Heroin

Effects

EuphoriaDry MouthMood liftItchinessRelaxantConstipationPupil ConstrictionAnalgesia TS

Overview

Diacetylmorphine or morphine diacetate (also known as diamorphine and heroin as well as colloquially as H, dope, smack, junk, brown, boy, and others) is a semi-synthetic opioid substance of the morphinan class. It is a derivative of morphine, a natural product of the opium poppy (Papaver somniferum). Heroin is known for its highly addictive properties and it makes up a large portion of the illicit traffic in narcotics. PW⚠ PsychonautWiki itself has flagged this text: citation needed.

A powerful opioid derived from Morphine, with 2-4x its potency. Infamous for a high addiction potential and fatal respiratory depression in overdose, C. R. Alder Wright first synthesised this compound in 1874 trying to find a less addictive alternative to Morphine. In recent years, it has often been sold cut with the extremely potent fentanyl, causing a spike in overdose deaths.[1–6] TS

Heroin, also known as diacetylmorphine and diamorphine among other names, is a morphinan opioid substance synthesized from the dried latex of the opium poppy; it is mainly used as a recreational drug for its euphoric effects. Heroin is used medically in several countries to relieve pain, such as during childbirth or a heart attack. 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.[7–10] WP

Heroin 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.[10–13] WP

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.[10][12] WP

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.[12] WP

As of 2015, an estimated 17 million people use opiates non-medically, of which heroin is the most common, and opioid use resulted in an estimated 109 thousand to 129 thousand deaths in 2015.[14][15][16] WP

The total number of heroin users worldwide is believed to have increased in Africa, the Americas, and Asia between 2000 and 2015. In the United States, approximately 1.6 percent of people reported using heroin at some point in their lives and 0.4% of people aged 12 or older in 2021 reported using heroin in the past 12 months.[12][17][18] WP

When people die from overdosing on a drug, the drug is usually an opioid and often heroin.[14][19] WP

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.[10][14][17][20–24] WP

History

History

The opium poppy was cultivated in lower Mesopotamia as long ago as 3400 BC. The chemical analysis of opium in the 19th century revealed that most of its activity could be ascribed to the alkaloids codeine and morphine.[32] WP

Diamorphine was first synthesized in 1874 by C. R. 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. M. Pierce of Owens College in Manchester for analysis. Pierce told Wright: WP

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 a 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. Marked want of coordinating power over the muscular movements, and loss of power in the pelvis and hind limbs, together with a diminution of temperature in the rectum of about 4°.[33][34] WP

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. Hoffmann was working at Bayer pharmaceutical company in Elberfeld, Germany, and his supervisor Heinrich Dreser instructed him to acetylate morphine with the objective of producing codeine, a constituent of the opium poppy that is pharmacologically similar to morphine but less potent and less addictive. Instead, the experiment produced an acetylated form of morphine one and a half to two times more potent than morphine itself. Hoffmann synthesized heroin on 21 August 1897, just eleven days after he had synthesized aspirin.[35][36] WP

The head of Bayer's research department reputedly coined the drug's new name of "heroin", based on the German heroisch which means "heroic, strong" (from the ancient Greek word "heros, ήρως"). Bayer scientists were not the first to make heroin, but their scientists discovered ways to make it, and Bayer led the commercialization of heroin.[37] WP

Bayer marketed diacetylmorphine as an over-the-counter drug under the trademark name Heroin. It was developed chiefly as a morphine substitute for cough suppressants that did not have morphine's addictive side-effects. Morphine at the time was a popular recreational drug, and Bayer wished to find a similar but non-addictive substitute to market. 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.[38][39] WP

From 1898 through to 1910, diamorphine was marketed under the trademark name Heroin as a non-addictive morphine substitute and cough suppressant. In the 11th edition of Encyclopædia Britannica (1910), the article on morphine states: "In the cough of phthisis minute doses [of morphine] are of service, but in this particular disease morphine is frequently better replaced by codeine or by heroin, which checks irritable coughs without the narcotism following upon the administration of morphine."[40] WP

In the US, the Harrison Narcotics Tax Act was passed in 1914 to control the sale and distribution of diacetylmorphine and other opioids, which allowed the drug to be prescribed and sold for medical purposes. In 1924, 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. WP

The Health Committee of the League of Nations banned diacetylmorphine in 1925, although it took more than three years for this to be implemented. In the meantime, the first designer drugs, viz. 3,6 diesters and 6 monoesters of morphine and acetylated analogues of closely related drugs like hydromorphone and dihydromorphine, were produced in massive quantities to fill the worldwide demand for diacetylmorphine—this continued until 1930 when the Committee banned diacetylmorphine analogues with no therapeutic advantage over drugs already in use, the first major legislation of this type. WP⚠ Wikipedia itself has flagged this text: citation needed.

Bayer lost some of its trademark rights to heroin (as well as aspirin) under the 1919 Treaty of Versailles following the German defeat in World War I.[41][42] WP

Use of heroin by jazz musicians in particular was prevalent in the mid-twentieth century, including Billie Holiday, saxophonists Charlie Parker, John Coltrane and Art Pepper, trumpeter and vocalist Chet Baker, guitarist Joe Pass and piano player/singer Ray Charles; a "staggering number of jazz musicians were addicts". It was also a problem with many rock musicians, particularly from the late 1960s through the 1990s. Pete Doherty is also a self-confessed user of heroin. Nirvana lead singer Kurt Cobain's heroin addiction was well documented. Pantera frontman Phil Anselmo turned to heroin while touring during the 1990s to cope with his back pain. Lou Reed's heroin addiction is well known and evident by the many references to the drug in his songs. James Taylor, Taylor Hawkins, Jimmy Page, John Lennon, Eric Clapton, Johnny Winter, Keith Richards, Shaun Ryder, Shane MacGowan and Janis Joplin also used heroin. Many musicians have made songs referencing their heroin usage.[43–52] WP

Trafficking history

The origins of the present international illegal heroin trade can be traced back to laws passed in many countries in the early 1900s 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 mid-1920s, 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 the 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 1930s. WP

Heroin trafficking was virtually eliminated in the US during World War II because of temporary trade disruptions caused by the war. Japan's war with China had cut the normal distribution routes for heroin and the war had generally disrupted the movement of opium. After World War II, the Mafia took advantage of the weakness of the postwar Italian government and set up heroin labs in Sicily which was located along the historic route opium took westward into Europe and the United States. Large-scale international heroin production effectively ended in China with the victory of the communists in the civil war in the late 1940s. The elimination of Chinese production happened at the same time that Sicily's role in the trade developed.[53] WP⚠ Wikipedia itself has flagged this text: citation needed.

Although it remained legal in some countries until after World War II, health risks, addiction, and widespread recreational use led most western countries to declare heroin a controlled substance by the latter half of the 20th century. In the late 1960s and early 1970s, the CIA supported anti-Communist Chinese Nationalists settled near the Sino-Burmese border and Hmong tribesmen in Laos. This helped the development of the Golden Triangle opium production region, which supplied about one-third of heroin consumed in the US after the 1973 American withdrawal from Vietnam. In 1999, Burma, the heartland of the Golden Triangle, was the second-largest producer of heroin, after Afghanistan.[54] WP

The Soviet-Afghan war led to increased production in the Pakistani-Afghan border regions, as US-backed mujaheddin militants raised money for arms from selling opium, contributing heavily to the modern Golden Crescent creation. By 1980, 60 percent of the heroin sold in the US originated in Afghanistan. It increased international production of heroin at lower prices in the 1980s. The trade shifted away from Sicily in the late 1970s as various criminal organizations violently fought with each other over the trade. The fighting also led to a stepped-up government law enforcement presence in Sicily.[54] WP

Following the discovery at a Jordanian airport of a toner cartridge that had been modified into an improvised explosive device, the resultant increased level of airfreight scrutiny led to a major shortage (drought) of heroin from October 2010 until April 2011. This was reported in most of mainland Europe and the UK which led to a price increase of approximately 30 percent in the cost of street heroin and increased demand for diverted methadone. The number of addicts seeking treatment also increased significantly during this period. Other heroin droughts (shortages) have been attributed to cartels restricting supply in order to force a price increase and also to a fungus that attacked the opium crop of 2009. Many people thought that the American government had introduced pathogens into the Afghanistan atmosphere in order to destroy the opium crop and thus starve insurgents of income. WP⚠ Wikipedia itself has flagged this text: citation needed.⚠ Wikipedia itself has flagged this text: weasel inline.

On 13 March 2012, Haji Bagcho, with ties to the Taliban, was convicted by a US District Court of conspiracy, distribution of heroin for importation into the United States and narco-terrorism. Based on heroin production statistics compiled by the United Nations Office on Drugs and Crime, in 2006, Bagcho's activities accounted for approximately 20 percent of the world's total production for that year.[55–60] WP

Legal status

• Australia: Heroin is controlled in Australia, but there is conflicting information about its exact legal status. Heroin was listed in Schedule I of the Narcotic Drugs Act of 1967; however, it is unclear whether the control system has changed since then. Personal quantities under 1 gram have been decriminalized in the Australian Capital Territory (ACT) as of 28 October 2023.[61] PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Austria: Diacetylmorphine is illegal to possess, produce and sell under the SMG (Suchtmittelgesetz Österreich). PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Brazil: Heroin is listed as a controlled substance, making the production, distribution, or possession illegal. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Canada: Heroin is a Schedule I substance in Canada. However, a unanimous Supreme Court decision in 2011 declared that there is a right under Section 7 of the Charter of Rights and Freedoms to have access to clean injection sites.[62][63] PW
• Czech Republic: The Czech Republic has decriminalized 1.5g or less of heroin and the punishment is similar in scale to a parking ticket. Sales, production, and larger quantity possession are still crimes.[64] PW
• Finland: Heroin is a controlled substance, making the production, distribution, and possession illegal without a license. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Germany: Heroin is controlled under BtMG Anlage I, II and III, making it illegal to manufacture, import, possess, sell, or transfer it without a license. There is an exception for preparations, that are approved for addiction treatment, which can be prescribed on a narcotic prescription form.[65][66][67] PW
• Italy: Heroin is a Schedule I drug.[68] PW
• Latvia: Heroin is a Schedule I drug.[69] PW
• New Zealand: Heroin is Class A in New Zealand. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Norway: Heroin is Schedule I in Norway and illegal to buy or possess without a special license. There have been some projects to establish needle rooms in Norway by the government where heroin addicts are allowed to get fresh needles for injecting heroin. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Portugal: The personal use of heroin was decriminalized by Law 30/2000 on July 2001. Possession of less than 1g is not regarded as a criminal offense although the substance is liable to be seized and the possessor can be referred to mandatory treatment. Sale or possession of quantities greater than the personal possession limit are criminal offenses punishable by jail time. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Russia: Heroin is a Schedule I controlled substance.[70] PW
• Switzerland: Heroin is a controlled substance specifically named under Verzeichnis D. It is legally available for addicts under an ongoing experiment but is otherwise illegal to possess.[71] PW
• United Kingdom: Heroin is Schedule II/Class A and is illegal to buy, sell or possess without a license. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• United States: Heroin is Schedule I in the United States. This means it is illegal to manufacture, buy, possess, or distribute without a DEA license. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Poland: Heroin is illegal to produce, sell and possess under "wykaz środków odurzających i substancji psychotropowych". PW⚠ PsychonautWiki itself has flagged this text: citation needed.

Names

Diamorphine is the international nonproprietary name and the British Approved Name. Other synonyms for heroin include: diacetylmorphine, and morphine diacetate. Heroin is also known by many street names including Big H, Black Tar, Chiva, Hell Dust, Horse, Negra, Smack, Thunder, dope, H, smack, junk, skag, brown, and unga among others.[72–76] WP

Whoonga (or wonga), nyaope and sugars are South African street names for heroin.[77–81] WP

Asia

In Hong Kong, diamorphine is regulated under Schedule 1 of Hong Kong's Chapter 134 Dangerous Drugs Ordinance. It is available by prescription. Anyone supplying diamorphine without a valid prescription can be fined $5,000,000 (HKD) and imprisoned for life. The penalty for trafficking or manufacturing diamorphine is a $5,000,000 (HKD) fine and life imprisonment. Possession of diamorphine without a license from the Department of Health is illegal with a $1,000,000 (HKD) fine and seven years of jail time.[82][83] WP

Europe

In the Netherlands, diamorphine is a List I drug of the Opium Law. 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.[84] WP

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.[85] WP

In Switzerland, heroin is produced in injectable or tablet form under the brand name Diaphin by a private company under contract to the Swiss government. Swiss-produced heroin has been imported into Canada with government approval.[86][87] WP

Australia

In Australia, diamorphine is listed as a schedule 9 prohibited substance under the Poisons Standard (October 2015). The state of Western Australia, in its Poisons Act 1964 (Reprint 6: amendments as at 10 September 2004), described a schedule 9 drug as: "Poisons that are drugs of abuse, the manufacture, possession, sale or use of which should be prohibited by law except for amounts which may be necessary for educational, experimental or research purposes conducted with the approval of the Governor."[88][89] WP

North america

In Canada, diamorphine is a controlled substance under Schedule I of the Controlled Drugs and Substances Act (CDSA). Any person seeking or obtaining diamorphine without disclosing authorization 30 days before obtaining another prescription from a practitioner is guilty of an indictable offense and subject to imprisonment for a term not exceeding seven years. Possession of diamorphine for the purpose of trafficking is an indictable offense and subject to imprisonment for life.[90][91] WP

In the United States, diamorphine is a Schedule I drug according to the Controlled Substances Act of 1970, making it illegal to possess without a DEA license. Possession of more than 100 grams of diamorphine or a mixture containing diamorphine is punishable with a minimum mandatory sentence of five years of imprisonment in a federal prison.[92] WP

In 2021, the US state of Oregon became the first state to decriminalize the use of heroin after voters passed Ballot Measure 110 in 2020. This measure will allow people with small amounts to avoid arrest.[93][94] WP

Turkey

Turkey maintains strict laws against the use, possession or trafficking of illegal drugs. If convicted under these offences, one could receive a heavy fine or a prison sentence of 4 to 24 years.[95] WP

Stigma

Heroin users are often referred to as 'amaparas' a term that researchers say is a dehumanizing and derogatory term that implies worthlessness and criminality. The term is perpetuating marginalization and discrimination, while preventing an understanding of the addiction crisis as a medical issue and addicts as people requiring social support.[81] WP

Legal opium production

Heroin is produced from opium, which is regulated differently around the world. Unlike coca leaves in Peru—handled exclusively by the state monopoly, the National Coca Company (ENACO)—there is no state company dedicated to the commercialization of opium and its derivatives. While international treaties—such as the Single Convention on Narcotic Drugs (1961)—require strict state control or monopoly over the legal production and commercialization of opium for medical and scientific purposes, in practice, only a few countries maintain such a state monopoly today. Notably, India operates a state monopoly through the Government Opium and Alkaloid Factories (GOAF), also known as Opium and Alkaloid Works, which is responsible for processing raw opium into alkaloids for the pharmaceutical industry and managing the legal opium trade for medical and scientific use. Legal opium production in India, as well as in countries such as Turkey, Australia, France, Japan, and the UK, supplies licensed pharmaceutical manufacturers under close supervision to prevent diversion to illicit markets.[96][97][98] WP

Licensed pharmaceutical manufacturers

Heroin and its production and distribution are strictly regulated by government health authorities and subject to international drug control treaties. In countries where medical diamorphine (heroin) is legal, a small number of licensed pharmaceutical manufacturers are authorized to produce diamorphine from morphine, which is derived from legally cultivated opium poppy. All manufacturing and handling are conducted by these licensed companies under close government oversight, operating under stringent national and international regulations. Their activities are monitored by agencies such as the International Narcotics Control Board (INCB), and the entire supply chain—from opium cultivation to the final pharmaceutical product—is subject to quotas, licensing, and detailed reporting requirements to prevent diversion to illicit markets.[99][100] WP

Distribution

Diamorphine produced by licensed manufacturers is distributed to hospitals and clinics for medical use, primarily for pain management and, in some countries, for heroin-assisted treatment of opioid dependence. Distribution within the health care system is tightly controlled, and all use is documented and audited by health authorities. There is no commercial retail market for diamorphine; it is dispensed only by prescription and administered under medical supervision.[101] WP

Production

Diamorphine is produced from acetylation of morphine derived from natural opium sources. One such method of heroin production involves isolation of the water-soluble components of raw opium, including morphine, in a strongly basic aqueous solution, followed by recrystallization of the morphine base by addition of ammonium chloride. The solid morphine base is then filtered out. The morphine base is then reacted with acetic anhydride, which forms heroin. This highly impure brown heroin base may then undergo further purification steps, which produces a white-colored product; the final products have a different appearance depending on purity and have different names. Heroin purity has been classified into four grades. No.4 is the purest form – white powder (salt) to be easily dissolved and injected. No.3 is "brown sugar" for smoking (base). No.1 and No.2 are unprocessed raw heroin (salt or base).[102][103] WP

Trafficking

Traffic is heavy worldwide, with the biggest producer being Afghanistan. According to a U.N. sponsored survey, in 2004, Afghanistan accounted for production of 87 percent of the world's diamorphine. Afghan opium kills around 100,000 people annually.[104][105][106] WP

In 2003 The Independent reported: The cultivation of opium [in Afghanistan] reached its peak in 1999, when 350 sq mi of poppies were sown... The following year the Taliban banned poppy cultivation,... a move which cut production by 94 percent... By 2001 only 30 sq mi of land were in use for growing opium poppies. A year later, after American and British troops had removed the Taliban and installed the interim government, the land under cultivation leapt back to 285 sq mi, with Afghanistan supplanting Burma to become the world's largest opium producer once more.[107][108] WP⚠ The source also gives this in other units.

Opium production in that country has increased rapidly since, reaching an all-time high in 2006. War in Afghanistan once again appeared as a facilitator of the trade. Some 3.3 million Afghans are involved in producing opium.[109][110] WP

At present, opium poppies are mostly grown in Afghanistan (224000 ha), and in Southeast Asia, especially in the region known as the Golden Triangle straddling Burma (57600 ha), Thailand, Vietnam, Laos (6200 ha) and Yunnan province in China. There is also cultivation of opium poppies in Pakistan (493 ha), Mexico (12000 ha) and in Colombia (378 ha). According to the DEA, the majority of the heroin consumed in the United States comes from Mexico (50%) and Colombia (43–45%) via Mexican criminal cartels such as Sinaloa Cartel. However, these statistics may be significantly unreliable, the DEA's 50/50 split between Colombia and Mexico is contradicted by the amount of hectares cultivated in each country and in 2014, the DEA claimed most of the heroin in the US came from Colombia. As of 2015, the Sinaloa Cartel is the most active drug cartel involved in smuggling illicit drugs such as heroin into the United States and trafficking them throughout the United States. According to the Royal Canadian Mounted Police, 90% of the heroin seized in Canada (where the origin was known) came from Afghanistan. Pakistan is the destination and transit point for 40 percent of the opiates produced in Afghanistan, other destinations of Afghan opiates are Russia, Europe and Iran.[111–117] WP⚠ The source also gives this in other units.

A 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 strictest. 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 1987, or the hanging of an Australian citizen Van Tuong Nguyen in Singapore. WP

The balkan route

The Balkan route remains the principal corridor for trafficking illegal opiates, primarily heroin, from Afghanistan to Western and Central Europe, with criminal networks-often highly organized and adaptable-leveraging both legal businesses and corruption to facilitate the smuggling, storage, and distribution of drugs. These groups generate enormous illicit profits, with the annual gross income from drug trafficking along the Balkan route estimated between $13.9 and $21.4 billion from 2019 to 2022, of which up to half is illegally moved across borders through complex financial flows that include shell companies, cryptocurrencies, and informal systems like hawala. The majority of these profits, around 90 percent, come from opiates, and the scale of this income rivals or exceeds the GDP of several countries along the route. The movement of these illicit funds not only sustains and expands drug trafficking operations but also undermines economic stability and governance in affected countries, making the Balkan route a persistent and multifaceted challenge for law enforcement and policymakers in the region.[118][119] WP

Street price

The European Monitoring Centre for Drugs and Drug Addiction reports that the retail price of brown heroin varies from €14.5 per gram in Turkey to €110 per gram in Sweden, with most European countries reporting typical prices of €35–40 per gram. The price of white heroin is reported only by a few European countries and ranged between €27 and €110 per gram.[120] WP

The United Nations Office on Drugs and Crime claims in its 2008 World Drug Report that typical US retail prices are US$172 per gram.[121] WP

Bluetoothing

In early 2017, sensationalist media reports claimed that ‘nyaope’ users shared the drug-induced high through small blood transfusions, a practice supposedly called "bluetoothing" (from the Bluetooth wireless technology). The claim was untrue: the practice is not known on the street and physiologically could not achieve the claimed effect.[81][122][123] WP

Claims that 'whoonga' or 'nyaope' is made from anti-retrovirals, rat poison, etc.

Sensationalist media reports have often claimed that ‘whoonga’ or ‘nyaope’ is a uniquely South African drug containing ingredients such as rat poison, anti-retroviral medication, and materials gleaned from the cathode tubes in stolen flat screen televisions. However scientific laboratory studies have shown these claims to be urban legends, and that 'whoonga' and 'nyapoe' are in fact simply heroin and do not contain the aforementioned adulterants. According to researcher Jesse Copelyn it "has been shown "that media accounts that frame nyaope as a new and exotic drug are misleading" and "have obscured the fact that South Africa simply has a major heroin crisis".[78][81][124–131] WP⚠ Part of this sentence could not be copied from the source. Open the source to read it in full.

Systemic criminality

It is often said that all or most users sustain their addiction via crime, however academic Mark Hunter shows that the majority work for extremely low pay, often for other poor people.[80][81] WP

Pharmacology

Pharmacology

When taken orally, heroin undergoes extensive first-pass metabolism via deacetylation, making it a prodrug for the systemic delivery of morphine. When the drug is injected, however, it avoids this first-pass effect, very rapidly crossing the blood–brain barrier because of the presence of the acetyl groups, which render it much more fat soluble than morphine itself. Once in the brain, it then is deacetylated variously into the inactive 3-monoacetylmorphine and the active 6-monoacetylmorphine (6-MAM), and then to morphine, which bind to μ-opioid receptors, resulting in the drug's euphoric, analgesic (pain relief), and anxiolytic (anti-anxiety) effects; heroin itself exhibits relatively low affinity for the μ receptor. Analgesia follows from the activation of the μ receptor G-protein coupled receptor, which indirectly hyperpolarizes the neuron, reducing the release of nociceptive neurotransmitters, and hence, causes analgesia and increased pain tolerance.[132–135] WP

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.[136][137] WP

Normally, GABA, which is 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.[138] WP

Both morphine and 6-MAM are μ-opioid agonists that bind to receptors present throughout the brain, spinal cord, and gut of all mammals. The μ-opioid receptor also binds endogenous opioid peptides such as β-endorphin, leu-enkephalin, and met-enkephalin. Repeated use of heroin results in a number of physiological changes, including an increase in the production of μ-opioid receptors (upregulation). These physiological alterations lead to tolerance and dependence, so that stopping heroin use results in uncomfortable symptoms including pain, anxiety, muscle spasms, and insomnia called the opioid withdrawal syndrome. Depending on usage it has an onset 4–24 hours after the last dose of heroin. Morphine also binds to δ- and κ-opioid receptors.[139] WP

There is also evidence that 6-MAM binds to a subtype of μ-opioid receptors that are also activated by the morphine metabolite morphine-6β-glucuronide but not morphine itself. The third subtype of third opioid type is the mu-3 receptor, which may be a commonality to other six-position monoesters of morphine. The contribution of these receptors to the overall pharmacology of heroin remains unknown.[140] WP

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 1874–75 along with diamorphine, dibenzoylmorphine and acetylpropionylmorphine, were made as substitutes after it was outlawed in 1925 and, therefore, sold as the first "designer drugs" until they were outlawed by the League of Nations in 1930. WP

Chemistry

Formula

C21H23NO5 PC

CAS number

561-27-3 PC

Molar mass (g/mol)

369.4 PC

IUPAC name (computed by PubChem)

[(4R,4aR,7S,7aR,12bS)-9-acetyloxy-3-methyl-2,4,4a,7,7a,13-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinolin-7-yl] acetate PC

SMILES

CC(=O)O[C@H]1C=C[C@H]2[C@H]3CC4=C5[C@]2([C@H]1OC5=C(C=C4)OC(=O)C)CCN3C PC

InChIKey

GVGLGOZIDCSQPN-PVHGPHFFSA-N PC

PubChem CID

5462328

Pop culture

• Album Dirt Alice in Chains · 1992

  Tracks: Junkhead, God Smack, Hate to Feel

  “Three tracks ("Junkhead", "God Smack", and "Hate to Feel") specifically reference heroin use and its effects.” WP

  Added by Colton (seed example)

References

1. Journal / agency Disrupted white matter integrity in heroin dependence: a controlled study utilizing diffusion tensor imaging
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