Who is at Risk for Heroin Addiction?

Who is at risk for heroin addiction? During the three decades that heroin use was legal in the United States; heroin abuse occurred throughout the country and affected people of both sexes and of all social classes and races. When heroin was made illegal in 1924, however, abuse of the drug became most prevalent in the inner cities.

As a result, heroin abuse faded from the view of mainstream America, and addiction stopped being considered a problem that could affect nearly anyone. Instead, the drug would come to be dismissed by most Americans as something that could affect only the inner-city poor. However, during the 1960s and again in the 1990s, heroin abuse rose among the wealthy and the middle class. Heroin's renewed widespread popularity served as a reminder to American society that heroin abuse is a problem that does not discriminate along lines of socioeconomic standing, race, or age.

So, who is at risk for heroin addiction today? According to the 1998 National Household Survey on Drug Abuse, which may actually underestimate illicit opiate (heroin) use, an estimated 2.4 million people had used heroin at some time in their lives, and nearly 130,000 of them reported using it within the month preceding the survey.

The survey report estimates that there were 81,000 new heroin users in 1997. A large proportion of these recent new users were smoking, snorting, or sniffing heroin, and most (87 percent) were under age 26. In 1992, only 61 percent were younger than 26.

The 1998 Drug Abuse Warning Network (DAWN), which collects data on drug-related hospital emergency department (ED) episodes from 21 metropolitan areas, estimates that 14 percent of all drug-related ED episodes involved heroin. Even more alarming is the fact that between 1991 and 1996, heroin-related ED episodes more than doubled (from 35,898 to 73,846). Among youths aged 12 to 17, heroin-related episodes nearly quadrupled.

NIDA's Community Epidemiology Work Group (CEWG), which provides information about the nature and patterns of drug use in 21 cities, reported in its December 1999 publication that heroin was mentioned most often as the primary drug of abuse in drug abuse treatment admissions in Baltimore, Boston, Los Angeles, Newark, New York, and San Francisco.

Who is at risk for heroin addiction? In the beginning, the heroin user will typically experiment just once or twice a week and in some cases less often, perhaps once a month or less. When a user is in the beginning stages of direct injection into a vein [mainlining], the most accessible veins are generally used. These are the veins located in the inner portion of the arm, near the elbow joint. This injection site is commonly called "the ditch" by users. If the person is mainlining, you may see scabs on the vein around this portion of the arm.

When someone becomes a heroin addict, they lose interest in their daily activities and find that their time is filled with using heroin or focused on obtaining more heroin. As their use progresses, addicts find that their tolerance continues to increase. This causes them to ingest more and more heroin to achieve the rush or high that they are looking for. As with other drugs of addiction, heroin addicts have trouble keeping their jobs and maintaining personal relationships. As their use becomes a priority in their lives their bank accounts begin to dwindle. It is not unusual for a heroin addict to spend upwards of $100-$200 dollars a day to feed their addiction.

At the early stages, there may be few signs of heroin addiction. At this point you would probably notice the injection sites. As the user progresses from experimentation to becoming a heroin addict, they will eventually reach a point where they shoot up at least once a day. At this point, several injection sites become noticeable. For example, over a 6 month period, the user will have shot up at least 180 times. This is when the needle marks manifest themselves as "tracks." Tracks are trails of tiny scabs that may extend 1-3 inches or more down the arm or leg in a straight line right over top of the vein.

Who is at risk for heroin addiction and what are the signs?

  • Pupils of the eyes are very small in reduced lighting conditions when pupils normally dilate
  • Track marks - If a person is right handed, he normally uses his right hand to inject himself in the left arm and left handed person normally injects into the right arm. As the tracks become progressively more visible, addicts will often wear long sleeves to hide the marks.
  • Collapsed veins - Injecting repeatedly into the same vein over and over again will cause the vein to collapse or "blow out". After a period of time, all veins in the arms may be blown out. At that point, the addict usually turns to veins located behind the knee or on the back of the hands.
  • Increase or decrease in appetite, changes in eating habits, unexplained weight loss or gain
  • Change in overall attitude / personality with no other identifiable cause
  • Changes in friends, new hang-outs, avoidance of old crowd, new friends are drug users
  • Change in activities, loss of interest in things that were important before
  • Drop in school or work performance, skips or is late to school or work
  • Changes in habits at home, loss of interest in family and family activities
  • Difficulty in paying attention, forgetfulness
  • Lack of motivation, energy, self-esteem, discipline
  • Bored, "I don't care" attitude
  • Defensiveness, temper tantrums, resentful behavior (everything's a hassle)
  • Unexplained moodiness, irritability, or nervousness
  • Violent temper or bizarre behavior
  • Paranoia - heroin addiction often causes users to become suspiciousness just about everyone and everything
  • Excessive need for privacy, keeps door locked or closed, won't let people in
  • Secretive or suspicious behavior
  • Car accidents, fender benders, household accidents
  • Chronic dishonesty
  • Trouble with the police
  • Unexplained need for money, can't explain where money goes, stealing
  • Change in personal grooming habits


  • Heroin is a semi-synthetic form of morphine.

  • Dead on arrival, Diesel, Dope, Eighth and Good H are other common street names for heroin.

  • There is an increased risk in infection when heroin users inject the drug.

  • Symptoms of an overdose from heroin would be convulsions, coma, and even death.

  • Sharing heroin needles lead to the spread of HIV/AIDS and hepatitis.

  • Major withdrawal symptoms of heroin use peak between 48 and 72 hours after the last dose.

  • Heroin is a powerful painkiller

  • Constant heroin use causes the brain to reduce or even stop producing its own endorphins.

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