Heroin

All drug use has risks. This page is for information only and does not constitute or replace medical advice. If you have medical concerns about your drug use, please speak to a medical professional.

Heroin is an opiate drug which is made from opium poppies. It is also known as diacetylmorphine and diamorphine.

Other names

H, kit, brown, gear, smack

Appearance

Fine brown powder

Drugs Wheel Category

Opioids

Legality

Misuse of Drugs Act (1971) – Class A.

Penalties for possession are up to 7 years in prison and/or an unlimited fine. Penalties for supply are up to life in prison and/or an unlimited fine.

How it’s taken

Heroin can be heated on foil and smoked/inhaled. In Scotland, it is commonly injected but injecting is almost always the riskiest way of taking drugs and is strongly discouraged.

Be aware that when injecting, a smaller dose is required to achieve the intended effect than when smoking.

Dose

The following information on dosage was taken from PsychonautWiki, but this should not be taken as a recommendation: duration and effects of any drug will depend on purity, regularity of use, other medications or drugs you have taken, your body and how it is taken (route of administration).  

Inhale (smoke/vape): 

  • Light: 5-15 milligrams (mg) – this would give 67 to 200 doses from a gram 
  • Common: 15-25 milligrams (mg) – this would give 40 to 67 doses from a gram 
  • Strong: 25-50 milligrams (mg) – this would give 20 to 40 doses from a gram 

Accessed November 2020  

It is essential to use accurate scales – ones that are capable of measuring to 10 milligrams (0.01 of a gram). Knowledge of how to use them and how to ensure they are measuring accurately is important.  

A slight difference in dose can create a different experience or effect. Find out more about reducing the risk from dosing including volumetric dosing.

General information on dosing.

Effects

Heroin can cause feelings of euphoria and relaxation. It is a downer drug and people may feel calm, relaxed, safe and warm. It can also cause constipation, nausea and vomiting.

In high doses heroin can cause respiratory depression (slowed/shallow breathing and reduced heart rate) and death.

Risks

  • Physical dependence to opiates can happen quickly, after only a few days of use. This means people will experience withdrawal symptoms if they do not take the drug. Try to limit use, and take regular breaks from use to allow your body time to heal and readjust.
  • Heroin was implicated in 45% of drug-related deaths in Scotland in 2018.

Harm reduction

If you choose to take heroin then the following steps can help to reduce harm.
  • If you can, get your drugs tested. Without testing your drugs there is no way to be sure that they contain only or any of the drugs you think you have. Visit WEDINOS.
  • In many countries, fentanyl has been found in products sold as heroin, benzodiazepines (such as diazepam and etizolam), cocaine and gabapentinoids. Fentanyl test strips can confirm the presence of fentanyl in products – these are available to order online.
  • Start low, go slow! Start with a small test dose to feel the effects.
  • Avoid taking drugs alone but if you do, let someone who can check on you know what you are taking, how much and when.
  • Avoid mixing drugs, including alcohol and medicines.
  • Avoid sharing equipment including needles, cookers, snorters or pipes etc.
  • Injecting is the most risky way to take heroin – when you have a new batch try smoking or snorting your test dose of it instead of injecting.
  • Snorting or smoking is less risky than injecting but there is still a risk of overdose.
  • Mixing heroin with other downers (including methadone, alcohol and benzodiazepines) is extremely dangerous and increases the risk of respiratory depression and death.
  • Always carry naloxone, this can be used to temporarily reverse an opioid overdose.
  • If you are taking drugs in a group ensure multiple naloxone kits are available and that one person is alert/sober enough to respond to an emergency (space out your dosing, instead of everyone dosing at the same time).
  • Those in Scotland can order a naloxone kit from Scottish Families Affected by Alcohol and Drugs.
  • Sleep on your side. This will help to keep your airway clear.
  • Call 999 and ask for an ambulance if you see the signs of an overdose: confusion, unconsciousness (won’t wake with a shout or a shake), severe nausea and vomiting, fitting, difficulty breathing, snoring/raspy breathing, blue/pale tingeing of knees, hands and lips, slow or erratic pulse (heartbeat), pale, cold and clammy skin.

FOR SMOKING 

Inhaling heroin can damage the mouth, throat and lungs and can cause breathing difficulties, wheezing, chest pain, shortness of breath and in extreme cases, respiratory failure. It can also impact negatively on oral health. 

  • Crush the powder as fine as possible before use. 
  • When smoking, the effects are intense but short-lived. Use a timer to keep track of use and try to wait as long as possible between doses. 
  • If smoking from foil, use clean foil each time. This is available from injecting equipment providers (IEPs or needle exchanges). 
  • There is a risk of burns when smoking. Keep all burns clean and dry. If they do not start to heal, and instead become more red, hot or inflamed, please seek medical help. 
  • Stay hydrated. Smoking dries out the mouth so it’s important to use lip balm, drink small sips of water regularly and brush your teeth twice a day.
  • Sharing foil can spread infections and blood borne viruses (e.g. hepatitis C, HIV) – only use your own equipment. Get tested regularly for BBVs.
  • Avoid holding the smoke in your lungs, as this can damage tissue without giving a better ‘hit’.  

FOR INJECTING 

There is a higher risk of overdose if heroin is injected. Injecting heroin also risks damaging veins or the injecting site and can cause life-threatening infections and abscesses. 

  • Only use new, sterile supplies. These are available from injecting equipment providers (IEPs or needle exchanges) or can be bought online.  
  • Sharing equipment including needles, filters, containers, spoons and water can spread infections and blood borne viruses (e.g. hepatitis C, HIV) – only use your own. Use colour coded equipment to avoid confusion and get tested regularly for BBVs.
  • Follow good hygiene practice and wash your hands and injection sites (before and after).
  • Citric acid/vitamin C and heat is needed to dissolve heroin (‘base’) powder. Use the smallest amount of acid possible to dissolve the drug – you should not need the full sachet. 
  • Once dissolved in water, it is important to use a sterile filter to remove non-soluble substances which can cause harms if injected. 
  • Use the smallest needle you can without it becoming blocked or breaking.  
  • Keep the needle sterile and avoid licking the needle as this can transfer bacteria from the mouth into the skin and cause infections.
  • Use a new needle each time – needles become blunt after one use. 
  • Rotate injection sites but try to avoid injecting in high-risk areas such as the neck and groin. 
  • Dispose of equipment responsibly. It can be returned to an IEP.  
  • Seek medical help if the injecting site is painful, tender or hot, or there is swelling for more than a few days.