Heroin Addiction, Effects, Detox, & Recovery

National survey data show that in 2019, an estimated 745,000 Americans aged 12 and older used heroin, and that approximately 438,000 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 controlling heroin use.
Understanding Heroin

What Is Heroin?

Man with heroin

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

Heroin enters the brain rapidly and produces a powerful and near-immediate high.4,5 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

Short-Term Effects of Heroin

Heroin use brings on an overwhelming rush of euphoria that contributes to its addictive potential.5 Other short-term effects of heroin include:4,5,6

  • Small pupils.
  • Warm, flushed skin.
  • Heaviness in the arms and legs.
  • Dry mouth.
  • Itching.
  • Nausea/vomiting.
  • Problems thinking clearly.
  • Drowsiness and “nodding off” (alternating between sleep and wakefulness).
  • Slowed breathing.
  • Slowed heart function.
Health Effects

What Are the Long-Term Health Effects of Heroin?

Long-term use of heroin can have many negative health consequences on your health, some of which are very severe. These can include: 4,7,8

  • Insomnia.
  • Chronic dry mouth.
  • Severe constipation.
  • Irregular menstrual cycles and reproductive disturbances in women.
  • Sexual dysfunction in men.
  • Lung and respiratory problems, such as pneumonia and tuberculosis.
  • Mental health issues, including depression and personality disorders.
  • Damage to the brain’s white matter, resulting in problems regulating behavior and handling stress appropriately.
  • Nasal tissue damage or holes in the nasal septum (the tissue that separates the nasal passages), for those who snort heroin powder.

Injecting heroin comes with its own set of very serious problems. Injection heroin use may result in:7,8,9

  • 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.

Prolonged heroin use can also lead to tolerance, where you need increasingly larger amounts of the drug to get high, and physical dependence, where your body requires the drug to function normally and avoid withdrawal symptoms.7, 8

Continued use may also lead to an opioid use disorder (opioid addiction), where you are unable to control your heroin use and compulsively seek out and use 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

Lonely, isolated man

A variety of possible warning signs, including changes in physical appearance and behavior, may raise your suspicion that a person is misusing 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 may 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) and possible 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.8  A doctor or mental health professional diagnoses someone with an opioid use disorder using criteria from the DSM.8  These criteria include:8

  • Cut back on or quit important activities because of heroin.
  • Experience strong cravings for heroin or other opioids.
  • Fail in their attempts to cut back on or stop using heroin.
  • Find themselves unable to quit using heroin even after it has caused or worsened physical, psychological, or social issues.
  • Need more heroin to get high or experience a diminished effect from their usual dose (tolerance).
  • Spend a lot of time getting, using, or recovering from the effects of heroin.
  • Struggle to complete tasks at work, home, or school because of heroin use.
  • Control how much or for how long they use heroin.
  • Use in situations that can be dangerous, such as while operating dangerous machinery or while driving.
  • Experience withdrawal symptoms when they try to reduce their use or take opioids for the purpose of avoiding withdrawal (dependence).
Heroin Detox & Treatment

Detoxing from Heroin

laguna treatment hospital

Laguna Treatment Hospital

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. Inpatient medical detox programs like the one at Laguna Treatment Hospital provide 24/7 care and medical supervision and have 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 trigger a return to drug use or relapse.

Rehab for Heroin Addiction

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

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, an approach known as medication-assisted treatment (MAT). This treatment approach has been proven effective for those who struggle with heroin addiction and use of certain medications have been shown to: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 MAT medications.

How to Pay for Addiction Treatment

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

You can . If you don’t have insurance, other options to pay for treatment include financing treatment, 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. For help, call us now at .