A Guide to Heroin (And Other Opiates)

A Guide to Heroin (And Other Opiates)
Photo credit: Kondor83 / Shutterstock

In this comprehensive guide to heroin, we outline everything there is to know about the drug, whether it is legal, the dangers of taking it, and how to prevent becoming addicted to the drug, as well as how to treat heroin addiction.

What is heroin?

Heroin, better known as diamorphine in the medical world, is part of a broader group of drugs called opiates, which derive from opium poppy plants grown in Asia, Mexico, and Columbia. Opium is the dried milk component of the poppy and it contains other drugs such as morphine and codeine, both of which act as effective painkillers today. Heroin, however, is developed from morphine and at its most pure, comes in a white powder, although it can also be in the form of a brown powder or a black sticky substance.

When used, medical heroin can be provided in the form of either tablets or an injectable liquid. Although, it can be smoked, snorted, and prepared for injection for non-medical uses too, all of which are heavily prohibited in the UK. Individuals that cannot gain access to heroin often seek synthetic opiates instead which are manufactured for medical application yet have similar effects to heroin.

Informal names: Boy, brown, china white, dragon, gear, H, horse, junk, skag, smack.

Medical names: Diamorphine, morphine, methadone, opium, codeine, pethidine, dihydrocodeine (DF118), palfium, Diconal, Temgesic, physeptone.

The history of heroin

The earliest known reference to opium usage was in the Middle Ages, some 6,000 years ago, when it was used for medicinal and recreational purposes by the Ancient Greeks. Following this, opiate use in China soon became widespread, with much of it being imported from India via a British company called the East India Company, from which the British government had a lucrative cut of the tax revenue. Although the Chinese attempted to introduce harsh laws restricting the use of opium, they were unsuccessful following a showdown between British troops and Chinese authorities.

Opium continued to see increased trade, with almost 15 million of the Chinese becoming regular smokers of the drug. Following this prevalence, they decided to legalise it and grow their own poppies to fill the demand. This eventually outstripped the India-grown supplies and enabled China to become their own main supply for opium use, as well as the mains supply for it amongst Europe too.

From the 1550s, Opium became known within Europe, including the UK, in the form of medicine. Later into the 17th century, drugs that combined opium with alcohol were used to treat pain, aid sleep, soothe coughs and remedy diarrhoea in a variation of ailments. This trend continued, with the drug becoming popular amongst renowned creative writers. Although, there were numerous infant deaths that arose from opium overdose, which triggered regulations on the sale of it in 1868.

Morphine was initially synthesised from opium by a German chemist in 1805 and was treated as a non-addictive and magical medicine. However, thousands of soldiers returned from the American Civil War with an addiction to the morphine that they were provided to ease the pain endured from their injuries, which ran contrary to these claims. However, yet another German chemist later created heroin out of morphine, with the drug once again advertised as a non-addictive drug that could be used as a substitute for morphine. However, it is regarded to have a significantly higher potency than morphine, meaning addictions soon occurred and continue to today.

Today, purer forms of heroin are becoming increasingly common yet much of the heroin found and distributed on the streets is ‘cut’ with various other substances.

Heroin use in the UK

Today, individuals consume heroin in three main ways: by smoking it, injecting it, and by snorting it. Within the past few years, the reported price of a 0.1g bag of heroin was roughly £10 within the UK.

Within the UK, it is predicted that opiates were behind 80% of all drug-related deaths recorded in 2018, making the reported number of heroin-induced deaths the highest they have been for numerous years according to the Home Office and Public Health England. Despite this being the case, heroin use has actually decreased in the UK, with the Home Office reporting that only 0.1% of adults throughout England and Wales had taken heroin in the year prior to the survey.

The associated risks of heroin

Due to the strength of heroin, doses can cause dizziness and nausea. However, the desired effects are that of relaxation, euphoria, and sleepiness. A heroin overdose is the most common reason for killing individuals in the UK compared to other illegal drugs, since heroin carries the risk of slowing your breathing down to the extent that you can fall into a coma or die.

An injection of heroin is even more dangerous since it is considerably easier to overdose from the drug when consumed in this way. There is also the risk of spreading a virus through sharing needles and syringes, potential damage to your veins, and even blood clots due to the injections. Often, injecting heroin causes a disease called gangrene, which is the death of certain body parts that comes with the infection.

The consumption of heroin alongside other drugs also has heightened risks. For example, the consumption of alcohol along with heroin significantly increases the possibility of an overdose due to its effects on blood pressure and heart rate, often resulting in sedation, comas, and even fatalities. Cocaine used alongside heroin can also cause serious harm since these two drugs have competing and opposing effects on our nervous systems which can result in an overdose and other alarming effects. This is true of mixing opioids in general with either alcohol or cocaine.

The effects of long-term heroin addiction extend beyond health risks too, from effects on finance, nutritional intake, self-care, and poor access to secure housing.

Treatment and prevention of heroin harm and addiction

Heroin is one of the most addictive drugs on the market and those that take heroin find that their brain develops strong cravings to continue using the drug. As with most addictions, since heroin is typically consumed regularly by users the body becomes tolerant to the drug, and users are required to take higher doses of heroin in order to feel the same highs that they initially did when taking the drug. The danger with this is that overdoses can arise more promptly than with other drugs. For this reason, professional help is often sought to respond to heroin and other opiate addictions.

Those with a heroin addiction might exhibit some of the following symptoms:

  • Constricted pupils
  • Respiratory issues
  • Frequent chest infections
  • Constipation
  • Damage to the skin caused by injections
  • Major unexplained weight loss
  • Seizures
  • Anxiety and depression
  • Nausea
  • Blood clots
  • Withdrawal symptoms
  • Pneumonia and tuberculosis
  • Malnutrition and exhaustion
  • Profuse sweating
  • Tremor and chills
  • Muscular spasms

Treatment and prevention of heroin addiction have proven especially challenging since once you have a break in taking heroin, even for a short period of time, your tolerance will decrease dramatically, meaning an overdose is far more likely when it is next consumed. In a bid to treat addictions, therefore, doctors are using safer equivalents to heroin to treat addiction in a sustainable way, these include drugs such as methadone and buprenorphine. These two drugs are useful in stabilising drug use.

Although many individuals can successfully overcome a heroin addiction, long term subsistence can prove incredibly difficult for many individuals. They may require some counselling and support when it comes to retrieving a healthy and secure lifestyle.

The law on heroin

Heroin and the various other opiates are regulated under the Misuse of Drugs Act, under which it is illegal to both possess and supply it without a legitimate prescription.


What class is heroin?

The Misuse of Drugs Act classifies Heroin as a Class A drug which means the penalties for possession without intent to supply being seven years in prison and or a fine. Meanwhile, if you are prosecuted for supplying heroin or other opiates, you may face a maximum sentence of life imprisonment and or a fine. However, it is worth noting that the maximum sentences are not often applied in practice, save for exceptional cases.

There is, of course, the possibility for a select few specially licensed professionals to prescribe heroin in the course of treating addiction or similar drugs to relieve individuals suffering very severe pain.

For more information on how heroin and other class A drugs are regulated, see the Misuse of Drugs Act.