What is heroin?

Heroin is an addictive drug that is illegal in Australia. It is made from the opium poppy.

Heroin belongs to the family of drugs called opioids, along with prescription medicines such as:

• morphine
• codeine
• pethidine
• methadone

Opioids work in the brain to relieve pain and make you feel relaxed and content. However, they can cause serious unwanted effects.

Heroin can appear as:

• a fine white powder
• granules that are an off-white colour
• small pieces that look like brown rocks

Heroin is usually injected into a vein, but it can be smoked or snorted as well.

Heroin is also known by other names, such as:

• smack
• gear
• hammer
• dragon
• opium
• skag
• junk

What are the effects of taking heroin?

Heroin is a central nervous system depressant. This means it slows down brain activity and produces feelings of relaxation and drowsiness.

If you inject heroin, you may feel these effects quickly:

• relaxed
• drowsy and comfortable
• intense pleasure

Heroin also dulls feelings of physical and psychological pain.

Other physical effects of heroin include:

• small pupils
• slow breathing
• a slow heart rate

The effects of heroin can last for 3 to 5 hours.

Heroin can affect people differently based on:

• how much is taken
• how strong it is
• their size, height and weight
• whether they are used to taking heroin or other opioids
• whether they take other drugs at the same time

What can go wrong with heroin?

Heroin can also have unwanted effects. In the short term, you may:

• have a dry mouth
• have a loss of appetite
• have a reduced sex drive
• have slow or slurred speech
• have breathing problems
• feel nauseous
• have trouble concentrating

Try healthdirect's Symptom Checker to find out what to do next when you have symptoms that worry you.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

Overdose

Overdoses can happen:

• if you take too much heroin
• if you use a strong batch of heroin
• if heroin is used with alcohol and other drugs

Signs that someone has overdosed include if they:

• have small ('pinned') pupils
• are sleepy or fall asleep
• have very slow breathing or snoring
• have cold skin and a low body temperature
• have a slow heartbeat
• have blue lips and fingertips

The effects of too much heroin can prevent you from getting enough oxygen when you breathe. This can lead to a coma and death.

An overdose of heroin is a medical emergency.

Ambulance officers don't have to call the police.

The effects of heroin can be reversed with a drug called naloxone.

How can I reduce the risks of using heroin?

Laced heroin

When you buy heroin it can be laced with (contain) unknown substances. These may include fentanyl, which is 50 times stronger than heroin. This makes using heroin more dangerous. When you don’t know how much of a drug you are taking you might overdose.

Pill testing or drug checking services are now available in some areas of Australia. These centres can help you find out if a drug is very strong or has been contaminated with other substances. However, drug checking services are not yet widely available.

Support for injection behaviour

If you inject heroin, you can reduce your risk of blood-borne disease by using clean needles from a needle and syringe program (NSP).

These services provide clean equipment to people who inject drugs. It's sometimes called 'needle exchange'.

There are different types of NSP sites. Some are in pharmacies. Others are available through dispensing machines.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

Can using heroin cause long-term problems?

People who use heroin regularly have a higher chance of:

• severe constipation
• dental problems
• menstrual and fertility problems (in females)
• erectile dysfunction in males
• loss of sex drive in males and in females

If you inject heroin, you may have a higher chance of:

• damaged veins from injecting behaviour
• heart infections (endocarditis)
• skin and lung infections
• blood-borne infections such as hepatitis B, hepatitis C and HIV

Regular heroin use can also lead to mental health problems, such as:

• mood swings
• depression
• anxiety
• insomnia

Some mental health symptoms can last for years after your last dose of heroin.

Regular use of heroin can impact your:

• physical health
• relationships
• daily functioning
• ability to work properly

You may experience legal or financial problems.

What if I use other drugs or alcohol with heroin?

It’s dangerous to mix heroin with other drugs. You are more likely to overdose if you take heroin at the same time as:

• ice (crystal meth)
• speed
• MDMA (ecstasy)
• cocaine
• alcohol
• GHB
• medicines called benzodiazepines

Taking heroin with other drugs can also affect your breathing and make you vomit.

You may breathe in vomit if you take heroin with:

• alcohol
• GHB
• benzodiazepines

If you think someone is having trouble breathing call triple zero (000) for an ambulance.

Can I become dependent on heroin?

People can become addicted to heroin. You may find it hard to stop using heroin or control how much you use. Some users may feel like they need the drug just to cope each day. Spending lots of time finding the drug can negatively impact your life.

In time, you can become tolerant to heroin. This means that you need to take larger and larger doses to get the same rush. Doing this can also make it easier to accidentally take an overdose.

If you are physically dependent on heroin, you may have withdrawal symptoms when you try to stop using the drug. These symptoms start between 6 and 24 hours after the last dose and feel worse after 1 to 3 days. Withdrawal symptoms usually last for about a week.

During withdrawal, you will crave (have a strong desire for) heroin. You may have other symptoms, such as:

• diarrhoea
• increased heart rate restlessness and irritability
• yawning
• muscle spasms, and stomach and leg cramps
• sweating and goosebumps
• hot and cold flushes
• runny nose and watery eyes

If you are concerned about your use of an opioid medicine, try the healthdirect Opioid Risk Indicator.

How can I stop using heroin?

Getting off heroin can be difficult. It's important that you speak to your doctor first. Your doctor can help work out the best approach for you to stop using, which may include:

• participation in support groups
• counselling and therapy
• referral to an addiction specialist
• detoxification and rehabilitation

Heroin rehabilitation might also include using prescription opioid medicines such as:

• methadone
• naltrexone
• buprenorphine

Methadone treatment involves taking methadone to replace heroin. It helps you overcome dependence while avoiding withdrawal symptoms.

Resources and support

Find out more about how drugs and alcohol can impact your health.

You or someone you know may be finding it hard to manage issues related to drug use. Look for more information about heroin at these support organisations:

• The Alcohol and Drug Foundation website.
• The Drug Help website, or the National Alcohol and Other Drug Hotline (1800 250 015).
• Turning Point, a national addiction treatment, training and research centre.
• Touchbase is a website for Australians identifying as LGBTQI+.
• Narcotics Anonymous Australia on 1300 652 820.
• Lifeline on 13 11 14
• If you have a friend or family member with a drug problem, find support through the Family Drug Support website. You can also call them on 1300 368 186.
• See 'What are the effects of taking drugs?' on the Department of Health, Disability and Ageing website.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Aboriginal and/or Torres Strait Islander peoples

If you need support for an Aboriginal and/or Torres Strait Islander person, visit:

• the Alcohol and Drug Foundation for resources for Aboriginal and Torres Strait Islander people, including information on heroin
• Your Room for Aboriginal people in NSW who want to reduce harm from drug use
• Turning Point has an Aboriginal drug support service, based in Victoria
• the Alcohol and Other Drugs Knowledge Centre website

Other languages

If you speak a language other than English, go to the Health Translations Victoria website. The ‘Where can I get help when alcohol or drugs are a problem?’ video is available in different languages.