What is heroin?
What does it look like?
Legal penalties
How heroin is used
The effects of heroin use

What is heroin?

Heroin is made from the opium poppy. Opium is a milky juice taken from the poppy's seed pods.

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What does it look like

In its purest form heroin is a white powder. The medical version is called diamorphine. But, heroin sold on the street is a greyish or brown powder, because it is usually cut (mixed) with other substances such as baby milk, paracetamol or caffeine. One of the street names for heroin is 'brown'.

Because of this mix, it is difficult for a user to know how much heroin they are using, and there is therefore an increased risk of overdose, which is often fatal. The impurities themselves can cause health problems, for example, baby milk can thicken in the veins, leading to serious circulatory problems and even loss of limbs.

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Legal penalties

You may have heard of Class A drugs. These are drugs which carry the heaviest legal penalties.

For possession: a maximum sentence of 7 years and a fine.

For supply: a maximum sentence of life imprisonment and a fine.

The cost of maintaining a drug habit can lead some people into criminality in order to pay for the drug.

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How heroin is used

Most users will start by smoking or inhaling heroin which has been heated on tin foil. Injection of heroin powder mixed with a liquid such as citric acid, lemon juice or vinegar, is a more dangerous way of taking heroin. The drug is injected under the skin, or into a vein. Intravenous injecting is more common than skin 'popping' (i.e. injecting just under the skin). Injecting into a vein is known as 'mainlining'.

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The effects of heroin use

Physical

Heroin is known to be an effective painkiller. That is part of the problem, because basically it suppresses uncomfortable feelings. It does this by depressing the central nervous system which carries those signals which tell the brain that you hurt. It also dilates blood vessels, so the body feels warm, and this also affects the eyes. The first-time heroin user will often have itchy skin and feel sick. A heroin user will also have characteristic pin-point pupils. Heroin slows down breathing and heart rate, suppresses the cough reflex, and also causes constipation. It also suppresses sexual feelings for both men and women.

Psychological

Sensations do vary from person to person, but usually follow a pattern of detachment from unpleasant feelings combined with contentment and extreme happiness, usually followed by drowsiness.

Dependence

All new users start out thinking they can control their drug use, but the vast majority end up dependent. Regular use can increase tolerance to heroin, which means that the user needs more and more heroin to get the same effect. And heroin can bring with it other health problems.

Other health hazards

Frequent injecting can lead to a variety of problems. These may include thrombosis, blocked veins leading to loss of blood circulation in limbs, boils, abscesses, and skin infection. The impurities in street heroin may also cause other health problems such as blood poisoning, heart disease and lung disorders. Repeated injecting into the same vein will cause the vein to collapse, and poor injecting techniques can also result in vein collapse. Sharing or borrowing injecting equipment such as needles, syringes and spoons, runs the risk of transmitting the blood-borne viruses hepatitis C and HIV.

Overdose

Because it is not possible to assess the purity of street-bought heroin, overdoses resulting in death have occurred when the heroin source has been unusually pure. Most overdose fatalities occur when the user has been abstinent for a while and then injected at the "usual" dose.

Withdrawal

Physical dependence on heroin becomes apparent when the pattern of use is interrupted. Withdrawal symptoms are at their worst after 3 - 5 days and pass after 10 - 14 days and can include any of the following: pin-point pupils, goosebumps, sneezing, runny eyes and nose, yawning, sweating, sickness, diarrhoea, pains in the muscles, bones and joints, anxiety and sleeplessness.

Managing own withdrawal

Local drugs services will give advice on management of withdrawal aided by use of acupuncture, herbal medicines and teas, wholesome diet and stress control. Drugs such as methadone and subutex are often prescribed to allow users to stabilise and/or reduce their use of street heroin. The unpleasant symptoms associated with withdrawal can be relieved by using over-the-counter medicines. Ask your local drugs service for advice. All people withdrawing from heroin will benefit from taking hot baths, eating small nutritious meals and drinking plenty of water. It is also advisable to stay away from other users in order to avoid the temptation and pressure to use again.

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