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What to Do When a Family Member is Using Heroin

It can be hard to accept that a loved one is abusing heroin or struggling with substance addiction. You may have all kinds of questions about why. Ultimately, the main focus should be on helping the person get help and find their way to lasting sobriety.

There are many addictive drugs out there, and heroin is among the most popular ones. It often comes up as one of the drugs that people with addiction struggle to break free from. In 2015, it was reported that more U.S. adults died from heroin overdoses than gun violence.

Table of Contents

What Is Heroin?

Heroin is an illegal opiate drug that is taken from morphine, a naturally occurring substance which is taken from the seed pod of the Asian opium poppy plant. Heroin is three times stronger than morphine and has no accepted medical use, according to the U.S. government. This also means heroin has a high potential for abuse.

The drug can be a white powder or it can be a black, brown, or tar-colored substance. The drug is typically cut with other items such as sugar, flour, starch, caffeine, powdered milk, and quinine. Heroin users commonly inject, snort, or smoke the drug, but to get a stronger high, injection and snorting it are popular ways to use it. Common nicknames for this drug include big H, horse, hell dust, and smack.

How do you know if a loved one is using heroin?

There are several ways to tell. Heroin use leaves different kinds of clues behind. After a person has used heroin, they typically appear “stoned” and may exhibit memory problems or find it hard to concentrate. They also typically experience ups and downs. The euphoric high they feel is commonly followed by apathy and depression.

Other physical signs and symptoms of heroin use are:

  • Small Constricted pupils
  • Drowsiness
  • Collapsed veins
  • Loose facial muscles
  • Shallow breathing
  • Scratching
  • Sexual dysfunction
  • Slurred speech

Intranasal users may have a perforation of the nasal septum, irritation of the nasal mucosa, or mucous membrane. Bacterial infections, skin wounds, and abscesses are common in heroin users. If you suspect your loved one of being a heroin user, also look for signs of illness. Hepatitis, HIV (human immunodeficiency virus), and tuberculosis are common health conditions among heroin users. That’s because needles are often shared between users, which increases the risk of contracting a disease. A family member who is using heroin may also neglect important responsibilities at home, their job, or at school.

Heroin users who try to mask their use may wear long-sleeved clothing to hide their track marks, even if the weather is warm outside. They also may keep ties or laces in their pockets that are used when injecting the needle with the addictive substance. If you’re not sure about any changes in behavior or their physical state, then check their living environmental clues. The following also may signal heroin abuse:

  • Blood stains on clothes from needle use
  • Track marks left by needles on one’s arms, legs, and hands
  • Burn holes in furniture, bed linen, or clothes
  • Burn holes in tin foil
  • Spoons that are missing from the kitchen
  • Spoons that are darkened or blackened underneath from where heroin was “cooked”


A common sign of heroin use is the “nod off,” or when users fall asleep just about anywhere because they are in a state of drowsiness. “On the nod” is a common term used to describe this practice, which the National Institute on Drug Abuse (NIDA) describes as “a back-and-forth state of being conscious and semi-conscious.” This is when users will have their heads down during a heroin high. They try to stay awake, but their heads will hang lower as they relax and become sleepier. Their heads will make a jerking motion when they are awake again.

“This nodding occurs because heroin is a sedative, and it can cause a person to go from feeling awake but sleepy into such a deep sleep that they cannot be shaken awake,” Dr. Daniel Ciccarone explained to LiveScience for its article highlights heroin facts. “This can seem like a desirable state for a heroin user, but it can be the first step on the road toward excess sedation,” he said.


Heroin Withdrawal

People who decide to end their heroin use abruptly can go into withdrawal, and that’s a dangerous place to be. Quitting the drug without professional help, especially after long-term use, can is risky. It can lead to death. Withdrawal symptoms can begin within a few hours after the drug was last taken.

Those symptoms include:

  • Diarrhea and vomiting
  • Restlessness
  • Severe muscle and bone pain
  • Sleep problems
  • Cold flashes with goosebumps ("cold turkey")
  • Uncontrollable leg movements ("kicking the habit")
  • Severe heroin cravings


What to Do Next?

If you have noticed that your loved one has exhibited any of these signs and symptoms, they may be battling a heroin addiction. This is the time to think about the health of the person and put their needs first. Confronting the person about their substance use can be a difficult decision, but it can be easier to make if you put the person’s health and well-being first.

Heroin overdose is a real possibility if the person does not receive the help they need. “When people overdose on heroin, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term mental effects and effects on the nervous system, including coma and permanent brain damage,” NIDA explains.

Heroin addiction is treatable. It is recommended that people who want to stop their use and end their dependence on the drug enroll in an addiction treatment program. With the help of addiction specialists, people in substance abuse recovery will undergo a range of treatment options that are customized according to their individual needs. Managing a heroin addiction will likely be a lifelong process. However, there are many resources to help people avoid relapse.

How Can You Help the Family Member Who Is Abusing Heroin?

  • The best help is the kind that is supportive, respectful, and engaging. Before you initiate the conversation, here are some tips to make the conversation a bit easier and keep it focused on helping your family member who is using heroin.
  • Show compassion when talking with the user and avoid blame or criticism. Blaming and criticizing someone with an addiction is not going to make them more likely to listen to you or remain open to what you say or the possibility of change.
  • Focus on the positive qualities and remind the person of who they are outside of their addiction. You can focus on talents they have, things like they like to do, and family interests or memories.
  • Find activities that take your family member’s focus off of using heroin. These activities can involve outdoor sports or other outside activities
  • Research treatment program options beforehand. This way, when you talk to your family member, you can show possible places they can go that can help them. It will also show the heroin user that you care and have given thought to how they can move on in addiction recovery.
  • Help your loved one take responsibility for their addiction. You are not there to enable them to continue on as they are. Set firm boundaries while continuing your support. Motivating them to enter a treatment program and start recovery is the goal.


Helpful Resource: The CRAFT Training Program

If you feel you need support, the Community Reinforcement and Family Training (CRAFT) program can help. According to the program’s site:

“Community Reinforcement and Family Training (CRAFT) teaches family and friends effective strategies for helping their loved one to change and for feeling better themselves. CRAFT works to affect the loved one’s behavior by changing the way the family interacts with him or her. It is designed to accomplish three goals:

  1. When a loved one is abusing substances and refusing to get help, CRAFT helps families move their loved one toward treatment.
  2. CRAFT helps reduce the loved one’s alcohol and drug use, whether or not the loved one has engaged in treatment yet.
  3. CRAFT improves the lives of the concerned family and friends.”

The heroin user you know likely isn’t going to seek help on their own for various reasons. They might deny they have a problem or they may be too deep into their addiction to get the treatment they need.

Consider using the CRAFT program to help you approach your loved one about their heroin abuse. Other resources to consider are 12-step fellowship programs, such as Narcotics Anonymous, that can offer help and guidance a pre- and post-addiction treatment.



Ready to End Heroin Addiction? We Can Help

Heroin is a highly addictive drug that jeopardizes so much for the people who use it—health, relationships, income, well-being, and more. Battling an addiction with one of the most addictive drugs out there can be difficult without professional help from trained addiction specialists. That’s why we’re here– to help you and your loved one.

Treatment programs at Delphi Behavioral Health Group’s facilities provide unique therapy and counseling methods for certain addictions. They are designed to allow you to receive the daily support of the facility’s staff and your loved ones when you return home. Our treatment centers provide just what’s needed for community, counseling, and support throughout the day so clients can apply the lessons they learn to their lives everyday life. Give us a call to discuss you or your loved one’s options today.