Quick summary
Heroin is a highly addictive opioid, and for the 660,000 people who used it in the past year it can take over a life quickly. Withdrawal is painful but rarely life-threatening on its own; the bigger danger is returning to use and overdosing. Methadone, buprenorphine, and naltrexone are FDA-approved and proven to help.
If heroin has a hold on you or someone you love, you already know how fast it can shrink a life down to the next dose. What is harder to see from inside it is that heroin use disorder is a treatable medical condition, and the medications that help are widely available. The fear of withdrawal keeps many people stuck. Treatment exists for that too.
If someone is unresponsive or breathing slowly, call 911 and give naloxone if you have it. For a mental health or substance use crisis, call or text 988.
What makes heroin so addictive
Heroin is an opioid drug, in the same family as prescription pain relievers like oxycodone and hydrocodone. It acts on the brain's opioid receptors, easing pain and producing a rush of pleasure and calm. NIDA describes heroin as a highly addictive opioid, and it notes that repeated use changes the brain so that people keep using even when it causes harm.
How many people are using it? SAMHSA's 2023 survey found that about 660,000 people aged 12 or older used heroin in the past year, and that 8.9 million people misused opioids overall. Those numbers are smaller than the opioid crisis as a whole, but each one is a person with a body that now depends on the drug to feel normal.
The risk that has grown around heroin
Heroin no longer comes alone. NIDA warns that deadly doses of illegally made fentanyl are commonly mixed into or sold as other drugs, including heroin, so what is sold as heroin may be far stronger than expected. NIDA reports that fentanyl is 50 to 100 times more potent than morphine, which means a batch that looks the same as last week's can kill.
People who inject drugs also face higher risks of viral infections, including HIV and hepatitis C, along with bacterial infections such as endocarditis, an inflammation of the lining of the heart. Those risks are one reason many people choose medication treatment over trying to stop alone.
What withdrawal is really like
Withdrawal is the wall most people hit. Hours after the last dose, the body begins to protest: muscle aches, nausea, sweating, chills, anxiety, and insomnia. It is rarely life-threatening in an otherwise healthy adult, but it is intensely uncomfortable, and the memory of it is what pulls people back to the drug.
The dangerous part comes after. Tolerance drops fast during abstinence. Someone who goes back to the dose they used to take can overdose, because their body can no longer handle it. That is why a supervised, medicated withdrawal is safer than white-knuckling it alone.
If you are also physically dependent on alcohol or benzodiazepines, do not stop on your own. That withdrawal can be life-threatening and needs medical supervision. For a medical emergency, call 911.
Medications that actually help
Medication is the backbone of treatment for heroin use disorder, and it is well studied. NIDA lists three FDA-approved options:
- Methadone, dispensed through certified opioid treatment programs, that relieves withdrawal and cravings.
- Buprenorphine, available as a daily tablet or film and as longer-acting injections, that can be prescribed in a doctor's office.
- Naltrexone, which blocks opioid receptors so the drug no longer produces a high, usually started only after opioids have cleared the body.
Lofexidine is a fourth medicine that eases acute withdrawal symptoms. NIDA notes that medication works best alongside counseling and behavioral therapy, and that these treatments are safe and effective, including during pregnancy.
Naloxone can save a life
Naloxone reverses an opioid overdose, including one involving heroin, and it is available over the counter without a prescription. If you suspect an overdose, call 911, give naloxone if you have it, try to keep the person awake and breathing, and stay until help arrives. Naloxone will not harm someone who is not overdosing.
A next step you can take today
You do not have to wait for a rock bottom, and you do not have to do this alone.
- Search FindTreatment.gov by ZIP code for methadone, buprenorphine, or counseling near you.
- Call SAMHSA's National Helpline at 1-800-662-HELP (4357), free and confidential, 24/7.
- Call or text (800) 653-9376 to talk through treatment options and check your insurance before you commit to anything.
Heroin use disorder is treatable, and reaching out is a strong first move. Calling is free, and the referral service is paid for by treatment providers.
Call 911 in a medical emergency. Call or text 988 for a mental health or substance use crisis.
Last updated: Sun Oct 18 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
Frequently asked questions
How many people use heroin in the United States?
SAMHSA's 2023 National Survey on Drug Use and Health found that about 660,000 people aged 12 or older, or 0.2 percent, used heroin in the past year. The survey also found that 8.9 million people misused opioids overall, including heroin and prescription pain relievers.
What does heroin withdrawal feel like?
Opioid withdrawal typically brings muscle aches, nausea, sweating, anxiety, and trouble sleeping. It is rarely life-threatening in a healthy adult, but it is intensely uncomfortable and drives many people back to use. Medical supervision and medication can make it safer and more bearable.
Is heroin withdrawal dangerous?
The withdrawal itself is rarely fatal in an otherwise healthy adult, but the days after are dangerous. Tolerance drops quickly during abstinence, so returning to a dose the body once handled can cause a fatal overdose. That risk is one reason treatment with medication matters.
What medications treat heroin use disorder?
NIDA reports three FDA-approved medications: methadone, buprenorphine, and naltrexone. They reduce cravings and withdrawal symptoms. NIDA notes medication combined with behavioral therapy is particularly effective.
Can heroin be mixed with fentanyl?
Yes, and often without the buyer knowing. NIDA says deadly doses of illegally made fentanyl are commonly mixed into or sold as other drugs, including heroin. Naloxone reverses an opioid overdose and is available over the counter without a prescription.