Heroin harm-reduction resource

Heroin leaflet details

Bayer Pharmaceuticals developed diamorphine in the late 1890s and branded it 'Heroin' - from the German word for 'heroic'. Marketed as a cough medicine, they promoted it as safer than morphine, but people quickly became dependent. Most countries banned it by the 1930s. Today, 'heroin' refers to the street drug.

Since then, heroin has developed a reputation as being the most dangerous and difficult drug to control. Based on recent data, around 300,000 people in England are estimated to be dependent on opioids (primarily heroin). A significant population of longer-term users, many now in their 40s and 50s, began using in the 1980s and 1990s. Many more people may be occasional users.

Preliminary figures suggest there were around 1,453 heroin- or morphine-related drug poisoning deaths in England and Wales in 2023. Evidence also indicates that a growing share of opioid-related deaths involves potent synthetic opioids, and their contribution to overall fatalities is rising.

Anyone using heroin or thinking about using heroin needs to know as much as possible. This leaflet is a practical tool for public health teams and drug and alcohol services to engage with people who use heroin. It helps users understand current contamination risks, why mixing substances increases danger, and how to manage their use more safely in today's unpredictable drug market.

This contemporary, well-designed and fully illustrated guide covers:

• What heroin is and how it affects you
• Different ways people use heroin and their risks
• Overdose signs and emergency response
• The risks of mixing with alcohol, benzos, gabapentinoids and other drugs
• Dependence, tolerance and withdrawal Blood-borne viruses and safer injecting
• The law (Class A; possession and supply)
• How to reduce harm and use more safely