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Heroin Use in Teens: What Parents Should Know

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Nov 23, 2023 • 12 cited sources

Less than 1% of teenagers use heroin.[1] Experts say heroin prevalence is at or near all-time lows after peaking in the 1990s.[1] But if you’re a parent of a child who uses heroin, you know that the only statistic that matters is your child. 

Today, we’re losing too many teens to drugs like heroin. Treatment can help.

Why Do Teenagers Use Heroin?

Many people consider heroin a dangerous drug of last resort. They’d assume teenagers would never touch something so strong and powerful. In reality, teenagers have very compelling reasons for turning to heroin. These are some of them: 

Other Drug Exposure

Heroin is an opioid drug. It shares several characteristics with opioid painkillers like OxyContin. Researchers say about 14% of teenagers abuse prescription opioids like this.[2] Some teens progress to heroin later. 

Painkiller abuse is widely publicized. Some teenagers can’t get the opioid painkillers they want. Their dealers sell them heroin instead. It’s cheaper, easier to find and stronger than many painkillers. Some teens think it’s a good bargain. 

Family History of Substance Use

About one in eight children lives in a household with at least one parent with a substance use disorder.[3] Children like this may share a genetic vulnerability for substance misuse with their parents. They may also pick up bad habits. 

Growing up in a household with substance misuse can mean learning to use powerful drugs to soothe uncomfortable sensations. Kids may also experiment with drugs they find within the house, starting their substance misuse habits very early in life. 

Mental Health Conditions

More than 40% of students admit to feeling persistently sad or helpless.[4] Sometimes, those feelings are strong enough to trigger poor mental health. Depression and anxiety disorders can make adolescence even more difficult. 

Teenagers with poor mental health may lean on heroin to improve their mood. The drug can cause powerful euphoria and sedation, which are ideal sensations for a worried or depressed teenager. That self-medication can become an addiction in time. 


Researchers say sensation seeking, which is a form of impulsivity, rises dramatically during adolescence.[5] Teenagers seek out experiences that seem both powerful and novel. Taking a notorious drug like heroin may fill this urge. 

Teenagers who want to try something completely different can buy heroin easily. Their first dose may produce sensations that are both overwhelming and hard to forget. They may begin a career of addiction with that one attempt at experimentation. 


As much as their parents try to protect them, teenagers can be exposed to trauma. Researchers have linked trauma to the development of substance use disorders in adolescents.[6]

Physical injuries, sexual assault, bullying and accidents can cause physical pain that doctors may treat with opioids. Those episodes can leave mental scars that teenagers can struggle to deal with. 

Heroin may not be a teenager’s first solution for trauma resolution. However, a teen with a poor social support system may find that this powerful drug is the only pathway to relief. 

Low Self-Esteem 

People with low self-esteem tend to avoid situations that include the risk of failure or embarrassment. For teenagers, this can mean avoiding school activities, making friends and trying new activities.[7] Social isolation can become crippling. 

Heroin’s euphoria can be a relief for these teenagers. When they’re high, they feel a little better about themselves. Buying, using and recovering from heroin can also give a lonely teen something to fill up the time.

Peer Pressure

Teenagers are social creatures. They tend to do what their peers tell them to do, even when they’re not sure they’re making a good choice. Sometimes, heroin becomes an epidemic within a teen community because one person starts using it and tells others to do the same. 

Peer pressure can happen in party situations involving plenty of people in a small space, and some teens experience this pressure via private conversations or social media. It’s hard for teens to escape this peer pressure, and it can lead to drug misuse.[8]

Signs Your Teen May Be Abusing Heroin 

Some teens may talk openly about heroin. Others leave their drug paraphernalia where their family members can see it. Other teenagers are sneaky, and it takes a little detective work to uncover drug misuse. 

Physical symptoms associated with heroin abuse include the following:[9]

  • Dry mouth: The teen may always have fluids or a water bottle nearby to combat this symptom. 
  • Flushing: The person’s face may seem warm and red when they’re high. 
  • Abdominal discomfort: Some teenagers experience nausea and vomiting when they use heroin. Others only experience this symptom when they try to quit using the drug. 
  • Confusion: Teenagers who are high on heroin may have a clouded mental state. 
  • Sedation: Heroin can cause a symptom called “on the nod.” People slip back and forth in and out of consciousness. 

Heroin users can also experience behavioral changes that you might notice. Their grades may drop, and some might resist going to school altogether. They may find new friends, hangouts and hobbies. They may engage in secretive behaviors too.[10]

Psychological changes include an unexplained change in personality. Sudden mood swings are common, as are angry outbursts. Some people seem fearful and anxious for no reason due to heroin use.[10]

How to Talk to Your Teen About Heroin Abuse 

Whether you think that your teen is using heroin now or you don’t want your teen to start experimenting, a conversation can help. Prevention and early intervention foster better long-term results, so don’t delay in starting a dialogue about heroin use.

Experts suggest the following steps:[11]

  • Pick a private space. Don’t try to bring up heroin when your teen is in a crowded room in front of friends. 
  • Open positively. Start by reaffirming your love for your teenager. Explain that you’re talking about this because you care about them. 
  • Stay calm. Don’t let your emotions get the best of you. Take a few breaths before responding if you’re feeling strong emotions.
  • Listen actively. Your teenager may explain why they’re using heroin. Let them share with you as openly and honestly as they can. 

One conversation may not be enough to help your teen develop new habits. Don’t be afraid to use these tips multiple times, and talk as often as you need to. It’s helpful to enlist the help of a professional, like an addiction expert or therapist, in this conversation.

Finding Treatment for Heroin Addiction 

If your teen is using heroin, quitting may be very difficult. Long-term heroin abuse changes brain chemistry in persistent ways. Suddenly quitting after prolonged use can lead to intense withdrawal symptoms, and your teen will likely develop cravings for opioids too. 

Medications like Suboxone latch to the same receptors used by heroin, but these medications don’t cause intoxication and addiction. Instead, they ease withdrawal symptoms and cravings. People with a heroin habit will not get high on Suboxone. Instead, they’ll just feel normal. 

Doctors administer Suboxone in Medication for Addiction Treatment (MAT) programs to treat opioid withdrawal and opioid use disorder. Therapy and medications combine to help people develop new habits and rebuild their lives. 

If your teen is struggling with heroin addiction, MAT is a good option.[10] At Bicycle Health, we offer this therapy via telemedicine, making treatment more accessible and convenient while protecting patient privacy.

Your teenager can meet with an expert via a video appointment. You can pick up the prescription at your local pharmacy. You can schedule appointments around your child’s schedule. No one will know that your child is in care unless you tell them. 

If your teenager is dealing with heroin addiction, don’t delay in getting them evidence-based treatment. Contact us to find out if the Bicycle Health model is right for your family.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Miech R, Johnston L, Patrick M, O’Malley P, Bachman J, Schulenberg J. Monitoring the Future national survey results on drug use, 1975–2022: Secondary school students. Monitoring the Future Monograph Series. Institute for Social Research, University of Michigan. Published June 2023. Accessed November 3, 2023. 
  2. High-risk substance use among youth. Centers for Disease Control and Prevention. Published September 29, 2022. Accessed November 3, 2023. 
  3. Report reveals that about 1 in 8 children lived with at least one parent who had a past year substance use disorder. Substance Abuse and Mental Health Services Administration. Published August 24, 2017. Accessed November 3, 2023. 
  4. Mental health. Centers for Disease Control and Prevention. Published June 1, 2023. Accessed November 3, 2023. 
  5. Romer D. Adolescent risk taking, impulsivity, and brain development: implications for prevention. Developmental Psychobiology. 2010;52(3):263-276. 
  6. Basedow LA, Kuitunen-Paul S, Roessner V, Golub Y. Traumatic events and substance use disorders in adolescents. Frontiers in Psychiatry. 2020;11. 
  7. Self-esteem and teenagers. Reach out. Accessed November 3, 2023. 
  8. Loke A, Mak Y. Family process and peer influences on substance use by adolescents. International Journal of Environmental Research and Public Health. 2013;10(9):3868-3885. 
  9. Heroin drug facts. National Institute on Drug Abuse. Published December 2022. Accessed November 3, 2023. 
  10. Warning signs of drug abuse. Tennessee Department of Mental Health and Substance Abuse Services. Accessed November 3, 2023.—recovery/treatment—recovery/prescription-for-success/warning-signs-of-drug-abuse.html 
  11. How to talk to teens about drugs and substance use. Psych Central. Published October 29, 2021. Accessed November 3, 2023. 
  12. Borodovsky JT, Levy S, Fishman M, Marsch LA. Buprenorphine treatment for adolescents and young adults with opioid use disorders. Journal of Addiction Medicine. 2018;12(3):170-183. 

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