Heroin Addiction: Abuse Signs, Effects & Treatment

Your Guide to Heroin Addiction Treatment

Heroin is a drug that affects the dopamine receptors in our brain, leading to euphoria. This is because the receptors are located in areas of the brain that perceive pain and pleasure and regulate breathing.

Heroin is a powder that is typically greyish in color. It is often mixed with water and then administered into the body through injection using a needle. However, it can also be smoked, snorted, or sniffed.

People in recovery from addiction often face a battle of the mind and body to stay sober. It takes everyone’s support, encouragement, and hard work to make it through.

Heroin Addiction Treatment

Heroin Abuse

Heroin abuse has become a worldwide crisis. Its use is more prevalent among young adults ages 18-25. When people overdose on heroin, it leads to respiratory depression that may result in death.

Statistically, according to the National Institute on Drug Abuse (NIDA), around 23 million people abuse opioids worldwide, with about 1.8 million in the United States and Canada alone. Here are some physical signs that someone has recently taken heroin:

• Weak pulse
• Bluish-colored lips and nails
• Pinpoint pupils
• Extreme drowsiness
• Delirium
• Muscle spasticity
• Low blood pressure
• Recurrence of loss of consciousness
• Difficulty breathing
• Coma

If you know that someone you love is using heroin, get them a few doses of Narcan. Naloxone hydrochloride, or Narcan, is an opioid antagonist that quickly reverses the effects of an overdose on opioids. If someone has overdosed, giving them Narcan before the paramedics arrive could save their life.

Heroin Addiction

Heroin addiction can happen very quickly. It is estimated that about 25% of people who try heroin will become addicted. Many professionals believe that this addiction has a genetic component.

Heroin addiction can lead to mental and physical health problems if not treated correctly. People with previous addiction history are more likely to progress more quickly into heroin addiction than non-addicts on the first try. This is why working with experts on the journey is vital for recovery.

Signs of Heroin Addiction

Symptoms of heroin addiction are classified into psychological and behavioral signs and physical signs.

Psychological and Behavioral Signs

When heroin use becomes a priority, a person’s entire universe shrinks and depends on it. Everything revolves around their next dose, and they start having psychological issues such as:

• Depression
• Anxiety
• Irritability
• Mood swings
• Deceptive behavior
• Avoiding eye contact with others
• Loss of motivation
• Lack of interest in hobbies or activities
• Decreasing quality of performance at school or work
• Hostile behavior toward loved ones
• Wearing long sleeves or pants to hide needle marks
• Reduced attention to personal hygiene
• Presence of drug paraphernalia
• Legal troubles

Physical Signs

Physically, heroin addiction can lead to risky behaviors, like driving under the influence, insubordinate behavior, or risky sexual behaviors. Also, heroin use can weaken the immune system and cause many health problems such as skin infections and abscesses, in addition to pneumonia, tuberculosis, and other communicable diseases. The need to inject or snort heroin also makes sharing needles or other drug paraphernalia more likely.

Heroin Addiction and Withdrawal

Heroin withdrawal can be challenging to endure. Heroin withdrawal symptoms peak on the first day after a significant dosage reduction or complete stoppage of the drug and decrease in intensity over about three to five days.

As with all opioids, heroin withdrawal symptoms comprise three distinct phases: acute withdrawal, subacute withdrawal, and convalescent withdrawal. Acute withdrawal peaks in severity between two to three days after the last dose. The signs for this phase include:

• Restlessness
• Diarrhea
• Yawning
• Tearing up
• Insomnia
• Sweating and chills
• Abdominal cramps or pain
• Vomiting and nausea
• Goosebumps
• Depression and mood changes

Subacute withdrawal lasts about four to 10 days. In this stage, you’ll experience symptoms such as:

• Anxiety
• Insomnia
• Depression
• Muscle aches and pains
• Exercise intolerance
• Lethargy
• Increased hunger
• Nausea
• Stomach ache

The third phase is the convalescent withdrawal, also known as chronic withdrawal. It lasts up to six months, depending on the severity of the addiction. In this phase, withdrawal symptoms may reoccur but decrease in intensity, frequency, and duration. A few withdrawal symptoms will continue indefinitely. The physical tolerance to opioids is reduced once the withdrawal is over.

The progression of each of these phases depends on multiple factors, including duration, frequency, amount of heroin consumed, and environmental factors such as stress and sleep quality. Withdrawal from heroin can be deadly and lead to relapse, so it is essential to seek professional help to receive treatment.

Treatment for Heroin Addiction

So far, there is no 100% effective heroin addiction treatment option. As a result, there is no special treatment for heroin addiction that works for all clients. Instead, various approaches to addiction work well for different people.

Inpatient Treatment

An inpatient rehab center provides addicts with intensive counseling and other therapies. The counselors and therapists at these centers help clients make healthy life changes to avoid relapsing into heroin use after they leave rehab.

Inpatient recovery programs last up to one year or more and often include group therapy sessions that incorporate the advice from peers in recovery and guidance from sober mentors and family members. This provides a support system needed to combat addiction and maintain long-term sobriety.


Detoxification is a medical intervention that involves stopping heroin use altogether. A patient is slowly weaned off heroin while being monitored by medical professionals. It usually occurs as an inpatient treatment as addicts are given medication to help them manage withdrawal symptoms and prevent relapse.

Medical professionals are meticulous during this time because relapse after detox can be fatal for some patients. Medically assisted detox allows you to rid your body of all heroin while minimizing the risks associated with withdrawal.

Cognitive-behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is a treatment approach that focuses on changing behaviors and the thought patterns that lead to them. In this type of therapy, patients learn to identify and understand their behaviors and thoughts to replace them with healthy alternatives. It helps addicts recognize triggers, which are stressors or situations that cause them to abuse heroin, and avoid them in the future. CBT can be combined with other therapeutic techniques to encourage long-term sobriety.

Rational Emotive Behavior Therapy (REBT)

Rational emotive behavior therapy focuses specifically on changing how you feel about various situations in your life. In this therapy, you change the way you think – for example, instead of telling yourself, “I am such an idiot for relapsing,” you tell yourself, “It is okay to make mistakes sometimes; everybody does! I will have to try harder next time.”

This type of therapy is beneficial after relapse when it’s easy to beat yourself up over a mistake and convince yourself that you can never recover. REBT also emphasizes the power of self-affirming statements. For example, a patient suffering from an addiction may tell himself repeatedly, “I cannot stop” or “I will not stop.”

This type of negative self-talk is counterproductive and sets you up for relapse. Patients are taught to replace these negative thoughts with self-affirming statements that focus on their ability to make changes rather than their ability not to change.

In REBT, patients also learn to choose responses instead of reacting in unhealthy ways when they have emotional reactions. For instance, a patient who gets frustrated when seeing people using heroin might initially react aggressively or lash out at the person.

With REBT treatment, the patient learns to identify his feelings and pinpoint what he responds to. He then comes up with alternative responses to avoid relying on his old ways of dealing with frustration and stress.

Contingency Management

Contingency management is a therapeutic approach that relies on positive reinforcement instead of punishments or rewards. As a result, this therapy gives patients something positive to work towards as they fight their addictions and maintain sobriety.

In a contingency management program, patients achieve milestones, such as a certain number of days of sobriety or completing a certain number of treatment sessions. As they meet these milestones, their therapists reward them with privileges that help them create healthy routines outside of treatment.

12-Step Facilitation

The 12-step program is an addiction treatment approach that teaches addicts how to use the 12 steps of groups like Narcotics Anonymous (NA) to achieve and maintain long-term sobriety. This therapy helps addicts work towards recovery by encouraging them to dedicate themselves to the tenets and practices of 12-step programs.

Twelve-step programs are based on a principle called “fellowship,” referring to the relationship between members who share their struggles and experiences as they work towards sobriety. Twelve-step treatment is often included as a component of other treatments.

Treatment With Medication

Treatment with medication is an approach that combines psychotherapy, counseling, education, and behavioral therapies with medicines that help people overcome addictions.

Medication used usually poses fewer risks than traditional detoxification methods because it involves prescribing a short course of treatment for patients who have not been previously treated for addiction or when detox has not been performed safely or adequately.

Principles of Drug Addiction Treatment


Treatment should be tailored to each individual’s unique needs and preferences. A person who wants to quit using requires a therapeutic environment that offers a positive motivation for abstinence, but what motivates each person is different. The severity, duration, and method of abuse use may impact which treatment options a client will best respond to. An optimal treatment approach should address each individual’s needs; otherwise, it won’t be successful.


Access and acceptance into treatment are the most critical factors in successful treatment. However, access to adequate or quality and affordable care remains challenging for some.

Co-morbid Disorders

Addiction is a primary disease that affects other behavioral and emotional disorders that require attention if the addiction is resolved. A client may have turned to heroin as a way to deal with anxiety, depression, or past trauma. It is only by dealing with these other mental health issues at the same time that a client can truly get well.

Stay Vigilant

A significant number of addicts relapse in their second year of treatment. Drug addiction recovery is a long-term process; hence, many treatment phases are necessary. Moreover, current treatment methods need to be improved and more attention paid to the rehabilitation process. Teaching clients about outcomes related to sustained abstinence is essential in helping them through the recovery journey.

Choosing a treatment facility that is the right fit will help you achieve your recovery goals. If you are struggling with addiction to heroin, do not fight the battle alone; talk to a medical professional and visit a facility. There are successful treatment methods that can assist you.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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