Heroin

Heroin has a long history as being an effective pain killer, used in medicinal practice.

Diamorphine, more commonly referred to as heroin, is an opiate and sits within the morphine family, a drug that originates from naturally-occurring alkaloids found in the opium poppy plant. Opiates are best known for their ability to relieve pain symptoms. Currently in the UK, heroin is a class A substance under the Misuse of Drugs Act 1971, meaning that it is an offence to possess or supply the drug for recreational purposes. Under the Misuse of Drugs Regulations 2001, opiates, including heroin, are subject to schedule 2 regulations, meaning they can be prescribed and legally possessed and supplied by pharmacists and doctors. Drugs within this schedule can also be possessed lawfully by anyone who has a prescription. For more information about drugs and the law, check out Release.

As with all drugs, heroin can have both short and long term effects. Many people who use heroin will experience a sense of relaxation and euphoria, as well as a sense of calmness and relaxation. However it can lead to a variety of side effects including constipation and vomiting. Taken in higher doses, it can lead to respiratory depression, meaning that the person’s breathing may become slower and shallower. This could increase the risk of death. Over a period of time, continual use of heroin could lead to the person developing a substance use disorder, meaning that if they then tried to stop using the drug, they may experience withdrawal effects.

There are also risks associated to how the person may administer heroin, especially via injecting. If someone was to undertake this behaviour, it increases the risk of an overdose compared to other forms of administration, such as smoking and snorting. Re-using any equipment and/or using in unsterile environments, could increase the risk of infection at the injection site on the body. For more information about safer injecting techniques, we would recommend reading Exchange Supplies ‘Safer Injecting Handbook’.

Withdrawal effects are a common sign that the individual has developed a substance use disorder associated to that particular drug. They tend to unpleasant experiences and can lead to the person using that drug again, to stop the withdrawals. In relation to heroin, such withdrawal symptoms include fever; aches and pains; diarrhea; vomiting; hot flashes and heavy sweating; insomnia; hallucinations and cravings. Withdrawal effects can last up to 10 days.

Opioid Substitution Treatment (OST) can help reduce the risk of someone experiencing withdrawal effects, when an individual aims to reduce and stop their heroin use. OST can also help an individual engage with treatment services, reduce the chance of them going back to using heroin and continue upon their recovery journey. Such medications include Methadone, Buprenorphine and Buvidal. Talk to your local Barod service for more information about these options. While we don’t provide any clinical or prescribing services, we do work closely with such organisations.

Below is a graphic, taken from our Welsh Overdose Awareness Day 2021 resources, highlighting some of the signs associated to a heroin overdose. If you were to ever come across someone experiencing such symptoms, call for medical assistance immediately by dialling 999. If you have been trained in how to respond to an overdose and administer naloxone, this would be the time to implement those skills. If you haven’t undertaken such training, visit our E-Learning page and find out more about our FREE Overdose Awareness course, here.

If you use heroin, or intend on using, below are some tips on how to reduce the harm, when using the drug.

Do not use out of sight of others. Using heroin alone can significantly increase the risk of experiencing a fatal overdose. By being in the company of other people, preferably those who are not using, can ensure that if something was to go wrong, you’d get the help you need.
Carry Naloxone. Naloxone can temporarily reverse the effects of an opiate overdose. You can get a naloxone kit, for free, from your local Barod service, or order one via our Naloxone Click and Deliver service and get it delivered straight to your door.
Access a needle exchange. Regardless of how you consume heroin, you can get clean, hygienic paraphernalia including needles, syringes, water and foil, from a needle exchange. You can also get free advice and harm reduction from a trained professional. By accessing one of Barod’s needle exchanges, we can also support you in accessing confidential 1-2-1 support too.
Do not share. Do not share or re-use any form of equipment. Always use sterile paraphernalia every time you use heroin.
Be responsible. Dispose of all equipment and paraphernalia, ideally by using a sharps bin, which can be obtained at your local needle exchange. We would then recommend taking your sharps bin back to your nearest needle exchange to be disposed of safely.
Smoke rather than inject. It is advised to smoke heroin rather than to inject it, as it reduces the risk of experiencing an overdose.
Get tested. You can access free, confidential dry blood spot testing from any Barod service, that tests for Hepatitis and HIV. If positive, we will support you in accessing the right treatment.
Wedinos. If available, access a drug checking service who can test to see what is in your sample. If you are concerned about what is in your sample, you can send it off to Wedinos.
Don’t mix with other drugs. Mixing heroin with other drugs, can lead to unwanted and unpredictable effects. Mixing heroin with alcohol, benzodiazepines or other opiates can significantly increase the risk of an overdose.
Start Low Go Slow. Start with a small test dose first and wait at least a couple of hours before re-dosing.
Tolerance. If you have never used heroin before, or haven’t used for a while, you tolerance may be very low. Therefore only use a small dose, if you do use again.
Concerned about your heroin use? If you are, seek support. There are also treatment options to help you reduce or stop your heroin use, if that is your goal. Ask your local Barod service about what is available to you. You can also chat confidentially to one of our trained support workers, via our Live Webchat Service.

Naloxone is a medicine used to temporarily reverse the effects of an opioid overdose, including those associated to heroin. Naloxone can come in two forms, an injectable and a nasal spray. Naloxone can work within five minutes of being administered and can last between 20 to 40 minutes. It is crucial that anyone who experiences an overdose gains medical assistance, so therefore you need to call 999 and ask for an ambulance immediately.

We provide a free Naloxone Click and Deliver service in Wales, where you can get the life-saving medication delivered to your door. For more information, please click here. You can also watch free video’s on how to administer either form of naloxone via our YouTube Channel.

You can also check out some of our top harm reduction tips for other drugs by clicking on each of the substances below:

General harm reduction tips

Cannabis

Ketamine

Nitrous Oxide

Heroin has a long history as being an effective pain killer, used in medicinal practice.

Heroin effects, risks and harms

Heroin withdrawal effects

Heroin overdose

Heroin harm reduction tips

Naloxone

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