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What are the signs of heroin addiction?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

The signs of heroin addiction can be classified as physical, psychological, and behavioral. According to the National Institute on Drug Abuse, these signs can appear soon after first use. 

Heroin addiction can have serious health effects when left untreated. Seek help as soon as possible. 

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Our personalized heroin addiction treatment program can help you detox in a medically supervised setting, and provide counseling to understand what drives your substance use. 

With time, effort, and support, our team can guide you toward sobriety and health so you can regain control of your life.

I went to Ardu only for detox (my first treatment ever) they made it incredibly comfortable for me. The nurses were awesome! They made it so comfortable for me going through something I felt very nervous about with it being my first time. Staff was welcoming to me to join groups but not pushy as I was detoxing. 

David Cline


What is heroin?

Heroin is an illegal, highly addictive opioid drug synthesized from morphine, which comes from the opium poppy plant. It can be a white or brown powder or a black sticky substance known as black tar heroin. When injected, snorted, sniffed, or inhaled, heroin quickly binds to the brain’s opioid receptors, giving that euphoric, sedative, and extremely addictive high. 

Addiction can develop quickly, but often develops after a stretch of regular use. Because of heroin’s intense habit-forming nature, it is considered one of the most dangerous and deadliest drugs out there.

Why is heroin so addictive?

With frequent use, the user’s tolerance to heroin increases, meaning that you need a higher dose to achieve the same high as before. When this happens, the user puts themself at increased risk for physical and psychological dependence. According to the Substance Abuse and Mental Health Services Administration, over 500,000 people battled heroin use disorder in 2013, 84% of which showed dependence. 

Heroin mimics natural opioid chemicals in the brain, which are normally used to reduce pain and increase pleasure. When it enters the brain, it rapidly binds to opioid receptors, triggering a surge of dopamine (the “feel-good” chemical) and pleasurable effects associated with a “rush” or “high.” 

The more a person uses heroin, the more it alters their brain’s opioid receptor signaling and natural dopamine reward system. Over time, this results in tolerance, dependence, cravings, and addiction. Significant brain changes also make the user unable to feel pleasure without the drug, leading to withdrawal symptoms, and increasing the likelihood of overdose.

To overcome heroin addiction, you need the help of a comprehensive drug rehab center. The knowledgeable professionals at Ardu in Provo, Utah implement traditional medicinal modalities alongside holistic treatment programs to make your recovery process as well-rounded and effective as possible.

If you notice any symptoms of heroin addiction in your loved ones, contact Ardu today.

What are the symptoms of heroin addiction?

Heroin addiction has overt physical, psychological, and behavioral symptoms. As dependence takes hold, these symptoms intensify and multiply. 

Here are the most common signs of heroin addiction:

Physical signs of heroin addiction

  • Track marks, bruises, and scabs from repeated injections
  • Dramatic fluctuations in weight stemming from metabolism changes
  • Bloodshot or glazed eyes
  • Slurred speech
  • Poor coordination and balance
  • Shifts between hyperactivity and sudden lethargy
  • Nausea, constipation, and digestive issues
  • Slowed breathing and heart rate, especially during overdose risk

Psychological and behavioral signs of heroin addiction

  • Powerful cravings for the next heroin dose
  • Deceit, secrecy, or defensiveness about drug use
  • Loss of inhibition and decision-making skills
  • Inability to control or cut back on using more heroin
  • Risky behaviors such as sharing needles or driving intoxicated
  • Isolation from family members and friends
  • Depression and anxiety
  • Apathy toward personal hygiene
  • Aggression, mood swings, lack of restraint
  • Problems at work, school, or home
  • Financial issues or illegal acts
  • Combining heroin with other substances

Heroin shares many common symptoms of addiction with other substances, as continued use changes brain chemistry, impacts health, and alters behaviors. See our comprehensive guide on how to recognize signs of drug addiction

How does heroin addiction affect health?

Heroin addiction has adverse health effects that worsen over long periods of continued use. The constant presence of the toxin disrupts normal bodily functions and the brain’s chemical balances. The longer you use heroin, the more systemic and severe the damage becomes. 

Possible effects of heroin use include:

  1. Significant changes in the structure and physiology of the brain. Heroin use can cause long-term imbalances in neuronal and hormonal systems, impairing decision-making and behavior-regulating abilities, as well as responses to stressful situations. 
  2. Damage to the respiratory system. Heroin affects the brain’s opioid receptors which are also tied to breathing. This can alter the person’s breathing patterns and potentially lead to chronic respiratory issues and insufficient oxygen delivery to the brain.
  3. Clogged blood vessels. Heroin addiction can impair the delivery of oxygen and nutrients to organs such as the liver and kidneys, leading to organ failure. 
  4. The use of contaminated injection equipment can lead to bacterial infections of the blood vessels and heart valves, such as endocarditis. According to the National Institute on Drug Abuse, heroin users who share syringes have an increased risk of contracting infectious diseases like HIV/AIDS and hepatitis B and C.
  5. Heroin addicts may suffer from hypoxic or ischemic brain damage, which can result in severe mental disturbances. Autopsies on 100 intravenous heroin addicts found that 5-10% had damage to the globus pallidus area of the brain from lack of oxygen. The globus pallidus coordinates movement, thinking, and drive. Damage to this region can impair mental faculties and motor control.
  6. Chronic heroin users may experience a variety of medical complications, including lung complications like pneumonia and tuberculosis, mental disorders, sexual dysfunction, and irregular menstrual cycles.

Start your journey to health and sobriety by breaking free of heroin’s hold. Our caring team will support you through detox and beyond. We help you embrace counseling and build the community you need to thrive in recovery’s blessings. Our heroin detox center provides a gentle, supportive environment to safely put a stop to dependence. 

Learn about our opioid detox services. Our experience and proven protocols help you to safely, comfortably, and effectively detox from a wide range of substances including fentanyl, oxycodone, codeine, and other opioids.

Heroin addiction vs. heroin abuse

Heroin abuse and addiction both involve recreational use, but there are important distinctions.

  • Heroin abuse is the recreational or non-medical use of the drug to experience its short-term intoxicating effects. While dangerous and illegal, people who abuse heroin sometimes use it more casually in social settings.
  • Heroin addiction indicates physical and psychological dependence on increasing doses of the drug, leading to cravings and drug-seeking behaviors. Addicts develop tolerance over time, needing more heroin without the ability to control or quit usage. 

While abuse seeks a temporary high, addiction is the compulsive pursuit of heroin to feel normal and avoid the excruciating symptoms of drug withdrawal. Addiction stems from changes in brain circuitry and hormone levels causing neurological imbalance when deprived of the drug. 

Both heroin abuse and addiction are extremely dangerous. 

We offer comprehensive drug detox services to help you safely and comfortably detox from heroin. Our experienced medical staff will develop an individualized treatment plan tailored to your unique needs and situation.

Ardu’s heroin addiction treatment center

If you are addicted to heroin, addiction treatment at a drug rehab center could be just the life-changing care you need. At Ardu Recovery Center, we provide compassionate care to help you reclaim your health, happiness, and purpose.

We offer comprehensive inpatient, outpatient, and dual diagnosis treatment tailored to your unique needs. Inpatient treatment, also called residential treatment, provides round-the-clock structured support and intensive therapy daily. Ardu’s outpatient treatment allows you to maintain your personal life while getting help on a weekly, bi-weekly, and even daily basis if needed.

Many people struggling with heroin addiction also face co-occurring mental health issues such as depression, anxiety, trauma, or bipolar disorder. This combination of substance use disorders and co-occurring mental health disorders is known as a dual diagnosis.

The experts who run our co-occurring disorder treatment programs are trained to treat both your addiction and any co-occurring mental health conditions. If you struggle with cross-addiction tendencies (trading one addiction for another), we can help with that as well. Our personalized aftercare services ensure you have ongoing support to maintain your sobriety long-term.

To enroll in an Ardu heroin treatment program, contact Ardu Recovery Center online or via phone (801-810-1234). We will work with you to find a recovery path that works for you during the detox process and beyond. 

Read our admissions process page for more information.

If you want to verify your health insurance coverage and gather more payment information and the Medicaid redetermination process in Utah, visit our insurance verification page.

Recovery is a lifelong journey, and we’re honored to walk this path with you.

Brandon Okey

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Signs of heroin addiction FAQ

What are the three main signs of addiction?

The three main signs of addiction are physical dependence, tolerance, and compulsive drug-seeking behavior. Physical dependence means experiencing withdrawal symptoms such as abdominal cramping, goosebumps, and sweating when heroin stops. Tolerance is needing larger doses to achieve feelings of euphoria. Compulsive drug-seeking behavior persists despite negative consequences like financial ruin or suicide risk.

Further dimensions of addiction involve an intense preoccupation with using the chosen substance (e.g., heroin). This manifests in behaviors like obsessionally tracking access to heroin, concealing drug paraphernalia, and spending excessive time under the influence or recovering from use. 

Addicts may engage in risky behaviors solely to obtain or use more of the substance despite the danger of overdose. Even with treatment, relapse rates remain high due to the intense cravings and difficulty avoiding environmental triggers.

How does drug addiction affect the brain?

Drug addiction alters brain structure and function over time by hijacking neural communication pathways that involve dopamine receptors as well as the opioid and endocannabinoid systems. Compulsive heroin injection or opioid pill-popping flood the reward circuitry with dopamine. This spikes feelings of euphoria and pleasurable sensations. 

With sustained use, dopamine receptors become overloaded and fatigued, dulling natural reward system reactions and enabling cravings, emotional addiction tendencies, and a higher risk for overdose in pursuit of that elusive dopamine high.

The prefrontal cortex responsible for concentration, decision-making, impulse control, and mood regulation also gets impaired, contributing to erratic behaviors, interpersonal issues, unemployment, social withdrawal, and co-occurring mental illnesses like depression or bipolar disorder. The amygdala also processes environmental triggers related to deeply embedded addiction memories making relapse more difficult to avoid on the journey to long-term recovery.

How do you reset dopamine levels?

Ways to reset dopamine levels without drugs include:

  • Exercise
  • Social interaction
  • Sufficient sleep
  • A balanced diet
  • Avoiding addictive behaviors that briefly spike and then deplete dopamine
  • Using amino acid supplements to aid production

The best way to make sure your dopamine levels are healthy and regulated is by giving your brain extended drug-free time to heal receptor functioning.

What classifies someone as a drug addict?

The main indicators of drug addiction are escalating usage, tolerance, withdrawal symptoms, failed attempts to quit, and excessive time spent using and recovering. Additionally, persistent use despite the harm to mental health, physical health, relationships, work, school, or the legal or financial realms of life classifies someone as a drug addict. 

Other hallmarks include an intense preoccupation with using the substance, inability to consistently fulfill roles and duties, and engaging in risky behaviors solely to obtain or use the drug of choice such as heroin or alcohol.

What drugs are psychologically addictive?

Highly psychologically addictive substances and behaviors include:

  • Opioids like heroin and oxycodosterone, used for their intense euphoria and pain relief
  • Stimulants like cocaine and meth for amplified energy, motivation, and attention
  • Club drugs such as MDMA for sociability and empathy
  • Depressants for reducing inhibition, and behaviors such as gambling, gaming, or pornography.

What is emotional addiction?

Emotional addiction is the compulsion to engage in pleasurable behaviors as a means to numb, alleviate, and avoid negative internal emotional states stemming from trauma, chronic stress, depression, anxiety, or boredom, rather than for the inherent enjoyment of the activity itself.

How does drug use affect mental health?

Drug use, especially heavier long-term use, commonly co-occurs with and exacerbates mental health conditions like depression, bipolar disorder, and anxiety disorders. This manifests both during intoxication and withdrawal, as the substance interferes with mood regulation. Long-term psychiatric issues can persist even after achieving sobriety.

Which part of the brain does addiction affect most?

The prefrontal cortex, responsible for concentration, decision-making, impulse control, and mood regulation, faces some of the clearest functional and structural neurological impacts of addiction. Addiction impacts emotion and reward centers in the prefrontal cortex, such as the amygdala and nucleus accumbens, which govern executive functioning and impulse control. It also affects memory consolidation in the hippocampus, leading to cravings being deeply embedded neural triggers.

Is drug addiction a brain disorder?

According to the disease model of addiction, drug addiction is a brain disorder. The modern view supports that substance use disorders such as heroin addiction constitute complex brain disorders stemming from changes in neurological communication pathways governing reward, learning, motivation, and behavioral inhibition. 

Continued heroin abuse alters critical signaling involving dopamine, opioid, and endocannabinoid receptors, leading to symptoms such as:

  • Cravings
  • Physical dependence
  • Increased tolerance escalation
  • Compulsive use despite unpleasant withdrawal effects or devastating personal consequences


Drug Misuse and Addiction | National Institute on Drug Abuse. (2024, January 5). National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction

Trends in Heroin Use in the United States: 2002 to 2013. (n.d.). https://www.samhsa.gov/data/sites/default/files/report_1943/ShortReport-1943.html

Why does heroin use create special risk for contracting HIV/AIDS and hepatitis B and C? | National Institute on Drug Abuse. (2021, April 13). National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/heroin/why-are-heroin-users-special-risk-contracting-hivaids-hepatitis-b-c

Andersen, S. N., & Skullerud, K. (1999, May 1). Hypoxic/ischaemic brain damage, especially pallidal lesions, in heroin addicts. Forensic Science International. https://doi.org/10.1016/s0379-0738(99)00040-7

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