HEROIN

Should heroin be legalized for pain control in the U.S.A.?

No. As far as the body is concerned, morphine and heroin (diamorphine) are the same drug. Heroin is diacetylmorphine. It is the same molecule as morphine, but with two acetyl (C2H5) groups added. It is rapidly metabolized to monoacetylmorphine, then to morphine, in the body. Heroin and morphine have identical effects. Heroin is slightly better absorbed from the gut, so a lower dose (in a ratio of 3:2) is needed to be equi-analgesic. (A patient who is pain-controlled on 30mg oral morphine every 4 hours would be pain-controlled on 20mg oral heroin every 4 hours.)

Clinically, the only advantage of heroin is that it is more soluble than morphine. (500mg of heroin dissolves in 0.8ml of water, as compared to 10ml of water to dissolve 500mg morphine sulfate.) Heroin injections can therefore be of a smaller volume.

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