Heroin is an illegal opioid drug processed from morphine, a natural substance derived from the opium poppy plant. It is highly addictive and can be a white or brown powder, or a black sticky substance known as “black tar heroin.” People use heroin by injecting, sniffing, snorting, or smoking it. Understanding the signs of heroin use is important for recognizing when someone may need help.
Physical Indicators
Observable physical signs can often point to heroin use. One prominent indicator is the presence of “track marks,” which are visible injection sites appearing as scabs, scars, bruises, or collapsed veins. These marks are frequently found on the arms, but can also appear on legs, hands, or other areas where injections occur. Individuals may wear long sleeves or pants, even in warm weather, to conceal these marks.
Another common sign is pinpoint pupils. Heroin, like other opioids, activates specific receptors in the brain that cause the pupils to constrict significantly, often to the size of a pinhead. Changes in overall appearance can also be present, including unexplained weight loss, pale skin, and a neglected appearance due to poor hygiene.
A person using heroin may exhibit “nodding off,” a state of fluctuating between wakefulness and deep drowsiness. Individuals may suddenly fall asleep or appear extremely drowsy at inappropriate times, often with their head bobbing. Skin issues like severe itching, frequent scratching, or abscesses at injection sites are also common.
Behavioral Changes
Heroin use often brings about noticeable shifts in a person’s behavior and personality. Unpredictable mood swings and irritability are common, with individuals exhibiting agitation or sudden shifts from calm to angry states. Increased secrecy and isolation are also frequently observed, as individuals may withdraw from family and friends, have unexplained disappearances, or lie about their activities.
Financial difficulties often emerge due to the cost of maintaining a heroin habit. This can manifest as an unexplained need for money, stealing, selling personal possessions, or accumulating sudden debt. Individuals may neglect responsibilities at work, school, or home, losing interest in previously enjoyed hobbies or activities.
Changes in sleep patterns are also indicative, with users staying up late or sleeping at unusual hours. While heroin initially causes drowsiness, chronic use can disrupt sleep quality and even lead to insomnia. Finally, a person using heroin may become highly defensive or angry when confronted about their behavior or suspected drug use.
Drug Paraphernalia
The presence of certain items can indicate heroin use:
- Needles and syringes are directly used for injecting the drug.
- Spoons or bottle caps often have burn marks on their undersides, as they are used to heat heroin to dissolve it for injection.
- Lighters are typically found alongside these items, providing the heat source.
- Cotton balls or filters are frequently used to strain impurities from the dissolved heroin before injection.
- Rubber tubing, shoelaces, or belts may be found, as these are used as tourniquets to make veins more prominent for injection.
- Small plastic bags or balloons are common for packaging and storing heroin.
- For those who snort heroin, straws or rolled-up bills, sometimes with residue, can be present.
Signs of Withdrawal
When a person physically dependent on heroin stops or significantly reduces their use, they experience withdrawal symptoms. These can resemble a severe flu, including nausea, vomiting, diarrhea, and muscle or bone pain.
Sweating and chills are also common, often accompanied by goosebumps, a phenomenon sometimes referred to as “cold turkey.” Restlessness, agitation, and anxiety are frequently reported during withdrawal. Insomnia, or difficulty sleeping, is another prominent symptom, alongside excessive yawning. A runny nose and watery eyes also typically occur.