Heroin Addiction: Signs, Symptoms, Effects, & Treatments

What Is Heroin?

Heroin is an illegal and dangerous opioid derived from morphine. Heroin can be smoked or “cooked” into liquid form and injected. Heroin activates the opioid receptors and reward system in the brain, causing a rush or sense of pleasure and relaxation. Some may abuse heroin as a recreational drug to escape reality.

Why Is Heroin Addictive?

Heroin is incredibly addictive because prolonged use alters pleasure and reward systems in the brain.²  Many may use heroin to experience the characteristic rush of “euphoria.” However, this high is short-lived, often resulting in continued use to perpetuate positive feelings. Individuals may develop tolerance to the drug and experience physical withdrawal symptoms when heroin use ceases.²  While these symptoms are not always life-threatening, they can be uncomfortable and strengthen urges to use again.

Symptoms of Heroin Addiction & Abuse

Heroin addictions range in severity. Individuals may develop tolerance to heroin and require more of the drug to experience desired effects. However, increased tolerance can result in dependence or addiction, increasing the potential for fatal overdose. Many start misusing heroin to disconnect from reality or feel a ‘rush’ of euphoria, but adverse heroin side effects can be unpleasant and painful.

Physical effects of heroin may include:²

• Slow or irregular breathing
• Itchy or flushed skin
• Nausea and vomiting
• Constipation and stomach pain
• Drowsiness
• Loss of consciousness
• Constricted or small pupils
• Slurred or incoherent speech

Signs of Heroin Addiction

Heroin addictions result in health problems, relationship turmoil, and failures to meet responsibilities. Recognizing someone is on heroin can be challenging, but certain physical or behavioral signs of heroin abuse may present.

Physical signs associated with heroin use include:²

• Depression
• Anxiety
• Irritability
• Mood swings
• Lying or deceptive behavior
• Avoiding eye contact with others
• Loss of motivation
• Lack of interest in hobbies or activities
• Decreasing quality of performance at school or work
• Withdrawal from friends and family
• Hostile behavior toward loved ones
• Repeatedly stealing or borrowing money from others
• Wearing long sleeves or pants to hide needle marks
• Lower attention to personal hygiene

Negative Side Effects of Heroin Addiction

The effects of heroin addiction can be harmful and life-threatening. Individuals’ entire worlds revolve around heroin when they develop a dependence. Heroin users may become erratic, aggressive, or depressed and withdraw from friends and family. Over time, heroin addiction puts individuals at risk of severe health complications.

Heroin often contains added ingredients, such as starch or sugar, that can clog blood vessels and damage the lungs, liver, kidneys, or brain. This damage may be permanent and result in life-long ailments. Additionally, sharing needles exposes heroin users to HIV, hepatitis, and other blood-borne infectious diseases.²

Short-term effects of heroin addiction may include:

• Warm flushing of the skin
• Dry mouth
• Heavy feeling in the arms and legs
• Nausea and vomiting
• Intense itching
• Decreased mental functioning
• Nodding (a back-and-forth state of being conscious and semi-conscious)

Long-term effects of heroin abuse may include:

• Insomnia
• Collapsed veins
• Infection of the heart lining and valves
• Skin abscesses (swollen tissue filled with pus)
• Constipation and stomach cramping
• Liver and kidney disease
• Lung complications, including pneumonia
• Mental disorders such as depression and antisocial personality disorder
• Sexual dysfunction for men
• Irregular menstrual cycles for women

Heroin Addiction Withdrawal Symptoms

A person may experience heroin withdrawal symptoms if they suddenly stop using the substance. Opioid withdrawal symptoms are often uncomfortable, possibly resulting in relapse to avoid unpleasant effects.

Symptoms of heroin withdrawal can begin a few hours after cessation, peak on day two or three, and continue for one to two weeks. The length of withdrawal depends on several factors, such as dosage, duration of use, and tolerance.

Withdrawal symptoms of heroin addiction may include:

• Restlessness
• Severe muscle and bone pain
• Stomach cramps
• Headaches
• Sleep problems
• Diarrhea and vomiting
• Cold flashes with goosebumps
• Sweating
• Uncontrollable leg movements
• Dilated pupils
• Poor sleep
• Restlessness
• Poor concentration
• Mood swings
• Fatigue/tiredness
• Increased depression or anxiety
• Panic attacks
• Irritability
• Memory loss

Signs of Heroin Overdose

Those struggling with heroin addiction risk overdose. Individuals who illegally buy heroin cannot determine if the drug is pure or contains additional ingredients. As a result, they can overdose and die at any time, regardless of tolerance or experience. Signs of heroin overdose may include difficulty breathing, weak pulse, and disorientation. Seek immediate medical attention if overdose symptoms present.

Heroin Addiction & Abuse Treatment Options

Heroin addictions require individualized treatment approaches to help restore some degree of normalcy to the body and brain. Typical recommendations include outpatient therapy, inpatient treatment, and medication-assisted treatment (MAT). Research shows that many people benefit the most from behavioral treatment and MAT.³

Outpatient Therapy

Many effective behavioral treatments are available for heroin addiction, and mental health professionals may provide substance abuse services in private practices and residential programs. Cognitive behavioral therapy (CBT), multidimensional family therapy, and motivational interviewing (MI) have shown promise in treating heroin abuse. These therapies can help individuals recognize the reasons behind their addiction, stay motivated, and improve functioning.

Inpatient & Rehab Treatment

Various rehab centers offer different treatment modalities. However, most facilities provide structured routines, activities, and daily individual and group therapy sessions. Individuals struggling with heroin addiction may benefit from art therapy, music therapy, hiking, meditation, and exercise. Inpatient rehab centers usually enroll clients for 30-60 days based on the severity of their addiction.

After inpatient treatment, clients are encouraged to pursue partial hospitalization programs (PHP), intensive outpatient treatment (IOP), or standard outpatient treatment (OP). Most reputable programs will promote aftercare involving community support addiction groups and outpatient therapy.

Medication-Assisted Treatment

Because heroin withdrawal is intense and painful, medication-assisted treatment (MAT) may help alleviate initial physical symptoms in heroin recovery. Medical physicians may provide clients with a supervised and monitored opioid to reduce cravings and future relapse. Some medications used can result in opioid addiction, overdose, and withdrawal. Therefore MAT is a delicate balancing act.

Medications used in MAT for heroin addiction may include:

• Methadone: Methadone or Dolophine is a long-acting, low-potent opioid. Long-term treatment is the most effective, but methadone can help with short-term detox. Clients may use methadone for months or years after completing intensive treatment for heroin use disorder.
• Buprenorphine: Buprenorphine is a partial opiate agonist that reduces cravings and withdrawal symptoms. Since buprenorphine and methadone act on opioid receptors, they are given during acute detoxification to help ease withdrawal effects.
• Naltrexone: Naltrexone blocks receptors that cause the euphoric feelings of heroin. Naltrexone is not administered during acute withdrawal or in the presence of other opioids.

Final Thoughts

Heroin addictions can cause life-long complications that require extensive treatment and support. However, recognizing the early warning signs of heroin abuse can help individuals achieve and maintain recovery. Professional guidance and assistance are available for those working to overcome heroin misuse.