Heroin Addiction & Treatment

What is heroin?

Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin is most commonly found as a white or brown powder depending on its purity and also comes as a black sticky substance known as black tar heroin. There are various methods of use for heroin, and some choose to inject or sniff, while others snort, or smoke it. Heroin is often mixed with other substances – most commonly, stimulants like crack cocaine – a practice called speed balling. It works by binding to the brain’s opioid receptors, including those responsible for controlling feelings of pleasure and pain as well as heart rate and breathing.

Signs or symptoms of heroin addiction

Heroin is a powerful substance which produces feelings of intense pleasure and euphoria, as well as eliminating physical pain and because of this, addiction can take hold very quickly. However, repeated use of heroin over a period of time can lead to physical dependence and your body will need heroin in order to function properly. Once this has occurred, you may notice various signs and symptoms of heroin addiction and these will become easier to identify in yourself or someone you know.

The symptoms listed below are some of the most commonly reported psychological, physical, behavioural and social signs that may indicate heroin abuse or addiction.

Psychological symptoms of heroin addiction:

  • Depression
  • Guilt
  • Shame
  • Inability to focus
  • Impaired judgement
  • Feeling confused or disorientated

Physical symptoms of heroin addiction:

  • Rapid or extreme weight loss
  • Feeling itchy
  • Insomnia
  • Kidney and liver damage
  • Exhaustion
  • Watery eyes and runny nose
  • Flu-like symptoms
  • Constipation
  • Bloodborne diseases such as Hepatitis C and HIV
  • Pneumonia and tuberculosis

Behavioural symptoms of heroin addiction:

  • Missing school/work
  • Poor school/work performance
  • Drug paraphernalia such as needles, foil, pipes, drug wraps etc.
  • Lying in order to conceal drug use
  • Lack of interest in previously enjoyed activities

Social symptoms of heroin addiction:

  • Isolating from friends and family
  • Withdrawn around others
  • Mood changes and aggression
  • Damaged relationships
  • Financial difficulties
  • Unemployment

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Heroin withdrawal symptoms

When you take a strong opioid like heroin for a prolonged period of time, your body builds up a tolerance to its effects, meaning you will require more each time in order to achieve the same high as you did when you first started using, however increasing your dosage puts you at risk of accidental overdose. Long-term heroin use leads to physical dependence as well as addiction. 

Physical dependence occurs because heroin alters the way your brain’s nerve receptors behave. These receptors become reliant on heroin in order to function normally, and suddenly stopping heroin after long-term use will result in unpleasant withdrawal symptoms. Withdrawal symptoms are the body’s physical response to the absence of the drug it has become accustomed to. To avoid experiencing painful withdrawal, many people continue using instead of seeking help, and due to the increased sense of wellbeing heroin gives you, symptoms of withdrawal are often mistaken for the flu and other illnesses. 

Heroin withdrawal symptoms will vary in severity depending on factors such as frequency of use, dosage and your overall health. Although the withdrawal experience will differ from person to person, the progression of an opioid withdrawal usually follows a general timeline. 

The first symptoms of heroin withdrawal typically begin within the first 24 hours after your last dose. These include: 

  • Restlessness
  • Anxiety
  • Watery eyes
  • Runny nose
  • Excessive sweating
  • Insomnia
  • Frequent yawning

After the first 24 hours, symptoms begin to intensify and it’s during this stage that many people relapse. These symptoms include:

  • Diarrhoea
  • Abdominal cramping
  • Nausea and vomiting
  • Shivering
  • Blurry vision
  • Rapid heartbeat
  • High blood pressure
  • Flu-like symptoms

Although these symptoms can be agonising, they tend to calm down after a week. However this will vary depending on how long you’ve been dependent on heroin. 

A period of up to six months of total abstinence from heroin is recommended to maintain recovery, and ongoing heroin withdrawal symptoms can continue for this time. This is known as “protracted abstinence.” While any symptoms at this stage should be mild, if you are still experiencing discomfort, you should seek professional medical advice.

What does heroin look like?

Heroin in most commonly found as a grey, brown or black powder, however, in its purest form it’s actually a very fine white powder. Once it hits the streets, heroin is “cut” with additives such as caffeine and sugar amongst other substances including strychnine1 and other poisons.

How is heroin made?

Heroin is predominantly made up of an ingredient called diacetylmorphine, or diamorphine, which is what produces its psychoactive effects. It’s an extremely potent chemical derived from the seed of an opium poppy and is what makes heroin so addictive. It’s then cut with other ingredients, making larger volumes and allowing dealers to sell more product. Some of these fillers are other opiates and share some of the ​psychoactive effects of heroin. Others are simply powders that share the appearance of the form of heroin they are cut with. And in some cases, the add-ins are toxins that can cause deadly side effects.

Heroin vs morphine

Morphine and heroin are made up of similar properties which is why they produce many of the same effects. However, heroin is a semi-synthetic substance made up of morphine and combined with other chemicals, most of which are unknown. This makes heroin three times more potent than morphine. Although both substances cross the blood-brain barrier, heroin does so much quicker, making it much faster-acting than morphine and can be more addictive for this reason. With morphine being more controlled and closely regulated, it’s less accessible than heroin, which is extremely cheap in comparison to other drugs.

Is heroin addictive?

Heroin is one of the most highly addictive substances available today, which is why trying to get clean without some form of medical intervention is agonising and extremely difficult. As mentioned earlier on, heroin binds to the brain’s receptors responsible for feelings of pleasure, anxiety and sleepiness. Once you take a hit of heroin, you’re instantly free of any feelings of physical or mental pain. However, over time, heroin begins to influence areas of the brain responsible for perception and judgement, eventually teaching itself to emphasise the pleasurable feelings that come with using heroin and ignoring the negative consequences.

Heroin addiction treatment and rehab

Heroin addiction can be physically, mentally, financially and socially debilitating, with the potential to cause serious long-term harm if not treated. The most effective form of heroin addiction treatment is a medically supervised detox combined with an extensive and intense therapy programme.

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At Step-by-Step Recovery, we are dedicated to providing the very best quality of care for each and every one of our clients and our ultimate goal is to provide you with the tools you need to maintain a clean and sober life free from heroin addiction.

The Lighthouse rehab, located in Essex, is our fully residential facility which offers all clients a medically assisted detox, supervised by doctors to ensure your safety and comfort. You will be prescribed the appropriate medication to help alleviate the uncomfortable symptoms of withdrawal.

We recommend a minimum 28-day residential stay with us to provide you with enough time to detox and participate in our therapy programme. However, heroin addiction is complex, and your stay will ultimately depend on the severity of your addiction. Alongside a medical detox, our treatment plan involves group and individual counselling & therapy. Our team of counsellors work hard to create a bespoke treatment plan for each individual in order to try and identify any issues that may have contributed to your addiction. As well as popular addiction treatment methods such as cognitive behavioural therapy, process therapy and relapse prevention workshops, we offer a range of holistic treatments such as yoga and mindfulness which focus on healing the mind and spirit as well as the body.

Many clients worry about returning to normal life once they complete a rehab programme, but at Step-by-Step Recovery, we don’t believe recovery ends once you leave us. In fact, this is where your journey truly begins, which is why we offer free lifetime aftercare support to all clients who finish a minimum of 28 days at The Lighthouse.

Transitioning from rehab to real life can be a scary prospect. After weeks of around-the-clock care, you may suddenly feel alone and out of your depth. It’s important to remember that you will have a great deal of support in the form of aftercare. Before you complete your rehab stay, your addiction counsellor will sit down with you and put together a personalised aftercare programme to help you maintain your sobriety once you leave.

A strong aftercare programme usually consists of relapse prevention workshops, individual and group counselling as well as alumni activities and events.


There are physical and psychological aspects to heroin addiction. While heroin can make you feel relaxed and enhance your feelings of wellbeing, it also alters the way the receptors in your brain send messages. Heroin can make you feel calm, sleepy and euphoric, however it can also cause damage to veins when injected and lungs if smoked.
Someone with a heroin addiction is often able to conceal it through lying and deceiving those around them. However, once the addiction becomes unmanageable, there are various signs that might indicate they are suffering with a heroin addiction.
Yes. Heroin overdose is a common occurrence, especially among those who inject it. The risk of overdose also increases if you abstain from using heroin for a period of time and go back to using the same amount you became used to. Your tolerance for heroin will have reduced significantly by this time, and the consequences can be fatal.
While the individual symptoms of heroin withdrawal aren’t dangerous, there is always a possibility of complications occurring during this stage, which is why it’s highly recommended that heroin detox is supervised by a medical professional.
The safest way to recover from heroin addiction is through inpatient rehab. This typically includes a detox to overcome the physical dependency, as well as a treatment programme to help resolve the psychological aspects of addiction.

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A page revised the 6 of July of 2021, by Danielle Byatt, a Level 4 addictions counselling, Level 5 in Leadership & Management, BA applied social work. and Treatment Director at Step by Step Recovery.

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