Heroin use requires a fair deal of equipment—lots red flags for family, friends, and roommates to stumble upon.

One of the most popular methods of consuming heroin is by injection, or “slamming.” Addicts who slam usually keep a hypodermic needle, a spoon, a lighter, and cotton filter in a case kept close to their bedroom or bathroom. They may also be hiding a rope, belt, or cord for helping to locate veins more easily.

Other forms of heroin paraphernalia: aluminum foil, used as a base for vaporizing and inhaling heroin vapors; glass or metal pipes, used for smoking the drug; and baggies or balloons, used for containing and concealing. If you find a bag that is tied but also deflated, you have a pretty tight case: someone probably stashed heroin in there.

Whatever containers addicts use to hide their paraphernalia may be stylized with colorful artwork, cartoon characters, or some other innocuous design. This is usually intentional, for the purpose of deterring suspicion.

Subtle Symptoms

Some signs of self-neglect are hard to miss: legal trouble, diminished hygiene, sketchy new friends. By the time the emergency sign lights up, most heroin addicts are well into their dangerous cycle. Though all drug addictions are treatable, it’s best to catch them early on–like cancer. If you have any suspicion that a friend or family member is using heroin, watch closely for the earliest signs…the sneakier ones.

Does the person wear long-sleeve shirts all the time, even in warm weather? Check their legs, neck, and ankle, or feet for track marks (scars from the needle). Heroin use is also recognizable in the face. As with most narcotics, the pupils constrict to a noticeable degree and stay that way for a few hours.

You may also notice that the user is breathing shallow and acting disoriented for certain periods of time.

Funding a heroin habit is expensive and draining, so listen tentatively to complaints: your loved one may be experiencing initial withdrawal. Heroin withdrawal makes addicts noticeably sick with a sort of super-flu: shakes, tremors, muscle pain, stomach cramps. They may end up bedbound or in the bathroom for countless hours, sometimes just to conceal their sickness–and addiction–from others in the house. When concerned family chime in, addicts may claim that they have food poisoning or a migraine, or that they’re just exhausted.

Listen carefully for language and slang that hint at heroin use, especially if you’re a parent of a teenager with friends whom you don’t know well. In person, on the phone, through texting, and on social media, addicts use various slang to reference drugs and drug use. Common terms for heroin are smack, junk, skag, browns sugar, H, horse, Charley, China, black tar, and the phrases skin popping, chasing the dragon, and speedballing refer to heroin use. (Speedballing refers to mixing the drug with an “upper” like cocaine or methamphetamine–an even more dangerous habit.)

Personal Troubles

Over time, addicts devote more and more of their resources to getting heroin. Heroin use damages the decision-making region of the brain, so the measures taken become riskier and riskier and more and more malicious-seeming. You may notice valuables disappearing, strange charges on credit cards, or large sums of cash being withdrawn without reasonable explanation. Addicts may also ask you or someone else for money to borrow, either to pay off debts, purchase more heroin, or both. In the most severe cases, addicts can become violent or self-destructive.

Asking Questions

Addicts have to make up a lot of excuses to those concerned about them. Where have they been? What have they been doing? Why have the been behaving like this? Few addicts can keep the lies and stories straight all the time. If you’re constantly catching your loved one lying, that should be a major cause for concern. You don’t have to pry, but be vigilant. Sometimes, it may feel like you’re being manipulated, but try not to get angry or resentful. The addict is sick: the addiction is driving them, not the other way around.

Taking Action

Now that you have a feel for the symptoms of heroin use, keep researching the drug and learn everything you can about it. The more you know the disease, the better you can understand it, and the easier it will be to show empathy and care. Tension between an addict and their friends or family only stands in the way of their treatment.

Discuss with the suspected addict what you’ve learned; encourage them to learn with you by attending meetings and researching your problem, and what you can do, together. If you can’t get them to accept their problem, consider contacting an intervention specialist. Once the addict agrees to enter treatment, they will have to discuss recovery options and find a treatment program that is affordable, effective, and specific to their individual needs.

Heroin is a deadly drug worth fighting, no matter how hard it may be. In response to all the havoc it wreaks on society is a huge amount of research, funds, and programs dedicated to helping those who want to get sober succeed.

Here at Hired Power, we’re dedicated to working individually with patients to figure out how to get them on the road to recovery as quickly and effectively as possible.

If you feel that someone you know is using heroin, and you’d like to discuss the matter with a licensed professional, give us a call at 800-910-9299.