Illustration by Cei Willis
Injecting heroin isn't for everyone. Your classmates who broke down in tears queuing for their BCG jab. Anyone who refuses to go to Sri Lanka because they'd rather avoid being vaccinated for Japanese encephalitis. These people are unlikely to develop an intravenous drug addiction. However, a fear of needles alone isn't always enough to steer people away from this kind of harmful behaviour.
Besides those admittedly rare anomalies, there are plenty of heroin addicts who inject but, strangely, have never held a syringe themselves. There are a number of reasons why that might be, but the main one is arguably because injecting drugs is a lot harder than you'd think, and comes with no instruction manual.
Like me, most who do inject have done so since their veins were both healthy and visible. However, after a substantial amount of time spent polluting your bloodstream, they tend to become considerably more difficult to detect and use.
After a few years of injecting drugs, I hit a wall; all of my previous injecting sites packed in pretty much simultaneously. There were still places I'd never used - some because they were out of reach and others due to common sense - so I persevered for a while. But as I saw no other short-term alternative, I set out to find a person who could "get" (inject) me.
I ended up using a selection of different people, all injecting drug users themselves, to inject my drugs for me. Most of the time these were people I didn't associate with - or even know very well - as my involvement in the British drugs scene is limited to a regular exchange with my usual supplier. After a few months of relying on these people to deliver me a daily supply, the veins in my arms became less visible. People began refusing to waste their time, wanting instead to go in my neck or groin - areas I hadn't injected before - where you could see or feel the vein. I didn't want to start injecting there, but the problem with addiction is that, at times, you can really feel like there's no other option.
I always found it strange how I'd unconsciously agree upon the terms of whoever was injecting me. How I had so little say on the outcome, regardless of the fact it was my body and my drugs. And this is undoubtedly the same for others; I've seen injectors get air in a pin, the recipient hoping it's not going to kill them when it's injected. I've seen people wipe the end of the pin with their fingers, or push the gear into somebody's skin instead of their vein (two big no-nos). But you're not in a position to complain because of the worry that you'll have to find somebody else who will undertake the whole ordeal, possibly losing your hit in the process.
The etiquette of asking someone to inject you also includes offering to share your drugs, or supplying the funds for them to buy their own - making the whole thing more of a challenge financially, as well as creating a kind of informal black market for addicts looking for assistance. The average "price" for injecting someone is usually a ten bag, or half of what you have yourself if it's less than that. This price applies to each individual hit, which often encourages users to take more in one go than they would otherwise.
(Photo courtesy of the author)
I spoke to Jane (all interviewees asked to remain anonymous), who - despite a fear of needles - has spent 10 years being injected with heroin. She began taking drugs intravenously with an ex-boyfriend, telling me that while she recovered from the breakup of their relationship emotionally, she was coping with the realisation that there was a much stronger physical attachment that needed satisfying: the desire to inject drugs.
"I was lucky that I knew someone I trusted, who helped me," she said. "I'd rather have them do it than anyone else, but it's not possible to pin somebody down 24/7. Besides the trust issues, I've had to spend twice as much money when I've asked other people to help me, because they need something in return."
Unsurprisingly, this relationship can have as much of an impact on your wallet as it can your body. Jane - who's currently holding down two part-time jobs - is finding it financially crippling to fund not just her own addiction, but also that of whoever injects her. I asked why she goes to these lengths to have her drugs injected, rather than switching to another method of ingestion - like smoking, for example.
"I think I just like to punish myself," she said. "While I'm injecting, my short-term situation gets a little better and the long-term health implications get much worse. This situation's a nightmare and I wouldn't recommend it to anyone, but I have no desire to start smoking it. The only way I see my situation improving is if I learn to do it myself."
Joy, another user I spoke to, was left without anyone to inject her when her partner was sentenced to 12 months in prison. "After digesting the news, I was struck by the realisation that I had drugs with no way of taking them," she said. "After many failed attempts, it hit me how little [information about injecting] I'd actually taken in over the years."
(Photo courtesy of the author)
This is a situation those who can't inject could end up finding themselves in, with some forced to wander the streets in search of an addict living rough who might be swayed by an offer of a ten bag. As Joy explained, "I couldn't think of anyone who could do it for me, so I decided to go to a church that provides breakfast for the homeless.
"I had a shit night trying to 'get' myself, which was made harder by the fact my circulatory system had been hammered by this point. The following day was horrible; I'd been throwing up all night and wondered whether you could get so sick that you couldn't go out, and if eventually I would just fall down and die."
Injecting other people with illicit substances is clearly not an ethical thing to do. Although the person who knows how to administer drugs intravenously might be without money or the drugs themselves, a huge power imbalance is created by the fact that the recipient physically needs them there to feed their addiction.
I'd always condemned anyone who injected others, but after experiencing heroin withdrawal myself I began to at least understand their reasoning. Due to the increased levels of anxiety and the onset of desperation and panic as the drugs leave your system, the prospect of breaking the law or contradicting your personal values becomes a more viable option.
Bundles of heroin (Photo via)
I spoke to Nick, who is currently facilitating the supply of another person's drugs, to get his perspective on the situation.
When I asked how the relationship came about, he said: "I live in a house with three other people who inject drugs, so as a household we get a lot of people asking us to score for them, inject their drugs or just have a smoke. I declined the first time [the person I inject] asked, and one of the other people I live with did it for her as a one-off, but she came back the following day."
I asked what changed his mind. "If I'm honest, I didn't have anything and couldn't afford to turn down the drugs," he replied. "At first, the continuous stream of heroin was enough to keep me doing it, but she started expecting me to give her a few [hits] throughout the day."
I wondered whether he'd grown used to injecting the woman - if it wasn't something that bothered him by this point. "It's tricky, because I'm still doing it, but it makes me feel like shit," he said. "I've wanted to say no, but when it comes to it, I can't. When I'm not feeling good myself, I've found it impossible to turn down a bag; everything else seems to go out of the window.
"The idea that I'm being bought is hard to accept," he continued. "To be honest, I'm sick of the whole thing - I don't want to put holes in myself, never mind someone else."
(Photo courtesy of the author)
Currently, I can inject myself, so I haven't recently been forced to find anyone to help me. That, of course, can't be said for everyone, with some stuck in a cycle of obtaining twice the amount of money, buying twice the amount of drugs and tracking down someone every day to inject them.
So what can be done to reduce the potential harm? One resolution would be to introduce supervised injecting sites throughout the UK, like the facilities in Switzerland, Germany, Spain, Denmark and the Netherlands. But considering drugs services here seem to be hung up on treating heroin addiction with methadone - subsequently leaving many addicts with a whole new addiction - that doesn't seem like a particularly likely outcome.
A related issue that also needs addressing is being addicted to the injecting itself. I've known people, for instance, who've given up heroin but continue to inject water into their veins. And when I asked Joy whether she'd ever considered smoking instead of injecting, she said: "I've never smoked it, and I don't think I could stop 'digging'. It's such a big part of my addiction that I wonder if I'm punishing myself through some unusual form of self harm, which I'm sure would be minimised if I could do it myself."
For long-term injecting drug users, the process of actually preparing the drugs becomes an intense, integral part of their lives. This can be linked to a release of dopamine in the brain when they handle the paraphernalia - a phenomenon known as "stimulus-conditioning". However, that's something that can only really be treated with time and therapy.
For me, the way forward is through specialist counselling, like cognitive behavioural therapy, and abstinence-based recovery. It's not having the drugs - or having them and not knowing how to inject them - that's at the root of this specific issue. So learning to live without drugs should be the quickest route to recovery, instead of substituting one highly addictive drug for another, as is the case with methadone treatment.
Unfortunately, that's obviously a lot easier said than done.
Below are a number of services that can help heroin addicts in the UK seek treatment:
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