Heroin

Compound: Diamorphine, diacetylmorphine, or morphine diacetate.
Other names: Black Tar, China White, Gear, H, Hammer, Harry, Homebake, Horse, Junk, Skag, Smack, The Dragon

 

Heroin is an analgesic (pain-relieving) depressant that acts on the central nervous system (CNS) slowing down breathing and heart rate. It is an opiate drug made from morphine, a natural substance taken from the seed pod of opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white, beige or brown powder, which is what is most common here in Australia, or can come in a black sticky substance known as ‘black tar’ heroin usually seen in Europe and North America. Heroin enters the brain rapidly and binds to opioid receptors, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.

 

Know Your Body & Mind — ‘Set’

Know Your Environment — ‘Setting’

Know Your Drug — Practice Harm Reduction

ADMINISTRATION
Most commonly injected into a vein or is smoked (‘chasing the dragon’) but can also be shelved (rectal), snorted or drunk in a liquid.

DURATION OF EFFECTS

Total duration: 4-5 hours (injected), 3-5 hours (smoked).
Onset: 15 seconds (injected)
30 minutes (swallowed)
5-10 minutes (smoked)
Peak: 30 minutes – 2 hours
Coming down: 6 – 12 hours
Hangover/after effects: 3 – 5 days 

HALF LIFE
Even though the apparent effects of the drug wear off after 1-3 hours, the drug is still active in your system for up to 5 hours after you have taken it. Remember this if using other substances or redosing.

DRUG TESTS
Roadside Police: Roadside saliva tests do not look for heroin, but other substances can be detected that might have been cut into your heroin. It is illegal to drive under the influence of any illicit drugs, including heroin and any driver may be subject to a roadside behavioural impairment test. Wait at least 24 hours before driving.

Workplace: Urine: 1 hr – 3+ days after; Hair: Up to 90 days; Blood: 15min – 2 days after.

Drug Checking: Lab-quality testing has been trialed in Australia and is not available as a health service yet but DIY reagent testing is an option. Mandolin, Mecke and Marquis all give a reaction. [See photos of testing results here > verbinding.110110]

EFFECTS
Effects vary from person to person.

SAFER DOSING
Taking drugs is never without risk. In an unregulated market it’s impossible to know the purity or dose of any drug.  ‘Dose’ depends on the form a drug is in (liquid, powder, pill, crystal) and how you have it (snort, eat, inject). The “maximum safe dose” for heroin is person-specific. Heroin can affect everyone differently. This can be based on:

  • A person’s size, weight & health.
  • Someone’s tolerance or whether a person is taking it regularly or is dependent on it 
  • If other drugs are taken in conjunction with it.
  • The amount taken. 
  • The strength of the drug, heroin strength varies greatly from deal to deal and batch to batch. If you are unsure, it is always best practice to take half your ‘normal’ dose first than to risk overdose. If you’re a non dependent person or someone who hasn’t used it in a long time, even 0.1ml can be fatal, it is suggested to take a very small test dose.

It is not recommended to use heroin if you have or are at risk of:

  • Asthma
  • COPD
  • Breathing issues
  • Heart issues
  • Circulatory issues
  • Major depression/anxiety

Physical effects

COMMON

  • Itchiness
  • Sedation
  • Drowsiness
  • Lethargy
  • Nausea/vomiting
  • Breathing slows down
  • Dry mouth
  • Constipation
  • Increased sweating
  • Analgesia (numbness)
  • Decreased heart rate
  • Decreased appetite
  • Pupil constriction

 

LESS COMMON

  • Increased energy
  • Irregular menstruation
  • Increased appetite

 

RARE

  • Hypoxia (not enough oxygen)
  • Seizure

 

Emotional effects

COMMON

  • Euphoria
  • Moodiness
  • Depression
  • Emotional numbness

Psychological effects

COMMON

  • Decreased sexual desire

 

RARE

  • Paradoxical reaction (energetic movements, noises)

SAFER USING

  • Use around friends/people you trust and in a safe environment – somewhere you feel comfortable.  
  • Avoid eating prior or wait at least 30mins after eating
  • Carry naloxone.
  • Test your gear using a testing kit.
  • Have a small amount of test shot to reduce overdose risk.

INJECTING

  • Avoid Blood Borne Viruses ‘BBVs’ (eg. Hepatitis C, HIV) by using new & sterile syringes & equipment.
  • Use sterile water to mix up.
  • Wash your hands thoroughly before and after, you can also use an alcohol swab to clean your fingertips.
  • Alcohol wipes can reduce the risk of skin infections if they are used correctly. For maximum effect, swab once, in one direction on the injection site, and leave to dry naturally.
  • Dispose of syringes & equipment responsibly in a yellow disposal bin, all NSPs have bins available.

SMOKING

  • Avoid sharing straws or pipes to prevent sharing blood borne viruses such as Hep C.
  • Keep your lips moisturised to avoid cracking/bleeding.
  • Clean your pipe regularly by soaking in boiling water for a few minutes.

SHELVING (dry)/ PLUGGING (wet mix)

  • Use lubrication to avoid tearing the skin
  • Use a condom or latex/vinyl glove to avoid internal scratches
  • Wash your hands before and after using
  • Find a discreet and safe place to do it
  • Dispose of used condom / glove responsibly.

LONG TERM EFFECTS

  • Abscesses (effects of poor injecting practice)
  • Infected heart valves
  • Pneumonia
  • Collapsed veins
  • Blood borne viruses ie.Hep B and C
  • Decreased liver function
  • Cirrhosis (scarring of the liver) as a result of chronic Hepatitis (Hep C)
  • Dependence both physical and psychological.
  • Withdrawal Symptoms can begin within hours of your last use and include: sneezing, excessive yawning, coughing, sweating, chills, restless legs,irritability, moodiness, insomnia, severe muscle & bone pain, diarrhea, increased urination, dehydration, anxiety, nausea, vomiting, cramps, involuntary spasms, sensitive genitals (females).

SAFER HANDLING
Carrying heroin and paraphernalia (e.g. injecting/snorting/plugging equipment) puts you at risk of criminal charges including trafficking, even if you don’t deal. Know your local laws e.g. the Drugs Poisons and Controlled Substance Act 1981 (Vic).

Safe disposal of equipment

  • Needles and glass pipes should always be disposed of responsibly to avoid accidents like needlestick injuries.
  • Sharps containers are available at all Needle and Syringe Programs (NSPs).
  • If you can’t get a yellow sharps container, put the used sharp/glass into a solid plastic bottle and put the lid on before returning to an NSP.
  • New sterile syringes can be picked up, and used needles & syringes can be disposed of where the NSP symbol is on display or yellow sharps bins.

Drug combinations

Polydrug use has many possible outcomes. What could be fun for one person could be dangerous for another. We do not endorse any of these combinations and recommend you proceed with caution

Unsafe combinations

  • Alcohol – increases sedation and can lead to unconsciousness and aspiration (choking on vomit).
  • Benzodiazepines – increases sedation and can lead to unconsciousness and aspiration.
  • Ketamine – vomiting & risk of unconsciousness.
  • MXE – can increase the effects of heroin.
  • DXM – CNS depressant causing breathing difficulty, heart issues, possible opioid tolerance reduction.
  • Cocaine – stimulant increases respiration rate allowing higher tolerance of opioids. If stimulant wears off before opiate, chance of opioid overdose. 
  • GHB/GBL- increases sedation and can lead to unconsciousness and aspiration.
  • Tramadol – CNS depressant, increases risk of seizures in people taking other opioids.
  • Lyrica and other anticonvulsants – Can reduce breathing and heart rate leading to hypoxia.
  • Some Antihistamines eg Phnergan or Unisom – Can reduce breathing and heart rate leading to hypoxia.

Cautionary combinations

  • PCP – can reduce opioid tolerance, increasing the risk of overdose.
  • N2O – increases effects, risk of unconsciousness, memory blackouts are likely.
  • Meth/Amphetamines – stimulant increases respiration rate allowing higher tolerance of opiates. If stimulant wears off before opiate, chance of opiate overdose.
  • MAOIs – has been associated with rare reports of severe and fatal adverse reactions.

Low risk effects

  • Psychedelics – The combination is unlikely to cause any adverse or undesirable reaction beyond those that might ordinarily be expected from these drugs.
  • Cannabis – A lower risk combination which can sometimes cause synergy between the two substances.

Check out the TripSit drug combinations chart here for info on other combinations.

Call 000 if experiencing adverse effects, feel unwell or concerned in any way

Disclaimer

This educational resource has been developed collaboratively by healthcare workers and people who use drugs for their peers and the wider community. The role of Hi-Ground is to provide practical, evidence-based, unbiased information to assist you to make educated choices and to promote harm reduction, community care, and wellbeing. In an unregulated market it’s impossible to know the purity or dose of any substance. Taking drugs from an unregulated market carries its own risk, and you can educate yourself and practice harm reduction to reduce this risk.

Knowledge is power.

This resource is produced by DanceWize & Hi-Ground