Heroin and other opiates
Heroin also called: boy, brown, china white, dragon, gear, H, horse, junk, skag, smack.
Medical names of other opiates: diamorphine, morphine, methadone, opium, codeine, pethidine, dihydrocodeine (DF118), Palfium, Diconal, Temgesic, Physeptone.
Heroin (medical name diamorphine) is one of a group of drugs called opiates
which are derived from the opium poppy. Opium is the dried milk of the opium
poppy. It contains morphine and codeine, both effective painkillers. Heroin is
made from morphine and in its pure form is a white powder.
In the UK street heroin usually comes as an off-white or brown powder. For medical use heroin usually comes as tablets or an injectable liquid. A number of synthetic opiates (called opioids) are also manufactured for medical use and have similar effects to heroin. These include pethidine, dihydrocodeine and methadone.
Heroin can be smoked ("chasing the dragon"), sniffed or prepared for injection. Methadone is usually prescribed as a liquid, which is swallowed. Buprenorphine is a tablet, which is dissolved under the tongue.
Prevalence
Heroin is commonly available in the area and can be bought in various size wraps for between £5-25. It is usually the brown variety and can be smoked in this form. To inject herion, an acid (usually citric or ascorbic acid) needs to be added.
Effects and risks
Using heroin can feel very pleasant and relaxing. It can make you feel safe as if wrapped in a blanket. Heroin and other opiates are sedative drugs that depress the nervous system. They slow down body functioning and can combat both physical and emotional pain. The effect is usually to give a feeling of warmth, relaxation and detachment with a lessening of anxiety. Effects start quickly and can last several hours but this varies with how much is taken and how the drug is taken.
Initial use can result in nausea and vomiting but these unpleasant reactions fade with regular use. With high doses sedation takes over and people become drowsy. Excessive doses can produce stupor and coma, and even death from respiratory failure.
With regular use tolerance develops so that more is needed to get the same effect. Regular use can also lead to physical dependence. Withdrawal after regular use can produce unpleasant flu-like symptoms and may include aches, tremor, sweating, chills and muscular spasms. While many people do successfully give up long-term heroin use, coming off and staying off heroin can be very difficult.
Fatal overdoses can happen, especially when users take their initial dose after a break during which tolerance has faded, or when opiate use is combined with use of other depressant drugs such as an alcohol, tranquillisers or other opiates.
The physical effects of long-term heroin use are rarely serious in themselves but may include chronic constipation, irregular periods for women and possibly pneumonia and decreased resistance to infection. This can be made worse by poor nutrition, self-neglect and bad housing. Regular injectors may suffer more health problems including damaged veins, heart and lung disorders, and a range of infections including hepatitis and HIV if injecting equipment is shared.
Treatment
The aim of treating people who have become dependent on heroin or other opiates is harm reduction – that is, working to reduce the ill-effects of the drug and how it is used (injecting or smoking), without
necessarily seeking abstinence, which can be extremely difficult and can have a high mortality. Treatment often includes prescribing some substitute medication, most commonly methadone or buprenorphine (trade name Subutex). There is overwhelming evidence that the right medication along with a good relationship with a regular member of staff is extremely effective in reducing morbidity and mortality in heroin users.
For more information on drugs of all kinds, visit the website www.drugscope.org.uk.