Heroin

Heroin (diacetylmorphine (INN)), also known as diamorphine (BAN),

is a semi-synthetic opioid drug synthesized from morphine, a
derivative of the opium poppy. It is the 3,6-diacetyl ester of morphine
(di (two)-acetyl-morphine). The white crystalline form is commonly the
hydrochloride salt diacetylmorphine hydrochloride, though often
adulterated thus dulling the sheen and consistency from that to a
matte white powder, which diacetylmorphine freebase typically
is.90% of diacetylmorphine is thought to be produced in Afghanistan.[
As with other opioids, diacetylmorphine is used as both an analgesic
and a recreational drug. Frequent and regular administration is
associated with tolerance and physical dependence, which may
develop into addiction. Internationally, diacetylmorphine is controlled
under Schedules I and IV of the Single Convention on Narcotic
Drugs.It is illegal to manufacture, possess, or sell diacetylmorphine
without a license in Belgium, Denmark, Germany, Iran, India, the
Netherlands, the United States, Australia, Canada, Ireland, Pakistan,
the United Kingdom and Swaziland.
Under the chemical name diamorphine, diacetylmorphine is a legally
prescribed controlled drug in the United Kingdom. It is available for
prescription to long-term users in the Netherlands, United Kingdom,
Switzerland, Germany and Denmark alongside psycho-social
care,and a similar programme is being campaigned for by liberal
political parties in Norway. Some countries allow the government to
sell or donate high-quality seizures of drugs and precursors which are
otherwise legal for medicinal use to pharmaceutical manufacturers for
use in preparing licit supplies of medical drugs and research
chemicals; this was the case in Croatia prior to 2007

Medical use
Worldwide, the UN estimates there are more than 50 million regular
users of diacetylmorphine, cocaine and synthetic drugs.Global users
of diacetylmorphine are estimated at between 15.16 million and 21.13
million people aged 15–64
Under the chemical name diamorphine, diacetylmorphine is
prescribed as a strong analgesic in the United Kingdom, where it is
given via subcutaneous, intramuscular, intrathecal or intravenous
route. Its use includes treatment for acute pain, such as in severe
physical trauma, myocardial infarction, post-surgical pain, and chronic
pain, including end-stage cancer and other terminal illnesses. In other
countries it is more common to use morphine or other strong opioids
in these situations.
In 2005, there was a shortage of diacetylmorphine in the UK,
because of a problem at the main UK manufacturers.[25] Because of
this, many hospitals changed to using morphine instead of
diacetylmorphine. Although there is no longer a problem with the
manufacturing of diacetylmorphine in the UK, many hospitals there
have continued to use morphine.
Diacetylmorphine continues to be widely used in palliative care in the
United Kingdom, where it is commonly given by the subcutaneous
route, often via a syringe driver, if patients cannot easily swallow oral
morphine solution. The advantage of diacetylmorphine over morphine
is that diacetylmorphine is more fat soluble and therefore more
potent, so smaller doses of it are needed for the same analgesic
effect. Both of these factors are advantageous if giving high doses of
opioids via the subcutaneous route, which is often necessary in
palliative care.
The medical use of diacetylmorphine (in common with other strong
opioids such as morphine, fentanyl and oxycodone) is controlled in
the United Kingdom by the Misuse of Drugs Act 1971. In the UK, it is
a class A controlled drug. Registers of its use are required to be kept
in hospitals.
Diacetylmorphine is also used as a maintenance drug to treat addicts.
Though this is somewhat controversial among proponents of a zero
tolerance drug policy, it has proven superior to methadone in
improving the social and health situation of addicts.