2021 May 19. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–.
ABSTRACT
Heroin, also known as diacetylmorphine, is a very efficient prodrug and more potent than morphine. Many deaths are caused by heroin overdoses throughout the world each year. Heroin, which can be sniffed, smoked, or injected, is experiencing a rebound in usage, partially related to the efforts to reduce the abuse of prescription pain relievers. With increased usage, there has been a corresponding increase in overdose-related deaths. For heroin-related death rates, 14 states in the USA had significant increases, with Washington D.C., West Virginia, and Ohio having the highest rates. Heroin is one of the most commonly used drugs among intravenous drug abusers. Conventionally, chemical compounds that are fractionated from the juice of the opium poppy (Papaver somniferum) are known as opiates. Similarly, acting synthetic chemical compounds are known as opioids. The predominant opiate is found in opium poppy juice. The juice of the opium poppy is harvested, which contains a variety of opiates, mostly morphine. Additional processing is necessary to refine the opium poppy liquid into heroin. Heroin is synthesized from morphine by acetylation at both 3 and 6 positions and metabolized in the human body to active opioid compounds first by deacetylation to 6 mono acetyl morphine (6MAM) then by further deacetylation to morphine. Heroin is smaller per dose, making it the version of the product preferred by drug smugglers.