Signs and symptoms of heroin addiction include unexplained sedation, needle marks on the arms and legs, falling asleep suddenly, and agitation and anxiety in between doses of the drug. People who are addicted to heroin often lie about drug use, miss work or social events, and experience decline in virtually every area of life.
Addiction involves an inability to stop use even if there is a desire to do that. While people may initially be able to hide signs of a heroin addiction, it eventually becomes impossible to do so.
The recommended treatment for heroin addiction is Medication for Addiction Treatment (MAT), and the preferred medication is usually Suboxone.
Heroin is a centuries-old drug derived from a poppy plant. People have smoked, injected and swallowed heroin since it was discovered. And they learned how dangerous the drug is if they survived even one overdose episode.
But today's heroin is arguably even more dangerous than it's ever been. Modern dealers mix heroin with much stronger drugs, resulting in products that can cause a lethal overdose in seconds.
Even though heroin's dangers are widely publicized, many people still use the drug. In fact, researchers say the number of people injecting heroin increased between 2002 and 2018.[1]
People who took and became addicted to pain pills like OxyContin switched to heroin for its affordability and ease of access. Once people start using heroin, it’s very difficult to stop. Treatment programs can help.
Heroin is a powerful opioid drug synthesized from the sap of poppy flowers. Most heroin sold within the United States is grown and processed in other countries before being smuggled into this country and dispensed to dealers for sale.
Heroin comes in several types, including the following:
Experienced heroin users often equate a lighter color with purity. But dealers can (and do) add toxins and other substances to their products. White-colored heroin could include talc, laxatives or baking soda. Brown or black versions could include coffee or dirt.
All heroin sold and used within the United States is made in illicit labs and sold by dealers. Officials recognize no legitimate use for the drug, so it's not sold in any pharmacy or made in a laboratory. Buying, selling or using the drug is illegal.
Heroin's legal status is fair, considering the drug's dangerous nature. Three main risk categories exist
Heroin is a powerful central nervous system depressant, capable of causing an overdose the very first time it's used.
Other short-term complications include the following:
Most people use heroin via injection. Researchers say abscesses at injection sites are common, often because the drug is tainted with substances that don't dissolve in the bloodstream.[6]
Other long-term complications include the following:
Heroin sold on the street is often laced with fentanyl. About half of people who use heroin say they believe fentanyl is in their drugs.[5] But since fentanyl is colorless, odorless and tasteless, the final amount of tainted drugs is likely much higher.
Fentanyl is an opioid, just like heroin. But it's up to 50 times stronger, and a tiny amount could be enough to kill.[7]
Dealers add fentanyl because it's cheaper to make, easier to smuggle and results in an addictive product that keeps users coming back for more. But dosing is haphazard, and it's far too common for people to buy doses that are strong enough to kill.
Heroin is so powerful that it causes persistent changes in the brain and body. Two of them, withdrawal and overdose, are experienced by almost everyone who uses heroin over the long term.
After long-term opioid exposure, cells don't work properly without the drug. People feel very sick when they try to quit heroin use abruptly, but they may also feel withdrawal symptoms between doses.
Withdrawal symptoms can include the following:
Taking too much heroin, or using heroin tainted with fentanyl, can lead to severe central nervous system depression. This is an overdose. More than 9,000 overdose deaths were caused by heroin in 2021.[8]
People who are overdosing have the following symptoms:
Quick treatment with naloxone (Narcan) can reverse an overdose in minutes. Without it, people can die, and many do.
People who use heroin display a collection of symptoms, both physical and mental, even if they want to hide the addiction.
Physical signs of heroin addiction include the following:
Behavioral signs of heroin addiction include the following:
Signs that it's time for treatment include the following:
Medication for Addiction Treatment (MAT) programs are the gold standard for treating heroin addiction. Instead of expecting people to endure sickness and drug cravings, doctors use medications to correct imbalances and allow the brain to heal.
MAT therapies begin with detox, allowing people to quit using heroin. They continue after detox, helping people to resist their heroin cravings without relapsing to drug use.
MAT programs often use buprenorphine/naloxone combinations (Suboxone), as they don't cause intoxication and are approved for at-home use. You can use these therapies as long as they're helpful. Many people use them indefinitely.
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Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role of the brain dopamine system in substance use disorders and in aging. He also studies brain function in obesity and eating disorders.
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