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Symptoms and Signs of Heroin Addiction

Heroin is a highly addictive, illicitly manufactured opioid drug.1 If you suspect that you or a loved one may be struggling with heroin use, this page will help you learn more about the signs someone is using heroin or addicted to heroin, and the next steps to take to get help.

What Are the Signs of Heroin Addiction?

Some people who use heroin develop a heroin addiction, which may be diagnosed as an opioid use disorder (OUD). An OUD is one of several types of substance use disorders (SUD), and is characterized by a pattern of compulsive heroin seeking and use despite experiencing serious consequences as a result of use.2

Psychiatrists and other healthcare professionals diagnose an OUD using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which outlines the signs, symptoms, and behavioral changes, including:2

  • Using heroin over a longer period or in larger amounts than intended.
  • Wanting to cut down on heroin use but being unable to do so.
  • Spending a significant amount of time obtaining, using, or recovering from the effects of heroin.
  • Experiencing a strong urge or craving to use heroin.
  • Failing to fulfill responsibilities at home, school, or work because of heroin use.
  • Using heroin despite persistent interpersonal and social problems caused or worsened by the effects.
  • Forgoing important occupational, recreational, or social activities in favor of heroin use.
  • Using heroin in dangerous situations (e.g., driving).
  • Experiencing physical and psychological problems as a result of heroin use.
  • Developing tolerance to heroin (e.g., needing larger quantities of heroin to achieve the desired effect).
  • Experiencing withdrawal symptoms after you stop using heroin.

To be diagnosed with an OUD, a person needs to demonstrate at least 2 of the above criteria within a 12-month period.2 Though OUD diagnoses can only be made by treatment professionals, recognizing the criteria as warning signs someone is addicted to heroin may be helpful in both detecting and getting help for you or someone close to you struggling with compulsive heroin use.

Other Signs of Heroin Use

The associated adverse side effects or symptoms of heroin use are not always visible to others, and the person using heroin may be the only one who is aware of them. Though some of the acute or short-term drug effects include more readily recognizable signs such as altered mental status and fluctuations in and out of consciousness, some less obvious symptoms that may be experienced by the individual include:3

  • Heaviness of the extremities (arms and legs).
  • Warmth/flushing of the skin.
  • Skin itching.
  • Dry mouth.
  • Stomach upset.

More chronic heroin use sometimes leads to longer-term health effects, including:3

  • Chronic sleep disturbances.
  • Vascular inflammation after injection use.
  • Localized skin inflammation, infection, abscesses.
  • Endocarditis (heart infection).
  • Chronic constipation.
  • Sexual problems in men.
  • Irregular menstrual cycles in women.

Symptoms of Heroin Withdrawal

One of the major risks of repeated heroin use would be the development of physiological dependence and the onset of an associated withdrawal syndrome should heroin use slow or stop.3 Symptoms of heroin withdrawal include:3

  • Insomnia.
  • Agitation and/or restlessness.
  • Nausea and/or vomiting.
  • Diarrhea.
  • Bone or muscle pain.
  • Chills and/or goosebumps.
  • Cravings.
  • Muscle twitches.

Paraphernalia as a Sign of Heroin Use

While it is not always possible to see the signs of heroin abuse from a person’s behavior or physical state, you may be able to find drug paraphernalia. A person may stash their paraphernalia in a backpack, case, gym bag, or purse. You may find it hidden in drawers or under the bed. Some common types of heroin paraphernalia can include:4

  • Needles.
  • Spoons.
  • Tinfoil.
  • Plastic pen cases or cut-up straws (for either snorting or smoking/inhaling).

What to Do If Someone Is Showing Signs of Heroin Use

If you believe that your loved one is showing signs of heroin use and addiction, it’s important to reach out for help. No matter how severe a person’s heroin use may seem, heroin addiction is treatable and recovery is possible. Heroin addiction treatment can take place in different settings, including:5

  • Inpatient rehab, which provides 24/7 care, monitoring, and support to help patients begin their recovery. Inpatient programs can vary in duration and intensity depending on a patient’s needs.
  • Outpatient rehab, which provides similar care to inpatient rehab, but with the flexibility of living at home. Like inpatient rehab, outpatient rehab can vary in duration and intensity depending on a patient’s needs.

Treat may begin with a period of medical detox to help patients withdraw from heroin as comfortably and safely as possible before continuing to ongoing treatment in an inpatient or outpatient rehab.5

There are numerous approaches to treatment, but patients can expect to participate in behavioral therapies, such as cognitive-behavioral or motivational enhancement therapy, which can help them learn new skills to avoid drug use and relapse after treatment.5 Treatment may also include medication-assisted treatment, or MAT, which is an important tool in helping people overcome heroin addiction. Medications such as buprenorphine or methadone are sometimes used to ease withdrawal symptoms, control cravings, and help people avoid relapse.6 Treatment can also address co-occurring disorders (e.g., anxiety, depression), which is important for recovery. Some programs offer this specialized, integrated treatment that addresses both conditions at the same time.7

See If Your Insurance Plan Covers Heroin Addiction Rehab

American Addiction Centers can help people recover from opioid addiction and other substance use disorders. Call to ask about your heroin addiction treatment options and start your recovery journey. To find out if your insurance covers treatment at an American Addiction Centers facility, you can fill out the short form below or easily verify your insurance online. Your information is kept 100% confidential and there is no obligation to enter treatment.