Heroin Addiction Symptoms, Signs, & Side Effects

Heroin is a Schedule I opioid that’s contributing to the drug epidemic affecting people in Colorado and across the U.S. For people who haven’t struggled with heroin, it can be challenging to understand the weight of a heroin addiction.

As with many substance use disorders, the addiction becomes stronger than the person using it. Heroin addiction is a chronic disease of the brain with complex symptoms and side effects. These effects need to be managed accordingly to prevent complications during recovery, like relapse and overdose.

Heroin Side Effects & Symptoms

The side effects of heroin stem from the nature of the drug. When someone uses heroin, it is converted to morphine and binds to the mu-opioid receptors in the central nervous system. Opioids slow brain stem activity and block pain messages that are transmitted through the body.

Heroin creates a euphoric rush or a high due to the release of dopamine in the brain. There are many short-term side effects of heroin use that accompany this high:

• Clouded mental function
• Slowed breathing and heart rate
• Flushing of the skin
• Dry mouth
• Feeling of heaviness in the arms and legs
• Nausea or vomiting
• Itchiness

Signs of Heroin Use

It’s vital for people to identify and understand the signs of heroin use if they believe a loved one has a heroin use disorder. Along with the drug’s short-term side effects, there are some other signs to look out for: 

• Excessive sleeping or nodding off, as well as odd sleeping habits
• Periods of extreme euphoria often followed by deep fatigue
• Confusion
• Disorientation
• Unexplained weight loss
• Sores or scabs on the skin
• Slurred speech
• Covering extremities with long pants and sleeves despite the weather, to cover injection marks or scars
• Drug paraphernalia, like needles, burnt spoons, lighters, roor aluminum foil 
• Stealing to get money for the drug
• Poor performance at school or work
• Dishonest, deceitful or secretive tendencies

Long-Term Effects of Heroin

Someone who is a long-term user of heroin will have developed a tolerance. This means that they may not even experience the pleasurable rush of the drug anymore, but they continue to take it because they are physically and psychologically addicted. The person may take higher and higher doses of heroin to maintain a sense of normalcy. They may not feel good when using the drug anymore, but they must continue because of their addiction and dependence.

Someone who is addicted to heroin will likely have difficulty maintaining a job or being successful at school. They may have failed relationships, and they may turn to criminal or risky behavior.

Another long-term side effect of heroin is physical dependence. When a long-term user of heroin suddenly stops the drug, they will experience withdrawal symptoms that can range from uncomfortable to severe.

The longer someone uses heroin, the more pronounced certain side effects can be. The impact on overall health can also be severe: 

• Poor dental health, such as bad teeth and inflamed gums 
• Gastrointestinal problems, like chronic constipation and appetite loss
• Skin problems like itching and pustules
• Cold sweats
• A weakened immune system
• Lung damage, especially if you smoke heroin
• Muscle weakness 
• Reduced libido and problems achieving orgasm
• Impotence in men
• Menstrual complications in women 
• Cognitive problems, including memory loss
• Mood issues like depression 
• Insomnia

Heroin Overdose Symptoms

Heroin overdose is relatively common and can be deadly. In 2019 alone, there were more than 14,000 heroin-related overdose deaths in the United States. 

When a person overdoses on heroin, their breathing slows to the point that they slip into a coma. This can happen even if the drug is used frequently with mild side effects, because it’s not easy to know the potency. Heroin could also be laced with even stronger narcotics like fentanyl, which can cause an overdose. Someone who quits heroin and later relapses is at an increased overdose risk since their body is no longer used to the drug and could be shocked by a high dose.

Be aware of these heroin overdose symptoms:

• Slow or shallow breathing
• Blue lips or nails
• Clammy skin
• Convulsions
• Coma

Heroin overdoses can be fatal. If you suspect someone is having a heroin overdose, give them naloxone (Narcan) if you have it available and call 911 immediately. Do NOT be afraid to seek help. You can also contact the Colorado Poison Center for online assistance.

Signs of Heroin Relapse

Many signs of a heroin relapse are similar to the initial signs of a heroin use disorder. These can include isolation from friends and family, or visiting places where heroin use is prevalent. Someone who has relapsed may show signs of deteriorating health and wellness, they may become more secretive and guarded, or they may show physical signs of heroin addiction, like dilated pupils.

When someone relapses, they are at a higher risk of a heroin overdose since their body has likely reduced its tolerance to the drug. Relapses can be triggered by many factors:

• Celebrations and successes
• Stress
• Boredom
• Spending time in locations or with people you associate with heroin use

Heroin relapse is among people who do not complete a full rehab program following detox. For people who only complete a heroin detox, one study showed that the relapse rate is 91%, with 59% of relapses occurring within one week of detox. For this reason, it’s important for people in Colorado struggling with heroin to seek proper treatment.

Heroin Addiction Treatment

Addiction is a lifelong condition, and for this reason heroin addiction treatment is a continuum. Treatment starts with detox and continues through rehab and aftercare options:

• Heroin detox: Detox is the first step in heroin recovery, in which your body and brain are cleansed of the drug.
• Heroin inpatient rehab: In inpatient rehab, you live at the facility to completely focus on your recovery. At this stage of recovery, you begin to explore the reasons you began to rely on heroin. You also develop coping strategies to live a heroin-free life.
• Heroin outpatient rehab: In outpatient rehab, you live in a sober living environment or at home and can attend school or work. You will continue to attend therapy and rehab sessions, which may take place via teletherapy.
• Heroin aftercare: Even after rehab is complete, it is important to stay focused on your recovery to avoid relapse. Aftercare includes support groups like Narcotics Anonymous and alumni groups to help you remain heroin-free for life.

It isn’t too late to begin your journey to recovery. Our skilled and compassionate staff at The Recovery Village at Palmer Lake are dedicated to finding the right treatment plan for your unique case. 

Editor – Erica Weiman

Erica Weiman graduated from Pace University in 2014 with a master's in Publishing and has been writing and editing ever since. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more