Heroin Addiction
Heroin’s reputation as a dangerous and highly addictive drug is well-deserved, and heroin addiction is serious. Learn more here.
What is Heroin?
It is difficult to find an illicit drug with a longer and more notorious history than heroin. Heroin’s reputation as a dangerous and highly addictive drug is well-deserved. In 2019 alone, four deaths for every 100,000 Americans were heroin-related.1 Tragically, one-third of all opioid-related deaths involved heroin. Heroin deaths have increased seven-fold In the past two decades, making heroin addiction a serious concern.
Heroin is an opiate, a class of drugs that come from the opium poppy plant. Within the pods of this plant is a milky-white substance, from which many potent painkillers — both legal and illegal — are made today. Opiates and drugs that have similar properties to opiates are all called opioids.
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How Addictive is Heroin?
Opioids, like heroin, are both psychologically and Cocaine addictive.2 All heroin users, regardless of how the drug is used or whether it’s the first time, have the potential to become addicted.
The current opioid epidemic has made heroin both more tempting and less attractive to people with an opioid substance abuse problem.3 For example, the rise in oxycodone addiction may have lured past and potential heroin users. However, current prescriptive restrictions on opioid painkillers may also push those addicted to those painkillers toward heroin use.
Drug Schedule
- Poppy
- Dope
- Big H
- China White
- Junk
How is Heroin Used?
Because of the negative social stigma associated with intravenous (IV) drug use, most first-time users start by smoking heroin or snorting heroin. Their high becomes less intense the more a person smokes or snorts heroin.
Repeated use reduces the euphoric feeling, creating the need for more of the drug. People who use heroin may resort to increasing their dose or injecting heroin to achieve the same feeling they did before, resulting in addiction or a heroin overdose.
Signs of Heroin Addiction
Heroin is a depressant that impacts the central nervous system (CNS), which accounts for much of the signs of heroin use. The CNS is the “central control” of the body’s functions, which is why heroin has both a psychological and physical effect. For example, “heroin eyes” are pinpoint and constricted due to heroin’s influence on the CNS. The following are the most common signs of heroin use:
Physiological Symptoms
- Slows down breathing, also called respiratory depression
- Slows down the heart rate
- Pain relief
- Changes in digestion, mainly constipation
- Causes pupil constriction
- Causes itching of the skin
- Itching
- Suppressing cough
Behavioral Symptoms
- Feeling happy or euphoric
- Drowsiness
- Memory Loss
- Depression
- Confusion
- Mood changes
- Sedation
- Euphoria
- Drowsiness
- Sedation
Individuals with heroin addiction may show the symptoms above when they are using alcohol overdose. However, the signs of heroin addiction may also include the following:
- Needle marks on their arms, legs, or areas under clothing
- Infected needle marks or boils
- Isolation from friends and family
- Excessive spending or loss of monetary funds
- Lack of interest in hobbies or interests
- Dramatic changes in work or school
- Changes in sleep patterns
- Overdose
- Signs of heroin withdrawal
Heroin Addiction’s Effects
Heroin addiction can have both short-term and long-term adverse effects on the body.
The short-term effects can include the physical effects listed above, like dry mouth, nausea, and vomiting. Long-term use of heroin can result in serious health complications like:4
- Collapsed veins due to repeated IV use
- Skin infections and rashes
- Respiratory and pulmonary infections
- Infertility
- Sexual dysfunction
- Constipation
- Brain damage
- Heart problems

Heroin Overdose
Chronic heroin use may blunt the euphoric effects of the drug, creating the desire for a higher dose. Due to heroin’s effect on the nervous system, higher doses can result in a heroin overdose. The nerve centers that control breathing and heartbeat are impacted by heroin, causing breathing and heart rate to slow down. Excessive heroin use can reduce breathing and heart rate, causing oxygen deprivation to the point of death.
Heroin Withdrawal
The most significant barrier to stopping the addiction to heroin is withdrawal. Chronic or heavy heroin use creates a physical dependency, and uncomfortable heroin withdrawal symptoms occur when use stops. Until the drug is sufficiently flushed from the body, heroin withdrawal symptoms can make the process difficult and distressing.
In the first twenty-four hours of withdrawal, the following heroin withdrawal symptoms may occur:5
- Runny nose
- Tearful eyes
- Goosebumps
- Insomnia
- Severe muscle pain
- Increased anxiety
- Significant nausea and vomiting
- Increased heartbeat
- Blurry vision
- Dilated pupils
How Long Does Heroin Stay in Your System?
Heroin is a drug with a short half-life. A half-life determines how long a drug remains in the body. For example, it takes fifteen to thirty minutes for half of a heroin dose to be eliminated from the body. Heroin is detectable in hair, blood, and urine. The drug remains in the body for varying amounts of time, depending on how it’s taken into the body.6
- Saliva: six hours when injecting heroin and twenty-four hours when smoking heroin
- Urine: sixty hours
- Hair: three to six months
Risks of Heroin Addiction
A heroin overdose is the most significant risk that can stem from heroin addiction because without an intervention it can result in death. Other risks include exposure to infected body fluids through intravenous drug use. Sharing drug paraphernalia like needles increases the risk of HIV and hepatitis. Additionally, heroin addiction makes individuals more proven to risky behaviors like unprotected sex.
Treatment for Heroin Addiction
Despite the addictive nature of opiates like heroin, there are a variety of approaches available for drug treatment. Addiction interventions may include behavioral and pharmacological therapies.

Detox
Treatment for heroin addiction starts with withdrawing through drug detox. The process of drug detox can be challenging due to heroin withdrawal symptoms, but medical attention can make the process less challenging. Detox alone is not enough to help an individual recover from heroin addiction. Typically, drug rehabilitation is the next step after detoxification.7
Rehabilitation
Rehabilitation for heroin addiction may occur through inpatient or outpatient services, depending on an individual’s needs. To help curb cravings and improve the chances for a successful recovery, some individuals choose medication-assisted therapy (MAT) to help in the rehabilitation process. MAT utilizes pharmacological options to reduce cravings and manage heroin withdrawal symptoms.
Therapy
Behavioral therapy can be initiated in conjunction with MAT, to help modify negative behaviors that result in continued drug use. A licensed therapist works with the individual using evidence-based treatments like cognitive behavioral therapy (CBT). CBT seeks to change harmful thought patterns and behaviors that lead to heroin use.
Resources
- https://www.cdc.gov/drugoverdose/deaths/heroin/index.html
- https://www.drugabuse.gov/publications/drugfacts/heroin
- https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis
- https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#heroin
- https://medlineplus.gov/ency/article/000949.htm
- https://emedicine.medscape.com/article/166464-overview
- https://www.drugabuse.gov/publications/research-reports/heroin/what-are-treatments-heroin-use-disorder