Email sent successfully

Message sent

Your message has been sent to Between the Lines.

Message sent

Your message has been sent to Between the Lines.

Stuff to keep in mind

There are many factors which may influence the effects that heroin can have on you.  The effects are different for every person and can differ each time they take the drug.

Dose, strength and purity

It is always best to take smaller doses of heroin, especially if you are trying a new mix for the first time. Using a large quantity of heroin can cause death. Breathing becomes very slow, the body temperature drops and the heartbeat becomes irregular.

Mood, environment and personal factors

Factors such as your mental or emotional state and physical health can influence the effects of a drug.

Avoid taking heroin alone. It is better to be with other people who may notice if something goes wrong and can call for help.

If you live in Sydney, you may want to consider using the Medically Supervised Injection Centre in Kings Cross. Here you can inject under supervision and receive immediate health care if something goes wrong. There are also people there who you can have a chat to about your heroin use and possible treatment options.

Method

Injection: Using this method, any contaminants will go straight into the bloodstream as injecting bypasses all of the body’s natural defences.  It also increases risk of blood-borne viruses (such as HIV and AIDS) and infections from using dirty equipment.

Always use fresh injecting equipment (including needles, syringes, spoons, tourniquets, swabs and water) and never share injecting equipment with anyone else. Free equipment can be found at Needle and Syringe programs (NSPs).

Dispose of your used injecting equipment properly after use; you don’t want other people stepping on them or re-using them.

Tolerance and withdrawal

Dependence on heroin can be psychological, physical or both.

People who are physically dependent on heroin usually develop tolerance to the drug making it necessary to take more and more to get the desired effects. Eventually, a dose plateau is reached, at which no amount of the drug is sufficient. When this level is achieved, the person may continue to use heroin, but largely for the purpose of delaying withdrawal symptoms.

If you are dependent and suddenly stop taking heroin or severely cut down the amount you use, you will experience withdrawal symptoms because your  body has to readjust to functioning without the drug. This usually occurs within a few hours after last use.

Withdrawal symptoms can include:

• a craving for the drug
• restlessness
• yawning
• low blood pressure
• elevated heart rate
• stomach and leg cramps, muscle spasms
• loss of appetite, vomiting and diarrhoea
• goosebumps
• tears and a runny nose
• increased irritability
• insomnia
• depression

These withdrawal symptoms get stronger and usually peak around 2 - 4 days after last use. They usually subside after 6 - 7 days but some symptoms such as chronic depression, anxiety, insomnia, loss of appetite, periods of agitation and a continued craving for the drug may last for periods of months and even years.

Sudden withdrawal from heroin rarely causes direct death, unless the user is also using other drugs and is in poor health.

Using heroin with other drugs

Medication: Using heroin with other drugs is risky. It can prevent drugs, such as mood stabilisers from working properly.

Other depressants: Don’t mix heroin with other depressants such as alcohol or GHB. Mixing depressants increases the risk of overdose and death.

Prescribed medication: Using heroin with any sedatives, including benzodiazepines (such as Valium, Xanax, Serepax, Mogadon), anti-psychotics (such as Seroquel), some anti-depressants (such as Luvox), some anxiety medication and older tricyclics, will make you feel a lot more high compared to if you had twice the amount of just heroin. Using sedatives and heroin may also make you collapse, pass out or die from your brain's control of breathing stopping. Paradoxically, you might enter a high energy state - as if you were much more affected in terms of disinhibition without being as sleepy - and you might be violent or do violent things without having any memory of what you've done.

If you are planning to take any illicit substance or alcohol while you are going to be on medication that is about to be prescribed to you, talk with your doctor. Unless they have immediate concerns for your safety it will remain confidential. Each drug is different and interactions can be unpredictable and very dangerous. This is especially so if you’re on any highly specialised drugs (e.g. for heart problems, neurological – brain and nerves – problems, blood thinning medications or drugs for cancer).

Driving

Don’t drive while on heroin. Remember, it’s a depressant like alcohol. This means it slows down the activity of the brain and other parts of the central nervous system.

The effects of heroin are influenced by a range of factors such as:

• Strength and purity. Heroin can vary in strength and purity so it can be difficult to predict the extent to which a person’s driving skills will be impaired after using heroin.
• How much is taken. Larger amounts can produce different effects.
• How it is used. For example, injected, swallowed or smoked.
• Your psychological and physical health. Factors such as your mental or emotional state and physical health can influence the effects of a drug.

This makes it difficult to predict exactly, in what way, and for how long, heroin will affect your ability to drive safely. As a general guide, some of the effects of heroin that may affect your driving ability include:

• slow reaction time
• taking longer to respond to events or situations, and possibly choosing an inappropriate response
• reduced coordination
• reduced ability to think clearly
• changes to visual acuity, such as blurred vision
• drowsiness or starting to “nod off”
• nausea and vomiting.

You might experience withdrawal symptoms when the effects of the heroin or opioid wears off. These can include cravings or “hanging out”, cramps and flu-like symptoms which may also affect your driving ability.

Pregnancy

If you are pregnant and using heroin, do not stop heroin use without expert medical guidance. Heroin withdrawal is dangerous to an unborn child. Contact your medical professional as soon as possible.

Bingeing and overdose – what it is and what to do

Develop a plan of action in case a friend overdoses. Be familiar with how to call an ambulance and how to give cardiopulmonary resuscitation (CPR).

An overdose may occur if you take too much heroin, take highly potent heroin or mix heroin with other depressants such as alcohol and benzodiazepines. An overdose causes the part of the brain that controls our breathing to shut down, possibly leading to respiratory arrest and death.

Signs of an overdose may include:

• Appearing to be asleep and unable to be awoken
• Shallow / no breathing
• Slow / no pulse
• Blue lips, toenails and fingernails
• Snoring and gurgling sounds when breathing

If you suspect a friend may have overdosed on heroin:

• turn them on their side
• clear their airways
• call an ambulance on 000 immediately

Death from a heroin overdose can occur within minutes so do not hesitate. Your quick actions may save your friend’s life.

If your friend stops breathing before the ambulance arrives, attempt mouth-to-mouth resuscitation. When the ambulance arrives, be honest about what drugs the person has taken. The ambulance officers can usually reverse the effects of heroin with a drug called Naloxone.

You may be worried that the police will be called but ambulance officers are under no obligation to call the police unless someone dies or becomes violent. If you don’t call an ambulance and your friend dies, you probably will be questioned by the police as to why you didn’t act.

This fact sheet was prepared with assistance from the Australian Drug Foundation.