Background: High production levels and availability of heroin in Middle East and North African (MENA) countries have been leading to the continuous rise in injecting drug use. On the contrary, in most Western countries, the proportion of heroin injectors may be falling. Interestingly, in Lebanon heroin sniffing has been gaining popularity. We therefore aimed at exploring the characteristics of intranasal heroin use compared to intravenous heroin use in patients admitted to treatment at Skoun, Lebanese Addiction Center. Methods: Between January and September 2013, 186 heroin-dependent users participated in this study: 92 were heroin sniffers and 94 injectors. Data collection was carried out using structured questionnaires on different sociodemographic characteristics and psychological and social functioning. Results: Injectors were significantly younger and had lower levels of employment compared to heroin sniffers. Analysis of health-risk profiles revealed that although injectors were significantly at higher risk of overdose, Hepatitis C infection, and anxiety, sniffers were not risk-free. Other sociodemographic and health-risk profiles did not materialize between the two study groups. Conclusion: The study provides evidence that heroin sniffers share many common characteristics with heroin injectors and therefore do not represent a protected group of heroin users.