Heroin. smack : brown : skag : diamorphine : H WHAT & WHY?

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1 WHAT & WHY? Heroin smack : brown : skag : diamorphine : H No. 5 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION

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3 What? Heroin is made from the sap of the opium poppy, Papaver somniferum, which has been the most effective painkiller known to medicine for at least 7000 years. The pharmaceutical name for heroin is diamorphine.

4 All drugs derived from the opium poppy have similar effects and are known as opiates. Synthetic drugs manufactured to mimic the effects of opiates such as methadone (Physeptone) and buprenorphine (Subutex) are known as opioids. Most of the illicit heroin imported into Britain comes from poppies grown in Pakistan and Afghanistan. Before it is exported it is processed from the raw opium sap into a brown powder which is around 70% pure heroin. The process involves mixing it with a sequence of chemicals, including hydrochloric acid and acetic anhydride (a chemical used in the manufacture of film). The mixture is dried and sieved between stages. Brown heroin is intended for smoking and is usually mixed with caffeine during manufacture to help release the drug at high temperatures for absorption by the body. To smoke heroin, users heat the powder on silver foil with a lighter. As it melts and boils it turns to a sticky tar which flows across the foil, giving off a rising column of smoke which is inhaled. This is known as chasing the dragon. Despite being made for smoking, some users inject brown heroin powder. As it doesn t easily dissolve in water they first have to mix it with an acid (usually ascorbic acid [vitamin C powder] or citric acid) to help it dissolve. Heroin can t be swallowed because it is largely inactivated by the stomach.

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7 Minimum amounts used usually cost If heroin is taken every day for more than a couple of weeks, the body becomes physically dependent, i.e. gets used to its presence and reacts if the person stops taking it. This reaction is called withdrawals. Using as little as 10 worth a day can create a level of physical dependence. Regular use also brings tolerance to the effects of the drug and dependent users either have to take breaks from using heroin or gradually increase consumption in order to feel the effects. Some users may spend in excess of 100 per day and still feel very little effect other than the absence of withdrawal symptoms. In contrast to legal drugs such as tobacco and alcohol, heroin itself does not damage any major organ (including the brain). However, injecting can lead to serious (preventable) health problems, including viral infection and overdose. The social problems associated with heroin use mainly stem from its illegality which keeps the drug expensive and encourages users to stay within a criminalised heroin-using social circle. The problems of heroin being cut with dangerous substances and the overdose risks of pure batches are media myths. The evidence shows that loss of tolerance following a detox, and using combinations of drugs with heroin, are much more dangerous.

8 Why? The effects of heroin are powerful. Most people experience a sense of the drug rushing through their body, bringing a very powerful, pleasant, relaxing effect, with a dream-like state of inner warmth and complete emotional insulation from all of life s problems.

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11 Not everyone enjoys the sense of detachment, and some first-time users describe an overwhelming feeling of discomfort. One effect of heroin that can be unpleasant is its tendency to slow the action of the intestine. This can induce sickness, and although people usually become tolerant to this, most dependent heroin users suffer from constipation. There is no simple answer to the question of why people take, or become dependent on, heroin. It is probably most helpful to try and understand heroin use on an individual basis, weighing up the relative importance of factors to do with: the person their psychological make-up, history, mood, emotional state, self-esteem and expectations of the drug; the drug the physical and psychological effects of the drug on the individual and its power to remove withdrawal symptoms; and society the ease with which the drug can be bought, the number of people using it, the attitudes of the person s peer group to the drug, employment status etc. Although some users may take it occasionally, heroin offers most users an unparalleled state of mind. Once used, many find it difficult not to keep going back for more. Dependence often takes weeks, months or even years to develop. The pattern is usually one of reducing times between occasions of heroin use, and moving from single doses every now and then to taking it every day for longer and longer periods.

12 The way epidemics of heroin use amongst young people have swept across the country in clear patterns spreading out from inner cities into rural towns as supply chains are set up has clearly demonstrated that availability of the drug is also a key factor in the rise in its use. Trying to understand this interplay of psychological, chemical and social factors is probably more helpful than trying to fit people into theories which say that those who take drugs or become dependent are victims of peer pressure or different because they have an addictive personality. Although many dependent users say that the main thing that drives them to continue using heroin is avoidance of withdrawals, it is important to understand the psychological component of the dependence. When people detox and find themselves feeling very emotional they often feel that this isn t normal and that they have to take more heroin in order to cope. The task of developing coping mechanisms to replace drugs is often the hardest thing for those trying to get off and stay off heroin. For those who are unable to stop, particularly injectors, a maintenance prescription for a substitute drug such as methadone can be a life-saving intervention.

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14 01 Smoking heroin, known as chasing the dragon Photo: David Hoffman Photo Library 02 Papaver somniferum the opium poppy Photo: A Z Botanical Picture Agency 03 Heroin in a wrap Photo: Murdo Macleod Photo Library 04 Chasing the dragon Photo: Jamie Baker/Demon Imaging 05 Injecting Photo: Jamie Baker/Demon Imaging 06 Heating the heroin, water and citric acid solution to help the drug dissolve Photo: Jamie Baker/Demon Imaging 07 Injecting paraphernalia Photo: Jamie Baker/Demon Imaging

15 WHAT & WHY? weed : dope : bud : skunk : hash : oil No. 1 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION WHAT & WHY? speed : whizz : base : amphet : sulphate No. 2 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION WHAT & WHY? mdma : E : pills No. 3 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION WHAT & WHY? c : coke : charlie : rocks : freebase No. 4 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION WHAT & WHY? smack : brown : skag : diamorphine : H what drugs are and why people take them SECOND EDITION WHAT & WHY? meth : physeptone : juice No. 6 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION No. 7 in a series of guides to help people understand what drugs are and why people take them SECOND EDITION Written by Andrew Preston What & Why? 5: Heroin. Second edition. Published by Exchange Supplies. ISBN Exchange Supplies Designed by fluke. Printed in the UK on recycled paper made from 100% chlorine-free post-consumer waste. Responsibility for all errors, omissions and opinions lies with the author. Exchange Supplies is an independent social enterprise producing information and resources to reduce drug-related harm. For more information go to: The What & Why? series covers cannabis, amphetamine, ecstasy, cocaine, heroin, methadone and harm reduction. All titles in the series are available direct from: Exchange Supplies, tel: Additional information on LSD, mushrooms, addiction and motivation are available on our website: Exchange Supplies, 1 Great Western Industrial Centre, Dorchester, Dorset DT1 1RD. Tel: Fax: info@exchangesupplies.org Cannabis 1 Amphetamine 2 Ecstasy 3 Cocaine Crack & 4 Heroin No. 5 in a series of guides to help people understand Heroin Methadone 6

16 What & Why? is a series of booklets for anyone who wants to understand illicit drug use. Illustrated with stunning photography, What & Why? explains what drugs are (how they are made, sold and used), their effects and why people choose to take them. Essential reading for anyone confronted with illicit drug use at home or at work. What & Why? is written mainly for professionals, parents and the relatives and friends of drug users. The booklets may also provide a useful contribution to secondary school discussion about drugs.