ABSTRACT

Using heroin is a risky business. As an illegal drug, heroin is expensive and difficult to purchase. The risk of arrest is high. Once obtained, the quality of the heroin is not guaranteed and the risk of overdose is ever-present. Other health risks include blood-borne viral infections, dependency on the drug, and social and occupational impairment. For the heroin user, these risks are offset by the euphoric experience and, for those dependent on the drug, the desire to avoid withdrawal symptoms. Descriptions of life as a heroin-dependent person can be found in Moore (2004) or Maher (2002). This chapter highlights the ways in which uncertainty is manifest in the area of heroin dependence. The policy-practitioner perspective is taken and three areas are explored: estimating the number of heroin users, evidence-based heroin policy and treatment of an acute mental health disorder in a heroin user. Each of the three chosen areas highlights different aspects of uncertainty and the ways in which they may be addressed.