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Identifying Heroin Paraphernalia

Written by Melissa Carmona

& Medically Reviewed by Benjamin Caleb Williams, RN

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Last Updated - 12/28/2022

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Updated 12/28/2022

Seeing heroin paraphernalia around can be a sign your loved one is addicted to this dangerous opioid. Recognizing these objects can be the first step to get them help.

Each day more than 115 Americans die from overdosing on opioids. Heroin is one of the strongest and most potent opioids currently used and is a common street drug in many areas of the country. Heroin use is both highly prevalent and highly dangerous, with sometimes fatal consequences. Being familiar with heroin paraphernalia can help you understand if someone is using heroin and recognize that they need help.

Heroin Use Statistics

Heroin use is somewhat common, but less commonly used than most other opioids. According to public health data, one in two hundred people between the ages of 18–25 use heroin. One in three hundred people over the age of 25 use heroin, and statistics even show that 0.3% of 8th graders are using heroin.

Heroin use is closely connected with the national opioid crisis. Statistics show that 80% of people who use heroin first abuse prescription opioids. Some have expressed concern that the recent crackdown on opioid-based pain medication may be driving people addicted to pain medications to heroin as these medications become less available. While the national response to the opioid crisis has been expanding, opioid-related deaths continue to grow in the United States.

Social Isolation, COVID-19, & Substance Abuse

As the COVID-19 pandemic has affected life across the world, one downside it has created is increased substance use. While data is still just beginning to emerge, surveys show that 20% of people with a substance use disorder have increased their substance use during the pandemic.

Increased stress caused by the pandemic and free time with nothing to do at home are thought to contribute to increased substance use. As people try to cope with social isolation and the fears caused by the pandemic, many experts believe that substance use problems will continue to increase.

Types of Heroin Paraphernalia

There are three main ways that heroin is used, and heroin paraphernalia will vary based on the method. The most common method is injection, but heroin may also be smoked or snorted. Some of the most common types of heroin paraphernalia include:

Heroin needle

A needle and syringe are used to inject heroin into the veins. Some people may go into a high with the needle and syringe still in their arm or may have it fall to the ground and not pick it up while they are intoxicated.

Heroin spoon

Heroin that is injected must first be turned into a liquid. This involves heating it by placing heroin in a metal spoon and applying heat to the bottom of the spoon. Heroin spoons will have burn or heat marks on the underside and dry white, brown or black residue on the inside.


To make the veins stand out so they are easier to inject into, people who use heroin will often use some kind of tourniquet. This may be a belt, shoelaces, a strip of cloth or any other long strip that can be used as a tourniquet.

Heat sources

Lighters will be used most often to heat heroin and make it a liquid before injecting.


Most people that inject heroin will filter it after heating it. Cigarette filters or cotton balls are common, but other makeshift filters may also be seen.

Heroin foil

Smoked heroin will often be heated in a filter that can be folded to direct the smoke. A square of foil with brown or black residue may be a heroin foil.

Heroin pipe

A glass pipe with a plastic mouthpiece is used to smoke heroin.

Rolling papers

Heroin could be smoked in a cigarette, and rolling papers may indicate heroin or another drug has been used.

Signs of Heroin Use

There are several signs that heroin is being used, aside from the discovery of heroin paraphernalia. Heroin and other opioids slow the body’s nervous system. This results in physical symptoms such as:

  • Slower breathing
  • Decreased responsiveness
  • Small pupils
  • Slurred speech
  • Nausea or vomiting
  • Sleepiness or loss of alertness

Someone who is injecting heroin may also have scars that look like lines in the arms’ veins. If someone who has used heroin is breathing slowly or not responding well when you talk to them, they may be overdosing and you should call 911 immediately.

There are also general behavioral signs of drug addiction that may help you recognize if substance abuse is occurring. These signs include:

  • Poor performance at work or school
  • Changes in friend groups
  • Missing obligations
  • Increased isolation or withdrawing from social settings
  • Big changes in behavior
  • New financial problems
  • Legal problems
  • Decreased hygiene or decreased attention to personal appearance

These signs are not specific to heroin but should be considered when evaluating someone for potential heroin abuse.

What To Do If You Find Heroin Paraphernalia

If you find heroin paraphernalia, you should ideally seek out a mental health professional for advice on how to talk to the person about their substance use. The Recovery Village’s addiction experts can guide you on the best approach and whether an organized intervention may be necessary.

Addiction treatment can help your loved one if they’re struggling with a heroin addiction. Treatment generally begins with medical detox and inpatient care, but may also include medication-assisted treatment and teletherapy options to receive treatment at home during COVID-19.

Finding Help for Heroin Addiction

If someone you love is struggling with an addiction to heroin, they don’t have to struggle alone. The Recovery Village at Baptist Health has a strong record of helping those with heroin addiction achieve long-term recovery. Reach out to one of our caring team members today to learn more about treatment options that can help your loved one start the path to a heroin-free life.


What kind of drug is heroin?

Heroin is an opioid drug and a central nervous system depressant.

What does heroin look like?

Heroin can have a variety of appearances. It will be a fine white powder in its purest form but may also be gray, brown or black.

How is heroin used?

Heroin is most commonly injected, but may be snorted or smoked.

What are the signs and tools that someone is using heroin?

Finding needles, burnt spoons and tourniquets is a sign someone is injecting heroin. When heroin is smoked, you may find pipes, foils and rolling papers.

What type of paraphernalia would you find in heroin use?

Many different objects can be used to abuse heroin, but spoons with burn marks, needles and syringes are among the most common types of heroin paraphernalia.

View Sources

National Institute on Drug Abuse. “Benzodiazepines and Opioids.” March 15, 2018. Accessed October 31, 2020.

O’Malley, Gerald & O’Malley, Rika. “Opioid Toxicity and Withdrawal.” May 2020. Accessed October 31, 2020.

National Institute on Drug Abuse. “Opioids Trends & Statistics.” February 5, 2020. Accessed October 31, 2020.

National Institute on Drug Abuse. “Opioid Overdose Crisis.” May 27, 2020. Accessed October 31, 2020.

Centers for Disease Control and Prevention. “Provisional Drug Overdose Death Counts.” September 16, 2020. Accessed October 31, 2020.

Borke, Jesse. “Opioid intoxication.” Medline Plus. April 25, 2019. Accessed October 31, 2020.