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How to Talk to a Heroin User

Heroin addiction is a complex medical condition that can lead to negative behavioral and health outcomes. It can be difficult to understand, especially if a loved one is struggling with heroin addiction. While the early signs and symptoms of heroin use and the signs and symptoms of advanced heroin addiction can be easy to recognize, approaching a heroin user to discuss their addiction can be quite challenging. 

Many individuals who struggle with heroin addiction may be unwilling to admit they have a problem, which may also mean they are unwilling to seek treatment through long-term rehabilitation

But in spite of these challenging circumstances, there are ways for friends and family to help a loved ones struggling with heroin addiction.

How to confront a heroin addict

The Key Challenge When Talking to a Heroin User

Overcoming addiction even with professional treatment is an arduous journey fraught with obstacles. To help a person overcome heroin addiction, they must first recognize they have a problem. This is where the first major issue is likely to arise. 

Persons with a heroin addiction may refuse to admit they have a problem, which partially explains why they continue their drug use despite all the detrimental effects and negative consequences. Even when approached by addiction specialists, heroin users may be confrontational and unwilling to cooperate and accept treatment.

How Heroin May Change the User

Overcoming heroin addiction is particularly challenging because of the lasting changes chronic administration and abuse of the drug cause in the brain. They may render the person incapable of resisting the intense urge to use.1 This is a premise on which orthodox neuroscientific approaches are based.2

There is an alternative approach that views drug addiction as a behavioral disorder in which drugs function as preeminent reinforcers.2 Although there is a clear discrepancy between this and the traditional neuroscientific approach, the emerging neuroscience of reinforcement and choice behavior may help understand the complex brain mechanisms related to excessive drug use.2

To truly understand how to help a person take meaningful action to start recovery, one should comprehend the nature and the repercussions of heroin addiction and addiction in general. This is why professional support is essential to effective treatment and lasting recovery. Although heroin addiction is incurable, it is possible to put it under control within a controlled environment such as a specialized treatment center.3

Approaching a Person With a Heroin Addiction

Heroin addiction is characterized by the consumption of excessive amounts of heroin to the detriment of the person who has developed an addiction, their friends and family, peers, and community. Addiction is a chronic disease characterized by compulsive drug seeking and use which is beyond the person’s control.3 As such, it is difficult for the person with an addiction to hide it even if they are unwilling to accept it and attempt to overcome it. 

What complicates matters further is the very notion of the term compulsion and its use in association with drug use which not only impacts the public understanding of addiction, but is also likely to deter persons who use heroin from attempting to overcome their addictions and significantly lowers their chances of making a successful long-term recovery.4 

Persons with a heroin addiction may refuse to acknowledge they have a problem in the first place, which may lead keep sinking deeper and deeper into addiction, at which point only a higher intensity treatment program in an inpatient or residential facility can be effective.

All this makes approaching the topic of addiction all the more difficult, which brings us to the two essential issues: denial and resistance presented by heroin users.5 These are common reactions of people with SUD. Once a person has reached the addiction stage, which is the final stage of SUD, their use of heroin is no longer voluntary and they no longer have self-control.6 So how to talk to a heroin user about their problem?

Frequently Asked Questions

How Do You Deal With Someone Who Is Under the Influence of Drugs?

When the topic of heroin use disorder is concerned, individuals with addiction may deny the problem exists, which is a complex response that is the product of psychological and physiological factors and may likely be a defense mechanism caused by cognitive distortions and memory issues which are in turn caused by substance abuse.5

This could complicate matters further. If a person is under the influence of heroin, discussing their addiction and convincing them to get treatment could be even more difficult. Friends and family are advised to consult a medical professional or a treatment center support representative on their best course of action. 

Although safety is the number one reason why the first stage in treatment should be a medically supervised detoxification process, another reason for this is that a person may not be ready to admit they have a problem and start to work on their rehabilitation before they have completed detox.

How to Organize an Intervention for a Heroin User?

Staging an intervention without professional help and support, especially a confrontational intervention when the person with addiction refuses to cooperate or does so under pressure is seldom effective.7 These interventions are considered to be both ineffective at convincing the person that they have a problem and at motivating them to change and abandon their habit by seeking treatment.

For this reason, an intervention should be organized through specialized substance abuse treatment programs that devise personalized treatment plans based on in-depth assessments with focus on the person’s substance use and history.5

How to Encourage a Heroin User to Seek Treatment?

Even when a person is willing to seek treatment, the risk of failure and relapse is high, partly because of the withdrawal symptoms heroin users experience during the detoxification stage.8 

Persons who have developed heroin addiction already know how unbearable withdrawal symptoms can be and are aware that they are highly unlikely to overcome them on their own. For this reason, the sooner individuals with a heroin addiction attempt treatment within a specialized program as opposed to self-treatment, the better. 

Issues That May Arise

Heroin users need ample encouragement and support from those close to them and from addiction specialists. Friends and family should first reach out to a specialized treatment program for support and guidance. One of the key problems that individuals attempting to understand and talk to a person with a chronic relapsing condition is the person’s resistance to cooperate. This may lead to frustrating conflicts.

Another problem stems from the fact that many individuals with a drug addiction suffer from other cognitive comorbidities.2 Even if they have not been officially diagnosed, disorders such as anxiety or depression can further contribute to the development and maintenance of drug abuse and addiction. This can further exacerbate things and complicate the situation, which is yet another reason to seek professional help if you don’t know how to talk to a heroin user.

For heroin addiction treatment to be effective, especially if the individual is confrontational, it must be supervised by a multidisciplinary team of addiction specialists. It should also be highly structured to incorporate activities specifically designed to help individuals struggling with addiction examine damaging beliefs and destructive patterns of behavior so that they can ultimately adopt different ways of interacting with others that are more harmonious and constructive.9


  1. National Institute on Drug Abuse. (2020). Drugs, Brains and Behavior: The Science of Addiction
  2. Gail Winger, James H Woods, Chad M Galuska, Tammy Wade-Galuska. (2005). Behavioral Perspectives on the Neuroscience of Drug Addiction.
  3. National Institute on Drug Abuse. (2018). Understanding Drug Use and Addiction DrugFacts.
  4. Nick Heather. Addict Behav Rep. (2017). Is the concept of compulsion useful in the explanation or description of addictive behaviour and experience?.
  5. Substance Abuse and Mental Health Services Administration. (2020). TIP 39: Substance Use Disorder Treatment and Family Therapy.
  6. Substance Abuse and Mental Health Services Administration. (2020). TIP 63: Medications for Opioid Use Disorder.
  7. National Institute on Drug Abuse. (2018). How to Recognize a Substance Use Disorder.
  8. National Institute on Drug Abuse. (2020). Principles of Effective Treatment: A Research-Based Guide (Third Edition).
  9. National Institute on Drug Abuse. (2020). Types of Treatment Programs.

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