1. Heroin

2. This is heroin in its most common form

3. What is Heroin? Heroin is processed from morphine, a natural substance extracted from the seedpod of the Asian poppy plant. Heroin is processed from morphine, a natural substance extracted from the seedpod of the Asian poppy plant. Heroin is typically sold as brown powder. Heroin is typically sold as brown powder. Street names for heroin include "smack," or “brown” Street names for heroin include "smack," or “brown” It is a highly addictive drug, and its use is a serious problem. It is a highly addictive drug, and its use is a serious problem. It is both the most abused and the most rapidly acting of the opiates It is both the most abused and the most rapidly acting of the opiates Sometimes people inject it but the most common route of use is smoking it from tin foil, (very few people smoke it rolled into a cigarettes like cannabis) Sometimes people inject it but the most common route of use is smoking it from tin foil, (very few people smoke it rolled into a cigarettes like cannabis) Street heroin is "cut" with other drugs or with substances such as sugar, starch, powdered milk, quinine, strychnine or other poisons. Street heroin is "cut" with other drugs or with substances such as sugar, starch, powdered milk, quinine, strychnine or other poisons. Because heroin users do not know the actual strength of the drug or its true contents, they are at risk of overdose or death. Because heroin users do not know the actual strength of the drug or its true contents, they are at risk of overdose or death. Heroin creates other problems; the transmission of HIV and other diseases that can occur sharing needles or injection equipment. Heroin creates other problems; the transmission of HIV and other diseases that can occur sharing needles or injection equipment.

4. Use of Heroin Typically, a heroin user will smoke or inject up to four times a day. Intravenous injection provides the greatest intensity and most rapid onset of euphoria (7 to 8 seconds). Typically, a heroin user will smoke or inject up to four times a day. Intravenous injection provides the greatest intensity and most rapid onset of euphoria (7 to 8 seconds). When heroin is smoked, peak effects are usually felt within 10 to 15 minutes. Although smoking heroin does not produce a "rush" as quickly or as intensely as intravenous injection, both forms of heroin administration are addictive. When heroin is smoked, peak effects are usually felt within 10 to 15 minutes. Although smoking heroin does not produce a "rush" as quickly or as intensely as intravenous injection, both forms of heroin administration are addictive.

5. Smoking and Injecting

6. Effects of Heroin One of the most detrimental long-term effects of heroin is addiction itself. Addiction is a chronic, relapsing disease, characterized by compulsive drug seeking and use, and by chemical changes in the brain. As with users of any addictive drug, heroin users spend more and more time and energy obtaining and using the drug. Once they are addicted, the heroin users' primary purpose in life becomes obtaining and using drugs. The drugs literally change their brains. Physical dependence develops with higher doses of the drug. With physical dependence, the body adapts to the presence of the drug and withdrawal symptoms occur if use is reduced abruptly.

7. The Effects of Heroin over time A series of arrest photographs of the same young heroin addict taken over the course of 10 years from age 31- 41. (Some of the photos were taken at closer time intervals than others)

8. The Effects of Heroin over time

18. Withdrawal Withdrawal can occur within a few hours after the last time the drug is taken. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhoea, vomiting, cold sweats with goose bumps ("cold turkey"), and involuntary leg movements. Major withdrawal symptoms peak between 24 and 48 hours after the use of heroin and subside after about a week. However, some people have shown persistent withdrawal signs for many months. Heroin withdrawal is rarely fatal to otherwise healthy adults, but it can cause death to the foetus of a pregnant addict. Physical dependence and the emergence of withdrawal symptoms are a key feature of heroin addiction. However, craving and relapse can occur weeks and months after withdrawal symptoms are long gone. We also know that patients with chronic pain who need opiates to function (sometimes over extended periods) rarely have any problems leaving opiates after their pain is resolved. (The patient in pain is simply seeking relief of pain and not the rush sought by the addict.)

19. Treatment for heroin addiction Treatment is varied and is provided due in part to how people view heroin addiction Treatment is varied and is provided due in part to how people view heroin addiction Generally treatment begins with medication; Methadone, Buprenorphine; Subutex, or Dihydrocodeine. Other pharmaceutical drugs are added for other symptoms caused by addiction Generally treatment begins with medication; Methadone, Buprenorphine; Subutex, or Dihydrocodeine. Other pharmaceutical drugs are added for other symptoms caused by addiction The psychological and social effects of treatment are more complicated; therapy includes; 12 Step programmes, Cognitive Behavioural Therapy, MET, MIT etc The psychological and social effects of treatment are more complicated; therapy includes; 12 Step programmes, Cognitive Behavioural Therapy, MET, MIT etc When there is a dual diagnosis added to drugs/alcohol use/addiction then the treatment becomes even more complicated When there is a dual diagnosis added to drugs/alcohol use/addiction then the treatment becomes even more complicated

20. CRACK

21. What is crack? Crack cocaine is a highly addictive and powerful stimulant made from powdered cocaine mixing it with baking powder and cooking it. Crack cocaine is a highly addictive and powerful stimulant made from powdered cocaine mixing it with baking powder and cooking it. Crack, or “rocks” emerged as a street drug in the mid- 1980s. Crack, or “rocks” emerged as a street drug in the mid- 1980s. It is commonly used together with heroin because it produces an immediate high and for those addicts who have been using heroin for a long time that high has gone. It is commonly used together with heroin because it produces an immediate high and for those addicts who have been using heroin for a long time that high has gone. Also, it is a different type of drug to heroin- crack is a stimulant, (speed), whereas heroin is a euphoric yet calming drug creating a sense of well-being rather than a “speeding” or adrenaline type feeling. Also, it is a different type of drug to heroin- crack is a stimulant, (speed), whereas heroin is a euphoric yet calming drug creating a sense of well-being rather than a “speeding” or adrenaline type feeling. Another reason it is often used together is that dealers usually sell them together offering a “bag of each” Another reason it is often used together is that dealers usually sell them together offering a “bag of each”

22. Uses of crack; “rocks” Crack is nearly always smoked. Smoking crack delivers large quantities of the drug to the lungs, producing an immediate and intense euphoric effect. Crack is nearly always smoked. Smoking crack delivers large quantities of the drug to the lungs, producing an immediate and intense euphoric effect. Crack is probably the most addictive substance ever devised. Crack is probably the most addictive substance ever devised.

23. Effects of crack Cocaine, in any form, is a powerfully addictive drug; addiction develops more quickly when the drug is smoked as crack. Cocaine, in any form, is a powerfully addictive drug; addiction develops more quickly when the drug is smoked as crack. Harmful effects include: constricted blood vessels; increased temperature, heart rate, and blood pressure; and risk of cardiac arrest and seizure Harmful effects include: constricted blood vessels; increased temperature, heart rate, and blood pressure; and risk of cardiac arrest and seizure Crack users often experience acute respiratory problems, including coughing, shortness of breath, then lung trauma and bleeding. Crack users often experience acute respiratory problems, including coughing, shortness of breath, then lung trauma and bleeding. Crack also causes aggressive and paranoid behaviour. Crack also causes aggressive and paranoid behaviour.

24. Withdrawal Crack is a very powerful drug, addiction is almost inevitable; once someone has tried crack they may be unable to predict or control the amount of crack they will use. It is common for people to use until they have no more money left to continue. Crack is a very powerful drug, addiction is almost inevitable; once someone has tried crack they may be unable to predict or control the amount of crack they will use. It is common for people to use until they have no more money left to continue. Crack users need more and more crack to attain the same high and avoid the intense "crash" or depression of withdrawal. They become physically and psychologically dependent on crack, which often is a result of only a few rocks smoked within a few days. Crack users need more and more crack to attain the same high and avoid the intense "crash" or depression of withdrawal. They become physically and psychologically dependent on crack, which often is a result of only a few rocks smoked within a few days. Crack withdrawal symptoms include: Crack withdrawal symptoms include: Agitation, depression, intense craving for the drug, extreme fatigue, anxiety, angry outbursts, lack of motivation, nausea/vomiting, shaking, irritability, muscle pain, insomnia

25. Treatment for crack use To balance off the intense lows, crack users often use other drugs, such as alcohol, cannabis and heroin to come down. To balance off the intense lows, crack users often use other drugs, such as alcohol, cannabis and heroin to come down. There are no medications currently available to treat crack addiction specifically. There are no medications currently available to treat crack addiction specifically. Crack use and addiction is a complex problem involving biological changes in the brain as well as psychological (pre-and post the onset of addiction), family and other social factors. Crack use and addiction is a complex problem involving biological changes in the brain as well as psychological (pre-and post the onset of addiction), family and other social factors. Treatment needs to assess the psychological and biological, social, and pharmacological aspects of the person’s drug abuse. Treatment needs to assess the psychological and biological, social, and pharmacological aspects of the person’s drug abuse.