What Are the Signs and Symptoms of Heroin Abuse?
Heroin produces a “downer” effect that rapidly induces a state of relaxation and euphoria (related to chemical changes in the pleasure centers of the brain). Like other opiates, heroin use blocks the brain’s ability to perceive pain. Heroin abusers, particularly those with prior history of drug abuse, may initially be able to conceal signs and symptoms of their heroin use.
Loved ones or co-workers may notice a number of signs of heroin use, which are visible during and after heroin consumption:
- Shortness of breath
- Dry mouth
- Constricted (small) pupils
- Sudden changes in behavior or actions
- Cycles of hyper alertness followed by suddenly nodding off
- Droopy appearance, as if extremities are heavy
The above signs are not unique to heroin abuse. More definitive warning signs of heroin abuse include possession of paraphernalia used to prepare, inject or consume heroin:
- Needles or syringes not used for other medical purposes
- Burned silver spoons
- Aluminum foil or gum wrappers with burn marks
- Missing shoelaces (used as a tie off for injection sites)
- Straws with burn marks
- Small plastic bags, with white powdery residue
- Water pipes or other pipe
Behavioral signs of heroin abuse and addiction include:
- Lying or other deceptive behavior
- Avoiding eye contact, or distant field of vision
- Substantial increases in time spent sleeping
- Increase in slurred, garbled or incoherent speech
- Sudden worsening of performance in school or work, including expulsion or loss of jobs
- Decreasing attention to hygiene and physical appearance
- Loss of motivation and apathy toward future goals
- Withdrawal from friends and family, instead spending time with new friends with no natural tie
- Lack of interest in hobbies and favorite activities
- Repeatedly stealing or borrowing money from loved ones, or unexplained absence of valuables
- Hostile behaviors toward loved ones, including blaming them for withdrawal or broken commitments
- Regular comments indicating a decline in self esteem or worsening body image
- Wearing long pants or long sleeves to hide needle marks, even in very warm weather
Users build tolerance to heroin, leading to increases in the frequency and quantity of heroin consumption. With growing tolerance, more definitive physical symptoms of heroin abuse and addiction emerge:
- Weight loss
- Runny nose (not explained by other illness or medical condition)
- Needle track marks visible on arms
- Infections or abscesses at injection site
- For women, loss of menstrual cycle (amenorrhea)
- Cuts, bruises or scabs from skin picking
What are the Symptoms of Heroin Withdrawal?
- Intense heroin cravings
- Profuse sweating (not explained by environment or physical activity)
- Severe muscle and bone aches
- Nausea and vomiting
- Feeling of heaviness
- Intense cramping in limbs, resulting in “kicking”
- Cold sweats
- Runny nose
Someone experiencing withdrawal symptoms following long-term heroin dependence is at risk for serious medical complications, including death when other medical conditions are present.
What are the Side Effects of Heroin Dependence?
Following heroin consumption, the user experiences a “rush” that is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities. Given the challenge of precisely calibrating the dosage of such a powerful narcotic, this initial rush can frequently be followed by nausea, vomiting, and severe itching.
Short-term physical side effects of heroin use include:
- Depressed respiration (shallow breathing)
- Clouded mental functioning
- Decreased pain from either physical conditions or emotional challenges
- Uncontrollable feelings of itching that result in compulsive scratching or picking at skin (itchy blood)
Heroin abuse and dependence produce serious medical side effects, which may directly or indirectly result in death:
- Heart problems, including infection of heart lining and valves
- Infectious diseases spread by shared needles (HIV and hepatitis B and C)
- Chronic pneumonia or other pulmonary diseases
- Blood clots or tissue death resulting from collapsed veins or impurities
- Bacterial infections
- Liver disease
- Arthritis and other rheumatologic problems
Because heroin addicts do not know what the strength of the heroin purchased on the street may be or what it may be mixed with, they are at risk of overdose or death. Studies show that after five years of use the average heroin user has a ninety percent chance of having contracted hepatitis C. A person injecting heroin is also at high risk for the transmission of HIV and other diseases from sharing non-sterile needles.
Heroin abuse and addiction are extremely serious medical diseases. They require care from chemical dependency specialists experienced in opiate detox and withdrawal. Please note:
- Curtailing long-term heroin use suddenly can cause serious medical complications, including death.
- Heroin detox should not be attempted at home, or without supervision from a licensed medical doctor who regularly treats patients for heroin dependence and withdrawal.
- If you or your loved one are concerned you may be experiencing a heroin overdose or other opiate withdrawal symptoms, call 911 for emergency assistance.
What Causes Heroin Addiction and Dependency?
Heroin usually appears as a white or brown powder. Larger blocks of heroin may also appear as a black sticky substance called black tar heroin. Heroin may have widely different levels of strength and purity, which have a significant impact on the symptoms and side effects a user will have.
Heroin acquired on the street is cut, or mixed, with other drugs or with white substances such as sugar, starch, or powdered milk. Street heroin has also been known to be mixed with strychnine or other poisons putting the drug user’s life in danger.
Abusers typically report feeling a surge of pleasurable sensation, typically referred to as a rush. The intensity of a rush depends on how much drug is taken and how quickly the drug enters the brain. Heroin is particularly addictive because it enters the brain so rapidly. There are three primary ways a user may consume heroin:
- Intravenously: direct injection into a vein using a needle
- Smoking: inhalation orally through a pipe
- Snorting: inhalation directly through the nose, possibly using a straw
Injection provides the fastest rush and greatest intensity of the drug, usually within seconds. When heroin is snorted or smoked the effects are usually felt within ten to fifteen minutes. Soon after injection (or inhalation), heroin crosses the blood-brain barrier. In the brain, heroin is converted to morphine and binds rapidly to opioid receptors.