The BNF notes that all opioid analgesics cause dependence and tolerance but that this is "no deterrent in the control of pain in terminal illness". When used in the palliative care of cancer patients, diamorphine is often injected using a syringe driver. In Switzerland, heroin is produced in injectable or tablet form under the name Diaphin by a private company under contract to the Swiss government. In Australia diamorphine is listed as a schedule 9 prohibited substance under the Poisons Standard October Possession of diamorphine for the purpose of trafficking is an indictable offense and subject to imprisonment for life.
Turkey maintains strict laws against the use, possession or trafficking of illegal drugs. If convicted under these offences, one could receive a heavy fine or a prison sentence of 4 to 24 years. Abused prescription medicine such as opioid can lead to heroin addiction. Diamorphine is produced from acetylation of morphine derived from natural opium sources. Numerous mechanical and chemical means are used to purify the final product.
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The final products have a different appearance depending on purity and have different names. Heroin purity has been classified into four grades. Traffic is heavy worldwide, with the biggest producer being Afghanistan.
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According to a U. In The Independent reported:  . The following year the Taliban banned poppy cultivation, Opium production in that country has increased rapidly since, reaching an all-time high in War in Afghanistan once again appeared as a facilitator of the trade.
At present, opium poppies are mostly grown in Afghanistan , hectares , acres , and in Southeast Asia, especially in the region known as the Golden Triangle straddling Burma 57, hectares , acres , Thailand , Vietnam , Laos 6, hectares 15, acres and Yunnan province in China.
There is also cultivation of opium poppies in Pakistan hectares 1, acres , Mexico 12, hectares 30, acres and in Colombia hectares acres. Conviction for trafficking heroin carries the death penalty in most Southeast Asian , some East Asian and Middle Eastern countries see Use of death penalty worldwide for details , among which Malaysia , Singapore and Thailand are the most strict. The penalty applies even to citizens of countries where the penalty is not in place, sometimes causing controversy when foreign visitors are arrested for trafficking, for example the arrest of nine Australians in Bali , the death sentence given to Nola Blake in Thailand in , or the hanging of an Australian citizen Van Tuong Nguyen in Singapore.
The origins of the present international illegal heroin trade can be traced back to laws passed in many countries in the early s that closely regulated the production and sale of opium and its derivatives including heroin. At first, heroin flowed from countries where it was still legal into countries where it was no longer legal. By the mids, heroin production had been made illegal in many parts of the world. An illegal trade developed at that time between heroin labs in China mostly in Shanghai and Tianjin and other nations.
The weakness of government in China and conditions of civil war enabled heroin production to take root there. Chinese triad gangs eventually came to play a major role in the illicit heroin trade. The French Connection route started in the s.
Buprenorphine Maintenance for Opioid Dependence in Public Sector
Heroin trafficking was virtually eliminated in the U. Japan's war with China had cut the normal distribution routes for heroin and the war had generally disrupted the movement of opium. The Mafia took advantage of Sicily's location along the historic route opium took westward into Europe and the United States. Although it remained legal in some countries until after World War II, health risks, addiction, and widespread recreational use led most western countries to declare heroin a controlled substance by the latter half of the 20th century.
This helped the development of the Golden Triangle opium production region, which supplied about one-third of heroin consumed in US after the American withdrawal from Vietnam. In , Burma, the heartland of the Golden Triangle, was the second largest producer of heroin, after Afghanistan. By , 60 percent of heroin sold in the U. The trade shifted away from Sicily in the late s as various criminal organizations violently fought with each other over the trade.
The fighting also led to a stepped-up government law enforcement presence in Sicily.
Following the discovery at a Jordanian airport of a toner cartridge that had been modified into an improvised explosive device , the resultant increased level of airfreight scrutiny led to a major shortage drought of heroin from October until April This was reported in most of mainland Europe and the UK which led to a price increase of approximately 30 percent in the cost of street heroin and an increased demand for diverted methadone.
The number of addicts seeking treatment also increased significantly during this period. Other heroin droughts shortages have been attributed to cartels restricting supply in order to force a price increase and also to a fungus that attacked the opium crop of District Court of conspiracy, distribution of heroin for importation into the United States and narco-terrorism.
Harm reduction is a public health philosophy that seeks to reduce the harms associated with the use of illicit drugs. One aspect of harm reduction initiatives focuses on the behaviour of individual users. In the case of diamorphine, this includes promoting safer means of taking the drug, such as smoking, nasal use, oral or rectal insertion. This attempts to avoid the higher risks of overdose, infections and blood-borne viruses associated with injecting the drug. Other measures include using a small amount of the drug first to gauge the strength, and minimize the risks of overdose.
For the same reason, poly drug use the use of two or more drugs at the same time is discouraged. Users are also encouraged to not use it on their own, as others can assist in the event of an overdose.
Another harm reduction measure employed for example in Europe, Canada and Australia are safe injection sites where users can inject diamorphine and cocaine under the supervision of medically trained staff. Safe injection sites are low threshold and allow social services to approach problem users that would otherwise be hard to reach. This has had the effect of drastically reducing an area's crime rate as individuals arrested for theft in order to supply the funds for their drugs are no longer in the position of having to steal to purchase heroin because they have been placed onto a methadone program, quite often more quickly than would have been possible had they not been arrested.
This aspect of harm reduction is seen as being beneficial to both the individual and the community at large, who are then protected from the possible theft of their goods. Researchers are attempting to reproduce the biosynthetic pathway that produces morphine in genetically engineered yeast.
From Wikipedia, the free encyclopedia. Not to be confused with Heroine. For other uses, see Heroin disambiguation. Opioid drug primarily used recreationally. IUPAC name. Interactive image. Main article: Heroin-assisted treatment. Main article: Opioid withdrawal. See also: History of opium in China. See also: Illegal drug trade in Turkey. Main articles: Harm reduction , Safe injection sites , and Needle exchange programs.
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Controlled Drug Administration Studies of High-Dose Buprenorphine in Humans
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