Heroin Symptoms: Heroin Use, Addiction and Overdose

heroin symptoms, heroin overdose symptoms, heroin use symptoms

An Overview of Heroin and Heroin Symptoms

Heroin symptoms is a broad term that encompasses many possible topics. Some of the things covered in this article include:

  • Heroin high symptoms
  • Heroin use symptoms and heroin abuse symptoms
  • Heroin addiction symptoms
  • Heroin withdrawal symptoms
  • Heroin overdose symptoms

What Is Heroin?

Briefly, what is heroin?

Heroin is an opioid derived from morphine. Morphine is a substance extracted from opium poppy plants natively grown in Asia, Mexico and Colombia. Heroin can come as a white or brown powder. There is also a black, sticky type of heroin called black tar heroin.

Heroin is used most commonly through injection, although it can be snorted and smoked as well.

What Happens When You Use Heroin?

When someone uses heroin, it quickly crosses their blood-brain barrier. Once that happens it binds to opioid receptors. These receptor sites are the same ones affected by prescription opioid pain medications like Vicodin.

Once the opioid receptors are occupied by the heroin, there is a slowdown of the user’s central nervous system and this is what leads to heroin symptoms and effects.

Why Is Heroin So Addictive?

Heroin is one of the most addictive drugs available. This illegal and dangerous drug creates a reward response in the brain—similar to what happens with prescription opioids. This reward response then leads the brain to compulsively seek out more heroin. Once this happens, a person’s use of heroin is out of their control and is considered an addiction.

With heroin, not only is it highly addictive but tolerance can form quickly. Tolerance means the user’s central nervous system no longer produces the same effects in response to the originally used dosage of heroin. In response, people will often take higher and higher doses to try and achieve the high and the desirable effects they initially got from using the drug.

heroin symptoms, heroin withdrawal symptoms, heroin overdose symptoms, heroin use symptoms, heroin high symptoms
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What Are the Heroin High Symptoms?

People often wonder “what are the signs someone is high on heroin.” Since it is a central nervous system depressant, there is a slowdown of most of the major bodily processes and this can show outwardly.

Initially, when someone uses it, symptoms include a euphoric high. A person may feel extreme pleasure, relaxation and pain relief. That high wears off, and a person will appear drowsy or sedated.

Heroin high symptoms and signs of heroin abuse can include nodding off, small pupils, and a lack of coordination.

Someone who’s high on heroin might seem to have slowed thinking, and they may walk slowly. The limbs of a heroin user may look droopy or heavy, and dry mouth and sudden changes in behavior are also potentially indicative of heroin use.

The effects of heroin addiction and use can include nausea and vomiting as well as itchiness.

Heroin Use Symptoms and Heroin Abuse Symptoms

Even if someone isn’t high on heroin at any given moment, there may be other heroin use symptoms and drug abuse symptoms that you can spot. Some of the possible heroin abuse symptoms that may be apparent include:

  • Changes in behavior
  • Paraphernalia including needles or syringes, burned silver spoons, aluminum foil or gum wrappers, or straws with burn marks
  • Other heroin paraphernalia can include small plastic bags and water pipes or other forms of pipes
  • Lying or becoming increasingly deceptive
  • Loss of motivation or a sense of apathy
  • Changes in sleep patterns
  • Problems at school or work
  • Decreasing attention to appearance or personal hygiene
  • Withdrawing from friends or family, or spending time with new groups of people
  • Loss of interest in activities that were previously interests
  • Stealing from friends or family
  • Defensiveness or hostility
  • Track marks not only on the arms but other places such as the ankles
  • Wearing seasonally-inappropriate clothing to cover track marks—for example, long shirts and pants in the summer
  • Weight loss
  • Cuts or scabs from skin picking
  • Runny nose not related to another medical condition
  • Over time developing infections at injection sites or even abscesses
  • Women may lose their menstrual cycle
heroin abuse symptoms, heroin use symptoms, heroin high symptoms
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Heroin Addiction Symptoms

When someone has a heroin addiction, they compulsively use the drug. They may find it distressing and they might also want to stop, but they aren’t able to. Heroin addiction will usually require professional treatment.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, also called the DSM-5 is published by the American Psychiatric Association. This is the primary guide used by doctors and clinicians to diagnose mental illnesses including addiction.

Opioid use disorder is included in the DSM-5 and there is a set of diagnostic criteria that can be used to identify an addiction to heroin or other opioids.

It’s a diagnosable, chronic disorder and some of the potential heroin addiction symptoms that may occur include:

  • Continuing to use heroin for longer periods of time or taking larger doses than intended
  • Having a desire to cut down or stop using heroin but not being able to
  • Spending a lot of time trying to get heroin or recovering from its effects
  • Strong cravings and urges to use heroin or other opioids
  • Other priorities and responsibilities are not met because of heroin use
  • Continuing to use heroin despite social and relationship problems
  • Giving up things that one was previously interested in because of their substance use
  • Continuing to use heroin despite harmful consequences and side effects
  • Developing a tolerance and needing more and more heroin to get the desired effects
  • Developing withdrawal symptoms when not using heroin

Typically to be diagnosed with an opioid use disorder, a person would need to display at least two of the symptoms above. Substance use disorders including heroin addiction can also be diagnosed based on severity.

  • A person with two or three symptoms would be diagnosed as having a mild heroin addiction.
  • Someone with anywhere from four to five heroin addiction symptoms would be diagnosed as having a moderate substance use disorder.
  • With six or more heroin addiction symptoms, it would be diagnosed as a severe substance use disorder.

Heroin Withdrawal Symptoms

When someone’s brain and body is exposed to a substance like heroin repeatedly, it changes the functionality of both. The brain’s chemistry and wiring change in response to heroin, and the presence of heroin becomes seen as normal.

People who are addicted to heroin and dependent on it stop using it because they like the high and they continuing using it because they need it to maintain a sense of normalcy.

If someone stops using heroin and they’re dependent on it, they may have withdrawal symptoms. Heroin withdrawal symptoms can vary depending on how heavy a user someone was, how long they used heroin, and whether they quit suddenly known as going cold turkey.

Heroin Withdrawal Timeline

For most people, heroin withdrawal symptoms will begin 6 to 12 hours after they use their last dose of the drug. Heroin withdrawal symptoms will peak within 1 to 3 days, and within 7 days most people find their withdrawal symptoms start to get better.

Mild Heroin Withdrawal Symptoms

The following are some of the milder heroin withdrawal symptoms that may occur, particularly in the first phase of withdrawal:

  • Runny nose
  • Nausea
  • Teary eyes
  • Sweating
  • Chills
  • Yawning
  • Muscle and bone aches
  • Abdominal cramps

Moderate Heroin Withdrawal Symptoms

These can include:

  • Vomiting
  • Diarrhea
  • Agitation
  • Tremors
  • Goosebumps
  • Fatigue
  • Sleep disturbances
  • Concentration problems

Severe Heroin Withdrawal Symptoms

Some of the more severe heroin withdrawal symptoms when someone is at the peak of the opioid withdrawal timeline can include:

  • Anxiety
  • Insomnia
  • Hypertension
  • Rapid heart rate
  • Changes in breathing
  • Problems experiencing pleasure
  • Cravings for heroin
  • Hypertension
  • Depression
heroin withdrawal symptoms, heroin abuse symptoms
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Heroin Overdose Symptoms

Heroin and other opioids slow the central nervous system. That’s how these drugs are able to alter how pain signals are sent to the brain. However, when someone takes heroin they are at a significant risk of overdosing because the drug can slow the central nervous system to a dangerous level.

The central nervous system controls breathing, heart rate and other essential functions. If someone uses too much heroin and their central nervous system can’t handle it, they may overdose. A heroin overdose can be fatal.

Opioid overdose rates have gone up to soaring levels in the United States in recent years, according to data from the National Institute on Drug Abuse and other federal organizations. Overdose deaths are at an all-time high and more than 130 people die every day in the U.S. from opioid overdoses.

Heroin overdose symptoms include:

  • Slow or stopped breathing
  • Shallow breathing
  • Breathing that seems difficult or labored
  • Very small pupils also known as pinpoint pupils
  • Low blood pressure
  • Weak pulse
  • A bluish tint to lips and nails
  • Delirium
  • Drowsiness
  • Uncontrolled muscle movements
  • Nodding off
  • Disorientation
  • Coma

If you see any of these heroin overdose symptoms it’s important to seek emergency medical attention right away—it’s a very serious medical emergency that can quickly lead to death.

Summing Up—Heroin Symptoms

When someone asks what heroin symptoms are there are different situations they could be referring to. Below is a brief rundown of what’s covered above:

  • Heroin use and abuse symptoms: These can include changes in mood and behavior, signs of being high on heroin, defensiveness and changes in lifestyle.
  • Heroin high symptoms: Heroin is a central nervous system depressant. When someone is high on it they may appear euphoric and elated, relaxed and eventually drowsy and nodding off.
  • Heroin addiction symptoms: Heroin is highly addictive. To be diagnosed with symptoms of a heroin use disorder, someone will have specific symptoms such as a desire but inability to stop using, and continuing to use even when there are negative effects and consequences.
  • Heroin withdrawal symptoms: Heroin leads to physical dependence. As a result heroin withdrawal symptoms can include nausea, vomiting, changes in sleep patterns, anxiety and depression.
  • Heroin overdose symptoms: Signs someone could be overdosing on heroin include extreme drowsiness and delirium, slow or stopped breathing, and a weak pulse.

For someone who is a short or long-term heroin user, treatment is available and they can stop using the drug. It does typically require professional drug rehab in a treatment center, however, because heroin is a very addictive substance.


National Institute on Drug Abuse. “What Is Heroin?” June 2018. Accessed February 22, 2019.

Bhandari, Smitha MD. “Heroin: What You Need to Know.” WebMD. May 20, 2018. Accessed February 22, 2019.

National Institute on Drug Abuse. “What are the immediate (short-term) effects of heroin use?” Accessed February 22, 2019.

Hartney, Elizabeth Ph.D. “A Guide to DSM 5 Criteria for Substance Use Disorders.” Verywell Mind. September 26, 2018. Accessed February 22, 2019.

Medline Plus. “Heroin Overdose.” Accessed February 22, 2019.

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