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Signs & Symptoms of Heroin Addiction

Heroin and other opiates are highly addictive, with the potential to produce profound degrees of drug tolerance and physical dependence. Studies have linked heroin use to some deterioration of the brain’s white matter, which may affect decision-making skills, the ability to control behavior and responses to stress.1 Heroin addiction symptoms, both physical and behavioral, vary based on short- and long-term use as well as mitigating factors like concurrent use of other drugs.

Short-Term Heroin Symptoms

  • Euphoria/elation
  • Clouded thinking
  • Confusion
  • Warm flushing of skin
  • Heavy feeling in the hands and feet
  • Track marks on arms
  • Intermittent nodding off or loss of consciousness
  • Marked drowsiness/sedation
  • Constipation
  • Dry mouth
  • Itching
  • Nausea
  • Constipation
  • Vomiting
  • Constricted pupils
  • Slowed breathing and heart rate1,2,3

Long-Term Signs of Heroin Addiction

  • Collapsed veins
  • Infection of the lining and valves in the heart
  • Weakened immune system
  • Liver disease
  • Kidney disease
  • Pneumonia
  • Gastric problems ranging from constipation and abdominal cramps to severe intestinal ileus and bowel perforation
  • Medical issues secondary to intravenous administration (e.g. localized abscesses, embolisms, systemic infection, blood-borne illnesses)
  • Significant respiratory depression
  • Cumulative hypoxic end-organ injury1,2,3

Other Signs of Opiate Abuse

  • Multiple prescriptions from different doctors
  • Excessive number of pill bottles
  • Dramatic mood shifts or swings
  • Social withdrawal/isolation
  • Sudden financial problems

Regardless of the drug, many physical signs of opiate addiction are similar. A major behavioral indicator of opiate addiction is continued use of the substance even when there are negative repercussions from doing so. The use of illicit drugs like heroin tends to result in more overt criminal behavior than abuse of prescription opioids. In addition, the societal stigma attached to heroin use is far greater than that attached to prescription opioid abuse. However, recent research indicates both heroin and prescription opioid abuse affect adolescents and adults across a full spectrum of social strata.

  1. Commonly Abused Drugs Charts. National Institute on Drug Abuse website. https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts Updated April 2016. Accessed October 4, 2016.
  2. What are the long-term effects of heroin use? National Institute on Drug Abuse website. https://www.drugabuse.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use Updated November 2014. Accessed October 4, 2016.
  3. Opiate Abuse. Drug Abuse website. http://drugabuse.com/library/opiate-abuse/ Accessed October 4, 2016.
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