Heroin Addiction Symptoms

Heroin is an illicit opioid drug made from morphine, a natural opioid derived from opium poppy plants.1 Many people use heroin by smoking, snorting, or injecting it. Chronic heroin use can lead to heroin addiction, which is characterized by uncontrollable use regardless of negative effects on your life. Knowing the heroin addiction symptoms can help you recognize when to seek professional treatment.

In this article:

Signs and Symptoms of Heroin Addiction

Heroin addiction is a serious and progressive condition characterized by compulsive heroin use despite the consequences on many aspects of your life, such as mental health, physical health, and relationships.2 Heroin addiction symptoms are things that you experience and can report to a clinician, whereas signs may be observed by others around you.


When clinicians evaluate your heroin addiction, they use the Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5). There are 11 criteria, but you do not have to meet all to have a heroin addiction. Instead, clinicians categorize them into mild, moderate, or severe.3

Mild heroin addiction means you have two to three heroin addiction symptoms. Moderate means you meet four to five of the criteria, and severe means you have six or more. The diagnostic criteria include the following:3

  • You are unable to cut back on use despite efforts to do so
  • You often use more heroin than intended and for more extended periods
  • You spend much of your day focused on heroin, including seeking, using, and recovering
  • You experience strong cravings
  • You find it difficult to fulfill personal, professional, or academic responsibilities due to heroin use
  • You continue to misuse heroin even though doing so causes relationship and social problems
  • You stop participating in work, home, or social activities to spend time using heroin
  • You put yourself in dangerous situations to obtain or use heroin
  • You continue to misuse heroin even though you know it will make a physical or psychological condition worse
  • Your tolerance for heroin increases
  • You experience heroin withdrawal symptoms when you suddenly quit use

Seeking heroin addiction treatment earlier rather than later can help prevent addiction from progressing or getting much worse.

Signs of Heroin Abuse

Signs of heroin addiction or abuse include those that you may notice in someone else, or someone else may observe in you. Signs of a heroin use may include physiological and behavioral signs, such as:4,5

  • Nausea or vomiting
  • Drowsiness and nodding in and out of consciousness
  • Severe itching
  • Clouded mental functioning
  • Lying or stealing
  • Being withdrawn
  • Wearing long-sleeves or inappropriate clothing to hide needle marks or scars
  • Losing or gaining weight
  • Changing friend groups
  • Changing personality or moods
  • Avoiding contact with family and friends
  • Having financial problems
  • Losing jobs, homes, relationships, and more
  • Appearing anxious or fearful
  • Frequent nose bleeds (from snorting heroin)
  • Track lines or puncture marks

Additionally, if someone experiences a heroin overdose, this could be a sign that they are struggling with a heroin addiction.

Heroin Withdrawal Symptoms

Chronic heroin use can lead to physiological dependence, which means your body relies on the presence of this opioid drug to function optimally. When you cannot access heroin or another opioid or have abruptly quit, you will experience heroin withdrawal symptoms, which can be very unpleasant, painful, and distressing.6

Heroin withdrawal symptoms can include:6

  • Extreme flu-like symptoms such as chills, fever, sweats, body aches
  • Intense cravings and urges to use heroin
  • Runny nose
  • Watery eyes or tearfulness
  • Goose bumps
  • Digestive problems such as nausea, vomiting, diarrhea
  • Dilated pupils
  • Sensitiveness to bright lights
  • Disturbed sleep, such as insomnia
  • Hyperactive autonomic system, including abnormal heart rate, breathing, temperature, blood pressure, etc.
  • Mental health symptoms such as depression, anxiety

These symptoms can be so debilitating that many people return to heroin use to alleviate them, creating a cycle of heroin use, withdrawal, and relapse. However, a medical detox program can provide you with 24/7 medical care to alleviate withdrawal symptoms and cravings as well as treat any other problems that may rise.

Heroin Addiction Self-Assessment

Licensed mental health professionals, including physicians, are the only ones who can diagnose you with a heroin addiction. They may use multiple assessment tools, lab testing, and imaging to help form a diagnosis based on heroin addiction symptoms.

How do you know when it is time to see a licensed mental health professional for a possible diagnosis? You can use a screening and assessment tool that asks questions regarding your thoughts, feelings, and actions surrounding your use.

Assessment questions will begin by asking you the type of substance(s) you misuse, how often, and using which method. Other questions are taken from the Drug Abuse Screening Test (DAST):7

  • Have you used drugs other than ones prescribed for medical reasons?
  • Do you misuse more than one substance at a time?
  • Do you find it too hard to quit using heroin once you get started?
  • Have you ever had blackouts or flashbacks caused by heroin misuse?
  • Do you ever feel guilt or shame after heroin use?
  • Does your spouse or family members complain about your heroin misuse?
  • Have you neglected your family to use heroin?
  • Have you engaged in illegal activities to obtain heroin?
  • Have you experienced withdrawal symptoms when you stopped taking heroin?
  • Has your heroin use led to medical problems, such as hepatitis?
  • Have you ever been in treatment for a drug problem?

The number of “yes” answers determines whether you can benefit from seeking a mental health assessment from a licensed professional. The higher the number of “yeses,” the more serious your heroin addiction and the more urgency applies to seeking treatment.

Other popular assessment tools include the Screening, Brief Intervention, and Referral to Treatment (SBIRT); Opioid Risk Tool; and Tobacco, Alcohol, Prescription Drugs, and Other Substance Use (TAPS). There are also tools for assessing withdrawal symptoms, such as the Clinical Opiate Withdrawal Scale (COWS).8

Professional Evaluation for Heroin Addiction Treatment

If your test results suggest moving forward with an assessment with a licensed treatment professional, you may be wondering what to expect. Assessments are a time of gathering information to help a treatment professional make the best decision regarding your diagnosis, detox, and recovery. Assessments typically collect information on the following areas of your life:9

  • Substance use history
  • Your family’s substance use history
  • Mental health symptoms for co-occurring disorders
  • Personal, professional, and social consequences of heroin misuse
  • Physical health for co-morbidity
  • Previous treatment history
  • Current medications
  • Poly-substance misuse

Once the assessment is complete, your treatment provider will likely provide recommendations for heroin addiction treatment, based on your needs and situation. This may include an inpatient rehab or an outpatient setting like partial hospitalization or intensive outpatient.

Find a Heroin Addiction Treatment Center

Heroin addiction treatment gives you the support you need to stay motivated in recovery. You learn the skills you need to avoid a relapse, such as recognizing triggers. Because you can receive medication to control withdrawal symptoms and treat ongoing cravings, you can successfully make it through detox and the rest of your treatment.

You deserve a happy and healthy life. You can start recovery today. We can help you reach the best treatment center for your heroin addiction symptoms. Call our helpline at 866-968-5444Who Answers? and let us make that connection for you. We are here 24/7 to assist you on your recovery journey.


  1. National Institute on Drug Abuse. (2021). Heroin Drug Facts.
  2. Jahan AR, Burgess DM. (2021). Substance Use Disorder. StatPearls [Internet]. Treasure Island (FL): StatPearls
  3. National Institute of Drug Abuse. (2018). The Science of Drug Use and Addiction: The Basics.
  4. National Institute of Drug Abuse. (2021). What Are the Immediate (Short-Term) Effects of Heroin Use?
  5. National Institute on Drug Abuse. (2014). Research Report Series: Heroin.
  6. Shah M, Huecker MR. (2022). Opioid Withdrawal. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
  7. U.S. National Library of Medicine. (2021). Drug Use Screening Tests. MedlinePlus.
  8. McNeely J, Adam A. (2020). Substance Use Screening and Risk Assessment in Adults [Internet]. Baltimore (MD): Johns Hopkins University.
  9. National Institute of Drug Abuse. (2022). Screening and Assessment Tools Chart.
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