Heroin Abuse Causes, Addiction Signs, Symptoms & Side Effects

Often times the signs of heroin addiction can be difficult to identify. One of the most important steps in the recovery journey is understanding the signs, symptoms and side effects of barbiturate addiction.

Understanding Heroin Addiction

Learn about heroin and substance abuse

Heroin is a fast-acting, highly addictive drug that is processed from morphine, a legal opioid narcotic. Unlike morphine, heroin is an illegal substance and the most commonly abused drug of the opioid class. Usage of heroin creates a state of relaxation and euphoria for the user that’s caused by the binding of the drug to the body’s endorphin sites. By binding to the body’s natural pain relievers, heroin blocks signals to the brain which in turn blocks an individual’s ability to feel pain.

Most commonly, heroin is used intravenously by injection with a needle. Other forms of use include smoking, inhalation with a pipe, snorting, or inhalation with the use of a straw.

Immediately after heroin is injected, it crosses the blood-brain barrier, where it is converted into morphine and binds to opioid receptors. Once consumed heroin is said to create a surge of pleasurable sensations, which is referred to as a “rush” or “high.” The intensity of the rush depends on how much of the drug is taken and how fast it enters the brain. The immediacy with which heroin enters the brain and the resulting “rush” is what makes this drug so addictive.

Heroin is most commonly found in white or brown powder form. Other forms of heroin may include a black sticky substance known as “black tar heroin.” Acquiring heroin on the streets is dangerous because you cannot be sure what it is mixed with or the exact level of purity you are receiving. Often street heroin is mixed with sugar, starch, pesticides, or other poisons which puts heroin users at an increased level of risk for overdose and death. Other common street names for heroin include: “smack,” “thunder,” “poppy,” “white junk,” and “dead on arrival.”


Heroin addiction statistics

It’s estimated that 9.2 million people use heroin worldwide. In 2011, 1.6%, or 4.2 million Americans over the age of twelve had used heroin at least once in their lives. Approximately 23% of people who use heroin later become dependent upon it.

Causes and Risk Factors

Causes and risk factors for heroin addiction

No specific cause to heroin has been identified, but research supports a number of possibilities. These possibilities include:

  • Genetic: Research has suggested genetics as a cause for heroin addiction. Individuals who have family members that are addicted to heroin or other substances appear to be more likely to develop a heroin addiction than those without a family history of the disorder.
  • Biological: Another theory suggests the possibility that some individuals may not produce enough natural endorphins in their brain which has an effect on mood. This could lead to heroin abuse in order to cope with this chemical imbalance.
  • Environmental: It has been postulated that people who have been exposed to a parent or guardian abusing heroin or other drugs may be at a greater risk for developing substance abuse problems in later life. Seeing the drug abused can cause a child to “normalize” the drug, therefore making it more accessible later in life.

Signs and Symptoms

Signs and symptoms of heroin addiction

There are a number of signs and symptoms that may be present in an individual who is abusing heroin. Some symptoms that may be noticeable immediately heroin use include:

  • Sudden changes in behavior
  • Loss of concentration or interest
  • Small pupils
  • Suddenly nodding off
  • Periods of hyper alertness
  • Shortness of breath

As the disease progresses into heroin addiction and dependence the signs and symptoms of heroin use may become more severe. Some more severe symptoms include:

Physical symptoms:

  • Warm flushing of skin
  • Dry mouth
  • Heavy feeling in the extremities
  • Nausea and vomiting

Behavioral symptoms:

  • Pushing loved ones away due to shame or disgust with oneself
  • Argumentative with family and friends
  • Stealing from loved ones or participation in other illegal activities to pay for drug use
  • Wearing long pants and long sleeves even in warm weather (to hide needle marks)
  • Lying or other deceptive behavior
  • Hostile behavior
  • Diminished coordination
  • Loss of interest in activities once enjoyed
  • Severe itching

Psychological symptoms:

  • Rapid shift in way life is prioritized (thoughts entirely focused around drug use)
  • Loss of sense of responsibility
  • Irritability
  • Hostility
  • Depression
  • Anxiety
  • Sleep disturbances such as insomnia
  • Restlessness


Effects of heroin addiction

Heroin addiction and abuse can have major consequence on all aspects of an individual’s life. Effects of heroin use can be physical, psychological, and affect all of your close social relationships. Prolonged heroin use produces tolerance and physical dependence, which causes heroin users to keep abusing this drug. Some of the effects of heroin abuse may include:

  • Social problems
  • Sleep issues
  • Financial problems
  • Adverse health consequences (HIV/AIDS, collapsed veins, infections in the heart, abscesses, Hepatitis C, Tuberculosis)
  • Neglected appearance
  • Work or school problems (being fired or expelled from school)
  • Involuntary commitment to mental hospital
  • Dependence on heroin
  • Suicide
  • Death from overdose or disease

Co-Occurring Disorders

Heroin addiction and co-occurring disorders

Many times individuals who abuse heroin have other co-occurring disorders. Sometimes the presence of this other unaddressed disorder contributes to the heroin abuse and addiction. These co-occurring disorders can often make the treatment and recovery process for heroin abusers more complicated.

Some disorders that may be present with heroin abuse and addiction include:

  • Depression
  • Alcohol abuse
  • Conduct disorder
  • Bipolar disorder
  • Antisocial personality disorder
  • Post-traumatic stress disorder
  • Anxiety disorders
  • Schizophrenia

Effects of Withdrawal

Effects of withdrawal from heroin

After an individual has become physically and psychologically dependent on heroin, once they stop using they begin to go through withdrawal. For individuals who are dependent on heroin, withdrawal symptoms can occur in as little as six to twelve hours after the last dose. They are usually at their most intense within one to three days and then gradually subside over a five to seven day period. However, the more chronic symptoms like anxiety, insomnia, and drug craving last for months. Due to the extreme discomfort of withdrawal symptoms, individuals often relapse.

The negative effects of withdrawal cause significant distress or impairment in an individual’s daily life. Some symptoms include:

  • Anxiety
  • Muscle aches
  • Increased sweating
  • Nausea or vomiting
  • Restlessness
  • Achy feeling
  • Irritability
  • Increased sensitivity to pain
  • Diarrhea
  • Cravings and drug-seeking behavior
  • Suicidal ideations