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Signs Of Heroin Use

Dr. Anna Pickering

Medically reviewed by

Dr. Anna Pickering

April 2, 2019

Many physical and behavioral changes in an individual can indicate heroin use, as well as the presence of certain types of paraphernalia used to consume the drug. A better understanding of these signs can help you identify heroin addiction, and hopefully, find a way to help.

Physical Symptoms

The most common physical sign of heroin use is thought to be “track marks,” or small puncture wounds on the skin. The injection site may become infected from multiple pokes, leading to scars. Track marks are most commonly observed on the arms and inside of the elbows. Long sleeves are often worn (even in warm weather) to hide heroin use. Here are a few additional signs of heroin use, both during and after consumption:

  • Constricted pupils
  • Labored breathing or movements
  • Dry mouth
  • Weakened immune system
  • Constipation, dehydration, itching, and vomiting
  • Kidney and bladder inflammation

Heroin can be smoked, or snorted, as well. As with most smoked and snorted substances, respiratory troubles can become more apparent when the user is abusing heroin. You may notice chronic coughing, wheezing, or a bloody nose. The user may become easily winded, or experience more frequent respiratory infections as a result of heroin use.

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Behavioral Indicators Of Heroin Use

Sudden financial struggle can indicate heroin use early on. Heroin addiction can cost as much as $200 per day to maintain. The user may borrow money from friends and family, or sell belongings to support the addiction. Other behavioral issues are common in heroin abuse, most frequently:

  • Hyper alertness, followed by sudden drowsiness or “nodding off”
  • Confusion, delirium, or hallucinations
  • Defensive when asked of whereabouts
  • Impulsive behavior
  • Poor hygiene
  • Loss of job, trouble with authorities, or lacking grades
  • Overall distraction

Heroin use can also lead to distance with family and friends, or an unexplained disappearance for days or weeks at a time. This is often due to heavier consumption, or guilt in the user. If a loved one is missing, it may be important to intervene to ensure the safety of the user.

Heroin Paraphernalia

Heroin can be purchased as an off-white to dark brown powder, or in a sticky, tar-like form. It is often distributed in a small plastic bag. When heated, heroin may let off a faint vinegar smell. Some physical items that indicate heroin consumption include:

  • Burnt spoons or aluminum foil
  • Needles and syringes
  • Belts, bands, or rope to use as a tourniquet for injection
  • Tubing, rolled aluminum foil, or glass bulb with glass tube is used for smoking heroin
  • Razor blades, rolled paper, and straws are used to prepare heroin for snorting

Users may refer to heroin as “Horse,” “Dragon,” “H,” “White (White Lady, China White),” “Chiba (or Chiva),” or “Scag.” A few other nicknames for the substance may be mentioned, so pay attention to conversations that seem to refer to code words.

Treatment For Heroin Addiction

Heroin is a highly addictive drug. Many users tend to relapse, even after achieving sobriety for a long time. Often, the addict will encounter a difficult life change, and turn to heroin for relief. Continuing therapy and treatment can aid in coping with the temptation, and offer alternative methods to cope. Many addicts fear treatment, because withdrawal symptoms are so intense. Treatment facilities are available to ease the transition into sobriety with the use of Methadone and Suboxone/Subutex. These substances are used to aid in recovery, and lessen the effects of withdrawal.

We Can Help

If you suspect that a friend or family member is abusing heroin, you may wonder what you can do to help. The caring staff at is here to help you find the answers you need. We can help find a rehabilitation center in your area, and guide you through the process of finding relief. Do not hesitate to reach out and contact us, we’re here for you.

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