Heroin

Heroin is the most well known opiate drug, synthesized from morphine:

• Morphine-based Heroin is a potent drug derived from the seedpods of poppy plants.
• Known as a semi-synthetic opioid.
• Its common white crystalline form is a hydrochloride salt called diacetylmorphine hydrochloride.
• Its freebase form also occurs as a common white powder.
• Used as both a painkiller and as a recreational drug.
• Most common method of use is intravenous injection.
• Produces profound relaxation and intense euphoria.
• Rapidly leads to tolerance with a high potential for addiction through frequent use.
• Tolerance develops no more quickly than morphine tolerance.
• Metabolizes into a quicker acting form of morphine.
• Shorter onset action than morphine, by crossing the blood-brain barrier more quickly.
• Withdrawal symptoms can appear after stopping use that has lasted as little as 3 days.
• Controlled under Schedules I and IV, internationally, of the Single Convention on Narcotic Drugs.
• In the UK, Heroin is available by prescription as diamorphine hydrochloride to treat acute pain, acute pulmonary oedema (fluid swelling), chronic pain, and myocardial infarction (heart attack).
• First synthesized in 1874, and later independently at Bayer Pharmaceuticals in 1897 during attempts to acetylate morphine into a mild codeine, but instead resulting potency almost doubled that of morphine.
• Sale, importation, and manufacture banned by US Congress in 1924.
• Like morphine, Heroin is particularly prone to abuse and addiction due to effects surpassing those of other opiate analgesics (such as fentanyl, hydromorphone, oxycodone and others.) (i)
• Recreational administration includes injection, snorting, and inhaling heated vapors.
• Binds to opiate receptors in the brain, gastro-intestinal system, and spinal cord.
• Large doses are fatal.
• In modern culture, has been used as an instrument of suicide and a murder weapon.
• Medical indications for terminal illness and cancer pain, only in rare cases where the advantages of diamorphine outweigh its addictive qualities.
• Produced on the black market from refined opium.
• Heroin traffic eliminated in the US during World War II.
• 87% of the world’s Heroin comes from Afiganistan. (ii)
• Current US supplies come from Colombia and Mexico.
• Trafficking Heroin in most Southeast Asian countries carries the death penalty.
• ‘Place conditioning’ occurs with ritualized administration, such that a familiar physical environment evokes greater drug tolerance and new locations increase the drug’s potency to ‘above normal’ doses—and toxic effect.
• All opioid analgesics cause dependence and tolerance.
• Potential to cause high physical and psychological dependence.
• Use with sedatives or alcoholic beverages increases risk of fatality.
• Increased dosage or period of use for prescribed opiates can lead to dependency.