Heroin

How is it used?

Heroin is usually injected into a vein, but it’s also smoked (‘chasing the dragon’), and added to cigarettes and cannabis. The effects are usually felt within seconds of injecting or smoking it, but will take around 10 to 15 minutes if snorted.²

Effects of heroin

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

Heroin affects everyone differently, based on:

• the person’s size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug (it varies from batch to batch).

The main effects of heroin, which usually last for three to five hours, include:

• intense pleasure and pain relief
• relaxation, drowsiness and clumsiness
• confusion
• feelings of detachment
• slurred and slow speech
• slow breathing and heartbeat
• dry mouth
• tiny pupils
• reduced appetite and vomiting
• decreased sex drive.^1-3

When injecting drugs, there is an increased risk of:

• tetanus
• infection
• vein damage.

If sharing needles, there is an increased risk of:

• hepatitis B
• hepatitis C
• HIV and AIDS.

Overdose

If you take a large amount or have a strong batch of heroin, you could overdose.

Call an ambulance straight away by dialling triple zero (000) if you or someone else has any of the symptoms listed below (ambulance officers don’t need to involve the police):

• trouble concentrating
• extreme drowsiness or falling asleep (‘going on the nod’)
• small (‘pinned’) pupils
• wanting to urinate but finding it hard to
• itchiness
• low blood pressure
• irregular heartbeat
• cold, clammy skin
• slow breathing, blue lips and fingertips
• hypothermia
• passing out
• death.^1-3

Naloxone (also known as Narcan®) reverses the effects of heroin and other opioids, particularly in the case of an overdose. Naloxone can be injected intramuscularly (into a muscle) or delivered by intranasal spray.

Coming down

In the days after heroin use, the following may be experienced:

• irritability
• depression.^{1, 2}

Long-term effects

Regular use of heroin may eventually cause:

• intense sadness
• irregular periods and difficulty having children
• no sex drive, erectile dysfunction and infertility in men
• constipation
• dental issues
• damaged heart, lungs, liver and brain
• vein damage and skin, heart and lung infections from injecting
• needing to use more to get the same effect
• dependence on heroin
• financial, work or social problems.^1-3

Using heroin with other drugs

The effects of taking heroin with other drugs – including over-the-counter or prescribed medications – can be unpredictable and dangerous, and could cause:

• Heroin + ice, speed or ecstasy: enormous strain on the heart and kidneys, and increased risk of overdose.⁴
• Heroin + alcohol, cannabis or benzodiazepines: breathing may slow and eventually stop. May also cause vomit aspiration.^{4, 5}

Withdrawal

Giving up heroin after using it for a long time is challenging because the body has to get used to functioning without it. Withdrawal symptoms usually start within 6 to 24 hours after the last dose and usually last for about a week - but can sometimes last up to ten days. Days 1 to 3 will be the worst. These symptoms usually include:

• cravings for heroin
• restlessness and irritability
• anxiety
• depression and crying
• diarrhoea
• restless sleep and yawning
• stomach and leg cramps
• muscle spasms
• vomiting and no appetite
• goosebumps
• hot and cold flushes
• sweating
• runny nose and watery eyes
• insomnia, disturbed sleep
• fast heartbeat.^1-3

Getting help

If your use of heroin is affecting your health, family, relationships, work, school, financial or other life situations, you can find help and support.

Call 1300 85 85 84 to speak to a real person and get answers to your questions as well as advice on practical ‘next steps’.

There are many avenues for treatment of heroin dependence, including methadone, naltrexone, and buprenorphine.