Heroin’s impact on urban communities

Heroin is associated with intense dependency, difficult withdrawal and a high risk of mortality. It, alongside morphine, is linked to the most drug-related deaths, causing around 1,213 poisonings per year (which equates to around 21.1 deaths per million people).

Whilst part of heroin’s danger lies in its links to the opiate overdose crisis, there are numerous other implications for users of heroin and the communities that they live in.

Heavy heroin use has been particularly associated with cities in Britain (such as London, Greater Manchester and Merseyside, among other towns on the western side of the nation) since the 1980s.

But as time goes on and more research is conducted, the spread of heroin use is occurring in other urban areas in England, including Yorkshire, the West Midlands, Avon and both South West and North East England.

Why does heroin use proliferate in our towns and cities? And, crucially, what impact does this actually have on our urban communities?

The Rise of Heroin Addiction

Heroin is an opiate, a drug with very strong pain killing properties. Whilst these types of drugs are effective at managing pain, frequent use can quite quickly lead to dependency.

If you are being prescribed legal opiates, then ‘the person who prescribed an opioid or your pharmacist should explain how long it is safe for you to take your medicine for.’

However, if you are using opiates outside of a prescription basis, then you need to be more cautious, as your use is not overseen by a medical professional, and could therefore lead to development of dependency and difficult withdrawal symptoms.

A 2020 report by Dame Carol Black suggests that there are approximately 261,000 users of heroin in the UK. It also suggests that the main profile for heroin users are individuals who started using the drug in the 80s or 90s. It indicates that heavy use is associated with ‘complex needs’ such as:

• Struggles with mental health, including dual diagnosis

 

• Unemployment

 

• Isolation, separation or estrangement from family

 

• Homelessness

 

• Financial issues

 

• Histories of offending

 

However, there are many instances of individuals who may use heroin recreationally and do not identify as ‘heroin addicts’ for a plethora of reasons.

So, how do you identify when heroin use slides into addiction?

 

Signs of Heroin Addiction

Heroin addiction is multifaceted and is often thought of as a ‘chronic disorder’.

This means that addiction results in a list of long-term effects that can manifest in emotional, physical and behavioural contexts.

Behavioural Signs

• Lying about heroin use and related activity

 

• Increased sleeping at different times of the day

 

• Lack of attention to personal care

 

• Lack of attention to the maintenance of living environment

 

• Difficulties at work

 

• Difficulties at school

 

• Social withdrawal and isolation

 

• Sudden and persistent issues with money

 

• Hiding evidence of use – either by hiding drug-related paraphernalia or the evidence of use left on the body

Physical Signs

• Intense tiredness and lethargy

 

• Unexplained weight loss

 

• Flu or cold symptoms such as muscle aches, sore or runny eyes and nose

 

• Sore, scabbed or bruised skin

 

Psychological Signs

• Confusion, lack of focus and attentiveness

 

• Depression

 

• Denial or difficulty accepting the reality of what is happening

 

• Guilt or shame

 

• Feeling hopeless and unable to change current circumstances

 

• Impaired judgement, reduced ability to assess risk

 

If you can identify these symptoms in yourself or someone around you, it is possible that there is a drug addiction present and appropriate support should be accessed as soon as possible.

The Heroin Epidemic: What Does it Mean for Urban Communities?

Opiates are considered to be one of the most dangerous substances available.

This is largely down to the impact they have on individual welfare, as well as the broader repercussions heroin use can have on the economic and social health of our communities.

The key impacts of heroin on urban communities can be broken down into three core categories:

• Health

 

• Economic

 

• Social

Health Consequences of the Heroin Epidemic

Heroin Overdose Crisis

Perhaps the most ominous consequence of heroin use is the potential risk of overdose. In 2019, 80% of all drug-related deaths (around 600,000) were linked to opioids. A quarter of these deaths (25%) were overdoses.

As heroin use becomes more frequent, more of the drug is needed each time to achieve a high. That means that the more our bodies become tolerant to heroin, the more we use.

But that carries many risks, as the body can only deal with so much before the levels of heroin in the body become toxic, resulting in a high risk of heroin overdose.

There are specific signs that suggest a heroin overdose:

• A blue or grey tint to the lips, extremities and nails

 

• A pale tone in the skin

 

• Very small ‘pin’ like pupils

 

• Compromised, shallow breathing

 

• Confusion

Long-term Health Effects

Whilst not every regular user of heroin will experience an overdose, it is very uncommon for chronic users of the drug not to develop some form of severe health problem as a result of their substance use.

Potential health risks of heroin use include:

• Severe weight loss

 

• Damaged or collapsed veins

 

• Issues with the respiratory system such as pneumonia and tuberculosis

 

• Issues with the cardiovascular system, including infections in the valves and lining of the heart

 

• Increased risk with developing infections such as HIV, AIDS and hepatitis from the use of sharps

 

• Issues with the renal system, including damage to the function of kidneys and liver

 

• Issues with dermatological disorders including ‘necrotising skin lesions,’

 

• Long-term issues with sleep including insomnia

 

• Issues with reproductive systems, including sexual dysfunction, issues with menstruation and increased risk of miscarriage

 

• The development and/or worsening of mental health issues such as depression, anxiety, panic disorder, schizophrenia and paranoia

 

These health effects can severely impact quality of life and can quickly become all-encompassing. They can ultimately restrict an individual’s ability to work, socialise and live in the manner they wish to, potentially risking general wellbeing and the likelihood of both financial and social independence.

 

 

Economic Consequences of the Heroin Epidemic

Between 2017 and 2018, ‘The total cost of harms related to illicit drug use in England was £19.3 billion.’ Over three quarters of this cost (86%) is associated with opiate (and crack cocaine) use specifically.

This can be broken down into:

• £9.3 billion spent on drug-related crime

 

• £733 million spent on criminal justice services

 

• £680 million spent on drug-related enforcement costs

 

• £6.3 billion related to deaths associated with drugs, either due to overdose or homicide

 

• £553 million spent directly on the treatment and prevention of drug use

 

• And £630 million spent on drug-related social care

 

This indicates that the use of heroin has a significant impact on the economy, costing billions of pounds in the UK justice, health and social care and addiction treatment sectors annually.

These numbers do not take into account the funding needed for heroin-related physical and mental health care.

This potentially means that other areas in these sectors risk being underfunded in order to ensure the costs for the appropriate enforcement and care related to the use of heroin and other illicit drugs can be undertaken reliably.

Social Consequences of the Heroin Epidemic

Whilst drug-related harm does cost billions every year, this does not mean that there are enough resources for every individual struggling with heroin addiction or seeking treatment for heroin-related harm. Of course, behind every statistic is the shadow of those individuals not represented.

There are around 140,553 adults in treatment for opiate use each year. Among these adults:

• 20,812 (16%) do not have secure housing,

 

• 93,380 (70%) were in treatment (or needed treatment) for mental health conditions,

 

• and 26,570 were living with children in some capacity

These statistics suggest that the effects of heroin are much more than an individual experience; they are a public health issue.

Individuals struggling with heroin addiction are less likely to be able to work consistently, either for direct reasons (due to the effects of the drug) or indirect reasons (such as stigma and workplace anxiety around drug use).

One report indicates that 80% of ‘problematic drug users’ are unemployed. When, as the report states, ‘paid work not only contributes to society but also provides an individual with a sense of responsibility, value and independence and of having a stake in society,’ this dearth in employment is alarming.

Lack of employment can be associated with low self-confidence, financial precarity and lack of housing security. It can also feed into a vicious cycle, as many studies into addiction indicate that a high proportion of drug users are individuals from deprived areas.

Children growing up in households where drugs are present are also more likely to develop substance use disorders in the future. This suggests that a prevalence of drug users today may lead to a similar prevalence in the future, leading to a generational inheritance of the heroin epidemic.

 

Ways to Tackle An Addiction to Heroin

The effect of heroin on the individual as well as the community is exponential. But with such high stakes, how can you begin the process of escaping from the grip of heroin addiction?

Heroin addiction is a serious experience, and as such, most people will require support from professionals in order to get it under control.

There are several ways to access support depending on what feels best for you. Potential sources of support include:

• Narcotics Anonymous

 

• Treatment recommended by primary clinicians such as GPs

 

• Treatment or support recommended or arranged by social workers

 

• Treatment or support recommended or arranged by staff in the education sector

 

• Specialist treatment from professional addiction services

Access Professional Addiction Services

At UKAT, we pride ourselves on our clinical and practical knowledge on addiction. We work with a variety of medical professionals from a range of fields who all bring a different expertise to our rehab treatments, meaning your support is holistic, personal, and above all, respectful.

We understand that heroin addiction is not something that takes hold overnight; so curing it over night is not necessarily possible either. We offer a range of inpatient treatment options (7 days, 14 days and 28 days) meaning you can access heroin rehab no matter your situation.

We can also help you take the first steps to detoxing from heroin safely so you can regain control of difficult cravings. At our centres you can access a range of bespoke therapy programmes designed to help you in your recovery from heroin addiction. These include:

• The 12-step programme

 

• Art therapy

 

• Cognitive behavioural therapy (CBT)

 

• Dialectical Behavioural Therapy (DBT)

 

• Holistic Therapy

 

• Music Therapy

 

• Physical Health recovery

Get Support for Heroin Addiction

At UKAT, We know first-hand what the impact of heroin addiction can be. But we are ready to help you move forward to a life without the weight of dependency.

Contact us today to discuss the treatment options available for you to begin your path towards a heroin-free life.