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Heroin

smack, junk, gear, h, brown
diamorphine

 

history

Heroin is produced by the chemical process from raw opium obtained from the opium poppy. Opiates are used medically for coughs, colds and diarrhoea. It is the most effective painkiller available and has been used by many civilisations for centuries.

 

appearance

Pure heroin is a white fluffy powder, but street deals are light brown and typically 20–60% pure and can be cut with paracetamol, sugar or other tranquillisers.

 

method of use

smoked, sniffed, swallowed, injected.

 

effects

A new user will often be sick. Other effects include feeling warm and safe, drowsy, or more lively even, but mostly content and trouble free. With regular use, the amount needed soon increases and once physical dependence is established, the pleasure gets largely replaced by the relief of getting hold of the drug.

 

health risks

If injecting, the user normally has no idea what chemicals or purity they might inject from a street deal. It is common for irritants that are injected without realising to cause severe problems such as collapsed veins, abscesses, and the threat of gangrene or even amputation.

Avoiding injecting heroin will by-pass many of the serious health risks. However, because of the risk of HIV infection, if heroin is injected, works must NEVER be shared with anyone. The only guarantee of safety from hepatitis or HIV infection is a new disposable syringe and needle for each person concerned.

There is a needle exchange at BDP, where new works are given free and any chemist will sell clean works cheaply. Pharmacy exchange schemes exist in Bristol (list available at BDP).

Safer Injecting

 

dependency

Most people would like to take the drug again after first use but are not immediately addicted.

There are a few who seem able to just dabble but for most people the desire for more creeps up on them. With regular use they soon develop physical and psychological dependencies.

The body adjusts so that more heroin is needed to have the same effect and a tolerance grows. As heroin is an expensive drug, the money required for a daily habit often becomes both frightening and damaging.

 

coming off

Stopping suddenly after regular use will cause the user to feel ill with withdrawal. Depression will follow withdrawal, feeling worse during the first three days. After a week most of the physical symptoms will have passed. These symptoms are like a heavy flu, which can include hot and cold sweats, heartburn, stomach cramps, sleeplessness, running nose, vomiting and diarrhoea.

For anyone who finds heroin hard to stop taking, there are many schemes to help get through withdrawal, such as herbal remedies, hospital in-patient detoxification, medical help involving substitute drugs, acupuncture, hypnosis, yoga and more. Some sympathetic GPs might prescribe one of these on the NHS.

Coming off can also cause considerable sleep disturbance for some time afterwards, and since heroin blocks endorphin sites, it can take some time for endorphin production to return to normal, causing a tendency towards depression. Exercise is of help with both of these.

 

substitute drugs

Methadone
Methadone is synthetic opiate which stops withdrawals and even if taken for years it causes no physical damage except to the teeth. BDP or any GP can refer someone to BSDS for a prescription if their GP is unwilling to prescribe or if they would rather not approach their GP.

Shared Care

Whilst methadone is not 'exciting', it does bring some benefits with it. It is legal with a prescription so the threat of fines and imprisonment can be removed. A regular dose with no variation in purity is easier for the body to cope with and helps reduce the risk of an overdose.

Also, since the effect of each dose lasts 10–36 hours, it need only be taken once a day. However, long-term use will lead to dependency. As little as 10mg of methadone kills children, so it needs to be kept out of their reach.

Subutex
Subutex works in a similar way to other opiod drugs, but is different from methadone and heroin because it does not have such a strong effect on the brain. It is an effective substitution medicine that helps relieve the cravings and withdrawal of heroin.

Subutex is a tablet taken sublingual (dissolved under the tongue). It can only be prescribed by a GP.

Shared Care

 

detox

The physical detox takes about four days, but can take a further 10 days to recover, so it is important to allow time for this and have somewhere stable to stay.

Detox from heroin begins within 24 hours after taking the last dose, depending on how much you use. Although the symptoms are very unpleasant, they are not life threatening. Make yourself as comfortable as you can, and find things to occupy yourself.

Try not to do it alone - get support from family and/or friends or contact BDP's Detox Service.

 

overdose

Heroin use carries a real risk of overdose, as street samples of the drug are of uncertain strength. Overdosing results in unconsciousness, coma and often death from breathing failure.

Under medical supervision an injection can be given to reverse these effects providing action is taken in time.

An overdose can result from taking the usual amount after some time spent clean, or if the hit is mixed with other drugs, especially alcohol. Equally threatening is the danger of choking on vomit whilst asleep. Since both alcohol and heroin cause unconsciousness and vomiting, it doesn't take a lethal dose to end up dead. The same risk applies to methadone.

In The Event Of An Overdose

Put them in the recovery position.

Dial 999 and ask for an ambulance — the police are no longer informed.

Stay with the person.

 

the law

Heroin is a class A, Schedule 1 drug under the Misuse of Drugs Act 1971. The maximum sentence for possession can be up to seven years imprisonment with a fine. For trafficking offences, supply or intent to supply, the maximum sentence can be life imprisonment plus a fine.

Published in Alcohol & Drugs