Signs of Heroin Use in Teens

Published On: October 18, 2023

Heroin History and Profile

Heroin has been used for thousands of years; the chemistry of Heroin was synthesised in 1874.1 Whilst originally used as an alternative to morphine, it’s been found to be more addictive with worse side effects and long-term issues.

Heroin is now classified as a recreational opioid, due to its addiction rates and the likelihood of overdose.

The ages of eighteen to twenty-five are the most common users of heroin, therefore it’s a continuous problem in all areas of life.2

Heroin is psychoactive; the depressant can be injected, smoked, and snorted, all of which have negative side effects such as anxiety and tremors.

Individuals usually start by snorting heroin, and as tolerance and addiction develop, injecting becomes the more appealable option as it gets into the bloodstream faster. However, no drug experience in individuals is the same, so it is important to know and spot the signs of use in others in order to get them to help.

The street name for heroin is also called:

  • Smack
  • Junk
  • Hero
  • Skunk
  • Smack

These terms are culturally relative, meaning the street name for heroin is dependent on the culture surrounding it. New terms are invented and used to avoid government and police intervention, for example, the new term ‘china white’ is occasionally used.

Heroin is a highly addictive drug, therefore addiction and dependence become highly likely. Withdrawal can then happen as quickly as 2 hours after the last use of heroin.

The way heroin affects individuals depends on:

  • Age
  • How much and how often you use
  • Method of use
  • Medical or psychiatric issues
  • Mixing, e.g., alcohol

The number of heroin overdoses that resulted in death was around 3,400 in 2019.4 This was higher than alcohol, cocaine, and prescriptive drugs. It is crucial to understand the dangers this drug poses to all users, including its effect on family and friends.

Why Teens are Susceptible to Drugs

A young woman in a beanie and glasses, smiling

Commonly, teenagers and adolescents use drugs and alcohol in social situations to relax, ease pressure or fit in.

Opioids reinforce drug-taking behaviour. Teens often experiment with drugs due to peer pressure, and later enjoy the feeling of euphoria and carry on using.

Family and friend problems can also lead to a lack of self-respect. This can quickly lead to taking risks.

Effects of Heroin

Two people holding hands across a table

After the preliminary euphoria, users will experience flushing of the skin and commonly a dry mouth. This is accompanied by nausea and occasional vomiting.

Heart rate is slowed, along with breathing. If these two functions are slow enough then this can be fatal and life-threatening.

Drugs tap into the brains communication system and disrupt:

  • Sending information
  • Processing information
  • Receiving information

This effect on information can alter the development of the brain. Teenage development is associated with maturity, a sense of self, and decisions.

Lacking brain development becomes evident through behaviour, such as risk-taking, impulsivity, and inability to maintain morality. Taking risks is part of finding personal boundaries; interlinked with character, risks enable individuals to find identity and independence.

Evaluating risk comes with cognitive development. If heroin interrupts psychological signals and development, risk and harm perception becomes distorted.

Drugs can be a temporary tool for mental instability, which many people use to get them through difficult times and emotions. However, taking drugs can lead to long-term mental health problems, a critical link between ill-mental health and drug use has long been correlated.

Recurrent use of heroin via any means can rapidly lead to a high tolerance and heroin cravings.5

Signs of Use

When a teen is using heroin, there are tell-tale signs to spot. For example, the easiest to stop is track marks; needle marks on the skin make teens wear long sleeves to cover them up.

This can be spotted especially in summer when the norm is to wear short-sleeved summer clothes. Pupils tend to be very small when teens are using, this is accompanied by extreme fatigue and slow thought.

Change in habits

A change in teenage habits is one of the first warning signs, these may be difficult to spot due to the changing nature of adolescents.

The alterations are as follows:

  • Cravings and appetite (increase or lack of)
  • Change in friendship groups or spending more time out of the house
  • Misbehaviour or secret behaviour
  • Poor grades and/or missing classes
  • Stealing: money or substances

Physical signs

The changes in looks will depend on the drug being used and how much or often they are using.

Things to look out for:

  • Long sleeves to hide track marks
  • Bloodshot and tired eyes
  • Unexplained bruises and marks
  • Sweating or constant flushing
  • Sudden poor hygiene
  • Dry lips or mouth, and constipation
  • Regular shaking
  • Changes to mental health (e.g., increase in anxiety)
  • Withdrawal

The difficult thing here is to differentiate between drug use and mere puberty, both of which can have synonymous signs. As a parent or carer, you make be one of the only ones able to spot the difference.

Withdrawal Signs

A woman sitting on the floor looking sad

Heroin withdrawal can be severe; beginning with anxiety and aching, the effects get worse over the first few days. Sweating and nausea turn into vomiting and diarrhoea as the brain struggles to mimic the effect of euphoria produced by the drug.

If you spot physical signs, the mental effects will soon follow. The emotional trauma interlinked with addiction is grave – there is a drastic change in mood, occasionally leading to suicidal tendencies. Drugs change the chemistry of the brain, leading to anxiety and depression, difficult mental illnesses to break free from.

If you have used it for prolonged periods, you have almost starved your brain of oxygen. This could result in a hypoxic brain injury, leading to permanent brain damage or worse.

Heroin puts the body under copious amounts of stress, and the lack of oxygen can damage the brain and the lungs severely. Continuous use means it becomes easy to contract HIV from needles or high risk from ‘cutting’. Some additives can clog the arteries leading to serious heart conditions and organ failure.

If you suspect drug use, don’t make direct accusations. Ask them where these signs have come from and see if they have a valid excuse. Occasionally, people get defensive if they have something to hide, but this isn’t the case for everyone.

Don’t let your emotions control your approach; if they tell you they have been using, getting them immediate help instead of lashing out is a better reaction.

Before taking matters further, reaffirm boundaries to make lifestyle changes. They may have fallen into ‘bad company’ or been experimenting. Teaching about the effects of drugs is the first step, followed by intervention and rehab if the problem is bad enough.

Every single use of drug carries with it the risk of overdose, don’t risk it.


  4. ,
  5. Schwartz RH. Adolescent heroin use: a review. Pediatrics. 1998 Dec;102(6):1461-6. doi: 10.1542/peds.102.6.1461. PMID: 9832585.

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