Heroin Addiction — Abuse And Treatment Options

Medically Reviewed by Johnelle Smith, M.D. on May 11, 2021

Heroin is an illicit drug that can become addictive with regular use. Heroin addiction can be treated through a drug rehab program with counseling, medication, and behavioral therapy.

Heroin Addiction, Abuse, And Treatment Options

Heroin is an illicit drug that is involved in thousands of fatal drug overdoses each year. When taken, it can provide a rush of euphoria, calmness, and relaxation.

Heroin can be very addictive. With treatment, overcoming heroin addiction is possible. Here you can find information about heroin abuse, addiction, and treatment.

What Is Heroin?

Heroin is an illicit opioid drug that works by depressing the central nervous system. It is derived in part from morphine, a natural opiate that is capable of relieving moderate to severe pain.

Heroin can come in the form of:

  • dark tar (black tar heroin)
  • brown powder
  • white powder

Not all heroin is the same. The appearance, smell, and taste of heroin can differ depending on how refined it is, cutting agents, and chemicals encountered during the manufacturing process.

What Does Heroin Do?

Heroin is a fast-acting drug that can slow down breathing, heart rate, and cause drowsiness. It’s most widely known for its ability to cause a rush of pleasure and relaxation almost instantly.

Ways To Use Heroin

Heroin can be used in multiple ways, depending on the form it comes in.

Heroin can be used by:

Shooting heroin, or injecting it, is the most common method of heroin use. This provides a near-instant rush.

How Is Heroin Made?

Heroin comes from morphine, which is a naturally occurring substance that comes from the opium poppy plant, also known as the “heroin plant”.

Morphine, which is extracted from the seed pods of the poppy plant, can be further processed with certain chemicals to create heroin.

Through the manufacturing and distribution processes, heroin is often cut with other adulterants, also known as heroin cutting agents, which can dilute its purity.

Types Of Heroin

Heroin can be found in multiple different forms. This includes forms of heroin that are more or less refined, as well as heroin mixed with other drugs.

Common types of heroin include:

  • black tar heroin: a crude form of heroin that can be sticky like tar or hard like a rock
  • brown powder: powder heroin that has been further processed from black tar
  • china white heroin: heroin in its white powder form
  • pure heroin: a shiny, white powder form of heroin
  • cheese heroin: heroin mixed with crushed Tylenol PM tablets
  • blue heroin: heroin mixed with fentanyl
  • synthetic heroin: refers to synthetic opioids life carfentanil, fentanyl, and methadone

In addition to various forms of heroin, there are also street names for drugs that misleadingly do not contain heroin, including pink heroin and hillbilly heroin.

Where Does Heroin Come From?

Heroin comes from opium poppy plants, which are grown across the world. Most of the heroin in the United States comes from Latin American countries, such as Mexico.

Side Effects Of Heroin

Heroin is a powerful drug. It can produce a number of physical and cognitive side effects, as a result of how it interacts with the body’s opioid receptors and central nervous system.

Read more about the side effects of heroin

Short-Term Effects

Heroin can produce a number of short-term side effects, including euphoria, dry mouth, nausea, and reductions in heart rate, blood pressure, and breathing rate.

Short-term effects of heroin also include heaviness of the limbs, flushed skin, as well as uncomfortable symptoms such as severe itching, cloudy thinking, and vomiting.

Long-Term Effects

Research shows that chronic heroin use, or prolonged heroin use, can have long-lasting effects physically, mentally, and emotionally.

These long-term effects can include:

  • increased tolerance
  • drug dependence
  • psychological addiction
  • liver and kidney disease
  • sexual dysfunction
  • irregular menstrual cycle
  • changes in brain structure
  • heart infection
  • insomnia

Additional long-term effects of heroin can also develop depending on the method of use—that is, from chronic injection, insufflation, plugging, or smoking.

Effects Of Heroin On The Brain And Body

All drugs, including heroin, interact with chemicals in the brain. Heroin can have both acute and long-term effects on the brain and body, some of which can be visible.

Physical Effects Of Heroin On The Body

The ways heroin affects the body can become apparent to those around people who use heroin.

When injected, heroin use can leave behind track marks, scarring, and bruises. People who smoke heroin may have cracked or burned lips, or burn marks on their fingers.

Another common sign of heroin use is falling in and out of consciousness, which is sometimes referred to as “going on the nod” or the heroin nod side effect.

Effects Of Heroin On The Brain

Once heroin enters the brain, it is converted to the naturally occurring substance, morphine, which binds to opioid receptors that are associated with the brain’s pleasure and reward center.

Opioids like heroin can alter activity in the limbic system, which may reinforce compulsive drug-taking behavior.

Dangers Of Heroin Use

Heroin can have dangerous effects on physical and mental health. It can also affect behavior and decision-making in a way that can put a person at risk for involvement in dangerous situations.

Dangers of heroin use include:

  • increased risk of disease (e.g. HIV)
  • psychological addiction
  • respiratory depression
  • overdose

Heroin can become particularly dangerous if it’s mixed with other drugs, including other opioids, benzodiazepines, or illicit stimulants such as cocaine and meth. This can lead to overdose.

Heroin Overdose: Signs And Symptoms

Overdose is a condition that develops when a person takes too much of one or more drugs at once. This has the potential to lead to life-threatening heroin overdose symptoms.

Signs and symptoms of a heroin overdose can include:

  • very shallow or slow breathing
  • difficulty breathing
  • stopped breathing
  • cold, clammy skin
  • bluish skin and lips
  • weak pulse
  • unresponsiveness
  • gurgling sounds
  • seizures
  • unconsciousness
  • pinpoint pupils (“heroin eyes”)

Overdose can be non-fatal if treated very quickly. People who overdose on heroin can be treated with naloxone (Narcan), which is a drug capable of blocking the effects of heroin in the brain.

Heroin Dependence And Addiction

Taking heroin regularly can cause physical dependence and addiction. This state is clinically diagnosed as heroin use disorder or opioid use disorder.

Physical dependence is when the body becomes physically reliant on heroin. Going without heroin for a few hours, once dependent, could lead to uncomfortable withdrawal symptoms.

A heroin addiction is defined as a chronic, relapsing condition in which a person can feel both physically and psychologically dependent on heroin.

Heroin Withdrawal

Withdrawal is a condition that develops if someone who is physically dependent on a drug tries to stop taking it too quickly. This can trigger physical and psychological symptoms.

Heroin withdrawal symptoms are not typically life-threatening. But they can be highly uncomfortable and may drive a person to relapse in the absence of professional medical support.

Heroin And Co-Occurring Disorders

Heroin use is much more common in people who have another type of mental health condition or substance use disorder than those without. This is known as having co-occurring disorders.

People with a heroin use disorder may also have a personality disorder, mood disorder, psychotic disorder, eating disorder, or a history of trauma.

Heroin And Polysubstance Abuse

Polysubstance abuse occurs when an individual combines two or more different drugs. Combining heroin with other substances can lead to worsened or even life-threatening side effects.

Oftentimes, people abuse heroin, a depressant, with a stimulant drug in order to counteract some of its depressing effects. One of the most common combinations is mixing heroin and cocaine, known as a speedball. This particular combination is extremely dangerous as these drugs have opposite effects on the body and can lead to respiratory failure, overdose, and death.

Learn more about the dangers of heroin and polysubstance abuse below:

Why Do People Use Heroin?

One of the most common questions asked about heroin use is: why do people do it?

The answer to this isn’t simple, nor does it apply to everyone. For many people, heroin is used for pain relief, in the absence of another strong enough painkiller.

Heroin is also commonly used for its euphoric effects, which can make a person feel happy and relaxed. For some, heroin can be used as a way to numb, escape, or cope with life stress.

Signs Of Heroin Use

Heroin use can be identified by its effects on the body, mood, and behavior. People who use heroin may experience disruptions to sleep, appetite, work, and ability to concentrate.

Heroin use can make a person act in ways that are uncharacteristic. This is largely due to its effects on the brain, which can influence a person’s thoughts, feelings, urges, and actions.

Read more about the signs of heroin use and abuse

Heroin Addiction: Signs And Symptoms

Heroin addiction is a serious issue that can affect a person’s behavior, physical appearance, mood, and mental health.

This can be identified by a number of common signs and symptoms, with the primary sign being an inability to reduce or stop using heroin.

Heroin addiction symptoms might include:

  • constantly thinking about or trying to get more heroin
  • increasing the amount or frequency of heroin use
  • experiencing cravings for heroin
  • neglecting work, school, or relationships with others in order to use heroin
  • continuing to use heroin despite negative effects on health
  • physical changes (e.g. unexplained weight loss)
  • increased anxiety or depression

Heroin Paraphernalia

One sign of heroin use that can be identified by loved ones is the possession of heroin paraphernalia. This refers to various supplies that are used to ingest heroin.

Common forms of heroin paraphernalia include:

Needles and syringes are standard injection drug use supplies. Pipes and spoons may be used to heat heroin and inhale or smoke its vapors.

How Long Does Heroin Stay In Your System?

Heroin has a short half-life, meaning it is processed and eliminated from the bloodstream fairly quickly. It can remain in blood for up to six hours, or urine for one to three days.

This timeframe for heroin detection times may vary depending on the amount used, frequency of use, the use of multiple drugs, or personal factors such as age and body fat percentage.

Heroin Addiction Statistics And Facts

Data on heroin use and addiction in the United States is collected annually.

According to the latest data on heroin use in the United States:

  • In 2019, about 745,000 people in the United States reported using heroin.
  • More than 400,000 people have a heroin use disorder, also known as heroin dependence or addiction.
  • More than 14,000 people died of a drug overdose involving heroin in 2019.
  • From 2010 to 2017, the number of heroin overdoses increased 400 percent nationwide.
  • Heroin is about twice as potent as morphine.
  • Street forms of heroin are increasingly found to be laced with fentanyl, which is a highly potent opioid that can have lethal effects even in small doses.
  • About 80 percent of people who use heroin first took prescription opioids.

Treatment For Heroin Addiction

Millions of people seek some form of substance use treatment each year. Even still, researchers estimate that only a small fraction of people who need treatment go on to receive it.

Heroin addiction can be treated in an addiction treatment center, or on an outpatient basis through a rehab clinic or with an outpatient treatment team.

Treatment programs for heroin addiction include:

  • detox programs
  • inpatient rehab
  • residential rehab
  • dual diagnosis rehab
  • medication-assisted treatment
  • outpatient treatment

The first step of the treatment process will likely require detox. After this, an inpatient or residential rehab program for 24-hour support and supervision is highly recommended.


Detoxification, or detox, is a process of allowing heroin to leave the body. This may trigger symptoms of withdrawal, such as drug cravings, vomiting, and diarrhea.

Detoxing from heroin can last five to seven days. Within a detox program, heroin withdrawal symptoms can be treated with medication and fluids.

Medication-Assisted Treatment

Medication-assisted treatment is a type of treatment that combines the use of medications for opioid use disorder with behavioral therapy.

This is the most effective treatment for opioid addiction and has shown to reduce the risk of relapse, overdose, and improve quality of life.

Medications for opioid use disorder include:

  • methadone
  • buprenorphine
  • naltrexone (Vivitrol)
  • Suboxone (buprenorphine and naloxone)

Medication-assisted treatment can be short-term or long-term, depending on a person’s needs. This is offered by outpatient clinics and within some inpatient treatment programs.

Behavioral Therapy

Behavioral therapies are helpful for addressing the thoughts, emotions, and actions related to drug addiction. Generally, this involves talk therapy, as well as therapeutic assignments.

Common behavioral therapies include:

  • cognitive behavioral therapy (CBT)
  • dialectical behavioral therapy (CBT)
  • contingency management

Group Therapy

Group therapy is a fundamental component of many addiction treatment programs. Group therapy can be skill-based, educational, or allow for an open process of thoughts and emotions.

Dual Diagnosis

Dual diagnosis treatment is highly recommended for people who have co-occurring disorders, such as anxiety disorder, depression, eating disorders, or post-traumatic stress disorder (PTSD).

Dual diagnosis treatment may incorporate psychiatric services, medication, and mental health counseling in addition to standard substance use treatment services.

Heroin Frequently Asked Questions (FAQs)

Having questions about heroin and heroin addiction is common. For answers to some of the most frequently asked questions regarding heroin, visit our Heroin FAQs page.

Yes. Recovery isn’t easy, but it is possible. This is not a quick process, but with time, treatment, and a strong support system, recovery can become a reality.

The cost of heroin can vary by a number of factors, such as the type and amount of heroin, as well as the region where heroin is being sold.

When a person uses heroin, they experience an immediate onset of effects, commonly referred to as a “rush”.

This includes feelings of euphoria, well-being, and relaxation.

Read more about what a heroin high feels like

Street names for heroin may vary by the type of heroin someone is referring to, as well as the location where the drug is being bought or sold.

Some heroin street names include dope, tar, and smack.

Heroin affects the pupils, a condition known as heroin eyes, causing them to turn into pinpoints.

Heroin is classified as an opioid drug, which is a depressant.

Call Today To Find Heroin Addiction Treatment

If you or a loved one is addicted to heroin, we can help you find an addiction treatment center that’s right for you. There are many available treatment options.

Don’t wait. Call our helpline today to find heroin addiction treatment near you.

This page does not provide medical advice. See more

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Medically Reviewed by
Johnelle Smith, M.D. on May 11, 2021

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