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The opioids are a class of drugs, of which heroin diacetylmorphine is a member, that include the natural products of the opium poppy and synthetic compounds derived from it. Heroin is a central nervous system depressant. Heroin was first synthesised in , and was sold as an over-the-counter cough suppressant between and The drug is highly addictive, and for this reason its use has been severely restricted. It is not prescribed for any medical purpose. The most commonly used form of heroin in Australia is white powder or rock, followed by brown powder or rock. The white powder from South-East Asia is soluble in water, and more readily used for injection. Dealers normally cut it with other substances, typically sugar or caffeine. The brown powder from South-West Asia is insoluble in water, so it is less amenable to injecting. While it may be injected, it is commonly heated and the vapours inhaled. Heroin was banned from legal prescription in Australia in The use of heroin for any purpose is illegal in all states and territories in Australia. Supply is much more severely punished than other activities associated with heroin use. In Australia, it is usually injected. While injecting carries the highest risk of overdose, people can also die from smoking, snorting or swallowing heroin. Lifetime use of heroin was also stable at 1. The proportion of people who had injected any illicit drug in the previous 12 months continued a long-term gradual decline, from 0. Heroin suppresses nerves that signal pain, making it an especially effective painkilling medication. It also suppresses the centres in the brain that control breathing and coughing. Other immediate symptoms can include nausea, vomiting and a severe itch. The effects are almost immediate, following injection or inhaling. After the initial rush, users become drowsy for several hours, with slowing of the heart and breathing, as well as reduced mental alertness and response to pain. Heroin use has very high mortality rate, estimated at 15 times that of the general population. The most common cause of death is overdose, with marked respiratory depression resulting in death. The use of heroin may cause marked depression of respiration, even in people who are tolerant to the drug. Many of the other damaging effects of heroin are associated with injecting. Constant injection can lead to collapsed veins, bacterial infection and abscesses at injection sites. Heroin injectors are also at risk of infections, such as endocarditis an infection of the lining of the heart , from non-sterile equipment. In particular, if a person shares needles or uses dirty equipment they are also vulnerable to blood-borne viruses, such as HIV, hepatitis B and hepatitis C. Regular heroin users are often in poor general health which, along with suppression of the respiratory system, makes them vulnerable to lung infections such as pneumonia. Their dental health is also very poor. Heroin users suffer high levels of major depression and anxiety disorders, including post-traumatic stress disorder PTSD. Suicide rates amongst heroin users are extremely high, and estimated at 14 times that in the general population. They also have high rates of borderline personality disorder and antisocial personality disorder. Heroin causes drowsiness and impairs alertness, concentration and reaction times. It is dangerous, as well as illegal, to drive under the influence of heroin. If heroin is used with alcohol or benzodiazepines the risk is greatly increased. Heroin taken by a pregnant woman crosses the placenta, and can affect fetal development. It increases the risk of miscarriage, premature birth, low birth weight and fetal death. The baby of a woman who uses heroin in pregnancy may have to go through a withdrawal following birth this is called neonatal abstinence syndrome. Neonatal abstinence can be effectively treated without long-term problems. In some cases, medication may be necessary. If the mother has a blood-borne virus such as hepatitis B or C, or HIV, the baby may become infected pre-delivery or at childbirth. Heroin users frequently use other depressant drugs such as alcohol and tranquillisers at the same time. Combining heroin with these drugs greatly increases the risk of overdose. Research suggests that around one in four of those people who ever try heroin become dependent on it. Daily heroin use over several weeks or months is probably necessary to develop dependence. Daily use typically occurs after a one or two-year period from first use. Australian research has found that people can develop a dependence through smoking heroin as well as by injecting. Within the first 12 hours after their last dose a dependent user can experience withdrawal symptoms, including:. Over the following weeks, general health and mood improve, but the former user may experience ongoing problems related to sleep and appetite, as well as drug cravings. The risks of overdose and death are high. Heroin is a very effective nervous system depressant, and death is commonly due to respiratory depression. The risk of death is substantially increased if other depressants, such as alcohol or tranquillisers, are used at the same time. In fact, most overdose deaths occur when heroin has been mixed with another depressant. A person returning to heroin after a break or a significant reduction in their use is at particular risk. They will have lost their tolerance to the drug, so then, if they take the amounts that they previously used, they can overdose. Opioid substitution treatment, also known as medication assisted treatment for opioid dependence MATOD is the most common frontline treatment for heroin dependence. It involves substituting other less harmful drugs for heroin, usually on a long term basis. The most common medicines used in Australia are methadone, buprenorphine and naltrexone. Another treatment less common in Australia is the use of naltrexone as a blocking agent. In high enough doses, naltrexone blocks the sites in the brain activated by heroin, so that any heroin taken will have no effect. Residential rehabilitation is also an option widely available in Australia, although there can be long waiting lists in the public sector. It is a drug-free treatment plan, where patients are required to reside at the treatment agency after first having undertaken detoxification. Residential rehabilitation can also be useful for people on medication-assisted treatment, to provide additional support when their lives are in chaos. The Australian Treatment Outcomes Study ATOS found that detoxification as a standalone treatment is associated with poorer outcomes over the long term. This indicates that detoxification should be considered as a gateway into other treatments. Methadone maintenance therapy is a commonly used substitution treatment. Methadone is a synthetic opioid agonist that affects the brain in the same way as morphine and heroin. Methadone is typically swallowed as a liquid. Because it is swallowed, the risks associated with injecting drug use are removed. When stabilised on methadone, a person is able to undertake usual life activities, including driving. Since the methadone is prescribed by a doctor, problems associated with controlling dosage and using the illegal market are less than with heroin. Methadone can be injected, and overdose is still possible. The evidence suggests, however, that methadone maintenance treatment substantially reduces the risk of death. It can also reduce heroin use, other criminal activity associated with the illegal market, and obstetric and fetal complications, and improve physical and psychological health. Because methadone is not effective for all heroin users, other drug therapies have been developed, including buprenorphine. Buprenorphine is taken by dissolving a tablet of the drug under the tongue. It activates the opioid receptors in the brain to a lesser extent than methadone, but it acts at the same time to block the receptors, preventing heroin and other opioids from having much effect. Buprenorphine is classified as a mixed opioid agonist-antagonist. This means the risk of overdose with buprenorphine is lower than with methadone. It must be prescribed at doses high enough to maintain people in treatment, and should be accompanied by appropriate psychological and social support. It has a similar effectiveness to methadone in terms of retention in treatment and reducing illegal drug use. Newer forms of treatment usually involve buprenorphine in combination with naloxone. Naloxone is the opioid antagonist administered at overdose to reverse the effects of opioids. The aim of combining it with buprenorphine is to prevent injecting, with the naloxone only being activated if the substance is injected. In high enough doses, naltrexone blocks the sites in the brain activated by heroin, so that any heroin taken will have no efect. However, most people who start taking the medication will discontinue its use. Naltrexone brings on a severe withdrawal reaction. Because of this, people planning to enter naltrexone treatment are often required to go through withdrawal before entering treatment. The treatment appears to be best suited to highly motivated people with good social support. Naltrexone can also be administered via an implant. However, as naltrexone implants are not registered for use in Australia treatment can only be authorised under the Therapeutic Goods Administration Special Access Scheme. Residential rehabilitation or therapeutic communities TCs can be an effective treatment for people who use drugs, including heroin. TCs are drug-free residences where people in recovery from substance use disorders help each other to understand and change their behaviours, subsequent to having undertaken detoxification. Clients on medication-assisted treatment may also be admitted for stabilisation and assistance. TCs can also provide support in other important areas — improving legal, employment and mental health outcomes. There are a range of pharmaceutical opioids used non-medically in Australia that have similar effects in the body to heroin. These include pain medications such as oxycodone and morphine. The side effects seen are also similar to those for heroin, including overdose. Pharmaceutical opioids can be taken orally or injected for the euphoric feelings that they cause. Links to services and agencies that can assist people needing treatment, information, advice, referral and support. For more information see NSW Health public drug warnings. Heroin and the law Heroin was banned from legal prescription in Australia in Low-prevalence illicit drugs in the NDSHS Effects Short term effects Heroin suppresses nerves that signal pain, making it an especially effective painkilling medication. Long term effects Heroin use has very high mortality rate, estimated at 15 times that of the general population. Heroin itself can cause: depression of respiration severe constipation tooth decay from lack of saliva irregular menstrual periods impotence in males loss of appetite and weight. Heroin use and psychological problems Heroin users suffer high levels of major depression and anxiety disorders, including post-traumatic stress disorder PTSD. Related content. What are drugs and what are the effects on the people who use them? This easy-to-read book is intended for anyone who is interested in finding information about drugs and alcohol. Topics explored include drugs and driving, pregnancy, treatment, statistics, drugs and the law, where to go for help and further information. Getting help.

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Australian Institute of Health and Welfare. Get citations as an Endnote file : Endnote. The risk of overdose for people who use heroin is high and there have been increases in deaths involving heroin in recent years. Prior to COVID in , the Australian heroin market was highly stable in terms of pricing, perceived drug availability, and perceived purity. The number and weight of heroin seizures at the Australian border have increased over the past 10 years. In —23, heroin was the fourth most common drug of concern for which people received treatment 4. Opioids refer to a class of drugs that include those that are derived from the opium poppy and those that are semi or fully synthetic ACIC ; NSW Ministry of Health Diacetylmorphine, commonly known as heroin, is a derivative of morphine, an alkaloid contained in raw opium ACIC This section focuses on the harms, availability and consumption of illicit opioids including heroin, as distinct from pharmaceutical opioids such as morphine, methadone and oxycodone. See the section on pharmaceuticals for recent trends and data in relation to the use and harms for pharmaceutical opioids. The availability of heroin in Australia has fluctuated over time. In the early s, there was a rapid and considerable reduction in the availability of heroin in Australia commonly referred to as the heroin shortage or drought and this was associated dramatic reductions in heroin-related overdoses Degenhardt et al. Since then, the availability of heroin has steadily increased. There were changes in the perceived purity and perceived availability of heroin. More specifically, in Data collection for took place in June and July. All interviews prior to were delivered face-to-face, this change in methodology should be considered when comparing data from the — samples relative to previous years Sutherland et al. The number of heroin detections at the Australian border has fluctuated over the past decade. Between —12 and — In —, 8. This figure shows the proportion of lifetime and recent use of heroin for people aged 14 and over between and In , only 0. Lifetime use of heroin has been decreasing since , from 1. Australians consumed an estimated kg of heroin in — Heroin consumption is typically higher in capital cities than regional areas. It should be noted that some data for Tasmania, the Australian Capital Territory and the Northern Territory have been suppressed due to small numbers. Please see the data quality statement for further information. For related content on Multiple drug involvement see Impacts: Ambulance attendances. For related content on illicit opioid including heroin impacts and harms, see also:. Heroin is a central nervous system depressant. Like other opioids, it binds to receptors in the brain, sending signals to block pain and slow breathing. Heroin may be snorted, swallowed or smoked, but is most commonly melted from a powder or rock form and injected. The Australian Burden of Disease Study found that opioid use was responsible for 0. Most of the burden due to opioid use was due to 2 linked diseases: poisoning and drug use disorders excluding alcohol. A further 2. This butterfly chart shows the number and rate of heroin-related ambulance attendances were higher for males than females across all age groups. Drug-induced deaths are determined by toxicology and pathology reports and are defined as those deaths that can be directly attributable to drug use. This includes deaths due to acute toxicity for example, drug overdose and chronic use for example, drug-induced cardiac conditions ABS People who use heroin have a particularly high risk of overdose, especially when heroin is used in conjunction with other drugs like benzodiazepines for example, alprazolam, diazepam and alcohol. However, there are some challenges in interpreting the numbers of heroin deaths. Heroin can be difficult to identify at toxicology because it is rapidly metabolised to morphine by the body and these metabolites cannot be distinguished from other morphine sources for example, codeine. Opioids, including both licit and illicit substances, have been the leading class of drug present in drug-induced deaths in Australia for the last 2 decades. Most illicit opioid deaths involve heroin, with other illicit opioids such as opium accounting for very few opioid-induced deaths in any given year less than 10 in Chrzanowska et al. However, deaths involving heroin have shown an increase over the last decade, from 0. It has since decreased to 1. In , deaths with heroin identified had a median age at death of The figure shows the number of drug-induced deaths due to all opioids and heroin only steadily increased from to The number of deaths due to all opioids has decreased from 1, in to in The number of deaths due to heroin has decreased from to in the same period. The latest Alcohol and other drug treatment services in Australia annual report shows that heroin was the principal drug of concern in 4. This has remained relatively stable over the year period to — Heroin was the 4th most common principal drug of concern 4. Assessment only was the most common main treatment type almost 1 in 4 episodes. Canberra: ABS, accessed 26 October ABS cat. Canberra: ABS, accessed 29 September AIHW, accessed 22 February Monograph no. In: Ritter, King and Lee eds. Drug use in Australian society. Oxford University Press. Accessed 25 October This website needs JavaScript enabled in order to work correctly; currently it looks like it is disabled. Please enable JavaScript to use this website as intended. We'd love to know any feedback that you have about the AIHW website, its contents or reports. The browser you are using to browse this website is outdated and some features may not display properly or be accessible to you. Please use a more recent browser for the best user experience. You are here: Go to Alcohol. Last updated: 10 Jul Topic: Alcohol. View citation formats for this report Citation Close. Vancouver Australian Institute of Health and Welfare. Enter the email address where you would like the PDF sent. This address will not be used for any other purpose. Key findings. Availability The availability of heroin in Australia has fluctuated over time. The number of national heroin seizures increased from 1, up to 2, seizures. The weight of heroin seized increased from kilograms to a record 1, kilograms ACIC Data from Report 21 of the NWDMP show that nationally: Between April and August , the population-estimated average consumption of heroin increased in both capital city and regional sites. In August , heroin consumption in capital cities exceeded consumption in regional areas ACIC Adapted from ACIC Harms For related content on illicit opioid including heroin impacts and harms, see also: Data by region: Drug-induced deaths Health impacts Economic impacts. Deaths Drug-induced deaths are determined by toxicology and pathology reports and are defined as those deaths that can be directly attributable to drug use. Figure HEROIN 4: Number or age-standardised rate per , population of drug-induced deaths a for all opioids and heroin only, to Previous page. Next page. Go back to top. Required fields. Analgesia Cough suppressant Euphoria Dry mouth Heavy feeling in hands and feet Nausea and vomiting Severe itch Drowsiness Respiratory depression resulting in fatal and non-fatal overdose, especially when used in conjunction with other sedative substances including benzodiazepines and alcohol. Severe constipation Tooth decay from lack of saliva Irregular menstrual periods in females Impotence in males Loss of appetite and weight Neurochemical changes in the brain Memory impairment Mental health issues including depression Physical dependence and associated withdrawal, which manifest as flu-like symptoms.

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