I’ve been thinking a lot recently about the enormous stigma that surrounds heroin.

Even people within the drug-using community who detest prohibition will often be heard saying something like “Yeah, legalise everything… but not heroin. Never heroin.“

Why is this the case? Is there evidence to support the view of heroin as the most harmful, addictive drug around?

Addiction

Would you be surprised if I told you that heroin has an addiction rate of around 23 percent? Whether or not you think that’s high, maybe it will surprise you to know that alcohol has a very similar rate of addiction.

I’ve heard many stories of people who’ve tried heroin, or take heroin fairly regularly, without being dependent. They don’t fall into a downward spiral of addiction. They’re simply using a drug in a similar way to the regulars you see in the pub three times a week.

Sure, alcohol and heroin are both addictive drugs. But heroin use is more complicated than taking one hit and ending up a drain on society forever. So why do we stigmatise heroin users when most of them are no more addicts than the middle-class wine enthusiast?

Harm

Professor David Nutt, the scientist who was fired by the government for (truthfully) saying that horse-riding is more dangerous than ecstasy, put together a highly influential paper that compared the social, personal and economic harms of various drugs in the UK. It ranked heroin as less harmful than alcohol, especially when it comes to societal damage.

Heroin can certainly cause physical harm – overdoses claim many lives. But unlike alcohol, heroin doesn’t cause cancer, damage your liver, or make you want to fight strangers.

Our idea of heroin as being harmful is directly linked to the social and economic situations that problem heroin users find themselves in. The most visible heroin users are the ones in crappy situations without access to proper support. This is very similar to alcohol, where we mostly notice problem users on the streets at weekends (although alcohol has the privilege of being legal – so the stigma isn’t as severe).

So can heroin use actually be safe?

Back in the 80s, a doctor in the UK was handing out heroin to addicts. He noticed that they all came back fairly reliably for their doses, but that their ‘habit’ didn’t seem to effect their lives or jobs. In fact, they were all pretty functional members of society. It seemed that heroin didn’t really have any inherent harms, to the surprise of the doctors involved, when not adulterated and when used with clean needles.

Following a similar model, we’ve seen that keeping heroin users off the streets (and before the watchful eyes of trained medics and social workers) in supervised injection facilities makes a dramatic difference heroin-related harm. Injection facilities reduce HIV transmission rates, reduce overdose deaths, and get drug users in touch with care and support services.

 

Heroin does not cause an inevitable never-ending downward spiral of drug use and destitution after just one hit. That’s a myth that has been perpetuated by media, prohibition, and our own prejudices. I haven’t been able to show you the true reality – but maybe some of these facts will help to break down some of our seriously harmful stigmas.