Signs and Symptoms of Heroin Addiction

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Understanding Heroin Addiction

Learn about heroin and substance abuse

Heroin, also called dope and junk, is an illegal, highly addictive opiate narcotic derived from the drug morphine (a prescription pain medication). Morphine is a naturally-occurring substance extracted from the seeds of some varieties of poppy plants. Heroin can be found as a white or brown powder or as a black sticky substance known on the streets as “black tar heroin.” The use of heroin in the United States is a serious problem. Not only is heroin the most abused opiate, it is also the most rapidly-acting, which can quickly lead to overdose and death.

Heroin can be abused in a number of different methods, it can be smoked, snorted, or dissolved in water and injected directly into a vein. Heroin very rapidly crosses the blood-brain barrier, leading to feelings of euphoria and happiness, which serves to increase its addiction potential. Additionally, the fast delivery of the drug to the brain leads to complex health risks. As it is sold on the streets, heroin is often cut with other drugs or substances such as baking soda; in some cases heroin is cut with poisons like bleach. Diluting the purity of the drug is a way for dealers to increase profits, however, this practice can produce deadly consequences as users are unable to ascertain the purity of the drug, even if it’s purchased from the same dealer. Heroin overdose can lead to decreased breathing, convulsions, coma, and death.

Over time and with regular heroin use, a heroin user will develop a tolerance requiring need more heroin in order to produce the same feelings. Eventually, increasing the frequency and amount abused will cause the development of physical and psychological dependence upon heroin. When this happens, should the user be unable to score drugs and stops using heroin, unpleasant withdrawal symptoms will occur.


Heroin addiction statistics

In 2011, 4.2 million people (or 1.6% of the population) in the United States age 12 and older reported using heroin at least once in their lifetime. Of those, about 23% will become dependent upon it.

Causes and Risk Factors

Causes and risk factors for heroin addiction

Researchers have been unable to determine the exact reason why some individuals develop an addiction for heroin. However, the general consensus is that a combination of genetic, environmental, and physical causes and risk factors work together to create addiction. The most commonly cited causes for heroin addiction include:

Genetic: Most researchers believe that genetics play a role in addiction. Individuals who have family members that struggle with addiction have an increased susceptibility to addiction. Additionally, some individuals inherited personality traits which can put them at a greater risk for becoming dependent on a substance like heroin.

Physical: Addiction and abuse of heroin leads to long-term changes in the structure and function of the brain. When these changes happen, it affects a person’s ability to make proper decisions and can affect self-control as they begin to crave the drug.

Environmental: People raised in a home in which addiction was normal learn that abusing drugs is the way to cope with negative life circumstances. Additionally, people who begin to experiment with drugs at younger ages are at a greater risk for developing addictions later in life.

Risk factors:

  • Being male
  • Presence of mental health disorders
  • Peer pressure
  • Lack of family involvement
  • Easy access to heroin
  • Lack self-esteem
  • Negative life events

Signs and Symptoms

Signs and symptoms of heroin addiction

Those that abuse heroin will display a number of different signs and symptoms, but not all abusers will react to the drug in the same way. Symptoms of heroin abuse will vary depending upon individual genetic makeup, length of abuse, amount of heroin used, and usage of other drugs or alcohol. Some of the most common symptoms of heroin abuse include:

Behavioral Symptoms:

  • Increasing amount time spent alone
  • Lying about drug use
  • Wearing long sleeves and pants even in summer
  • Engaging in illegal activities
  • Unexpected, sudden need for money
  • Incapable at maintaining responsibilities at work, home, or school
  • Strained interpersonal relationships
  • Increased sleeping

Physical Symptoms:

  • Warm flushing of the skin
  • Heaviness in the extremities
  • Decreased respiration rate
  • Bradycardia
  • Dry mouth
  • Slurred speech
  • Scabs or bruises
  • Constant runny nose
  • Weight loss
  • Track marks on legs or arms
  • Tolerance

Cognitive Symptoms:

  • Alternating between wakefulness and a drowsy state
  • Disorientation
  • Mental fogginess
  • Decreased mental focus
  • Inability to solve problems

Psychosocial Symptoms:

  • Anxiety
  • Surge of euphoria
  • Depressive disorders
  • Mood swings


Effects of heroin addiction

The long-term consequences of heroin abuse and addiction are not only devastating, but can be life-threatening. The effects an individual experiences will depend upon genetic makeup, presence of other health-related issues, length of addiction, frequency of use, and presence of other drugs in the body. Long-term effects of heroin abuse may include:

  • Legal problems or incarceration
  • Crumbled, interpersonal relationships
  • Divorce
  • Domestic violence
  • Child abuse
  • Social isolation
  • Poverty
  • Loss of job
  • Infectious diseases – such as HIV/AIDS, hepatitis B, C
  • Liver disease
  • Collapsed veins
  • Abscess at injection sites
  • Kidney disease
  • Pulmonary complications
  • Permanent damage to all vital organs
  • Death due to health complications or overdose

Withdrawal and Overdose

Heroin withdrawal and overdose effects

Withdrawal from Heroin: Chronic heroin abuse leads to physical dependence which can lead to withdrawal symptoms should the drug be suddenly discontinued. Withdrawal should always occur in a medically-monitored detox and rehabilitation treatment program to prevent complications. Symptoms of heroin withdrawal may begin within a few hours following the discontinuation of heroin use and include:

  • Restlessness
  • Agitation
  • Insomnia
  • Muscle and bone pain
  • Nausea, vomiting, diarrhea
  • Cold flashes
  • Involuntary jerking movements
  • Severe cravings for heroin

Heroin Overdose: Overdose from heroin can occur when too much heroin is used in one sitting or if the purity of the heroin is higher than an addict is accustomed to. Heroin overdose is a medical emergency – if you suspect you or someone else is experiencing an overdose of heroin, dial 911 or go to the nearest emergency room immediately. Heroin overdose may include the following symptoms:

  • Slow, labored breathing
  • Stops breathing altogether
  • Pinpoint pupils
  • Discoloration of tongue
  • Dry mouth
  • Extreme hypotension
  • Weak, thready pulse or no pulse at all
  • Cyanosis of lips and nails
  • Spasms of gastrointestinal tract
  • Muscle spasticity
  • Drowsiness
  • Disorientation
  • Delirium
  • Coma
  • Seizures
  • Death

Co-Occurring Disorders

Heroin addiction and co-occurring disorders

Men and women who have become addicted to heroin are likely struggling with a mental health disorder. There are a number of disorders that occur alongside heroin addiction as heroin abuse may be the result of an attempt to “self-medicate” unpleasant symptoms. The most commonly co-occurring, comorbid disorders include:

  • Depressive disorders
  • Anxiety disorders
  • Bipolar disorder
  • Schizophrenia
  • Other substance abuse and addiction
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
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Everyone at Pacific Grove Hospital, from my assigned physician to the social workers were absolutely wonderful to work with. Groups were informative and useful- I learned and reinforced a lot of different coping skills.

– Brooke C.
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