Heroin Addiction

With opiate use on the rise, so too is heroin addiction. Heroin is a street drug that comes from the milky substance of the poppy plant. It may be sold as a fine white powder, but less pure forms can range anywhere from a pink-gray or brown powder to a black, tar-like substance. The color may be due to the purity, or lack of purity, and can be attributed to what the heroin is mixed with; and here’s where it gets dangerous.

The practice of cutting, or mixing, heroin with other drugs is common today. Some substances used may include caffeine, starch, painkillers or even talcum powder in an attempt by a dealer to get more money for less of the drug. Fentanyl is a synthetic and lethal drug used to cut heroin because it is cheaper and becoming easier to find by heroin manufacturers. Any of these can have unforeseen adverse or even deadly side effects, and there is no way for the user to know ahead of time. Even with the dangers of un-pure or cut heroin, heroin abuse remains on the rise in America.  It is touted as a euphoric high that may be used as a replacement for someone addicted to prescription painkillers. Others may succumb to peer pressure because of widespread use as a recreational drug. It can be smoked, snorted or injected; but no matter which way it is used, it is highly addictive.

Educating our children and other family members of these dangers can be a deterrent to heroin addiction. Oversight of opioid pain relievers may ward off accidental addiction, which can lead to heroin abuse. Awareness of alternatives to pharmaceutical pain relievers may help one avoid using opioids altogether.

Signs of Heroin Abuse

Heroin is consumed in a variety of ways, and these practices may help you know what to watch for if you suspect a loved one is using. While physical symptoms can indicate drug use, they may not always be indicative of heroin use.  But along with physical signs, the following are some warning signs to watch for that may be cause for concern.


Finding small, plastic bags with an obvious powder residue may be a clue that heroin was purchased. Watch for pipes and aluminum foil (even gum wrappers) or straws with burn marks as well as spoons with black soot or burn marks. Missing shoelaces may be an indication one is using the lace to tie a limb for injection. Needles and syringes that are not for medical use (such as for a diabetic) is a cause for concern, too. Of course, any one of these may not be a cause for concern; but there are other negative behavioral and physical changes to also watch for.

Behavioral Changes

Some behaviors change as the addict feels the need to conceal their habit.  They may become distant, paranoid and avoid eye contact. They will spend more time sleeping since heroin is a depressant, and eventually may lose interest in things they once really enjoyed. You may even notice slurred speech, decreasing hygiene or hostility. When addiction gets even more out of control, the addict may begin lying and stealing to covertly support their habit.

Physical Symptoms

Some physical symptoms are commonly associated with heroin use, with the most recognized being needle tracks from frequent injections of heroin, often called mainlining. Tracks are needle marks at injection sites on the body. Tracks may be found on the arm, inner thighs, lower legs and even the feet. The user may attempt to hide them by wearing shirts with long sleeves in warm weather, or socks or long pants even during hot spells.

Some users snort the powder and will often have a runny or leaky nose. They may appear to have allergies or seem to get colds quite often. Others smoke heroin and seem to have chronic respiratory problems and coughing, or they may experience shortness of breath for no apparent reason. 

Longer term use can lead to other common symptoms and signs of heroin abuse such as weight loss and pale skin as the person neglects personal needs, such as food. Scabs and bruising can happen as the addict picks at the skin from itchiness or even hallucinations.

While high, a user may experience:

  • Dry mouth
  • Shortness of breath
  • Constricted pupils
  • Flushed skin
  • Heaviness of their legs and arms.

A noticeable and disturbing behavior is going “on the nod.” Heroin is a depressant and slows down body functions such as blood pressure, breathing and temperature. After the initial high, the user may alternate between a waking state and extreme drowsiness. This semi-conscious state often causes the addict to literally “nod out,” even during a conversation.

As the cycle of addiction continues, the above symptoms may become more noticeable. Some addicts may disappear for days at a time as they binge on the drug and stay away to hide it from family, loved ones or even coworkers.

As use continues, addicts become more tolerant, meaning they can consume more of the drug. This leads to extreme changes that eventually cannot be hidden such as; extreme weight loss, cuts, bruises, scabs, needle marks and infections at the injection sites. With a higher tolerance comes higher dosing, leading to a higher chance of overdosing.

Street Names for Heroin

Heroin addiction is a subculture; therefore, users have a wide variety of nicknames or street names for heroin. This makes it easier to hide when they use, buy or sell heroin. Knowing some of these street names and jargon can help you identify when a loved one may be on a path to self-harm. The following is a list of some street names used for heroin:

  • Big H
  • H
  • Horse
  • Junk
  • Dope
  • Dragon
  • Crystal
  • Hell Dust
  • Smack
  • Black Tar
  • Black Pearl
  • Black Eagle
  • Black Stuff

  • Brown Sugar
  • Brown Crystal
  • Brown Tape
  • Brown Rhine
  • Mexican Brown
  • Mexican Mud
  • Chiva
  • Skag
  • China White
  • Snow
  • Snowball
  • Skunk

Heroin is often combined with other street drugs as regular use creates a tolerance within the addict and they seek a more intensive high. These will take on their own set of street names, some of which are below:

  • Heroin mixed with marijuana – Atom bomb, Woola or Woo-woo
  • Heroin with Cold medicine – Cheese
  • Heroin with Ecstasy – H Bomb
  • Heroin with Cocaine – Goofball, Boy-Girl or He-She
  • Heroin with Crack – Chocolate Rock, Dragon Rock, or Moonrock

Like most drugs, different cities and subcultures each have their jargon with the local dealers and addicts. Paying attention to words used too often by loved ones or used inappropriately may be an indication they are dabbling in covert activities and lead to earlier intervention and recovery.

Heroin Withdrawal Symptoms

Because heroin abuse changes personality and alters brain and body chemistry, heroin withdrawal symptoms can be harsh. Professional intervention is recommended, especially if addiction has been going on for a longer time.

Withdrawal symptoms may begin shortly after the last use of heroin, possibly within hours and grow to intensity over the next few days, and then subside around a week to ten days later. At this point, lower level symptoms may last for weeks, months or longer. It is an intense and difficult process that can physically harm the addict.

Unfortunately, the intense withdrawal symptoms are often the reason a heroin addict relapses. Understanding what symptoms will arise ahead of time may help one to cope with the unpleasant effects.

As the heroin addict begins refraining from using, intense cravings for the drug set in. Because the brain has relied on heroin to stimulate its pleasure centers, abstaining can cause the opposite and lead to depression, anxiety, rapid heart rate or overall lethargy.

More physical heroin withdrawal symptoms may arise within hours, similar to flu-like symptoms, such as nausea, runny nose, sweats, and chills. Insomnia, fever and agitation may intensify. As withdrawal continues, symptoms may progress to nausea and vomiting along with painful stomach cramps and diarrhea. Goosebumps, shivering or tremors may become prevalent at this point.

More severe withdrawal symptoms occur after long term heroin abuse. These are considered severe because they may last longer, causing the addict to lose hope and relapse. These may include: rapid heart rate, muscle spasms, hypertension, impaired breathing, anxiety and depression, and difficulty feeling pleasure. Knowing these are symptoms and only temporary may help someone in recovery keep going since there is an end to their pain in sight.

Treatment for Heroin Addiction

The treatment for heroin addiction may begin with drug replacement therapy under the supervision of a licensed physician. “Stepping stone drugs” such as methadone or suboxone can help alleviate the severity of heroin withdrawal symptoms. Using this method of detoxification may help reduce discomfort, but recovery will take longer; though, some claim it is well worth it to be free of this deadly drug.

If an addict is experiencing acute detoxification symptoms, they may be given anti-anxiety medications such as diazepam or chlordiazepoxide. These can be helpful to keep patients calm and help avoid relapse during the withdrawal process.

Choosing to not use stepping stone drugs is also a viable option. Some prefer this quicker method to avoid the temptation of having another drug to become dependent on. Since heroin is a fast-acting opioid, it can leave the body quickly so the worst of the physical symptoms may subside over a period of about 7-10 days.

As with any addiction therapy, support and behavioral modification are imperative. A person who has been abusing heroin for a long time must learn to cope with real world stress in different ways. Extensive therapy and support is necessary to help prevent the addict from relapsing.

Rapid Detoxification

Rapid detoxification is a controversial method for treatment of heroin addiction and is carried out while patients are under general anesthesia. Physicians administer medications called opiate blockers to immediately stop the effects of heroin on the system. The entire process lasts less than 10 hours and the patient can leave merely 48 hours later.

Critics of rapid detox say with great promises come great risks. The physical risk may lead to heart attack, aspiration and even death because such rapid detoxification may shock the organs. But advocates believe it is necessary in today's world where heroin addiction and abuse are rampant, with the rate of new addicts still climbing every year.

Inpatient Treatment

Inpatient treatment programs are the most effective to break the cycle of addiction. This is considered the safest method since serious side effects such as respiratory problems, infection from scratching scabs, and even cardiac problems may arise during the initial detoxification stages. If medications are given, they can be safely monitored in this setting, and if no medications are preferred then there can be patient oversight to ensure they rest, take care of their needs and avoid relapse during this time.

Outpatient Treatment

Outpatient treatment centers are for those who may not have access to inpatient treatment clinics. The patient may visit a clinic to receive a daily drug replacement to aid in heroin withdrawal. Receiving a daily pill  in this type of setting can help avoid abuse of the medication, since the patient will not have oversight. Group and individual therapy is vital with this method to help avoid relapse. Luckily most insurance companies will help cover the cost of heroin addiction treatments.

Support from loved ones or family can help make the process more comfortable with less chance of relapse. Recovery and treatment are possible; if you or a loved one need help, don't wait, take action today. You are not alone, and with help can conquer this addiction and lead a healthy life.