Signs of Heroin Use

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The signs of someone using heroin become obvious in many different ways.

In the event of someone developing a heroin addiction (clinically termed heroin use disorder or opioid use disorder), loved ones may want to know what signs of heroin use to look out for. Today’s guide outlines the signs of heroin use in men and women.

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Common Signs and Symptoms Someone is Using Heroin

Heroin is an illicit narcotic classified as a schedule I controlled substance. Like all drugs in this class, there are no current medical uses for heroin, and the substances has a strong tendency to trigger abuse and addiction. 

Heroin is a semi-synthetic opioid derived from morphine, a substance that occurs naturally in the pods of opium poppies. 

Heroin comes as one of the following types

  • Off-white powder
  • Brown powder
  • Black paste (Mexican tar)

Heroin enters the brain quickly and binds to opioid receptors. The physical effects of heroin use become almost immediately apparent. Injecting heroin delivers a near-instant feeling of euphoria. Smoking or snorting the substance do not produce such a quick reaction, but the high still comes on within minutes. 

These are the most common signs and symptoms of heroin use:

  • Flu-like symptoms
  • Nausea and vomiting
  • Suddenly losing consciousness
  • Persistently dry mouth
  • Ongoing constipation
  • Track marks on arms
  • Poor personal hygiene
  • Impaired decision-making
  • Memory loss
  • Loss of self-control
  • Disorientation
  • Confusion
  • Slowed breathing
  • Itching the skin
  • Constricted pupils
  • Noticeable weight loss
  • Liver damage
  • Kidney damage
  • Runny nose and watering eyes
  • Memory loss
  • Extreme exhaustion
  • Lethargy
  • Neglected responsibilities
  • Disrupted sleep patterns
  • Pneumonia
  • Hepatitis C
  • Tuberculosis
A n image of a man showing signs of heroin use

Physical Signs of Heroin Use

These are the most reported physical signs of heroin abuse:

  • Track marks or scars
  • Wearing long sleeves
  • Dry mouth
  • Nausea and vomiting
  • Slowed speech
  • Flushed skin
  • Decreased respiration rate
  • Heaviness in arms and legs
  • Increased lung infections
  • Slow movements
  • Constricted pupils
  • Drooping eyelids
  • Constipation

Some people who use heroin experience atypical reactions. These reactions may occur due to contaminated or adulterated heroin. CDC (Centers for Disease Control and Prevention) lists these symptoms as indicative of an atypical reaction: 

  • Episodes of anxiety
  • Palpitations
  • Tremors
  • Shortness of breath
  • Headaches
  • Chest pain

The long-term abuse of heroin can bring about adverse physical effects, such as: 

  • Compromised immune system
  • Brain damage
  • Insomnia
  • Collapsed veins
  • Skin abscesses
  • Respiratory problems
  • Liver disease
  • Increased risk of contracting HIV
  • Higher risk of Hepatitis B and C
  • Increased risk of blood clots and strokes
  • Greater likelihood of overdosing

Track Marks

Heroin track marks clearly indicate intravenous drug use. 

Injecting heroin or any other drug can cause the formation of visible marks known informally as track marks. Track marks form as discolored areas along damages veins in the arms, legs, or hands of intravenous drug users. As veins in the forearm become too scarred or damaged, people often progress to veins in the hands, legs, or feet. 

Track marks may appear as scars, discolored patches, or puncture wounds. They result from repeated injections into the same vein, damaging both the skin and the underlying vein. 

If you use dirty or dull needles, this can increase the risk of developing track marks. 

The main dangers of track marks are:

  • Infection
  • Scars
  • Abscesses
  • Collapsed veins

Some tracks marks will heal, leaving minimal residual scar tissue. In other cases, the damage to skin and veins might be irreversible.

Psychological Signs of Heroin Use

These are the most reported psychological signs of heroin abuse: 

  • Anxiety
  • Episodes of major depression
  • Disorientation
  • Hostility
  • Irritation
  • Agitation and aggression
  • Reduced interest in hobbies and activities
  • Pronounced mood swings
  • Concealing drug use
  • Lying about drug use
  • Social isolation
  • Tolerance
  • Withdrawal
  • Hallucinations
  • Paranoia
  • Cravings

Chronic heroin abuse can permanently damage gray matter in the brain, impairing: 

The sustained abuse of heroin will lead to the development of physical and psychological dependence, a condition that requires medical detox and evidence-based treatment.

view from california detox 30 day inpatient rehab

Heroin Rehab at California Detox

Research shows that MAT (medication-assisted treatment can be effective for reducing the dangers of opioid detox and for improving treatment retention. Additionally, pharmacological interventions for opioid abuse can: 

  • Decrease opioid abuse
  • Reduce criminal activity
  • Minimize transmission of diseases

Our treatment programs for heroin addiction are designed to help you from detox to discharge and beyond. These include: 

  • Inpatient programs (residential rehab)
  • OPs (outpatient programs)
  • IOPs (intensive outpatient programs)
  • Virtual outpatient treatment (remote rehab)
  • PHPs (partial hospitalization programs)
  • Dual diagnosis treatment programs

Detoxing from heroin will take a week or so. Medication-assisted treatment can streamline withdrawal and can also be beneficial during ongoing treatment. In addition to MAT, you can access these interventions at California Detox: 

  • Individual counseling
  • Group therapy
  • Family therapy
  • Psychotherapy (CBT and DBT)
  • Holistic therapies

When you are ready to reclaim your life from heroin addiction, contact admissions at 949.390.5377.


NIDA (National Institute on Drug Abuse) reports that the most common signs of heroin use are: Euphoria, Nausea, Vomiting, Itching, Slowed heart rate, Drowsiness, and Clouded thinking
Puffy hand syndrome, characterized by swollen hands, is an uncommon complication that presents in some chronic intravenous users of heroin.


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