Equipotent injected doses had comparable action courses, with no difference in subjects' self-rated feelings of euphoria, ambition, nervousness, relaxation, drowsiness, or sleepiness. Nausea , vomiting , and severe itching may also occur. After the initial effects, users usually will be drowsy for several hours; mental function is clouded; heart function slows; and breathing is also severely slowed, sometimes enough to be life-threatening.
Slowed breathing can also lead to coma and permanent brain damage. Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of the brain's white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.
Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence , the body adapts to the presence of the drug , and withdrawal symptoms occur if use is reduced abruptly. Intravenous use of heroin and any other substance with needles and syringes or other related equipment may lead to:. The withdrawal syndrome from heroin may begin within as little as two hours of discontinuation of the drug; however, this time frame can fluctuate with the degree of tolerance as well as the amount of the last consumed dose, and more typically begins within 6—24 hours after cessation.
Symptoms may include sweating , malaise , anxiety, depression, akathisia , priapism , extra sensitivity of the genitals in females, general feeling of heaviness, excessive yawning or sneezing, rhinorrhea , insomnia , cold sweats, chills, severe muscle and bone aches, nausea, vomiting, diarrhea, cramps, watery eyes,  fever, cramp-like pains, and involuntary spasms in the limbs thought to be an origin of the term "kicking the habit" .
Heroin overdose is usually treated with the opioid antagonist , naloxone. This reverses the effects of heroin and causes an immediate return of consciousness but may result in withdrawal symptoms. The half-life of naloxone is shorter than some opioids, such that it may need to be given multiple times until the opioid has been metabolized by the body. Between and it was the leading cause of drug related deaths in the United States. Depending on drug interactions and numerous other factors, death from overdose can take anywhere from several minutes to several hours.
Death usually occurs due to lack of oxygen resulting from the lack of breathing caused by the opioid. Heroin overdoses can occur because of an unexpected increase in the dose or purity or because of diminished opioid tolerance. However, many fatalities reported as overdoses are probably caused by interactions with other depressant drugs such as alcohol or benzodiazepines. This means that the user may prepare what they consider to be a moderate dose while actually taking far more than intended. Also, tolerance typically decreases after a period of abstinence.
If this occurs and the user takes a dose comparable to their previous use, the user may experience drug effects that are much greater than expected, potentially resulting in an overdose. It has been speculated that an unknown portion of heroin-related deaths are the result of an overdose or allergic reaction to quinine , which may sometimes be used as a cutting agent. Drug overdoses killed more than 70, in the US in , with heroin involved in 15, of those deaths.
US yearly overdose deaths involving heroin. US yearly deaths from all opioid drugs. Included in this number are opioid analgesics, along with heroin and illicit synthetic opioids. When taken orally, heroin undergoes extensive first-pass metabolism via deacetylation , making it a prodrug for the systemic delivery of morphine.
Unlike hydromorphone and oxymorphone , however, administered intravenously, heroin creates a larger histamine release, similar to morphine, resulting in the feeling of a greater subjective "body high" to some, but also instances of pruritus itching when they first start using. Normally GABA , released from inhibitory neurones, inhibits the release of dopamine. Opiates, like heroin and morphine, decrease the inhibitory activity of such neurones.
This causes increased release of dopamine in the brain which is the reason for euphoric and rewarding effects of heroin. The contribution of these receptors to the overall pharmacology of heroin remains unknown. A subclass of morphine derivatives, namely the 3,6 esters of morphine, with similar effects and uses, includes the clinically used strong analgesics nicomorphine Vilan , and dipropanoylmorphine ; there is also the latter's dihydromorphine analogue, diacetyldihydromorphine Paralaudin.
Two other 3,6 diesters of morphine invented in —75 along with diamorphine, dibenzoylmorphine and acetylpropionylmorphine , were made as substitutes after it was outlawed in and, therefore, sold as the first " designer drugs " until they were outlawed by the League of Nations in Heroin is derived from opium through a process involving various chemicals such as acetone and acetic anhydride. The major metabolites of diamorphine, 6-MAM, morphine, morphineglucuronide and morphineglucuronide, may be quantitated in blood, plasma or urine to monitor for abuse, confirm a diagnosis of poisoning or assist in a medicolegal death investigation.
Most commercial opiate screening tests cross-react appreciably with these metabolites, as well as with other biotransformation products likely to be present following usage of street-grade diamorphine such as 6-acetylcodeine and codeine. However, chromatographic techniques can easily distinguish and measure each of these substances.
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When interpreting the results of a test, it is important to consider the diamorphine usage history of the individual, since a chronic user can develop tolerance to doses that would incapacitate an opiate-naive individual, and the chronic user often has high baseline values of these metabolites in his system. The opium poppy was cultivated in lower Mesopotamia as long ago as BC. Diamorphine was first synthesized in by C. Alder Wright , an English chemist working at St. Mary's Hospital Medical School in London who had been experimenting combining morphine with various acids.
He boiled anhydrous morphine alkaloid with acetic anhydride for several hours and produced a more potent, acetylated form of morphine which is now called diacetylmorphine or morphine diacetate. He sent the compound to F. Pierce of Owens College in Manchester for analysis. Pierce told Wright:. Doses… were subcutaneously injected into young dogs and rabbit… with the following general results… great prostration, fear, and sleepiness speedily following the administration, the eyes being sensitive, and pupils constrict, considerable salivation being produced in dogs, and slight tendency to vomiting in some cases, but no actual emesis.
Respiration was at first quickened, but subsequently reduced, and the heart's action was diminished, and rendered irregular. Wright's invention did not lead to any further developments, and diamorphine became popular only after it was independently re-synthesized 23 years later by chemist Felix Hoffmann. Instead, the experiment produced an acetylated form of morphine one and a half to two times more potent than morphine itself. Bayer scientists were not the first to make heroin, but their scientists discovered ways to make it, and Bayer led commercialization of heroin.
In , the German drug company Bayer marketed diacetylmorphine as an over-the-counter drug under the trademark name Heroin. Morphine at the time was a popular recreational drug, and Bayer wished to find a similar but non-addictive substitute to market.
How Did Opium Poppies Get Their Painkilling Properties?
However, contrary to Bayer's advertising as a "non-addictive morphine substitute," heroin would soon have one of the highest rates of addiction among its users. From through to , diamorphine was marketed under the trademark name Heroin as a non-addictive morphine substitute and cough suppressant. In the U. In , the United States Congress banned its sale, importation, or manufacture. It is now a Schedule I substance , which makes it illegal for non-medical use in signatory nations of the Single Convention on Narcotic Drugs treaty, including the United States.
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The Health Committee of the League of Nations banned diacetylmorphine in , although it took more than three years for this to be implemented. In the meantime, the first designer drugs , viz. Bayer lost some of its trademark rights to heroin as well as aspirin under the Treaty of Versailles following the German defeat in World War I.
Pete Doherty is also a self-confessed user of heroin. Heroin is also known by many street names including dope, H, smack, junk, horse, and brown, among others. It is available by prescription.
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It is available for prescription under tight regulation exclusively to long-term addicts for whom methadone maintenance treatment has failed. It cannot be used to treat severe pain or other illnesses. In the United Kingdom, diamorphine is available by prescription, though it is a restricted Class A drug. According to the 50th edition of the British National Formulary BNF , diamorphine hydrochloride may be used in the treatment of acute pain, myocardial infarction , acute pulmonary oedema , and chronic pain. The treatment of chronic non- malignant pain must be supervised by a specialist.
The BNF notes that all opioid analgesics cause dependence and tolerance but that this is "no deterrent in the control of pain in terminal illness". When used in the palliative care of cancer patients, diamorphine is often injected using a syringe driver. In Switzerland, heroin is produced in injectable or tablet form under the name Diaphin by a private company under contract to the Swiss government. In Australia diamorphine is listed as a schedule 9 prohibited substance under the Poisons Standard October Possession of diamorphine for the purpose of trafficking is an indictable offense and subject to imprisonment for life.
Turkey maintains strict laws against the use, possession or trafficking of illegal drugs.
OPIUM, MORPHINE AND HEROIN AND THEIR HISTORY | Facts and Details
If convicted under these offences, one could receive a heavy fine or a prison sentence of 4 to 24 years. Abused prescription medicine such as opioid can lead to heroin addiction. Diamorphine is produced from acetylation of morphine derived from natural opium sources. Numerous mechanical and chemical means are used to purify the final product.
The final products have a different appearance depending on purity and have different names. Heroin purity has been classified into four grades. Traffic is heavy worldwide, with the biggest producer being Afghanistan. According to a U. In The Independent reported:  . The following year the Taliban banned poppy cultivation, Opium production in that country has increased rapidly since, reaching an all-time high in War in Afghanistan once again appeared as a facilitator of the trade. At present, opium poppies are mostly grown in Afghanistan , hectares , acres , and in Southeast Asia, especially in the region known as the Golden Triangle straddling Burma 57, hectares , acres , Thailand , Vietnam , Laos 6, hectares 15, acres and Yunnan province in China.
There is also cultivation of opium poppies in Pakistan hectares 1, acres , Mexico 12, hectares 30, acres and in Colombia hectares acres.
Conviction for trafficking heroin carries the death penalty in most Southeast Asian , some East Asian and Middle Eastern countries see Use of death penalty worldwide for details , among which Malaysia , Singapore and Thailand are the most strict. The penalty applies even to citizens of countries where the penalty is not in place, sometimes causing controversy when foreign visitors are arrested for trafficking, for example the arrest of nine Australians in Bali , the death sentence given to Nola Blake in Thailand in , or the hanging of an Australian citizen Van Tuong Nguyen in Singapore.
The origins of the present international illegal heroin trade can be traced back to laws passed in many countries in the early s that closely regulated the production and sale of opium and its derivatives including heroin.
At first, heroin flowed from countries where it was still legal into countries where it was no longer legal. By the mids, heroin production had been made illegal in many parts of the world. An illegal trade developed at that time between heroin labs in China mostly in Shanghai and Tianjin and other nations. The weakness of government in China and conditions of civil war enabled heroin production to take root there.
Chinese triad gangs eventually came to play a major role in the illicit heroin trade. The French Connection route started in the s. Heroin trafficking was virtually eliminated in the U. Japan's war with China had cut the normal distribution routes for heroin and the war had generally disrupted the movement of opium.