What is heroin?

Heroin is an addictive drug made from the opium poppy. It belongs to the family of drugs called opioids, along with prescription medicines such as morphine, codeine, pethidine and methadone. Opioids work in the brain to relieve pain and make people feel relaxed and contented.

Heroin comes as a fine white powder, off-white granules or tiny brown ‘rocks’.

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

It is also known as smack, gear, hammer, the dragon, H, dope, junk, harry, horse, black tar, white dynamite, homebake, china white, Chinese H, poison, Dr Harry.

What are the effects of taking heroin?

Heroin produces an immediate ‘rush’, which can make people who use it feel good, as well as drowsy and very relaxed. It also dulls physical and psychological pain. People who take heroin may have small (‘pinned’) pupils, become itchy, and find it hard to urinate. The effects can last for 3 to 5 hours.

Heroin is a central nervous system depressant, which means it slows down brain activity and produces feelings of relaxation and drowsiness. People who take heroin may have slurred speech, slow breathing and 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 it
• whether they take other drugs at the same time

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

What can go wrong with heroin?

Accidental overdoses are common because users don’t know how ‘pure’ their supply is. Batches often contain other substances, making them very poisonous. Overdoses also happen when too much heroin is injected into a vein, or if it’s used with alcohol and other drugs. The signs 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 can cause seizures, or a stroke or a cardiac arrest, leading to coma and death. If you think someone has overdosed on cocaine, call triple zero (000) for an ambulance. Ambulance officers don’t have to call the police.

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

Can heroin cause long-term problems?

People who use heroin regularly might:

• develop confusion
• have mood swings, depression and anxiety
• neglect their health
• have relationship problems
• find it hard to do their work properly
• have an overdose, either accidentally or deliberately
• pick up infections such as hepatitis B, hepatitis C and HIV
• suffer physical illnesses
• experience legal or financial problems

People who use heroin regularly are more likely to develop skin, heart and lung infections, loss of sex drive (in men), menstrual and fertility problems (in women), and risk infectious diseases such as HIV from sharing needles.

You can reduce the risk of HIV and other blood-borne diseases, such as hepatitis B and C, through needle and syringe programs (NSPs). These provide clean needles or syringes to people who inject drugs and is sometimes referred to as ‘needle exchange’.

The types of NSP outlet vary, from participating pharmacies to vending machines. Find an NSP in your state or territory here.

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 alcohol or tranquilisers like Valium or Xanax. Breathing can be affected and you can breathe in vomit.

Taking ice, speed or ecstasy along with heroin puts strain on the heart and kidneys and also increases the risk of overdose.

Can I become dependent on heroin?

In time, some users become tolerant to heroin and need larger and larger doses to get the same rush.

Sometimes people become dependent on heroin. This means they spend a lot of time thinking about it and trying to get it. They also find it difficult to stop using it or to control how much they use. The longer people use heroin, the more likely they are to develop dependence.

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

Some mental health symptoms, such as depression, anxiety, insomnia and continued cravings, can last for years after the last dose.

Getting off heroin can be tough, and might include using medicines such as methadone (a prescription opioid drug) along with counselling and support groups.

Resources and support

Find information about heroin on the Alcohol and Drug Foundation website or by calling DrugInfo on 1300 85 85 84.

You can find help on the Drug Help website or by calling the National Alcohol and Other Drug Hotline on 1800 250 015. You can also call Lifeline on 13 11 14.

There are many different ways to treat heroin addiction. Counselling and support groups are common approaches. Some people recommend methadone, which is a prescription drug used as a replacement for heroin. Find out about methadone on the Alcohol and Drug Foundation website.

If you or someone you know are finding it difficult to manage issues as a result of drug use, try healthdirect’s Symptom Checker and get advice on when to seek professional help.

The Symptom Checker guides you to the next appropriate healthcare steps, whether it’s self care, talking to a health professional, going to a hospital or calling triple zero (000).