Heroin Abuse & Addiction: Signs, Symptoms, and Treatment


Heroin is an opioid drug that’s made from opium poppy plants and morphine, a natural substance from the poppy seed pod. It is an illegal substance that has no approved use in medical settings. People who use heroin can take it by snorting, sniffing, injecting, or smoking it.

The National Survey on Drug Use and Health, an annual national survey, estimates that in 2018, around 808,000 people aged 12 and older used heroin in the past year.  An estimated 506,000 people misused heroin as well as prescription opioid pain relievers.1

Addiction is a treatable, chronic medical disease marked by the compulsive use of heroin and/or other substances despite negative consequences in a person’s relationships, career, and other aspects of their life.2 Aside from the risk of addiction, heroin use can alter how the brain works3 and have other long-term health consequences.

Heroin is often cut with other powder-like substances such as powdered milk, sugar, or even with cheaper and more powerful synthetic opioids similar to fentanyl,4 which increases the risk of a deadly overdose.5

Evidence-based treatment, both pharmacological and behavioral, based on years of research and treatment experience make it possible to recover from heroin addiction and lead a sober life. Detoxification, treatment, and a life free from the grip of heroin are all within reach.

What is Heroin Use Disorder?

When a person takes heroin, either by injecting, sniffing, snorting, or smoking, it attaches to opioid receptors in the brain that are involved in feelings of pleasure and pain. The more a person uses heroin, the bigger the chance is that they develop a tolerance of the substance. This means that they’ll continue to need more heroin to get the same high they had before.3

Learn More About Heroin

Methods of Use

When a substance like heroin—and the compulsive use of the drug—interferes with a person’s day-to-day life or creates health issues, an individual may be diagnosed with a substance use disorder.3

For a medical or clinical professional to diagnose a heroin use disorder, a person must exhibit at least 2 of the following signs of heroin addiction in a 12-month period:6

  • Takes more heroin for longer than they intended.
  • Cannot control heroin use even if they want to.
  • Attempts to get, use, or recover from heroin regularly.
  • Constantly wants to use heroin.
  • Doing heroin interrupts their day-to-day life, including work, home, or school duties.
  • Continues to use heroin even though it causes issues with loved ones or colleagues.
  • Avoids activities they used to be passionate about due to heroin use.
  • Uses heroin in situations where it can be physically dangerous.
  • Realizes they are abusing heroin and continues to take it.
  • Tolerates larger quantities of heroin.
  • Experiencing withdrawal symptoms when stopping heroin use.

Signs of Heroin Use

While the diagnosis of an opioid use disorder should only be made by medical or clinical professionals, there are signs suggestive of heroin addiction or abuse that someone like a family member or friend might identify.

heroin

The signs suggestive of heroin use include:7

  • Marked drowsiness or sleepiness.
  • Slowed movement, breathing or cognition.
  • Decreased pupil size.
  • Marks on the skin, if the person injects heroin.
  • Itchiness.
  • Nervousness.
  • Insomnia.
  • Vomiting.

Physical Effects of Heroin

Some of the common health risks of abusing heroin can include:3

  • Nausea and vomiting.
  • Severe itchiness.
  • Clouded mental functioning.
  • Shifting between conscious and semi-conscious states.

When someone abuses heroin over the long-term, other health risks might present, including:3, 8

  • Constipation and stomach cramping.
  • Insomnia.
  • Lung problems.
  • Liver and kidney disease.
  • Poor cognition, including problems with decision-making, behavior regulation, and stress response.

Learn More About Health Risks

Heroin Withdrawal

Because heroin is an illicit substance and is not regulated, it often gets cut with other additives like powdered milk or sugar. When used intravenously, heroin with these additives may clog a person’s blood vessels and lead to further health complications that can cause permanent damage to the lungs, liver, kidneys, or brain.3

Those who inject heroin might also experience skin abscesses or boils, collapsed veins, an infection of the heart lining and valves, viruses like HIV or Hepatitis C from sharing needles.

Those who consume the substance nasally (i.e., “snorting”) might have damaged tissue in the nose which may even perforate the separation between the nostrils.

Mental health disorders such as depression may develop or worsen, and men may experience sexual disfunction while women might have irregular menstrual cycles.

Heroin Addiction Treatment

When a person enters an addiction treatment program to curb their heroin use, the likely first step will be detoxification, including medical management of uncomfortable, moderate to severe withdrawal symptoms.

Doctors may prescribe medication to help manage cravings and alleviate or stave off withdrawal symptoms, including:9

  • Buprenorphine, a weaker opioid that’s long-lasting.10
  • Methadone, which reduces opioid craving and withdrawal and blocks the effects of opioids.11

Naltrexone, which helps stop opioid drugs like heroin from attaching to the opioid receptors in the brain, is also sometimes prescribed to suppress heroin cravings, but it can’t be used until a person completed withdrawal.3

Learn More About Heroin Treatment

Quitting Heroin

How to Treat Heroin Addiction

A qualified physician can dispense buprenorphine after an in-person physical examination and assessment at a doctor’s office without requiring attendance to a treatment facility.10 During COVID-19, the in-person requirement is waived and the assessment may be done via telemedicine.12

For many though, a heroin addiction treatment center has the tools a person will need to for more effective treatment leading to long-term recovery. Inpatient programs offer a sober environment where doctors and behavioral health professionals can monitor the patient, and the patient can relearn how to live life without heroin.3

Inpatient or intensive outpatient programs offer group or one-on-one cognitive behavioral therapy (CBT). CBT can help a patient shift the way they think about heroin and themselves, as well as teach ways to avoid relapse by managing stress and triggers that may make them want to start using again.3

Heroin Abuse Treatment at Recovery First

Learn More About Recovery First

Treatment Overview

Explore Our Facility

Admissions

Recovery First Treatment Center offers safe medical detox from heroin and a number of other substances, as well as a full continuum of care for treatment of substance use disorders. From intensive medical rehab to telehealth addiction treatment, Recovery First can provide you with the medically validated help you need to reach sobriety and recovery. Call 954-526-5776 to talk to one of our compassionate, knowledgeable Admissions Navigators today. You can even see if your health insurance would cover treatment below.

FAQs

How do people take heroin?

Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin. People who use heroin can take it by snorting, sniffing, injecting, or smoking it.3 Nearly all people who use heroin use at least 1 other drug.13

In a study looking at heroin use between 2002-2013, 96% of past-year heroin users reported use of at least one other drug during the past year, and 61% reported using at least three different drugs.14

Why is heroin addictive?

Heroin binds to the opioid receptors in the brain, which regulate feelings of pain and pleasure. Taking heroin provides users with a “rush,” or surge of euphoria. As someone continues to take heroin, they may need to consume more of the substance to get the same feeling (i.e., tolerance) or experience withdrawal symptoms when they reduce their use or stop taking heroin altogether (i.e., dependence). Tolerance and dependence greatly increase the risk of addiction.3

Can you overdose on heroin?

Yes. If a person takes too much heroin, their breathing can slow or stop. Short and long-term effects can occur if the amount of oxygen decreases to the brain. Among the worst outcomes are coma, permanent brain damage, and death.3 In 2018, nearly 15,000 people died from a drug overdose involving heroin, that’s 5 deaths for every 100,000 people in the U.S.15

Naloxone can be used to treat an opioid overdose.3

What are heroin withdrawal symptoms?

If someone who has been using heroin regularly stops taking the substance abruptly or reduces their use, they may experience mild to severe withdrawal symptoms. These can include:3

  • Craving heroin.
  • Insomnia.
  • Pain in muscles and bones.
  • Stomach issues, including diarrhea and vomiting.

Attending detox for the cessation of heroin means the patient could have help managing their uncomfortable withdrawal symptoms.

 

Sources

  1. Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  2. American Society of Addiction Medicine. (n.d.). Definition of addiction.
  3. National Institute on Drug Abuse. (2019). Heroin Drugfacts.
  4. United States Drug Enforcement Administration. (n.d.). Heroin.
  5. Schiller, E.Y., Goyal, A., Cao, F. & Mechanic, O.J. (2020). Opioid overdose.
  6. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: APA.
  7. National Institute on Drug Abuse. (n.d.). Signs of heroin use.
  8. National Institute on Drug Abuse. (2018). What are the medical complications of chronic heroin use?
  9. Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. Rockville, MD: Center for Substance Abuse Treatment.
  10. Substance Abuse and Mental Health Services Administration. (2020). Buprenorphine.
  11. Substance Abuse and Mental Health Services Administration. (2020). Methadone.
  12. Substance Abuse and Mental Health Services Administration. (2020). FAQs: Provision of methadone and buprenorphine for the treatment of opioid use disorder in the COVID-19 emergency.
  13. Centers for Disease Control and Prevention. (2020). Heroin.
  14. Centers for Disease Control and Prevention. (2015). Vital signs: demographic and substance use trends among heroin users—United States, 2002-2013.
  15. Centers for Disease Control and Prevention. (2020). Heroin overdose data.

 



About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More


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