A report on Heroin

Heroin paraphernalia in a Jack Daniels tin
Advertising sign from Bayer for use in US drug stores, dating from before the federal prohibition of Heroin in 1924
A 2010 study ranking various illegal and legal drugs based on statements by drug-harm experts. Heroin was found to be the second overall most dangerous drug.
Short-term effects of usage
Long-term effects of intravenous usage, including – and indeed primarily because of – the effects of the contaminants common in illegal heroin and contaminated needles.
Black tar heroin
Advertisement for Bayer Heroin
Bayer Heroin bottle
International drug routes
Afghanistan opium poppy cultivation, 1994–2016 (hectares)
Primary worldwide producers of heroin
Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in delphic analysis regarding 20 popular recreational drugs. Heroin was ranked 1st in dependence, physical harm, and social harm.
Drug overdoses killed more than 70,200 in the US in 2017, with heroin involved in 15,482 of those deaths.<ref name=NIDA-deaths>{{cite web | url = http://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates | title = Overdose Death Rates | archive-url = https://web.archive.org/web/20151128091723/http://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates | archive-date=28 November 2015 | work = National Institute on Drug Abuse (NIDA) }}</ref>
US yearly overdose deaths involving heroin.<ref name=NIDA-deaths/>
US yearly deaths from all opioid drugs. Included in this number are opioid analgesics, along with heroin and illicit .<ref name=NIDA-deaths/>

Opioid used as a recreational drug for its euphoric effects.

- Heroin
Heroin paraphernalia in a Jack Daniels tin

97 related topics with Alpha

Overall

A localized reaction to intravenous morphine caused by histamine release in the veins

Morphine

30 links

Pain medication of the opiate family that is found naturally in opium, a dark brown resin in poppies .

Pain medication of the opiate family that is found naturally in opium, a dark brown resin in poppies .

A localized reaction to intravenous morphine caused by histamine release in the veins
Before the Morphine by Santiago Rusiñol
Morphine Hydrochloride Ampoule for Veterinary Use
Latex bleeding from a freshly-scored seed pod
Morphine biosynthesis in the opium poppy
Chemical structure of morphine. The benzylisoquinoline backbone is shown in green.
Morphine structure showing its standard ring lettering and carbon numbering system.
Same structure, but in a three-dimensional perspective.
First generation production of alkaloids from licit latex-derived opium
Friedrich Sertürner
Advertisement for curing morphine addiction, c. 1900
An ampoule of morphine with integral needle for immediate use. Also known as a "syrette". From WWII. On display at the Army Medical Services Museum.
Example of different morphine tablets
Two capsules (5 mg & 10 mg) of morphine sulfate extended- release
1 milliliter ampoule containing 10 mg of morphine

About 70 percent of morphine is used to make other opioids such as hydromorphone, oxymorphone, and heroin.

Chemical structure of morphine, the prototypical opioid.

Opioid

26 links

Opioids are substances that act on opioid receptors to produce morphine-like effects.

Opioids are substances that act on opioid receptors to produce morphine-like effects.

Chemical structure of morphine, the prototypical opioid.
US. Top line represents the number of benzodiazepine deaths that also involved opioids. Bottom line represents benzodiazepine deaths that did not involve opioids.
Locants of the morphine molecule
INTA: selective agonist of KOR-DOR and KOR-MOR heteromers. Does not recruit β-arrestin II. Antinociceptive devoid of aversion, tolerance, and dependence in mice.
A sample of raw opium
US yearly deaths from all opioid drugs. Included in this number are opioid analgesics, along with heroin and illicit .<ref name=NIDA-deaths/>
US yearly deaths involving other, predominately Fentanyl.<ref name=NIDA-deaths/>
US yearly deaths involving prescription opioids. is a category dominated by illegally acquired fentanyl, and has been excluded.<ref name=NIDA-deaths>Overdose Death Rates. By National Institute on Drug Abuse (NIDA).</ref>
US yearly overdose deaths involving heroin.<ref name=NIDA-deaths/>

As of 2015, increased rates of recreational use and addiction are attributed to over-prescription of opioid medications and inexpensive illicit heroin.

Adriaen Brouwer, TheSmokers (1636)

Recreational drug use

10 links

Altered state of consciousness either for pleasure or for some other casual purpose or pastime by modifying the perceptions, feelings, and emotions of the user.

Altered state of consciousness either for pleasure or for some other casual purpose or pastime by modifying the perceptions, feelings, and emotions of the user.

Adriaen Brouwer, TheSmokers (1636)
Edgar Degas, L'Absinthe (1876)
Bhang eaters from India c. 1790. Bhang is an edible preparation of cannabis native to the Indian subcontinent. It has been used in food and drink as early as 1000 BCE by Hindus in ancient India.
A man smoking cannabis in Kolkata, India
A rational harm assessment of drugs<ref>{{Cite journal|last1=Blakemore|first1=Colin|last2=Saulsbury|first2=William|last3=King|first3=Leslie A.|last4=Nutt|first4=David|date=2007-03-24|title=Development of a rational scale to assess the harm of drugs of potential misuse|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60464-4/abstract|journal=The Lancet|language=en|volume=369|issue=9566|pages=1047–1053|doi=10.1016/S0140-6736(07)60464-4|issn=0140-6736|pmid=17382831|s2cid=5903121}}</ref>
This 1914 photo shows intoxicated men at a sobering-up room
alt=A chart showing dependence potential versus safety ratio.|An analysis of the dangers of drugs<ref>{{Cite book|url=https://books.google.com/books?id=xpZhjBuDkuwC&pg=PA149|title=Drugs and Society: U.S. Public Policy|last=Fish|first=Jefferson M.|date=2006|publisher=Rowman & Littlefield|isbn=9780742542457|language=en}}</ref>
Total recorded alcohol per capita consumption (15+), in liters of pure alcohol
Caffeinated alcoholic beverages, such as Vodka Red Bull, are widespread and legal routes of administration for multiple drugs.
Insufflation of powdered drug
Injection of heroin
Cocaine is a commonly used stimulant
alt=A chart showing relative drug harm.|A chart showing relative drug harm.

What controlled substances are considered generally unlawful to possess varies by country, but usually includes methamphetamine, heroin, cocaine, LSD, psilocybin mushrooms, MDMA, Lean, and club drugs.

Molecular structure of morphine

Opioid use disorder

11 links

Substance use disorder relating to the use of an opioid.

Substance use disorder relating to the use of an opioid.

Molecular structure of morphine
Material used for intravenous injection of opioids
Fentanyl 2 mg. A lethal dose in most people. Diameter of a US penny is 19.05 mm, or 0.75 inches.
Buprenorphine/naloxone tablet
Overdose deaths involving opioids, United States. Deaths per 100,000 population by year.
US yearly deaths from all opioid drugs. Included in this number are opioid analgesics, along with heroin and illicit .<ref name=NIDA-deaths/>
US yearly deaths involving other, predominately Fentanyl.<ref name=NIDA-deaths/>
US yearly deaths involving prescription opioids. is a category dominated by illegally acquired fentanyl, and has been excluded.<ref name=NIDA-deaths>Overdose Death Rates. By National Institute on Drug Abuse (NIDA).</ref>
US yearly overdose deaths involving heroin.<ref name=NIDA-deaths/>

Opioids include substances such as heroin, morphine, fentanyl, codeine, dihydrocodeine, oxycodone, and hydrocodone.

Governments of opium-producing Parties are required to "purchase and take physical possession of such crops as soon as possible" after harvest to prevent diversion into the illicit market.

Single Convention on Narcotic Drugs

9 links

International treaty that controls activities (production, supply, trade, use) of specific narcotic drugs and establishes a system of regulations (licenses, measures for treatment, research, etc.) for their medical and scientific uses.

International treaty that controls activities (production, supply, trade, use) of specific narcotic drugs and establishes a system of regulations (licenses, measures for treatment, research, etc.) for their medical and scientific uses.

Governments of opium-producing Parties are required to "purchase and take physical possession of such crops as soon as possible" after harvest to prevent diversion into the illicit market.
The Single Convention was the first international treaty to prohibit cannabis.
Under Article 37, "Any drugs, substances and equipment used in or intended for the commission of any of the offenses . . . shall be liable to seizure and confiscation."
Different nations have drawn different conclusions as to whether the treaty requires criminalization of drug possession for personal use.
Articles 23 and 28 of the Single Convention on Narcotic Drugs require cannabis-producing nations to have a government agency that controls cultivation.

Earlier treaties had only controlled opium, coca, and derivatives such as morphine, heroin, and cocaine.

Oxycodone

13 links

Semi-synthetic opioid medication used for treatment of moderate to severe pain.

Semi-synthetic opioid medication used for treatment of moderate to severe pain.

A liquid solution containing 10mg of oxycodone per 1ml
Main side effects of oxycodone
Two tablets (10 mg) of oxycodone and safety blisters
Canadian oxycodone HCL/acetaminophen 5/325 mg tablet

In 2011, it was the leading cause of drug-related deaths in the U.S. However, from 2012 onwards, heroin and fentanyl have become more common causes of drug-related deaths.

Fentanyl

13 links

Powerful opioid used as a pain medication and, together with other medications, for anesthesia.

Powerful opioid used as a pain medication and, together with other medications, for anesthesia.

A fentanyl nasal spray with a strength of 100 μg per use
A fentanyl transdermal patch with a release rate of 12 micrograms per hour, on a person's arm
US yearly overdose deaths, and some of the drugs involved. Among the more than 70,200 deaths estimated in 2017, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (other ) with over 28,400 overdose deaths.
US yearly deaths involving other, predominantly fentanyl.
A package of 30 tablets, 600 mcg of fentanyl, each
Fentanyl powder (23% fentanyl) seized by a sheriff

It is also used as a recreational drug, sometimes mixed with heroin, cocaine, benzodiazepines or methamphetamine.

Naloxone

8 links

Medication used to reverse the effects of opioids.

Medication used to reverse the effects of opioids.

A naloxone kit as distributed in British Columbia, Canada

It is included as a part of emergency overdose response kits distributed to heroin and other opioid drug users, and to emergency responders.

Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in delphic analysis regarding 20 popular recreational drugs. Street methadone was ranked 4th in dependence, 5th in physical harm, and 5th in social harm.

Methadone

5 links

Synthetic opioid agonist used for chronic pain and also for opioid dependence.

Synthetic opioid agonist used for chronic pain and also for opioid dependence.

Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in delphic analysis regarding 20 popular recreational drugs. Street methadone was ranked 4th in dependence, 5th in physical harm, and 5th in social harm.
40 mg of methadone
Methadone
EDDP
EDMP

It is used to treat chronic pain, and it is also used to treat addiction to heroin or other opioids.

Naltrexone

6 links

Medication primarily used to manage alcohol or opioid use disorder by reducing cravings and feelings of euphoria associated with substance use disorder.

Medication primarily used to manage alcohol or opioid use disorder by reducing cravings and feelings of euphoria associated with substance use disorder.

Naltrexone levels following a 50 mg oral dose of naltrexone at steady state during treatment with 50 mg/day naltrexone.
Naltrexone levels following a 380 mg dose of naltrexone in microspheres (Vivitrol) by intramuscular injection at steady state during monthly treatment with 380 mg naltrexone in microspheres.

Long-acting injectable naltrexone is an opioid antagonist, blocking the effects of heroin and other opioids, and decreases heroin use compared to a placebo.