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Heroin

Usage and Effects: – Heroin is used recreationally for euphoric effects. – Tolerance develops quickly, leading to increased doses. – Short-term studies show rapid tolerance […]

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Usage and Effects:
– Heroin is used recreationally for euphoric effects.
– Tolerance develops quickly, leading to increased doses.
– Short-term studies show rapid tolerance development similar to morphine.
– Former addicts prefer heroin and morphine over other opioids.
– Heroin and morphine produce more euphoria compared to other opioids.
– Medical uses include pain relief, palliative care, trauma, and maintenance therapy.

Production, Distribution, and Impact:
– Illegal trade involves mixing heroin with substances like fentanyl and caffeine.
– Global production reached 448 tons in 2016.
– Afghanistan produced around 66% of the world’s opium in 2015.
– Estimated 17 million people use opiates, with heroin being common.
– Opioid use resulted in 122,000 deaths in 2015.
– Diamorphine maintenance programs have shown positive health and social impacts.

Administration and Legal Implications:
– Injection is a popular but risky method with potential health hazards.
– Different routes of administration affect the onset of effects and addiction risk.
– Various countries have implemented diamorphine maintenance programs for addicts.
– Legal status of heroin is generally prohibited without a license.
– Different countries have tightened regulations on heroin after inquiries and incidents.

Adverse Effects and Withdrawal:
– Heroin is classified as a hard drug due to harmfulness and purity variations.
– Short-term effects include intense rush, euphoria, and potential coma.
– Long-term use affects brain structure, physiology, and decision-making abilities.
– Withdrawal symptoms range from sweating and anxiety to muscle aches and vomiting.
– Injection poses risks of blood-borne pathogens, endocarditis, and kidney function decline.

Overdose and Pharmacology:
– Overdose is treated with naloxone and is a leading cause of drug-related deaths.
– Heroin is a prodrug for morphine, activating μ-opioid receptors for euphoria.
– Chronic users may have high baseline metabolite values affecting drug tests.
– Heroin metabolizes into 3-monoacetylmorphine, 6-monoacetylmorphine, and morphine.
– Opiates increase dopamine release, leading to rewarding effects.

Heroin (Wikipedia)

Heroin, also known as diacetylmorphine and diamorphine among other names, is a morphinan opioid substance synthesized from the dried latex of the Papaver somniferum plant; it is mainly used as a recreational drug for its euphoric effects. Medical-grade diamorphine is used as a pure hydrochloride salt. Various white and brown powders sold illegally around the world as heroin are routinely diluted with cutting agents. Black tar heroin is a variable admixture of morphine derivatives—predominantly 6-MAM (6-monoacetylmorphine), which is the result of crude acetylation during clandestine production of street heroin. Heroin is used medically in several countries to relieve pain, such as during childbirth or a heart attack, as well as in opioid replacement therapy.

Heroin
Clinical data
PronunciationHeroin: /ˈhɛrɪn/
Other namesDiacetylmorphine, acetomorphine, (dual) acetylated morphine, morphine diacetate, Diamorphine (BAN UK)
AHFS/Drugs.comheroin
Dependence
liability
Very high
Addiction
liability
Very high
Routes of
administration
Intravenous, inhalation, transmucosal, by mouth, intranasal, rectal, intramuscular, subcutaneous, intrathecal
Drug classOpioid
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability<35% (by mouth), 44–61% (inhaled)
Protein binding0% (morphine metabolite 35%)
MetabolismLiver
Onset of actionWithin minutes
Elimination half-life2–3 minutes
Duration of action4 to 5 hours
Excretion90% kidney as glucuronides, rest biliary
Identifiers
  • (5α,6α)-7,8-didehydro-4,5-epoxy-17-methylmorphinan-3,6-diol diacetate
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.008.380 Edit this at Wikidata
Chemical and physical data
FormulaC21H23NO5
Molar mass369.417 g·mol−1
3D model (JSmol)
  • CC(OC1=C(O[C@@H]2[C@]34CCN(C)[C@@H]([C@@H]4C=C[C@@H]2OC(C)=O)C5)C3=C5C=C1)=O
  • InChI=1S/C21H23NO5/c1-11(23)25-16-6-4-13-10-15-14-5-7-17(26-12(2)24)20-21(14,8-9-22(15)3)18(13)19(16)27-20/h4-7,14-15,17,20H,8-10H2,1-3H3/t14-,15+,17-,20-,21-/m0/s1 checkY
  • Key:GVGLGOZIDCSQPN-PVHGPHFFSA-N checkY
  (verify)

It is typically injected, usually into a vein, but it can also be snorted, smoked, or inhaled. In a clinical context, the route of administration is most commonly intravenous injection; it may also be given by intramuscular or subcutaneous injection, as well as orally in the form of tablets. The onset of effects is usually rapid and lasts for a few hours.

Common side effects include respiratory depression (decreased breathing), dry mouth, drowsiness, impaired mental function, constipation, and addiction. Use by injection can also result in abscesses, infected heart valves, blood-borne infections, and pneumonia. After a history of long-term use, opioid withdrawal symptoms can begin within hours of the last use. When given by injection into a vein, heroin has two to three times the effect of a similar dose of morphine. It typically appears in the form of a white or brown powder.

Treatment of heroin addiction often includes behavioral therapy and medications. Medications can include buprenorphine, methadone, or naltrexone. A heroin overdose may be treated with naloxone. An estimated 17 million people as of 2015 use opiates, of which heroin is the most common, and opioid use resulted in 122,000 deaths. The total number of heroin users worldwide as of 2015 is believed to have increased in Africa, the Americas, and Asia since 2000. In the United States, approximately 1.6 percent of people have used heroin at some point. When people die from overdosing on a drug, the drug is usually an opioid and often heroin.

Heroin was first made by C. R. Alder Wright in 1874 from morphine, a natural product of the opium poppy. Internationally, heroin is controlled under Schedules I and IV of the Single Convention on Narcotic Drugs, and it is generally illegal to make, possess, or sell without a license. About 448 tons of heroin were made in 2016. In 2015, Afghanistan produced about 66% of the world's opium. Illegal heroin is often mixed with other substances such as sugar, starch, caffeine, quinine, or other opioids like fentanyl.

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