Signs and Symptoms of Heroin Addiction
Heroin is a diamorphine that can be processed in multiple ways with several different additive agents. Some are stronger than others depending on what methods and substances are used in the making of heroin. This article will help open your eyes to some potential signs of heroin addiction.
This drug is highly addictive due to the way the human body quickly builds up a tolerance to its effects. Heroin addiction takes place when physical and physiological changes in the body compel someone to continue taking the drug past the point where they know it could harm them. 
Table of Contents
- 1. What causes heroin addiction?
- 2. Opiates & heroin addiction
- 3. Who is at risk?
- 4. Recognising addiction
- 5. Diagnosing heroin addiction
- 6. Types of heroin use
- 7. Risk of infectious diseases/a>
- 8. Consequences of heroin use
- 9. Symptoms of heroin use
- 10. Parapharnelia
- 11. Signs of heroin overdose?
- 12. Heroin withdrawal symptoms
- 13. How to help an addict
- 14. References
What Causes Heroin Addiction?
Changes in brain chemistry affect the way the person taking Heroin experiences emotions and pain. It delivers a strong depressant to the system, which provides the user with a euphoric feeling while at the same time entirely numbing physical pain.
Certain people are more prone to being drawn into an addictive relationship with the drug based on genetic, biological, psychiatric, or environmental factors.
The Link Between Opiate Drugs and Heroin Addiction
The American Society of Addiction Medicine estimates that “Four in five new heroin users started out misusing prescription painkillers.” 
The majority of current heroin addicts started on prescription opiate drugs and started taking heroin because it is cheaper than traditional opiate subscription pills.
Who is at Risk of Heroin Abuse?
The highest risks for heroin misuse come from environmental, genetic, and biological factors. Below is a list of the most common risk factors: 
- Low income and unemployment
- History of substance abuse within the family
- Personal past substance abuse and prior addiction-related rehabilitation
- Younger age bracket
- Previous criminal activity or legal issues, especially DUIs
- High-risk relationships and regularly visiting high-risk environments
- Mental health disorders
- Regularly chases adrenaline rushes or buzzes with unsafe behaviour
- Heavy smoker or tobacco chewer
- Past or present depression
- Stressful environment
Recognising Heroin Addiction
The signs & symptoms of heroin addiction can be a little tricky to spot on someone who is new to using, but it does not take long before the body and mind begin to manifest symptoms. There are eleven officially listed in the Diagnostic and Statistical Manual. 
- Heroin is taken for a greater period and in higher amounts than initially intended
- Inability to cut down on heroin use despite a desire to do so
- An inordinate amount of time is spent attempting to obtain heroin, suffering from the effects, or experiencing withdrawal
- Craving for heroin
- Use of the drug causing significant conflict with life priorities such as at work, home, or school
- Continuing heroin use despite interpersonal conflict caused by using it
- Giving up activities or goals previously held dear in exchange for spending that time using, attempting to purchase, or obsessing over heroin
- Recurrent episodes of using heroin in situations where this is physically dangerous
- Continued heroin use despite full knowledge that it is causing physical and psychological damage which is likely to increase
- Increased tolerance causing the need to increase the dosage to maintain the same high or a diminished effect from taking the same dose
- Relief from withdrawal symptoms upon taking heroin
Steps to Diagnosing Heroin Addiction
The first step towards an official diagnosis is to visit a doctor or medical professional who will be able to perform an assessment and blood or urine test. The second step is to visit a mental health professional to get diagnosed with substance abuse disorder.
After a formal evaluation of all areas of psychological and physical health, a treatment plan will be put into place to help set in place a support system to increase the likelihood of successful rehabilitation.
Types of Heroin Use
Heroin comes in many varieties and mixtures. The main types are white powder, black tar, and brown powder. Their looks are a result of the different methods in which they are refined and what substances are mixed with them during that process.
Brown powder heroin is generally smoked or snorted. White powder dissolves easily in water, so it is often injected. Black tar heroin can be injected, smoked, or snorted.
Also, there are also mixtures of the three. This includes the following.
- China White – heroin mixed with fentanyl
- Speedball – heroin mixed with a stimulant such as cocaine
- Gunpowder – a very potent form of black tar that resembles dry coffee grounds
- Scramble – white and brown powder heroin mixed with an additive and then placed in a gel capsule
The Risk of Infectious Diseases and Heroin Abuse
The most common source of bloodborne illness in drug addicts is from sharing needles between users. There is also an increase in sexually transmitted diseases as addicts are more likely to partake in unsafe sexual activities.
There are a number of physical and mental side effects of heroin abuse, but infectious diseases often are the most prominent.
Consequences of Heroin Abuse
Below we have listed the most common and anticipated side-effects of prolonged heroin abuse. We have split the symptoms into two categories, short-term and long-term.
1. Short-Term Effects of Heroin
Short-term effects include the following.
- A trance-like state
- Constricted pupils
- Impaired mental ability
- Slurred or slow speech
2. Long-Term Effects of Heroin Abuse
The risk of suicide and suicide attempts increase the longer someone is addicted to heroin. A study by the National Drug and Alcohol Research Centre of the University of New South Wales showed that heroin users are 14 times more likely than peers to die from suicide. 
Heroin also creates an inflammatory response in the brain which can lead to brain damage and higher chances of diseases like Alzheimer’s.
Other long-term effects include the following though this is not an exhaustive list:
- Organ damage
- De-oxygenation of the brain
- Breathing difficulties
Signs of Heroin Addiction
Below we have categorised the various factors that indicate an addiction to heroin. They are as follows:
Below are some of the common physical signs & symptoms of heroin addiction.
- Significant weight loss and malnutrition
- Exhaustion, lethargy, and sleep problems
- Breathing issues and routine chest infections along with continued flu-like symptoms like watery eyes and runny nose.
- Constipation and other gastrointestinal issues
- Bruises, cuts or scabs on the skin along with uncontrollable and persistent itching
- Organ damage, blood clots, and loss of menstrual cycle for women
- Bloodborne illness from sharing needles
- Constricted pupils
- Collapsed veins
Psychological signs & symptoms of heroin addiction can vary, but here are a few.
- Depression, anxiety, low self-esteem, and the sense that heroin has encompassed all aspects of life
- Feeling extreme shame or guilt
- Mood swings from one extreme to another
- Inability to concentrate and poor judgment
- Persistent confusion
- Inability to stop thinking about and taking heroin to an extreme degree
Social relationships are perhaps hit the hardest by heroin addiction with the following being just a few of the consequences.
- Strained relationships and isolation from family or friends
- A new peer group
- Loss of job, status, and financial stability
- Legal issues such as DUIs
- Strained relationships with all outside influences
Heroin addiction will encompass all aspects of a person’s behaviour from their appearance to all interpersonal relationships.
There will be a distinct lack of proper grooming, self-preservation, self-care, and a new reckless kind of impulsivity. Paranoia, confusion, and trouble communicating are almost always present in observable behaviour.
Heroin Paraphernalia to Look Out For
Most of the paraphernalia that will be visible is usually associated with injected heroin. This includes everyday items that can be used to tie-off and cause the veins to pop for easier injection which include:
- Rubber hose
- String or rope
- Orange syringe covers,
- Bloody cotton balls
- Burnt silver spoons
- Tinfoil wrapping with brown or white powder residue
- Dark stains transferred onto surfaces like door handles, light switches, and furniture can also be an indication of drug use
Signs of Heroin Overdose and How to React
The following signs are indicative of a heroin overdose.
- Dry mouth
- Tiny pupils
- Drowsiness and disorientation
- Weak pulse and shallow breathing
- Blue nails, skin or lips
If you notice these signs, then you must act quickly. Below we have set out some guidelines as to how to respond:
- Call emergency services
- Perform rescue breathing
- Give them naloxone if you have some on hand
- Continue rescue breathing until emergency personnel arrives 
Experiencing a much deeper sense of calm and a strange heaviness after taking a dose of heroin is a direct sign of overdose and emergency services should be contacted immediately.
Heroin Withdrawal Symptoms
If you see heroin withdrawal symptoms, then it is essential to get medical assistance as withdrawal. After a long period of consistent drug use, heroin withdrawal can be fatal. Here are some signs to look out for:
- Anxiety, agitation, irritability, and paranoia
- Insomnia and depression
- Vomiting and diarrhoea accompanied by severe abdominal cramps
- Muscle and bone aches
- Extreme flu-like symptoms
How to Help a Heroin Addict
Stay positive when you reach out to help your loved one. Heroin rehab may be exactly what they need to get back on track with their life, but using force or negative reinforcement will only cause them to isolate themselves further. 
Be supportive within boundaries that you are comfortable with maintaining. It can also be beneficial to speak with a therapist or counsellor before approaching someone who is struggling with heroin addiction to providing an outside perspective and professional suggestions on best methods.
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About the author:
Jon writes for ADT Healthcare and a number of other websites. Jon graduated with a degree in psychology in 1992. Jon has been in recovery for 19 years.