Heroin and Opiates

Slang
H, Smack, Homebake, Misties, Morph, Morphine, Scag, Schmack, Dope, Gear, Junk

How it is taken
Injected
Smoked
Snorted

Common Effects

• intense pleasure
• a sense of wellbeing
• pain relief
• drowsiness, warmth and sleepiness
• decrease in breathing, blood pressure and pulse
• diminishment of hunger and sexual urges
• nausea and vomiting

What it is
Heroin is in the opiate group of drugs. Opiates come from the sticky resin from the opium poppy seedpod. Other opiates include opium, morphine, methadone, codeine and pethidine.

It is a highly addictive drug and there is significant risk of overdose.

In New Zealand, 'homebake' can be manufactured from over-the-counter and prescription painkillers, and the most common source is morphine tablets. In other countries, heroin is more common.

Opiates are classed as depressants, although they won't necessarily make a user feel depressed. Depressants slow down activity in the brain and central nervous system. Other forms of depressants include alcohol and cannabis.

For centuries, opiates have been used both recreationally and medicinally. While the recreational use of opiates is outlawed in most countries, their use as a painkiller is widespread, especially when they are produced in laboratories.

Methadone is often used as a replacement therapy for people addicted to opiates. A newer product called buprenorphine is also used as a replacement for heroin.

Short-term effects
Under medical supervision, the short-term use of opiates do not produce significant health problems, and many people are prescribed opiates such as pethidine for a few days following an operation.

Using greater amounts may cause loss of concentration, nausea, sweating, itching falling asleep ('on the nod'), and slow and shallow breathing. This is potentially dangerous and could lead to death.

Pure opiates, such as pure heroin, are relatively non-toxic to the body. However, heroin bought from the illicit market and homebake are usually cut with other substances, such as caffeine and sugar, and some of these additives can be very poisonous. Not knowing the purity and therefore, not knowing how much to take, can lead to overdose.

Because much of the opiate supply in New Zealand is homebake or derived from morphine sulphate tablets, and not pure heroin, the risk of abscesses is high. Other substances used to process homebake could be toxic.

Long-term effects
The long-term effects of opiate use include irregular menstrual cycles, constipation, infertility and loss of sex drive. In addition, long-term and heavy opiate users tend to spend less money on housing, food and other essentials, which can lead to malnutrition and increased susceptibility to infection.

Injecting opiates can lead to skin, heart and lung infections, collapsed veins and tetanus. Using dirty injecting equipment and sharing needles increases the risk of contracting HIV and hepatitis.

Dependence, addiction and overdose risk
Using large doses of heroin and other opiates can lead to death. This can be because the user has used too much heroin or a particularly strong or pure batch.

Breathing becomes very slow, the pulse becomes irregular and the body temperature drops. Blue lips and fingernails, pinpoint pupils, cold skin, convulsions and snoring can also indicate an overdose.

Because opiates cause physically dependency, a person who stops or reduces the amount they use may suffer withdrawal symptoms. These symptoms include craving the drug, restlessness, yawning, tears, diarrhoea, low blood pressure, stomach and muscle cramps, vomiting, goose bumps and a runny nose. These symptoms usually peak around two to four days after the last time a person uses the drug.

Other symptoms that may last up to a week after last use include insomnia, irritability, appetite loss, vomiting, elevated pulse, muscle spasms and emotional depression. Sometimes, symptoms including chronic depression, anxiety, insomnia, appetite loss and agitation. Further cravings for the drug can last for months and even years.

Sudden withdrawal from opiates rarely causes death unless the user is using other drugs and/or is in poor health.

The New Zealand context
Opiates are used by a relatively small proportion New Zealanders. Recent surveys do not indicate significant fluctuations in the rate of opiate use.

The prevalence of heroin is relatively low. Instead, much of New Zealand opiate use is derived from morphine sulphate tablets.

New Zealand has a well-developed needle exchange programme which allows injecting drug users to swap used needles for new ones. This service has lowered the rate of infection from communicable diseases like hepatitis and HIV/AIDS. The service also helps reduce the incidence of used needles being discarded in public places where other people could come across them.

It is estimated that heroin costs $1000 per gram in New Zealand, significantly more expensive than in other countries.

In 2001, 0.6 percent of New Zealanders surveyed were current users of opiates, stable from 1998.

The law and penalties
Heroin is classified in the Class A schedule of the Misuse of Drugs Act 1975, attracting a maximum term of life imprisonment for importing, manufacturing and/or supplying. Possession carries a six month imprisonment term and/or $1000 fine.

Opium, pethidine, methadone and morphine are scheduled as Class B drugs. The penalties on this schedule include up to 14 years imprisonment for manufacture, supply and importation, up to 10 years imprisonment for conspiracy to commit such an offence, and up to three months imprisonment and/or $500 fine for possession.

Some other opiates, including codeine and analogues of pethidine, are scheduled as Class C drugs. Importation, supply and manufacture would attract a maximum eight years in prison, or up to three months in prison and/or a $500 fine for possession.

Safe use
Infectious diseases, such as hepatitis and HIV, and skin infections are significant risks when using injecting drugs. Clean needles obtained from a needle exchange service should always be used to minimise the risk of attracting an infectious disease or skin condition.

Never share needles or syringes.

Because of the high risk of overdose, it is best not to use opiates alone. Having someone else around is important.

Opiates should always be filtered or boiled. Because most opiates in New Zealand are impure, the level of contamination with other substances can be high. Using a filter reduces the risk of contamination.

In the advent of an overdose, and ambulance should be called immediately. Ambulance officers are not obliged to involve police and the life of someone you know is at risk if they have overdosed. Stay with the person who has overdosed and apply mouth-to-mouth and CPR resuscitation until the ambulance arrives.

If someone is still breathing and has a pulse, keep them rolled on their side in the recovery position. A person could choke on vomit if they are left lying on their back.

How to get help
There are a number of treatment organisations that can help. If you feel that you or anyone you know needs help, then you can call these services in strict confidence.

If you are faced with an emergency, call 111 immediately.

To talk to someone about your or someone else's drug use, call the Alcohol Drug Helpline - 0800 787 797

You can also get contact details for your local alcohol and other drug counsellor or treatment provider by calling the helpline or by visiting www.addictionshelp.org.nz .

Links
www.needle.co.nz Information on needle exchange programmes around New Zealand.

The Heroin Vault and Opiate Vault hosted by erowid, a website offering chemical, health, media and user esperience information.