Heroin is made from chemicals in the opium poppy. It belongs to a group of drugs called opioids.
Heroin comes as a powder that people:
- smoke - on foil or in a pipe
- inject
- snort - but this is less common
Heroin use has a high risk of overdose. The risk is highest if you inject heroin. But you can overdose on heroin no matter how you take it.
Drug monitoring in Ireland found cases of nitazenes in heroin. Nitazenes have a high risk of overdose and death.
Drug category: opioid
Opioids are drugs that are made:
- from chemicals in the opium poppy (opiates) - such as heroin
- to mimic the effects of opiates (synthetic opioids) - such as fentanyl or nitazenes
Opioids relieve pain but have a high risk of physical dependency or overdose.
Other names for heroin
Other names include: brown, china white, dragon, gear, H, horse, junk, skag, smack
Effects of heroin
The effects of heroin can vary depending on:
- your size, weight and sex
- if you have any health conditions or mental health difficulties
- how you take the drug
- the strength of the drug
- how much you take
- if you take alcohol, medicines or other drugs at the same time
- where you take the drug and how you feel before you take it
- if you have taken the drug before and how often
If you inject or smoke heroin, the effects can start quickly and last for several hours.
How you may feel or behave
You may feel:
- warm, relaxed and secure
- calm
- confused or sleepy
- disconnected from your body
Effects on your brain and body
Heroin can cause:
- nausea and vomiting - often the first time you use it
- pinpoint pupils
- low sensitivity to pain
- slow heart rate and breathing rate
- constipation or diarrhoea
- drowsiness (goofing off)
- low or no cough reflex - this can lead to choking
- problems speaking or controlling your body
- problems breathing
- coma
- vein damage - if you inject it
- lung and heart problems - if you smoke heroin over a long time
- irregular periods - this can lead to unplanned pregnancy
- low appetite and weight loss - this can affect your health and energy levels over time
- mood swings
Heroin and mental health
Heroin can cause mental health difficulties or make existing difficulties worse, for example:
- low mood and depression
- anxiety
- thoughts of suicide
If you use heroin and have mental health difficulties, you can get support for both.
Heroin and dependency
Regular use of heroin can cause:
- tolerance - when you need to take more of the drug to get the same effects
- dependency
Signs of dependency can include:
- cravings for a drug
- withdrawal symptoms
- continuing to use a drug even when it causes you harm
Withdrawal symptoms
If you stop taking heroin after regular use, you may get withdrawal symptoms.
These include:
- aches and pains
- nausea and vomiting
- muscle spasms and shaking
- sweating and chills
- sneezing and yawning
- diarrhoea
- anxiety, irritability and depression
- increased heart rate and blood pressure
How long does heroin stay in your system?
It can be hard to know how long heroin stays in your system.
There are tests to detect heroin. But different types of tests have different detection times.
Things that affect how long a drug stays in your system
The time it takes for a drug to leave your system depends on many things.
For example:
- how much you took
- how often you take the drug
- how strong the drug was
- your age, sex and metabolism
- your general health
Reducing risks from heroin
It’s always safest not to take drugs. The strength and contents of drugs can vary. Your dealer does not always know the contents of what they sell.
Drugs sold as heroin may contain synthetic opioids such as nitazenes. These drugs may be called new heroin. They have a higher risk of overdose.
There are ways to reduce the risk of harm if you use heroin. Select a piece of advice to find out more.
Be with people you trust - use a buddy system if possible.
Do not use alone. Look out for each other.
Prepare a plan with your buddy on what to do in case of an emergency.
This may be that you both agree to:
- learn the signs of an overdose
- use naloxone in an opioid emergency
- call the emergency services
- stay with the other person until help arrives
Start with a small amount and wait 2 hours before you take more.
This is to reduce the risk of an overdose or drug emergency. The contents or strength of drugs can vary, even in the same batch.
If you start with a small test amount, you can:
- see how you react
- stop if you get an effect you did not expect or do not want
It can take up to 2 hours for some effects to happen. If you take too much too soon, it increases your risk.
Only use 1 substance at a time.
Using opioids with alcohol, medicines or other drugs can have unpredictable and negative effects. Mixing drugs is always more risky.
Consider less risky ways of using if you inject heroin.
Injecting drugs increases the risk of overdose and can cause vein damage or infections.
Keep track of what you use.
Take breaks between use to reduce your risk of tolerance.
Make sure you get enough food and rest.
Get and carry naloxone.
Naloxone is a prescription medicine that can temporarily reverse the effects of opioids. It can help prevent death from an overdose.
If you are at risk of an opioid overdose, you can get a naloxone kit through your GP or other services.
Give a naloxone kit to another person - this could be a family member, friend or someone who is around you when you use.
You may need an extra dose of naloxone if someone takes a nitazene instead of another opioid.
Know what to do in case of a drug emergency.
If you take any kind of drug, it is important to know:
- signs of a drug emergency, including signs related to mental health
- what to do in case of overdose or other emergencies
An overdose can be a life-threatening condition. It happens when someone has too much of a drug or another substance in their system.
Getting help can prevent serious damage or death. Your wellbeing is the main priority.
Check our drug alerts for extra risky drugs in Ireland.
We issue alerts if extra risky drugs are found in Ireland.
Follow us for updates on drug monitoring:
Mixing heroin with alcohol or other drugs
Using heroin with alcohol, medicines or other drugs can have unpredictable and negative effects.
There is a high risk of overdose or death if you mix heroin with substances that slow down messages between the brain and the body.
For example:
- alcohol
- medicines such as benzodiazepines, methadone or pregabalin
- other opioids
- G (GHB or GBL)
Emergency action required: Call 112 or 999 if
you or someone else has taken heroin and has:
- problems breathing - they may make a snoring or gurgling sound
- blue or grey lips or fingertips
- cold or clammy skin
- chest pain
- slow heartbeat
- lost consciousness
Use naloxone if you have it.
Tell the medics everything you know about the drug and give them any leftover drug if possible. It will help them decide the right treatment.
If you are worried about heroin use
If you are worried about your own or someone else’s use, you can get support. This can be when heroin use affects your health, relationships, work or other areas of your life.
Getting help can prevent overdose. You can contact a drug service even if you are not sure that you want to change your drug use. They can help you find ways to reduce your risk of harm.
Non-urgent advice: Drugs and alcohol helpline
You can contact the helpline for support, information or advice on treatment and support options.
Freephone: 1800 459 459
Monday to Friday, 9.30am to 5.30pm
Email: helpline@hse.ie