Heroin Pronunciation Heroin: Other names Diacetylmorphine, acetomorphine, (dual) acetylated morphine, morphine diacetate, Diamorphine (  BAN ) UK AHFS/ Drugs.com heroin Dependence liability High  Addiction liability High  Routes of administration Intravenous, inhalation, transmucosal, by mouth, intranasal, rectal, intramuscular, subcutaneous, intrathecal Drug class Opioid ATC code Legal status
Bioavailability <35% (by mouth), 44–61% (inhaled)  Protein binding 0% ( morphine metabolite 35%) Metabolism liver Onset of action Within minutes  Elimination half-life 2–3 minutes  Duration of action 4 to 5 hours  Excretion 90% kidney as glucuronides, rest biliary
CAS Number PubChem CID DrugBank ChemSpider UNII ChEBI ChEMBL CompTox Dashboard ( EPA) ECHA InfoCard 100.008.380 Formula C 21 H 23 N O 5 Molar mass g·mol 369.417 −1 3D model ( JSmol)
(verify) Heroin, also known as diacetylmorphine and diamorphine among other names, is an  opioid used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt which is distinguished from black tar heroin, a variable admixture of morphine derivatives—predominantly 6-MAM (6-monoacetylmorphine), which is the result of crude acetylation during clandestine production of street heroin. Diamorphine is used medically in several countries to relieve pain, such as during childbirth or a  heart attack, as well as in opioid replacement therapy.  
It is typically injected, usually into a vein, but it can also be smoked, snorted, 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. Side effects of use by injection can include  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. 
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, with 950,000 using it in the last year.   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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