What are the signs and symptoms of heroin abuse?
Heroin produces a “downer” effect that rapidly induces relaxation and euphoria, through chemical changes in the pleasure centers of the brain. Like other opiates, it blocks the brain’s ability to perceive pain.
People using heroin, particularly those with a prior history of drug use, may be able to conceal it entirely at first. That is not a failure of attention on your part. It is what the disease does.
What you might notice during or after use
- Shortness of breath
- Dry mouth
- Constricted (small) pupils
- Sudden changes in behavior or actions
- Disorientation
- Cycles of hyper-alertness followed by suddenly nodding off
- A droopy appearance, as if the arms and legs are heavy
Paraphernalia
The signs above are not unique to heroin. More definitive warning signs include things kept to prepare, inject or consume it:
- Needles or syringes not used for another medical purpose
- Burned silver spoons
- Aluminum foil or gum wrappers with burn marks
- Missing shoelaces, used to tie off an injection site
- Straws with burn marks
- Small plastic bags with a white powdery residue
- Water pipes or other pipes
Changes in behavior
- Lying, or other deceptive behavior
- Avoiding eye contact, or a distant field of vision
- A substantial increase in time spent sleeping
- Slurred, garbled or incoherent speech
- A sudden decline at school or work, including expulsion or job loss
- Less attention to hygiene and appearance
- Loss of motivation, and apathy about the future
- Withdrawal from friends and family, and time spent instead with new friends who have no natural tie to the rest of their life
- Loss of interest in hobbies and activities they used to care about
- Repeatedly stealing or borrowing money, or valuables going missing without explanation
- Hostility toward the people closest to them, including blaming them for withdrawal or for broken commitments
- Regular remarks that suggest falling self-esteem or a worsening body image
- Long sleeves or long trousers to cover needle marks, even in warm weather
Physical symptoms as tolerance grows
Tolerance builds, which drives up how often and how much a person uses. As it does, more definitive physical symptoms emerge:
- Weight loss
- A runny nose not explained by another illness
- Needle track marks visible on the arms
- Infections or abscesses at an injection site
- In women, loss of the menstrual cycle (amenorrhea)
- Cuts, bruises or scabs from skin picking
If you have recognized something on this page
You do not need to be certain, and you do not need to have a plan. The helplines below are free and confidential, and they talk to parents in exactly this position every day.