What does a heroin addict look like?

What does a heroin addict look like? Get the grim truth from a former heroin addict himself as Richie describes his former heroin addiction. Taken from his book “What’s Left of Us”, learn what a heroin addict looks like… a real look at the streets.

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What does a heroin addict look like?

Each morning I do what all the other runners down here on Adam Street do: I lurk in the doorways, dodge the police, jones, and wait for addicts to drive up and buy their morning dose.  Now Adam Street isn’t safe. And only one rule counts—the strong survive. The drug trafficking goes on all night long without a break. There’s routine police surveillance, nothing big though. Every shift the cruiser drives by just to let us know they know. But for the most part the drug trade is in your face twenty-four hours a day, seven days a week.

I wasn’t always a homeless, jobless, low-life heroin addict. Once I was a good kid, an altar boy for Farther Muldoon right here at St. Patrick’s. I went to the YMCA as a young boy and played basketball, baseball, and football.  And I was a pretty fair student—but school bored me. I think it had something to do with the fact both my parents were teachers.


How would you describe a heroin addict? From where you start…or where you end up?  And how does opiate addiction typically change the way a person looks, feels, or present themselves?

About the author
Richie Farrell won the du-Pont-Columbia for directing the HBO documentary film, High on Crack Street: Lost Lives in Lowell. That film inspired the 2010 major motion picture The Fighter that went on to win academy awards for Christian Bale and Melissa Leo. Farrell's memoir What’s Left of Us: A Memoir of Addiction has been optioned for a movie and currently in development. Richie Farrell is one of the top substance abuse and motivational speakers in the United States. More Info @ My Heroin Life.


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  1. Heroin is like no other drug, it has no come down like coca in or exctacy so in the early stages of taking this drug u can wake up the next day with no come back at all, it also feels so relaxing and warm, the only way I can explain it is , it is as if u have been wrapped up in CottenWoll. it relaxes you intensely and takes away any bad emotions your feeling, that’s why it’s so addictive -because it is so nice. When you first start you can get out of it on around 3 or 4 pounds worth, that soon becomes 30 – 40 if u chase the initial buzz. I functioned fairly well and like any other normal non user whilst taking this drug for years, but I was lucky and didn’t let my priorities slip too badly

  2. Hi I was clean for 3 months now but I relapsed like a dumbass. I am 5’4″ and weigh about 135-140lbs. I was just wondering if I did 2 bags of heroin on Sunday at 7:30pm and I have a urine test on Friday at 2:00pm will I be clean? I need to know wat I can do if u don’t think that I will pass. I did a test today at 2pm which is Thursday and I failed the top red line was faded it was light on the test strip. Please help me out asap thanks so much hope to hear from someone soon

  3. its so strange to me when people wil make comments about an “junkie” stating “you dont look like a heroin.addict ” well i am and more than ever now i wish people did know or i could tell bcuz it is so lonely waking up every day only to have withdrawls staring me in the face, the devil doesn’t discriminate.

  4. My little sister…55 yrs old…has had a problem with alcohol for years. She has been in and out of hospitals and rehabs many times. She’s been found on the street unresponsive….and has been near death a few times. She’s had a pretty rough adulthood…most of it brought on by her own poor choices. She is/was a wonderful person/wife/mother until a horrible divorce and a manipulating, evil, mentally abusive ex. He did everything he could to ruin her, as he promised he would, and left his legacy even after his death. She also has a debilitating illness for which there is no cure…only treatment. Everyone believes her problem is alcohol….we know that is a problem for sure. She’s to the point where she has to have her abdomen drained now and then because of fluid buildup. Alcoholism is killing her. But, I believe she also has a drug problem….probably heroin or meth. She has lost a lot of weight, her face is so thin and her cheeks are sunk in…her teeth are rotted, she does not look like the person we all knew. She has been delusional and paranoid at times, attacking her family with unfounded accusations and things she believes in her mind to be true. She has become a habitual liar and manipulator. Her actions have alienated all of her friends and family. She moves from place to place and can’t seem to be happy anywhere for very long. She refuses to put any of her family on as emergency contacts at hospitals and with her doctors. I believe this is because she doesn’t want anyone to know what is going on. At one point, it was found that she had heroin in her system during one of her emergency trips to the hospital. Her story was that someone followed her home, shot her up with heroin, and raped her. She was recently at our parents’ home for a visit….refused to visit with siblings, went out and did not return until after dinner…which our mom had taken the time to prepare especially for her. Then she said she was not hungry and she did not eat. This has happened a few times when she’s come to visit. She’d come home and just go to bed. She has no appetite. There are times when she seems “normal” and it seems she is on the road to recovery and finding some happiness….but eventually it all falls apart. She now has her drivers license back and lives away from everyone…in a hotel where she says she’s happy because she has no maintenance, no other bills, and her place gets cleaned once a week. She’s far enough away from everyone to prevent “surprise” visits from family….and she can go visit whoever she wants, when she wants. We’ve all tried to help her over the years but have realized that there is nothing any of us can do unless she is willing, and wanting, to help herself. I have come to accept that she will more than likely die within a couple of years, if not sooner, partially due to her illness…but more so because of the alcohol and drugs. I do still pray that she will decide to fight, and beat, her demons….and, even though it is more than likely that her physical condition can not reversed….she will be able to have a little more time here with the people that love her, and find some peace and happiness before her journey here on earth is over. My heart goes out to those who fight their demons every day….and to their families that feel so helpless in their struggle to understand and help their loved ones.

  5. My 19 year old niece is addicted to heroin and she has a 2 year old! She doesn’t even weigh 100 lbs. Her teeth are rotten and she was a beautiful girl. We are all scared shes going to die. There has been so many deaths from heroin in this area. She does not know what she is doing to her family. Her child is going to be motherless.

  6. i am with my partner who had been on heroine for 17 yrs. when i found out i couldn’t handle it so we went our separate ways. she had got 3 children , and to our amazement we have another . i only came home from abroad after the recession and we found each other again, her 3 children are from different fathers . but number four belongs to me 100%. but still i remember her telling me that she is clean as can be for now . she goes to the chemist every day to take a tablet called subitex . i have only one thing going for me in this relationship and that’s the fact that she will stay clean and be a proper mother . her eldest throws it all back in her face and it can turn nasty . but as i have said to her, you have only yourself to blame. as your eldest has to live with all the memories and lies that you put her through. and has now grown up to understand what was really going on . lie after lie . trying to keep it all under wraps.. but that you should be grateful that her eldest ( daughter ) didn’t go down the same road.. but as for those who say that smack heads are all scum bags . they should be asked one question .What did you think of AMY WHINEHOUSE ? .if you get the answer your looking for. you will also understand the meaning of contradictory.never mind stereotyping……

  7. Rebecca, your post was the most honest reply I have read. Everyone knows the stereotype of a drug user but heroin reaches across those lines. I have used off and on for over 10 years and most people have never even known. I have been through methadone, suboxone, in-patient and out-patient rehab. To the outside world I look like a healthy, 30- something female and except for being heavily tattooed (another stereotype because I’ve had them since before I used), I look perfectly normal.

  8. I just came upon this post and felt compelled to leave my little mark on this world with a reply. to answer the question, “what does a heroin addict look like?” is obviously a very complex and varied subject. i am a licensed clinical social worker by trade, well-educated, attended 4 years of a very good university, and then 2 years of the masters program required to begin the practice of social work. then passed all my boards, etc to get my clinical license, with with I practiced therapy with adolescents in the inpatient psychiatric hospital in my hometown.
    always a drug user, i used nearly every drug under the sun except for heroin until I was about 25. then i realized I could snort it and approximate that high that i saw my fiancee and his brother acheiving by IV’ing it. and thus began this two, going on three year battle to stop using heroin. I am now on suboxone, but still struggle to abstain and havent thus far made it more than a week without using. I lost my career for now as a social worker, which is well related to my heroin use. i guess my point is, as others are saying, there is no “type” of person who becomes a heroin addict. I am a Caucasian, upper-middle to upper class, attractive and well educated woman who is the daughter of two tax attorneys. I have a close loving relationship with my parents and with my two siblings, and my family is intact. Thus, at the surface, the risk factors that normally predict one to be a heroin user were not present in my life, and I went ahead and became an addict anyway. this disease is hands-down the most difficult thing I have ever had to conquer, and most days it feels as if it is conquering me, not the other way around. i wont sit here and tell people not to do it, to stay away from drugs, yada yada – because if it were that easy, then you probably wouldn’t be on this or other sites like it would you? best of luck to those in the throes of addiction and those who are recovering. this is a terrible road, and I wish I never started down it.

  9. “C.W.

    10:48 pm
    October 18th, 2011”

    Ive read apologies for kickin a dead thread, or something along those lines but I dont feel its nessicary here. A year could be compared to a months, or even 24hours, time has become nearly irrelevent.
    Not important.

    As i read your post CW I felt a glimmer of hope. Could it be? Someone who understands.. Without having met me, let alone listen to my fustrated half sentences as I TRY to explain my story from my point of veiw AND the person whom is listening.. Well.. The person Im talking at anyway.

    I am really hoping to hear from you. I dont know what help there is in my city and this is a new addiction but I am not new to addiction. I really need your guidance & understanding.

  10. Hi again, cornelius. Al-Anon is a great place to start. Also look into online forums for parents of addicts, and theantidrug [dot] com; good places for information and support. And let us know what we can do to help.

  11. Hello cornelius. I feel for you. It is a very difficult and painful situation to be in when you want your child to live, but cannot keep supporting the self-destruction caused by heroin addiction. Some people would tell you to kick the child out on the streets. Your kid will either die or eventually get clean. But you may just be prolonging the death, while having to take care of your child’s life and hazards, while keeping your kid in your house.

    Have you sought help for yourself yet? Parents of drug addicts need support.

    1. worst way to look at it. dont ever suggest the expellment of your lved ones because they picked up a disease u did not prepare them for. they need love and thats not something u would put on the street would u?

  12. What do you do if you are a parent and they’ve been using for years; you got them into treatment and they used in treatment; you let them come home when they are hungry and desperate but they sneak out to use, burn cigarette holes in their mattresses, the carpeting, furniture etc., and are a fire hazard to have around, plus they keep you up all night because they are up at night and sleep in the day; and you’ve provided a highly skilled psychiatrist and suboxone treatment, they have said they really want to stop, you believe they do, but they keep destroying their opportunities (e.g., going off sub to use, breaking house rules ao you can’t have them home, etc.). And when they do have another place to live, a friend, or whatever, it is always short-lived and you live in terror of them being on the street or killing themselves?

  13. They look like anyone else.. You just have to stop ignoring your conscience..the signs of [heroin] addiction are pretty straght up.

    When you are loaded…They’re always tired or nodding off. Loose all ambition and motivation and go straight downhill. They eat a ton of sweets. They’re not at all happy and promise you’re going to stop tomorrow. Masters of manipulation. They will never admit to being high, ever. And nothing [not even family] will hurt or stop them because they are numb themselves.

    Without it…They are miserable and unstandable be around. And going thru wihdrawls without anything is out of the question cuz ur used to feeling numb all of the time, the pain becomes unbearable and is [almost] always impossible without being physically removed from getting it. Manipulation again, but in a ruthless way.

    If you get or seek help, it is possible to get thru it…but ONLY if You want it. Trust me, I know best… I am one and I’ve been thru it all.

  14. Well, I can for one say, that there is virtually no way to randomly pick an opiate addict from a non-user in a line up. Due to many factors such as; Diet, Income, Social status, etc. E.G. A wealthy, happily married, heroin addict will look better than a single, poor, homeless person, at least at a glance. Make no mistake though, you are looking at the same person, just at two different points in their life. Before and after the storm of serious addiction.
    Opiate dependency generally goes on for years. It is a constant downward spiral, and on a long enough time-line, you will see that the differences become much more noticeable, and piecing certain things together will become easier, and you will ask yourself in the end, “how did I not notice this?” The homeless guy, next to the business executive.
    Well, its not that you didn’t notice, you did. One can never under-estimate the power of denial though… You looked but chose not to see. You listened but chose not to hear. Heroin has received such an ugly stigma, that it has even negatively influenced the minds of people who surround the user. Family and Friends feel so strongly about Heroin being nasty, dirty, evil, etc. That they adopt whats called the “normalcy bias” They could never imagine their own flesh and blood being the same as the homeless junkie down on “X-Street” They lie to themselves and basically ignore the problem, creating the perfect setup for a disastrous future. This allows themselves to continue on like nothing is happening, but even worse allows the addict to get deeper, and deeper into their addiction, ultimately becoming a chemical dependency modeling no difference than a diabetic needing insulin daily. The addict does not want to quit until they see it become a problem, ironically when their vision is clear, that road is now closed. And even with the best intentions, and dreams of sobriety, it now becomes a war of Bio-Chemistry vs. Will. And the afflicted WILL lose…..everything. If it was just in the mind, they might stand a chance, but using your mind to conquer a body process is very difficult. (we’ve all tried to will ourselves to “hold it” until the next stop, but sometimes you gotta go.) Conceptually, this is no different…
    As, you can guess…. Yes, I have been on both sides of the line, and I understand with a perfect knowledge about the causes and effects of Opiate Addiction / Dependency. I will not continue to write as I can literally go on infinitely. If you are interested in hearing more, or have someone who needs help, or want me to talk with, let me know. I do care, and I do understand, and I have and I can help all parties.

  15. Hiya, I followed the link “what does a heroin addict look like?”, gleaning from the text that this question would be answered. I’m glad it was not, as I believe it is dangerous ground to suggest Symptom X=Issue Y. In the UK, unemployment welfare agencies are currently employing drug Co-ordinators and, should a claimant be identified as having a substance issue, the individual’s payments can be compromised. I am currently employed as a substance misuse worker and deliver drug awareness training on a self-employed basis. Welfare Dept staff have asked me to reveal “tells” re: drug use e.g. weight loss+ a running nose=a drug problem. There have already been instances of people with unrelated issues being accused of having substance issues.

  16. You know, in the case of my family member, he was headed downhill fast but not on the street yet. Oh, he was a heroin addict, no doubt. I think that there are plenty of addicts that are lucky enough to have someplace to stay and therefore somehow still on the “funtional” level. He still cleaned up well. If he had long sleeves on, I doubt anyone meeting him would guess he was an addict. I suppose if things had gone on longer it may have gotten to the homeless stage though.

    Thanks for your great posts, I can’t wait for your movie to come out.

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