Even if the road ahead appears dark and hopeless, heroin addiction can be effectively treated if you find the right medical help and holistically resolve all the reasons behind the addiction.

The fight against addiction always starts with awareness of the signs and symptoms so that you can take the necessary step for yourself or a loved one as soon as possible.

Signs of a Heroin Problem

Awareness is the pre-requisite to seeking help for yourself, a loved one in your family, or somebody in your community for whom you are concerned.

Heroin is one of the most addictive illegal substances because it can significantly alter brain chemistry, the constant rush of dopamine and endorphins hijacks your central nervous system and can create a physical dependence after a few uses. Furthermore, heroin is often used as a coping mechanism for discontent, stress, or trauma, creating psychological dependence.

The more you use heroin, the more dependent you become and the higher likelihood of addiction. Trying to go “cold turkey”, and suddenly stopping will likely cause severe withdrawal symptoms. Studies suggest that rates of heroin relapse after attempting to stop can go as high as 88%, which speaks to the severe addiction symptoms it causes and the need for professional help [1] [2].

The signs of heroin dependence and addiction are physical and mental symptoms, differences in behaviour, and disruption in an individual’s personal and professional life.

Seeing them in a loved one will allow you to convince them to seek professional help and intervene as quickly as possible before the condition gets worse.

Heroin addiction is a serious disorder, but no matter how challenging, it can be beaten if you support one another and seek help from qualified professionals. No matter if you or a loved one have tried in the past and failed, the fight against addiction is not a hopeless one, so you should never give up.

Physical Signs of Heroin Dependence

Despite the euphoric and exhilarating psychological effect that heroin creates, the illicit drug is by no means a safe substance. Chronic use of heroin creates visible physical signs that you can see in others and may lead to the development of long-term health problems.

Heroin changes your brain chemistry, which shifts your body’s natural state of balance. As a result, many of the physical signs of heroin dependence are not only due to the harmful chemicals in the substance but also your body’s inability to function normally without the substance.

Physical signs of heroin dependence to watch out for:

  • Itchy and clammy skin
  • Fever and tremors
  • Nausea and vomiting
  • Stomachaches
  • Constipation
  • Fluctuations in hunger and eating patterns
  • Runny nose
  • Weight loss
  • Dry mouth
  • Muscle spasms
  • Needle marks and bruises on the skin

Psychological Signs of Heroin Addiction

Although less visible, especially since the person struggling with addiction can try to hide those symptoms, heroin addiction can severely hurt a person’s mental health.

The “high” you experience after taking heroin comes due to the rush of dopamine, serotonin, and other brain chemicals, but unfortunately, it comes with a huge price. Heroin, much like other illicit drugs, creates significant chemical, neuronal, and hormonal imbalances. Studies on heroin addicts have shown disruptions and deterioration in various brain circuits due to substance abuse [3].

Heroin abuse can disrupt cognitive function, exacerbate symptoms of other mental health disorders, and leave trauma and other sources of stress unaddressed because it’s used to hide those issues.

Psychological signs of heroin dependence to watch out for:

  • Loss of orientation and confusion
  • Anxiety and heightened sensitivity to stress
  • Mood swings
  • Numbness and apathy
  • Symptoms of depression
  • Impulsivity, aggression and hostility toward people
  • Frustration and irritability with oneself and others
  • Inattention and inability to concentrate
  • Reduced cognitive function and struggle to make decisions
  • Memory issues
  • Restlessness, sleep issues or insomnia
  • Paranoia
  • Hallucinations and episodes of delirium

Behavioural and Social Consequences of Heroin Use

The damage to a person’s physical and mental health and the need to constantly manage cravings will inevitably change how an individual treats loved ones and friends, carries themselves at work, and their general attitude toward life.

Unfortunately, society has a high degree of stigma against addiction and substance abuse. As a result, people often associate addiction with a moral wrong or a personal failure for which the person is responsible. When shame and guilt are the strongest feelings you associate with addiction, you are unlikely to seek help and will often do everything possible to hide your symptoms.

Behavioural and social signs of heroin abuse to watch out for:

  • Slurred speech and trouble with communication
  • Falling behind on responsibilities and work at school, university, or at work
  • No attention to personal hygiene, how they dress, etc
  • Needle marks and scars on arms and legs
  • Wearing long and baggy clothes even if it’s very warm
  • Distancing from loved ones and friends
  • Getting hostile and defensive when the substance is mentioned
  • Mood fluctuations
  • Switching between periods of hyperactivity and lethargy
  • Lack of motivation and loss of interest in activities they previously enjoyed

Get help for heroin addiction today!

Symptoms of Heroin Withdrawals

One of the most obvious and visible signs of heroin addiction is the dependence you are likely to develop if you abuse the substance. Your body seeks a state of balance, also known as homeostasis.

Chronic use of heroin shifts the balance so that you need the substance to function normally. Suddenly stopping heroin or trying to lower doses can shock your body and create many withdrawal symptoms affecting your physical and mental health.

Heroin withdrawal symptoms to be aware of:

  • Chest pains and heart palpations
  • Flu-like symptoms
  • Hallucinations and paranoia
  • Brain fog and inability to make decisions
  • Mood swings
  • Irritaonality and irritability
  • Exacerbated symptoms of other mental health disorders
  • Restlessness
  • Inability to sleep and insomnia
  • Intense and uncontrollable cravings for the substance

Symptoms of Heroin Overdose

Chronic use of heroin increases the chance of overdosing because your body builds a tolerance toward the substance. In the beginning, the “high” you get from a dose of heroin can feel like a stark difference in how you feel and think. However, the more doses you take, the more your body gets used to the substance and requires more frequent or higher doses to get the same effect.

Since heroin is often used as a coping mechanism for some underlying mental health disorder, a source of stress and dissatisfaction, or a repressed trauma, the desire to get the same psychological effect can be very intense. Furthermore, while under the substance, you may fear the effect running out or not pay attention as to how much you’ve already taken, which further increases the chance of heroin overdose.

Here is a comprehensive list of heroin overdose symptoms to watch out for:

  • Inability to control muscles
  • Constricted pupils
  • Loss of consciousness
  • Choking, inability to breathe and uncontrollable vomiting
  • Respiratory arrest
  • Slowed pulse and a noticeable fall in blood pressure
  • Slurred speech and incoherent sentences
  • Extreme fatigue and disorientation
  • Changes in skin tone and temperature
  • Severe flu-like symptoms

If you suspect that someone near you is experiencing a heroin overdose, immediately call 911. While waiting for medical help, try to keep them awake and resting so they don’t start choking.

How Is Heroin Dependence Treated?

Heroin addiction treatment requires a comprehensive approach, which tackles all the underlying reasons behind addiction and also offers effective management of the various symptoms and problems that arise due to the use of heroin.

The most effective treatment for heroin addiction will begin with an individual action plan, which considers a person’s health condition, potentially co-occurring conditions, the severity of the addiction, and other essential factors to craft a personalised treatment strategy.

Heroin dependence treatment begins with a detox, preferably in an inpatient programme, due to the highly addictive nature of heroin, which can cause intense withdrawal symptoms that qualified medical professionals must manage.

Happening simultaneously with the heroin detox and continuing after that, individual, family, group and various other forms of therapy will be required to improve mental health and address the hidden reasons behind addiction.

Although treatment can end once the inpatient programme is over, many people choose to enrol on an aftercare programme. Stepping back into the real world can be a frightening experience, which is why an aftercare programme can maintain individual therapy sessions for both emotional support and practical guidance, help in the finding of community initiatives for addicts, and maintain a strong sense of accountability.

Is There Such Thing as Heroin Abuse?

Very often, the terms addiction and substance abuse are used interchangeably. Substance abuse is when a person misuses a prescription for a medicine and uses the substance in an unintended way. For example, using a much higher dose of painkillers than prescribed.

Following that definition, if you spot the term heroin abuse, it likely refers to heroin addiction or to somebody who used the drug recreationally but developed intense cravings and a dependence on the substance.


  • Chalana, Harsh, et al. “Predictors of Relapse after Inpatient Opioid Detoxification during 1-Year Follow-Up.” Journal of Addiction, U.S. National Library of Medicine, 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5046044/.
  • K;, Smyth BP;Barry J;Keenan E;Ducray. “Lapse and Relapse Following Inpatient Treatment of Opiate Dependence.” Irish Medical Journal, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/20669601/.
  • “What Are the Long-Term Effects of Heroin Use?” National Institutes of Health, U.S. Department of Health and Human Services, 13 Apr. 2021, https://nida.nih.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use.
Paul Spanjar, CEO

Paul is passionate about high-quality addiction treatment and truly believes that, with the right treatment, anyone can recover.

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