Heroin

Licit:
Pharmaceutically manufactured heroin is a pure white powder, which can be made into tablets and ampoules, or as a linctus.

Illicit:
Commonly a beige or brown powder. Or more rarely as a white powder (Chinese no. 4, or 'China White').

Desired Effects:

Intense rush, euphoria, exhilaration, relaxation and decreased anxiety, feelings of warm wellbeing.

Side Effects:

Nausea, vomiting, drowsiness, decreased heart-rate, shallow breathing, coma sometimes fatal.

• You can never be sure of the purity of heroin or what it is cut with.
• Smoking heroin is safer than injecting intravenously; chasing heroin gives the user a hit like injecting as it gets into the bloodstream quickly, and it is far safer.
• If you do inject, always use clean needles and injecting equipment (spoons, swabs, water etc). You can access these from needle exchanges, drug agencies and pharmacies; this can protect you from blood borne viruses like Hepatitis B & C and HIV.
• Never share your needles or works with anyone else, no matter how well you know them.
• If you inject, learn how to inject yourself using the safest technique. Injecting with poor technique is one of the riskiest things you could ever do and can be extremely damaging to your body causing problems such as abscesses, infections, blood clots & deep vein thrombosis (DVT), or hitting an artery. You can contact drug services and needle exchanges for advice on safer injecting.
• If you are going to inject, use sterile citric acid or ascorbic acid rather than lemon juice or vinegar as these are particularly risky acids and can cause even more damage to veins and other health problems.
• Mixing heroin with other drugs can increase the risk of overdose, especially drugs like alcohol, benzo's and methadone.
• Speedballing (using heroin and crack together) can lead to an extreme decline in your health and lifestyle.
• Avoid using alone or in unfamiliar or locked places. More overdoses happen in these environments than anywhere else.
• If you have had a break from using, your tolerance will be significantly lower and you are at a greater risk of overdose.
• If you suspect someone has overdosed, put them in the recovery position and call for emergency help immediately.
• Know about Naloxone. Naloxone is a short acting opiate antagonist that reverses the effects of heroin and other opiates like morphine - it can save lives.

Long term risks:

Dependence and in long term users there can be a risk of failing to take normal care of the body as heroin is a very effective pain killer and appetite suppressant.

Injection of impure heroin - typical UK purity rates range from 10% to 40% - can damage circulatory system, leading to abscesses, ulcers, thrombosis, etc.

Unsterile injection practices increase the risk of blood borne diseases such as septicaemia, hepatitis C, and HIV.

Short term risks:

Tolerance and overdose, problems may also arise from impurities if heroin is injected, such as dizziness, headache, loss of coordination, nausea, as well as risks from injecting like abscess and collapsed veins.

Central nervous system depressant, analgesic.

Class A under the Misuse of Drugs Act.

Snorted up the nose, smoked from tinfoil ('tooting', 'chasing' or 'chasing the dragon') or mixed with tobacco in a hand-rolled cigarette, or injected.

If snorted:
Razor blade, hard level surface (such as a mirror or glass), tube or rolled banknote.

If smoked:
Tinfoil, matches or lighter, cigarette papers, tobacco.

If injected:
Needle and syringe, water, citric acid, matches or lighter, spoon, tourniquet, swabs.

In it's pharmaceutical form as Diamorphine to treat extreme pain eg. terminal cancer.

Heroin is derived from the opium poppy, which grows in many parts of the world (including Britain). The main centres of illicit production include the border regions of Iran, Afghanistan and Pakistan (known as the Golden Crescent), and around the borders of Thailand, Burma and Laos (known as the Golden Triangle).

Heroin users can access support from ‘street agencies’ or projects, sometimes called community drug services or community drug teams, which offer a range of services including information and advice, counselling, detoxification and prescribing for opiate users, needle exchanges and sometimes support groups and other services such as acupuncture. Some may have extended opening hours and may be open at weekends. GPs and hospitals can make referrals to specialist drug services like Drug Dependency Units (DDUs). These are usually located in or adjacent to a hospital and specialise in helping problem drug users, especially people who are dependent on drugs like heroin. They provide counselling, detoxification, substitute prescribing and other treatments. Residential services offer treatment programmes for heavily dependent drug users who are trying to give up. Residents must usually be drug free on admission which means they usually have to undergo detoxification before entry. Programmes usually last 3-6 months, but some 12 steps programmes last longer. The types of programmes vary. Self help groups like Narcotics Anonymous (NA) co-ordinate local support groups for problem drug users around the country. Families Anonymous run similar groups for the families of drug users. Many heroin users are referred for treatment through the criminal justice system.

Parents & other relatives

Drug agencies also provide lots of advice and support to parents of people using these drugs. Many street agencies can provide relative support groups or counselling for family members, partners etc.