Signs of Heroin Addiction

Derived from the opium poppy, heroin is considered a highly addictive drug.  Opium has been used for medical, ritual, and recreational purposes for millennia, and its addictive properties have been well documented.  Because withdrawal from heroin causes such severe symptoms, some experts recommend that subsitution therapy (like Methadone or Suboxone) be used to ease the transition or that addicts complete longer (up to 2 years) residential treatment programs to increase the likelihood of successful recovery.  Opiate addictions in general and heroin addiction specifically can be incredibly difficult for an addict to end without help.  In 2003, over 280,000 Americans received treatment for heroin addiction.  The National Survey on Drug Use and Health from 2009 indicated that 180,000 people were heroin “initiates” (i.e., tried heroin for the first time) that year, which was an increase of 60,000 people from the previous high of 118,000 in one year between 2002 and 2008.  Below you will find a number of possible signs that someone is addicted to heroin.

• Physical Signs of Administration – Heroin is commonly injected directly into the addict’s blood stream; it may also be smoked, eaten, or snorted.  Frequent IV injection can cause veins to collapse; scarred veins become dark and create “track marks” on the person’s skin.  In addition, you may see abscesses on the sites that the person favors for injection (most often the arms).  However, eventually, the addict will need to start injecting the heroin into other veins when those that have been damaged can no longer be used.  When addicts are desperate and do not have clean needles on hand, they may share syringes with others, which can lead to contracting HIV or hepatitis among other diseases.  If the addict smokes heroin, you may also find aluminum foil or a pipe or other device.
• Paraphernalia – Finding tourniquets (like bands of rubber or bandanas), syringes, lighters (to heat the heroin prior to injection), spoons (for heating and dissolving it), and sterilizing solution may indicate a heroin (or possibly crack) addiction. 
• Depressed Respiration – All opiates depress the central nervous system and, by extension, breathing.  You may notice that the person seems to be breathing shallowly, especially after recent use.
• Lethargy – Use of heroin will cause extreme relaxation in a user. Their limbs may hang at their sides heavily, they may seem disoriented and sleepy, and they may have difficulty remembering things or conveying their thoughts.  They may have a perpetually “glazed” expression and may behave like a “zombie.”
• Pinpoint Pupils – An addict’s pupils will be constricted (i.e., very small), even in dark light (when a normal person’s pupils expand to take in as much light as possible to enhance vision).  However, during withdrawal, the addict’s pupils may dilate (i.e., become large).
• Constipation – If the person spends an unusually long time in the bathroom, it may, in combination with other signs, suggest heroin use.
• Poor Appetite – Weight loss is common in people who are addicted to heroin. A person who has been a heroin addict for a while may show signs of malnutrition and dehydration.
• Mood Fluctuations – The addict’s mood can swing between depression and elation like a pendulum.
• Changes in Libido – Although some addicts report that, on initial use, heroin increases libido, long-term use often does the opposite.
• Scratches on Face and Body – Heroin use can cause a histamine reaction, which may make the user itch obsessively.  If the scratches are not kept clean, an infection can result.