Heroin Needle: Identifying A Heroin Syringe

Medically Reviewed by Johnelle Smith, M.D. on March 15, 2021

Possessing needles and syringes can be a sign of heroin use. Injection is the most common way people use heroin. Injecting heroin can cause a range of acute and long-term health consequences that may require medical and behavioral health treatment.

How To Identify A Heroin Needle

Heroin is a highly addictive drug that can cause a fast but short-lived high when injected into the veins (intravenous), muscles (intramuscular), or under the skin (“skin popping”).

Although heroin can also be snorted or smoked, shooting heroin is the most common way that heroin is used, especially among people aged 35 and older.

Drug paraphernalia associated with heroin injection includes:

  • heroin needles
  • heroin syringes
  • heroin spoons
  • heat source (e.g. lighter, match, candle)

Identifying drug paraphernalia in the possession of a family member or loved one can be one of the first warning signs of heroin addiction. Addiction to heroin can be treated in an inpatient or outpatient substance abuse program.

Identifying A Heroin Needle

Not all needles and syringes used to inject heroin are the same. Needles can vary in size and brand. The gauge of the needle may indicate the injection site and how a person injects heroin.

Heroin can be injected into the muscles (intramuscular), veins (intravenous), or under the skin (“skin popping”) for surface-level injection.

Types And Sizes Of Heroin Needles

According to the Harm Reduction Coalition, most people who inject heroin intravenously use either a standard insulin set (27G or 28G with an orange cap) or a standard tuberculin set (25G with a blue tip).

Higher-Gauge Needles

These are thinner in size. This may be preferable for people planning to inject into delicate veins, such as those in the hands.


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People who shoot heroin intramuscularly may use higher gauge needles than those who inject into the vein.

Smaller-Gauge Needles

Smaller-gauge needles may cause less bleeding and a smaller puncture wound. Sharing needles and syringes is one of the leading unsafe injection practices.

Sharing injection supplies carries a risk of transmitting infectious diseases such as HIV, hepatitis C, and hepatitis B.

What Other Paraphernalia Might Someone Have?

Needles aren’t the only sign of heroin injection. Heroin needles will likely be attached, or close in proximity to, a syringe or other form of applicator.

Injecting drug users may possess supplies, also known as “the works,” for sanitizing needles, dressing wounds, or tying off the arm for injection.

People who inject drugs like heroin may possess:

  • syringes
  • lighters
  • matches
  • heroin spoons
  • shoe-laces
  • rubber tubing
  • cotton balls
  • cigarette filters
  • antiseptic or alcohol pads

Injection drug use can involve a range of drug paraphernalia for the purpose of preparing heroin for injection and filtering the impurities from the heroin prior to injection.

What Are The Dangers Of Injecting Heroin?

The practice of shooting heroin is associated with a wide range of consequences on physical health, mental health, and general well-being.

Heroin injection is a risk factor for:

  • heroin overdose
  • infectious diseases
  • abscesses
  • collapsed veins
  • damaged blood vessels
  • drug-induced mood disorders
  • wound botulism
  • dependence and withdrawal symptoms

Injecting Heroin Increases Risk For Overdose

Life-threatening overdose and addiction are primary concerns surrounding injection drug use.

Heroin overdose may be treated quickly with the drug naloxone (Narcan), but without treatment, may lead to fatal drug overdose if someone has taken too much heroin or has taken heroin laced with other drugs.

Heroin IV Use Increases Risk For Addiction And Dependence

Injection drug users are also more likely to struggle with drug dependence and addiction.

Once addicted, it can be difficult to stop using heroin without receiving addiction treatment through a behavioral healthcare provider.

Treatment Options For Heroin Addiction

Drug addiction affects the lives of millions of individuals and families in the United States. Overcoming an addiction to drugs like heroin can take time, but is possible with the right treatment.

Treatment programs for heroin addiction may offer medically assisted detox, medications for opioid use disorder, and behavioral therapy.

These treatments can address the physical, mental, and psychological effects of living with addiction and can help prevent relapse.

If you or a loved one is injecting heroin, Addiction Resource may be able to help you find treatment.

Call our helpline today to learn more about available treatment options for heroin addiction and how to find treatment near you.

This page does not provide medical advice. See more

Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.

These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

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Medically Reviewed by
Johnelle Smith, M.D. on March 15, 2021


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