Heroin is one of the most addictive substances in the world. When consumed, it provides short-term euphoric highs that are extremely sought-after.
Generally, heroin comes in the form of a white powder. However, due to variations in manufacturing as well as the purity of the substance, heroin can also appear as a brownish powder or even black and tar-like.
The appearance of heroin is very similar to that of cocaine or other amphetamines.
To consume the drug, there are a few common methods which individuals may use, each with their own preparation and ritual.
Each method provides a different effect, and an individual may progress through the different ways of consuming heroin whilst suffering from an addiction.
The most common methods are listed below:
Each of these methods has associated paraphernalia, or equipment, meaning that heroin addiction can sometimes be identified by the presence of this paraphernalia.
To recognize the signs of heroin addiction, and to identify common heroin paraphernalia, this page has laid out some of the techniques used as well as what to look for.
This is perhaps the most common way people expect heroin addicts to consume the substance. Made famous across TV shows and films, most individuals are familiar with the idea of injecting heroin into the bloodstream or into a muscle.
This can make the individuals feel the effects in under five minutes, though it also requires the most preparation.
Individuals injecting heroin require the largest number of paraphernalia including the needle, cotton buds, a spoon or heating receptacle, a tie-off or tourniquet, and a lighter or candle.
Identifying this equipment is usually very easy, though it is important to remember that this paraphernalia is adapted from common household items.
Commonly associated with other drugs such as cannabis, smoking heroin is perhaps not one of the first methods of consumption people expect.
Achieved using the powder form of heroin, individuals smoke heroin using significantly less paraphernalia than injecting.
Equipment often includes tin foil, a lighter, a straw to inhale smoke, and a cigarette or tobacco to roll with.
Similar to cocaine, heroin can also be snorted. This is one of the first ways that individuals begin consuming heroin as it requires the least preparation and planning.
Common paraphernalia includes a straw or tube to snort through. Alternative methods include using rolled notes or loose razor blades to organise the substance before consumption.
Aside from the physical paraphernalia that an individual may possess, there are several behaviours or changes that an individual may display.
Heroin can impact the way that the brain functions, altering neural pathways and plasticity (1) which can have a serious effect on the individual’s behaviour.
As a result of this, the individual may seem very different.
For example, behavioural changes include irritation, depression, and general mood swings – commonly associated with those suffering from heroin addictions.
There are also several physical effects that may be visible to those who know the individual well. If the individual has recently consumed the substance or is currently using it, they may display features such as bloodshot eyes or a change in pupil size.
An extreme change in pupil size, especially shrinking, can be an early sign of a heroin overdose.
Additionally, noticing any needle marks, or ‘tracks’, is a sign that someone may be using or has recently used heroin.
Especially with the opiate and opioid categories of drugs, individuals are also far more likely to experience side effects such as excessive skin scratching (2), often visible on the skin or if the individual is noticed repeatedly doing so.
As an effect of heroin, and also as a common feature amongst other opioids, individuals are also likely to experience extreme tiredness or nodding off, sometimes resulting in deep sleep or comas, in extreme cases.
As the use of heroin paraphernalia is generally associated with an addiction, the associated dangers are applied.
An addiction can be incredibly dangerous as an individual seeks to consume more and more of the substance to reach their increasing tolerance level.
The substances often have very damaging effects when used in the long term. For example, heroin can cause a deterioration in an individual’s cognitive functioning and therefore impact their everyday lives.
Aside from these health concerns, possession or discovery of heroin paraphernalia is considered illegal in some countries, resulting in fines or arrests, in some cases.
Where the equipment is not discovered or confiscated, it can become dirty and unhygienic, especially when shared amongst many people. This can lead to the development of infectious diseases such as hepatitis and HIV.
Specifically, in terms of needle sharing, the consequences can be life-threatening due to the risk of developing infectious diseases. This is not always through needles as well, as some diseases such as hepatitis can be spread through mucous such as when smoking.
These effects are not always specific to the individual using the paraphernalia, either. For example, leaving equipment around at home could be potentially dangerous to young children or others who reside there and are unaware of the uses etc.
If you are aware of someone’s usage of heroin, or wish to support them in seeking further care, then there are several steps that you can take to approach the issue in the least confrontational way possible.
The first step is to start the conversation, or make the individual aware of your support, in the most sensitive way possible. This refers to gently easing into the conversation instead of springing the subject up randomly in front of many other people, for example.
Throughout the conversation or providing care to the individual, it is important to remain as calm as possible and not overreact to any situation or conversation.
Though this is difficult in some situations, remaining calm for the sake of the individual will be a great support for them in the long term and prove your commitment to their wellbeing.
If the individual is receptive to this conversation or steps in your relationship, then it is important to relay your thoughts and suggestions carefully, making sure to establish boundaries or rules where necessary.
This is a great way to moderate the relationship and expectations moving forward.
Alternatively, it is also important to prepare for a negative reaction. For example, the individual may react in anger, perhaps due to their feelings of denial or encroachment on personal issues.
Although this is not the ideal situation, preparing for this situation fully ensures your readiness to begin this support. If the individual does not react in this way, it can also be motivating to know how you would have handled the situation.
Following on from an offer of support, the individual may accept and therefore further steps are required.
Luckily, there are thousands of sources of support, meaning that help is never difficult to access, or too far away.
Rehab 4 Addiction offers a 24/7 addiction hotline on 0800 140 4690 where we are happy to discuss further addiction treatment options, but there are also many other options.
Below are some of the most common treatments offered to those struggling with a heroin addiction:
[1] Angelucci, F., Ricci, V., Pomponi, M., Conte, G., Mathé, A.A., Attilio Tonali, P. and Bria, P., 2007. Chronic heroin and cocaine abuse is associated with decreased serum concentrations of the nerve growth factor and brain-derived neurotrophic factor. Journal of psychopharmacology, 21(8), pp.820-825.
[2] de los Cobos, J.P., Trujols, J., Ribalta, E. and Pinet, C., 2009. A typology of heroin-dependent patients based on their history of self-injurious behaviours. Psychiatry research, 167(1-2), pp.169-177.
Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline. You can connect with Boris online at LinkedIn or X.com.
