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 people feel relaxed and contented. However, they can cause unwanted effects, such as breathing problems.

Heroin comes as:

• a fine white powder
• off-white granules
• tiny brown 'rocks'

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

Heroin is also known as:

• smack
• gear
• hammer
• dragon
• H
• opium
• skag
• junk
• harry
• horse
• hope
• black tar
• white dynamite
• homebake
• china white
• Chinese H
• poison
• Dr Harry

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.

When a person uses heroin, they can experience an immediate 'rush', which can:

• make them feel drowsy, relaxed and comfortable
• dull physical and psychological pain

These effects can last for 3 to 5 hours.

Heroin can also have unwanted effects. In the short term, people who take heroin may:

• have small ('pinned') pupils
• become itchy
• find it hard to urinate
• have slurred speech
• have slow breathing
• feel nauseous
• have trouble concentrating

In the days after using heroin, people may become irritable or experience depression.

Heroin can affect people differently based on:

• how much they take
• 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 batches often contain other substances. This can make heroin batches poisonous and prevent a user from knowing how much heroin they are taking. This can lead to an overdose.

Overdoses can happen:

• when too much heroin is injected into a vein
• if heroin is used with alcohol and other drugs

Signs that someone has overdosed include:

• very slow breathing or snoring
• cold skin
• low body temperature
• slow heartbeat
• muscle twitching
• being very vague or sleepy
• gurgling in the throat
• blue lips, tips of fingernails or toenails

An overdose is a medical emergency and can cause:

• seizures
• a stroke
• a cardiac arrest (where your heart stops beating — this is a medical emergency)

These can lead to a coma and death.

Ambulance officers don't have to call the police.

Heroin's effects can be reversed with a drug called naloxone.

Can using heroin cause long-term problems?

People who use heroin regularly have a higher risk of:

• severe constipation
• dental problems
• loss of appetite
• menstrual and fertility problems (in females)
• loss of sex drive (in men)
• mood swings, depression, anxiety and confusion

• skin and lung infections
• heart infections (endocarditis), leading to damaged heart valves
• severe blood infections

• damaged veins from injecting behaviour
• blood-borne infections such as hepatitis B, hepatitis C and HIV

People who use heroin regularly might also:

• neglect their health
• have relationship problems
• find it hard to do their work properly
• have an overdose, either accidentally or deliberately
• experience legal or financial problems

What if I use other drugs or alcohol together with heroin?

It is 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)

Taking these drugs with heroin can also cause heart and kidney problems.

Your breathing can be affected, and you may breathe in vomit if you take heroin with:

• alcohol
• cannabis
• medicines called benzodiazepines
• antidepressant medicines

Can I become dependent on heroin?

In time, some users become tolerant to heroin. This means that they need to take larger and larger doses to get the same rush. Doing this puts them at higher risk of side effects and overdose.

People can also become addicted to heroin. This is when they spend a lot of time thinking about the drug and trying to get it. Some users may even feel like they need the drug just to get through the day. This can impact their:

• life
• work
• relationships

People can also be dependent on heroin. They may find it difficult to stop using heroin or control how much they use. This is often due to withdrawal symptoms.

Withdrawal symptoms start between 6 and 24 hours after the last dose, and are worst after 2 to 4 days. They usually last for about a week and include:

• cravings
• diarrhoea
• increased heart rate
• vomiting
• loss of appetite
• restlessness and irritability
• yawning
• stomach and leg cramps
• muscle spasms
• goosebumps
• hot and cold flushes
• sweating
• runny nose and watery eyes

Some mental health symptoms can last for years after the last dose These can include:

• depression
• anxiety
• insomnia
• continued cravings

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
• inpatient detox 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

See 'What are the effects of taking drugs?' on the Department of Health website for more information.

Find out more about how drugs and alcohol can impact your health, including where to find help and support.

You or someone you know may be finding it hard to manage issues related to drug use. You can try healthdirect's Symptom Checker to get advice on when to seek professional help.

The Symptom Checker guides you to the next appropriate healthcare step for you. This could be:

• self-care
• talking to a health professional
• going to a hospital
• calling triple zero (000)

You can find support and more information about heroin through the:

• Alcohol and Drug Foundation website, or you can call their Drug Info and Advice Line on 1300 85 85 84
• Drug Help website, or call the National Alcohol and Other Drug Hotline on 1800 250 015
• Turning Point website — Australia's leading national addiction treatment, training and research centre — or call them on 1800 250 015
• Touchbase website for Australians identifying as LGBTI
• Narcotics Anonymous Australia on 1300 652 820
• Lifeline on 13 11 14

Support for injection behaviour

If you inject heroin, you can reduce your risk of blood-borne disease by attending a Needle and Syringe Program (NSP).

Needle and Syringe Programs provide clean needles or syringes to people who inject drugs. It's sometimes referred to as 'needle exchange'.

The types of Needle and Syringe Programs vary, from pharmacies to vending machines.

You can also find a local Needle and Syringe Program using the healthdirect Service Finder. Select 'By name' and type 'needle' into the search bar.