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Heroin Addiction

Heroin is an opioid derived from morphine, which comes from the poppy plant. 

Like other opioids, heroin is highly addictive, and its use can result in fatalities. Heroin is used recreationally and is most commonly ingested in several ways, among them insufflation, injection, and inhalation. 

Heroin addiction is one of the culprits of the growing opioid epidemic that has plagued the United States in recent years. Also, the number of opioid-related overdose deaths continue to occur as a result of heroin addiction.

The rate of drug overdose deaths in America has more than tripled between 1999 to 2016, according to the U.S. Centers for Disease Control and Prevention (CDC). Among all drug overdose deaths in 2016, heroin was the second-most encountered drug next to fentanyl, according to the National Vital Statistics Reports by the CDC. 

Heroin is becoming less pure, especially when it is in powder form. A lot of the heroin nowadays is being cut with potent synthetic opioids like fentanyl and carfentanil, which are not intended for human consumption at all.

What Is Heroin?

Heroin (chemical name diacetylmorphine) is a habit-forming narcotic analgesic. 

Repeated heroin use changes the physical structure of the brain, meaning it causes both neurological and hormonal disparity. Long-term heroin effects are not easily reversible; however, many tools are available to overcome heroin addiction.

Heroin addiction is the result of an increase in tolerance and dependence of heroin, or other opioids which lead an individual to use heroin.

Either way, heroin use is dangerous, and it can lead to severe consequences rapidly.

This drug immediately attaches itself to the opioid receptors in the brain and activates them, causing an influx of pleasure, relief, and suppression of all functioning in the body. 

Heroin is both physically and psychologically addictive. Its use produces an intense rush, which is the feeling most sought after the initial use of heroin, and even after continuous use.

This rush of pleasure from heroin is due to the surge of  dopamine, the “feel-good” neurotransmitter. According to Harvard Health Publishing from Harvard Medical School, addictive drugs like heroin can release between two to 10 times the amount of dopamine than natural processes, and these substances perform this function more quickly and reliably. 

Although heroin use might initially be pleasant, the long-term consequences of heroin addiction on the brain alone can be alarming. The prefrontal cortex and medial temporal lobe of the brain are highly affected by long-term heroin use. The effects of heroin on these parts of the brain consist of:

  • A poor ability to recognize the extent of one’s behavior
  • Lack of emotions
  • Impaired memory
  • Inability to make rational decisions
  • Inability to effectively reason, make plans, or problem solve
  • A decrease in the ability to see beyond the present
  • Inability to complete tasks or create new ones

Heroin also comes in several forms—powder or black tar. One is no different from the other; they are both highly addictive and dangerous. A number of names are associated with the word “heroin,” and a few alternative names for the substance are:

  • Smack
  • H
  • Boy
  • Horse
  • Tar
  • Dope
  • Junk
  • Scag
  • D
  • Mexican mud

What Are the Signs of Heroin Addiction?

Heroin addiction is relatively easy to spot, especially if someone has been using it for an extended period. However, if someone is suspected to be addicted to heroin, and is just beginning to show signs, it might be challenging, but it is possible to recognize before it is too late.

Every individual struggling from heroin addiction will show similar signs, all of which can lead to various negative consequences. Below are the signs of heroin addiction: 

  • Itching
  • Dry mouth
  • Pinpoint pupils
  • Slurred speech
  • Nausea
  • Less active and alert
  • Delayed reaction
  • Feeling sleepy
  • Slowed breathing and heart rate
  • Nodding out (intervals of being asleep and awake)
  • Needle marks or bruising on the skin
  • Infections
  • Skin that appears gray
  • Sudden weight loss
  • Sunken eyes
  • Lack of hygiene
  • Inability to keep up with responsibilities
  • Financial issues
  • Legal Troubles
  • Collapsed veins / Abscess
  • Diseases such as Hepatitis C or HIV
  • Paraphernalia
  • Frequent trips to the bathroom or isolated areas
  • Increased depression
  • Isolation
  • Unreliability
  • Stealing (missing items)
  • Unkempt appearance
  • Red nose

Heroin causes physical withdrawal symptoms that can help determine if someone is using it. Heroin withdrawal signs include:

  • Agitation
  • Edginess
  • Sweating
  • Nausea
  • Vomiting
  • Diarrhea
  • Cold sweats
  • Insomnia
  • Increased joints and/or muscle pain
  • Cravings
  • Restless leg syndrome
  • Depression
  • A runny nose
  • Excessive yawning

If someone is actively using heroin, the risks are much higher if they are undergoing heroin withdrawal. Withdrawal is not deadly; however, using increases the chance of experiencing an overdose due to the cutting agents that are in circulation in the illicit heroin market.

Heroin Withdrawal Symptoms

When someone reaches the stage of withdrawal, it means they have developed dependence. They develop dependence due to repeated exposure to heroin to the point where the body only functions normally when the drug is present, according to the National Institute on Drug Abuse (NIDA). 

The person using heroin experiences physiological disturbances or withdrawal symptoms after the drug exits the body.

While heroin withdrawal is not life-threatening, it is capable of producing painful, flu-like symptoms. According to, the following withdrawal symptoms occur in early and late phases:

Early symptoms of withdrawal include:

  • Yawning
  • Runny nose
  • Sweating
  • Agitation
  • Muscle aches
  • Increased tearing
  • Anxiety
  • Insomnia

Late symptoms of withdrawal include:

  • Abdominal cramping
  • Nausea
  • Vomiting
  • Diarrhea
  • Dilated pupils
  • Goosebumps

People in heroin withdrawal can expect symptoms to begin about 12 hours after last use. The danger of opioid and opiate withdrawal are that the symptoms are uncomfortable enough to drive someone to relapse. 

What Is Involved in Heroin Addiction Treatment?

Heroin addiction is treated in various ways. The most effective is the addiction treatment process. It consists of medical detox, inpatient (residential), and outpatient programs

There also are other forms of heroin addiction treatment, such as the use of buprenorphine, along with therapy or 12-step support groups. However, since heroin withdrawal is both physically and psychologically severe, the beginning stage of treatment should consist of detox.

A detoxification program lasts anywhere from three to 10 days. During this process, the detox client will be given a buprenorphine (Suboxone) taper along with other medications to ease symptoms of withdrawal. The client will also be surrounded by medical professionals and other clients undergoing similar struggles. 

Heroin paraphernalia

Detox is beneficial because the client is in a safe environment. This is particularly important in case an emergency arises during the withdrawal period. In the detox setting, the client will be surrounded by constant support to help suppress the psychological aspect of heroin addiction and withdrawal.

 It is possible to detox from heroin “cold-turkey” although it is strongly discouraged. It might not be as comfortable as detoxing in a medical facility. Also, the success rate of detox and following through with an inpatient program, such as Suboxone maintenance and 12-step meetings, is much higher, especially in early recovery.

The next step in the treatment process is attending a residential program. Residential treatment programs give the client an opportunity to treat the underlying issues associated with heroin addiction. Residential programs can last anywhere from 30 days to 90 days, and they consist of:

  • Individual therapy
  • Group therapy
  • Cognitive behavioral therapy
  • Constant surveillance
  • Separation from drugs or dangerous environments
  • Surrounded by support at all times
  • Relapse prevention
  • Addiction or mental health education

The success rate of attending an inpatient program in a residential setting after detox is high and the tools obtained from participating in this kind of program are everlasting.

After a residential treatment stay, it is recommended that clients in recovery continue treatment with an outpatient program in conjunction with attending 12-step meetings such as Narcotics Anonymous. Outpatient treatment usually lasts up to eight weeks. Clients are typically required to attend one to three days of therapy a week for a couple of hours. This can help the client stay accountable while adjusting to life in sobriety outside of a treatment center.

How Dangerous Is Heroin?

Heroin addiction is highly dangerous and can result in negative consequences, including overdose and death. This drug is extremely potent, especially when it is being cut with agents that are much more potent than morphine and not intended for human consumption. 

Tolerance and dependence develop quickly when it comes to heroin use, resulting in the need for more of the drug to achieve the desired effects. 

This becomes dangerous when fentanyl or carfentanil are involved; in many cases, users may not realize the substance they are buying is cut, and they also may use more of the drug than they would if they had no tolerance. 

Since not many people with a heroin abuse problem test their drugs, they end up overdosing or dying from using too much heroin that has been cut.

Overdose symptoms associated with heroin impact different parts of the body. According to, those symptoms include: 

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  • Shallow breathing
  • No breathing
  • Slow and difficult breathing


  • Dry mouth
  • Pinpoint pupils
  • Discolored tongue


  • Weak pulse
  • Low blood pressure


  • Bluish nails and lips


  • Constipation
  • Stomach and intestinal spasms


  • Delirium
  • Disorientation
  • Coma
  • Drowsiness
  • Uncontrolled muscle movements

Although there are overdose reversal drugs such as Narcan, it is becoming increasingly difficult to reverse an overdose caused by powerful synthetic opioids.

Heroin has a strong physical and psychological hold on all who use it. It consumes the individual and eventually strips them of everything known to be true. It is also common for people with heroin addiction to get caught up with the law due to the need for more money to support their habit, leading to one or more criminal charges due to heroin addiction.

Heroin is also used in conjunction with other drugs, like cocaine. This leads to an increase in risks associated with the use of heroin, along with having to deal with the symptoms of multiple drug addiction. Also, the use of heroin and other substances take a significant toll on the brain and body, in which it takes a long time to recover.

Heroin Abuse Statistics

The opioid epidemic is sweeping the United States with no end in sight. The alarmingly high numbers of overdose deaths, money spent on treatment, and the rising number of individuals using heroin or other opioids are far beyond what the U.S. has ever seen.

The number of opioid-related overdose deaths in 2015 totaled to more than 52,000 people; more than 12,000 involved heroin and that number is rising.

The availability of heroin is also at an all-time high in the United States. More people seek treatment for heroin addiction than any other illicit drug.


U.S. Centers for Disease Control and Prevention. (n.d.). Products – Data Briefs – Number 294 – December 2017. Retrieved from

Harvard Health Publishing. (n.d.). How addiction hijacks the brain. Retrieved from

Hedegaard, H., M.D., Bastian, B. A., Trinidad, J. P., M.P.H., Spencer, M., M.P.H., & Warner, M., Ph.D. (n.d.). National Vital Statistics Reports [PDF File]. U.S. Centers for Disease Control and Prevention (CDC). Retrieved on June 11, 2019. from (n.d.). Heroin overdose: MedlinePlus Medical Encyclopedia. Retrieved from (n.d.). Opiate and opioid withdrawal: MedlinePlus Medical Encyclopedia. Retrieved from

The National Institute on Drug Abuse. (n.d.). What are the long-term effects of heroin use? Retrieved from

Substance Abuse and Mental Health Services Administration (SAMHSA). (2015, June 15). Buprenorphine. Retrieved from

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