Symptoms and Signs of Heroin Use

The United States has been struggling with a substance abuse epidemic, and opioids are at the forefront with roughly 10.1 million Americans having misused opioids at least once over a 12-month period.

Heroin is a highly addictive substance derived from the opium poppy plant. Historically heroin was used for pain relief; however, it is now classed as a Schedule I substance with no legal medical use for the drug and a high potential for heroin abuse. It is recognized as one of the most addictive drugs in the world. Despite regulations from the drug enforcement administration, the number of opioid-related deaths rises each year. Knowing the signs of heroin abuse could help you in supporting a loved one with a drug abuse problem and even prevent overdose.

Heroin users can rapidly become addicted to the drug. Abusing heroin causes a range of physical and psychological signs; symptoms often progress quickly as addiction takes hold.

Heroin Abuse

Individuals who abuse heroin often do so by snorting, smoking, or injecting the drug. Injecting heroin is the most dangerous method of use as it increases the risk of overdose and the chance of contracting diseases from a dirty needle. Injecting heroin directly into your veins results in a fast, euphoric high that is soon followed by feelings of contentment, relaxation, and sleepiness. Smoking and snorting the drug produce similar effects but are slightly slower.

When heroin enters the body, it is metabolized into morphine and 6-acetyl morphine and very quickly binds to opioid receptors. This creates an intense rush of dopamine, producing the euphoric high that is so intoxicating and addictive. Some report that the faster the drug enters the body, the more intense the rush is. However, there are also reports that one can never recreate the feeling of their first heroin high, and are left chasing the euphoric rush.

Heroin is a fast-acting drug, and heroin users will generally experience the initial euphoric effects within a minute.

Risk Factors of Substance Abuse

There are certain causes and risk factors that contribute to drug use and heroin abuse and addiction:


Addiction is not a case of having poor willpower or a lack of morals; addiction can be hereditary. The chemical reactions that occur in the brain of a person with heroin addiction are very different from those happening in someone without one. According to the National Institute on Drug Abuse, approximately half of the risk factors of heroin addiction are related to genetics. Those with family members who struggle with substance abuse heroin problems are more likely to become physically dependent on addictive drugs themselves.


In recent years, there has been increasing recognition of the significance of the environment in the development of heroin addiction. A lack of parental involvement, love, and attention during formative years is associated with a higher risk of drug experimentation. It is not uncommon for children who suffer abuse or neglect to turn to drugs or alcohol to ‘self-medicate’, or deal with their emotions. Then, the effects of heroin can be devastating.

Dual Diagnosis

A dual diagnosis refers to the diagnosis of co-occurring disorders alongside a substance use disorder. This may include mental disorders such as anxiety, bipolar disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and depression. Co-occurring disorders and mental health issues can increase an individual’s risk of addiction. Additionally, drug addiction can intensify the severity of co-occurring mental illness.

Prescription Opioid Use

The United States has been struggling with a so-called ‘opioid epidemic’ caused by the unregulated dispensing of prescription drugs containing opioids. Despite the fact that tight controls have now been put on these medications, those who were prescribed them by a doctor and developed a dependence or addiction may have turned to heroin as a cheaper and stronger alternative. About 80% of people who use heroin initially misused prescription opioids. Prescription opioid use is a significant risk factor for heroin addiction and should be considered if you are looking for signs that a person may be abusing heroin.

Life Changes or Loss

Events such as divorce, the loss of a loved one, trauma, or illness are not themselves significant causes for concern. But, in combination with the other risk factors or when they occur for those with a history of drug abuse or addiction, it is time to keep an eye on their behavior. If a loved one has had a recently stressful or traumatic life experience, it is especially important to consider their needs and that they may turn to substance abuse if these needs are not met, and they do not have the tools or support mechanisms to cope.

Signs of Heroine Use

There are a range of common psychological, physical, behavioral, and social symptoms which are signs and effects of heroin addiction that may indicate that an individual is abusing or has become dependent upon the drug:

Psychological symptoms of heroin addiction:

  • Feelings of shame, guilt, and depression
  • Hopelessness and despair
  • Decline in mental health or development of mental illnesses
  • Difficulty concentrating or focusing
  • Poor judgment
  • Confusion and disorientation

Physical symptoms of heroin addiction:

  • Extreme weight loss
  • Lethargy, fatigue, or exhaustion
  • Bruising or scabbing of the skin
  • Watery eyes and runny nose
  • Flu-like symptoms that don’t go away
  • Bruising or scabbing of the skin
  • Itchiness
  • Trouble sleeping
  • Kidney damage and liver disease
  • Contracting hepatitis C and HIV/AIDS or other blood-borne pathogens
  • Finding drug paraphernalia such as syringes, small glass or metal pipes, spoons, lighters, belts, or rubber tubing.

A heroin user may even leave heroin lying around. Most commonly, the heroin comes as a white or brown powder, but a sticky, black form called ‘black tar heroin’ can also be found.

Social and Behavioral Symptoms:

Social symptoms of heroin addiction can often be the first to be spotted. The highly addictive drug causes negative consequences in your social life and relationships can break down. This can be incredibly isolating for people who use heroin, further driving dependence on the heroin ‘high’ for feelings of joy that may previously have been filled through human connections and relationships. The effects of heroin and other substances can often:

  • Withdraw from family and friends
  • Become close with a new group of friends
  • Have drastic mood swings and display unprovoked outbursts of anger
  • Develop strained relationships
  • Lose a job, become unemployed, or have trouble maintaining employment
  • Wear long-sleeved tops in public to hide injection sites
  • Create financial difficulties and instability
  • Become socially isolated and lose of interest in activities that were previously important

Heroin Addiction and Withdrawal

When a person has become addicted or developed physical dependence on heroin, they will experience withdrawal symptoms when they attempt to stop taking the drug. This makes it incredibly difficult to quit and people often overdose.

Heroin withdrawal symptoms can range from mild to severe depending on the length of time a person has been abusing the drug. Heroin use causes a combination of both physical symptoms and psychological withdrawal symptoms. The National Institute on Drug Abuse (NIDA) sites list common symptoms of heroin withdrawal as:

  • Sweats
  • Nausea
  • Tremors
  • Chills
  • Muscle aches and spasms
  • Diarrhea
  • Anxiety
  • Insomnia
  • Depression
  • Rapid heart rate
  • Drug cravings

Symptoms typically last for about seven to ten days, peaking around day three to five. Heroin drug craving during the detoxification process can be strong, and many find it difficult to detox alone. There is a significant danger of heroin overdose during withdrawal as a person’s tolerance to the drug decreases. Many who relapse don’t take this into consideration and take the same dose that they would have before they began to detox. This is often more heroin than their body can handle and a fatal overdose can occur, after causing dangerously slowed breathing and heart rate.

Heroin Overdose

Heroin overdose deaths in the US are high, and knowing the effects and signs of an overdose could help you save the life of someone that you suspect may be addicted to heroin.

A heroin overdose is a medical emergency and you should dial 911 immediately if you suspect a person may be having an overdose. Inform the telephone operator of the fact you suspect it may be a heroin overdose and follow their instructions carefully. If their breathing has slowed dramatically or stopped, you may be asked to perform CPR. It is important to act fast as an overdose can cause permanent brain damage and even death.

Addiction Treatment

Heroin addiction treatment will always begin with detoxification, where the body rids itself of all toxins and traces of the drug. Medical detox can provide support through this process, as withdrawal symptoms can be incredibly distressing and too challenging for most people to overcome alone.

When this process is complete, you will begin addiction treatment. This will likely involve finding the root cause of your drug use, when you began abusing heroin or other drugs, and why you turned to heroin abuse. For many, it is a form of ‘self-medication’ for mental or physical pain. A treatment center will offer an addicted person therapy in addition to support groups and treatment for co-occurring disorders.

If you are considering treatment options for heroin use or addiction, NP Addiction is here to support you. We can help you detox safely and comfortably. We provide inpatient or outpatient addiction treatment, alongside providing therapy for co-occurring mental health issues that may have developed as a result of drug use, or been an underlying cause of the drug abuse in the first place.

If you are ready to start your recovery journey and are looking for treatment advice or information, contact us today.

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Samantha Kelly​

Director of National Business Development & Admissions Coordinator

I am a dedicated and passionate professional with extensive experience in business development Admissions and marketing. I have an incredible passion for showing others that there is a light at the end of this dark tunnel if someone truly wants it.
Being in recovery myself I understand the struggles of addiction and alcoholism. I Started this Career path in 2009. With multiple years of experience, I bring a multi-faceted approach and am always seeking new ways to make a difference in the lives of those I work with.

Kim L. Buckner


As a Substance Abuse Motivational Speaker, Pastor, Peer Advocate, and Facilitator. Kim helps clients avoid relapse by understanding their triggers. Those people, places and things that can cause craving, as well as internal triggers like feelings, thoughts, or emotions. Kim also clients with identifying and building healthy relationships now that they’re clean and sober.

Kim’s background includes extensive experience as a motivational speaker and work in faith-based organizations helping youth and adults alike. He says he is motivated by giving back to the community, understanding, and not judging who she comes into contact with. Kim’s favorite quote is by Dr. Raymond Johnson: “The respect given to others rebounds to the giver to deny the scared in the Other is to deny it in oneself.”

Caty Burns


Caty graduated from Indiana University Bloomington in 2015 with a Bachelor of Arts in Psychology and minors in Counseling and History. Throughout her undergrad, she worked at the local CASA program, supporting volunteers advocating for children who had experienced abuse and neglect. Caty worked for seven years at a community mental health center (CMHC), partnering with children, adults, and families.

During those seven years, she taught life and coping skills as well as behavior management, provided case management and peer recovery services, and facilitated treatment teams that included the client, family, providers, and community members. I have also worked at an IOP providing group therapy services. She is currently working towards my Master of Social Work.

In her free time, Caty enjoys reading, especially historical fiction, spending time outdoors and having movie nights with her family. Disney World is her happy place, and she dreams of living among the elephants.

Madison Knowles

Mental Health Therapist

My name is Madison Knowles, I am a Mental health therapist at NPAC. I am a single-mother of two and I have a daughter who is globally delayed and has been diagnosed with autism. I have been in this industry since I was 16 years old, as I was fascinated with human behavior. I obtained my masters in applied behavioral analysis and started off working with people with disabilities. I then found my love for counseling when I worked with juveniles who had mental health and substance use issues. I then decided to go back for my mental health therapy license after that and working in a forensic treatment center. I went on to obtain my therapy credentials and since 2017, I have also been working on my PhD in forensic psychology in which I am currently working on my dissertation. I am inspired by change and how resilient people can be. My favorite inspirational quote is “Some will, Some won’t, So what, NEXT!!!” This quote has inspired me to try, try, and try again no matter how hard life gets, someone will give you a chance eventually. As a therapist at NPAC, I have been given the opportunity to work with diverse populations such as in substance use and mental health and I am known for my work with people on the schizophrenic spectrum as well as with other clients with other severe conditions including personality disorders.

Megan Carmona, LMHC

Lead Therapist

Our Lead Therapist, Megan, is a bilingual Licensed Mental Health Counselor who specializes in working with adults who struggle with addiction, anxiety, depression, and trauma. As Lead Therapist, she provides individual, family, and group therapy sessions to our clients.  Megan says “I am very passionate about therapy, especially about supporting my clients in exploring their strengths and identity. My goal is to provide individuals with the tools that can help them achieve independence in coping with their challenges and facilitating personal development.” In her free time, Megan enjoys watching docu-series and playing video games with her family. Her dream is to own acres of land so she can care for vulnerable animals, especially old dogs, cats, and horses. 

Kristen Bensley

Primary Clinician

As Primary Clinician, Kristen works with all aspects of our clinical team, from case management to primary therapy.  She has broad experience working in the mental health field. Prior to joining our team at the Neuro Psychiatric Addiction Clinic, Kristen was part of the team awarded the Evernorth Behavioral Health Center of Excellence Designation by Cigna. She says her motivation is to help people rediscover who they are and become excited about the future and all the possibilities life offers. Kristen’s favorite quote is: “You can’t go back and change the beginning, but you can start where you are and change the ending.”

Ronn Daigle, MSW

Therapist, Utilization Review Clinician

Ronn Daigle services as a Therapist and Utilization Review Clinician at the Neuro Psychiatric Addiction Clinic. He has been working in the field of substance use disorder treatment since 2011, with experience in all facility-based levels of care. Ronn earned, both an Associate of Arts in Psychology (2013) and Bachelor of Science in Human Services, with an Addiction Studies Concentration (2015) from Indian River State College. 

Ronn additionally earned a Master of Social Work degree in 2021 and is a current Registered Clinical Social Work Intern working toward licensure (LCSW). He describes himself as detail oriented, and solution focused.

Ronn says: “There is nothing more fulfilling than working with someone who doesn’t believe in himself or herself, and being there in the moment with them when the belief begins. We work with individuals who come to us at a point and time in their respective lives where they do not believe that change for others is possible; let alone for themselves…throughout the process they eventually come to a point where they realize that change is not only possible, but achievable.”

Erika Melecio, LMHC, MCAP, CEI

Assistant Clinical Director

Erika Melecio, LMHC, MCAP, CEI is the Assistant Clinical Director at Neuropsychiatric Addiction Clinic who specializes in the treatment of LGBTQ, addiction, as well as mental health disorders ranging from depression and anxiety, to Bipolar Disorder, trauma, personality disorders, psychotic disorders, and eating disorders. Erika utilizes a number of modalities including Cognitive Behavioral Therapy, Solution Focused Therapy, Motivational Interviewing, Dialectical Behavioral Therapy, and Mindfulness amongst others. Erika has been in practice for close to a decade and has earned her license in Mental Health Counseling, as well as being a Master’s Certified Addiction Professional. Erika has worked with many individuals including couples counseling and family therapy, and is fluent in Spanish.
Throughout my years of practice, one of the things I enjoy helping people find is inner peace. Whether you are in the deepest parts of depression, overrun by your anxiety, controlled by your addiction, or there are certain issues in your life that are negatively impacting your ability to function, and have a happy, healthy life, maybe now is the time to talk about it. I am a big believer in empowerment, working hard in therapy, and utilizing different techniques to help you regain that inner peace that may have been lost along the way. I want to work with you as a team because with two people, absolutely everything is possible. I want to be there as a therapist, to help build you up, support you, but also help you be honest with yourself and accountable. At the end of the day, when all is said and done, my biggest goal for you is going to be simple….for you to no longer need my services. Why? Because if you no longer need my services, it means that you have regained your peace, you have regained your strength, you have regained your confidence. It means that you now have the tools to address any issues that try to derail you, and best of all, you will have the insight to overcome and thrive. So let’s begin this journey together, and get you to the place you want to be, emotionally, mentally, psychologically, and in your sobriety.

Aurelio Ayuso, MSW, LCSW, CAP, ICADC

Clinical Director

Aurelio has worked with those that suffer from the disease of addiction in adults and juveniles alike for over 10 years, beginning in the United States Navy where he proudly served for 20 years, working with those that were succumbed by addiction due to trauma and continuing his passion for helping those in need locally in Central Florida.

He specializes in both Addictions and Trauma, he has worked first as a therapist then as the clinical supervisor to both the Juvenile and Adult Drug Court programs in Brevard County. Aurelio has been instrumental in developing substance abuse treatment programs directly tailored to help those that also suffer from complex trauma due to their addiction. He has been recognized by several organizations for his forward thinking and ability to tailor treatment to individuals in the most restrictive environments.

Mr. Ayuso received his Graduate Degree in Clinical Social Work from the University of Central Florida in Orlando. He is a Licensed Clinical Social Worker as well as Certified Addictions Professional in the State of Florida, and Internationally Certified Alcohol & Drug Counselor. Aurelio specializes in the treatment of Addiction, Trauma, and Abandonment using strength based strategies deeply rooted in Solution Focused, and Mindfulness Therapies. At the Neuropsychiatric Addiction Clinic he passionately develops holistic curriculums that foster the belief that through addressing the mind, body, and spirit together, the Disease of Addiction can be addressed successfully.

Robert Lehmann, MHSA

Chief Operating Officer

Bob Lehmann is the Chief Operating Officer at the Neuro Psychiatric Addiction Clinic. He has a Master’s Degree in Human Services Administration with a concentration in Mental Health Administration and over twenty-five years of experience as a senior executive at addiction and mental health treatment facilities.

One of the reasons for his commitment to excellence in addiction treatment was his experience related to family members who suffered from the disease of addiction. Bob has been actively involved in community organizations throughout his career. Recently he was one of the founders of the Florida Addiction Treatment Coalition (FATC) and is its present Vice President. FATC was designed to bring together treatment executives in Florida to advocate on behalf of treatment facilities and the clients they serve adhering to a foundation of integrity and service excellence.

Jose R. Toledo, M.D.

Medical Director

A well-rounded and accomplished individual, Jose R. Toledo, M.D., is the Medical Director of Neuro Psychiatric Addiction Clinic.

Dr. Toledo is a neurologist with 25 years of experience and has been in private practice since 1991 on the Treasure Coast of Florida. He completed his neurology training at the State University of New York and his Fellowship training at the University of Pittsburgh in Epilepsy and Clinical Neurophysiology.

He also completed 24 months of acute inpatient psychiatry at the Western Missouri Mental Health Center, University of Missouri in Kansas City. In 2008, Dr. Toledo participated in and was certified in the continuing medical education activity entitled “Buprenorphine and Office-Based Treatment of Opioid Dependence” from The Medical University of South Carolina during which began his quest to found and head Neuropsychiatric Addiction Clinic.

Dr. Toledo is a brain specialist with particular competence in addiction medicine and out-patient detoxification treatment and integrates the fields seamlessly. He is certified to prescribe Buprenorphine (Suboxone). He incorporates his background in neurology into the addiction field. Dr. Toledo is member/fellow of The American Medical Association, The Florida Medical Association and The American Society of Addiction Medicine