Heroin Addiction: Signs, Effects, Withdrawal & Recovery

Written By: Facility Staff

Edited By: Editorial Team

Published Date: 01/29/24

Last Updated: 01/29/24

If you or someone you know are in the grips of a heroin addiction, you’re not alone in your struggles.

Heroin is well-known for being one of the most dangerous illicit drugs on the market, largely due to its addictive nature and high risk for overdose. 

And heroin use is becoming more common and problematic as the opioid epidemic continues to grow throughout the United States. Largely, this is because heroin is presented as a cheaper and more accessible option to prescription painkillers. 

Find out more about the dangers of heroin drug addiction, including the signs, effects, withdrawal symptoms, and recovery treatments for heroin abuse and addiction. 

Heroin Addiction (Heroin Use Disorder): Quick Definition

Heroin addiction, or heroin use disorder, is the chronic, relapsing disorder that happens when someone uses heroin and becomes addicted to (mentally reliant on) the substance.

And heroin addiction can happen quickly due to the drug’s intense high (‘heroin high’).

This high is said to be one of the most powerful available, but it is also one of the riskiest and most dangerous. 

Heroin is a natural opiate that is produced out of morphine found in the seed pods of opium poppy plants. The different types of heroin produced can be smoked, snorted, or injected directly into a vein or muscle. 

The risks of heroin use increase exponentially as a person finds themselves in a cycle of heroin addiction and withdrawal. This cycle may completely consume the person with thoughts of their next high, making them willing to do whatever it takes in order to achieve it. 

Someone in this position may wish they could stop using heroin, but will find that it can be extremely difficult to do so on their own and without professional support. 

Key Facts on Heroin Addiction & Heroin Abuse

  • Around 103,000 new people start using heroin in America each year.
  • Close to one million Americans use heroin every year.
  • Heroin use makes up around 4.5% of all illicit drug use.
  • Around 2% of high school students have used heroin before.
  • Heroin use disorders make up around 1.7% of all substance use disorders.
  • The number of heroin-related deaths tripled in the United States between 2010 and 2021.

How Does Heroin Use Disorder Start?

Because heroin can be so pleasurable and addicting, it often does not take long for heroin use to turn into a heroin use disorder. 

Why Do People Abuse Heroin?

People abuse heroin for a variety of reasons. And there has been a rise in heroin use in recent years connected to increased abuse of prescription painkillers and especially opioids.

Reasons people abuse heroin include: 

  • They enjoy the high from heroin
  • They want to relax
  • They want to escape their problems or stress
  • To fit in with friends or a romantic partner
  • They were previously addicted to prescription opioids and need something cheaper and stronger
  • They are curious 
  • They want to stop but the withdrawal symptoms are too difficult to manage

Pleasurable Effects That Lead to Heroin Misuse

One of the reasons why heroin is said to be so addictive is because it delivers such a pleasurable high, one that is said to be relaxing, euphoric, and intensely calm. 

The high from heroin is also fast-acting and strong, with intravenous injection being the most common method of administration that people use for a near-instant release of effects. 

How Heroin Affects the Brain

Using heroin or other opioids causes a release of dopamine, an important neurotransmitter which affects the brain’s reward system and how it experiences pain and pleasure. 

Over time, the brain will produce less dopamine on its own and the person will need more and more of the opiate in order to be able to feel the euphoric high, increase in pleasure, and reduction in pain they are accustomed to. 

Is Heroin Addiction a Choice?

While it is initially a choice to use heroin the first time, addiction is considered a chronic brain disease and is thus not a choice once a person has reached the point of dependence. 

Once someone has reached the point of addiction, it is very difficult to overcome it without professional medical intervention and support.

What Are Common Heroin Addiction Signs?

Heroin addiction has some telltale signs that are common in many people who use it. Signs may be physical, emotional, mental, or behavioral.

Common signs of heroin addiction include:

  • Uncharacteristic lying
  • Hiding drug use
  • Stealing from loved ones
  • Wearing long sleeves all the time 
  • Evidence of heroin paraphernalia (i.e. small spoons, needles, plastic baggies, lighters, white, powdery residue, etc)
  • Pinpoint pupils (very small pupils)
  • Unexplained and sudden weight loss
  • Lack of interest in usual hobbies or activities
  • Withdrawing from friends or family members
  • Effects on performance at work or school

Heroin Addiction vs Heroin Dependence

Someone who is addicted to heroin will crave it mentally and physically. These cravings (withdrawal) will be so strong, it will rob them of the ability to care about the consequences of using it or who they are harming in the process. 

On the other hand, someone who is dependent on heroin will experience intense and uncomfortable withdrawal symptoms when not using it, and have a difficult time performing everyday functions without it. 

Heroin Withdrawal Symptoms

Heroin withdrawal is said to be extremely unpleasant, and can play a large role in preventing people from overcoming their addiction. 

Heroin withdrawal symptoms include:

  • Insomnia
  • Irritability
  • Moodiness
  • Muscle aches
  • Intense cravings
  • Diarrhea
  • Fever 
  • Overall feeling of being sick or unwell 

What Causes Heroin Addiction to Develop?

Addiction usually starts once a person begins to develop a tolerance to heroin and needs more of it in order to feel the same high. 

Around the same time, their brain chemistry will start to change. They will begin to develop a physical dependency that makes the periods in between using heroin more painful and uncomfortable. 

This physical dependency will keep them in a state of continual use in order to avoid withdrawal, and they may find themselves thinking about heroin throughout most of their day. 

They will continue to seek heroin in order to satisfy their intense and uncontrollable cravings, regardless of the consequences and the harm it is causing to themselves or others. 

Risk Factors for Heroin Addiction

Certain people are at a higher risk for abusing heroin, and within this group are often people who have been led to heroin through drug use of another kind. 

Risk factors for heroin addiction include:

  • Having a previous prescription to opioids like Norco or Percocet
  • Living in a high-stress environment
  • Being young — teens and young adults in their 20s are at highest risk
  • Family history of substance abuse
  • Having untreated mental health conditions

Who Experiences Heroin Abuse Problems?

Anyone can experience heroin abuse problems, although some demographics are more likely than others. 

Men have always been about twice as likely to use heroin as women, although this gap is narrowing in recent years, particularly in the adolescent age group. 

There are also alarming disparities regarding heroin overdose deaths in areas where there are large amounts of minorities and non-hispanic blacks, possibly driven by an increase in the presence of illicit fentanyl. 

In addition, it is estimated that up to 80% of heroin users first started by abusing prescription opioids. In many instances it was their own valid prescription drugs that led to opioid abuse. 

Running out of the prescription prompted them to find an alternative, and heroin can be easy to obtain in many areas. 

Side Effects of Heroin Abuse

In addition to causing a pleasant rush and an intense, euphoric high, heroin abuse can also come with a series of negative short-term effects as well.

Short-term side effects of heroin abuse include:

  • Drowsiness
  • Slowed heart rate
  • Shallow breathing
  • Nausea and vomiting
  • Feeling hot
  • Itching 
  • Constipation 

Long-Term Effects of Heroin Addiction

Heroin can have dangerous effects in the short term, such as an elevated risk of overdose with every use.

These effects and potential health problems only amplify the longer a person abuses heroin. 

Long-term effects of heroin addiction include: 

  • Tolerance, dependence, and addiction
  • Loss of white matter in the brain
  • Insomnia
  • Track marks and abscesses around injection sites
  • Sexual dysfunction
  • Increased risk of bacterial infection or viral infection from IV use, such as hepatitis B, hepatitis C, or HIV
  • Increased risk of heroin overdose

Heroin Addiction Treatment Options

There are numerous treatment options that have been proven effective in helping people manage and recover from heroin addiction or abuse. 

Heroin Detox 

Treatment for heroin addiction will always begin with a period of detoxification, during which the person will go through withdrawal under medical supervision and with the assistance of opioid replacement medications

It is possible to go through detox without professional help or supervision, but it is not recommended when quitting heroin. 

Heroin Rehab 

Heroin rehab can be outpatient or inpatient, but heroin addictions at the start are often so severe they may be best served in a residential environment.

This is because inpatient treatment allows for 24/7 supervision and relapse prevention support, both of which can be crucial when overcoming heroin addiction. 

Following detox, people with heroin addictions may choose an outpatient follow-up program such as partial hospitalization or intensive outpatient treatment.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment is similar and related to detox, but allows people to come off a substance over a more prolonged period of time.

Medications that are commonly used in MAT when treating heroin and other opioid use disorders are methadone (Methadose), naltrexone (Vivitrol), and buprenorphine (Suboxone).

Dual Diagnosis Treatment

Dual diagnosis treatment is often beneficial when treating heroin addiction because many of those who are addicted to heroin have a co-occuring mental health disorder as well. 

Mental disorders that commonly co-occur with addiction include:

  • Depression
  • Anxiety and other mood disorders
  • Bipolar disorder
  • Schizophrenia
  • Eating disorders
  • Obsessive compulsive disorder
  • Post-traumatic stress disorder

Behavioral Therapy & Counseling

Behavioral therapy and counseling are useful for helping people to understand their thoughts, feelings, and behaviors (particularly their addictive behaviors) and how they are related. 

Therapy is also great for helping people to get to the root of their addiction and its cause, and helping them identify their personal triggers and either avoid or face them when appropriate. 

Alternative Therapy

Alternative therapies for addiction often incorporate holistic methods and can include options like art therapy and music therapy as well as specific techniques like SMART recovery. 

Heroin Recovery Options

It is important that anyone in recovery for a heroin addiction continue to participate in recovery options in some form after their treatment is completed. 

Continuing care lends to lasting recovery and helps avoid relapse.

Narcotics Anonymous (NA) Support Groups

Peer support is incredibly important for people during and after recovery, and Narcotics Anonymous meetings are great places to find this support. 

During these meetings people can share their own stories, connect with others who can relate and understand, and find sponsorship and guidance for moving forward. 

Sober Living Homes

Transitioning from a residential environment to a sober living home is the best choice for many people, as it offers a supportive and sober environment where people can focus on their goals. 

Residents can also hold each other accountable and help to keep each other on track with recovery while getting ready to live on their own again. 

Aftercare Options

Other aftercare options are provided in the form of outpatient treatment that usually incorporates continued therapy and counseling. 

These services may also include relapse prevention support to recently recovered individuals to help prevent and address any relapse situations that arise. 

Heroin Addiction Recovery Resources 

There are multiple resources available to help people in different ways as they recover from a heroin use disorder or other addiction. 

Heroin addiction recovery resources include:

  • Narcotics Anonymous — a national organization similar to Alcoholics Anonymous but for all drug users, this group hosts local meetings and support groups for people around the United States. 
  • National Harm Reduction Coalition — this national organization is focused on ending the national opioid crisis, including by connecting people with heroin or opioid addiction to clean syringes and life-saving naloxone in case of an opioid overdose. 
  • Partnership to End Addiction — this organization is meant for parents and caregivers who are concerned about substance abuse in their child and also offers a free and confidential helpline that parents can call for more help. 
  • Substance Abuse and Mental Health Services Administration (SAMHSA) — in addition to a mental health and behavioral health treatment locator, this organization also provides numerous mental health resources for individuals and health care providers. 

Find Compassionate Heroin Treatment at Otter House Wellness

An addiction to heroin can be scary and overwhelming, whether the person who is addicted is a loved one or yourself.

But it’s important to remember that people can and do overcome this addiction every day. And at Otter House Wellness, we offer a highly tailored approach to aid you in meeting your recovery goals. 

Our programs include intensive options like partial hospitalization and IOP, as well as therapy, counseling, and case management.

To find out how you or a family member can get started in one of our targeted treatment programs, contact Otter House Wellness to speak to a compassionate representative today.

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Why is heroin so addictive?

Heroin is addictive partly because its effects are so pleasurable and appealing to those who try it. Heroin also causes uncomfortable withdrawal symptoms that make it difficult to stop using the drug. 

People also tend to use heroin intravenously much of the time as well, a method that delivers a stronger, more short-lived, and thus more addictive high. 

What percent of people who use heroin first misused prescription opioids?

The United States Drug Enforcement Administration (DEA) states that up to 80% of heroin users started with prescription opioids. 

The reason they move on to heroin is because it is often cheaper, more easily available, and delivers a stronger and faster high.

How to spot signs of heroin use?

To spot signs of heroin use, you can first look for signs of withdrawal, such as fatigue, scratching, flushed skin, and small pupils. 

You can also look for changes in their behavior or lifestyle, such as having a new group of friends, growing financial problems, neglecting responsibilities, or changes in sleep habits. 

How can you help someone with a heroin addiction?

If someone you love has a heroin addiction, you can start by educating yourself on their disorder, letting them know you care, and helping them find treatment if necessary. 

You can also help further by providing transportation, participating in therapy with them, and being someone they can talk to when they are worried about relapse. 

Can people recover from heroin?

Yes, people can recover from heroin addiction, but it is important to be aware of how much hard work and dedication recovery can require. 

Further, recovering from heroin or another opioid drug often involves professional rehab and medical detox to make the withdrawal process more manageable. 


Centers for Disease Control and Prevention. “Heroin.” Retrieved from: https://www.cdc.gov/opioids/basics/heroin.html. Accessed on January 19, 2024. 

National Center for Drug Abuse Statistics. “Heroin Statistics.” Retrieved from: https://drugabusestatistics.org/heroin-statistics/. Accessed on January 19, 2024. 

National Institute on Drug Abuse. “Disparities in opioid overdose deaths continue to worsen for Black people, study suggests.” Retrieved from: https://nida.nih.gov/news-events/news-releases/2021/09/disparities-in-opioid-overdose-deaths-continue-to-worsen-for-black-people-study-suggests. Accessed on January 19, 2024. 

National Institute on Drug Abuse. “What are the long-term effects of heroin use?” Retrieved from: https://nida.nih.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use. Accessed on January 19, 2024. 

National Institute on Drug Abuse. “What is the scope of heroin use in the United States?” Retrieved from: https://nida.nih.gov/publications/research-reports/heroin/scope-heroin-use-in-united-states. Accessed on January 19, 2024. 

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