Heroin Addiction: Effects, Detox & Treatment

National survey data show that in 2022, an estimated 1 million Americans aged 12 and older used heroin, and approximately 900,000 had a heroin use disorder.1 An addiction to opioids, whether prescription painkillers or heroin, is not a moral failing but a chronic disease that usually requires professional treatment.2,3 This article will help you understand how heroin affects the brain and behavior, the signs of heroin addiction, and treatment options if you or a loved one is struggling with heroin use.
Did you know most health insurance plans cover addiction treatment?
About Heroin

What Is Heroin?

Heroin is an illegal drug made from morphine. Heroin comes in several forms: white powder, brown powder, or a black sticky form called “black tar.” Heroin is usually snorted, sniffed, smoked, or injected.4

Heroin enters the brain rapidly and produces a powerful and near-immediate high. It does this by binding to and activating opioid receptors throughout the body and brain that regulate the body’s response to pain and pleasure. These receptors also are involved with controlling vital functions such as sleeping, heart rate, and breathing.4,5

Common street names for heroin include:21 

  • Dope.
  • H.
  • Smack.
Heroin Effects & Risks

Effects of Heroin

Heroin use brings on an overwhelming rush of euphoria that contributes to its addictive potential. Other short-term effects of heroin include:4–6

  • Small pupils.
  • Warm, flushed skin.
  • Heaviness in the arms and legs.
  • Dry mouth.
  • Itching.
  • Nausea and vomiting.
  • Confusion.
  • Drowsiness and “nodding off” (alternating between sleep and wakefulness).
  • Slowed breathing and heart rate.

Dangers of Injecting Heroin

Injecting heroin comes with its own set of very serious problems. Heroin injection use may result in:7–9

  • Scarred and collapsed veins.
  • Peripheral edema.
  • Abscesses (painful wounds filled with pus).
  • Cellulitis (a serious bacterial skin infection).
  • Severe bacterial infections from contaminated needles, including tetanus, botulism, and endocarditis (infection of the heart lining and valves).
  • Increased risk of getting/transmitting HIV, hepatitis, and other viral bloodborne diseases.
  • Clogged blood vessels, which can cause serious and permanent damage to the kidneys, lungs, liver, and brain.

Risk of Fentanyl-Laced Heroin

Fentanyl is a powerful synthetic opioid increasingly being used as an additive or adulterant in street drugs like heroin. This is especially dangerous because people using heroin may not realize it contains fentanyl, heightening the risk that they may take too much and potentially overdose.22,23

The number of deadly overdoses in the U.S. has skyrocketed in recent years, largely attributed to the rising use of fentanyl.24,25

In 2021, the number of opioid-related deaths jumped to 80,411. Of those overdoses, nearly 88% involved synthetic opioids like fentanyl.24,26

Heroin Dependence & Addiction

Prolonged heroin use can also lead to tolerance, where someone needs increasingly larger amounts of the drug to get high, and physical dependence, where the body feels like it needs the drug to function normally and avoid withdrawal symptoms.7,8

Continued use may also lead to an opioid use disorder (opioid addiction), where a person becomes unable to control their heroin use and compulsively seeks out and uses opioids such as heroin despite negative consequences that severely degrade one’s quality of life or ability to function (e.g., work, school, family life, etc.).7

Signs of Addiction

Signs of Possible Heroin Use

A variety of possible warning signs, including changes in physical appearance and behavior, may raise your suspicion that a person is using heroin or other substances.

If you’re worried that someone you know is using heroin, you may look for some of the short-term effects of heroin listed earlier in the article, such as small pupils, nodding off, and constant itching/scratching.4

You might also notice that the person is exhibiting unusual personality changes, having mood swings, or becoming socially isolated. They may be increasingly unreliable and struggle to maintain positive relationships with friends, family, and even colleagues.4,10,11

In addition to the physical and behavioral signs of injection drug use (IDU), a person who is injecting drugs like heroin may have needles, belts (for use as tourniquets), or spoons lying around or in the trash can. Someone who is smoking drugs may have pipes or pieces of aluminum foil with burn marks lying around or disposed of in the trash. Someone who is snorting drugs might leave cut straws or tubes or hollowed-out pen cases lying around or collected in the garbage.12,13

Signs of Heroin Addiction

Heroin addiction, or opioid use disorder, involves a cluster of physical, mental, and behavioral symptoms that affect one or more areas of your life.  A doctor or mental health professional diagnoses someone with an opioid use disorder using criteria from the DSM. These criteria include:8

  • Reducing or quitting important activities because of heroin.
  • Experiencing strong cravings for heroin or other opioids.
  • Failing in their attempts to cut back on or stop using heroin.
  • Being unable to quit using heroin even after it has caused or worsened physical, psychological, or social issues.
  • Needing more heroin to get high or experiencing a diminished effect from their usual dose (tolerance).
  • Spending a lot of time getting, using, or recovering from the effects of heroin.
  • Struggling to complete tasks at work, home, or school because of heroin use.
  • Using heroin for longer periods or in a larger amounts than originally intended.
  • Using in situations that can be dangerous, such as while driving.
  • Experiencing withdrawal symptoms when reducing their use or taking opioids for the purpose of avoiding withdrawal (dependence).
Heroin Detox & Treatment

Heroin Withdrawal & Detox

laguna treatment center

Laguna Treatment Center

Detox is a necessary first step in treatment for opioid use disorder. Heroin withdrawal brings on symptoms that are very tough to endure alone.

The heroin withdrawal syndrome includes numerous symptoms that mimic a severe flu (e.g., muscle aches and pains, nausea, vomiting, and fever), as well as cravings, anxiety, and depressed mood. For those with opioid use disorders, avoidance of withdrawal can keep them returning to opioids for relief, often derailing their attempts to control their use.8,14

Professional medical detox provides a supportive environment with medical interventions (e.g., withdrawal medications) to ease the withdrawal process. Heroin detox can take place in both inpatient and outpatient programs; the program that is right for you will depend on how much support you need and the severity of your withdrawal symptoms.

Outpatient detox programs provide flexibility and freedom but limited supervision. An inpatient medical detox facility for opioid abuse, like the one at Laguna Treatment Center, provides 24/7 care and medical supervision and has the added benefit of a drug-free space to detox. This can be crucial for those who do not have the skills to cope with the people, places, or things in their home environment that may trigger a return to drug use or relapse.

Rehab for Heroin Addiction

Following detox, additional treatment is usually needed to delve into and address the underlying problems that contributed to the addiction. A variety of treatment types, offered in both inpatient and outpatient settings, are available to help you recover from heroin addiction.15,16

Behavioral therapies are utilized in both inpatient and outpatient treatment settings to help you change how you think about heroin and drug use, improve your ability to cope with stressors and triggers, strengthen communication skills, and build a sober support group. 15,17

Many treatment programs also utilize medications in combination with behavioral therapy to effectively treat heroin addiction. Certain treatment medications have been proven effective for those who struggle with heroin addiction and may:18

  • Help patients stay in treatment longer.
  • Decrease illicit drug use.
  • Decrease criminal activity.
  • Reduce rates of HIV risk behavior.
  • Reduced risk of HIV and hepatitis C infection.
  • Reduced risk of overdose-related death.

Opioid treatment medications include methadone, buprenorphine/Suboxone, and naltrexone. Not all treatment programs will offer all medications for opioid use disorder (MOUD).

Paying for Addiction Treatment

Health insurance typically offers some coverage for addiction treatment. The Affordable Care Act (ACA) made addiction treatment one of the essential health benefits that most plans are required to offer.19,20

You can . If you don’t have insurance, other ways to pay for treatment include private financing, taking out a loan, or working out a payment plan.

Our team will work with you to make recovery possible in whatever situation you are in.

Heroin Addiction Treatment in California

Laguna Treatment Center is a medical detox and rehab facility in Orange County, CA, that provides professional, evidence-based care for anyone struggling with fentanyl use or addiction.

Our facility offers different levels of addiction rehab and personalized treatment plans designed to meet the individual needs of each patient.

Call  to start the admissions process or learn more about using insurance to cover the cost of addiction treatment, other rehab payment options, and what to expect in rehab.

When you’re ready, we are here to help you get the care you deserve and begin the path to recovery.


Was this page helpful?
Thank you for your feedback.

American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information. We strive to create content that is clear, concise, and easy to understand.

Read our full editorial policy

While we are unable to respond to your feedback directly, we'll use this information to improve our online help.