Drug Treatment HeroinHeroin has been receiving more attention in the news recently. CBS NEWS: Hooked on Heroin;  NY TIMES: Heroin in New England, More Abundant and Deadly; BBC News: Cory Monteith: The Heroin users that don't fit the 'junkie' stereotype; USA Today: OxyContin a Gateway to Heroin for Upper-Income Addicts. Although it can be upsetting this is very helpful because greater awareness about Heroin and its warning signs can help save lives.   Sadly heroin use has increased all over the US, including in Chicagoland area.

How can you tell if someone you love is abusing heroin?  Here are 54 warning signs to look for:

Physical or Bodily Signs of Heroin Abuse

Heroin causes a number of affects on the body.  It causes the body to release histamine (think of why you take antihistamines: for runny nose, itchiness), it slows down the body, causes constipation.  Heroin withdrawal largely shows the opposite effects from heroin use.

  • Persistent hacking cough (common if heroin is smoked)
  • Sudden weight loss or loss of appetite
  • Dry mouth
  • Extremely small pinpoint pupils
  • Eyelids and arms/legs appear to be heavy
  • Cuts, bruises or scabs from skin picking (heroin causes the body to release histamine which leads to itchy skin, which may be scratched to point of causing a sore or scab)
  • Infections or abscesses (from injecting)
  • Sores on nostrils or lips (from smoking)
  • Nosebleeds (from snorting)
  • Burn marks on fingers or mouth (from smoking)
  • Dark circles or puffiness under the eyes
  • Flu like symptoms: fever, achy, vomiting, always cold
  • Runny nose or constant sniffing (from the release of histamine heroin causes)
  • Needle marks on arms or legs – could look like small bruises or red dots
  • Constipation (when using heroin), or diarrhea (when withdrawing)
  • For women, loss of menstrual cycle

Behaviors That May Indicate Heroin Abuse

  • Sudden changes in behavior or actions such as poor school or work performance, being expelled or fired
  • Movement is slowed or uncoordinated
  • Disoriented
  • Extreme alertness/jitteriness followed by suddenly nodding off
  • Excessive or sudden sleeping
  • Itchiness, picking at skin (histamine release from heroin)
  • Speech somewhat slurred, garbled or incoherent
  • Very little motivation, apathy, no interest in favorite activities
  • Hostility toward others
  • Lying or other deceptive behavior
  • Avoiding eye contact
  • Lack of hygiene and disregard for physical appearance, may not shower or bathe, repeat wearing of same clothing
  • Withdrawal from friends and family
  • Spending a lot of time with new friends and/or alone
  • Wearing long pants or long sleeves (to hide needle marks) even in very warm weather
  • Suddenly wearing sunglasses frequently or inappropriately

Indirect Warnings Signs of Heroin Use:

  • Large increase in mileage on the car used by your loved one (showing trips to purchase drugs)
  • Missing prescription pills (or entire bottles), especially Vicodin (hydrocodone), OxyContin (oxycodone) or codeine
  • Missing money or valuables or frequent requests to borrow money, particularly with nothing to show for it
  • Needles or syringes (check sock and other drawers)
  • Tiny orange caps from syringes
  • Spoons with burn marks (used to heat the heroin in water prior to injection)
  • Aluminum foil or gum wrappers with burn marks (used to smoke heroin)
  • Missing shoelaces (used to tie off injection sites)
  • Rubber straps or bands (used to tie off)
  • Straws (used to snort), especially with burn marks (used to smoke)
  • Empty plastic pen cases (used for snorting or smoking)
  • Small plastic bags
  • Water pipes or other pipes (used in smoking heroin)
  • Bottled water (water used for mixing and cap used for heating)
  • Bottle caps (used in heating heroin)
  • Rolled up dollar bills or paper (used for snorting)
  • Razor blades, IDs and credit cards with a powder residue on them (used for snorting)
  • Empty plastic/drug capsules (heroin sometimes sold in capsules)
  • Antihistamine boxes (used to counteract histamine release)
  • Nasal spray bottles (used for snorting heroin/water mixture)
  • Unusual residue in coffee-bean grinder (to grind up heroin)
  • Very small cotton balls, Q-tips, or pieces of cigarette filter (used prior to injecting)
  • Vitamin C or ascorbic acid packets/sachets (common in Europe to allow heroin to be water soluble)

If you do suspect your loved one is using heroin, get help immediately.  It is an extremely deadly drug.  It is highly addictive so persuading your loved one to go to treatment, or at least initially visiting a doctor is very important.  New Hope Recovery Center is an alcohol and drug addiction facility that has helped many clients successfully stop heroin use.  We are happy to answer your questions.  Contact us at 888-707-4673 or email us at info@new-hope-recovery.com.


Want to read more about Heroin? Check out these related articles:

America's Failed Drug Policy

Parents' Guide to Prevent Heroin Use and Addiction

Chicago's Heroin Epidemic - Parents Beware


Written by: New Hope Recovery Center