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

Heroin belongs to the group of pain-killing drugs known as opiates. In themselves, opiates are relatively safe drugs, and are used by doctors for treating severe pain, such as in cancer patients. Some over-the-counter remedies contain codeine, also an opiate.

According to DrugScope, the UK's main independent centre of expertise on drugs, people who obtain heroin or methadone on prescription and who maintain a stable, hygienic lifestyle do not necessarily suffer serious physical damage. Research studies conducted in England and Scotland in 2004–2005 demonstrated that some people can take heroin regularly without its use getting out of control. However, most people find this hard, and this is where problems start.

Is recreational use possible?
It's easy to build up a physical tolerance to heroin, so it soon becomes hard to use it just recreationally or occasionally. Instead, users become dependent on the drug to the extent that it becomes the focus of their lives, sometimes replacing other priorities like relationships, education and work.

Many people start out thinking they can control their heroin use, but within a short time (2–3 weeks of repeated use) tolerance builds up. Users find that they have to increase the dose and/or change how they take the drug. It's often at this point that heroin smokers start injecting. Tolerance will build up more quickly if the drug is injected. There is greater risk of overdose. Injecting also puts users at risk of ulcers, abscesses, collapsed veins and infection with hepatitis B and C, and HIV. Even if the user is able to continue increasing the dosage, eventually they will be using heroin just to keep them feeling normal and to avoid withdrawal effects.

This is another reason why it's hard to take heroin in a recreational way. Because the symptoms of withdrawing from heroin are so unpleasant, and because they start so soon after you stop taking the drug (8–12 hours), it's not surprising that heroin users find it hard to take a break from using the drug, even if they want to.

These physical symptoms are temporary, but heroin users also become psychologically dependent. This is not only because of the feeling of comfort and detachment it produces in the user, but also because using heroin is very much based around routines. These routines include buying and dealing heroin as well as preparing it and using it. Users find it hard to break these routines, especially if there are other heroin users in their immediate environment.

Diagnosing a heroin problem
If someone thinks they may have a problem, it's likely they do. However, it can be hard to be honest about drug use. It could be useful to answer the following questions – the more 'yes' answers, the more likely it is that you need change your use.

• Do you need heroin on a daily basis just to feel normal?
• Do you need to use more and more to get the effect you want?
• Do you continue to take it despite negative consequences?
• Have you changed your method of taking heroin? For example, have you moved from smoking to injecting heroin?
• Have you tried to give up or cut down, and failed?
• Has your work or education suffered as a result of drug use?
• Have you ever stolen drugs or stolen money to obtain drugs?
• Has using heroin affected your relationships with family, friends or partners?
• Do you feel it's impossible to live without heroin?

There are also official definitions. The Advisory Council on the Misuse of Drugs defines a 'problem user' as someone who is 'either experiencing or causing social, psychological, physical or legal problems related to their self-administration of drugs'. Any form of injecting drug use is also considered 'problematic'.

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