Inspired by some discussion about whether locking up drug uses is any more tolerable than locking up perpetrators of hate speech I did a little digging on Wikipedia to confirm my understanding of the medical implications of Heroin use. Wikipedia lists the following complications that can arise from Heroin use:-
1. For intravenous users of heroin (and any other substance), the use of non-sterile needles and syringes and other related equipment leads to the risk of contracting blood-borne pathogens such as HIV and hepatitis, as well as the risk of contracting bacterial or fungal endocarditis and possibly venous sclerosis.
2. Poisoning from contaminants added to “cut” or dilute heroin
3. Chronic constipation
4. Addiction and an increasing tolerance.
5. Physical dependence can result from prolonged use of all opiate and opioids, resulting in withdrawal symptoms on cessation of use.
6. Decreased kidney function. (although it is not currently known if this is due to adulterants used in the cut)
Of these 1 and 2 are primarily a problem associated with illegality. If heroin was legal then quality would improve.
Number 3 is obviously uncomfortable but in and of itself not generally a serious medical problem.
Number 4 is a given. The hit that heroin creates is highly addicative. Number 5 is merely the other side of the same coin.
Number 6 is the only real medical implication included in the list. However when you dig into the first source document that Wikipedia links to in relation to this it actually says “Use of marijuana, amphetamines, heroin, and other drugs was associated with elevated, but not statistically significant, risks for mild kidney function decline.” In other words there is a risk but not a big one. Alcohol consumption is know to cause similar problems.
Let me be real clear. I don’t recommend to anybody that they mess with heroin. It is very addictive and in my opinion the implications of possible legal sanctions and the economic cost associated with addiction is not worth it. The pleasure benefit does not endure with extended usage in any case. However the ongoing criminalisation of heroin use is stupid. All the significant negatives associated with heroin use stem from criminalisation not the actual substance itself. If harm minimisation is the goal then prohibition is a dismal failure.