Heroin Relapse: Know the Signs and Symptoms

Spotting the signs of a heroin relapse can save someone’s life before overdosing on drugs. The duration of time someone has been in recovery before relapsing can also put them at higher risk for heroin overdose because their tolerance levels have decreased. Plus, more reports are affirming fentanyl-laced heroin are being sold on the streets unknowingly, meaning people may overdose without realizing they are using more potent opioids.

While some people are quick to judge when someone in recovery relapses and returns to a life of substance abuse, there are many factors that determine why someone has a relapse. From daily stress to trauma to simple availability, people with heroin addiction have to be incredibly strong to remain in recovery and not succumb to temptation.

If you are concerned that a loved one may have relapsed into heroin addiction, here are a few signs to indicate that immediate action needs to be taken:


Addiction makes even the most social individuals withdrawn and distant. Especially when it comes to family members and friends who are concerned about drug use and safety, recovered heroin addicts who have relapsed will quickly become distant. This affords them a buffer between themselves and others, allowing them to recreationally abuse heroin without worrying that their loved ones notice they’re intoxicated.

Keep watch on their social media profiles as well. If they were routinely active and suddenly go into a quiet spell, that’s something to keep watch for. Pay attention to what pages they like, new “friends” they’ve made, and whether they avoid replying back to your messages through these mediums.


Financing a drug addiction will inevitably drain a person’s bank account, no matter how rich they are. The need for more drugs will exceed the supply of money and may then take more priority than paying bills, buying groceries, supporting families, etc. If you notice a loved one is struggling to pay rent or afford a car payment, gas, insurance, or food despite having a place of employment, it may be something to keep your eyes on.

People struggling with addiction also ask to borrow money, which means your loved one may be asking for your money a little too much. Take note of this and whether they ever pay it back. Also, keep watch of where they go to obtain their income. Some people deep into addiction will resort to gambling, prostitution, or drug dealing themselves to afford their addiction, but they are also liable to get into deeper financial debt, be arrested, or be in trouble with the wrong people.


One of the most apparent signs of heroin use is the appearance of track marks on a person’s arms. Track marks can appear like ink pen marks smudged on the skin or thumbprint-sized bruises, indicating the site of heroin injection.

If a heroin user has relapsed, they will have track marks if they are an intravenous user. If they are wearing unseasonable clothing that covers their arms and legs, it’s possible that the individual is trying to hide track marks. Some people may even attempt to use skin foundation or concealer makeup to cover their track marks.


Another very common symptom of a heroin relapse is pronounced drowsiness. Opioids act on the body as depressants, making individuals incredibly drowsy and lethargic. By appearances, heroin users appear inexplicably tired and will often have difficulty staying awake. It’s not uncommon to see heroin users falling asleep while sitting up or even standing, which is one of the most telltale signs of an opioid problem.

Heroin users also tend to fall into an incredibly heavy and deep sleep from which they are very, very difficult to wake. If a recovered heroin addict appears to be so excessively drowsy that they are on the verge of falling asleep while standing or sitting up, it’s very likely that a heroin relapse may have occurred. Seek medical help immediately, especially if a respiratory collapse or depressed heartbeat occurs.


When a person is developing a substance abuse problem that they are trying to hide from others, they readily become very defensive and argumentative when they are questioned. Whether it’s about their behavior, appearance, or even just small talk, heroin and drug users quickly become defensive and readily create excuses to justify their observations.

In some instances, defensiveness can become quite aggressive or violent; doors are often slammed, glasses or plates broken, and other messes are made. This should be a warning, especially if they are not usually physically threatening to others. This behavior is an inverse reaction to the guilt and shame that they feel at the thought of others noticing their unusual behaviors. People in recovery who view their heroin relapse as a sign of “failure” will also go to great lengths to hide their actions.


After becoming addicted to alcohol or drugs, a person will soon show decreasing interest in things that he or she used to enjoy. For instance, hobbies frequently fall by the wayside. Extracurricular activities are suddenly much less interesting. The reason for this is that addicts suffer from a persistent and unrelenting concern as they wonder when and how they will obtain their next fix. Their focus may be more on drugs and not necessarily healthy activities without them.

Family members and close friends are more likely to notice when their loved one suddenly stops playing basketball on the weekends or doesn’t pick up the paintbrush again because “they don’t have any more ideas.” This can be a sign of mental illness, including substance use disorder. Pay attention to the small details of loved ones, and you may be able to realize that heroin relapses can be more obvious than you think.


The Palm Beach Institute encourages anyone battling a heroin or opioid addiction to seek treatment as soon as possible, even if it’s not your first time around the block. Sometimes recovery means going to rehab a few times, but that doesn’t mean it’s a failure on drug treatment.

The Palm Beach Institute recognizes every individual is different, which means every client that walks through our doors will be treated like family and be given extra attention. We want to find out what worked and what doesn’t so that you can start your recovery on the right foot. We’re here to support you as long as you are ready to support yourself.

If you or a loved one is struggling with addiction, feel free to call our 24-hour helpline at (866) 804-6507. One of our call agents will gladly answer any questions you may have about addiction treatment and will guide you through the process of admission. Start your recovery today.

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