also known as diamorphine among other names,[1] is an opioid most commonly used as a recreational drug for its euphoric effects.[2] Medically it is used in several countries to relieve pain or in opioid replacement therapy.[7][8][9] Heroin is typically injected, usually into a vein; however, it can also be smoked, snorted or inhaled.[2][10][11] Onset of effects is usually rapid and lasts for a few hours.[2] Common side effects include respiratory depression (decreased breathing), dry mouth, euphoria, and addiction.[10] Other side effects can include abscesses, infected heart valves, blood borne infections, constipation, and pneumonia.[10] After a history of long-term use, withdrawal symptoms can begin within hours of last use.[10] When given by injection into a vein, heroin has two to three times the effect as a similar dose of morphine.[2] It typically comes as a white or brown powder.[10] Treatment of heroin addiction often includes behavioral therapy and medications.[10] Medications can include buprenorphine, methadone, or naltrexone.[10] A heroin overdose may be treated with naloxone.[10] An estimated 17 million people as of 2015 use opiates such as heroin,[12] which together with opioids resulted in 122,000 deaths.[13] The total number of opiate users has increased from 1998 to 2007 after which it has remained more or less stable.[12] In the United States about 1.6 percent of people have used heroin at some point in time.[10] When people die from overdosing on a drug, the drug is usually an opioid.[12] Heroin was first made by C. R. Alder Wright in 1874 from morphine, a natural product of the opium poppy.[14] Internationally, heroin is controlled under Schedules I and IV of the Single Convention on Narcotic Drugs.[15] It is generally illegal to make, possess, or sell heroin without a license.[16] In 2015 Afghanistan produced about 66% of the world's opium.[12] Heroin, which is illegally sold, is sometimes mixed with other substances such as sugar, starch, quinine, or strychnine.[2]
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