Heroin: Advice for staying safer
This page is about heroin, its side effects and risks, how to keep yourself safer, and how to access support to address your heroin use.
Heroin is a very strong opiate that usually comes as a white or brown powder. People take it by injecting it with a needle, smoking it, snorting it, or using the method called UYB: ‘up your bum’.
It is very easy to overdose on heroin, and you can quickly become dependent on it. On this page you’ll find lots of advice for reducing the risks of heroin, and how to access support to address your drug use.
Side effects and risks of heroin
It’s very easy to overdose. Heroin is a sedative, so it slows the way your body works, including your breathing. If you take too much, your breathing will slow down so much you can fall into a coma and even die. In the UK, more people die from heroin use than from any other illegal substance.
It’s very dangerous to inject. It’s much easier to overdose from injecting heroin than taking it any other way. Smoking it or taking it orally can still result in overdose but are less risky to your healt.
Using a needle can cause abscesses, ulcers and damage to your veins and skin. Using an unclean needle, sharing needles or using the same needle more than once can also pass on viruses like hepatitis C, hepatitis B and HIV.
Heroin reacts badly with other substances, including alcohol. It is especially bad for you when you take it along with other sedatives, such as benzodiazepines or methadone.
It is often contaminated with other substances. People often mix heroin with other drugs before selling it, which means you don’t always know what you’re taking. This makes it easier to overdose.
Many drugs are now contaminated with synthetic opioids which can be hundreds of times stronger than heroin, so always test dose before every use.
If you become dependent, not taking heroin will cause very unpleasant withdrawal symptoms. These can feel like a heavy flu, and include aches and pains, shakes, tremors, feeling sick, sweating, chills and diarrhoea.
If you notice withdrawal symptoms when you are not taking heroin, please do not stop using suddenly. Get in touch with your local treatment service and speak to a doctor about safely reducing your use and stopping.
Know the signs of overdose
Keep an eye out for someone if:
- They are making deep snoring/gurgling noises.
- You can’t wake them up, and they don’t respond if you shake their shoulders or call their name.
- They have a blue or grey tinge to the lips, nail beds or other extremities.
- They have stopped breathing.
Always call 999 if you think someone is having an overdose.
Don’t be scared that you’ll get in trouble. The ambulance will not bring the police except in very particular cases.
Carry naloxone – the overdose reversal drug. Using naloxone can temporarily stop the effects of a heroin overdose. You can get a free naloxone kit and training from your local Change Grow Live service.
Find out more about naloxone and how it could help you save a life.
Stay safer
If you’ve had a break from heroin, don’t go back to your old dose. Your tolerance to heroin fades away after just a couple of days, so your old dose will be too high and the effects will be much stronger. Start with a much smaller amount to help prevent an overdose.
Only take heroin when someone else is around. If you become ill or start to experience an overdose, they can call for help. If you have a naloxone kit, make sure other people know about it so they can use it in an emergency.
If you must use alone, have an OD buddy who you can contact before using to let them know where you will be; ask them to check on you at an agreed time; and discuss what they should do if you don’t respond to their follow-up call. You can also make a plan with your worker.
Take a look at our advice for safer injecting. The best way to stay safe is by not injecting, but you can lower the risks of infections and injuries by following the advice in the link below. You’ll find tips for keeping your equipment clean and the safest areas to inject into.
Read our advice for safer injecting
Get new, sterile equipment from a needle exchange. You can also safely get rid of old equipment and get lots more advice about keeping yourself safe.
Find out more about needle and syringe programmes and how to find one.
Avoid injecting and try another way of taking heroin. Smoking, snorting and inserting heroin up your bum still carry risks, but they are all safer than injecting.
To snort heroin, cut it up into small lines on a clean surface. Start with very small lines and wait to see how they affect you before taking more. Don’t share notes, straws or any other items you use to snort.
To smoke heroin, put creases into a square piece of foil. Put a very small amount of heroin on the foil and heat it up from below with a lighter. The heroin will heat up and turn into a small drop of liquid. Move the bead of liquid along the creases in the foil and inhale the vapour it gives off with a straw. Don’t share your straw with anyone else.
To insert heroin up your bum, use a 1ml syringe with the needle removed. Do not use the syringe with the needle still attached and use lube if you can get it. Prepare the heroin in the same way you would for injecting, but put the syringe a short way into your bum and gently squirt.
Avoid reusing or sharing equipment, or using dirty equipment, just like you would with an injection.
Avoid mixing with downers. Drugs such as benzodiazepines (benzos) or alcohol can be fatal if taken together with heroin.
Get treatment and support for heroin
If you want to take steps to address your drug use, don’t be afraid to reach out for help. You’re not alone and there's nothing to be ashamed of.
There is lots of help and support available. Speak to your doctor about how you’re feeling and speak to supportive family and friends if you can.
Advice and support are always available from your local Change Grow Live Service. We’re here to help.
We offer lots of options, including prescriptions for heroin substitutes such as methadone and buprenorphine. These are much safer alternatives to heroin.
They can help you to withdraw from opioids you’ve become dependent on and work towards quitting heroin. If you’ve tried them before and have stopped for whatever reason, we still welcome you to get in touch. We can chat about your needs and find a treatment approach and dosage that's right for you.