Updated on November 16, 2023
8 min read

Heroin Dependence, Risks, and Treatment

What is Heroin?

Heroin is a highly addictive, illegal drug from processed morphine. As an opioid, it binds to the body’s natural opioid receptors to quickly induce euphoria and relaxation.  

Heroin is related to legal opioid drugs such as codeine, fentanyl, hydrocodone, and oxycodone. These drugs increasingly play their part in the opioid epidemic in America, which is responsible for thousands of deaths each year.

Heroin comes in the following forms:

  • White heroin: Pure heroin is a pristine white powder. Variations may contain additives such as sugar, powdered milk, starch, or quinine to maximize profits. 
  • Brown powder: Another variation includes a light or dark brown powder
  • Black tar heroin: This form looks like a black sticky substance.

What Are The Dangers and Risks Associated with Heroin Use?

The National Center for Drug Abuse Statistics noted that over 902,000 Americans used heroin from 2019 to 2020. This accounts for approximately 1.5% of all illicit drug use among Americans aged 12 or older. The number of annual deaths resulting from heroin overdoses stands at 14,019.

The repercussions of heroin abuse include dangerous side effects, from behavioral changes to health risks. Heroin use may lead to:


Physical dependence occurs when the brain adapts to the effects of a drug and develops tolerance. This means requiring more of the drug to achieve the same impact. As a result, users become reliant on the medication to avoid experiencing unpleasant withdrawal symptoms.


Heroin is an incredibly addictive substance with a staggering potential for heroin use disorder. Shockingly, 25% of first-time users find themselves addicted.

Addiction specifically targets the brain's regions that govern decision-making and self-control. Some users even describe heroin use as being as vital as breathing itself. The devastating consequences of heroin addiction reverberate through families and communities alike.

The most common signs of heroin addiction include:

  • Depression
  • Poor decision-making
  • Loss of control
  • Neglect of personal relationships and isolation
  • A decline in fulfilling responsibilities at work and home
  • Visible fatigue and drifting off
  • Seemingly distant or “out of it”
  • Mood swings
  • Apathy
  • Lapses in memory
  • Decreased appetite and weight loss
  • Financial or legal problems
  • Doing anything to obtain money for the drug, including theft


Illegal vendors often cut and combine heroin with other hazardous substances. Unfortunately, people will often consume whatever they can obtain and unknowingly bring these toxins to their bodies.

A notable instance is a concoction known as "gray death." This drug combines heroin and potent opioids like fentanyl, carfentanil, U-47700 (pink), or other potent drugs, resulting in numerous side effects.

High heroin toxicity levels can cause severe symptoms, including:

  • Vomiting and stomach cramps
  • Slurred speech and loss of essential motor functions
  • Low blood pressure
  • Slow or non-existent pulse
  • Pin-point-shaped pupils
  • Blue lips and fingertips
  • Cold to the touch
  • Clammy skin
  • Loss of consciousness
  • Seizure

Risk of HIV and Hepatitis

Intravenous heroin users face severe risks of HIV and hepatitis since sharing needles puts individuals at risk of contracting these diseases. Track marks, the visible scars from frequent injections, can also become infected, leading to further health complications.

Besides the risk of contracting HIV, the additives found in heroin, such as sugar, powdered milk, and starch, can block veins and impede blood flow to the brain and major arteries. This can cause lasting and substantial harm.


When you become dependent on heroin, abruptly stopping the drug will lead to withdrawal symptoms. The severity of these symptoms depends on factors such as your genetics, the amount of heroin you use, and how long you've been using it.

With its high potency, heroin can create a strong drug dependence, resulting in intense withdrawal effects. Heroin withdrawal symptoms include:

  • Runny nose
  • Profuse sweating and clamminess
  • An intense craving for the drug
  • Cold flashes with goosebumps
  • Restless leg-like symptoms
  • Stomach cramps
  • Nausea and vomiting
  • Insomnia
  • Depression
  • Psychosis
  • Agitation and irritability
  • Hallucinations
  • Homicidal or suicidal thoughts


Overdose occurs when heroin overwhelms your body. In a heroin overdose, essential neurons in the brain become suppressed, leading to dangerously slowed or halted breathing. The lack of oxygen can seriously affect the brain and other vital organs.

The drug Naloxone offers a solution to a heroin overdose. By binding to opioid receptors in the brain, it effectively halts and reverses the effects of heroin. This fast-acting medication rapidly restores and normalizes breathing, potentially saving lives.

If you or someone you know is experiencing a heroin overdose, contact emergency medical services immediately. Getting these immediate emergency medical services are crucial to prevent severe damage or even death:

  • Life support
  • Intubation
  • Mechanical ventilation
  • Airway management
  • Close monitoring


Untreated heroin use can result in potentially fatal overdoses. High amounts of heroin can harm the heart and lungs, causing significant respiratory depression and slowing the heart rate to a life-threatening extent. 

Without prompt medical intervention, survival becomes unlikely. CDC WONDER reports over 80,411 reported opioid-involved overdose deaths in 2021.

This is a disastrously high increase from the previous year, which incurred 68,630 deaths. With trends seemingly increasing, opioid addiction continues to be a dangerous threat.


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Why Do People Use Heroin?

People abuse heroin for the following reasons:

  • Its ability to induce a state of euphoria: The allure of experiencing sensations of happiness and pleasure and a dream-like perception of time makes people use heroin. It’s particularly appealing to people with muscle and bone pain, temporarily alleviating discomfort and other symptoms.
  • The escalating misuse of prescription opioids: This has driven many users to seek heroin as an alternative since prescription opioids and heroin share similar effects. People with substance use disorder (SUD) often resort to mixing it with other drugs or polydrug use.
  • Heroin’s potency compared to prescription painkillers: It delivers a more intense euphoria, mimicking the high hydrocodone and oxycodone produce. Once a person develops tolerance for these drugs, this becomes a sought-after trait.

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What Are The Side Effects of Heroin Abuse?

There are short-term and long-term effects of heroin addiction and abuse.

Short-Term Effects

According to the National Institute on Drug Abuse, the following are the associated short-term effects:

  • Anxiety
  • Depression
  • Slowed breathing
  • Hypotension (low blood pressure)
  • Heart arrhythmias
  • Inability to focus
  • Lapsing in and out of consciousness
  • Palpitations

Long-Term Effects

Heroin's addictive nature leads many to long-term use, resulting in significant consequences. The long-term effects of heroin abuse include: 

  • Insomnia
  • Constipation and stomach cramps
  • Sexual dysfunction
  • Irregular menstrual cycles
  • Depression
  • Psychosis
  • Collapsed veins from damage caused by frequent injections
  • Damaged nose tissue and nose bone erosion from those who snort it frequently
  • Infection of the heart lining and valves
  • Abscesses
  • Liver and kidney disease
  • Lung complications, including pneumonia
  • HIV, Hepatitis B, and C from IV drug use

What Are The Treatment Options for Heroin Addiction?

The first and most crucial step is having the desire to quit. While some people can do it independently, most success stories stem from receiving professional help.

Heroin addiction treatment is a multi-faceted approach. Fortunately, many tools are readily available to end heroin addiction.

Potential treatment options you can try include:

Behavioral Therapy

Usually, underlying issues lead to somebody falling into addiction, such as depression or PTSD. In behavioral therapy, mental health professionals can teach relapse prevention skills and help them identify triggers to overcome opioid dependence.

Cognitive Behavioral Therapy (CBT)

CBT takes a comprehensive approach to help people identify their triggers, manage expectations, and tackle the stress accompanying sobriety. By recognizing harmful behaviors and addressing external influences and internal thought processes, CBT empowers users to break free from addiction.

Group Therapy

Group therapy is a crucial part of behavioral treatment. It allows users to openly discuss their experiences and support one another in their struggles. They can also learn techniques to prevent relapse if they feel the urge to use and connect with others to seek advice on their struggles.

Motivational Interviews

This method involves a one-on-one or small group setting to ensure personalized care. The process of dealing with addiction is stressful, so motivational interviews help people cope with the process and stay focused.

Contingency Management

This program uses positive reinforcement by giving people tangible rewards for their sobriety. It uses a “point system” that gives them a sense of gratification for sober living. It’s a great way to encourage healthy habits after receiving rehabilitative treatment.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) involves taking drugs that can help alleviate severe withdrawal symptoms. People undergoing addiction recovery may be administered certain medications in conjunction with behavioral therapy for optimal efficacy.

Some common drugs include:


This medication is a non-addictive opioid receptor antagonist that blocks the effects of other narcotics. It comes in either a daily pill form or a monthly injection.


This medication is an opioid partial agonist that blocks other narcotics. This particular drug has the added benefit of reducing withdrawal symptoms and severe heroin cravings. Physicians prescribe it as a daily dissolving tablet, cheek film, or a 6-month implant under the skin.


This drug is another opioid agonist but doesn’t block other narcotics while preventing withdrawal. People take this medication as a daily liquid from highly regulated clinics. They must visit in person to receive this medicine to prevent abuse.

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Heroin is an illegal and highly addictive substance that induces euphoria and relaxation, often in a white or brown powder form. Due to its effects, heroin addiction is a serious problem that has long-lasting and devastating consequences.

Many treatment options are available to those who want to manage severe heroin cravings and other related withdrawal symptoms. With medication-assisted treatment, behavioral therapy, and other forms of support, people suffering from heroin addiction can find hope against heroin addiction.

If you or someone you know suffers from addiction, remember that you’re not alone, and that help is available. Take the first step towards a new life today.

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Updated on November 16, 2023

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