• get skin abscesses (sores with pus)
• find it difficult to get pregnant (women)
• find it difficult to get an erection (men)
• get pneumonia — a serious lung disease
• have heart and lung problems
• get tetanus — a disease caused by infection through the places on your body where you inject.

The way a person uses heroin can also cause some problems:
• Street heroin is usually mixed with other things, therefore, it is hard to know how strong the heroin is. This can lead to accidental overdose or death.
• Injecting heroin with used or dirty injecting equipment makes you more likely to get infected with HIV, hepatitis B or C, get blood poisoning (septicaemia) and skin abscesses.

So that you don’t get these problems, DO NOT SHARE fits (needles and syringes), spoons, water, filters, alcohol swabs or tourniquets.

Overdose
Overdose of heroin (‘dropping’) is very common and can happen to anyone. Even small amounts of heroin may cause some people to overdose — for example, new users or those who started using again. This can happen after even a short time of not using.

When a person overdoses, they may have:

• very slow breathing, or snore
• cold skin and low body temperature
• slow heartbeat
• muscle twitching
• slow working of the central nervous system
• gurgling sound in the throat from vomit or saliva
• blue tips of fingernails or toenails because of low oxygen.

The person may go into a coma or even die.

If someone overdoses, other people with them should:
• phone 000 to get an ambulance and tell the operator that the person has overdosed (the police will not come unless the person dies or becomes violent)
• try to keep the person awake — walk them around, talk to them, use their name
• if the person is unconscious, put them on their side, in the ‘recovery’ position
• stay with the person
• try not to panic
• check their breathing, clear their airway
• do mouth-to-mouth resuscitation if they stop breathing
• if the person is ‘on the nod’ and looks like they may overdose, put them on the floor, on their side.

Do NOT:
• inject the person with anything. Salt, milk, or speed don’t work against the heroin and can cause more harm
• put them under the shower
• put anything in their mouth as it can cause choking and stop them from breathing.

Even if someone fits (has a seizure or convulsions), the best thing to do is move things from around them, so they don’t hurt themselves.

Preventing overdose

To help prevent overdose:
• don’t use heroin alone
• don’t use heroin at the same time as alcohol, tranquillisers or other drugs
• if buying heroin from a new dealer, try a small amount first to test how strong the heroin is
• Be aware of how tolerance can affect you (see on page 3).