Use and abuse
Heroin stories
Friends and family
Heroin and the law

Starting points
Why do people start taking heroin? Often it's just curiosity, the desire for experimentation, maybe after other drugs have been tried. Some people's heroin use is a progression from other drugs such as cannabis, ecstasy, speed and cocaine.

Some people try it because they know it makes them feel better about things that are wong in their lives. Opiates are particularly effective, because they're painkillers that level out psychological as well as physical pain. Sarah started using heroin soon after a close friend's baby died, an event that affected her severely.

'I've never been able to get the look in her eyes out of my mind... The father of the baby gave me some Valium to calm me down. I had taken pills and drugs before but only socially. I loved the way I felt that night, even through the stress and pain. The next day I went out looking for a bag of gear.'

Heroin lifestyles
Although heroin use is often associated with a certain kind of deprived lifestyle, some people can take heroin regularly without its use getting out of control. However, because heroin is so addictive, it can become the focus of your life, to the detriment of other important factors such as health and education. Knock-on effects include unemployment, dropping out of school or college, and neglecting family. Heroin's illegal status means that there are risks to your safety, especially if you become involved in dealing, as Sarah did.

'I really enjoyed the people, with all the fake confidence drugs give you. But the downside was never having a minute's space. Also the constant not knowing where I stood with people. I think the worst thing that happened was when six men, all with balaclavas, broke through my door one day. They had several weapons: guns; a harpoon gun, loaded; and a knife. It was obvious they were on crack as they were hyped up and panicky. This made me even more scared. Having a gun put to my son's head was one of the scariest experiences I've ever had.'

She also experienced health damage caused by smoking and then injecting heroin.

'I have been really underweight (five and a half to six stone), to the extent of having no energy for anything. And my lungs were so screwed up that I couldn't walk up to the phone box without stopping for breath. Each morning I had to spend 30 minutes or so before I could breathe well enough to take my gear.'

Relapse
Even when heroin users have stopped taking the drug and gone through physical withdrawal symptoms, it's easy to relapse. Sometimes this is due to stressful situations, or a setback such as losing a job or a partner. Other times, it's due to the presence of other users, especially those you use to use with. Many users will relapse many times in their lives.

'Even if I managed to stay clean for a few months, I would use again. I would probably start to drink first, then I would want a smoke with it. Then one day when I'm pissed up I would let it into my head that one bag of gear is OK. Once using again I would begin to deal again. Being in a big city there would be plenty of drugs for me to use. Also plenty of stress for me to use to keep my excuses strong.'

Going into rehab
It is possible to detox on your own, but a lot of drug users need more help. A residential rehab programme can include taking medication such as methadone or Subutex, and other activities. Sarah's rehab involved meetings, parenting groups, physical exercise and one-to-one work with key workers, which gave her a strong sense of routine. It also helped her look at why she used heroin in the first place.

'A lot of my using was because of my lack of confidence and low self-esteem. Admittedly drugs gave me confidence, but it was a fake confidence that left me when the gear wore off. Treatment gave me the chance to build my confidence and self-esteem. The rehab I went to has a very wise ethos: they focus on people taking responsibility and on honesty, as well as supporting you.

'Recovery is a process, one I'm still living and which will always be a part of my life. But I am more liberated than I've ever been. For every difficult feeling I let myself experience, there is a good feeling that no drug could achieve.'