Heroin: Difference between revisions

'''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 [[psychoactive class::opioid]] substance of the [[chemical class::morphinan]] class. It is a derivative of [[morphine]], a natural product of the opium poppy (''Papaver somniferum'').<ref>Norn, S., Kruse, P. R., & Kruse, E. (2005). History of opium poppy and morphine. ''Dansk medicinhistorisk arbog'', ''33'', 171-184.</ref> Heroin is known for its highly addictive properties and it makes up a large portion of the illicit traffic in narcotics.

Heroin was first synthesized from morphine by English chemist, C.R. Alder Wright in 1874 and was introduced as a commercial product by the Bayer Company of Germany in 1898.<ref name=":0">Wright, C.R.A. (1874). "On the Action of Organic Acids and their Anhydrides on the Natural Alkaloids". Journal of the Chemical Society. 27: 1031–1043. doi:10.1039/js8742701031|https://web.archive.org/web/20040606103721/http://adhpage.dilaudid.net/heroin.html</ref> Although the name heroin is a trade name, it has since been widely adopted for all intents and purposes and may describe a recreational depressant that may or may not contain pure diacetylmorphine.  

There are no pharmacological differences in effects between heroin and [[morphine]], except that heroin is more potent and acts faster. In its pure form, heroin is active at doses of 5 mg and above; however, the substance is most commonly found in a preparation containing significant impurities. These impurities can result from including processing faults during synthesis, the addition of harmful or benign cutting agents, or the substitution of significantly more potent and dangerous analogous substances such as [[fentanyl]] adulterated into the end-product before distribution.<ref>Much of Heroin Supply Adulterated with Fentanyl | http://mha.ohio.gov/Portals/0/assets/Research/OSAM-TRI/092015-OSAMogram-heroin-fentanyl-update.pdf</ref><ref>InFocus: Fentanyl-Laced Heroin: A Deadly Combination (Medicine News)| http://journals.lww.com/em-news/Fulltext/2014/04000/InFocus__Fentanyl_Laced_Heroin__A_Deadly.5.aspx</ref><ref>Illicit Version Of Painkiller Fentanyl Makes Heroin Deadlier | http://www.npr.org/sections/health-shots/2015/08/26/434618809/ilicit-version-of-painkiller-fentanyl-makes-heroin-deadlier</ref><ref>What You Need to Know About Fentanyl-Laced Heroin | http://www.projectknow.com/what-you-need-to-know-about-fentanyl-laced-heroin/</ref><ref>Killer batch of white heroin responsible for at least 100 deaths across the country... and rising | http://www.dailymail.co.uk/news/article-2549944/Killer-heroin-fentanyl-epidemic-responsible-100-deaths-country-rising-half-month.html</ref> This makes accurate dosing particularly difficult.  

Diacetylmorphine was originally synthesized by C.R. Alder Wright in 1874 when attempting to combine morphine with various acids.<ref name=":0" /> The synthesis was achieved through boiling anhydrous morphine with morphine alkaloid with acetic anhydride.<ref>Wright, C.R.A. (1874). "On the Action of Organic Acids and their Anhydrides on the Natural Alkaloids". Journal of the Chemical Society. 27: 1031–1043. doi:10.1039/js8742701031|https://web.archive.org/web/20040606103721/http://adhpage.dilaudid.net/heroin.html</ref> Up until 1897, Diamorphine was mostly unknown to the medical community and it wasn't until Felix Hoffmann synthesized the drug for the German pharmaceutical company, Bayer, that the drug entered the narcotic market. Felex Hoffmann is the same man who is widely believed to have synthesized a pure form of Aspirin.<ref name=":1">''Felix Hoffmann''. Science History Institute. (2021, January 5). Retrieved July 7, 2022, from <nowiki>https://www.sciencehistory.org/historical-profile/felix-hoffmann</nowiki></ref> In 1898 under Bayer, Diamorphine began production on a commercial scale and was marketed for a variety of ailments. Primarily, the drug was used for cough, general pain, and anesthesia, and to control some mental illnesses.<ref name=":1" /> At the time, Heroin was mostly used as a substitute to [[codeine]], as it was believed to be non-addictive. All was well, as it was assumed that Heroin was more potent yet less harmful than its fellow narcotics. A review of Heroin's effects in 1900 concluded that addiction and tolerance to Heroin were only a minor issue. In America, by 1906 the Pure Food and Drugs Act was passed in part due to concern over the number of people addicted to narcotics. In 1914, the US government continued to regulate the pharmaceutical industry and passed the Harrison Act and by 1925 a physician was only allowed to prescribe narcotics to non-hospitalized addicts only to sustain them. Many physicians at this time stopped prescribing narcotics, although it remained legal to do so. It was around this time that illegal use of narcotics truly began to take off. As a result of the prohibition of narcotics, many addicts were left with little option except to turn to the illicit market where prices were significantly greater than they were when the drugs were readily available over the counter. In an effort to save money, many users switched to intravenous use. When addicts ran out of money (due to the inflated cost) they turned to crime to fund there costly addiction. This is the beginning of where drug use becomes associated with crime.

Heroin itself is an inactive drug, but it is metabolized into [[morphine]] when inserted into the body.<ref>The therapeutic use of heroin: a review of the pharmacological literature | http://www.nrcresearchpress.com/doi/abs/10.1139/y86-001</ref> When taken orally, heroin undergoes extensive first-pass metabolism via deacetylation, making it a [[prodrug]] for the systemic delivery of [[morphine]].<ref>The therapeutic use of heroin: a review of the pharmacological literature (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/2420426</ref> When the drug is injected, however, it avoids this first-pass effect, very rapidly crossing the [[Blood–brain barrier|blood–brain barrier]] because of the presence of the acetyl groups which render it much more fat-soluble, and thus more potent, than [[morphine]] itself.<ref>Development of pharmaceutical heroin preparations for medical co-prescription to opioid-dependent patients (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0376871605001511</ref>  

*'''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.<ref>Controlled Substances Act of 1970 https://www.govinfo.gov/content/pkg/STATUTE-84/pdf/STATUTE-84-Pg1236.pdf#page=13</ref>