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Heroin Addiction: Signs, Symptoms, Effects and Treatment

Are You Addicted to Heroin?

Heroin is a highly addictive illicit narcotic. Those abusing heroin – first timers and chronic users alike – place themselves at high risk of an overdose. Heroin addicts are estimated to be between 6 and 20 times more likely to die than a non-using peer. 5 However, people can and do recover from heroin addiction.

How to Tell if You or a Loved One Is Addicted

Heroin addiction is associated with a few explicit signs and symptoms. If you or someone you love has exhibited at least 2 of the following behaviors in the past year, you may be addicted to heroin:2

  • Using more heroin than originally intended.
  • Inability to decrease or quit heroin use.
  • An excessive amount of time is spent getting and using heroin, as well as recuperating from its effects.
  • Strong cravings for heroin.
  • Inability to fulfill responsibilities due to heroin use.
  • Persistent heroin use in spite of negative consequences such as interpersonal or social problems.
  • Choosing heroin in favor of hobbies or social activities.
  • Routinely using heroin in dangerous situations such as driving.
  • Using heroin in spite of psychological or physical ailments worsened by or caused by heroin.
  • Tolerance: increasingly more heroin must be used in order to get desired effect, and less of a “high” is experienced when using the same amount of heroin as usual.
  • Withdrawal: after a certain duration of time since last heroin use, withdrawal symptoms arise; heroin use continues in an attempt to alleviate or prevent withdrawal symptoms.

Heroin Addiction Treatment and Starting Recovery

It’s never too late to begin your road to recovery from heroin addiction. Whether your addiction is mild or severe, there is a treatment program that’s the right fit for you. Below are examples of the different types of recovery programs available:
man being confronted about heroin addiction in group therapy

  • 12-step programs: 12-step fellowships, such as Heroin Anonymous and Narcotics Anonymous, provide supportive environments for people looking to recover from heroin addiction.
  • Dual diagnosis: Some treatment centers specialize in treating people with a dual diagnosis – that is, a heroin addiction and a co-occurring mental health disorder. It’s particularly important that both conditions are treated to prevent relapse.
  • Group counseling: A certified mental health professional facilitates a group therapy session in which you share experiences and develop sober social skills.
  • Individual therapy: A therapist directly works with you to address any mental health problems or reasons for your heroin addiction and teaches you appropriate coping skills for stressful situations.
  • Outpatient rehab center: If you can’t abandon work, school or home responsibilities, outpatient recovery is a good option, because it allows you to live at home while attending treatment.
  • Inpatient or residential rehab: Those suffering from more severe heroin addictions frequently seek some form of inpatient treatment. People who enter this type of rehabilitation live at the facility while receiving therapy, group counseling and other addiction treatment measures after first completing an initial mental health evaluation and detoxification period.

Medications Used to Treat Heroin Dependence and Withdrawal

Most treatment for heroin addiction consists of medication combined with behavioral therapy. Some medications that are commonly used to treat heroin dependence include: 8

  • Buprenorphine: As a partial opioid receptor agonist, buprenorphine helps to ease heroin cravings throughout recovery. It is available as an affordable, generic medication.
  • Methadone: It is used to manage heroin addiction, especially in those who don’t respond well to alternatives.
  • Naltrexone: This medication blocks the rewarding effects of heroin and prevents overdose when diligently taken. Naloxone is an opioid antagonist medication and doesn’t have any addictive properties of its own.

Short-Term Effects of Dependency

The short-term or side effects seen in someone with a heroin dependency may include: 4

  • Frequently constricted pupils.
  • Vision problems.
  • Dry mouth.
  • Slowed speech; altered tone of voice.
  • Foggy mental functioning.
  • Nausea.
  • Vomiting.
  • Itchy skin; excessive scratching.
  • Reduced heart rate.
  • Depressed breathing, which can lead to a coma and death.

Long-Term Effects of Dependency

Prolonged heroin use causes changes throughout the brain, including desensitization of the opioid receptors. When this occurs, users find themselves needing more and more heroin to achieve the same desired effects. This is phenomenon is called tolerance, and it is inextricably linked with a developing heroin dependency. 7 Chronic or long-term heroin abuse also has many harmful effects.

The long-term effects of heroin use include:

  • Intravenous users: collapsed veins, track marks, cellulitis, abscess formation, infection of the heart valves and lining of the cardiac muscle, HIV, hepatitis and tuberculosis. 2
  • Intranasal users: perforation of the nasal septum and irritation of the nasal mucosa. 2
  • Decreased volume of white matter in the brain, which may affect decision-making and regulation of behavior. 6
  • Increased risk of suicide. 2
  • Sexual dysfunction. 2

American Addiction Centers has helped thousands recover from addiction and we can help you or your loved one too. Check your insurance to find out instantly if your insurance provider may be able to cover all or part of the cost of rehab and associated therapies. You can also sign up 24/7 text support for addiction questions at your convenience.

Heroin Withdrawal Symptoms


If you are addicted to heroin and suddenly stop using it, withdrawal symptoms may appear about 6-12 hours after the most recent dose. These withdrawal symptoms include: 2
  • Nausea.
  • Vomiting.
  • Sweating.
  • Chills.
  • Goose bumps.
  • Increased tearing in eyes.
  • Muscle aches.
  • Insomnia.
  • Fever.
  • Diarrhea.
  • Spontaneous ejaculations.
  • Dysphoria, or general dissatisfaction.
  • Impaired ability to experience pleasure.
  • Irritability.
  • Increased sensitivity to pain.
  • Anxiety.

In general, many of these unpleasant symptoms abate within a week or two. However, some of these withdrawal symptoms may persist for months or even years, depending on the severity of your heroin addiction. 3

For many, these withdrawal effects are difficult to endure and may increase relapse risk. This is why it is important to seek the supervision and intensive treatment provided through a professional heroin recovery program.

Why Is Heroin So Addictive?

When you use heroin, it binds to opioid receptors in your brain, resulting in a cascade of molecular events including the activation of the mesolimbic reward system. This reward system typically releases dopamine when you participate in activities that support survival, such as sex and eating, resulting in a feeling of well-being and pleasure.man overdosing on heroin

Heroin causes dopamine to be released in large quantities, which in turn acts as positive reinforcement for you to continue using heroin. The brain records the details and circumstances of this pleasurable activity and stores it as conditioned associations, which may be the source of heroin cravings when you quit or are experiencing withdrawal. 7

Further, when you continue abusing heroin, your brain changes so that it begins to function sub-optimally without the constant presence of the opioid drug. Tolerance and dependence result from these neuronal adaptations, and withdrawal symptoms will occur if you stop using at this point.

The withdrawal symptoms are painful and uncomfortable and are “one of the most powerful factors driving opioid dependence and addictive behaviors,” according to researchers. 7

Frequently Asked Questions

Can You Get Addicted to Heroin the First Time You Try It?

It is highly unlikely that you will get addicted to heroin the first time you try it. Addiction is characterized by problematic use that causes profound impairment in your life.

Everyone’s physiology is different, and some people may be more susceptible to addiction than others. If someone enjoys heroin the first time he or she uses it, this may lead to further use, which can in turn transition into dependence. Studies have shown that about 23% of people who use heroin will develop a heroin dependency. 1

Find a Heroin Rehab Center

If you or someone you care about is struggling with heroin addiction, help is available. Call today to get more information about heroin rehab programs in your area. Trained recovery support advisors are available to answer any questions you have about insurance and payment.

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