive outpatient programs offer fewer hours of treatment per week but still offer a great deal of support. Standard outpatient programs involve minimal hours of therapy and are often utilized by those who are continuing in their treatment journey after completing a higher level of care.20
AdCAare offers the full range of treatment programs, and we can help you determine what your particular treatment path may look like when you call us at .