- Heroin DrugFacts | National Institute on Drug Abuse
- How do people use heroin?
- What are the effects of heroin?
- Short-Term Effects
- Long-Term Effects
- Other Potential Effects
- Can a person overdose on heroin?
- How can a heroin overdose be treated?
- Is heroin addictive?
- How is heroin addiction treated?
- 20143 Heroin
- Where does it come from?
- What does it look ?
- Who uses it?
- How does it make you feel?
- How long does the feeling last?
- Is it addictive?
- Is it dangerous?
- What are the long-term effects of using it?
- Where can I find more information?
- The Signs & Symptoms of Heroin Use
- Behavioral Heroin Addiction Symptoms
- Short-term behavioral signs of heroin addiction include:
- Long-term behavioral signs of heroin addiction include:
- Physical Heroin Addiction Symptoms
- Short-term physical signs of heroin addiction include:
- Long-term physical signs of heroin addiction include:
- Mental and Emotional Heroin Addiction Symptoms
- Short-term mental and emotional effects of heroin abuse include:
- Long-term mental and emotional effects of heroin abuse include:
- The Evidence of Heroin Use
- Heroin Withdrawal Symptoms
- Below are signs and symptoms heroin withdrawal has begun:
- Don’t Wait Too Long to Seek Help for Heroin Use
- How To Know If Someone Is on Heroin — The Recovery Village Drug and Alcohol Rehab
- Article at a Glance:
- Visible Signs of Heroin Use
- Withdrawal and Detox Symptoms
- Emotional Changes
Heroin DrugFacts | National Institute on Drug Abuse
Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.
How do people use heroin?
People inject, sniff, snort, or smoke heroin. Some people mix heroin with crack cocaine, a practice called speedballing.
What are the effects of heroin?
Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.
Prescription opioid pain medicines such as OxyContin® and Vicodin® have effects similar to heroin. Research suggests that misuse of these drugs may open the door to heroin use.
Data from 2011 showed that an estimated 4 to 6 percent who misuse prescription opioids switch to heroin1-3 and about 80 percent of people who used heroin first misused prescription opioids.1-3 More recent data suggest that heroin is frequently the first opioid people use.
In a study of those entering treatment for opioid use disorder, approximately one-third reported heroin as the first opioid they used regularly to get high.4
This suggests that prescription opioid misuse is just one factor leading to heroin use. Read more about this intertwined problem in our Prescription Opioids and Heroin Research Report.
People who use heroin report feeling a «rush» (a surge of pleasure, or euphoria). However, there are other common effects, including:
- dry mouth
- warm flushing of the skin
- heavy feeling in the arms and legs
- nausea and vomiting
- severe itching
- clouded mental functioning
- going «on the nod,» a back-and-forth state of being conscious and semiconscious
People who inject drugs such as heroin are at high risk of contracting the HIV and hepatitis C (HCV) virus.
These diseases are transmitted through contact with blood or other bodily fluids, which can occur when sharing needles or other injection drug use equipment.
HCV is the most common bloodborne infection in the Unites States. HIV (and less often HCV) can also be contracted during unprotected sex, which drug use makes more ly.
Read more about the connection between heroin and these diseases in our Heroin Research Report.
People who use heroin over the long term may develop:
- collapsed veins for people who inject the drug
- damaged tissue inside the nose for people who sniff or snort it
- infection of the heart lining and valves
- abscesses (swollen tissue filled with pus)
- constipation and stomach cramping
- liver and kidney disease
- lung complications, including pneumonia
- mental disorders such as depression and antisocial personality disorder
- sexual dysfunction for men
- irregular menstrual cycles for women
Other Potential Effects
Heroin often contains additives, such as sugar, starch, or powdered milk, that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage. Also, sharing drug injection equipment and having impaired judgment from drug use can increase the risk of contracting infectious diseases such as HIV and hepatitis (see «Injection Drug Use, HIV, and Hepatitis»).
Can a person overdose on heroin?
Yes, a person can overdose on heroin. A heroin overdose occurs when a person uses enough of the drug to produce a life-threatening reaction or death. Heroin overdoses have increased in recent years.5
When people overdose on heroin, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term mental effects and effects on the nervous system, including coma and permanent brain damage.
How can a heroin overdose be treated?
Naloxone is a medicine that can treat an opioid overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of heroin and other opioid drugs.
Sometimes more than one dose may be needed to help a person start breathing again, which is why it’s important to get the person to an emergency department or a doctor to receive additional support if needed.
Read more in the Substance Abuse and Mental Health Services Administration’s Opioid Overdose Prevention Toolkit.
Naloxone is available as an injectable (needle) solution and nasal sprays (NARCAN® Nasal Spray and KLOXXADO®). Friends, family, and others in the community can use the nasal spray versions of naloxone to save someone who is overdosing.
The rising number of opioid overdose deaths has led to an increase in public health efforts to make naloxone available to at-risk persons and their families, as well as first responders and others in the community. Some states have passed laws that allow pharmacists to dispense naloxone without a prescription from a person’s personal doctor.
Read more about naloxone in Naloxone DrugFacts.
Is heroin addictive?
Heroin is highly addictive. People who regularly use heroin often develop a tolerance, which means that they need higher and/or more frequent doses of the drug to get the desired effects.
A substance use disorder (SUD) is when continued use of the drug causes issues, such as health problems and failure to meet responsibilities at work, school, or home.
An SUD can range from mild to severe, the most severe form being addiction.
Those who are addicted to heroin and stop using the drug abruptly may have severe withdrawal. Withdrawal symptoms—which can begin as early as a few hours after the drug was last taken—include:
- severe muscle and bone pain
- sleep problems
- diarrhea and vomiting
- cold flashes with goose bumps («cold turkey»)
- uncontrollable leg movements («kicking the habit»)
- severe heroin cravings
Researchers are studying the long-term effects of opioid addiction on the brain. Studies have shown some loss of the brain’s white matter associated with heroin use, which may affect decision-making, behavior control, and responses to stressful situations.6–8
How is heroin addiction treated?
A range of treatments including medicines and behavioral therapies are effective in helping people stop heroin use. It’s important to match the best treatment approach to meet the particular needs of each individual patient.
There are medicines being developed to help with the withdrawal process. The FDA approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms.
Medicines to help people stop using heroin include buprenorphine and methadone. They work by binding to the same opioid receptors in the brain as heroin, but more weakly, reducing cravings and withdrawal symptoms. Another treatment is naltrexone, which blocks opioid receptors and prevents opioid drugs from having an effect.
A NIDA study found that once treatment is initiated, both a buprenorphine/naloxone combination and an extended release naltrexone formulation are similarly effective in addiction.
Because full detoxification is necessary for treatment with naloxone, initiating treatment among active users was difficult, but once detoxification was complete, both medications had similar effectiveness.
Behavioral therapies for heroin addiction include methods called cognitive-behavioral therapy and contingency management. Cognitive-behavioral therapy helps modify the patient’s drug-use expectations and behaviors, and helps effectively manage triggers and stress.
Contingency management provides motivational incentives, such as vouchers or small cash rewards for positive behaviors such as staying drug-free. These behavioral treatment approaches are especially effective when used along with medicines.
Read more about drug addiction treatment in our Treatment Approaches for Drug Addiction DrugFacts.
- Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of various opium poppy plants.
- Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.
- People inject, sniff, snort, or smoke heroin. Some people mix heroin with crack cocaine, called speedballing.
- Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.
- People who use heroin report feeling a «rush» (or euphoria). Other common effects include dry mouth, heavy feelings in the arms and legs, and clouded mental functioning.
- Long-term effects may include collapsed veins, infection of the heart lining and valves, abscesses, and lung complications.
- Research suggests that misuse of prescription opioid pain medicine is a risk factor for starting heroin use.
- A person can overdose on heroin. Naloxone is a medicine that can treat a heroin overdose when given right away, though more than one dose may be needed.
- Heroin can lead to addiction, a form of substance use disorder. Withdrawal symptoms include severe muscle and bone pain, sleep problems, diarrhea and vomiting, and severe heroin cravings.
- A range of treatments including medicines and behavioral therapies are effective in helping people stop heroin use. However, treatment plans should be individualized to meet the needs of the patient.
- Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The Changing Face of Heroin Use in the United States: A Retrospective Analysis of the Past 50 Years. JAMA Psychiatry. 2014;71(7):821-826. doi:10.1001/jamapsychiatry.2014.366.
- Carlson RG, Nahhas RW, Martins SS, Daniulaityte R.
Predictors of transition to heroin use among initially non-opioid dependent illicit pharmaceutical opioid users: A natural history study. Drug Alcohol Depend. 2016;160:127-134. doi:10.1016/j.drugalcdep.2015.12.026.
- Cicero TJ, Ellis MS, Kasper ZA. Increased use of heroin as an initiating opioid of abuse. Addict Behav. 2017 Nov;74:63-66. doi: 10.1016/j.addbeh.2017.05.030.
Epub 2017 May 23. PubMed PMID: 28582659. https://www.ncbi.nlm.nih.gov/pubmed/28582659
- Centers for Disease Control and Prevention (CDC). Multiple Cause of Death, 1999-2015. CDC WONDER Online Database. https://wonder.cdc.gov/mcd-icd10.html. Accessed April 4, 2017.
- Li W, Li Q, Zhu J, et al.
White matter impairment in chronic heroin dependence: a quantitative DTI study. Brain Res. 2013;1531:58-64. doi:10.1016/j.brainres.2013.07.036.
- Liu J, Qin W, Yuan K, et al. Interaction between dysfunctional connectivity at rest and heroin cues-induced brain responses in male abstinent heroin-dependent individuals. PloS One. 2011;6(10):e23098. doi:10.1371/journal.pone.
- Qiu Y, Jiang G, Su H, et al. Progressive white matter microstructure damage in male chronic heroin dependent individuals: a DTI and TBSS study. PloS One. 2013;8(5):e63212. doi:10.1371/journal.pone.0063212.
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NIDA. Heroin DrugFacts. National Institute on Drug Abuse website. https://www.drugabuse.gov/publications/drugfacts/heroin. June 1, 2021
The opioid family of drugs includes natural, synthetic and semi-synthetic opioids. Opiates, such as morphine and codeine, are natural opioids found in the opium poppy. Synthetic opioids, such as methadone, are chemically made. Heroin is a semi-synthetic opioid: it is made from morphine that has been chemically processed. It enters the brain quickly and produces a more immediate effect.
The most common ways of using heroin are:
- injecting either into a vein (“mainlining,” intravenous or IV use), into a muscle (intramuscular or IM use) or under the skin (“skin-popping” or subcutaneous use)
- snorting the powder through the nose (also called sniffing)
- inhaling or smoking (“chasing the dragon”), which involves gently heating the heroin on aluminum foil and inhaling the smoke and vapours through a tube.
Where does it come from?
Most heroin is produced in Asia and Latin America, where opium poppies are grown. Morphine is extracted from the opium gum in laboratories close to the fields, and then converted into heroin in labs within or near the producing country.
What does it look ?
In its pure form, heroin is a fine, white, bitter-tasting powder that dissolves in water.
When it is sold on the street, its colour and consistency vary depending on how it is made and what additives it has been “cut” with.
Street heroin may come in the form of a white powder, a brown and sometimes grainy substance or a dark brown sticky gum. The purity of heroin varies from batch to batch.
Some additives, such as sugar, starch or powdered milk are used to increase the weight for retail sale. Other drugs may be added to increase the effects of the heroin.
Fentanyl, a prescription opioid that is 100 times more powerful than morphine, is sometimes used to cut heroin or other street drugs. It may also be made into tablets that look prescription medication.
Many overdoses have occurred because people did not know that what they were taking was contaminated with fentanyl.
If you or someone you know uses opioids, it is a good idea to have a free naloxone kit. Naloxone is a medication that can temporarily reverse the effects of an opioid overdose and allow time for medical help to arrive.
Who uses it?
Heroin is used by a range of people from a variety of cultural, social, economic and age groups. First-time users tend to be in their teens or 20s, but most people who use heroin regularly are over 30.
How does it make you feel?
When heroin is injected into a vein, it produces a surge of euphoria, or “rush.” This feeling is not as intense when it is snorted or smoked. Following the rush, there is a period of sedation and tranquility known as being “on the nod.”
New users often experience nausea and vomiting. The desired effects include detachment from physical and emotional pain and a feeling of well-being. Other effects include slowed breathing, pinpoint pupils, itchiness and sweating. Regular use results in constipation, loss of sexual interest and libido and irregular or missed periods in women.
The way heroin affects you depends on many factors, including:
- your age
- how much you take and how often you take it
- how long you’ve been taking it
- the method you use to take the drug
- the environment you’re in
- whether or not you have certain pre-existing medical or psychiatric conditions
- whether you’ve taken any alcohol or other drugs (illegal, prescription, over-the-counter or herbal).
How long does the feeling last?
If heroin is injected into a vein, the rush is felt in seven or eight seconds and lasts from 45 seconds to a few minutes. When it's injected under the skin or into a muscle, the effect comes on slower, within five to eight minutes.
Someone may be «on the nod” for up to an hour. Regardless of how it is used, the effects of heroin generally last for three to five hours, depending on the dose.
People who use heroin daily must use every six to 12 hours to avoid symptoms of withdrawal.
Is it addictive?
Regular use of heroin can lead to addiction within two to three weeks. Signs of addiction include:
- using over a longer period or using more than planned
- wanting to quit or cut down, or trying unsuccessfully to quit
- spending a lot of time and effort getting, using and recovering from opioids
- experiencing cravings
- failing to fulfil responsibilities at work, school or home as a result of opioid use
- continuing to use opioids despite the negative social consequences caused by opioid use
- giving up activities that were once enjoyable
- using opioids in dangerous situations
- needing to take more of the drug to get the same effect (tolerance, a sign of physical dependence)
- feeling ill when opioid use suddenly stops (withdrawal, a sign of physical dependence)
- showing signs of opioid intoxication (e.g., nodding off, pinpoint pupils).
Not all people who experiment with heroin become addicted. Some people use the drug only on occasion, such as on weekends, without increasing the dose. However, with regular use, people develop tolerance, and they need more of the drug to achieve the same effects. This leads to physical dependence on heroin.
Once someone is dependent, stopping their use can be extremely difficult. People who have used heroin for a long time often report that they no longer experience any pleasure from the drug. They continue to use heroin to avoid the symptoms of withdrawal and to control their craving for the drug.
Is it dangerous?
Heroin is dangerous for a number of reasons. The most immediate danger is overdose. In an opioid overdose, breathing slows down and may stop completely. A person who has overdosed is unconscious and cannot be roused, and has skin that is cold, moist and bluish.
If someone is overdosing, call 911 immediately. While you are waiting for medical help to arrive, you can use your naloxone kit to temporarily reverse the effects of the overdose.
The risk of overdose is increased by:
- the unknown purity of the drug, which makes it difficult to determine the correct dose
- injection, because the drug reaches the brain more quickly than by other ways of taking the drug, and because the dose is taken all at once
- combining heroin with other sedating drugs, such as alcohol, benzodiazepines or methadone.
Additional dangers of heroin use include:
- Injection: Injection drug use puts a person at high risk of bacterial infections, blood poisoning, skin infections and collapsed veins. Sharing needles increases the risk of becoming infected with, or spreading, HIV and hepatitis B or C.
- Combining heroin with other drugs, such as cocaine (in “speedballs”): When drugs interact inside the body, the results are unpredictable and sometimes deadly.
- Addiction: The constant need to obtain heroin and the repeated use of the drug can result in criminal involvement or other high-risk behaviour, breakdown of family life, loss of employment and poor health.
- Pregnancy: Women who regularly use heroin often miss their periods; some mistakenly think that they are infertile, and become pregnant. Continued use of heroin during pregnancy is very risky for the baby.
What are the long-term effects of using it?
Research using brain scans shows that long-term regular use of heroin results in changes in the way the brain works. While the effect of these changes is not fully understood, this research illustrates that it may take months or years for the brain to return to normal functioning after a person stops using heroin.
Do You Know… Heroin © 2010 Centre for Addiction and Mental Health Fundamentals of Addiction: A Practical Guide for Counsellors © 2014 Centre for Addiction and Mental Health Straight Talk: Fentanyl © 2017 Centre for Addiction and Mental Health About opioids © 2017 Government of Canada Opioid crisis in Canada © 2018 Government of CanadaWhat is fentanyl? © 2017 Royal Canadian Mounted Police
Where can I find more information?
The Signs & Symptoms of Heroin Use
It’s important to be able to recognize the signs and symptoms of substance abuse in loved ones. Heroin is one of the most dangerous forms of opioids. It’s made from morphine, but un the morphine or fentanyl you get at the hospital, heroin is a street drug. Heroin sold on the street is usually impure and contains any number of toxic chemicals in different combinations.
Heroin is known by several slang terms:
- Black tar
It’s often combined with other drugs under other slang terms, such as speedballs (heroin and cocaine).
If you suspect someone you know is using heroin, it’s helpful to know what to look for. The signs of heroin use below are broken into short- and long-term effects.
- Short-term effects include those visible while someone is under the influence or immediately after.
- Long-term signs of heroin use develop after someone has become addicted.
Behavioral Heroin Addiction Symptoms
Many of these signs and symptoms aren’t exclusive to heroin abuse. They may indicate any kind of drug abuse. However, if you notice these in combination with other signs and symptoms here, heroin is ly involved.
Short-term behavioral signs of heroin addiction include:
- Slower movements
- Fatigued appearance—drooping eyelids, yawning
- Sleeping more than usual
- Slurred speech
Long-term behavioral signs of heroin addiction include:
- Withdrawal from family and friends (wanting to spend less time with them)
- Forming new friends, seemingly the blue
- Poor performance in school and at work
- Poor hygiene
- Stealing or borrowing money
- Wearing long-sleeved shirts to hide needle track marks
- Lying, evading, or other deceptive behavior
Physical Heroin Addiction Symptoms
The physical effects of heroin use include the signs that heroin is taking its toll on the body. Heroin begins to cause damage immediately after someone first uses it. Some of the physical signs of addiction are known only to the person using heroin. Over time, physical effects will be visible to others and may become obvious.
Short-term physical signs of heroin addiction include:
- Needle tracks, commonly on the arms – Track marks can look small puncture holes in the skin. If they’re new, they’ll be bright red or pink. If they’re healing, they may be covered by new scar tissue or a scab.
- Pinpoint (small) pupils
- Arms and legs feeling heavy
- Nausea and vomiting
- Shortness of breath
- Dry mouth
- Bone and muscle pain
- Flu- symptoms (when heroin wears off)
Long-term physical signs of heroin addiction include:
- Frequent illnesses – This happens because heroin decreases the user’s immunity.
- Weight loss
- Loss of menstrual cycle (periods) in women
- Skin infections around injection sites
Mental and Emotional Heroin Addiction Symptoms
Sometimes the mental and emotional effects of heroin quickly cause behavioral changes. Other times, heroin users are very good at hiding how heroin makes them feel. The closer you are to someone who is using heroin, the better you’ll be able to notice subtle changes in their thinking and emotions.
Short-term mental and emotional effects of heroin abuse include:
- Euphoria (intensely pleasurable feelings of excitement and happiness)
- Brain fog (difficulty carrying on a conversation, following simple instructions, or solving basic problems)
- Anxiety (when heroin wears off)
Long-term mental and emotional effects of heroin abuse include:
- Irritability and anger
- Mood swings
- Feeling numb to emotions
The Evidence of Heroin Use
If you suspect your loved one is using heroin, pay close attention to their living space. Their behaviors, combined with lack of normal functioning, are probably affecting their surroundings. There is also ly to be heroin paraphernalia, which may or may not be hidden. Some paraphernalia can seem normal household items until you look more closely.
Keep an eye out for these signs of heroin abuse in the places where your loved one lives or spends time:
- Needles and/or syringes
- Small plastic baggies with white, black, gray, or brown residue
- Aluminum foil or wrappers with burn marks
- Burned straws
- Burned silver spoons
- Missing valuables
Heroin Withdrawal Symptoms
Addiction happens when the body becomes used to functioning with a substance and depends on it. This is why addiction is also called “chemical dependency.” When a person goes for too long without the drug they’re addicted to, they can become physically sick.
Heroin withdrawal symptoms persist and get more intense until more heroin is taken or the user gets through the withdrawal period. Heroin withdrawal can be deadly. This is why it’s important to go through a medically-supervised detox program.
Below are signs and symptoms heroin withdrawal has begun:
- Intense cravings
- Persistently low mood
- Whole body pain and muscle aches
- Increased blood pressure
- Respiratory distress or wet lung (when fluid builds up in the lungs, depriving them of oxygen)
Don’t Wait Too Long to Seek Help for Heroin Use
Using heroin is extremely dangerous. Nearly 15,000 people died from a heroin-related overdose in 2018. It doesn’t take a lot of heroin to cause an overdose. This is especially true when tolerance has formed. Tolerance is built when you need to take more and more of the drug over time to get the same high. A higher tolerance can mean not noticing when your body has had too much.
If a heroin user builds up tolerance and then stops using the drug for a while, tolerance decreases. Former heroin users can easily overdose if they start abusing heroin again. This is because they often go back to using the same amount they were using before, which their bodies now can’t handle.
There is no safe amount of heroin to use or “recreational” use of heroin. Whether by heroin overdose, withdrawal, or long-term health complication, heroin addiction can be fatal and should never be left unchecked.
There are steps you can take to protect your loved ones, even if you only suspect they use heroin. These precautions include keeping naloxone nearby and knowing how to use it. You should also have knowledge of local resources for heroin addiction recovery.
Heroin abuse treatment comes in different forms, each designed for a different level of need. They are:
If you know someone struggling with heroin addiction, are addicted yourself, or just would more information, contact Footprints to Recovery treatment center. Calls are free and confidential. We’re happy to help you find the best course of heroin addiction treatment for your or your loved one’s needs.
How To Know If Someone Is on Heroin — The Recovery Village Drug and Alcohol Rehab
Heroin, or diamorphine, is a synthetic opioid that is mostly used worldwide as a recreational drug. All opioid medications work in similar ways; heroin activates opioid receptors located in the cell membrane of brain cells. Heroin acts as an analgesic, which reduces the perception of pain.
When opioid receptors are activated too much, they produce euphoria or a pleasant feeling. Achieving this result is the reason some people use heroin. Using heroin also releases dopamine in parts of the brain that encourages a person to keep repeating heroin use. In this way, heroin reinforces its use.
Article at a Glance:
Keep the following key points in mind when attempting to identify if someone is on heroin:
- Heroin is an opioid, many prescription pain medications
- Signs of heroin abuse can be physical or emotional
- Look for key pieces of paraphernalia to identify heroin use
- An opioid overdose is deadly. Call 911 immediately if you suspect an overdose.
- Heroin use not only affects the individuals using the drug but their family and friends too
Visible Signs of Heroin Use
People using heroin will ly exhibit characteristic signs of heroin use. If you think your loved one is hiding heroin use, look for these signs:
- Pinpoint pupils: Pupils are the black dots at the center of the eyes. The size of the pupils adjusts to the light. For example, if someone flashes light into your eye, your pupil will constrict (get smaller or pinpoint), so the light appears less bright. Heroin causes the pupils to constrict even when they should not, in a dark room.
- Sleepiness: Heroin causes people to act very sleepy, and they might appear drowsy if they are currently on heroin.
- Slow movement: Heroin slows down movement and thinking, and someone on heroin may complete tasks slower than normal.
- Track marks: These are the needle marks that are left behind when someone uses an intravenous (injection) drug. Marks can appear in the space between the bicep and the forearm. Other injection sites are on the back of the hand, between the toes or in the inner thigh.
- Withdrawal symptoms: Signs that someone is on heroin and experiencing withdrawal can include insomnia, cold flashes, pains throughout the body, goosebumps, involuntary leg movements, diarrhea, vomiting, restlessness and mental issues such as depression, anxiety or paranoia.
Drug paraphernalia is the tool that someone utilizes when using heroin. You may discover different paraphernalia depending on how the person uses heroin:
- Injecting: Look for needles, which pharmacies often sell in ten-packs. The syringe, or the part that holds the drug, is usually one milliliter (mL) or less. The needle length may vary, but are typically 0.5 to 1 inch and may appear smaller than needles shown in movies. Someone using IV heroin will also have something to melt the drug in, usually a spoon. Cotton balls are sometimes placed in the spoon to filter impurities the drug while they draw heroin into the syringe. Belts or large rubber bands may be wrapped around the arm to help bulge veins for injection.
- Smoking: People can smoke heroin in glass pipes or on spoons and tin foil. Cigarette lighters and butane lighters both work for smoking heroin. Straws may be used to help breathe in the smoke.
- Snorting: Mirrors or similar, small and flat surfaces are used for snorting heroin off of. Razor blades can be used to move the powder around on the surface into lines. Someone might have straws or rolled-up dollar bills for snorting.
Withdrawal and Detox Symptoms
Heroin causes withdrawal symptoms because it changes the way brain cells interact with each other. When opioid receptors are activated too much, brain cells adjust by making less of them. This result can make withdrawal pain more intense.
Opioid receptors do different things in different parts of your body, so when their levels change, a person can experience all kinds of symptoms of abuse. Some common symptoms are:
- Heart pounding
- Hot and cold flushes
- Muscle cramps
- Stomach cramps
If a person used opioids long-term (months to years), they may experience more severe withdrawal symptoms, including:
- Abdominal cramping
- Dilated pupils
If you suspect someone is overdosing on heroin, call 911 immediately. While opioid overdoses are deadly, it is preventable if caught. Look for the following symptoms if an overdose is suspected:
- Blue nails and lips
- Dry mouth
- Shallow or no breathing
- Pinpoint pupils
- Weak pulse
Someone overdosing on heroin may be administered naloxone by the emergency treatment team. Naloxone binds to opioid receptors heroin, but it does not activate them. Naloxone blocks opioid receptors so heroin cannot activate them further.
People using heroin may start acting differently. Look for some of these emotional and behavioral changes when someone is using heroin:
- Drug use taking priority over other tasks
- Spending less time with friends and family
Heroin use not only affects the individual consuming the drug, but it can have side effects that affect friends and family members as well.
Related: Help for Addiction & Mental Health through Teletherapy