Heroin is an opioid, a drug originally derived from the poppy plant to help manage pain. Heroin and other opioids are prescribed as strong pain medications, but are also used recreationally as well.

Heroin, can be smoked, snorted or injected; the goal is to get the drug into the bloodstream and ultimately the brain. In the brain, heroin converts to morphine, and binds to opioid receptors in the brain, relieving pain and spreading euphoria.

Repeated heroin abuse can result in disruption in what is called the reward pathway, the brain functions that control motivation, reward-seeking and the perception of pleasure. It is this disruption that makes heroin an incredibly addictive substance. Nearly 1 in 4 people who try heroin will suffer from an opioid addiction.

In recent years, heroin use has increased dramatically in a number of populations, among men and women, across most age groups and across all income levels.

The opioid epidemic and the increase in heroin abuse disorders go hand in hand, 4 in 5 new heroin users had already abused prescription painkillers before trying heroin.

Signs of Abuse

  • Dilated pupils, dry mouth, shortness of breath, erratic behavior, disorientation, drowsiness, nodding off, track marks, shaking, slurred words, droopy appearance, nauseas, vomiting, itching, weight loss, scabs
  • Trouble at work or school, lying about drug use, financial issues, repeated borrowing/ theft of money lack of motivation, withdrawal from friends, family, hobbies/interests, disheveled appearance, lack of attention to appearance of personal hygiene, lethargy, increase in time spent sleeping, lower self esteem/ body image, erratic/hostile behavior, weight loss, runny nose, wearing long sleeves when inappropriate (to hide track marks), infection/ abcess at injection site, interrupted menstrual cycle, erectile dysfunction, skin picking leading to cuts, bruises or scabs

Nodding Off

Nodding out, or nodding off is a common phrase used to describe someone who just took heroin. It becomes immediately apparent that this person is high. Breathing becomes more shallow, muscles go slack, and you appear to fall in and out of sleep. Even while awake, you can not react to the world around you. You might feel good, but this is an incredibly dangerous situation.

Nodding off can be an early sign of an overdose. Even if you haven’t taken a lethal dose, and just took your regular dose, nodding off can lead to death. Without control of your body, you drift in and out of sleep, which can put you in a dangerous position, with your airway compromised. Heroin often makes you nauseous, and causes you to vomit, which can block your airways. The strain on your body, from the drugs and your position, can be deadly.

Symptoms of Withdrawal


Each individual faces different withdrawal symptoms, depending on a number of factors, including how long they were using heroin, how they were ingesting the drug, how often they were taking it and other individual factors.

Withdrawal symptoms can start 6-12 hours from the last time you used, and peak 24-72 hours from that time. Acute withdrawal symptoms generally begin to subside after 7 days, but can last longer depending on a number of factors.

  • Shaking, dilated pupils, slurred words, nausea, cramps, tearing, runny nose, sweats, chills, yawning/drowsiness, muscle aches, bone aches, vomiting, diarrhea, agitation, restlessness, tremors, trouble concentrating, goose bumps, fatigue, anxiety, insomnia, depression, hypertension, rapid heart rate, muscle spasms, impaired respiration, difficulty feeling pleasure, drug cravings

Heroin can be injected, smoked or snorted. Identifying common paraphernalia can help determine whether an individual is abusing heroin.


  • Stamps, bundles/bindles, bricks –  
  • Balloons, rubber gloves – heroin is sometimes sold in latex materials, including balloons or tied up latex gloves
  • Small ziploc bags, or corners of larger bags tied together – used to hold heroin


  • Hypodermic needles – used to inject liquefied drug
  • Cotton balls – used to filter liquefied heroin for impurities
  • Spoons or bottle caps – used for cooking heroin, liquefying it for injection
  • Shoelaces, rubber hoses, length of string or similar – used to “tie off,” restricting blood flow on one’s limbs to make veins pop out
  • Lighters/ candles – heat source used to melt the drug


  • Lighters/ Candles – heat source used to smoke the drug
  • Straws or similar – used to capture smoke and steam given off by heat
  • Aluminum foil, cigarettes, rolling papers, pipes – All can be improvised to smoke heroin


  • Rolled dollar bills, cut straws or similar – used for snorting heroin
  • Razor blades or similar – used to cut heroin into “lines” for snorting
  • Small mirrors or glass – surface for snorting of heroin

Detox Process


Amatus Health detox facilities offer medically assisted detox for individuals facing acute withdrawal from heroin, as well as inpatient and outpatient therapy programs designed to build the skills for long term recovery.

During detox, every individual in our care has access to around the clock nursing care, to monitor their vitals and provide medication when necessary. Our staff will assess each individual’s needs, and help design a plan for them to taper their use smoothly and safely, with the least amount of discomfort.

Further Treatment Options


At Amatus Health we off the full continuum of care, from intensive inpatient programs through a number of outpatient levels of care. We believe, supported by evidence, that a longer stay in treatment sets patients up for a better chance at long term recovery.

We are committed to helping every individual achieve long term recovery. This means treating not only physical addiction, but addressing the mental and spiritual aspects as well. Our staff will create an individualized treatment plan with you, using a variety of therapeutic modalities to help every individual build the skills for long term recovery.

If you or a loved one is struggling with heroin addiction, dealing with acute withdrawal, have just completed detox or another level of care and are looking for the next step in recovery, call us now to speak with a treatment professional.

What it means to be an Amatus Managed Recovery Center

  • Person First Philosophy

    Our mission is to get you in the best facility that will allow you to heal and find long term recovery. Whether you enter one of our facilities or another facility, we will help everyone who contacts us find the appropriate place for them to heal.

  • National Footprint, Community Focus

    Our nationwide network of treatment centers and referral partners allows us to make an impact in multiple communities. We want every individual to thrive, and become a positive force in your community. We desire to help people and communities recover.

  • Facility and Treatment

    We are committed to providing the highest level of care, delivered in cutting-edge facilities designed to support your recovery. Every individual gets an individualized treatment plan, with the highest-level of care standards and quality.

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