&lt;h1 data-start=&quot;156&quot; data-end=&quot;202&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong data-start=&quot;159&quot; data-end=&quot;202&quot;&gt;What Heroin Is and How It Works&lt;/strong&gt;&lt;/span&gt;&lt;/h1&gt;
&lt;hr /&gt;
&lt;p data-start=&quot;204&quot; data-end=&quot;480&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;204&quot; data-end=&quot;214&quot;&gt;Heroin&lt;/strong&gt; (chemical name: &lt;strong data-start=&quot;231&quot; data-end=&quot;251&quot;&gt;diacetylmorphine&lt;/strong&gt;, DAM) is a &lt;strong data-start=&quot;263&quot; data-end=&quot;288&quot;&gt;semi-synthetic opioid&lt;/strong&gt;. It is made from &lt;strong data-start=&quot;306&quot; data-end=&quot;318&quot;&gt;morphine&lt;/strong&gt;, which is extracted from the &lt;strong data-start=&quot;348&quot; data-end=&quot;363&quot;&gt;opium poppy&lt;/strong&gt;. Opioids are substances primarily used for &lt;strong data-start=&quot;407&quot; data-end=&quot;422&quot;&gt;pain relief&lt;/strong&gt;, but they also affect mood, breathing, and consciousness.&lt;/span&gt;&lt;/p&gt;
&lt;p data-start=&quot;482&quot; data-end=&quot;644&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Heroin acts as an &lt;strong data-start=&quot;500&quot; data-end=&quot;518&quot;&gt;opioid agonist&lt;/strong&gt;, meaning it binds to opioid receptors in the brain and nervous system. These receptors control pain, emotions, and breathing.&lt;/span&gt;&lt;/p&gt;
&lt;p data-start=&quot;482&quot; data-end=&quot;644&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;646&quot; data-end=&quot;686&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Medical and substitution opioids&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;p data-start=&quot;687&quot; data-end=&quot;813&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Certain opioids are legally used in &lt;strong data-start=&quot;723&quot; data-end=&quot;754&quot;&gt;opioid substitution therapy&lt;/strong&gt; to stabilize people with heroin dependence. These include:&lt;/span&gt;&lt;/p&gt;
&lt;ul&gt;
&lt;li data-start=&quot;816&quot; data-end=&quot;829&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;816&quot; data-end=&quot;829&quot;&gt;Methadone&lt;/strong&gt;&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;832&quot; data-end=&quot;872&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;832&quot; data-end=&quot;849&quot;&gt;Levomethadone&lt;/strong&gt; (e.g., &lt;em data-start=&quot;857&quot; data-end=&quot;871&quot;&gt;L-Polamidon&amp;reg;&lt;/em&gt;)&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;875&quot; data-end=&quot;943&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;875&quot; data-end=&quot;905&quot;&gt;Sustained-release morphine&lt;/strong&gt; (e.g., &lt;em data-start=&quot;913&quot; data-end=&quot;942&quot;&gt;Sevre-Long&amp;reg;, MST&amp;reg;, Kapanol&amp;reg;&lt;/em&gt;)&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;946&quot; data-end=&quot;982&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;946&quot; data-end=&quot;963&quot;&gt;Buprenorphine&lt;/strong&gt; (e.g., &lt;em data-start=&quot;971&quot; data-end=&quot;981&quot;&gt;Subutex&amp;reg;&lt;/em&gt;)&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;985&quot; data-end=&quot;1047&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;985&quot; data-end=&quot;1005&quot;&gt;Diacetylmorphine&lt;/strong&gt; (pharmaceutical heroin, e.g., &lt;em data-start=&quot;1036&quot; data-end=&quot;1046&quot;&gt;Diaphin&amp;reg;&lt;/em&gt;)&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p data-start=&quot;1049&quot; data-end=&quot;1204&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;⚠️ These substances are &lt;strong data-start=&quot;1073&quot; data-end=&quot;1142&quot;&gt;dangerous or life-threatening for people without opioid tolerance&lt;/strong&gt;, even at low doses, due to severe &lt;strong data-start=&quot;1177&quot; data-end=&quot;1203&quot;&gt;respiratory depression&lt;/strong&gt;.&lt;/span&gt;&lt;/p&gt;
&lt;p data-start=&quot;1049&quot; data-end=&quot;1204&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;1206&quot; data-end=&quot;1221&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong data-start=&quot;1210&quot; data-end=&quot;1221&quot;&gt;Effects&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;ul&gt;
&lt;li data-start=&quot;1224&quot; data-end=&quot;1244&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Strong pain relief&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1247&quot; data-end=&quot;1285&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Calming and anxiety-reducing effects&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1288&quot; data-end=&quot;1333&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Feelings of warmth, balance, and relaxation&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1336&quot; data-end=&quot;1394&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Intense initial euphoria (&amp;ldquo;rush&amp;rdquo; or &amp;ldquo;flash&amp;rdquo;), followed by:&lt;/span&gt;
&lt;ul&gt;
&lt;li data-start=&quot;1399&quot; data-end=&quot;1409&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Well-being&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1414&quot; data-end=&quot;1434&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Emotional detachment&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1439&quot; data-end=&quot;1447&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Serenity&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1452&quot; data-end=&quot;1486&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Reduced motivation and alertness&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;1488&quot; data-end=&quot;1514&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong data-start=&quot;1492&quot; data-end=&quot;1514&quot;&gt;Onset and duration&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;ul&gt;
&lt;li data-start=&quot;1517&quot; data-end=&quot;1571&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;1517&quot; data-end=&quot;1540&quot;&gt;Injected or smoked:&lt;/strong&gt; effect begins within seconds&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1574&quot; data-end=&quot;1622&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;1574&quot; data-end=&quot;1586&quot;&gt;Snorted:&lt;/strong&gt; effect begins after a few minutes&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1625&quot; data-end=&quot;1704&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;1625&quot; data-end=&quot;1638&quot;&gt;Duration:&lt;/strong&gt; approx. &lt;strong data-start=&quot;1647&quot; data-end=&quot;1660&quot;&gt;2&amp;ndash;5 hours&lt;/strong&gt;, depending on dose, purity, and tolerance&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;1706&quot; data-end=&quot;1720&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong data-start=&quot;1710&quot; data-end=&quot;1720&quot;&gt;Dosage&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;ul&gt;
&lt;li data-start=&quot;1723&quot; data-end=&quot;1816&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Dosage varies greatly depending on &lt;strong data-start=&quot;1758&quot; data-end=&quot;1768&quot;&gt;purity&lt;/strong&gt;, &lt;strong data-start=&quot;1770&quot; data-end=&quot;1786&quot;&gt;route of use&lt;/strong&gt;, and &lt;strong data-start=&quot;1792&quot; data-end=&quot;1816&quot;&gt;individual tolerance&lt;/strong&gt;&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1819&quot; data-end=&quot;1914&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;For people &lt;strong data-start=&quot;1830&quot; data-end=&quot;1851&quot;&gt;without tolerance&lt;/strong&gt;, the &lt;strong data-start=&quot;1857&quot; data-end=&quot;1872&quot;&gt;lethal dose&lt;/strong&gt; of pure heroin is approximately &lt;strong data-start=&quot;1905&quot; data-end=&quot;1914&quot;&gt;60 mg&lt;/strong&gt;&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1917&quot; data-end=&quot;2047&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Pharmaceutical diacetylmorphine (e.g., &lt;em data-start=&quot;1956&quot; data-end=&quot;1966&quot;&gt;Diaphin&amp;reg;&lt;/em&gt;) is &lt;strong data-start=&quot;1971&quot; data-end=&quot;1985&quot;&gt;much purer&lt;/strong&gt; than street heroin &amp;mdash; &lt;strong data-start=&quot;2007&quot; data-end=&quot;2047&quot;&gt;effective doses are roughly 5&amp;times; lower&lt;/strong&gt;&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;2049&quot; data-end=&quot;2062&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong data-start=&quot;2053&quot; data-end=&quot;2062&quot;&gt;Forms&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;ul&gt;
&lt;li data-start=&quot;2065&quot; data-end=&quot;2121&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;2065&quot; data-end=&quot;2083&quot;&gt;Street heroin:&lt;/strong&gt; white, cream, gray, or brown powder&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2124&quot; data-end=&quot;2202&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;2124&quot; data-end=&quot;2169&quot;&gt;Pharmaceutical heroin (diacetylmorphine):&lt;/strong&gt; tablets or injectable solution&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p data-start=&quot;2963&quot; data-end=&quot;3075&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h1 data-start=&quot;2209&quot; data-end=&quot;2263&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong data-start=&quot;2212&quot; data-end=&quot;2263&quot;&gt;Risks, Long-Term Effects, and Safer Use&lt;/strong&gt;&lt;/span&gt;&lt;/h1&gt;
&lt;hr /&gt;
&lt;h2 data-start=&quot;2265&quot; data-end=&quot;2289&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong data-start=&quot;2269&quot; data-end=&quot;2289&quot;&gt;Short-term risks&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;ul&gt;
&lt;li data-start=&quot;2292&quot; data-end=&quot;2321&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Slowed or shallow breathing&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2324&quot; data-end=&quot;2345&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Nausea and vomiting&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2348&quot; data-end=&quot;2357&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Itching&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2360&quot; data-end=&quot;2380&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Low blood pressure&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2383&quot; data-end=&quot;2395&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Slow pulse&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2398&quot; data-end=&quot;2418&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Constricted pupils&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2421&quot; data-end=&quot;2440&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Urinary retention&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;h4 data-start=&quot;2442&quot; data-end=&quot;2460&quot;&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;&lt;strong data-start=&quot;2442&quot; data-end=&quot;2460&quot;&gt;Overdose risks&lt;/strong&gt;&lt;/span&gt;&lt;/h4&gt;
&lt;ul&gt;
&lt;li data-start=&quot;2463&quot; data-end=&quot;2525&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Severe respiratory depression or complete respiratory arrest&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2528&quot; data-end=&quot;2634&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Brain damage, organ failure, or death&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2528&quot; data-end=&quot;2634&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;2571&quot; data-end=&quot;2634&quot;&gt;Any suspected overdose requires immediate medical attention&lt;/strong&gt;&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;2636&quot; data-end=&quot;2659&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Long-term risks&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;h4 data-start=&quot;2660&quot; data-end=&quot;2677&quot;&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;&lt;strong&gt;With regular use:&lt;/strong&gt;&lt;/span&gt;&lt;/h4&gt;
&lt;ul&gt;
&lt;li data-start=&quot;2680&quot; data-end=&quot;2711&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Confusion and memory problems&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2714&quot; data-end=&quot;2741&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Slurred or unclear speech&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2744&quot; data-end=&quot;2771&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Coordination difficulties&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2774&quot; data-end=&quot;2795&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Severe constipation&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2798&quot; data-end=&quot;2814&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Reduced libido&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2817&quot; data-end=&quot;2863&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Strong psychological and physical dependence&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;h4 data-start=&quot;2865&quot; data-end=&quot;2879&quot;&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;&lt;strong data-start=&quot;2865&quot; data-end=&quot;2879&quot;&gt;Withdrawal&lt;/strong&gt;&lt;/span&gt;&lt;/h4&gt;
&lt;ul&gt;
&lt;li data-start=&quot;2882&quot; data-end=&quot;2949&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Begins &lt;strong data-start=&quot;2889&quot; data-end=&quot;2903&quot;&gt;8&amp;ndash;12 hours&lt;/strong&gt; after last use when tolerance has developed&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2952&quot; data-end=&quot;2969&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong&gt;Symptoms include:&lt;/strong&gt;&lt;/span&gt;
&lt;ul&gt;
&lt;li data-start=&quot;2974&quot; data-end=&quot;2990&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Sweating, chills&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2995&quot; data-end=&quot;3014&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Runny eyes and nose&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3019&quot; data-end=&quot;3040&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Vomiting and diarrhea&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3045&quot; data-end=&quot;3071&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Restlessness, irritability&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3076&quot; data-end=&quot;3095&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Anxiety, depression&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3100&quot; data-end=&quot;3122&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Muscle cramps and pain&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3127&quot; data-end=&quot;3137&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Insomnia&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;/li&gt;
&lt;li data-start=&quot;3140&quot; data-end=&quot;3165&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong&gt;Less common but possible:&lt;/strong&gt;&lt;/span&gt;
&lt;ul&gt;
&lt;li data-start=&quot;3170&quot; data-end=&quot;3184&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Hallucinations&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3189&quot; data-end=&quot;3207&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Psychotic episodes&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3212&quot; data-end=&quot;3222&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Seizures&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;3224&quot; data-end=&quot;3254&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong data-start=&quot;3228&quot; data-end=&quot;3254&quot;&gt;Risks by method of use&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;h4&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;&lt;strong data-start=&quot;3257&quot; data-end=&quot;3270&quot;&gt;Snorting:&lt;/strong&gt;&lt;/span&gt;&lt;/h4&gt;
&lt;ul&gt;
&lt;li data-start=&quot;3277&quot; data-end=&quot;3322&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Damage to nasal septum and mucous membranes&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3327&quot; data-end=&quot;3358&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Increased risk of hepatitis C&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;h4&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;&lt;strong data-start=&quot;3362&quot; data-end=&quot;3374&quot;&gt;Smoking:&lt;/strong&gt;&lt;/span&gt;&lt;/h4&gt;
&lt;ul&gt;
&lt;li data-start=&quot;3381&quot; data-end=&quot;3418&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Damage to lungs and bronchial tubes&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3423&quot; data-end=&quot;3465&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Chronic buildup of residues in the lungs&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;h4&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;&lt;strong data-start=&quot;3469&quot; data-end=&quot;3483&quot;&gt;Injecting:&lt;/strong&gt;&lt;/span&gt;&lt;/h4&gt;
&lt;ul&gt;
&lt;li data-start=&quot;3490&quot; data-end=&quot;3522&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Vein inflammation and collapse&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3527&quot; data-end=&quot;3591&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;High risk of HIV, hepatitis C, fungal and bacterial infections&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3596&quot; data-end=&quot;3626&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Organ damage from impurities&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;3628&quot; data-end=&quot;3673&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Safer-use principles (harm reduction)&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;ul&gt;
&lt;li data-start=&quot;3676&quot; data-end=&quot;3752&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Start with a &lt;strong data-start=&quot;3689&quot; data-end=&quot;3706&quot;&gt;very low dose&lt;/strong&gt; and wait for full effects before using more&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3755&quot; data-end=&quot;3885&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;3755&quot; data-end=&quot;3803&quot;&gt;Overdose risk is extremely high after breaks&lt;/strong&gt; (2+ days without use)&lt;/span&gt;&lt;br data-start=&quot;3825&quot; data-end=&quot;3828&quot; /&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&amp;rarr; Always &lt;strong data-start=&quot;3839&quot; data-end=&quot;3885&quot;&gt;reduce dose significantly after abstinence&lt;/strong&gt;&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3888&quot; data-end=&quot;3935&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Injection carries the &lt;strong data-start=&quot;3910&quot; data-end=&quot;3935&quot;&gt;highest overdose risk&lt;/strong&gt;&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3938&quot; data-end=&quot;3985&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Always use &lt;strong data-start=&quot;3949&quot; data-end=&quot;3985&quot;&gt;new, sterile injecting equipment&lt;/strong&gt;&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3988&quot; data-end=&quot;4036&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Never share syringes, filters, water, or swabs&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4039&quot; data-end=&quot;4122&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Do &lt;strong data-start=&quot;4042&quot; data-end=&quot;4049&quot;&gt;not&lt;/strong&gt; copy doses from experienced users &amp;mdash; their tolerance may be much higher&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4125&quot; data-end=&quot;4176&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Take &lt;strong data-start=&quot;4130&quot; data-end=&quot;4147&quot;&gt;longer breaks&lt;/strong&gt; (several days) between use&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4179&quot; data-end=&quot;4296&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Avoid &lt;strong data-start=&quot;4185&quot; data-end=&quot;4210&quot;&gt;grapefruit and citrus&lt;/strong&gt; before or during use &amp;mdash; they can intensify opioid effects and respiratory depression&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;4298&quot; data-end=&quot;4332&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong data-start=&quot;4302&quot; data-end=&quot;4332&quot;&gt;Mixed use (very high risk)&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;p data-start=&quot;4333&quot; data-end=&quot;4397&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Combining heroin with other substances greatly increases danger:&lt;/span&gt;&lt;/p&gt;
&lt;h4 data-start=&quot;4399&quot; data-end=&quot;4436&quot;&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;&lt;strong data-start=&quot;4399&quot; data-end=&quot;4436&quot;&gt;Especially dangerous combinations&lt;/strong&gt;&lt;/span&gt;&lt;/h4&gt;
&lt;ul&gt;
&lt;li data-start=&quot;4439&quot; data-end=&quot;4448&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Alcohol&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4451&quot; data-end=&quot;4468&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Benzodiazepines&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4471&quot; data-end=&quot;4480&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;GHB/GBL&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4483&quot; data-end=&quot;4508&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Ketamine, nitrous oxide&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4511&quot; data-end=&quot;4526&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Other opioids&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p data-start=&quot;4528&quot; data-end=&quot;4589&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&amp;rarr; High risk of &lt;strong data-start=&quot;4543&quot; data-end=&quot;4589&quot;&gt;unconsciousness, vomiting, and suffocation&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;h4 data-start=&quot;4591&quot; data-end=&quot;4619&quot;&gt;&lt;span style=&quot;color: #cc99ff;&quot;&gt;&lt;strong data-start=&quot;4591&quot; data-end=&quot;4619&quot;&gt;Other risky combinations&lt;/strong&gt;&lt;/span&gt;&lt;/h4&gt;
&lt;ul&gt;
&lt;li data-start=&quot;4622&quot; data-end=&quot;4720&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;4622&quot; data-end=&quot;4630&quot;&gt;DXM:&lt;/strong&gt; increases risk of heart, brain, and breathing complications and lowers opioid tolerance&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4723&quot; data-end=&quot;4774&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;4723&quot; data-end=&quot;4747&quot;&gt;Methoxetamine (MXE):&lt;/strong&gt; increases opioid effects&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4777&quot; data-end=&quot;4832&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;4777&quot; data-end=&quot;4832&quot;&gt;Stimulants (cocaine, amphetamine, methamphetamine):&lt;/strong&gt;&lt;/span&gt;
&lt;ul&gt;
&lt;li data-start=&quot;4837&quot; data-end=&quot;4879&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Extreme strain on heart and nervous system&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4884&quot; data-end=&quot;4965&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Masked effects can lead to &lt;strong data-start=&quot;4911&quot; data-end=&quot;4931&quot;&gt;delayed overdose&lt;/strong&gt; when stimulant effects wear off&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;

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