Heroin

Heroin is a powerful and illegal opioid drug. It is usually sold as a white or brown powder and is made from morphine, which comes from opium poppies.

In the UK, including across the North West, heroin is commonly known by street names such as:

  • Brown

  • Smack

  • Gear

  • H

  • Horse

  • Junk

The strength and contents of heroin can vary widely, which makes it especially risky.

What does heroin look like?

Street heroin in the UK is most commonly brown, although it can range from a pale brown or beige powder to a darker brown substance depending on what it has been mixed with.

It may have:

  • A vinegary smell, or no smell at all

  • A bitter taste

There is no reliable way to know what heroin contains just by looking at it.

How do people use heroin?

People use heroin in different ways. All carry risks, but some are more dangerous than others.

Injecting
Heroin is dissolved in water and injected. This carries a very high risk of overdose, infections, vein damage and blood-borne viruses.

Smoking
Heroin is heated on foil and the smoke inhaled. This is often called “chasing the dragon”.

Snorting
Heroin can also be snorted, although this still carries a risk of overdose and dependence.

How heroin can make you feel

Heroin is a strong sedative drug. Effects can include:

  • Feeling relaxed, calm or euphoric

  • Drowsiness or feeling very sleepy

  • Nausea or vomiting, especially with first use

  • Dizziness and slowed reactions

When smoked, effects usually begin within a few minutes. The main effects may last around an hour, but after-effects such as drowsiness can last for several hours.

Risks to physical health

Heroin causes more drug-related deaths in the UK than any other substance. This is largely because it slows breathing and is easy to overdose on.

An overdose can cause:

  • Extreme sleepiness or unconsciousness

  • Very slow or stopped breathing

  • Blue lips or fingertips

  • Collapse or coma

Mixing heroin with other substances, especially alcohol, benzodiazepines (such as diazepam or “benzos”), or other opioids, greatly increases the risk of overdose.

Using heroin regularly also increases the risk of:

  • Dependence and withdrawal

  • Breathing problems

  • Serious infections

  • Poor overall physical health

Injecting heroin increases the risk of:

  • Vein damage and blood clots

  • Abscesses and severe infections

  • Gangrene

  • HIV and hepatitis B or C through shared equipment

Heroin can also suppress the cough reflex. If someone vomits while very sedated, this can block their airway and stop them breathing.

Tolerance, breaks and overdose risk

With regular use, the body builds tolerance, meaning more heroin is needed to feel the same effect.

However, tolerance drops very quickly. If someone stops using for even a few days, then returns to the amount they used before, the risk of overdose is extremely high.

This is a common cause of fatal overdoses.

What heroin is often mixed with

Heroin is rarely pure. It is often mixed with other substances to increase profit or strength.

This can include:

  • Other opioids, including fentanyl or similar substances

  • Benzodiazepines

  • Barbiturates

  • Sugars, starch, powdered milk

  • Paracetamol or quinine

These mixtures increase the risk of overdose and other serious harm.

Staying safer

If someone is using heroin, there are ways to reduce risk:

  • Avoid using alone

  • Never mix heroin with alcohol or other depressant drugs

  • Start with a small amount, especially after a break

  • Always use sterile injecting equipment

  • Carry naloxone and make sure people around you know how to use it

Naloxone can temporarily reverse an opioid overdose and save lives. It is available for free through Wirral Ways.

If someone is unconscious or not breathing, always call 999. Seeking medical help will not get you into trouble.

Support from Wirral Ways

Wirral Ways provides free, confidential support for people affected by heroin use, as well as support for families and carers.

We can offer:

  • One-to-one support

  • Opioid substitution treatment, including methadone and buprenorphine

  • Support to reduce or stop safely

  • Harm reduction advice and equipment

  • Naloxone kits and training

  • Physical and mental health support

  • Help with housing, benefits and wider wellbeing

Support is tailored to your needs and goals. Whether you want to stop, cut down, stay safer, or just talk, we are here to help.

Worried about someone else?

If you are concerned about someone you care about, you can still contact us for advice and support. You do not need to manage this on your own.

Get support

You can contact Wirral Ways to find out more or access support:

  • Self-refer online

  • Speak to a member of our team

  • Visit one of our services

Help is available. Recovery is possible.

Last Updated on 4 February 2026