What Does Heroin Look Like? A Visual Guide for Parents

Based on recent data from 2024, teen heroin use affects a very small percentage of teens, less than 0.1%. Fortunately, these numbers have drastically declined since the peak of the opioid crisis in the early to mid-2000s, when heroin stole hundreds of thousands of adult and teen lives. This decline is due to a broader reduction in teen substance use disorders seen over the past decade, with current drug and alcohol use among teens at an all-time low [1]. 

Despite progress in reducing heroin use, continued investment in harm reduction, education, and access to life-saving tools such as Narcan is essential. Recognizing what heroin looks like and the signs of teen use helps support these harm prevention efforts and protect youth. 

Parents should recognize the forms of heroin (powder or black tar) and common paraphernalia associated with heroin use, such as spoons and needles, to stay aware of the signs. 

Why Parents Need to Recognize Heroin

Heroin is an illicit opioid derived from morphine and sold illegally on the street. It’s known for its rapid onset, including a quick spike in euphoria and relaxation. Although heroin use in teens remains low, the teen overdoses crisis is still significant, and overdose fatalities more than doubled during the COVID pandemic [2]. 

Parents should also know what heroin and teen heroin use looks like, even if overall rates are low, because: 

1. Early warning signs are similar across several substance abuse disorders. Signs such as secretiveness, mood swings, declining grades, poor hygiene, pinpoint pupils, and track marks can be heroin, fentanyl, or another substance abuse disorder. 

2. Teens may unintentionally use heroin if it is contaminated with other drugs or if they are abusing multiple substances at once (polydrug use). 

3. Addiction prevention through early detection of illicit drug use can reduce the risk of negative outcomes, including academic decline, legal problems, health issues, and homelessness. 

4. Low rates don't mean there’s no risk. Despite low prevalence, heroin is a notorious, deadly drug that has contributed to over 700,000 deaths between 2000 and 2022. Knowing the signs and how to recognize heroin can prevent life-threatening situations. 

What Does Heroin Look Like? Common Forms and Colors 

Heroin typically appears in three primary forms. Understanding what it looks like or is “supposed to look like” can help recognize it and its purity level. Heroin can be smoked, snorted, or injected [3]. 

White or Off-White Powder 

This often has the highest purity level, but is still mixed with substances like sugar, caffeine, or fentanyl. This form is most common in the Northeast and Midwest/Great Lakes region of the US. It is typically snorted, smoked, or injected after dissolving. 

Brown Powder 

Brown heroin varies from light to dark, and often has a gritty or coarse texture rather than a “refined powder”. It is more commonly smoked or snorted, and requires an acid solution to be dissolved for injection. It is found in various regions in the US, and is most common in the Southwest Asia region of the world. 

Black Tar Heroin

This is a dark brown to black, sticky substance primarily produced in Mexico through less refined methods. It is common in the West and Southwest region of the US and has a much lower level of purity than powder forms, only 25% to 30%. It has some of the highest risks of overdose, infections, and vein damage [4]. 

For photos of each, you can refer to this guide from the Drug Enforcement Agency→ Drug Fact Sheet: Heroin 

Paraphernalia Linked to Heroin Use 

Those who abuse heroin may struggle to hide their addiction after a while due to the intense physical and psychological effects of the drug, as well as the “maintenance” it takes to abuse heroin. Heroin users often use several kinds of paraphernalia, making it a bit easier to spot the signs. Below is a list of standard paraphernalia linked to heroin use: 

• Heroin Spoon: Used to cook heroin and dissolve it into a liquid form for injection by heating it over a lighter or stovetop. Heroin users often have broken or bent spoons lying throughout the home. 

• Needles: Used to inject liquid heroin directly into muscles or veins. You may find dirty or used needles, or their caps, around the home, in garbage cans, or even hidden under or behind furniture. 

• Aluminum Foil: Used as a surface to smoke heroin by heating it underneath. Heroin users may have random, rolled-up pieces of aluminum lying throughout the home. 

• Pipe: Heroin pipes are often makeshift or less elaborate than a typical tobacco or cannabis pipe. Sometimes it’s just a piece of foil with burn marks, or a basic pipe without a bulb. 

• Straws: Rolled up pieces of paper, money, or straws that have been cut and are lying around the home are often used to snort heroin in powder form. 

Warning Signs of Teen Heroin Use

Many of the signs of teen heroin use can look like other opioid or substance abuse disorders, manifesting as physical, psychological, and behavioral signs. 

What to Do If You Suspect Heroin Use 

It can be horrifying for any parent to suspect or find out their teen is using heroin, and taking the steps to ensure their safety is essential. If you believe your teen is using heroin, stay calm and approach them with compassion. 

Addressing heroin use in teens is not the same as finding out they are vaping or drank a beer at a party; it often requires quick medical intervention due to the intensity and strength of the drug. Connect with a local treatment center, mental health professional, or your primary care doctor. 

A typical recovery plan for heroin addiction involves several levels of care, including: 

• Supervised Medical Detox ensures safety and comfort during heroin withdrawal, which can cause intense cravings, flu-like symptoms, itchiness, vomiting, depression, anxiety, and exhaustion. 

• Residential Treatment is often recommended for heroin use as it helps teens focus on the roots of addiction in a safe inpatient environment away from triggers and temptations. 

• Ongoing Aftercare, outpatient therapy, case management services, and sometimes the use of Medication-Assisted Treatment (MAT) through a methadone or suboxone program can greatly reduce the risk of relapse by managing cravings and long-term symptoms of opioid use disorders. 

If you notice any signs of an overdose in your teen, such as loss of consciousness, slowed or stopped breathing, and bluish/purple lips or fingertips, call 911 immediately. If you have Narcan in the home (a life-saving nasal spray sold over the counter in 50 states that quickly reverses opioid overdose), administer it. Here is a guide on how to access and administer Narcan safely. 

How Lotus Behavioral Health Can Help Your Teen 

Lotus Behavioral Health understands the difficulty of breaking an addiction to heroin and other opioids. We prioritize your teens' well-being, safety, and comfort during treatment. Our residential treatment center in Florida provides a safe and medically supervised environment to care for your teen and help them achieve stability. 

We offer evidence-based therapies designed to evolve with their individual needs and address the root of substance abuse. Let our team help you recover safely, repair relationships, and equip you with the skills to achieve long-term recovery. 

Contact our admissions team today to learn about life-saving interventions and discover how we can support your teen. 

Sources 

[1] National Institute of Drug Abuse. 2024. Drug Overdose Deaths: Facts and Figures. 

[2] DEA. Drug Fact Sheet: Heroin. 

[3] Transnational Drug Market Analysis. The Global Heroin Market. United Nations Office on Drugs and Crime. 

[4] Ciccarone D. (2009). Heroin in brown, black and white: structural factors and medical consequences in the US heroin market. The International journal on drug policy, 20(3), 277–282.

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