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The term narcotic ( / n ɑːr ˈ k ɒ t ɪ k / , from ancient Greek ναρκῶ narkō , "I make numb") originally referred medically to any psychoactive compound with numbing or paralyzing properties. In the United States, it has since become associated with opiates and opioids , commonly morphine and heroin , as well as derivatives of many of the compounds found within raw opium latex. The primary three are morphine , codeine , and thebaine (while thebaine itself is only very mildly psychoactive, it is a crucial precursor in the vast majority of semi-synthetic opioids, such as oxycodone or hydrocodone ).

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74-429: Legally speaking, the term "narcotic" may be imprecisely defined and typically has negative connotations. When used in a legal context in the U.S., a narcotic drug is totally prohibited, such as heroin , or one that is used in violation of legal regulation (in this word sense , equal to any controlled substance or illicit drug ). In the medical community, the term is more precisely defined and generally does not carry

148-400: A maintenance drug to assist the treatment of opiate addiction, normally in long-term chronic intravenous (IV) heroin users. It is only prescribed following exhaustive efforts at treatment via other means. It is sometimes thought that heroin users can walk into a clinic and walk out with a prescription, but the process takes many weeks before a prescription for diamorphine is issued. Though this

222-488: A prodrug for the systemic delivery of morphine. When the drug is injected, however, it avoids this first-pass effect, very rapidly crossing the blood–brain barrier because of the presence of the acetyl groups, which render it much more fat soluble than morphine itself. Once in the brain, it then is deacetylated variously into the inactive 3-monoacetylmorphine and the active 6-monoacetylmorphine (6-MAM), and then to morphine, which bind to μ-opioid receptors , resulting in

296-408: A rush as a forerunner to the high experienced with the use of heroin, which is most pronounced with intravenous use. While the onset of the rush induced by injection can occur in as little as a few seconds, the oral route of administration requires approximately half an hour before the high sets in. Thus, with both higher the dosage of heroin used and faster the route of administration used, the higher

370-838: A combination of extraction and chemical synthesis: (i) Opium, opiates, derivatives of opium and opiates, including their isomers, esters, ethers, salts, and salts of isomers, esters, and ethers whenever the existence of such isomers, esters, ethers, and salts is possible within the specific chemical designation. Such a term does not include the isoquinoline alkaloids of opium. (ii) Poppy straw and concentrate of poppy straw. (iii) Coca leaves, except coca leaves and extracts of coca leaves from which cocaine, ecgonine and derivatives of ecgonine or their salts have been removed. (iv) Cocaine, its salts, optical and geometric isomers , and salts of isomers. (v) Ecgonine, its derivatives, their salts, isomers, and salts of isomers. (vi) Any compound, mixture, or preparation which contains any quantity of any of

444-474: A fast onset. Snorting heroin becomes an often unwanted route, once a user begins to inject the drug. The user may still get high on the drug from snorting, and experience a nod, but will not get a rush. A "rush" is caused by a large amount of heroin entering the body at once. When the drug is taken in through the nose, the user does not get the rush because the drug is absorbed slowly rather than instantly. Heroin for pain has been mixed with sterile water on site by

518-539: A few addicts who have tried methadone and buprenorphine without success. Beginning in February 2010, addicts in Copenhagen and Odense became eligible to receive free diamorphine. Later in 2010, other cities including Århus and Esbjerg joined the scheme. It was estimated that around 230 addicts would be able to receive free diamorphine. However, Danish addicts would only be able to inject heroin according to

592-469: A law allowing diamorphine prescription as a standard treatment for addicts; a large-scale trial of diamorphine prescription had been authorized in the country in 2002. On 26 August 2016, Health Canada issued regulations amending prior regulations it had issued under the Controlled Drugs and Substances Act ; the "New Classes of Practitioners Regulations", the "Narcotic Control Regulations", and

666-623: A moderate dose of oxycodone . Analgesics are drugs that relieve pain . There are two main types: non-narcotic analgesics for mild pain, and narcotic analgesics for severe pain. Narcotic analgesics tend to be opioids . They bind to opioid receptors which are G protein-coupled receptors distributed in brain, spinal cord, digestive tract, peripheral neurons. There are three types of opioid receptors: mu ( μ-opioid receptors ), delta, and kappa ( κ-opioid receptor ). Endogenous opioids ( enkephalins , dynorphin , endorphin ) do not bind specifically to any particular opioid receptor. Receptor binding of

740-608: A more common cause of drug-related deaths. Depending on drug interactions and numerous other factors, death from overdose can take anywhere from several minutes to several hours. Death usually occurs due to lack of oxygen resulting from the lack of breathing caused by the opioid. Heroin overdoses can occur because of an unexpected increase in the dose or purity or because of diminished opioid tolerance. However, many fatalities reported as overdoses are probably caused by interactions with other depressant drugs such as alcohol or benzodiazepines . Since heroin can cause nausea and vomiting,

814-419: A narcotic. Research acknowledges that alcohol can have similar effects to narcotics in head and/or trunk trauma situations. The adoption of this convention is regarded as a milestone in the history of the international drug ban. The Single Convention codified all existing multilateral treaties on drug control and extended the existing control systems to include the cultivation of plants that were grown as

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888-609: A narcotic. From a U.S. legal perspective, narcotics refer to opium, opium derivatives, and their semi-synthetic substitutes, though in U.S. law, due to its numbing properties, cocaine is also considered a narcotic. The definition encompassing "any illegal drug" was first recorded in 1926. Its first use as an adjective is first attested to c.  1600 . There are many different types of narcotics. The two most common forms of narcotic drugs are morphine and codeine . Both are synthesized from opium for medicinal use. The most commonly used drug for recreational purposes created from opium

962-577: 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 . Bayer 's original trade name of heroin

1036-499: A period of abstinence. If this occurs and the user takes a dose comparable to their previous use, the user may experience drug effects that are much greater than expected, potentially resulting in an overdose. It has been speculated that an unknown portion of heroin-related deaths are the result of an overdose or allergic reaction to quinine , which may sometimes be used as a cutting agent. When taken orally, heroin undergoes extensive first-pass metabolism via deacetylation , making it

1110-483: A significant number of deaths attributed to heroin overdose are caused by aspiration of vomit by an unconscious person. Some sources quote the median lethal dose (for an average 75 kg opiate-naive individual) as being between 75 and 600 mg. Illicit heroin is of widely varying and unpredictable purity. This means that the user may prepare what they consider to be a moderate dose while actually taking far more than intended. Also, tolerance typically decreases after

1184-471: A trial diamorphine maintenance program for users that had failed multiple withdrawal programs. The aim of this program was to maintain the health of the user by avoiding medical problems stemming from the illicit use of diamorphine. The first trial in 1994 involved 340 users, although enrollment was later expanded to 1000, based on the apparent success of the program. The trials proved diamorphine maintenance to be superior to other forms of treatment in improving

1258-402: A variable single dose range using a hypodermic needle . The dose of heroin used for recreational purposes is dependent on the frequency and level of use. As with the injection of any drug, if a group of users share a common needle without sterilization procedures, blood-borne diseases, such as HIV/AIDS or hepatitis , can be transmitted. The use of a common dispenser for water for the use in

1332-466: Is heroin . Synthesized drugs created with an opium base for use in pain management are fentanyl , oxycodone, tramadol, pethidine (Demerol), hydrocodone, methadone, and hydromorphone. New forms of existing pain medications are being created regularly. The newest formulation to come out was in 2014 when zohydro, an increased dosage formula of hydrocodone, was released; this is so far the strongest hydrocodone formulation created for pain management, on par with

1406-490: Is a tropane alkaloid found naturally in coca leaves. It has a close structural relation to cocaine : it is both a metabolite and a precursor , and as such, it is a controlled substance in many jurisdictions, as are some substances which can be used as precursors to ecgonine itself. Structurally, ecgonine is a cycloheptane derivative with a nitrogen bridge . It is obtained by hydrolysis of cocaine with acids or alkalis , and crystallizes with one molecule of water,

1480-630: Is based on the Greek word ναρκωσις (narcosis) , the term used by Hippocrates for the process of numbing or the numbed state. Galen listed mandrake root , altercus (eclata), seeds, and poppy juice ( opium ) as the chief examples. It originally referred to any substance that relieved pain, dulled the senses, or induced sleep. Now, the term is used in many ways. Some people might define narcotics as substances that bind at opioid receptors (cellular membrane proteins activated by substances like heroin or morphine), while others refer to any illicit substance as

1554-466: Is clouded; heart function slows, and breathing is also severely slowed, sometimes enough to be life-threatening. Slowed breathing can also lead to coma and permanent brain damage . Heroin use has also been associated with myocardial infarction . Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of

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1628-415: Is heated by a flame underneath it, with the resulting smoke inhaled through a tube of rolled up foil, a method also known as " chasing the dragon ". Another popular route to intake heroin is insufflation (snorting), where a user crushes the heroin into a fine powder and then gently inhales it (sometimes with a straw or a rolled-up banknote , as with cocaine) into the nose, where heroin is absorbed through

1702-418: Is higher than expected. Users report an intense rush , an acute transcendent state of euphoria , which occurs while diamorphine is being metabolized into 6-monoacetylmorphine (6-MAM) and morphine in the brain. Some believe that heroin produces more euphoria than other opioids; one possible explanation is the presence of 6-monoacetylmorphine, a metabolite unique to heroin – although a more likely explanation

1776-498: Is less common than other methods of administration, mainly because there is little to no "rush", and the effects are less potent. Heroin is entirely converted to morphine by means of first-pass metabolism , resulting in deacetylation when ingested. Heroin's oral bioavailability is both dose-dependent (as is morphine's) and significantly higher than oral use of morphine itself, reaching up to 64.2% for high doses and 45.6% for low doses; opiate-naive users showed far less absorption of

1850-404: Is more fat soluble and therefore more potent by injection, so smaller doses of it are needed for the same effect on pain. Both of these factors are advantageous if giving high doses of opioids via the subcutaneous route, which is often necessary for palliative care. It is also used in the palliative management of bone fractures and other trauma, especially in children. In the trauma context, it

1924-699: Is more common to use morphine or other strong opioids in these situations. In 2004, the National Institute for Health and Clinical Excellence produced guidance on the management of caesarean section , which recommended the use of intrathecal or epidural diamorphine for post-operative pain relief . For women who have had intrathecal opioids, there should be a minimum hourly observation of respiratory rate, sedation and pain scores for at least 12 hours for diamorphine and 24 hours for morphine. Women should be offered diamorphine (0.3–0.4 mg intrathecally) for intra- and postoperative analgesia because it reduces

1998-420: Is not disputed. Stieren was convicted after special agents testified that he had and attempted to sell them a large quantity of cocaine. Defendant urges that the testimony and reports by physicians and scientists demonstrate that cocaine is not a narcotic. He also cites cases that hold that cocaine is not a narcotic under the pharmacological definition of the term. State v. Erickson , 574 P.2d 1 (Alaska 1978). It

2072-415: Is primarily given by nose in hospital; although a prepared nasal spray is available. It has traditionally been made by the attending physician, generally from the same "dry" ampoules as used for injection. In children, Ayendi nasal spray is available at 720 micrograms and 1600 micrograms per 50 microlitres actuation of the spray, which may be preferable as a non-invasive alternative in pediatric care, avoiding

2146-544: Is reduced abruptly. Intravenous use of heroin (and any other substance) with needles and syringes or other related equipment may lead to: The withdrawal syndrome from heroin may begin within as little as two hours of discontinuation of the drug; however, this time frame can fluctuate with the degree of tolerance as well as the amount of the last consumed dose, and more typically begins within 6–24 hours after cessation. Symptoms may include sweating , malaise , anxiety, depression, akathisia , priapism , extra sensitivity of

2220-447: Is slightly different from mu and delta, in that Ca channels close instead of K channels, and K channels open in mu and delta. Heroin Heroin , also known as diacetylmorphine and diamorphine among other names, is a morphinan opioid substance synthesized from the dried latex of the opium poppy ; it is mainly used as a recreational drug for its euphoric effects. Heroin

2294-517: Is somewhat controversial among proponents of a zero-tolerance drug policy , it has proven superior to methadone in improving the social and health situations of addicts. The UK Department of Health's Rolleston Committee Report in 1926 established the British approach to diamorphine prescription to users, which was maintained for the next 40 years: dealers were prosecuted, but doctors could prescribe diamorphine to users when withdrawing. In 1964,

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2368-631: Is the most common, and opioid use resulted in 122,000 deaths; also, as of 2015, the total number of heroin users worldwide 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. 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,

2442-410: Is the rapidity of onset. While other opioids of recreational use produce only morphine, heroin also leaves 6-MAM, also a psycho- active metabolite . However, this perception is not supported by the results of clinical studies comparing the physiological and subjective effects of injected heroin and morphine in individuals formerly addicted to opioids; these subjects showed no preference for one drug over

2516-415: Is the result of crude acetylation during clandestine production of street heroin. Heroin is typically injected , usually into a vein , but it can also be snorted, smoked, 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

2590-450: Is typically used in non-medical settings. It is used as a recreational drug for the euphoria it induces. Anthropologist Michael Agar once described heroin as "the perfect whatever drug." Tolerance develops quickly, and increased doses are needed in order to achieve the same effects. Its popularity with recreational drug users, compared to morphine , reportedly stems from its perceived different effects. Short-term addiction studies by

2664-459: Is used medically in several countries to relieve pain , such as during childbirth or a heart attack, as well as in opioid replacement therapy . Medical-grade diamorphine is used as a pure hydrochloride salt . Various white and brown powders sold illegally around the world as heroin are routinely diluted with cutting agents . Black tar heroin is a variable admixture of morphine derivatives—predominantly 6-MAM (6-monoacetylmorphine), which

2738-410: 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 . Use by injection can also result in abscesses , infected heart valves , blood-borne infections , and pneumonia . After a history of long-term use, opioid withdrawal symptoms can begin within hours of

2812-462: Is within the legislative prerogative to classify cocaine, which is a non-narcotic central nervous system stimulant, as a narcotic for penalty and regulatory purposes. 21 U.S.C. § 802(16)(A). The use of cocaine poses serious problems for the community and has a high potential for abuse. Congress's choice of penalty reflects a societal policy that must be adhered to by the courts.2 Congress has the power to reclassify cocaine. This power has been delegated to

2886-517: The Brain Committee recommended that only selected approved doctors working at approved specialized centres be allowed to prescribe diamorphine and cocaine to users. The law was made more restrictive in 1968. Beginning in the 1970s, the emphasis shifted to abstinence and the use of methadone; currently, only a small number of users in the UK are prescribed diamorphine. In 1994, Switzerland began

2960-648: The United States , heroin is not accepted as medically useful. Under the generic name diamorphine, heroin is prescribed as a strong pain medication in the United Kingdom , where it is administered via oral , subcutaneous , intramuscular , intrathecal , intranasal or intravenous routes. It may be prescribed for the treatment of acute pain, such as in severe physical trauma , myocardial infarction , post- surgical pain and chronic pain , including end-stage terminal illnesses . In other countries it

3034-505: The east-coast United States is most commonly found in the hydrochloride salt form, requiring just water (and no heat) to dissolve. Users tend to initially inject in the easily accessible arm veins, but as these veins collapse over time, users resort to more dangerous areas of the body, such as the femoral vein in the groin. Some medical professionals have expressed concern over this route of administration, as they suspect that it can lead to deep vein thrombosis . Intravenous users can use

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3108-422: The route of administration . Smoking is the fastest route of drug administration, although intravenous injection results in a quicker rise in blood concentration. These are followed by suppository (anal or vaginal insertion), insufflation (snorting), and ingestion (swallowing). A 2002 study suggests that a fast onset of action increases the reinforcing effects of addictive drugs. Ingestion does not produce

3182-667: The "Food and Drug Regulations", to allow doctors to prescribe diamorphine to people who have a severe opioid addiction who have not responded to other treatments. The prescription heroin can be accessed by doctors through Health Canada 's Special Access Programme (SAP) for "emergency access to drugs for patients with serious or life-threatening conditions when conventional treatments have failed, are unsuitable, or are unavailable." Medicinal uses: Neurological: Psychological: Cardiovascular & Respiratory: Gastrointestinal: Musculoskeletal: Skin: Miscellaneous: The onset of heroin's effects depends upon

3256-558: The Attorney General. 21 U.S.C. § 811(a)(1). If cocaine is to be reclassified, the defendant's arguments should be made to the legislative branch, not the courts. We hold that Congress had a rational legislative purpose when it classified cocaine as a Schedule II narcotic drug to impose penalties. JUDGMENT AFFIRMED. The term "narcotic" is believed to have been coined by the Greek physician Galen to refer to agents that numb or deaden, causing paralysis or loss of feeling . It

3330-732: The Permanent Central Board and the Drug Supervisory Board. The 1961 Convention seeks to control over 116 drugs that it classifies as narcotic. These include: The Convention divides drugs into four groups, or schedules, to enforce a greater or lesser degree of control for the various substances and compounds. Opium smoking and eating, coca leaf chewing, cannabis resin smoking, and the non-medical use of cannabis are prohibited. The 1972 Protocol to this Convention calls for increased efforts to prevent illicit production of, traffic in, and use of narcotics as defined by

3404-671: The Schedules of the convention. If it is on some of the Schedules, it is narcotic. The term usually refers to opiates or opioids, which are called narcotic analgesics. In common parlance and legal usage, it is often used imprecisely to mean illicit drugs, irrespective of their pharmacology. For example, narcotics control legislation in Canada, the US, and certain other countries includes cocaine and cannabis as well as opioids (see also conventions, international drug). Because of this variation in usage,

3478-451: The UK. Because significant tolerance to respiratory depression develops quickly with continued use and is lost just as quickly during withdrawal, it is often difficult to determine whether a heroin lethal overdose was accidental, suicide or homicide. Examples include the overdose deaths of Sid Vicious , Janis Joplin , Tim Buckley , Hillel Slovak , Layne Staley , Bradley Nowell , Ted Binion , and River Phoenix . Use of heroin by mouth

3552-406: The anus or vagina before the plunger is pushed. The rectum or the vaginal canal is where the majority of the drug would likely be taken up, through the membranes lining their walls. Heroin is classified as a hard drug in terms of drug harmfulness . Like most opioids , unadulterated heroin may lead to adverse effects . The purity of street heroin varies greatly, leading to overdoses when the purity

3626-562: The attending physician, and administered using a syringe with a nebulizer tip. Heroin may be used for fractures, burns, finger-tip injuries, suturing, and wound re-dressing, but is inappropriate in head injuries. Little research has been focused on the suppository (anal insertion) or pessary (vaginal insertion) methods of administration, also known as "plugging". These methods of administration are commonly carried out using an oral syringe . Heroin can be dissolved and withdrawn into an oral syringe which may then be lubricated and inserted into

3700-438: The brain's white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations. Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence , the body adapts to the presence of the drug , and withdrawal symptoms occur if use

3774-536: The context of international drug control, "narcotic drug" means any drug defined as such under the 1961 Convention. 4. Assessment of the definitions of counterfeit medicines (or equivalent) in the Member States 4.2 The nature of legal definitions: the unambiguity requirement In order to avoid room for difference in interpretation, lawmakers ( codificators ) sometimes deviate from etymological (definiendum plus definientia) definitions. In doing so, they approach

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3848-598: The convention, while highlighting the need to provide treatment and rehabilitation services to drug abusers. This document contains the current list of narcotic drugs under international control and additional information to assist governments in filling in the International Narcotics Control Board questionnaires related to narcotic drugs, namely, form A, form B and form C. In medicine, a chemical agent that induces stupor, coma, or insensibility to pain (also called narcotic analgesic). In

3922-642: The drug at low doses, having bioavailabilities of only up to 22.9%. The maximum plasma concentration of morphine following oral administration of heroin was around twice as much as that of oral morphine. Injection , also known as "slamming", "banging", "shooting up", "digging" or "mainlining", is a popular method which carries relatively greater risks than other methods of administration. Heroin base (commonly found in Europe), when prepared for injection, will only dissolve in water when mixed with an acid (most commonly citric acid powder or lemon juice) and heated. Heroin in

3996-456: The drug's euphoric, analgesic (pain relief), and anxiolytic (anti-anxiety) effects; heroin itself exhibits relatively low affinity for the μ receptor. Analgesia follows from the activation of the μ receptor G-protein coupled receptor , which indirectly hyperpolarizes the neuron, reducing the release of nociceptive neurotransmitters, and hence, causes analgesia and increased pain tolerance. Ecgonine Ecgonine ( tropane derivative)

4070-400: The effects of heroin and causes an immediate return of consciousness but may result in withdrawal symptoms. The half-life of naloxone is shorter than some opioids, such that it may need to be given multiple times until the opioid has been metabolized by the body. Between 2012 and 2015, heroin was the leading cause of drug-related deaths in the United States. Since then, fentanyl has been

4144-495: The fear of injection in children. A number of European countries prescribe heroin for treatment of heroin addiction . The initial Swiss HAT ( heroin-assisted treatment ) trial ("PROVE" study) was conducted as a prospective cohort study with some 1,000 participants in 18 treatment centers between 1994 and 1996, at the end of 2004, 1,200 patients were enrolled in HAT in 23 treatment centers across Switzerland. Diamorphine may be used as

4218-429: The genitals in females, general feeling of heaviness, excessive yawning or sneezing, rhinorrhea , insomnia , cold sweats, chills, severe muscle and bone aches, nausea, vomiting, diarrhea, cramps, watery eyes, fever, cramp-like pains, and involuntary spasms in the limbs (thought to be an origin of the term "kicking the habit" ). Heroin overdose is usually treated with the opioid antagonist naloxone . This reverses

4292-401: The judgment of conviction for possession of cocaine with intent to distribute and dispense under 21 U.S.C. § 841(a)(1). Stieren contends that the statute is unconstitutional because "cocaine is classified as a narcotic under Schedule II of 21 U.S.C. § 812(c) when as a matter of scientific and medical fact cocaine is not a narcotic but is a non-narcotic stimulant." The sufficiency of the evidence

4366-476: 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. Treatment of heroin addiction often includes behavioral therapy and medications. Medications can include buprenorphine , methadone , or naltrexone . A heroin overdose may be treated with naloxone . As of 2015, an estimated 17 million people use opiates, of which heroin

4440-404: The need for supplemental analgesia after a caesarean section. Epidural diamorphine (2.5–5 mg) is a suitable alternative. Diamorphine continues to be widely used in palliative care in the UK, where it is commonly given by the subcutaneous route, often via a syringe driver if patients cannot easily swallow morphine solution . The advantage of diamorphine over morphine is that diamorphine

4514-461: The opioid causes a cascade leading to the channel opening and hyperpolarization of the neuron. The opioid receptors have the following channel types: mu, K channel; l delta, K channel; kappa, Ca channel. Hyperpolarization can lead to post-synaptic neural inhibition and presynaptic inhibition of neurotransmitter release. Post-synaptic neural inhibition can reduce analgesia and central hyperactivity may reduce its efficacy. The mechanism of kappa receptors

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4588-462: The other. Equipotent injected doses had comparable action courses, with no difference in subjects' self-rated feelings of euphoria, ambition, nervousness, relaxation, drowsiness, or sleepiness. The rush is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities. Nausea , vomiting , and severe itching may also occur. After the initial effects, users usually will be drowsy for several hours; mental function

4662-485: The policy set by Danish National Board of Health . Of the estimated 1500 drug users who did not benefit from the then-current oral substitution treatment, approximately 900 would not be in the target group for treatment with injectable diamorphine, either because of "massive multiple drug abuse of non-opioids" or "not wanting treatment with injectable diamorphine". In July 2009, the German Bundestag passed

4736-409: The potential risk for psychological dependence / addiction . Large doses of heroin can cause fatal respiratory depression, and the drug has been used for suicide or as a murder weapon. The serial killer Harold Shipman used diamorphine on his victims, and the subsequent Shipman Inquiry led to a tightening of the regulations surrounding the storage, prescribing and destruction of controlled drugs in

4810-500: The preparation of the injection, as well as the sharing of spoons and filters can also cause the spread of blood-borne diseases. Many countries now supply small sterile spoons and filters for single use in order to prevent the spread of disease. Smoking heroin refers to vaporizing it to inhale the resulting fumes, rather than burning and inhaling the smoke. It is commonly smoked in glass pipes made from glassblown Pyrex tubes and light bulbs. Heroin may be smoked from aluminium foil that

4884-521: The raw material of narcotic drugs. The principal objectives of the convention are to limit the possession, use, trade, distribution, import, export, manufacture, and production of drugs exclusively for medical and scientific purposes, and to address drug trafficking through international cooperation to deter and discourage drug traffickers. The convention also established the International Narcotics Control Board, merging

4958-412: The same negative connotations. Statutory classification of a drug as a narcotic often increases the penalties for violation of drug control statutes. For example, although U.S. federal law classifies both cocaine and amphetamines as "Schedule II" drugs, the penalty for possession of cocaine is greater than the penalty for possession of amphetamines because cocaine, unlike amphetamines, is classified as

5032-521: The same researchers demonstrated that tolerance developed at a similar rate to both heroin and morphine. When compared to the opioids hydromorphone , fentanyl , oxycodone , and pethidine (meperidine), former addicts showed a strong preference for heroin and morphine, suggesting that heroin and morphine are particularly susceptible to misuse and causing dependence. Morphine and heroin were also much more likely to produce euphoria and other positive subjective effects when compared to these other opioids. In

5106-444: The social and health situation for this group of patients. It has also been shown to save money, despite high treatment expenses, as it significantly reduces costs incurred by trials, incarceration, health interventions and delinquency . Patients appear twice daily at a treatment center, where they inject their dose of diamorphine under the supervision of medical staff. They are required to contribute about 450 Swiss francs per month to

5180-427: The soft tissue in the mucous membrane of the sinus cavity and straight into the bloodstream. This method of administration redirects first-pass metabolism , with a quicker onset and higher bioavailability than oral administration, though the duration of action is shortened. This method is sometimes preferred by users who do not want to prepare and administer heroin for injection or smoking but still want to experience

5254-408: The substances referred to in paragraphs (b)(31)(i) through (v) of this section. A 1984 amendment to 21 USC ( Controlled Substances Act ), Section 802 expanded and revised definition of "narcotic drug", including within term poppy straw, cocaine, and ecgonine. 608 F.2d 1135 United States Court of Appeals, Eighth Circuit . Decided Oct. 31, 1979. LAY, Circuit Judge. John Arthur Stieren appeals from

5328-480: The term from the law enforcement point of view. The best example is the definition of narcotics in the United Nations Conventions. Narcotics are substances and preparations that induce drowsiness, sleep, stupor, insensibility, etc., and that these effects (and their rate) are complicated to prove, e.g. during litigation. Thus, the legal definition of a narcotic is whether or not it is listed on

5402-463: The term is best replaced by one with a more specific meaning (e.g. opioid). Section 1300.01 Definitions relating to controlled substances: (b) As used in parts 1301 through 1308 and part 1312 of this chapter, the following terms shall have the meanings specified: (30) The term narcotic drug means any of the following whether produced directly or indirectly by extraction from substances of vegetable origin or independently using chemical synthesis or by

5476-687: The treatment costs. A national referendum in November 2008 showed 68% of voters supported the plan, introducing diamorphine prescription into federal law. The previous trials were based on time-limited executive ordinances. The success of the Swiss trials led German, Dutch, and Canadian cities to try out their own diamorphine prescription programs. Some Australian cities (such as Sydney) have instituted legal diamorphine supervised injecting centers , in line with other wider harm minimization programs. Since January 2009, Denmark has prescribed diamorphine to

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