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Heroin Addiction

Heroin is an opioid drug derived from morphine, a substance found in poppy plants. It currently has no legitimate medical use in the U.S. but is a common illicit street drug commonly known as smack, horse, wren, and big H.

Heroin and other opioids are highly addictive, but treatment can help people quit using heroin and live healthy, productive lives.1 This page will discuss the impact of and treatment of heroin addiction.

What is Heroin?

Heroin is an opioid drug that is classified as a Schedule I substance, which means it carries a high risk for abuse or addiction and has no medical use.2 It is commonly obtained as either a sticky black substance (black tar heroin) or a white, tan, or brownish power.2,3

There has been an increase in heroin use and addiction in the United States, which may be due in part to the prescription opioid crisis. This is because there is a risk that people who are abusing prescription opioids may eventually move on to heroin, either due to difficulty in obtaining a prescription or drug affordability.

What are Opioids?

Opioids are a class of drugs that include many prescription medications for pain relief as well as illicit drugs like heroin. Heroin and other opioids attach to the opioid receptors in the brain, and when taken, it dulls an individual’s perception of pain; they may also experience pleasurable feelings and even euphoria at higher doses.4 Some prescription opioids, such as Oxycodone and Vicodin, are also sold illegally as street drugs.4

Heroin is typically found as either a white or brown powder or as a black, sticky substance known as black tar heroin. Heroin can be snorted, smoked, or mixed with water and injected.1

Checking Your Insurance Benefits

If you are looking for heroin addiction treatment, it can feel overwhelming As you consider your options, knowing exactly what your insurance plan covers can give you peace of mind while you or your loved one is in rehab. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles. For more information on what your insurance plan covers, call AAC at , click here, or fill out the form below.

What is Heroin Addiction?

Heroin addiction is the continued, compulsive use of heroin despite serious negative consequences, such as health, work, school, and relationship problems.5 Addiction is a treatable medical illness that affects the brain and changes behaviors such as self-control.5

Heroin use and prescription opioid use in the United States is a serious public health issue. According to the 2019 National Survey on Drug Use and Health, approximately 750,000 people in the United States aged 12 or older used heroin in the past year, which is almost double the number of people who reported using it in 2002. The same survey estimates 9.7 million people aged 12 or older misused prescription opioids in the past year, with 404,000 misusing both prescription opioids as well as heroin.6

Is Heroin Addictive?

Yes, heroin can be very addictive. There is no single cause of heroin addiction. Scientists and researchers have identified many genetic, biological, and environmental risk factors that can contribute to a person developing an addiction. Drugs like heroin get some of their addictive power through a person enjoying the feelings of euphoria and pleasure.5 Not only do people generally like to repeat enjoyable experiences, but heroin and other opioids activate parts of the brain that contributes to the reinforcement of rewards. Repeated drug use alters the way the brain functions in a way that makes it harder and harder to stop using heroin and other opioids.5

Many people who are addicted to heroin have developed a physiological dependence, where stopping the use of heroin or reducing their opioid intake leads to experiencing uncomfortable withdrawal symptoms and intense drug cravings. Avoiding these uncomfortable symptoms can be a powerful motivator for continued heroin use.7

Take Our “Am I Addicted to Heroin?” Self-Assessment 

Take our free, 5-minute “Am I Addicted to Heroin” self-assessment below if you think you or someone you love might be struggling with heroin addiction. The evaluation consists of yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder. Substance use disorders should be diagnosed by professionals using these diagnostic criteria after thorough patient assessment. This self-assessment is free and confidential and may serve as an indicator of a potential addiction but should not replace a diagnosis from a professional treatment provider.

What are the Signs and Symptoms of Heroin Addiction?

Although heroin use is rare in the population of people who misuse prescription opioids, some individuals turn to heroin after becoming dependent on prescription opioids.1 It’s estimated that around 80% of heroin users started with opioid prescription drug misuse.1

Response to the opioid overdose crisis generally has resulted in prescriptions for opioid painkillers becoming more difficult to obtain. At the same time, heroin has seen increased availability, and studies suggest that heroin is typically cheaper and easier to obtain than most prescription opioids.1,8.9

Signs and symptoms of possible heroin use and/or addiction may include:10,11

  • Drowsiness and “nodding off.”
  • Clouded thinking and judgement.
  • Small pupils.
  • Bloodshot eyes.
  • Sudden weight loss.
  • Needle marks if the person injects heroin (or hiding needle marks by wearing long sleeves).
  • Signs of withdrawal, such as nausea, muscle aches, sleep problems, and chills, if the person cannot obtain heroin.
  • Heroin becomes a more important priority than anything else, including relationships, work/school obligations, and personal health.
  • Isolation from family and friends.
  • Financial problems.
  • Performance issues at work and/or school.
  • Poor hygiene.
  • Changes in appearance.

What are the Health Risks of Heroin Abuse?

Using heroin regularly can have an impact on the individual’s behavior and thinking because it alters the brain, potentially leading to tolerance and dependence.9 Users may experience tolerance after regularly using the drug for several weeks. Tolerance to a drug results in diminished effects of the original dose and a person needs more and more of the drug to feel the same way it used to make you feel.15

Continued, regular use of heroin or other opioids can also result in physiological dependence, which means the body becomes used to exposure to the drug and a person experiences withdrawal symptoms when stopping or reducing opioid use.15 Tolerance and dependence may occur together, although they can both be experienced on their own as well.15

Taking any opioid (whether legally or illicitly) poses a risk of dependence, tolerance, and addiction. Injection of heroin and other opioids not only carry the potential for overdose but also other serious health complications, including viral infections such as HIV, Hepatitis C, and Hepatitis B, as well as bacterial skin infections and endocarditis (infection of the lining of the heart).1,16

How Do I Get Help for Heroin Addiction?

Effective treatment and support exist for heroin addiction and opioid use disorder (OUD). Treatment may be delivered by private rehab, via state or local treatment programs in either an inpatient or outpatient setting, through support groups, or in various other ways.

Addiction treatment may include the following:

  • Inpatient treatment typically involves staying in a facility with around-the-clock care and monitoring, group therapy, and individual counseling.
  • Outpatient treatment allows the patient to attend group and individual counseling sessions while living at home. This type of care may provide you with the opportunity to attend, school, work, and participate in daily life while working on your recovery.

There are several evidence-based therapies that can be used in any treatment setting:12-14

  • Behavioral therapy, which may be delivered individually or in a group, helps you identify your relationship with heroin and other drugs and teaches you strategies to avoid people, places, things, or events that may trigger drug use, such as alternative coping methods to deal with stress.
  • Medication-assisted treatment (MAT) is the use of one of three FDA-approved medications to treat OUD, methadone, buprenorphine, and naltrexone. These help manage cravings, prevent withdrawal, and keep people on the road to long-term recovery.
  • Integrated treatment of co-occurring disorders. Many people who have SUDs also meet the criteria for another mental health disorder, such as depression or anxiety. The relationship between both disorders is complex and intertwined, with symptoms of SUDs and other mental health conditions often overlapping. Integrating the treatment of both conditions has been found to be consistently superior vs. treating each diagnosis separately.
  • Individualized treatment plans. There is no one size fits all plan for addiction treatment, and a successful treatment approach is tailored to the individual’s needs, addressing all areas of a person’s life, such as employment training, housing, or legal issues, that may affect a person’s ability to stay on track with treatment and avoid relapse.

There are also support groups that can help you as you work toward becoming sober and maintaining that sobriety. Narcotics Anonymous (NA) is a mutual help support group that offers people the opportunity to use peer bonds, sponsor relationships, and self-expression to work toward sobriety. There are also non-12-step programs available that offer alternatives to NA.

Where Can I Learn More about Treating Heroin Addiction?

For more information about heroin and opioid abuse and addiction treatment, you may want to reach out to your doctor. Or you can contact one of our admissions navigators at for the information and support you are looking for as you look for heroin addiction treatment.

There are numerous treatment programs and strategies available for heroin addiction, so don’t give up if the first program you check out doesn’t meet your individual needs. To learn more about treatment for heroin addiction, click here.


  1. National Institute on Drug Abuse. (2019). Heroin DrugFacts.
  2. Drug Enforcement Administration. (2015). Drugs of abuse.
  3. National Institute on Drug Abuse. (2017). Heroin.
  4. National Institute on Drug Abuse. (2020). Prescription Opioids DrugFacts.
  5. National Institute on Drug Abuse. (2018). Understanding Drug Use and Addiction DrugFacts
  6. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  7. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Is there a difference between physical dependence and addiction?
  8. National Institute on Drug Abuse. (2018). Prescription opioid use is a risk factor for heroin use.
  9. National Institute on Drug Abuse. (2018). Prescription Opioids and Heroin Research Report: Heroin use is driven by its low cost and high availability.
  10. National Institute on Drug Abuse. (n.d.). Signs of heroin use.
  11. Healthline. (2021). Signs of heroin addiction.
  12. National Institute on Drug Abuse. (2019). DrugFacts: Treatment Approaches for Drug Addiction DrugFacts.
  13. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Principles of Effective Treatment.
  14. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Types of Treatment Programs.
  15. National Institute on Drug Abuse. (2018). The Science of Drug Use and Addiction: The Basics.
  16. Centers for Disease Control. (2021). Heroin.

More resources about Heroin Addiction: