There are countless rock stars, for example, that maintained families and highly successful careers while regularly using heroin.

> Heroin addiction is the problem, not the adulterants, so purity is unimportant.

Heroin addiction doesn't kill you. What kills you is when you buy a gram that's three times as pure as the last one so you accidentally overdose.

Even if you don't believe addicts can lead normal lives, as long as they're shooting up clean, cheap heroin of predictable purity there at least exists a chance of rehabilitation and a normal life in their futures.

Heroin is the most harmful drug, statistically, according to numerous studies.

Historically, heroin was used by people that WERE holding down jobs[0].

>According to Dr James Mills, a historian who has traced drug use through the 20th century, they tended to be doctors or middle-class patients who could afford to sustain a habit.

Additionally, if we were to legalize heroin's use, we could sell naloxone packaged alongside the heroin. Naloxone, if you're not familiar, is an opiate antidote that is extremely effective. This would greatly reduce the chance of an overdose having fatal effect.

As I've noted with meth elsewhere in this thread, I'm not suggesting anyone go and pick up a drug habit, but the vast majority of the dangers related to heroin (and most drugs - though obviously stuff like jimson weed is just plain bad for you...) are related to the illegal nature of it, and even those inherent to the drug itself can be mitigated much more easily in a legal setting

[0]http://news.bbc.co.uk/2/hi/uk_news/magazine/4647018.stm

People do not get addicted to non-narcotic adulterants and become prostitutes. A cutting agent like caffeine or sugar is probably the safest ingredient...

The biggest physical danger of heroin use is the risk of overdose. The main reason people overdose is because of the adulterants - they don't know how potent the stuff is. x mg of batch A might be a good high, whereash x mg of batch B will kill you from an overdose.

Even if the adulterants are themselves safe, the presence of them is a risk to the users, because they make it impossible to determine dosage.

The adulterants and bulking agents cover a wide range of substances.

At the cleaner end you have caffeine (reduces vapour point of heroin), Chloroquine (looks a bit like heroin), and paracetamol.

https://www.unodc.org/unodc/en/frontpage/2009/June/afghanist...

At the dirtier / dangerous end you have lead (possibly a contaminant from "cooking" vessels, causes serious harm when injected)

http://www.cph.org.uk/wp-content/uploads/2012/08/cut-a-guide...

The illegal nature of the drugs means there are risks of bacterial / fungal contamination - anthrax, botulism, etc from the drug, but also from household products used to increase the potency. For example, if a heroin user goes to a clinic they'll be provided with clean vitamin C. If they're at home they may use lemon juice.

> In Glasgow 23 heroin users were diagnosed with Candida endophthalmitis (intraocular fungal infection), bio-typing analysis indicated that the lemon juice used to prepare heroin injections was the source of contamination (Shankland & Richardson, 1988). In Spain, contaminated lemon juice was also suspected as the cause of an outbreak of Candida albicans amongst injecting heroin users (Miro et al., 1987).

Probably most relevant:

> As discussed previously, the evidence detailed above suggests that adulterants are added to heroin typically either to (1) dilute the product with benign substances making it less pure and increasing profits, or (2) to enhance the heroin (i.e. to make it more efficient when smoked) (Huizer, 1987). The evidence does not concur with the mythology of the addition of gravel, brick dust, household cleaning products or poisons by unscrupulous drug dealers.

@bcook:

Heroin, if it was 100% pure (e.g. as manufactured by a pharmacuticals company), and used with completely safe equipment (e.g. sterylised needles), and used at not-too-high dose levels, it would actually be pretty safe. It essentially has the same effect as morphine or oxycodone, both of which are prescribed legally (my dad has been on morphine for a few years, extended release so he doesn't get high.. but it also doesn't kill him).

The biggest danger is indeed purity - if you think that "x" amount is the right dose for your tolerance (and tolerance not only varies based on how much a user has had before, but also on that person's body in the first place) but one batch you buy is y% pure and the next batch is 2y% pure, you can accidentally dose yourself twice as much as you are expecting and overdose.

Of course overdose is possible with drugs where you completely know the strength - such as oxycontin pills - but with semi-sensible use it's a lot harder, since you actually know how much of the drug you're taking.

Yes it can be addictive, but if you never over do it and can afford to keep buying clean drugs like oxycontin you're most likely going to be fine. The biggest risk with prescription painkillers like this is not that they'll kill you, but that you'll become addicted to them and, when you either can't get another prescription or can't afford your illegal purchases, you move onto heroin because it's much cheaper per dose. Cheaper per dose, but also less pure and therefore more likely to be dangerous.

I personally wouldn't try heroin because I don't want to become dependant on something (other than tobacco..), but if it was completely pure then addition would be the only thing that scared me away from it, not fear of death from using it.

I posted 3 well-established papers above if you want some reading.

Here's a paper about treating opiate addicts with pure heroin and it having positive effects: http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2008....

If you read up pretty much any information about the dangers of heroin, you will see that they are overdose (which you can prevent by using the right amounts), risk when mixed with other drugs (including alcohol), and risk surrounding it (e.g. sharing needles, committing crimes to afford it, etc.) You're still as likely to get addicted, but if you know the dose you're putting into your body you'll probably be fine.

Wikipedia (https://en.wikipedia.org/wiki/Heroin#Adverse_effects) cites "Merck Manual of Home Health Handbook – 2nd edition, 2003, p. 2097" for the following statement: "Like most opioids, unadulterated heroin does not cause many long-term complications other than dependence and constipation." Followed by "...purity levels between 40% and 60%; this variation has led to people suffering from overdoses as a result"

Pure Heroin is actually prescribed as a legal drug in some countries, e.g. the UK: http://patient.info/medicine/diamorphine and once inside your body is almost exactly the same as morphine that is prescribed as a painkiller in most countries. These drugs, when prescribed (and therefore completely pure and dosage known), very rarely cause problems for their users other than tolerance build-up and potential for users to use recreationally without knowing what dose to use.

So stop being rude and go do some Googling yourself, or ask any doctor the next time you go see one / are in a hospital, and they'll tell you the same thing.

Nothing that you referenced says that. Yes, it is a part of any drug use and is a big reason to legalize, but purity is not the biggest danger. The physical and psychological dependance are the biggest problem.

Adulterants are nearly impossible to study, given the unknowns.

Sorry about the "put up or shutup".

Sincerely, I apologize for being so non-collaborative in our search for answers.

I guess overdose being the biggest risk is subjective - if a substance gets you addicted but never kills you then personally I'd consider that less bad than a substance that doesn't get you addicted but could kill you - so I'd rather use pure heroin than, for example, cocaine or un-pure heroin. Not that I plan on trying regardless, myself.

Considering purity fluctuations will actually KILL you rather than just make you want more, yeah I'd say that's by far the most dangerous part of street heroin.

So I'm inclined to believe the 30% number unless you have a source for thinking it's much lower.

A lot of the harm from heroin come from adulterants which are injected, causing abscess; or from the illegality of providing clean needles and injection advice and safe spaces to inject which causes infection etc; or from the illegality of providing maintenance doses from doctors which cause people to burgle or sex work to get money to buy the drug.

Heroin is undoubtedly an unwise choice, but keeping it illegal has been a public health disaster.

http://www.thelancet.com/journals/lancet/article/PIIS0140-67...

http://bmjopen.bmj.com/content/2/4/e000774.full.html#T1

There are more, but freely accessing journals online is troublesome. I have NEVER seen any study say heroin is anything but one of the most crippling and dangerous addictions. I am still waiting for anyone to cite one...

Have a read. Do you think it still supports your position? It says, clearly, that alcohol is more harmful than heroin. Are you calling for alcohol to be made illegal?

Or: Bob is a heroin addict. Should Bob continue to buy heroin from the street? That heroin will be adulterated; of unknown strength; sold by criminals; and may require Bob to engage in acquisitive crime or prostitution to get the money needed. It will be injected with whatever needle Bob has, which may not be sterile and may be shared with other people, some of whom have blood borne diseases. Or should Bob be prescribed heroin by his doctor. That heroin will not be adulterated; will be of known strength; will be supplied with clean needles and advice on safe injection; and will not require Bob to engage in acquisitive crime or prostitution to get it.

Again: Heroin is undoubtedly an unwise choice, but keeping it illegal causes very great harm.

Yeah, alcohol, meth, crack all rank similarly and should be avoided unless you know are very sure how you will react.

People seem to be confused what my position actually is. That is mostly my fault though...

Fentanyl-linked heroin deaths part of larger drug overdose trend

http://articles.baltimoresun.com/2014-02-08/news/bs-md-sun-i...

Also, I assumed "citation" would infer that a reputable book or scholarly white paper should be referenced, not a very short newspaper article.

Though, we both seem to be unwavering in our views, so I am cool with stopping this back and forth. :)

I didn't say that.

My point was that people can lead functional lives on heroin with families and jobs. If the heroin is impure, laced with dangerous chemicals or of unknown strength then the cutting agents can harm people or they may overdose.

Clean heroin is free of harmful cutting agents, of known purity and not laced with other drugs. You mock the term "clean heroin" but that's what it is.

You misread my original post.

I cited Wikipedia.

You have still cited nothing of worth.

That's what I mean by harmful. Meth addicts are psychotically violent and are responsible for countless murders and attacks.

Heroin addicts get smacked out and unconscious. Perhaps dangerous to themselves.

You are avoiding, or simply ignorant of, many aspects of drug addiction.