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How can you spot heroin use, and what are some of the signs that heroin addiction has set in?

Heroin is a highly addictive substance. This pleasure-inducing drug packs lots of power and is classified among the opiate family. It can provide pain relief and produces a relaxing feel. Its interaction with your central nervous system may result in severe long-term damage. Smoking, snorting, sniffing, or injections are common ways to ingest the substance.

Heroin is just one of almost countless dependence-inducing drugs in the opiate family. Thanks to its addictive potential, heroin is the world’s most lethal drug. The DSM-5 classifies heroin addiction as opioid use disorder — together with addictions to other opioids. This disorder alters a user's brain functions and causes behavioral changes. Eventually, heroin addiction renders its victims powerless. 

How heroin addiction happens

When you ingest heroin, it binds to certain brain receptors. This triggers the release of large amounts of dopamine, the feel-good chemical. As you continue to use heroin, your brain starts to adapt to its effects. Over time, you'll need more and more to function normally, and may fall into addiction. A heroin addict will compulsively use heroin even in the face of severe negative health or social effects. 

What are the signs of heroin abuse and addiction?

From "junkies" shooting up in alleyways to rock musicians pumping themselves full of heroin, the perception most people have of heroin addicts is misleading.  It is, therefore, not surprising that people find it hard to identify when a close friend or loved one uses this drug. 

There are signs of heroin abuse, however, that can help you identify a user and see that they get immediate medical attention. For instance, you may see paraphernalia — like burned spoons, rubber tubes, and syringes that they use to inject heroin into their bodies.

Some tell-tale signs of heroin abuse include:

  • Residue in bags as well as on surfaces
  • Constricted pupils
  • A runny nose
  • Envelopes or folder pieces of paper
  • Flushed skin
  • Vomiting
  • Scratching or picking at their skin
  • Poor personal hygiene
  • Always wearing long-sleeves to conceal needle marks. 

Once users ingest heroin, they feel an initial rush before going into a state called a "nod". During the nod, they fall into a semi-conscious state with wakeful periods in between. At other times, they may just go to sleep for a couple of hours. You may also find glass tubes that an addict uses to inhale the drug.  

Opioid use disorder may not initially come with any overt symptoms. This is because a user could be trying hard to hide their condition. However, as they continue to use larger amounts, it becomes nearly impossible to hide the condition.  Other symptoms of heroin addiction include you might want to look out for are:

  • Slurred speech
  • Depression
  • Impaired memory
  • Agitation
  • Limited sense of pain
  • Sores in the nose for users who snort heroin
  • Abdominal issues
  • Drowsiness
Some behavioral signs are associated with heroin addiction as well. You may notice that a user suddenly becomes secretive or aggressive. They may have more frequent money issues and always be after extra cash for suspicious reasons. Sometimes, they encounter problems at work or at school. Users may also exhibit very dangerous behavior. A glaring signal of heroin addiction is the continuous use of the drug despite adverse effects.  

The side effects of heroin abuse and addiction

Many people claim to be in total control of their heroin use, but this is rarely true — statistics show that there is a high chance of developing heroin dependence. About 23 percent of heroin users develop a dependence on the drug. 

The side effects of heroin addiction manifest both in the short and long term. Initially, heroin ingestion produces a sensation surge called "a rush". Next, the skin becomes warm and the mouth goes dry. This initial reaction may sometimes cause the user to vomit while experiencing severe itching. As the short-term effects fade, drowsiness sets in for a couple of hours and basic body functions slow down.

As the effects of heroin begin to wear off, the user’s system starts begging for more and if another fix is not available, withdrawal sets in. This situation is characterized by severe physical and mental symptoms which include extreme aches, pains, and discomfort, as well as diarrhea and vomiting. The user will need to ingest higher amounts to feel normal again.  

The short-term effects of heroin addiction include:

  • Slowed breathing
  • Nausea
  • Hypothermia
  • Coma or death
  • Vomiting
  • Poor mental functioning
  • Drowsiness
  • Sedation

In the long-term, the continuous use of heroin produces destructive effects. Frequent injections cause the veins to collapse and can result in blood vessel infection as well as heart valve infection. The poor state of health can also lead to tuberculosis, and some users will develop arthritis. 

In the long-term, heroin abuse can produce the following effects:

  • Cold sweats
  • Abdominal problems
  • Impaired sexual capacity
  • Difficulty reaching orgasm
  • Memory impairment
  • Impotence in men
  • Facial pustules
  • Breathing problems
  • Coma
  • Bad teeth and gum inflammation
  • Itching
  • Lack of appetite
  • Sleeping problems
  • Depression and Introversion
  • Menstrual issues
  • Weak muscles and partial paralysis

Heroin addiction encourages an addict lifestyle — a situation where needles are shared by a group of heroin users. This may lead to HIV as well as other infections. An estimated 35,000 new cases of hepatitis C2 infections are reported annually in the US, and more than 70 percent involve IV drug users. 

  • Photo courtesy of SteadyHealth
  • www.drugabuse.gov/publications/drugfacts/heroin
  •  https://www.ncbi.nlm.nih.gov/m/pubmed/22329304/
  •  https://easyread.drugabuse.gov/content/signs-heroin-use
  •  https://www.drugabuse.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use
  •  ​https://www.drugabuse.gov/publications/research-reports/heroin/scope-heroin-use-in-united-states

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