I have a confession to make.

I introduced a friend to heroin recently; I am not proud. Rather, in fact, I am very, very worried.

Geoffrey (let’s call him that) is a friend of mine whose usual drug of choice is alcohol. But foolishly, I gave him his first taste of heroin a few weeks back. Once, and then once more. And now, I fear I have unleashed the demon in him. He asks me for a taste several times a day now whenever I see him; I tell him no, so then he asks me if I know of anyone nearby from whom he could score.

“For the last time, no.” But he isn’t listening.
“It makes me feel really comfortable. I felt so calm after that one last little taste…” I nodded, knowing exactly what he meant. My stomach sank, in fact, because I knew too well how he felt, how seductive that calm can be… and how much I wanted to shield him from the cycle of destruction which almost inevitably followed that glorious feeling.

“So, can you fix me up?” he asks again.
“No,” I tell him.
“But I can keep it under control.”
“Oh, we all think that. In the beginning, anyway. Few of us ever can keep it in check, though, in the long term…” I trailed off, took a long drag of my cigarette, and sighed loudly. “It fucks up your life, Geoff. You will like it too much, and it will fuck up your life. Best advice I never took.” I pulled a wry face, and looked at him sadly. “I should never have said yes to you in the first place, actually. It was stupid, stupid, stupid.”

Actually, if I’m sick at myself now, it’s nowhere near how sick I was at myself - with panic and remorse - the night I gave Geoffrey his first taste. I guess I should have known that he, as a non-user who wasn’t completely freaked out by the fact that I used now and again, was going to ask. Sooner or later, they nearly always do. Which probably explains why I like to use alone.

Needles didn’t freak him out. “I’ve done speed intravenously,” he told me. “It was a while ago, but yeah…” I sipped my beer cautiously, waiting for what was to come next. “You know my son’s been doing it. I want to know what the fuss is all about.”

“Once, Geoff, and no more.” Goodness knows why I caved in. Was it the mention of his son, a kid eleven years younger than myself, whom I’ve never met? Who knows. But I nodded, and dug in my bag for my kit.

He hovered about me while I got out what I needed and set to it, intent on mixing up our taste. (Okay, I’d done one a few hours previously, and didn’t really need another. But there was no damned way I was doing him up without a little shot myself, to steady the nerves and so on… besides, I’ve never known anyone who’s a user who can mix up a taste for someone else, and not have one themselves. I mean, there’s self-control but nobody has that much cool… really!)

“Gear’s been really… rocky, lately,” I muttered, busy with plunger-end and spoon. “Could you pass me the lighter, Geoff?” He passed me what I asked for, wordlessly. Good, I thought. Someone who respects the sanctity of the mix. That silent time when one is mixing up, be it in a car, a park, a public toilet, or the relative safety of a friend’s kitchen (where I was now) - that mix-time is a form of junkie meditation, a time I hold sacred in some special sense, even if it lasts just thirty seconds.

Wordlessly, I held the spoon up, and gestured for Geoff to run the lighter underneath. “Okay, that’s it.” I said after a few seconds, and put the spoon down again. I worked the plunger which I had separated from its syringe, back into the barrell, and dropped a tiny piece of cotton into the spoon. Deftly, I drew the heroin solution up through the cotton, tapped the barrell, and levelled off the plunger.

Forty-five units, give or take one or two. (The syringes are 100 units large; 100 units equals 1 cc.) I drew out a fresh syringe, pulled out its plunger with the now-familiar *THWOCK* sound, and pushed forty units into the new barrell. That was my “taste”; after all, I’ve been doing this for nine years; Geoffrey, by comparison, had no tolerance at all. What was left, I reasoned, should get him nice and high.

I reassembled my syringe, wrapped a belt around my arm and started tapping up a vein. Hmmm, that one doesn’t look too bad… I plunged the point into my arm, and with relatively little hide-and-seek, I found my vein. Bingo, I silently congratulated myself as I slid the syringe home. Sliding the belt off my arm, I licked a drop or two of blood from the injection site and savoured the feeling of the hit for a few seconds, while telling Geoffrey in a sepulchral post-heroin whisper to get his own arm tied off so I could shoot him up next.

“Guys’ veins are so much easier to get than girls’,” I said as I knelt beside him with the loaded syringe. His arms were a contrast to mine - fresh, unblemished, the veins full and fresh and simple to use. “What a time I could have with veins like yours,” I chuckled, mostly to myself. I ran my hand up his inner arm… there. I slid the needle home; drew up a little to make certain I was in, and pushed the plunger down. Done. I watched his face intently.

“Are you okay?” I asked. He nodded, bliss shining through every pore.

“Yeah.”

I turned away, busying myself with putting the used needles in the disposal bin… chatting away to him idly, it could only have been ten seconds when I turned back, and the words died in my mouth.

“Geoff?” He’d gone blue. Oh, SHIT. I knelt down to his motionless form on the kitchen chair, and started pinching his arm. “Geoffrey. Come on, now…”

No response. With one arm, I started slapping his face, softly, while with the other I reached down to feel the pulse in his wrist. Faint. He was turning purple now, and still not breathing. Oh shit shit shit shit SHIT…

“Geoffrey!” My slaps became stronger, as my voice, quiet but panicked, cracked from the strain. Nothing for it. I’d have to call the ambos. I grabbed his cellphone from the table, dialled triple 0, and shut my eyes as the call connected.

“Emergency. What services do you require?”

“Ahm… I need an ambulance at…” my mind went blank. Where was I? What the hell was Geoff’s address again? I started babbling. “Oh Jesus, I just walked in and my friend… I think he’s overdosed…”

“Are you on his phone?”
“Yes, but it’s a mobile…”
“We have that registered to a…” and the operator listed an address in Kelvin Grove. Of course. He bought this phone when he moved to Brisbane. That’s his LAST address. Damn, where are we?

“No, no, it’s Red Hill, it’s…” quickly, I walked outside the flat, looked at the door. Something in me freed up and I suddenly knew the address. “Red Hill. Flat 18, 132 Musgrave Road, Red Hill.”

“Okay, what has he taken?”
I’ve been pacing the floor; I walk back to the kitchen. “He’s not breathing… I… I think it might have been heroin.” (Disingenuity is always the key. Don’t admit anything until you have to.)

“Okay, the ambulance is on its way. No, I have not dispatched the police. Stay with your friend and put him in the recovery position, do you know how to do that?”
“Yes.” I disconnected the phone and again took Geoff’s pulse. Weaker. Damn you… stay with me… “Stay with me, Geoff.” I pinched off his nose and blew into his mouth, hoping to force some air into his lungs. I was rewarded with a ragged breath.

“Yes… that’s it. Stay with me. Come on. Ambulance is on it’s way. Breathe.” I heard him breathe a few times more, then I heard the sirens outside. I decided it was safe to leave Geoff where he was, for the time being, and I raced downstairs to show the ambulancemen up and go through the barrage of questions with them.

“What’s he taken?”
“Heroin.”
“And have you had any heroin this evening?” The paramedic looked into my eyes and I shrugged; I have pale blue eyes, so with people in the know, there’s no point in my lying. “I’ll take that as a yes.”

The kitchen was cramped and small, the men dragged Geoff out onto the livingroom floor. “What’s his name?”
“Geoff. Geoffrey.”
“Wake up, Geoffrey.” He was breathing, but only barely. I saw them prepare a shot of Narcan, and shuddered. Well, you ruined my shot by nearly dying, said a selfish part of me, and dammit, nobody dies on my watch. I knew I shouldn’t have given you that taste. Stupid, stupid, stupid…

“Are you going to have to take him to hospital? Because he really doesn’t like hospitals.”

“Probably. In fact, it’s very likely. How much did he use?”
“I’m not sure,” I lied. “I don’t think he’d had any for quite some time… I was out of the room, and I came back and found him like this.” Damned if I’ll admit to a bunch of paramedics that I nearly killed someone. They look down on users enough already. Junkys, the modern-day lepers…

In the end, Geoff came around enough for them to trust me to watch him for the rest of the evening, as an alternative to them sending him to hospital. We were both pretty quiet after the ambulancemen left, each thinking our own thoughts. I was mainly thinking about what an idiot I’d been.

A week or so later, Geoff asked me again for a taste. “Only a TINY bit,” I told him. “And only because that first time was such a fucking disaster. But that’s it, Geoff. No more. And I’ll do everything in my power to make sure that nobody sells to you, either. Although I know I won’t have to, really. I doubt you’d bother going looking for it, not that it’s easy to find in this town anyway.”

I did him up again, probably only giving him half what I had before, and watched him like a hawk until I was dead certain he couldn’t have overdosed on this gear. Needless to say, he enjoyed it. But I hope like hell he sticks to beer.

AUTHOR’S NOTE: Opiates on their own can sometimes cause overdose, especially in opiate-naive individuals; however, opiates mixed with other central nervous system (CNS) depressants, such as alcohol or benzodiazepenes, can be far more deadly. Alcohol and heroin were used together in this story, and I mean it when I say DO NOT try this at home. Anyone. Please.

“The information you will learn here will not only help keep you safe, it will help keep your friends safe, and by extension, the wider community will benefit.” Edith, one of the facilitators of the course, told the assembled fifteen or so people. We ranged in age from teenagers to middle-aged, and even more widely in drug using preferences. Some had been using for years, some for months. One or two people didn’t use at all, but for their own reasons, wanted to help those who did.

My boyfriend, S., and I met at a state-run user group and needle exchange in the inner suburbs of Brisbane, in the mid nineteen-nineties. He and I were the beneficiaries of a free five-day “peer education” course which taught us the basics of needle exchange programs, peer education, user outreach services, resuscitation and what to do in the event of an overdose. It even covered vein care and better injection techniques. It was this information, as well as vigilance on our part and semi-regular health checkups, which I believe saved our lives. Well, it saved mine, anyway. I haven’t spoken to S. in over four years, but the last I heard, he was free of both HIV/AIDS and Hepatitis C, the two major blood-borne diseases which are the bane of any junky’s life. At time of writing, I have tested consistently clear of both viruses.

Junkys are not known for being the cleanest or most organised of people, generally. More occasional injecting drug users, who come into contact with the more hardcore, regular, and generally infected population, therefore run all sorts of risks. Addiction, police sanctions and overdose are just a few of these risks – but blood-borne illnesses like Hepatitis C are in the long term, perhaps, a more sinister threat, due to their long-lasting effects.

Hepatitis C is a blood-borne viral condition which causes inflammation of the liver, leading to liver cirrhosis and other serious life-threatening problems in many people who have the disease. The most common way in which people get Hepatitis C in Australia is by sharing drug injecting equipment, but it can also be transmitted by other blood-to-blood contact. The most common mode of Hepatitis C transmission amongst intravenous drug users is sharing of injection equipment – not only needles and syringes but spoons, swabs, filters, tourniquets… anything to do with the injection process and therefore possibly able to transmit blood. Even tiny amounts of blood, invisible to the naked eye, can result in Hep C transmission from person to person.

Around sixty percent of injecting drug users in Australia are thought to have the Hepatitis C virus. The number of new cases each year increased by 45% between 1997 and 2001. Figures from 2001 state that prevalence of the disease amongst people reporting less than three years of injecting drug use was almost three in ten, therefore, naturally, the risk of infection increases with length of using time. I started injecting drugs in 1996, and almost every user I knew (apart from my boyfriend and I) was Hep C positive. Reading these statistics (the most recent available) recently, though, was truly alarming.
It seems I really was one of the lucky ones, to inject for as long as I did and still come out of it pathogen-free…

As a naïve young injector almost a decade ago, I knew a little about the risk of HIV/AIDS, but almost nothing about Hepatitis C. And yet it is this latter illness which is, even today, so prevalent amongst the intravenous drug using populations in Australia and elsewhere. Thanks to more relaxed laws relating to the supply of needles, as well as needle exchange programs introduced (and funded by governments) from the late 1980s onwards in Australian states, Australia today has one of the lowest rates of HIV/AIDS amongst IV drug users in the world. But by the mid-1990s, it had become evident that the strategies which were keeping injectors from contracting the Human Immunodeficiency Virus, were not working anywhere near as well for Hepatitis C.

“A new fit for every hit!” exhorted the posters seen at many needle exchanges. This and other slogans had drummed into users the importance of being careful with their injection equipment, using brand new syringes and needles wherever possible. And, it was true, as availability of needles had increased, the rate of HIV infection had decreased. But the same had not been anywhere near as true for Hepatitis C, which turned out to be a much hardier virus, able to survive outside the body for far longer periods than HIV, thus making it much more able to be transmitted from user to user.

The training S. and I received has indeed kept us safe. Information shared is knowledge gained, and a little knowledge is a lot better than none at all. The information about Hepatitis C which was given to us in our peer education course, helped S. and I develop routines and injection practices which, even when we became addicts ourselves, saved us from taking the sort of risks that would probably have led to us becoming infected with Hep C, and then infecting others. A little knowledge about how to inject safely was indeed, as Ingrid had said, not only beneficial to ourselves, but to others we injected with.

Sadly, a decade on from our training, simply far too few injecting drug users are aware enough of the risks of Hepatitis C, and the infection rate amongst the drug-using community continues to rise.
I know too many people younger than myself, with much less injecting time behind them, who are infected with Hepatitis C - for which there is currently neither vaccine nor cure -and who may indeed have their lives (and the lives of the people close to them, whether those people were ever injectors themselves) affected dreadfully in the future by the insidious nature of this illness. It’s hard not to feel saddened. It’s also one of the reasons I believe so passionately in the concepts and practice of harm reduction, peer education, and needle exchange programs.