Polydrug use is the norm, not the exception. Increased risks are associated with certain combinations, but it matters to understand why people use them—with pleasure a meaningful factor. Reasons for combining methamphetamine and heroin come down to both reducing harms and enhancing pleasure, according to 14 drug users interviewed for a study published in Harm Reduction Journal.
In Melbourne, Australia, 12 men and two women described to researchers that each of the drugs can mitigate the negative consequences of, and boost enjoyment of, the other. They identified four key motivations for combining the depressant and the stimulant.
For one, heroin eased the harsh symptoms of a meth comedown, like sweats, shakes and an inability to sleep. “I like the feeling of it [heroin], like just the way that it helps you sleep. And like, when I’m coming off the ice, just to get back down… coming off one hundred miles an hour,” said a 35-year-old male participant.
The participants also said that meth helps to extend their heroin high while delaying the withdrawal. “For heroin on its own I could have a taste of heroin, then five minutes later I would want another one. Whereas if I had a cocktail, I’ll have one and I’ll be alright for about eight hours. It doesn’t come to mind and I don’t crave it, so I use less of it,” a 31-year-old man told interviewers.
Meth can provide an alternative high when being prescribed opioid substitution therapies, like buprenorphine, study participants said. Crystal meth is “a bit of a substitute, a big substitute actually” for heroin, the 35-year-old man said. “It just sort of satisfies me, much the same way that heroin did.”
For some, combining the two in a single injection simply “feels better” than using either of them alone. “In this combination, it actually boosts the heroin and makes the heroin sensation stronger. It brings on the aroma of the heroin but you are also in this state where you want to be tinkering and doing things, or where you can drift off,” said a 39-year-old man.
The researchers also noted, though, that meth use “simply reflect[ed] an increased availability” of the stimulant in the local drug supply.
“[O]ur findings indicate that co-use of stimulants and opioids can present as an effect or symptom of more fundamental issues faced by opioid-dependent individuals, such as ineffective opioid dependency treatments and a perceived lack of pleasure from their lives,” wrote study authors Anna Palmer, Nick Scott, Paul Dietze and Peter Higgs. “Approaches to harm reduction for opioid-stimulant co-use should reflect the context of the behaviour and address the specific needs of opioid-dependent individuals.”
Photo of someone preparing heroin for injection by Psychonaught via Wikimedia Commons/Public Domain