Heroin has a bad rap – and rightfully so. Its reputation often exceeds the actual facts when it comes to what most really know about the drug. What most people do know is that it’s highly addictive, but not as many realize that it also triggers dependence. Addiction is an inability to stop using a substance. Dependence requires increasingly larger amounts to be taken to get the same desired effect.

How does it start?

By the time that high school graduation comes about, a large quantity of teens will have already experimented with drugs, such as prescription pain medications. Whether the drugs were originally prescribed to the user but are then taken recreationally, or if the teen is given the drugs by a classmate, makes little to no difference. When the prescription drugs become too expensive or no longer provide the same high, teens may start to search for a less-expensive and more potent alternative – heroin. It doesn’t automatically follow that if you’ve tried less stigmatized substances, you’ll automatically move on to more serious drugs like heroin, but there is a link.

The initial effect of heroin is a “rush”. After the rush, the user will feel drowsy for several hours and basic body functions, such as breathing and heartbeat, slow down. Then within hours, the addict’s body will begin to crave another rush. If they can’t get hold of more, withdrawals begin.

Signs of Heroin Use

The initial signs of use are similar to other addictive substances; flushed skin, small pupils, watery eyes, a runny nose, etc. A user might also experience severe itching of the skin or acute drowsiness.

The impact of heroin can’t be overstated. Users often talk about becoming addicted within one week of their first snort.

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Signs of Heroin Addiction

Heroin addiction is not always obvious. As with other addictive substances, users can function on a day-to-day basis for a while, but over time this becomes much more difficult. The numerous, but sometimes hard to detect, side effects of heroin use are what a concerned person needs to look for in the person they suspect may be using.

Signs of heroin use – the first signs of addiction are changes in usual behavior. Users can become unpredictably moody and withdrawn. Users tend to seek other users, so old friends may no longer come around and new friends may unexpectedly appear. Addicts may also become restless and agitated and react aggressively to anyone who expresses concern.

To a heroin addict, nothing is as important as heroin. They may lie and steal to get the next hit and are in a vicious cycle of emotional highs and lows. They may skip work or other responsibilities due to the highs, lows, and all-consuming desire.

There may also be obvious signs of drug use. The most common method of taking heroin is to inject it – the street term is skin-popping – and needles always leave a mark.

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Long-Term Effects

There are so many effects, it’s difficult to know where to start to list them. The relatively benign effects of unhealthy teeth and gums, and loss of sexual appetite or ability, are just a few. But quickly additional effects kick in, such as collapsing veins and exposure to AIDS and hepatitis. Users are also at an elevated risk for falling into coma.

Addicts will begin to take on the heroin ‘look’, which absurdly, some in the fashion world tried to reflect as chic. Users often have a blank expression, dark circles under the eyes, and perhaps become excessively thin.

Heroin Withdrawal

Withdrawal starts as soon as the body doesn’t receive the next hit that it craves. This could be as soon as 6 hours after the last hit. The withdrawal effects from heroin and opiates are so severe that users often continue using just to avoid them.

People who go through withdrawal will experience some, or all, of the following symptoms: insomnia, depression, drug cravings, anxiety, nausea, vomiting, and severe body aches.

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Heroin Addicts Need Help

Because the risk of relapse is so high for addicts going through the recovery process, a residential program is often the best way to avoid temptations that may arise when dealing with the public. Therefore, while in the safety of the residential facility, users can go through a medically assisted detox.

The effects of heroin remain long after the drug is out of one’s system. Thereafter, while in therapy, addicts continue to spend much of their time learning about the drug, it’s effects, and how to continue to avoid it altogether.

An experienced team of professionals can help an addict through the worst of times, but it must be the addict’s decision to stop using. Learn about the signs of heroin use so you can help.

Amanda Hilzer

Reviewed for accuracy by:

Amanda Hilzer M.Ed, CAADC, IADAC, ICCS, LCADC, CCS


Amanda graduated from Lehigh University with both an undergraduate degree in Psychology and a Master’s of Education degree in Counseling Psychology and has worked in the field of substance use disorder treatment and mental health treatment as a counselor and as a clinical manager for over 14 years.