Heroin

Heroin, or diacetylmorphine, is a synthetic opiate, first created by Bayer in the late 1800s and marketed for pain relief and treatment of morphine addicts. It has a high abuse potential because of its rapid onset of action and short half-life. Heroin is therefore a Schedule I substance (i.e., not available for therapeutic use in the United States). Heroin can be injected intravenously (IV), subcutaneously (SC, "skin popping"), or snorted intranasally, as well as smoked in freebase form. Use of the intranasal route has greatly increased, along with the purity of street heroin and awareness of human immunodeficiency virus (HIV) infection risk associated with injecting. Heroin itself is an inactive prodrug with two active metabolites, one of which is morphine, and both of which are active at the mu opioid receptor. After intravenous (IV) injection, users describe an intense rush within 1 to 2 minutes, followed by a period of euphoric sedation lasting about 1 hour. In dependent users, withdrawal symptoms can begin within 4 to 6 hours (Ries et al., 2009).

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