In Clearbrook Treatment Centers Massachusetts, Family Resources, Heroin Addiction, Opioid Addiction, Personal Resources

Heroin is a commonly abused opioid drug in the United States. It’s produced, trafficked, and sold illegally on the streets. Heroin is derived from another opioid called morphine, which occurs naturally in opium poppy plants. Heroin addiction is an ongoing problem in the U.S. and a major part of the opioid epidemic, mainly because people who start off abusing prescription opioids turn to illegal opioids like heroin for a cheaper and more accessible alternative. While heroin can be used in many ways, intravenous (IV) use is most common. Due to this, we wanted to share an in-depth guide on heroin track marks so you can recognize them in those who might need help.

Why Do People Inject Drugs?

The World Health Organization (WHO) estimates that 13 million people are IV drug users, and of those 13 million, 1.7 million are also living with HIV. Despite risks like easily contracting diseases and the physical damage of the drug itself, many people still choose to inject drugs that could be used in other ways. But why?

For someone who isn’t addicted to drugs, the idea of purposely injecting yourself with anything could be difficult to imagine. But for someone with a heroin addiction, IV use is a no-brainer.

When you swallow a pill or ingest a drug orally, it can take anywhere from 15 minutes to an hour for the effects of the drug to kick in. When you crush and snort pills, on the other hand, the effects are much quicker. If you take it a step further, when drugs are injected directly into the bloodstream, the effects are even faster and stronger.

People often resort to more intense forms of drug use when their tolerance to the drug grows, and they become more dependent on it. Someone who abuses opioids, for instance, may start with swallowing pills. After a few months or years, they might notice their tolerance increasing, causing them to use more and more pills.

However, prescription opioids are costly, so many users will begin to crush and snort their pills to get more out of them. But this, too, only lasts so long, and eventually, they’ll find that their tolerance continues to grow. At this point, they’ve exhausted all of their other options and are now more likely to turn to IV drug use to get high.

What Are Track Marks?

Drug track marks are areas of discoloration and scarring along a vein that was damaged by intravenous drug use. Heroin track marks are the most noticeable sign of IV drug use. Common injection sites for drug users include the crook of the arm, the forearm, hands, feet, legs, neck, and even groin. However, according to a study of 200 IV drug users and their track marks, the most common injection site on the body was the crook of the arm (99%).1

Track marks happen as a result of repeated injections to the same vein with a needle. Because people with heroin addictions use the drug repeatedly and daily, they are constantly damaging their skin and the underlying vein, which can cause scarring and tissue damage. If these wounds become infected – which is common among IV drug users who share needles or reuse old ones – the damage can be even more severe and obvious.

Heroin track marks are most noticeable on the forearms, where veins are most visible, although any visible veins on the body can be used as heroin injection sites. IV track marks can also appear as puncture wounds or discolored scars and veins. Usually, once veins in the forearms are too damaged or scarred to inject drugs, IV drug users usually switch to the veins in the hands, feet, and legs.

At this point, it’s not uncommon to find track marks between fingers, toes, and in various areas of the leg. Sometimes, IV drug users might even inject drugs into the veins in their necks or groins, as well. Basically, any visible vein on the body can serve as a drug injection site.

What Do Track Marks Look Like?

Track marks look like small holes in the skin in various stages of healing. New heroin needle marks might look bright or pink, and as they heal, they’re usually scabbed or covered with new scar tissue. Healed track marks can look white or light pink, and sometimes the vein itself is scarred, as well.

Scars from needles can make the veins appear dark, which is usually quite noticeable. Track marks may also look like bruises. People often try to hide heroin track marks by wearing long-sleeved shirts and jackets, and long pants, even if the weather doesn’t dictate the need for warm clothing.

Common Heroin Injection Sites

Arms and Hands

IV drug users usually go for veins in the arms and hands because they’re often the most visible and easy to get to. In most people, these veins are close to the surface of the skin. Arms are also easy to cover with long-sleeved clothing, which makes hiding track marks easier. When people run out of places on the arms to inject drugs, they move onto the veins in their hands, as they’re also close to the surface. However, it’s harder to hide track marks in your hands.

Legs and Feet

Veins in the lower extremities may also be used to inject heroin and other drugs, especially if the veins in the arms and hands have become too damaged or scarred. Veins in the legs can sometimes appear to be deeper into the skin and harder to access than the veins on the tops of the feet.

As a result, the veins at the tops of the feet and in between the toes are also common injection sites. People can also easily cover up these track mark scars by wearing socks or shoes. Some might even choose these areas before the hands and arms if they’re trying to hide their heroin injection marks.

Side Effects of Heroin Track Marks

There are several risks associated with IV drug use and track marks, including:

  • Infection: The risk of infection is associated with any form of IV drug use, especially when dirty, used, or dull needles are used. Also, if the drug is not prepared with sterile water, the drug itself may be contaminated with bacteria or fungi, which can lead to infection. Bloodstream infections may require medical attention and even become life-threatening.
  • Collapsed veins: Veins may collapse due to repeated punctures, which prevents the vein walls from staying open to allow blood flow. Collapsed veins are difficult to puncture, and attempting to continue injecting drugs in collapsed veins is usually unsuccessful, painful, and irritating to the vein and skin.
  • Scars: Scars might form as a result of repeated IV drug use, especially if injection sites aren’t kept clean or aren’t allowed to heal. Scarring can be extensive and sometimes run vein-deep to the point where that vein cannot be used for further intravenous use.
  • Abscesses: An abscess is a swollen, tender mass that’s usually caused by a bacterial infection and can be quite painful and warm to the touch. Abscesses usually need to be surgically drained to release any build-up of pus and debris.

Need Heroin Addiction Treatment?

The safest and most effective way to get rid of track marks is by seeking medical help. And of course, our Massachusetts treatment center also advises that you stop IV drug use altogether. Heroin is just one of the many drugs that can be used intravenously and cause damage.

Heroin is especially potent and addictive and tends to contain various harmful chemicals that can damage the skin, veins, and other areas and functions of the body. If you or a loved one is addicted to this drug, don’t wait to seek professional care.

Our Northeast addictions treatment center offers heroin addiction treatment programs that include detox and on-site psychotherapy and counseling to help clients heal physically and psychologically. We understand that addiction is a multidimensional disease, so we strive to create individualized addiction treatment plans for each patient that addresses all of their needs and concerns.


From heroin detox to individual and group counseling, our specialists will work with you through every step of your recovery. Call Clearbrook Treatment Center today at 570-536-9621 to learn how our Massachusetts drug rehab programs can help.



  1. NIH – Physical injecting sites among injecting drug users in Sydney, Australia


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