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What are the Signs of Heroin Addiction?

Jessica Ellis
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Updated: Feb 01, 2024
Views: 124,873
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Heroin addiction is a dangerous condition that can have potentially fatal consequences. One of the most widely trafficked drugs in the world, heroin is easy to find in almost any part of the world, and can have devastating effects on both the user and those around him or her. Understanding some of the signs and indications of both drug use and heroin addiction can help parents and concerned friends discover and try to help an addicted person before far worse consequences ensue.

The drug known as heroin is an opiate drug created from certain poppy seeds. Originally developed as a morphine substitute, heroin was originally touted for its ability to help alcohol addicts overcome withdrawal symptoms. Unfortunately, the synthesized drug is in itself extremely addictive, causing both physical and psychological dependence that grows with repeated use.

Heroin typically comes in powder form and is usually melted, injected, or smoked before use. One of the most critical indications of addiction is the drug paraphernalia used to administer the drug. Pipes and syringes are common heroin implements but users may also have spoons or aluminum foil nearby in order to heat or melt the drug before using. Rolled tubes made from paper or paper money may also be a sign of addiction, since some users snort the drug from a flat surface using a tube placed in one nostril.

There are several physical signs associated with heroin addiction, although many of these are common to several different types of recreation drugs including alcohol, marijuana, and cocaine. Constricted pupils, slurred speech, drowsiness and signs of confusion are all common signs of a person who is currently under the influence of drugs. Severe symptoms, such as blue-tinged skin or nails, slow pulse, seizures, or loss of consciousness, can be an indication of a heroin overdose. If an overdose is suspected, summon medical attention immediately and do everything possible to keep the person awake until professional help arrives.

Injecting heroin intravenously also leaves signs that point to an addiction. If a person has “tracks,” or several injection marks or wounds in the same area, he or she may be using an injectable drug. Veins on the arm are a common injection site where tracks are noticeable, but veins will collapse overtime, causing many users to alternate injection sites.

Behavioral changes may also be a sign of heroin addiction or a similar drug problem. Changes in appearance, falling grades or job performance, and abandonment of once-loved hobbies or activities can all signal drug use. However, behavioral symptoms can be a sign of many things, including depression, stress, or even new relationships. Many experts urge caution when confronting a suspected drug user about behavioral changes; judgmental accusations without proof can be detrimental, and may cause the accused to become secretive and paranoid.

Heroin addiction is notoriously linked to overdose, death, and lifelong struggles against returning to active addiction. If drug abuse is suspected in a family member or friend, it is important to discover the truth and help the person as quickly as possible. Keeping a close eye out for signs of recreational drug use may not only prevent an addiction from forming, but possibly save a life.

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Jessica Ellis
By Jessica Ellis
With a B.A. in theater from UCLA and a graduate degree in screenwriting from the American Film Institute, Jessica Ellis brings a unique perspective to her work as a writer for WiseGeek. While passionate about drama and film, Jessica enjoys learning and writing about a wide range of topics, creating content that is both informative and engaging for readers.

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Discussion Comments
By anon968303 — On Sep 02, 2014

@anon325665: What is the significance of black marks on a wall? My son uses and I began to notice that the black marks coincided to his visits home. Thanks.

By anon936132 — On Feb 27, 2014

I believe and I have hope. Sometimes, one has to take a stand and love someone despite his or her weaknesses. It is best when an addict loves you back enough not to take too much, not to steal the love out from under you and make you hurt.

Sometimes, though, an addict will even find a way to break even with you in other ways. I find myself as a caregiver to addicts. I do my best to support and encourage sobriety and demonstrate the bliss of a sometimes mundane and sober experience. It seems to me, sometimes, one has to take a stand as a friend and be what a friend can be, and take a few troubles and pains, and keep helping a change to take place.

In my experience, an addict needs a friend to demonstrate what a real friend is: someone who has enough self love not to be taken advantage of, yet will endure the occasional trouble and pain, while minimizing drama.

Sometimes it is surprising to an addict that someone just wants good things for them, for no other reason than to witness their success. Sometimes addicts are surprised that person could have no agenda. There is nothing wrong with being the example of such person.

It makes me sad, the weakness that leads to heroin addiction. I don't know about weakness. I am puzzled myself, without ever giving heroin a try. When it was offered, I said, no. I looked at the result of a man on heroin and I said no thank you. I have no regrets, and if I can take my friend with me on this high -- the bliss of mundane honesty -- I will be satisfied.

If you love an addict, be strong. State your limits. Keep your respect, and for every moment of recovery, be present with recognition. There is a terrible pain behind the weakness, and some people were not blessed with the strength to subdue it alone.

By anon355178 — On Nov 14, 2013

My nephew has used heroin since he was 18. He is now 30. He has always said he has never injected.

He also is on anti-psychotic drugs. He was in hospital with blisters on his feet and had black toenails, with pus in between his toes. The hospital doctor refused to treat him, saying it was self inflicted, and he obviously wouldn't discuss it with the family. He admitted again a few days later he has blood clots in his leg and lungs and now cannot stand so he's in a wheelchair.

They say the blisters are attacking his bones and they don't know why. Can anyone tell me if this is from injecting heroin in his legs/feet/groin?

By loki68 — On Oct 23, 2013

I don’t know where to start. The comment to run as fast as you can, it’s cold, but I can see their point. I can also see someone wanting to help.

I shot heroin for over 10 years, and I’d like to say I’m clean. I’m on Methadone (in a sense I am ). I take my dose every day and have six take-home bottles because my urine tests are clean. I’m waiting on 13 bottles now. See the thing is, yes, the methadone is like a substitute, but I’m not out there robbing people, breaking down doors, selling stolen goods and going to prison.

Yes, I have done everything I’ve named. I’ve been in 11 rehabs and 20-some detoxes from ages 16 -31. I started out getting high when I was about 13. But no one can make you stop; it’s impossible. You have to do it for you. Even what I’m doing is keeping me out of jail and out of trouble, but I hate the fact I’m on it, and I’ll be on it for the rest of my life. Some heroin addicts never get better, and that’s a fact, and that’s why I’m on methadone. I can keep this monster at bay this way.

The best advice for parents is if your kid is doing heroin, try to get them help. Relapse is a part of recovery, but there is a point you have to stop enabling them. If they don’t want help, throw their butts out and get them out of your house, or it will cause you nothing but pain, and you will be robbed blind.

Like I said, I can see both sides of the fence, and I see kids 15 years old sticking needles in their arms and they have no idea what kind of hell is awaiting them. We lost the war on drugs long ago, so now we need to come up with ways to battle it without condemning things like methadone, Suboxen and Subutex. Doctors are finally seeing that sometimes these are the only things that work. You’ve got a legal substitute that doesn’t get you high, or death. These are your choices if you don’t catch it fast enough.

That’s all I’ve got. I could go on and on and I’m sure some will criticize me while others might understand and even some users themselves will identify with me. We never wanted to be like this. We just are. I don’t have all the answers, and I never will. I just know what’s working for me! And if anyone ever wants to contact me, you can. I will listen and try to help.

By anon341370 — On Jul 11, 2013

@valverde: My brother is a 21 year old heroin addict. His friend who is helping me try to stop him explained the sharpies. When someone uses, they keep a sharpie to sniff in case they begin to go in too deep of a high. It stimulates the brain and gives a sudden sensation to kick them awake so they won't fall asleep and potentially OD easier. Good luck with everything.

P.S. If any person you suspect to be shooting up looks and acts very drowsy and sleepy and claims they're on Klonopin, and say it's what messed them up, they're lying their butts off.

P.P.S. Beware of their "friends" who don't seem to enjoy hanging out when you're around. Most likely who they get it from.

By anon340841 — On Jul 06, 2013

An addict will not inject into a muscle; this is very dangerous. Even 'skin popping' is seldom done due to danger of an abscess forming, and there is even less of a high from skin popping due to slow absorption than from smoking, so there is no point.

Also, there is no way to know how recently foil has been used to smoke a drug.

H is slang for heroin. It is also true that needles are very thin, but not 1/10ths the size of a sewing needle. The lowest gauge I have heard being used is 29 or maybe at a push 31, but the drug needs to be able to flow through the pin, and any smaller would not work.

Post number 3, why would you want to convince your brother in law his son is using? How can you be sure?

@Valverde: The foil is used by placing the heroin on the foil, heating from underneath and inhaling through the hollowed out pen. Don't know what he has sharpies for, though.

Also, I have met addicts who still work, and have for years. These are known as functioning addicts, and you would not recognize these from other members of society; it is just their drug of choice.

I have worked with addicts for a few years due to my line of work and I will answer any questions.

By anon340674 — On Jul 04, 2013

Honest to God, you may think that you love all of these people, but if there is any possible way (you are not their parent or spouse) run for your life! Do not stay with an addict. It will not get better any time soon. It will get worse, and it will get chronic. It is not possible for you to help them, and you certainly cannot fix them. Honestly: run.

By anon339434 — On Jun 23, 2013

People who don't understand the life of an addict, please don't judge. I have read some comments and some come across as uneducated. I've been with my boyfriend for nearly 13 years. He's a good, hard-working man, but his downfall is he's a heroin addict.

When we first met, he had just gotten out of rehab (which I didn't know at the time) but we fell in love anyway, and then I found out just over two years down the line when he started using again. He lost weight, lied, came home late and looked awful. I stayed with him because I believe you don't give up on a person you love.

He got clean again then relapsed again and so forth. He's now been clean for three years, but now I'm worried. My gut instinct is telling me he's using again. He's gone from a 38 waist and his trousers were getting tight at that, to a 36 in a month or so. He makes excuses that he's taking the dog for a walk. Why does he need to take the car? He comes in late from work. When I ring him to see where he is, he says he is working late and I can walk up to where his car is. I have sent him texts telling him I'm not an idiot.

When he comes home he says it's only a recent thing. I really hope he's not using. I can't do this again. It's so hard. I can't watch him destroy his life and soul. I love him so much. He is a good man, but I will walk this time.

By anon326883 — On Mar 24, 2013

I found a ball of crumbled, burned foil and a lighter. Is there a way to tell how recently it would have been used to cook drugs?

By anon325665 — On Mar 17, 2013

I had my suspicions with my boyfriend of over a year, but chalked it up to all the severe injuries in his life (car accident, coma, pro boxing). He had excellent excuses for everything. The final straw was when I found out he lied to me about losing his job and not paying rent and there was at least 3k of missing money. Then I knew for sure.

I bought a drug test which he refused to take. I did notice a lot of black marks on the walls, but figured that was from working in auto industry. After he lost his job, in a month, the black marks doubled. He nods out a lot, comes home very sweaty with flushed skin, complaining of dry mouth. He always keeps his cars locked and me away from them. He never has "friends" over, always walks away to have phone conversations and deletes texts as they come in. He has no contacts saved in his phone other than me and his parents.

He always makes excuses to leave for an hour or so. Recently, he's been jumping out of bed, throwing on sweatpants and running out the door (he used to be so concerned with designer clothing, keeping his hair trimmed, his teeth, etc). So far there has not been one morning where we've lounged around in bed snuggling like normal couples. The other day he woke up and ran out, and I checked his pockets to see if he had actually been working. I can't say I was surprised to see a beer can bottom with burn marks all over it. This most likely means he's using the can to heat up the heroin and inject it. Other giveaway signs: the nodding out (always blamed on being tired, but if you look online, you can see the difference), constant scratching, insomnia, kicking (literally kicking the habit- withdrawal), lying, missing money and jewelry, extreme secretiveness. Oh – and constricted pupils! They don't change with the lighting. That's how I know if he's high now. He has slurred speech, sometimes (not always) raspy. He always blamed it on alcohol, but doesn't seem to be drunk. He also has loss of coordination and clumsiness, along with spots on his legs he said were picked pimples, but now I'm assuming otherwise. He is mixed with pretty, tan skin, the spots are purple and a little smaller than an eraser tip. Also, keep in mind needles now are 1/10th the size of a sewing needle, so it's hard to see your stereotypical track marks. And you can inject into muscle instead of vein, although the effects are not as strong.

As far as behavior, my boyfriend is the most sweet, affectionate, loving person. He loves to talk to me for hours, and seems to remember everything I say. But he gets defensive and leaves if I even hint at drug use. He seems to be going downhill quickly, now. He worked at same place for six years, but now is constantly job hopping, but for the past two months, doesn't seem to care about anything, even knowing we will most likely get evicted and he will lose me. He used to spend hours at the gym, but hasn't worked out in forever. I can't believe it took me a over a year to piece everything together, especially being a psychology major.

I knew something was wrong and tried to fool myself, and now look what I got myself into. The signs are often very subtle and accompanied with the most brilliant excuses, so watch out! This is a lifelong battle for anyone. Best of luck to you all.

By anon302102 — On Nov 07, 2012

God help the addicts and their loved ones. It's a nightmare!

By anon286460 — On Aug 21, 2012

What does it mean when someone says they did some h. Is that a sign of them doing heroin?

By anon273419 — On Jun 07, 2012

Why does anyone put something into their body that they will not know the outcome of? It has to be absolute ignorance!

I only have one body and I want to keep it for as long as I can, and I am not taking any chances of harming it.

If you would wash and wax your car, or do the laundry, etc., then why would you care less for your own life? I just do not get it! Can you imagine the first time someone ever tries this stuff? I mean, what can they be telling themselves: Jump off a high bridge; it will feel good on the way down?

By anon212505 — On Sep 07, 2011

@valverde: Many people hide cigarettes or joints in emptied Sharpie pens. Try taking them apart to see what's inside. Wish your family the best!

By amypollick — On Aug 12, 2011

@valverde: First, my prayers are certainly with all of you. Nar-anon is a great resource. Also, if he will go to a Narcotics Anonymous meeting, that's wonderful.

The Nar-Anon folks will probably be your best local resource. They're dealing with this, just as you are, and have a lot of time put in doing homework and getting educated, and you can benefit from that.

Also, if there is a mental health association in your area, they may be a good resource, too. Addiction is a mind game, even more than a physical one.

If you can't get a copy of the Alcoholics Anonymous "big book" from your Nar-Anon group, get your hands on one somewhere. Yes, it's alcohol, but AA is the blueprint for all other 12-step programs, and that book is by far the best look at the addictive personality ever written. Just substitute "heroin" for "alcohol" as you read, and there you are. It's very readable and not at all clinical, as far as a lot of medical terminology being used.

God bless you all. Good luck.

By valverde — On Aug 12, 2011

We just found out our 20 year old grandson has been using heroin for over a year! We are very unfamiliar with drug or alcohol abuse. He came clean after his mother saw him sitting in his car smoking? He doesn't smoke cigarettes.

He told the family about his problem, that he wants to quit, and was glad he got caught, etc. We scrambled to find info and local help. He has been taken to several meetings, and has joined a clinical program to help him. He said he never did drugs at home, but we cleaned his room while he was away at a meeting and found several cigarette lighters, hollowed out pens, foil squares, and a bunch of sharpie pens?

We found out online, and from other people we spoke with, that when heroin is smoked, the hollowed out pens are used like a straw (?) to inhale smoke. What we don't know yet is what is with the foil and the sharpies? If anyone can clear this up please post an answer or info. We need all the information we can get to be of help if needed. We are also looking into local nar-anon meetings.

It has been a very hard, stressful five days. So many questions. Thank you whoever you are for taking time to read this and offer information. Anything, suggestions, advice will be so very much appreciated. So many things are starting to make sense now. There were things we noticed, but he always had a good answer for. The list is too long to go into it now. The whole thing is mind boggling. Only by the grace of God can a family deal with this kind of news.

By anon188414 — On Jun 20, 2011

My stepson Steven posted it on his face book. I wonder what it could do to family members. He told his dad and showed it on the facebook to him. He is upset with me now Steven and I don't get along. He's been caught with drugs before. --Scared

By anon175768 — On May 13, 2011

anon160317, I'm not sure if you still need help, but it is very possible that he is smoking heroin. I am actually dealing with my boyfriend hiding heroin use right now, and I can tell you signs of smoking black tar heroin that you won't find on many other sites.

Usual signs include nodding out, unbearably itchy skin, constricted pupils, and dry mouth. There are all signs I have observed personally. Also, look for aluminum foil lying around in rolls or sheets. The way I found out for sure was I actually snooped in his closet while he was in the shower and I found balled up foil in his closet. I opened it up, and there were burnt black lines on it. I also found "straws" made out of hollowed out pens. They use the straws to chase the smoke as it burns off of the foil.

Another thing to look for is black residue on the fingers as well as on objects that he frequently touches, including walls. The tar is sticky and it gets on everything. I feel for you and I am in a very similar situation you are in. My boyfriend admitted an addiction to oxycontin to me a couple of months ago, and now I am in a lot of pain knowing what he has been doing since then and I have to confront him very soon.

By anon160317 — On Mar 15, 2011

My boyfriend of eight years and the father of my four year old little girl has concerned me lately! I have already caught him hiding an addiction to oxycontin in the past and i am afraid that he may have now moved on to heroin because of the people he surrounds himself with and he has been having severe mood swings and deleting everything out of his cell phone which he never did before.

I am a medical student so I know the signs of an injection site, but I have seen none. I just know that the man I fell in love with is not the same man today. Can you give me more advice on what to look for? he is so defensive every time I try to talk to him!

By anon158379 — On Mar 07, 2011

I need help, how do I convince my brother in law that he is son is using heroin. how do I get him to believe it?

By Fiorite — On Jun 06, 2010

If you are worried about a child’s exposure to heroin or drugs, the best approach is a preventative approach. Being open with your kid about the realities of drugs and their role in society can discourage a child from use. It also builds trust and opens up channels of communication should your child need to talk to someone about their addiction. Kids are very smart and capable of having serious discussions. This is especially true if your kid feels that you can relate to him/her and the stresses s/he is facing. Kids are not naturally born with the ability to cope with life situations. That ability must be taught or learned by trial and error.

By ValleyFiah — On Jun 06, 2010

Most addicts are very good at hiding the signs of their addiction until it has progressed to full blown dependency. "Track" marks are not necessarily going to be on the arm, they can be anywhere that a needle can access a vein. Often times the signs of heroin addiction are only obvious once significant damage has been done to that person’s life. Recreational use can be mistaken for a few drinks, or a weekend with friends. Sometimes you just have to take the chance and ask that person if they need help. Whatever you do, try not to sound critical at first. That will only push the addict away. If you are wrong in your assessment than all you have to worry about is the immediate awkward situation that you will find yourself in.

Jessica Ellis
Jessica Ellis
With a B.A. in theater from UCLA and a graduate degree in screenwriting from the American Film Institute, Jessica Ellis...
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