Heroin Addiction: Symptoms, Causes, Effects and Treatment

Heroin addiction is a disorder that involves the repeated use of the illegal opioid heroin, leading to strong cravings and physical dependence. It includes a cycle of intense highs, withdrawal symptoms, and continued use despite serious health and life problems. According the the DEA.gov, the top four states with the most heroin reports were New Jersey, New York, Ohio, and Pennsylvania with New York being considered the largest heroin market in the world.

The main symptoms of heroin addiction are intense cravings, uncontrollable use, mental health problems, neglect of personal responsibilities, and withdrawal symptoms like nausea and shaking.

Main causes of heroin addiction include genetic factors, biological factors, environmental factors, social influence, and psychological triggers. Heroin addiction can lead to several negative effects, including physical health, mental health, social, economic, and legal problems.

Main treatment options for heroin addiction include behavioral therapies and counseling, medications, detoxification and withdrawal management, support groups, and rehab centers.

What is Heroin Addiction?

Heroin addiction is a severe form of a substance use disorder, defined by an uncontrollable urge to use heroin despite harmful physical, emotional, and social effects, according to André Schmidt and Stefan Borgwardt in their study “Impaired Cognition Control and Inferior Frontal Cortex Modulation in Heroin Addiction.”

Heroin is an opioid drug made from morphine, which binds to opioid receptors in the brain and gives feelings of euphoria and pain relief. Repeated use of heroin leads to physical dependence and addiction as the brain becomes addicted to the drug to function.

Heroin is available in various forms, including “white powder heroin”, “brown powder heroin”, and “black tar” heroin, a dark and sticky substance. No matter what form you consume, heroin always gives a euphoric high with intense relaxation and a feeling of warmth and well-being. However, prolonged use can cause significant damage to the brain and body.

Take a quick 12 question assessment to see if you are addicted to heroin

How Common is Heroin Addiction?

Heroin addiction continues to be a significant public health concern in the United States and globally. In 2021, approximately 0.4% of individuals aged 12 or older, or about 1.1 million people, reported using heroin within the past 12 months, according to the National Survey on Drug Use and Health. According to the United Nations Office on Drugs and Crime (UNODC), around 13.5 million people worldwide use opium-like drugs, with approximately 9.2 million using heroin.

The National Institute on Drug Abuse highlights that in 2022, around 0.3% of 8th graders, 0.2% of 10th graders, and 0.3% of 12th graders indicated they had used heroin at least once in the past year. The same source tells that an estimated 0.4% of individuals aged 12 or older, or roughly 1.0 million people, experienced a heroin use disorder in 2021.

The number of heroin overdose deaths has also significantly increased over the past decades. In 2022, there were 107,941 drug overdose deaths in the U.S., with an age-adjusted rate of 32.6 deaths per 100,000 people, according to the National Center for Health Statistics. This rate has increased since 2002, when it was 8.2, but remained relatively stable between 2021 and 2022. Over the same period, the overdose death rate for males slightly increased by 1.1%, while the rate for females dropped by 1.0%. 

Statistics and Trends:

• In 2007, 93% of the world’s opium used to make heroin came from Afghanistan, according to a study by Dyer, Owen, in the Senlis Council report.
• The SAMHSA 2020 National Survey on Drug Use and Health reported that 153,000 people were using heroin in the U.S.
• In Europe, four out of five drug-related deaths in 2008 were linked to opiate drugs, mainly heroin.
• In the U.S., around 18% of individuals receiving treatment for drug and alcohol problems in 2018 were there due to opiates like heroin, as reported by the United Nations Office on Drugs and Crime.
• In 2019, an estimated 745,000 people aged 12 or older in the U.S. reported using heroin, with about 136,000 new users that year, indicating a decrease from previous years.
• The age group with the highest rate of heroin use in 2019 was young adults aged 18 to 25.
• Approximately 10% of people who use heroin develop an addiction.
• Heroin-related overdose deaths have been on the rise, with over 14,000 heroin-involved overdose deaths in the U.S. in 2019.
• Many people who misuse prescription opioids often transition to heroin use. About 80% of heroin users reported misusing prescription opioids before using heroin, according to the National Institute on Drug Abuse (NIDA).

What are the Signs & Symptoms of Heroin Addiction?

The signs of heroin addiction include a combination of physical, behavioral, and psychological symptoms.

These signs and symptoms of heroin addiction are listed below.

What are the Physical Signs of Heroin Addiction?

The physical signs of heroin addiction, according to Medical News, are listed below.

• Drowsiness
• Slurred speech
• Weight loss
• Frequent scratching or picking of the skin
• Runny noses
• Small pupils
• Nausea & vomiting

What are the Behavioral Signs of Heroin Addiction?

The behavioral signs of heroin addiction, according to Medical News, are listed below.

• Neglect of responsibilities
• Being secretive
• Hiding your heroin consumption
• Financial problems
• Changes in sleep patterns
• Withdrawal from social activities

What are the Psychological Signs of Heroin Addiction?

The psychological signs of heroin addiction, according to Medical News, are listed below.

• Mood swings
• Intense cravings
• Anxiety, depression, or paranoia
• Cognitive problems
• Lack of motivation
• Suicidal thoughts
• Psychotic symptoms

What are the Causes of Heroin Addiction?

The causes of heroin addiction include genetic factors, biological factors, environmental factors, social influence, and psychological triggers.

These causes of heroin addiction are listed below.

• Genetic Factors: Genetic factors play a significant role in the risk of developing heroin addiction. Individuals with a family history of substance abuse are more likely to become addicted themselves, according to Kenneth S. Kendler and Henrik Ohlsson in their study “Genetic and Familial Environmental Influences on the Risk for Drug Abuse.”
• Biological Factors: Heroin addiction is influenced by biological factors, including changes in brain chemistry and structure. Heroin alters neurotransmitter systems related to dopamine, which affects pleasure and reward pathways and increases the risk of addiction, according to a study by the National Institutes of Health.
• Environmental Factors: Environmental influences such as exposure to drug use in the home or social lives can increase the likelihood of heroin addiction. Research by Kenneth S. Kendler highlights that living in an environment where drug use is normalized or prevalent can make you more vulnerable to addiction.
• Social Influence: Social influence and peer pressure significantly impact heroin use, specifically for teenagers and young adults. They are more prone to interacting and experimenting with opioids if they are in environments where drug use is common among friends and family, according to the National Library of Medicine.
• Psychological Factors: Psychological factors such as trauma, mental illness, or stress can trigger heroin use as a coping mechanism. Individuals with underlying mental health conditions may use heroin and other drugs like cocaine to self-medicate and alleviate symptoms of depression or anxiety, according to Katherine M Harris and Mark J Edlund in their study Self-Medication of Mental Health Problems: New Evidence from a National Survey.

What are the Effects of Heroin Addiction?

Heroin addiction shows various physical health, mental health, social, economic, legal, and extremely negative effects.

These effects are described below.

Physical Health Effects

The physical health effects of heroin addiction include respiratory issues, cardiovascular problems, gastrointestinal issues, weakened immune system, organ damage, and malnutrition.

These physical health side effects of heroin addiction are listed below.

• Respiratory Issues: Heroine consumption significantly affects the respiratory system, leading to slow or irregular breathing. Chronic use can cause respiratory failure, and in severe cases, overdose can result in death due to respiratory arrest, according to JM White and RJ Irvine in their study “Mechanisms of fatal opioid overdose.”
• Cardiovascular Problems: Heroin use increases the risk of cardiovascular complications such as collapsed veins, infections of the heart lining, and blood clots. Long-term intravenous and compulsive use can lead to damage to blood vessels and cardiovascular diseases, according to the National Institute on Drug Abuse.
• Gastrointestinal Issues: Heroin addiction can cause severe constipation and other gastrointestinal problems due to its effects on the opioid receptors in the gut, leading to bowel dysfunction, according to Michael Camilleri in the study “Opioid-induced constipation: challenges and therapeutic opportunities.”
• Weakened Immune System: Prolonged heroin use weakens the immune system, making individuals more prone to infections and diseases. This is more common for those who inject heroin, as they face a higher risk of bloodborne infections like HIV and hepatitis, according to the National Institute on Drug Abuse.
• Organ Damage: Chronic and compulsive heroin use can lead to long-term damage to vital organs such as the liver and kidneys. This can eventually lead to liver or kidney failure, according to the National Institutes of Health.
• Malnutrition: Heroin affects appetite, and individuals don’t consume the required amount of calories, leading to poor nutrition and significant weight loss. Over time, this malnutrition weakens the body, leading to a range of health complications like anorexia and anemia, according to F J Santolaria-Fernández and  J L Gómez-Sirvent in their study “Nutritional assessment of drug addicts.”

Mental Health Effects

The mental health effects of heroin addiction include anxiety or depression, cognitive problems, insomnia, mood swings, and emotional numbness.

These mental health effects are listed below.

• Anxiety or Depression: Heroin use can significantly disturb the brain’s reward system, especially when you are not using the drug. This can lead to mental health issues, such as anxiety or depression, according to Christina Marel and Jack Wilson in their study “Patterns and Predictors of Heroin Use, Remission, and Psychiatric Health Among People with Heroin Dependence: Key Findings from the 18–20-Year Follow-Up of the Australian Treatment Outcome Study.”
• Cognitive Problems: Long-term heroin use can impair thinking, memory, and decision-making abilities. This cognitive disturbance occurs because heroin changes the brain’s structure and how it functions, particularly in areas responsible for learning and memory, according to Karen D. Ersche and Luke Clark in their study “Profile of Executive and Memory Function Associated with Amphetamine and Opiate Dependence.”
• Insomnia: Many people who use heroin struggle with sleep disorders like insomnia. The drug disrupts natural sleep patterns, making it hard to fall or stay asleep, which can lead to chronic fatigue and worsen mental health, according to the National Institutes of Health.
• Mood Swings: Heroin can cause extreme highs and lows (mood swings) in a person’s mood. People may feel intense euphoria when using, followed by deep sadness, anger, or irritability during withdrawal or when the effects wear off, according to Julia Blum and Hana Gerber in their paper “Acute effects of heroin on emotions in heroin-dependent patients.”
• Emotional Numbness: Regular and compulsive heroin use can make people emotionally numb. The drug suppresses their ability to feel pleasure, happiness, sadness, or other emotions. This emotional numbness can distance heroin addicts from their relationships.

Social Effects

The social effects of heroin addiction include strained relationships and social isolation.

These social side effects of heroin addiction are listed below.

• Strained Relationships: Heroin addiction can damage relationships with family, friends, and partners. The behavior of addicts with substance use disorders, such as lying, stealing, or neglecting responsibilities, creates mistrust and emotional distance, according to the National Library of Medicine.
• Social Isolation: Individuals with heroin addiction tend to withdraw from social circles and activities they once enjoyed. Heroin use can lead to feelings of shame or guilt, making addicts avoid contact with friends and family. Over time, this isolation increases, making it difficult for them to engage with society, according to the study “The role of social isolation in opioid addiction.”

Economic Effects

The economic effects of heroin addiction include job loss and financial strain.

These economic effects are listed below.

• Job Loss: Heroin addiction can impact your work performance due to the lack of focus and the trip of the drug. This leads to job loss and unemployment, as employers still consider heroin addiction a stigma, according to a study, “Income Generation, Heroin Use and Economic Uncertainty in 21st Century Detroit.”
• Financial Strain: Financial strain refers to issues like financial instability, debts, depletion of personal savings, and bankruptcy. These issues arise because of job loss, medical expenses for overdose treatment, rehabilitation, and legal fees.

Legal Effects

The legal effects of heroin addiction are arrest or imprisonment and custody loss.

These legal effects are listed below.

• Arrest or Imprisonment: Heroin addiction can lead to criminal behavior, such as possession or theft, further leading to arrest and imprisonment. These legal problems can disturb careers and bring additional financial burdens, including court fees and legal costs.
• Custody Loss: Heroin addiction can impair the ability to care for their children, potentially leading to custody loss. Legal battles for child custody can lead to significant financial strain and emotional distress. 

Extreme Negative Effects

The extreme negative effects of heroin addiction include homelessness and the risk of overdose and death.

These extremely negative effects are listed below.

Risk of Overdose and Death: One of the most severe consequences of heroin addiction is the risk of overdose, which can lead to death. Heroin’s potency is unpredictable, and users often underestimate the dose, leading to respiratory failure. The US has reported approximately 14,000 deaths because of heroin overdose, according to statistics by the National Institute on Drug Abuse.

Homelessness: Heroin addiction can lead to financial instability, loss of employment, and fractured relationships, ultimately leading to homelessness. Addicts often find it difficult to maintain housing due to the high cost of their addiction and lack of steady income. A US-based study found that a significant percentage of the homeless population struggles with substance use disorders, with heroin being a common drug of abuse.

What are the Treatment Options for Heroin Addiction?

The treatment options for heroin addiction include behavioral therapies and counseling, medications, detoxification and withdrawal management, support groups, and rehab centers.

These treatment options are described below.

• Behavioral Therapies and Counseling: Behavioral therapies, like cognitive-behavioral therapy (CBT), help patients identify and change harmful thoughts and behaviors associated with heroin and other drug addictions, according to the National Institutes of Health. Similarly, counseling with medical professionals provides emotional support and guidance during recovery. The recovery time with behavioral therapies and counseling varies but may take several months.
• Medications: Medications like methadone, buprenorphine, and naltrexone are ideal for managing heroin cravings and withdrawal symptoms, according to the National Institute on Drug Abuse. However, medications come with side effects and can take several months to a year to show results.
• Detoxification and Withdrawal Management: Detoxification is the process of eliminating heroin from the body, usually under medical supervision. It typically lasts 5 to 7 days, depending on the severity of addiction. Detoxification is a safe and controlled technique for withdrawal management. However,  it does not address the underlying causes of addiction.
• Support Groups: Support groups like Narcotics Anonymous (NA) in the US provide emotional support and a sense of community to help heroin addicts stay clean. However, the recovery process of support groups can last for years, and it’s usually combined with counseling and medication.
• Rehab Centers: Rehab centers offer treatment in a structured environment with 24/7 care, including medical, psychological, and social support. This treatment option is specifically for people with a high level of heroin addiction and co-occurring mental and health issues. Addicts are admitted to rehab centers for 30 – 90 days, depending on their condition. However, rehab centers can be expensive and require a complete cut-off from the outside world.

What Is The Importance of Support System For Heroin Addicts To Maintain Long term Sobriety?

Support systems play a pivotal role in the journey of overcoming heroin addiction, providing crucial emotional, practical, and motivational assistance. These systems, which can include family, friends, therapists, support groups, and healthcare professionals, offer a network of understanding, encouragement, and accountability. They help individuals navigate the challenges of withdrawal, cravings, and relapse by offering a safe space to share experiences and insights. A strong support system can instill hope, boost self-esteem, and reinforce the commitment to recovery, ultimately enhancing the chances of successfully overcoming heroin addiction and maintaining long-term sobriety.

What Are The Harm Reduction Strategies For Heroin Addiction?

Harm reduction strategies for heroin addiction aim to minimize the negative consequences of drug use, improve health outcomes, and reduce the risk of overdose. Two key approaches are needle exchange programs and medication-assisted treatment (MAT). Needle exchange programs provide clean needles to reduce the transmission of infections like HIV and hepatitis C and offer education on safer practices and healthcare access. MAT uses FDA-approved medications such as methadone, buprenorphine, and naltrexone, along with counseling, to reduce cravings and withdrawal symptoms, helping individuals stabilize and focus on recovery. These harm reduction strategies have been shown to improve treatment retention, reduce illicit drug use, and lower overdose risks.

Where to Get Treatment for Heroin Addiction?

Heroin addiction is a complex medical condition that affects individuals, families, and communities. Recovery is possible with comprehensive treatment, support, and understanding.

Key Steps in Heroin Addiction Treatment:

1. Seek Help Early: Early intervention increases the chances of successful recovery.
2. Access Evidence-Based Treatments: Utilize treatments that have been proven effective in managing addiction.
3. Address All Aspects of Addiction: Focus on the physical, psychological, and social components of addiction.

Where to Find Treatment:

• Government-Funded Facilities: Information on these can be found on the SAMHSA website.
• Local Treatment Centers: For example, Valley Spring Recovery Center offers specialized heroin addiction treatment in New Jersey.

With the right interventions, a strong support network, and a commitment to change, recovery from heroin addiction is achievable. Seeking help early and accessing appropriate treatments are essential steps towards a healthier, more fulfilling life.

What are the Withdrawal Symptoms of Heroin Addiction?

The withdrawal symptoms of heroin addiction include muscle aches, sweating, nausea or vomiting, restlessness, insomnia, intense cravings, diarrhea, and rapid heartbeat.

These withdrawal symptoms are listed below.

• Muscle Aches: Muscle aches and joint pain are common during withdrawal, making the body feel sore and stiff.
• Sweating: Excessive sweating occurs during heroin withdrawal as the body struggles to regulate its temperature.
• Nausea or Vomiting: Intense nausea and vomiting are common and frequent symptoms due to the body’s reaction to the absence of heroin.
• Restlessness: Restlessness refers to the inability to relax, with heroin addicts feeling anxious and jumpy.
• Insomnia: Insomnia refers to difficulty sleeping or staying asleep, sometimes lasting for weeks during withdrawal.
• Intense Cravings: Intense cravings are strong urges to use heroin, driven by both physical and mental dependence.
• Diarrhea: The digestive system becomes unstable during heroin withdrawal, often leading to bouts of diarrhea.
• Rapid Heartbeat: As the body undergoes withdrawal, the heart rate can increase, contributing to feelings of anxiety.

How to Prevent Heroin Addiction Relapse?

To prevent heroin addiction relapse, you should develop a strong support network, identify triggers, maintain a healthy lifestyle, avoid risky situations, develop new hobbies, seek professional help, and practice mindfulness and stress management.

These strategies are listed below.

• Develop a Strong Support Network: Surround yourself with family, friends, or support groups that offer encouragement and moral help during recovery.
• Identify Triggers: Identify the triggers, such as people, places, or situations that lead to cravings, and work to avoid or manage them.
• Maintain a Healthy Lifestyle: Exercise, eat a balanced diet, and get enough rest to strengthen both physical and mental health.
• Avoid Risky Situations: Avoid risky situations and steer clear of environments or activities where drug use is common, such as certain social events or parties.
• Develop New Hobbies: Engage in new activities or interests, like sports, arts, or volunteering, to fill your time and keep your mind off heroin or other drugs.
• Seek Professional Help: Seek professional help through therapy or counseling sessions to help manage emotional struggles and prevent relapse.
• Practice Mindfulness and Stress Management: Techniques like mindfulness, meditation, and deep breathing exercises can help reduce stress and keep cravings in control.

How is Heroin Addiction Different from Other Addictions?

Heroin addiction is more intense and develops faster compared to other addictions like alcohol or prescription addiction. Individuals can face severe physical and psychological dependence after just a few uses. Withdrawal from heroin is more painful and dangerous, too. While prescriptions and alcohol are socially accepted, heroin is illegal, making its addiction come with significant legal consequences. 

What is the difference between Heroin addiction and Drug addiction?

Heroin addiction is specifically a dependency on heroin, an illegal opioid known for its euphoric effects and severe withdrawal symptoms. On the other hand, drug addiction is a broader term that includes dependence on any substance, whether legal or illegal. Drug addiction can include substances like cocaine, meth, heroin, etc.  While heroin addiction is a type of drug addiction, it often has more intense cravings and severe consequences. Treatment for heroin addiction typically requires medical detox, unlike some other drug addictions.

What is the difference between heroin addiction and prescription opioid addiction?

Heroin addiction involves dependence on heroin, an illegal opioid known for its rapid and intense effects. Prescription opioid addiction refers to the misuse of medications legally prescribed for pain relief, such as oxycodone, hydrocodone, or morphine. While both addictions involve opioids that affect the brain’s reward system similarly, the key differences lie in the legality and source of the substances. Heroin is often more potent and carries a higher risk of overdose due to varying purity levels on the street. Prescription opioids may be perceived as safer because they are medically prescribed, but misuse can lead to addiction and similar health risks as heroin.

What is the difference between heroin addiction and fentanyl addiction?

Both heroin and fentanyl are powerful opioids, but fentanyl is significantly more potent—up to 50 to 100 times stronger than morphine. Heroin addiction involves dependence on heroin, which is illegal and typically injected, snorted, or smoked. Fentanyl addiction can stem from the misuse of prescription fentanyl or exposure to illicitly manufactured fentanyl, which is often mixed with other drugs without the user’s knowledge. Due to fentanyl’s high potency, the risk of overdose is considerably higher compared to heroin. While both addictions are dangerous and require medical treatment, fentanyl addiction poses an increased risk because even a small amount can be lethal.

What is the difference between Heroin addiction and Alcohol addiction?

Heroin addiction involves the compulsive use of heroin, an illegal opioid. On the other hand, alcohol addiction, or alcohol use disorder, develops more gradually and involves a legal substance. Heroin withdrawal symptoms are often more painful and intense compared to alcohol, though alcohol withdrawal can also be life-threatening.

What is the difference between Heroin addiction and Food addiction?

Heroin addiction involves an uncontrollable urge to consume heroin, with intense physical and psychological withdrawal symptoms. On the other hand, food addiction refers to the compulsive consumption of a certain food item. Treatment for heroin addiction involves detox and medication, whereas food addiction is often managed through behavioral therapies.