Is There Such a Thing as Casual Heroin Use?

Garrett Stanford
May 2, 2020

Heroin is probably one of the best known recreational drugs, and its reputation as a dangerous and addictive substance is well-earned. Heroin is an opioid that is used recreationally because of the intensity of the high it provides. While it can be snorted, smoked, or inhaled, most users opt to inject it into their veins in order to get more intense and rapid-onset effects. While heroin does indeed provide a euphoric high, like all opioids it is extremely addictive. In fact, the world is currently suffering from an opioid epidemic, and, along with synthetic opioids such as fentanyl, heroin is a primary culprit. While synthetic opioids, which function as analgesics, are used legitimately to treat chronic and severe pain, these pain medications are increasingly over-prescribed, leading to addiction and recreational use. Many who suffer from a physical dependence on opioids eventually turn to heroin as a cheaper and more effective route of administration. According to the National Institute on Drug Abuse, in the United States, approximately 170,000 people tried heroin for the first time in 2016, a dramatic increase from 2006, when 90,000 tried it. The results have been catastrophic, with 15,000 Americans dying in 2018 as a result of heroin overdose.

Is it Possible to be a Casual Heroin User?

While many substances, like alcohol and marijuana, can be used recreationally without necessarily leading to a substance use disorder, heroin is far more difficult to use without developing problems. It is far more physically addictive than most substances, resulting very quickly in physical dependence that requires users to consume the drug in greater quantities or at a greater frequency to achieve desired effects.

The effects of opioid withdrawal can also make it nearly impossible to stop using heroin without outside help. Withdrawal symptoms include:

  • Gastrointestinal problems such as nausea, diarrhea, and abdominal pain
  • Nervousness and agitation
  • Heavy sweating
  • Shaking, trembling, and muscle spasms
  • Depression
  • Severe drug cravings

While there are people who use heroin recreationally with no desire to quit, they have likely accepted these excruciating symptoms as regular occurrences in their lives. While they might consider the high that heroin provides worth the anguish, few people would describe destabilizing drug use as “casual.” 

Even people who successfully use heroin recreationally for long periods of time often eventually become addicted. At this point, a heroin user might find it increasingly difficult to manage and control their drug abuse as they had done before. Heroin addicts inflict enormous suffering on themselves, close friends, and family members.

Signs of Drug Addiction

The method a heroin user employs to consume the drug affects its addictive potential. While injecting heroin is the most dangerous way to consume it, heroin can also be smoked and snorted. In fact, most people begin with snorting or smoking heroin and move on to injecting it once they are addicted. Smoking is in some circles perceived to be safer than injecting, partly because much of the dose floats up into the air as smoke. However, smoking is actually the most addictive way of consuming heroin. Smoking any substance is the fastest way for its effects to reach the brain. The speed at which a drug user experiences effects is a major determining factor in the development of an addiction, since the brain is more readily conditioned to associate a behavior with certain effects when there is less waiting time. As a result, even people who use heroin “safely” by smoking or snorting it are putting themselves at enormous risk over the long term. By the time people transition to full-blown heroin addicts, they have transitioned to injecting heroin so that they can get a higher dose.

If you are a concerned family member or friend, or if you are wondering if your own heroin use is something more than “casual,” it is worth seeing if the individual in question is exhibiting any of these signs of heroin addiction:

  • Track marks or nose sores that indicate drug use
  • Depression and unusual agitation
  • Slurred speech
  • Altered behavior, including aggression or an increased need for privacy
  • Changes in appearance and worsening hygiene
  • Financial problems, especially an urgent need for large sums of money
  • Dangerous and impulsive behavior
  • Difficulties meeting obligations at work, school, or home


Risks of Heroin Addiction

Over time, people suffering from heroin addiction usually find their lives become very small. Substance use disorder causes individuals to prioritize drug use and drug-seeking behavior over all else, the result being that most addicts suffer innumerable difficulties in their relationships with others and at work. Heroin addiction poses a number of risks to both physical and mental health. Mental illnesses such as anxiety and depression can arise from the lifestyle associated with substance abuse. Heroin users are also at increased risk of collapsed veins, infection of the heart lining and valves, abscesses, liver and kidney disease, lung problems, and even sexual dysfunction. The greatest risk associated with heroin addiction is drug overdose, which can result in life-threatening respiratory failure.

Getting Help

While there are indeed some people who use heroin recreationally, the vast majority do so unwillingly as the result of a substance use disorder. If you suspect that your casual heroin use has developed into an uncontrollable pattern and you are ready to get help for your addiction, the best course of action is reaching out to a formal treatment center. Beginning with supervised medical detox, most individuals move on to inpatient treatment facilities or outpatient programs, where they can begin to develop the skills and coping strategies necessary to avoid relapse. While treating heroin addiction is a lifelong process, the rewards of long term sobriety are endless.

Garrett Stanford
Garrett Stanford brings years of experience working with individuals and families struggling with substance abuse and behavioral health issues. He began working in the nonprofit treatment sector for 2 years before transitioning into the private sector. Garrett has been involved in treatment since 2010, with 10+ years of experience ranging from operations, administration, admissions and addiction research.
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