Opiates & Opioids (eg Heroin)

Opiate is the name given to drugs which derive from the opium poppy (opium, morphine, heroin, codeine). Opioid is the name given to their synthetic equivalents (methadone, pethadine, palfium etc). Traditionally these drugs have been used in the treatment of pain, particularly with terminally ill patients, Heroin in its purest form (diamorphine) is the most powerful painkiller available. It produces a mental and physical state of euphoria helping a patient to suppress pain. Opiates / 0pioids act upon the pain receptors in the brain, acting in a similar way to the body's natural painkillers (endorphins and enkephalins). }It is the effect of euphoria and related detachment which makes heroin and other opiates / opioids attractive to those who want to use drugs for pleasure. This group of drugs will make the user feel warm, contented and drowsy, although initially, the individual may feel nauseous and vomit until their body has become used to the drug.

In its pure form, heroin is a white powder most often used for injecting, but it can also be bought in a brown granulated form often used for smoking. Before being sold on the street, it is usually diluted ( or cut ) with other substances ( flour, talcum powder, glucose, baby laxative etc for white heroin ) so that a person using street heroin can never be totally certain what substance he/she is using.

Heroin can be snorted, smoked or injected. The process of smoking heroin is called "chasing the dragon", where the user inhales the fumes given off as the powder is heated on foil. When injecting, the powder is dissolved in liquid which can be injected intravenously ( into a vein ), intramuscularly ( into a muscle ), or subcutaneously ( beneath the skin ).

Opiates/opioids are potentially "addictive" whether snorted, smoked or injected. Once tolerance develops the user may experience cravings when the drug is not available, as someone might crave a cigarette or alcohol: A person who experiments with heroin once or twice will not become addicted - it takes, time. It is possible to use heroin recreationally without becoming dependent and without needing to increase the dose.


In small amounts, opiates / opioids are probably not physically damaging. They have the effect of depressing the central nervous system including respiration and heart rate, and blood vessels are dilated (which is why users experience a sense of warmth). Users are also likely to experience chronic constipation. In smaller doses there is little change to motor skills or intellect, while higher and regular doses make the user feel drowsy, relaxed and detached. Interest in food and sex is reduced. These sensations are intensified when the drug is injected. If injecting into a vein, the user experiences a rush, an immediate pleasurable sensation lasting less than a minute. This occurs as the drug enters directly into the blood stream and targets the pain receptors in the brain, gut and genitals. Injecting under the skin (skin popping) or into a muscle gives a slower and less intense experience. Smoking heroin produces as fast a response as intravenous injection, but not as intense because the dose is smoked over a period of time rather than injected all at once.

It is possible to overdose on heroin if the drug is purer and stronger than expected, or if the user has not been using the drug for a while and their body has lost tolerance. The risk of overdose is increased if heroin is used in conjunction with other drugs such as barbiturates or alcohol.


As tolerance develops there may be a tendency for users to move from snorting or smoking to injecting to maximise the effect for the amount of heroin used.

Long term injecting can carry many risks from the use of unsterile injection equipment and from the injection of adulterants. Unsterilised and shared needles can transmit infections such as hepatitis B and the HIV virus; while repeated injection of adulterants can contribute to respiratory disease, damaged veins, blood clots, abscesses, tetanus etc Repeated snorting of heroin can aggravate the nasal passages.

Personal neglect sometimes associated with opiate / opioid use (lack of food, bad housing etc) can contribute to the general bad health of the user. However, opioids such as methadone, as compared with impure street heroin, are relatively kind drugs .to the body. A stabilised user on a prescribed daily dose of methadone is under no physical threat and is virtually indistinguishable from any non-using member of the public.

Once a user has developed tolerance to the presence of opiates / opioids, a withdrawal syndrome can be expected to set in generally between 8-24 hours after the drug was last taken. The experience of withdrawal is very much affected by the expectations of the user, but certain physical symptoms are common, such as running nose and eyes, hot and cold sweats, insomnia, nausea, vomiting, diarrhoea and muscle cramps. Recovery usually takes 1-2 weeks, though it may take longer for sleep patterns to return to normal. Sudden withdrawal is not life-threatening in the way it can be with barbiturates or alcohol, provided there is no serious underlying medical condition.

There is often a severe psychological reaction to stopping use, when the individual feels unstable and vulnerable, and this is why the greatest hurdle in stopping use is adjusting to life without drugs.

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