Smoking heroin as addictive as injecting?

The Scottish Executive (in the press release for the second wave of the ‘Know the Score’ campaign) has made the claim that smoking heroin is as addictive and has the same health effects as injecting heroin.
www.scotland.gov.uk/News/Releases/2006/08/10162158
While I have never heard anybody claim that smoking heroin is safe or does not lead to health problems or addiction, the claim made by the Scottish Executive is wrong.

In the press release they state that heroin and morphine were responsible for 356 deaths in Scotland in 2004. Most of these deaths are due to overdosing. My knowledge of the mechanisms of injecting and smoking has always been that smoking heroin is less likely than injecting heroin to lead to overdose (I’d welcome any evidence they have that says otherwise). Surely death counts as a ‘health effect’ as does HIV, Hepatitis, Abscesses, Ulcers, Deep Vein Thrombosis, Gangrene, and Blood poisoning etc. All of which are a result of injecting and not smoking.

I’ve come across heroin users who smoke the drug and never go on to inject heroin as they rightly fear it is more dangerous, I’ve also come across heroin users who started to inject because they did not know how to smoke the drug. Starting off by smoking heroin often leads to injecting somewhere down the line, usually for economic reasons in that injecting is a more efficient (and more dangerous) practice. By all means publicise the dangers of heroin, by all means tell people that smoking heroin often leads to injection. But smoking heroin is safer than injecting it –to say otherwise is dangerous and could lead to more deaths. Know the Score?

Mike Linnell
Lifeline