What is Drug Paraphernalia?
The term drug paraphernalia refers to any equipment that is used to produce, conceal, and consume illicit drugs. These are the items used for drug addiction or substance abuse. It includes but is not limited to items such as bongs, roach clips, miniature spoons, and various types of pipes.
Under federal law the term drug paraphernalia means “any equipment, product or material of any kind which is primarily intended or designed for use in manufacturing, compounding, converting, concealing, producing, processing, preparing, injecting, ingesting, inhaling, or otherwise introducing into the human body a controlled substance.”
Federal law  states it is illegal for any person:
- To sell or offer for sale drug paraphernalia
- To use the mail or any other facility of interstate commerce to transport drug paraphernalia; or
- Import or export drug paraphernalia
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How to Identify Heroin Paraphernalia?
Identifying drug paraphernalia can be challenging because products often are marketed as though they were designed for legitimate purposes. Heroin paraphernalia commonly includes the following:
- Small spoon
- Tin foil
- A plastic pen case or cut-up drinking straw
Among heroin addicts, the most commonly used ones are hypodermic needles and syringes, quinine, milk sugars, mannitol, glassine envelopes, and gelatin capsules. Addicts are also renowned for their ingenuity in substituting cellophane bags for glassines, bicarbonate of soda for quinine, and so on, depending upon supply and demand. Some of these drug implements may be responsible for many of the supposed heroin overdose deaths and diseases that have long influenced our thinking about heroin. their high cost helps to explain why heroin addiction has proven so expensive, both for the addict and the larger society. 
Heroin Paraphernalia Pictures
Photos from MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); [updated Jun 24; cited 2020 Jul 1]. Available from: https://medlineplus.gov/.
The merchandising of heroin paraphernalia has become a big business. A majority of states prohibit the possession or sale of items specially adapted for narcotics use, the latter being regarded as harm-producing. Such laws have had as a stated aim the reduction of narcotics offenses and offenses arising from addiction, i.e., muggings, and burglaries. several inconsistencies emerge in this connection.
However, it is not known exactly how laws controlling heroin paraphernalia would result in a reduction in the incidence of heroin abuse. as far as drug-related street crimes are concerned, the new laws appear to have caused the cost of paraphernalia to skyrocket, so it would logically follow that addicts now have to steal more to support their habit. 
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Heroin Smoking Paraphernalia
Foil smoking is generally heroin consumption by inhalation. By heating an aluminum foil with a fire lighter the heroin on top of the foil starts melting and the smoke is then inhaled using a straw. Foil smoking is the second most common form of heroin consumption after intravenous use. 
Severe bronchospasms can occur in heroin abusers with or without prior pulmonary disease such as asthma bronchiale. One cerebral consequence of foil smoking is leukoencephalopathy, a spongiform degeneration of the brain’s white matter. This is likely triggered by the pyrolysate generated during the heating process.
Paraphernalia Related to Injecting Heroin
People who inject illicit drugs with the use of needles or syringes have a risk of getting wound botulism, a serious illness that can be life-threatening. Your risk of getting wound botulism increases if you inject illicit drugs, especially black tar heroin, under your skin (“skin popping”) or into your muscle (“muscle popping” or “muscling”).
Key facts according to CDC :
- You cannot see the germ that causes botulism. Contaminated drugs do not look different from non-contaminated drugs. Lab testing is the only way to tell if your drugs are contaminated with the germ that causes botulism
- Heating (“cooking”) heroin will not kill the botulism germ. It takes special conditions to kill this germ
- You cannot get botulism from another person. It is not contagious. But if you share contaminated heroin or equipment (“works”) with another person, both of you might get botulism
Wound botulism is a rare but serious illness that happens when a germ called Clostridium botulinum gets into a wound and makes a toxin. This toxin attacks your body’s nerves, which can make it hard to breathe and can cause muscle weakness and even death.
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Paraphernalia Related to Snorting Heroin
Heroin use is commonly depicted in media in the injected form using a syringe, but it can also be smoked or snorted. Each way of taking a dangerous illicit drug like heroin has specific health risks. To snort heroin, you only need a pure powder form of the drug, a flat surface, and a straw or rolled-up paper. Even when the heroin drug is not refined or pure enough to snort directly, it can be melted and groaned into the nose with the barrel of the syringe.
Whichever method an abuser used, no matter what heroin paraphernalia they chose, it will all lead to the harmful effects of abusing heroin. The general deadly effects of using heroin are:
- Heart infections
- Death from overdose
- People who inject the drug also risk getting infectious diseases, including HIV/AIDS and hepatitis
Those who are addicted to heroin and stop using the drug abruptly may have severe heroin withdrawal. Withdrawal symptoms—which can begin as early as a few hours after the drug was last taken—include:
- Severe muscle and bone pain
- Sleep problems
- Diarrhea and vomiting
- Cold flashes with goose bumps (“cold turkey”)
- Uncontrollable leg movements (“kicking the habit”)
- Severe heroin cravings
Other Signs of a Heroin Addiction
Signs and symptoms of heroin use and dependence can include:
- Euphoria or feeling “high”
- Reduced sense of pain
- Drowsiness or sedation
- Slurred speech
- Problems with attention and memory
- Constricted pupils
- Lack of awareness or inattention to surrounding people and things
- Problems with coordination
- Sweaty, clammy skin
- Runny nose or nose sores (if snorting drugs)
- Needle marks (if injecting drugs)
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How to Help Someone Who is Using Heroin?
The sooner you seek help for drug abuse or dependence, the greater your chances for long-term recovery. If your loved one is struggling with heroin use, speak with your primary doctor or see a mental health provider, such as a doctor who specializes in addiction medicine or addiction psychiatry, or a licensed alcohol and drug counselor.
Make an appointment to see a doctor if:
- You or a loved one can’t stop using a drug
- You or a loved one drug use has led to unsafe behavior, such as sharing needles or unprotected sex
- You or a loved one think you may be having withdrawal symptoms after stopping drug use
If you’re not ready to approach a doctor, help lines or hotlines may be a good place to learn about treatment.
Seek emergency help if you or someone you know has taken a drug and:
- May have overdosed
- Shows changes in consciousness
- Has trouble breathing
- Has seizures or convulsions
- Has signs of a possible heart attack, such as chest pain or pressure
- Has any other troublesome physical or psychological reaction to the use of the drug
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Detoxing from heroin in a detox and addiction treatment facility is the safest way to address potentially life-threatening withdrawal issues.  In a medical detox facility, patients have access to 24/7 care & monitoring as well as access to immediate interventions. Patients can receive an IV drip with life-saving fluids, vitamins, and even medications for additional unpleasant symptoms.
If you noticed your loved one preparing or purchasing heroin paraphernalia, seek help immediately. Don’t risk your life or the life of a loved one, get help today!
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 How to Identify Drug Paraphernalia – https://www.getsmartaboutdrugs.gov/content/how-identify-drug-paraphernalia
[2-3] HEROIN PARAPHERNALIA – BREAKDOWN OF A FIX – U.S. Department of Justice https://www.ojp.gov/ncjrs/virtual-library/abstracts/heroin-paraphernalia-breakdown-fix
 Foil Smoking/Heroin Inhalation – National Center for Biotechnology Information – https://pubmed.ncbi.nlm.nih.gov/31166873/
 Injection Drug Use and Wound Botulism – Centers for Disease Control and Prevention https://www.cdc.gov/botulism/wound-botulism.html
 The Truth About Heroin Withdrawal & Death by Level Up Lake Worth, FL
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