Heroin is a drug that comes from the opium poppy. It is a highly effective painkiller and is still used in medical settings for the relief of severe pain. It is part of a family of drugs that includes morphine and codeine. Heroin is a powder; its colour ranges from white, off-white, yellowish to reddish brown, and the most commonly available. At a street-level, heroin is sold by the gramme or part of a gramme as a ‘bag’. A bag will cost a fraction of a gramme and often cost £10, though larger or smaller amounts are also sold.
Street heroin is usually ‘cut’ or mixed with other powders to bulk it out and increase profits. Purity of heroin normally ranges from 20% to 50%. Adulterants may be harmful. Periodically, very pure heroin is sold on the street, causing a series of fatalities as people overdose on heroin that is stronger than expected.
How is it used?
Heroin is usually smoked or injected; it is also snorted. When smoking or ‘chasing the dragon’, a small line of heroin is placed on a piece of silver foil and heated from below. The heroin runs into a liquid and gives off a curl of smoke, which is inhaled through a rolled tube of paper. When injected, heroin is dissolved in water and injected into a vein, a muscle or just below the skin.
What are the effects?
Heroin is a powerful painkiller and the absence of pain that it offers is combined with euphoric qualities. The combined effects are a sense of well being, feeling warm and content, drowsy and untroubled. At higher doses, the user may become drowsy, find it hard to talk, and appear to fall asleep for a few minutes at a time. The user’s pupils become smaller; some users get an itchy sensation. First-time users often experience nausea or vomiting when using heroin.
What are the risks?
Heroin use poses a number of risks. Some are related to the drug itself, some related to the drug’s legal status and others due to the lifestyle which is often linked to regular heroin use. The risks include dependency, health problems and social problems.
Heroin is a physically addictive drug. After a period of regular use, there is an unpleasant period of withdrawal as the drug is cleared from the body and the body adjusts to functioning without the presence of heroin.
Regular use of heroin leads to an increase of tolerance to the drug. Initially, this means that one needs to take increasingly large amounts to achieve the same sense of euphoria and well-being. Subsequently, it means that users find they need to use increasingly large quantities to prevent going into withdrawal or just to feel ‘normal’. This means that spending on heroin inevitably escalates with regular use. The flip side of this is that when heroin use is discontinued (for example, after a spell in prison), tolerance drops. A user whose tolerance has dropped who attempts to use the amount they were using when their tolerance was higher stands a good chance of overdosing.
Regular heroin users who stop using experience a range of highly unpleasant symptoms of withdrawal. These include hot and cold sweats, severe stomach and muscle cramps, sleeplessness, diarrhoea, nausea, vomiting, runny nose and feeling high levels of pain and discomfort. While unpleasant, sometimes lasting for over a week, it is not a life-threatening process. Far more difficult is to resist the psychological temptation to use during period in the knowledge that it would instantly alleviate the symptoms of withdrawal.
One of the biggest risks is of overdosing or taking too much of the drug in one go. Heroin varies in strength and purity and people’s tolerances to the drug go up and down. Heroin can depress breathing and in overdose breathing can cease altogether. Death through overdose remains a significant cause of mortality amongst heroin users.
Injecting heroin is especially dangerous; injectors are more likely to overdose and experience health problems such as vein damage, abscesses or blocked veins. Injectors who share equipment (needles, syringes, spoons, filters or other paraphernalia) run the risk of becoming infected with Hepatitis B and C and HIV.
While pure heroin is not especially toxic to human organs, contaminants in street heroin can cause damage, especially when they are injected. Heroin can cause severe constipation amongst regular users. It also suppresses the cough-reflex, leaving users at risk of chest and bronchial problems.
Further problems relate to heroin-lifestyle and the need to pay for the drug every day. This can lead to poor diet, poor accommodation and other illnesses. Some people commit crimes to get the money that they need to pay for the drug and end up with legal as well as drug problems.
Heroin is a Class A drug. It is illegal to possess the drug unless prescribed by a Doctor. Unlawful possession and supply can carry very high penalties.