Heroin Addiction Signs and Symptoms

Heroin addiction is a serious and very dangerous issue. Learn more about this disorder here. 

How is Heroin Used?

Parents and loved ones need to look out for heroin addiction signs because addiction rates continue to grow. According to data from the National Survey on Drug Use and Health (NSDUH), about half a million Americans reported using the drug within the past year. The good news is that rates of first-time heroin use in middle school and high schoolers have declined.1

Unfortunately, most people who use heroin start in early adulthood, about the same age group currently experiencing the highest addiction rates (eighteen to twenty-five). What’s important to remember is that heroin addiction can occur at any age. Loved ones should be on the lookout for addiction signs because heroin is highly dangerous. 

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Recognizing Heroin

Heroin is an opiate, a class of drugs under the category of opioids. Opiates are drugs derived from the poppy plant. Although opiates are effective painkilling drugs, they are also highly addictive and dangerous. In America, it is an illegal drug and is a Schedule I controlled substance. Drugs that meet the Schedule I criteria do not have legitimate medical use and have a high potential for abuse.

Heroin is a white or brownish color, and it is typically sold in powder form. The powder is often mixed or “cut” with other ingredients like powdered milk, starch, or sugars to increase profitability. By mixing it with other substances, people selling the drug can make more money — but they also make the drug unpredictable. Every purchase of heroin is a mystery dose because the purchaser can never be sure of the actual potency of the product they’re using.

Highly pure heroin can be snorted or smoked. People may snort or smoke the drug to avoid the social stigma that is associated with injecting heroin. However, the substance is just as dangerous when used through these other methods. 

Snorting Heroin

Heroin addiction signs

The absorption process for snorting heroin is longer than injecting or smoking it. When snorted, the high from this substance takes about five minutes to begin. What makes snorting heroin more appealing is that no tools are necessary — unlike when it is smoked or snorted. In addition, ingesting heroin through the nose does not have the same stigma that smoking or injecting it does. 

Side Effects of Snorting Heroin

Because of the delay in absorption, less heroin accumulates in the body. That said, heroin itself remains highly addictive, even when snorted. People who use the drug by snorting it eventually desire a quicker and more intense high and experience side effects from smoking.

The short-term effects of snorting heroin include a runny nose (due to the body’s immune response), sniffling, watery eyes, and small pupils. The long-term effects are damage to the nasal membranes in the nostrils. Long-term snorting of the cocaine addiction can also create a hole in the nasal septum from the drug, in addition to nasal inflammation. 

Signs of Snorting Heroin

Although snorting heroin does not require any tools, there are still signs to look for. People who snort this substance may use straws or rolled-up papers, or dollar bills, which they may leave around. Moreover, remnants of the powder can linger around their nostrils or on flat surfaces, pointing to clues to heroin addiction. 

What Happens if You Snort Heroin?

Regardless of how heroin is ingested, it affects the central nervous system (CNS). The CNS controls main body functions and nerve cells, creating both physical and psychological effects. More common effects include:

Physical Effects

  • Pain relief
  • Reduction in breathing rate
  • Reduction in heart rate
  • Skin flushing
  • Dry mouth
  • Heavy feeling in limbs
  • Digestive changes
  • Constricted pupils
  • Itching
  • Constipation
  • Cough suppression
  • Physical dependence/Withdrawal 

Psychological Effects

  • Euphoria, feeling “high”
  • Feeling “cloudy,” confused
  • Mood swings
  • Loss of memory
  • Depression
  • Drowsiness
  • Sedation

Link Between Heroin Abuse and Prescription Drug Abuse

According to the National Institute on Drug Abuse, studies find three main paths to heroin abuse through other drugs:

  • Polysubstance use (the use of multiple medications) to heroin use
  • Cocaine use to heroin use
  • Prescription opioid abuse to heroin use 

Dangers of Mixing Heroin with Other Drugs

Although the most common path to heroin use is through polysubstance use, the belief is that many people who become addicted to it start through prescription opioid abuse of drugs like OxyContin. People may use other drugs (polysubstance), which can include prescription opioids. When prescription opioids become unavailable or too costly, people addicted to opioids turn to heroin.

Polysubstance use can heighten the dangers of using heroin. Using multiple drugs can lower inhibitions and increase risk-taking behavior. In these situations, people may tend to share needles or try higher dosages. Even more concerning, mixing heroin with other opioids or other CNS depressants (like alcohol and benzodiazepines) can increase the effects of the drug, making a heroin overdose more likely. 

Other Ways Heroin is Abused

Heroin addiction signs


People who begin using heroin by snorting it progress eventually to smoking or injecting the drug, creating a more potent high.4 When smoked, one typically uses the tar or powder form of it. The drug can be smoked in either powder or tar form by heating the drug on a piece of foil or metal or placing it in a glass pipe (crackpipe). Some people also lace tobacco or marijuana cigarettes with tobacco and smoke them. 


The heroin used for injection is usually black due to impurities. By injecting the substance, a person receives a more potent effect. This impure heroin is typically dissolved and injected into veins or muscles, making needle marks a visible addiction sign. People who inject this drug routinely have scars on their skin from needle marks and infections. When people use it intravenously and share needles, they risk bloodborne diseases like HIV and hepatitis. 

Signs of Heroin Use and Addiction

Aside from the symptoms of heroin use, other addiction signs include:

  • Pinpoint pupils and glassy eyes
  • Deceptive behavior
  • Lack of interest in hobbies or activities
  • Reduces quality of work (school or work)
  • Withdrawal from loved ones
  • Hostile or aggressive behavior
  • Stealing or borrowing money, often repeatedly despite negative consequences
  • Wearing warm clothing when not needed to cover needle marks
  • Decreased attention to personal hygiene
  • Depression
  • Anxiety
  • Irritability
  • Mood swings
  • Drug paraphernalia like pipes, straws, or foil 

Heroin Addiction’s Effects

Heroin addiction can upend a person’s life and cause their loved one pain. The short-term effects of addiction can include poor performance at work or school, withdrawal from loved ones, and loss of funds due to drug use. However, the long-term effects can have significant consequences.

A few addiction signs include:

  • Struggling with legal encumbrances for stealing or other illegal risky behaviors.
  • Losing their job or dropping out of school.
  • Losing their home.
  • Burning bridges with their loved ones.
  • Suffering health consequences from chronic heroin use and drug contaminants. These health conditions may include:
    • Lung problems from smoking heroin
    • Bloodborne diseases
    • Scarred or collapsed veins
    • Chronic bacterial infections
    • Cardiovascular problems
    • Kidney or liver disease
    • Cognitive/mental decline 

The Dangers of Heroin Use


A heroin overdose is a life-threatening situation. To highlight this fact, four out of every 100,000 Americans die from a heroin-related overdose each year.5 These types of overdoses occur when enough of the drug is ingested to slow or healthy breathing, which causes oxygen deprivation. Without emergency assistance, an overdose can be fatal.

Drug withdrawal from opioids like heroin occurs when long-term use of the drug is stopped. As the body eliminates toxins accumulated from chronic drug use and the brain returns to functioning without the drug, uncomfortable withdrawal symptoms typically appear. Though not life-threatening, withdrawal symptoms can cause significant distress.

Early Symptoms of Heroin Withdrawal

  • Sweating
  • Drug cravings
  • Insomnia
  • Restlessness
  • Excessive yawning
  • Runny nose
  • Tearful eyes
  • Anxiety
  • Agitation
  • Sore muscles

Late Symptoms of Heroin Withdrawal

  • Enlarged or dilated pupils
  • Abdominal cramping
  • Diarrhea
  • Nausea
  • Vomiting
  • Abdominal cramping