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What is it?

Heroin is an opioid that is made from the opium poppy (sounds like a cute dog name). It’s a depressant, which means that they slow down the messages travelling between the brain and the body – basically, it means that we are a few steps behind the beat.

It is usually produced as white to brownish granules or powder. It is sometimes called smack, gear, the dragon, hammer, H, dope, junk, Harry, horse, black tar, China white, poison, black tar, and white dynamite.

Heroin is most often injected. With injecting, there is a risk of contracting blood-borne viruses, such as hepatitis B & C and HIV if needles are shared and the risk of infection at the injecting site. It can also be smoked (aka chasing the dragon) or added to cigarettes or joints.

What are the effects?

The effects will usually be felt immediately after smoking or injecting the drug, but can take five to fifteen minutes if snorted and last between 3-5 hours.

  • Intense pleasure and pain relief
  • Relaxation, drowsiness and clumsiness
  • Confusion
  • Feelings of detachment
  • Slurred and slow speech
  • Slow breathing and heartbeat
  • Dry mouth
  • Tiny pupils
  • Reduced appetite and vomiting
  • Decreased sex drive
  • Intense sadness
  • Irregular periods and difficulty having children
  • No sex drive, erectile dysfunction and infertility
  • Constipation
  • Dental issues
  • Damaged heart, lungs, liver and brain
  • Vein damage and skin, heart and lung infections from injecting


It is very easy to overdose on heroin, due to the unknown strength of the batch or from losing consciousness. Knowing the signs of overdose helps keeps us and others safe, and when we might need to call an ambulance. Watch out for these symptoms and call 000 in an emergency:


Trouble concentrating


Cold, clammy skin


Small pupils


Wanting to urinate but finding it hard to.




Low blood pressure


Irregular heartbeat


Extreme drowsiness or falling asleep ('going on the nod')


Passing out




Slow breathing, blue/grey lips and fingertips

Naloxone is an over the counter drug used to temporarily reverse an overdose on opioids. It can be purchased at local pharmacies and anyone can administer it. It’s handy to have around, just in case!! It can be used as a nose spray or injected – and no, it’s not like Pulp Fiction! Even after naloxone has been used, medical attention should be sought immediately.

Mixing with other drugs

The effects of mixing heroin with other drugs – including over the counter or prescribed medications can be unpredictable and dangerous. Do not mix heroin with the following medications because it may increase the risk of overdose, and even death:

  • Ketamine
  • Cocaine
  • Alcohol
  • GHB
  • Tramadol
  • Benzos

To discover more about the specific interactions between heroin and other drugs, refer to TripSit.

HIV Medications

The interactions between heroin and antiretroviral medications are not well known. There’s currently no evidence to suggest that heroin use directly reduces the efficacy of antiretroviral medications. If some new research comes to light, then we’ll update this section and let you know.

We did find that protease inhibitors, and other drugs, including Efavirenz or Etravirine, can amplify the effects of heroin if it’s injected or inhaled. Patients of these medications should chat with an HIV specialist about signs of opiate toxicity.

The interactions between heroin and PrEP and PEP are not well known. There’s currently no evidence to suggest that heroin use directly interacts with these medications or reduces their efficacy. We’ll keep looking and update you if any new research comes to light.

To learn about the interactions between specific HIV medications and heroin head to Liverpool HIV Drug Interactions Checker.


There’s currently no evidence to suggest that heroin use reduces the efficacy of HRT. We’ll keep looking and update this information if something new comes to light.

Heroin is an opioid and Oestradiol can affect our opioid receptors, and how the body processes them, so it’s best to chat with a healthcare professional about whether our dosage needs to be adjusted.

Spironolactone and opioids can potentially lead to a build-up of toxicity and affect our kidneys.

Progesterone and Cyproterone Acetate can have sedative effects and cause tiredness and fatigue, so taking these along with other depressants may lead to feeling more exhausted during or after using opioids.

Both testosterone and opioids can cause water retention, which means we may experience constipation and bloating when taking both.

We don’t yet know enough about how opioid-induced androgen deficiency (OPIAD) may impact bodies that are taking testosterone, including whether it may impact our absorption or processing of our HRT.

For more information about heroin head to the Australian Drug Foundation or TripSit

The information given on this page is not medical advice and should not be relied upon in that way.