How heroin is taken
Most commonly, heroin is injected, either into a vein. This has the highest risk of death through overdose and other health issues, so many choose to snort or smoke instead. Smoking, or ‘chasing the dragon’, involves heating the heroin on a sheet of foil and inhaling the smoke. Snorting is when the powder is sucked in through the nose, allowing the drug to pass into the bloodstream through nasal membranes.
How heroin works
The human body has its own natural painkillers — endorphins. Heroin mimics these and provides an intense rush of pleasurable sensation and sense of well-being. When the full effects kick in depends on how heroin is taken:
- Smoking - 5 to 10 seconds
- Injecting into a vein- 10 to 15 seconds
- Snorting - 5 to 10 minutes.
The effects will normally wear off after several hours. As the central nervous system is depressed, the user can ‘nod off’, in that they appear to be sleeping but are awake. Blood pressure, respiration and pulse will all be lowered. The mouth becomes dry and pupils will become smaller. Some users may feel nauseous, particularly if they are not regular users.
Health risks of heroin
The biggest problem with heroin is overdose, especially when injected. Many deaths have happened when heroin has been used with other central nervous system depressants, like alcohol or benzodiazepines. Injection can also cause a variety of problems with viruses such as hepatitis C and HIV/AIDS, vein infections and vein damage. This can be through poor shooting technique, reusing old needles or the adulterants that heroin is frequently cut with (i.e. sucrose, starch, talcum powder). Although the addiction potential is dramatised by the media, heroin can lead to high levels of dependency. Heavy users are often less likely to eat and health problems can arise from malnutrition and lower personal hygiene.
Safer use of heroin
A great way to lower your chances of overdose is by snorting or smoking instead of injecting. If you do inject, try a small taste first to judge the strength of the mix. Be very careful if you haven’t been using for some time. Your body’s tolerance to heroin will be lower than normal. Never use heroin alone. If you overdose, your mates can give you first aid or get the ambulance, who won’t call the police unless they expect violence. Don’t mix heroin with other drugs, particularly depressants like alcohol and benzos. This is a major cause of overdose. Even a stimulant like cocaine with heroin (a ‘speed ball’) is bad news. The cocaine wears off quickly, then the central nervous system is depressed while the heroin is still active.
If you do inject, practise safer injecting - make sure you never share needles or injecting equipment. Always use a clean fit for each shot. Ensure proper hygiene of your preparation space and equipment. Talk to experienced health professionals or drug user organizations in your area, about injecting technique to reduce damage to your veins. See your doctor or go to the hospital the moment if you feel ill or find lumps or swelling around your injection sites. Use filters to help remove bacteria and adulterants from your mix. This will lessen your chances of infections and a dirty hit. You can often obtain filters and information on using them at your local needle and syringe outlet if there is one in your area.
If heroin is alkaline (ie. beige or brown in colour) it will need acid to make it water soluble. The best option is a few grains of citric acid, available from most supermarkets. The next best option is vinegar. Last is lemon juice, as fungal spores can lead to serious infections of the eyes or heart.
Addiction or dependency on heroin
Trying heroin once does not create an addiction. Some regular users of heroin can stick to a reduced level that avoids physical addiction. However, many find that regular use leads to tolerance developing within their bodies, and they need to have more heroin to get the same effect. Detox from heroin usually takes about a week, and symptoms include muscle and stomach cramps, nausea, physical and nervous tension, vomiting, insomnia, anxiety, yawning, tears, runny nose, irritability, depression, diarrhoea, headaches, sweating, hot and cold flushes. There is a wide range of options for people wanting to detox off heroin. You can have a supervised detox at home or in a residential facility. New medications can be used to detox quickly, often with less adverse effects. Maintenance drugs such as methadone can be used to act as a substitute for heroin, letting you get your life together without having to go through detox.
Long term effects of heroin use
In its pure form, heroin is a surprisingly harmless drug, with its main effects being addiction with regular use, constipation and ensuing bowel disorders. If care is not taken, malnutrition can set in as there is less desire to eat. Most health problems are caused by the method of getting the drug into the body, particularly with injecting — viral infections, bacterial infections, vein problems and other illnesses. The adulterants used to cut heroin also take their toll with time.
Talk to experienced health professionals or your drug user association about getting off heroin, reducing your use or minimizing the harm that can arise from using heroin.
Copyright © 2007 Safer Injecting: harm reduction for injecting drug users