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Heroin Frequently Asked Questions
by Anonymous
v 1.0 - 2000
Erowid Note: This FAQ was not authored by Erowid. It may include out-of-date and/or incorrect information. Please check the version date to see when it was most recently revised. It appears on Erowid as part of our historical archives. For current information, see Erowid's summary pages in the substance's main vault.
INDEX

WHAT IS HEROIN?

Heroin is an opiod agonist. It's is a semi-synthetic drug which is derived from opium, and has the chemical formula C21H23NO3. Opium is produced by the opium poppy - papaver somniferum. The group of opiod agonists includes many other drugs, one is morphine, the direct derivative of opium. There are semi synthetics that are also derived from opium, heroin is one, along with codeine and dilaudid; and many fully synthetic drugs which act upon the same parts of the brain, like pethidine, methadone, and LAAM.

All natural and synthetic opiates exhibit a three dimensional T shaped configuration A called the piperidine ring, which Includes methylated nitrogen and a hydroxyl group.

Most psychoactive drugs act by binding to a receptor in the brain. Think of a receptor as a lock, and the drug is the key which comes along and releases all these effects which have been cruelly imprisoned. Endorphins, the body's own pain killers, are the natural binding agents (called ligands) for the opiate receptors. Opiate receptors have a few types locking up slightly different effects each., and which drugs may bind more effectively too. The more effectively a drug can bind to a receptor, the greater the effect it will have. The m receptor prefers morphine, heroin and methadone, while the e receptor prefers the neurochemical b-endorphin. Opiate receptors have been found in every vertebrate species, indicating that endorphins have played an important role in evolutionary development.

There are also opiate antagonists, including Narcan, which is used to reverse the effects of heroin overdose, and Naltrexone, which blocks the effects of opiates for several days, meaning that people don't get psychoactive effects when they use heroin or other opiates. These drugs do not create an opposite effect to agonists. Rather, they bind to the receptor very effectively without penetrating it - the lock is blocked and keys can't fit in. They also kick out any drugs already in there, creating almost immediate withdrawal in dependent users.

The word Heroin is actually a brand name under which Bayer marketed the drug diacetylmorphine, the chemical name for heroin. The drug was so widely used prior to its outlawing that the word heroin passed into popular consciousness as the commonly known name of the drug, in a similar way to panadol being used for paracetemol.


WHAT IS HEROIN USED FOR?

Opium has been used to alleviate pain and reduce stress for hundreds of years. In the 1800s morphine was extracted from the opium poppy. The hypodermic syringe was invented shortly thereafter to provide a means of delivering relief quickly to wounded soldiers during the Crimean War. (The wife of the inventor went on to become the world's first dependent person to use needles.) Heroin was synthesised in the 1870s, shelved, and then mass marketed from the 1890s through until the '20s.


HOW DO YOU FEEL WHEN YOU TAKE HEROIN?

Heroin is a more refined form of morphine, and requires a smaller dose for the same effect. Many opiates may be very efficient painkillers, with few euphoric effects, and the vice versa applies in a couple of examples. Heroin has very effective abilities in both the euphoric and analgesic areas. This essentially means that it creates an intense feeling of well being and relief from stresses and it relieves physical pains. Many users will feel an increase in self-confidence, an empathy with people around them, and some users report increased creativity. Larger doses will create a dreamlike state, with visual distortions, which could be described as hallucinations.

In a pure form heroin does not take a great toll on the body, but there are some side-effects. Constipation is a fairly uncomfortable one. Nausea can effect many users. Response time is certainly slowed, making driving dangerous.


WHAT IS A HEROIN OVERDOSE?

Heroin slows down breathing, and can stop it altogether. Most heroin overdoses occur when heroin is combined with other drugs with a depressant effect, particularly alcohol and sleeping pills like Valium or Normison. While overdoses caused by a single high IV dose of pure heroin may cause immediate death, many overdose victims do not fall into an immediate coma as is often the portrayal of OD in popular culture. It is often a prolonged process of breathing becoming slower, the brain becoming damaged through lack of oxygen, and eventually the person dying. This means that the person can generally be helped if they have assistance in time. In fact, at least 80% of fatal heroin Ods occur because the person used on their own. Early detection signs of overdose are not being able to get a response, very slurred speech, lips turning blue, and slow breathing.


WHAT OTHER RISKS ARE ASSOCIATED WITH USING HEROIN?

Regular heroin use can lead to physical and psychological dependence. It takes using the drug daily for several weeks for this to occur. Regular use will also lead to increases in tolerance, meaning you will need more of the drug to achieve the same effect. The result of this is that many dependent users rarely reach the level of high which they are hoping for, instead spending most of their time at a functional level, with perhaps a decent high for a short time after the hit.

As a habit progresses, the money required to maintain it can be significant. This can cause many problems, which many people equate with heroin use, but is not an automatic consequence at all. Low body weight (nausea can affect this too, but poverty moreso), and stress-related mental illness are two examples. When prescribed heroin was trialled in Switzerland, the body weight of 90% of trial participants came within normal range within a year, and rates of mental illness fell to 5% - lower than in the Swiss population at large.


WHAT IS HEROIN WITHDRAWAL?

If a user ceases consumption of opiates after developing dependence, they will experience withdrawal. Physical withdrawal from heroin peaks on the 3rd or 4th day, and is pretty much over by the 8th day. Level of severity and types of withdrawal symptoms experienced can be very individual. A user consuming more each day will tend to have more severe symptoms than a friend using less, but gender, age, state of physical and mental health, and many other thing can affect this.

Withdrawal symptoms include aches and pains, sweating, itches, sneezing, sleep disturbances, hallucinations in cases of heavy use, and vomiting and nausea.


WHAT IS "HEROIN TREATMENT"?

Although we are refused prescription heroin, users are offered drugs like methadone and buprenorphine, supposedly to "treat" your dependence. These drugs simply maintain your habit, and withdrawal will be experienced if you stop using them straightaway, same as with heroin. They can be very important, providing people with a way of functioning without heroin, but prescription diacetylmorphine could meet this role just as well.

Naltrexone is a drug which blocks the effects of opiates. If you have already withdrawn from heroin you can take this drug and you will not be able to feel the effects of any heroin you take. The theory here is that you won't buy heroi if you can't feel it. The drugs effect only lasts 48 hours, so some users choose when to take Naltrexone, and when to stop so that they can use in a few days time. It does not "stop cravings" , contrary to how it has been promoted.


HOW DOES HEROIN AFFECT SEXUALITY?

In smaller doses many users find that heroin stimulates libido, and increases sensuality and connection with a partner. Orgasm is generally more difficult to achieve, but this can prolong the sexual act and enjoyment. In larger doses orgasm may prove impossible, which can be frustrating, and some people find it embarrassing.

In dependent users, high doses, out of control stress levels and a poor state of general physical health often contributes to suppress libido. This generally returns (with a vengeance) following withdrawal. Many users also find that sex helps relieve tension during withdrawal, while other users find physical touch abhorrent during this brief period.


WHAT ABOUT THE FIRST TIME I USE IT?

Many users find their first experience to be not all that fun. In my case I used the drug again to try and achieve the effects experienced by my friends, and had to go through several unpleasant experiences before I got what I wanted out of the drug. Nausea and vomiting will often continue for several hours during these first attempts. It may seem funny, but many users actually find the vomiting to be not all that bad, particularly when compared with being sick while on alcohol or amphetamines.

Other users report their first time to be amazing, and say that they are unable to reach that level of enjoyment again. This is perhaps analogous to ecstasy and speed experimentation, where many users report their first times as their best.


DOSAGE

The amount of any drug required to provide the desired affect will obviously differ from person to person depending on body weight, metabolism, and tolerance, and purity of material.

A sufficient starting dose for most users on their first experience would be between 5 - 20 mg injected, or 20- 30 mg smoked. In Melbourne the market price is around $300 a gram, and this is split up into probably 15 $50 caps. This means there is about 66 mgs in each cap. This means the average sized first time user should start off with maybe 1/5 or of a cap.

With tolerance, habits can easily develop to the point of 1 gram a day or beyond. The average dependent person probably uses between 150 - 250 mgs per day, divided into 3 administrations.

Heroin can be active when eaten. It is estimated that an active dose when eaten starts at around 60 mg for a user without tolerance. Oral doses exceeding 200 mg in said user would probably be sufficient to lead to overdose.


HOW IS HEROIN USED?

Heroin can be active through most forms of consumption - snorting, smoking, eating, shafting and injecting. In areas where heroin is legal or very affordable, many users smoke or snort their drugs. Injecting heroin is the most efficient use of the drug, and thus users can take a smaller amount to achieve the same effect.

A recent survey done with young Indo-Chinese heroin users in Melbourne & Sydney indicated that 90% of them started smoking heroin, but that the overwhelming majority now injected. The main reasons given for this was that smoking became too expensive and that to get stoned, they needed to inject.

To smoke, heroin is generally placed on a piece of foil or very thin piece of metal. A cone shaped tube is made out of foil or paper, placed to the mouth, and held above the drug. A flame is held below the metal, the drug is heated into smoke and the user "chases" the smoke up with the tube.

To inject heroin is mixed with water to form a relatively clear solution. A few types of heroin will require heating to break down, although often the gunk left after mixing heroin is not the drug at all, rather adulterants. Some forms of heroin are also alkaline, and require an acid to be broken down. Lemon juice should not be used as it can contain a dangerous fungus, so white vinegar is far safer. Alkaline dope is quite rare in Australia at this time.


ARE THERE RISKS ASSOCIATED WITH CONSUMPTION?

Many of the health risks associated with heroin use are actually associated with its consumption. This essentially means that they are risks which can be minimised or avoided altogether.

Injecting has quite a few risks. Long term, heavy use can lead to serious scarring around the veins, and in some cases vein loss or collapse. The condition of veins is generally far worse in areas where users cannot have a new needle for every injection. Used needles tear veins and cause greater scarring. Scarring can also be reduced through the use of creams like Hirudoid or Vitamin E. Veins have the ability to reroute themselves, choosing to divert the flow down different veins when veins are scarred and flow rate is reduced. However these veins are often a lot weaker than the ones previous, and can be damaged more easily. Injecting beyond the arms can have dangers, as some of these veins may be very thin, centred close to nerves, or might be confused with arteries.

If you hit an artery (generally when injecting into the groin or legs) the blood will shoot back into the syringe with a great force. Do not inject under any circumstances, or you will most likely lose the limb. Remove the syringe, elevate the site and apply pressure for at least 30 minutes. Medical advice is a godd idea.

Sharing needles and syringes is a very effective vehicle for the transmission of viruses passed through blood, like HIV or Hepatitis C, because blood is taken directly from a vein and injected straight into another. These viruses die off with time away from the body, so that syringes found on the street rarely contain these viruses (but of course may have other nasties in them.) In approximately 40 million cases of HIV worldwide, zero are believed to have been transmitted through outdoor needlestick injuries. In appropriate disposal is an environmental nightmare, and creates image problems for users, so doing the right thing with used syringes is important on those levels.

If you don't have access to clean equipment seriously consider another route of administration. The stone from smoking is quite nice. Smoking can obviously create some respiratory difficulties after a while, and snorting may cause nasal bleeding and dryness, but these are generally long term risks, so alternating methods can be a great idea.


WHAT HAPPENS IF I COMBINE HEROIN WITH OTHER DRUGS?

Some ravers first use heroin as a comedown drug, as it can aid sleep and relieve pains associated with a heavy nights partying. People should beware of trying to push too hard through existing amphetamine effects, especially if alcohol has been consumed. The combined depressant totals may be enough to significantly slow down the respiratory system.

Cocaine and heroin is a fairly famous combination often referred to as speedballing. In other areas speed and heroin go by the same name. Either way, this combination places a fair amount of strain on the heart, and John Belushi and River Phoenix have both died of a speedball combination (morphine is also sometimes substituted for heroin in this combo.)

An interesting aside is that cocaine use actually increases the number of opiate receptors. The more receptors you have, the more drug it takes to fill them, and therefore the more drug you need to get you stoned. So using coke actually increases your tolerance to heroin..


SOURCES

A: Bargas, Berger, Ciaranello, & Elliot (1977). Psychopharmacology From Theory to Practice

Thanks to Jocelyn Woods, National Alliance of Methadone Advocates for "How Methadone Works" ACTIV News, Australia, Vol 2 No 3 1996.


REVISION HISTORY & CREDITS

v 1.0 Oct 23, 2000 Original FAQ by Anonymous author
v 1.1 Oct 28, 2000 FAQ HTML'd and minor edits made by Erowid.org