Heroin is a highly addictive drug that can cause feelings of euphoria and relaxation. It’s known for its analgesic (pain-killing) effects.

In Scotland, heroin is often injected but it can also be heated on foil and smoked.

Risks of mixing drugs

Avoid mixing heroin with any other drugs (including medicines).

Taking heroin and other drugs together is very dangerous.

9 out of 10 overdose deaths involve people using heroin or other opioid drugs with substances like benzodiazepines, methadone, cocaine or alcohol.

Heroin and dependence

Physical dependency on heroin may develop quickly. This can happen over a couple of days or within a few weeks of daily use.

Physical dependence means the body adapts to the presence of the drug. Withdrawal symptoms also occur if use is suddenly stopped.

Withdrawal symptoms may occur a few hours after the drug is last taken.

Physical symptoms of withdrawal include:

  • restlessness
  • muscle pain
  • bone pain
  • insomnia
  • diarrhoea
  • vomiting
  • hot and cold flushes
  • muscle spasms
  • uncontrollable shaking

Withdrawal can occur alongside mental health issues. This is particularly the case for those experiencing trauma or mental health problems with painful memories, intrusive thoughts and anxiety.

Severe withdrawal symptoms peak between 24 to 48 hours after the last dose of heroin. They subside after about a week.

Heroin and harmful effects

Smoking heroin can cause damage to the lips, mouth and lungs.

Injecting heroin can lead to injuries and wounds. It can also cause bacterial and viral infections by using or sharing dirty or used needles.

Left untreated, wounds and infections can result in amputation of limbs.

Further information on injection and wound care.

Try to be safer

Make sure you’re in a safe environment with people you trust. If you’re alone let someone know you are planning to use heroin.


  • sleep on your side as it will help keep your airway clear
  • remember that substances can stay in your system long after the effect of the drug has worn off
  • carry naloxone


  • do not share equipment including needles, filters, spoons/cookers and pipes
  • do not mix heroin with other substances (including alcohol and medicines) – this increases the risk of a fatal overdose

In an emergency

There’s a high risk of overdose when using heroin. Heroin can slow a person’s breathing and heart rate which can be life threatening.

In an overdose, it is important to get urgent medical help.

Phone 999 or go to A&E if:

You or someone else has taken heroin and experiences negative side effects like:

  • blue lips
  • loss of consciousness
  • noisy, rasping or slow breathing
  • fitting or seizures
  • extreme mental confusion
  • hallucinations

Naloxone is a life-saving medicine that temporarily reverses the effects of an opioid overdose. Naloxone should be given to anyone who is non-responsive and displaying the signs of an overdose.

Reversing the effects of opioids (such as heroin, codeine, morphine, tramadol and methadone) with naloxone can be the difference between life and death.

Naloxone buys a person time until an ambulance arrives, or they can be seen by a medical professional.

Home delivery of naloxone can be accessed through Scottish Families Affected by Alcohol and Drugs.

Further information on naloxone.


If you would like help or support related to drug use please visit support for people affected by drugs.

PH Stransparent 240 x 80

Source: Public Health Scotland

Last updated:
01 December 2022

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