{"ATC Code":["N - Nervous system","N07 - Other nervous system drugs","N07B - Drugs used in addictive disorders","N07BC - Drugs used in opioid dependence","N07BC06 - Diamorphine","QN - Nervous system","QN07 - Other nervous system drugs","QN07B - Drugs used in addictive disorders","QN07BC - Drugs used in opioid dependence","QN07BC06 - Diamorphine"],"Abbreviation":["Heroin"],"Absorption, Distribution and Excretion":"Bioavailability is less than 35% when orally administered. In particular, some studies have determined that the bioavailability of orally administered diamorphine could be as low as 22.9% (16.4-29.4%) on average in opioid-naive subjects.  Nevertheless, diamorphine administered by any many medically indicated routes of administration leads to a rapid absorption. Peak serum levels are achieved five to ten minutes subcutaneously, three to five minutes intranasally and intramuscularly, and less than one minute intravenously.","Actives":["Morphine","6-Monoacetylmorphine"],"Adverse Effects":"The intended effects of heroin misuse are those classically associated with any opioid effects. These are analgesia, euphoria, and often alleviation of opioid withdrawal symptoms. All other effects of heroin could be considered adverse. Respiratory depression is likely the most concerning adverse effect, leading to death in an increasing number of misusers. Extreme physiologic dependence also represents a major concern in those who misuse heroin.","Aliases":["Heroin","Diacetylmorphine","Diamorphine","Acetomorphine","3,6-Diacetylmorphine","Morphacetin","Diaphorm","Eclorion","O,O'-Diacetylmorphine","Morphine diacetate","Acetomorfine","Diacetylmorfin","Diamorfina","Diasetilmorfin","Diacephin","Diasetielmorfien","Diasetylmorfiimi","Diazetylmorphine","Diacetyl morphine","3,6-O-Diacetylmorphine","7,8-Dihydro-4,5-α-epoxy-17-methylmorphinan-3,6-α-diol diacetate","J6.494G","IDS-NH-001","Dtxsid6046761","Chebi:27808","Ids-nh-001(sect.3)","7,8-Didehydro-4,5-epoxy-17-methylmorphinan-3,6-diol diacetate","(5α,6α)-7,8-Didehydro-4,5-epoxy-17-methylmorphinan-3,6-diol diacetate","Dtxcid4026761","Morphinan-3,6-α-diol, 7,8-didehydro-4,5-α-epoxy-17-methyl-, diacetate","Morphinan-3,6-diol, 7,8-didehydro-4,5-epoxy-17-methyl-, (5α,6α)-, diacetate","17-methyl-7,8-didehydro-4,5α-epoxymorphinan-3,6α-diyl diacetate","209-217-7","Diamorf","((4R,4aR,7S,7aR,12bS)-9-acetyloxy-3-methyl-2,4,4a,7,7a,13-hexahydro-1H-4,12-methanobenzofuro(3,2-e)isoquinolin-7-yl) acetate","((4R,4aR,7S,7aR,12bS)-9-acetyloxy-3-methyl-2,4,4a,7,7a,13-hexahydro-1H-4,12-methanobenzofuro(3,2-e)isoquinoline-7-yl) acetate","[(4R,4aR,7S,7aR,12bS)-9-acetyloxy-3-methyl-2,4,4a,7,7a,13-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinoline-7-yl] acetate","Hydrochloride, Heroin","Min I Jet Morphine Sulphate","Hydrochloride, Diacetylmorphine","(1S,5R,13R,14S,17R)-14-(acetyloxy)-4-methyl-12-oxa-4-azapentacyclo(9.6.1.01,13.05,17.07,18)octadeca-7(18),8,10,15-tetraen-10-yl acetate","Morphinan-3,6-diol, 7,8-didehydro-4,5-epoxy-17-methyl-(5α,6α)-, diacetate","Preza","Aspron","Eroina","Heroien","Heroiin","Herolan","Iroini","Persian","Dooje","Dujie","Stuff","Junk","Scot","Amsterdam Marble","TNT","HSDB 6473","Acetomorphin","Hairy","Harry","White stuff","JOY POWDER","Smack","Rufus","Crap","Persian brown","Malaysian Pink","Mexican Brown","White junk","Black tar","Indian Pink","Penang Pink","Scag","BOY","Einecs 209-217-7","Heroin base","DEA No. 9200","Unii-70d95007sx","Diamorphine-","Ncgc00168253-01","Epitope ID:2269951","Schembl35150","Chembl459324","GTPL9082","Schembl29631710","Tox21_112612","DB01452","Cas-561-27-3","DB-220304","NS00000040","Heroin, analytical standard, \u003e=98%","C06534","D07286","Heroin (Diacetylmorphine) 1.0 mg/ml in Acetonitrile","Heroin (3,6-Diacetylmorphine), 1mg/ml in Acetonitrile","17-Methyl-5α,6α-7,8-didehydro-4,5-epoxymorphinan-3,6-diyl diacetate","morphinan-3,6-diol, 7,8-didehydro-4,5-epoxy-17-methyl-, diacetate (ester), (5α,6α)-"],"Biological Half-Life":"In humans, administered diamorphine has a half-life of approximately two to three minutes.","Boiling Point":"272-274 °C at 1.20E+01 mm Hg","CAS":"561-27-3","ChemicalClasses":["morphinan"],"Chirality":"absolute","Classes":["Prodrug","Opioid"],"Color/Form":"Orthorhombic plates, tablets from ethyl acetate","DBI-IGS":["Heroin"],"Decomposition":"... Decomposes by boiling with water.","Density":"1.56 g/cu cm at 25 °C g/cm\u003csup\u003e3\u003c/sup\u003e","Dosing Info":[{"Method":"Insufflated","Tiers":{"Common":{"Entries":42,"Lower":14,"Percentage":23.5,"Unit":"mg","Upper":18},"Extreme":{"Entries":18,"Lower":32.6,"Percentage":10.1,"Unit":"mg","Upper":32.6},"Heavy":{"Entries":21,"Lower":25,"Percentage":11.7,"Unit":"mg","Upper":32.6},"Light":{"Entries":49,"Lower":14,"Percentage":27.4,"Unit":"mg","Upper":14},"Strong":{"Entries":49,"Lower":18,"Percentage":27.4,"Unit":"mg","Upper":25}}},{"Method":"Intramuscular","Tiers":{"Common":{"Entries":0,"Lower":100,"Percentage":0,"Unit":"mg","Upper":100},"Extreme":{"Entries":1,"Lower":160,"Percentage":20,"Unit":"mg","Upper":160},"Heavy":{"Entries":0,"Lower":100,"Percentage":0,"Unit":"mg","Upper":160},"Light":{"Entries":4,"Lower":100,"Percentage":80,"Unit":"mg","Upper":100},"Strong":{"Entries":0,"Lower":100,"Percentage":0,"Unit":"mg","Upper":100}}},{"Method":"Intrarectal","Tiers":{"Common":{"Entries":47,"Lower":18.3,"Percentage":15.4,"Unit":"mg","Upper":22.5},"Extreme":{"Entries":31,"Lower":47.2,"Percentage":10.2,"Unit":"mg","Upper":47.2},"Heavy":{"Entries":42,"Lower":32,"Percentage":13.8,"Unit":"mg","Upper":47.2},"Light":{"Entries":107,"Lower":18.3,"Percentage":35.1,"Unit":"mg","Upper":18.3},"Strong":{"Entries":78,"Lower":22.5,"Percentage":25.6,"Unit":"mg","Upper":32}}},{"Method":"Vaporized","Tiers":{"Common":{"Entries":1,"Lower":33.9,"Percentage":33.3,"Unit":"mg","Upper":50},"Extreme":{"Entries":1,"Lower":130,"Percentage":33.3,"Unit":"mg","Upper":130},"Heavy":{"Entries":0,"Lower":100,"Percentage":0,"Unit":"mg","Upper":130},"Light":{"Entries":1,"Lower":33.9,"Percentage":33.3,"Unit":"mg","Upper":33.9},"Strong":{"Entries":0,"Lower":50,"Percentage":0,"Unit":"mg","Upper":100}}}],"Drug Classes":["Breast Feeding","Lactation","Milk, Human","Analgesics, Opioid","Narcotics","Street Drugs"],"Drug Indication":"Diamorphine, as a prescription medication in the United Kingdom, is indicated for use in the treatment of severe pain associated with surgical procedures, myocardial infarction or pain in the terminally ill and for the relief of dyspnoea in acute pulmonary edema.","Drug Warnings":"Care should be exercised in treating the elderly, children or debilitated patients and those with hepatic or renal impairment. /Diamorphine hydrochloride/","DurationOfAction":"4 – 5 hours\u003ca href='#cite_note-4'\u003e\u003csup\u003e[4]\u003c/sup\u003e\u003c/a\u003e","EliminationHalfLife":"2 – 3 minutes\u003ca href='#cite_note-3'\u003e\u003csup\u003e[3]\u003c/sup\u003e\u003c/a\u003e","Esters":[],"European Community (EC) Number":"209-217-7","Formating":[],"HeavyAtomCount":27,"Human Drugs":"Breast Feeding; Lactation; Milk, Human; Analgesics, Opioid; Narcotics; Street Drugs","Human Toxicity Values":"Toxic heroin blood concentration: 10-100 ug/dL; Lethal heroin blood concentration: \u003e400 ug/dL /From table/","IUPACName":"[(4R,4aR,7S,7aR,12bS)-9-acetyloxy-3-methyl-2,4,4a,7,7a,13-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinolin-7-yl] acetate","Impurities":"Two decades ago /during the 1980s/, the average purity of heroin in the United States was 7%. In 2000, the nationwide average was 36.8%. The availability of South American heroin in the northeastern United States, where purity exceeds 80%, has driven this increase.","InChI":"InChI=1S/C21H23NO5/c1-11(23)25-16-6-4-13-10-15-14-5-7-17(26-12(2)24)20-21(14,8-9-22(15)3)18(13)19(16)27-20/h4-7,14-15,17,20H,8-10H2,1-3H3/t14-,15+,17-,20-,21-/m0/s1","InChIKey":"GVGLGOZIDCSQPN-PVHGPHFFSA-N","Interactions":"In a randomized double-blind study ... the effect of adding diamorphine 0.25 mg and 0.5 mg to intrathecal bupivacaine anesthesia for major orthopedic surgery was examined. Duration of postoperative analgesia was considerably greater in patients given either doses of intrathecal diamorphine than in a control group of patients given bupivacaine alone (p less than 0.001) However, there was no significant difference between the two diamorphine doses (0.25 mg and 0.5 mg) each providing prolonged analgesia (10.8 and 9.9 hr, respectively). Although there was no evidence of late respiratory depression, the frequency of adverse effects, in particular urinary retention, nausea and vomiting, was high in both groups receiving intrathecal diamorphine.","KEGG Entries":[{"Id":"D07286","Interactions":[],"Synonyms":["Diamorphine","Heroin","Diacetylmorphine"]},{"Id":"D07286","Interactions":[],"Synonyms":["Diamorphine","Heroin","Diacetylmorphine"]},{"Id":"D07286","Interactions":[],"Synonyms":["Diamorphine","Heroin","Diacetylmorphine"]},{"Id":"D07286","Interactions":[],"Synonyms":["Diamorphine","Heroin","Diacetylmorphine"]}],"MeSH Headers":[{"Id":"M0006166","Link":"https://id.nlm.nih.gov/mesh/M0006166.html","Name":"Heroin","Ref":64},{"Id":"DescTree","Link":"https://www.nlm.nih.gov/mesh/meshhome.html","Name":"MeSH Tree","Ref":66},{"Id":"PubMed from MeSH","Link":"https://www.nlm.nih.gov/mesh/meshhome.html","Name":null,"Ref":88},{"Id":"M0001068","Link":"https://id.nlm.nih.gov/mesh/M0001068.html","Name":"Analgesics, Opioid","Ref":89},{"Id":"M0014481","Link":"https://id.nlm.nih.gov/mesh/M0014481.html","Name":"Narcotics","Ref":90}],"MeSH Pharmacological Classification":[{"Id":"M0001068","Link":"https://id.nlm.nih.gov/mesh/M0001068.html","Name":"Analgesics, Opioid","Ref":89},{"Id":"M0014481","Link":"https://id.nlm.nih.gov/mesh/M0014481.html","Name":"Narcotic","Ref":90}],"Mechanism of Action":"When administered orally, diamorphine experiences extensive first-pass metabolism by way of deacetylation to generate the active metabolites 6-monoacetylmorphine (6-MAM) and morphine. Alternatively, when given as an injection the acetyl groups present in the diamorphine/diacetylmorphine compound confer the substance lipophilicity that facilitates diamorphine's rapid crossing of the blood-brain-barrier. Once in the brain, diamorphine is metabolised via deacetylation to the active 6-MAM and morphine metabolites as well. Despite diamorphine possessing little to no opioid agonist activity itself, its rapid transit across the blood-brain-barrier elicits a far faster onset of activity in comparison to the extensive first-pass metabolism of oral administration. Regardless, the metabolism of diamorphine to morphine makes heroin a prodrug for the delivery of morphine.  Morphine is subsequently a mu-opioid agonist. It acts on endogenous mu-opioid receptors that are spread in discrete packets throughout the brain, spinal cord and gut in almost all mammals. Morphine, along with other opioids, are agonists to four endogenous neurotransmitters. They are beta-endorphin, dynorphin, leu-enkephalin, and met-enkephalin. The body responds to morphine in the brain by reducing (and sometimes stopping) production of the endogenous opioids when morphine is present. Endorphins are regularly released in the brain and nerves, attenuating pain. Their other functions are still obscure, but are probably related to the effects produced by morphine besides analgesia (antitussin, anti-diarrheal).  Nevertheless, morphine ultimately elicits the majority of its analgesic activity by binding to mu opioid receptors in both the central and peripheral nervous systems. The overall effect of morphine is activation of descending inhibitory pathways of the central nervous system as well as inhibition of nociceptive afferent neurons of the peripheral nervous system, which results in an overall reduction of the nociceptive pain transmission.","Melting Point":"173 °C","Metabolism/Metabolites":"Once administered into the body, diamorphine undergoes deacetylation via various esterase enzymes to generate active metabolites like 6-monoacetylmorphine and morphine. In particular, when administered orally, diamorphine undergoes extensive first pass metabolism.","MolecularFormula":"C\u003csub\u003e21\u003c/sub\u003eH\u003csub\u003e23\u003c/sub\u003eNO\u003csub\u003e5\u003c/sub\u003e","MolecularWeight":"369.4 g/mol","Non-Human Toxicity Values":"LD50 Mouse intracerebral 137 ug/kg","Odor":"Odorless","Opticalactivity":"( - )","Pharmacodynamics":"The onset of heroin's effects is dependent on the method of administration. Taken orally, heroin is totally metabolized in vivo via extensive first-pass metabolism into morphine before crossing the blood-brain barrier; so the effects are the same as orally administered morphine. Take by injection, diamorphine's acetyl groups facilitate rapid crossing into the brain. Once in the brain, heroin is rapidly metabolized into morphine by removal of the acetyl groups, therefore making it a prodrug for the delivery of morphine. Subsequently, whether eliciting actions peripherally (on smooth muscle, skeletal muscle, kidney, lung, liver, or spleen tissue, for example) or on the central nervous system, it is ultimately the morphine metabolite of heroin that then binds with opioid receptors and produces the narcotic opioid effects commonly associated with the substance.","PubChemId":5462328,"Records":{"UNII":{"Impurities":[]}},"RefChem":"783762","RefCount":5,"RefCur":"","References":[{"Name":"Wikipedia","Urls":[{"Link":"https://en.wikipedia.org/wiki/Heroin","Name":"Diacetylmorphine","Sub":false}]},{"Name":"Wikidata","Urls":[{"Link":"https://www.wikidata.org/wiki/Q60168","Name":"Diacetylmorphine","Sub":false}]},{"Name":"DrugBank","Urls":[{"Link":"https://go.drugbank.com/DB01452","Name":"Diacetylmorphine","Sub":false}]},{"Name":"PubChem","Urls":[{"Link":"https://pubchem.ncbi.nlm.nih.gov/compound/5462328","Name":"Diacetylmorphine","Sub":false}]},{"Name":"Common Chemistry","Urls":[{"Link":"https://commonchemistry.cas.org/detail?cas_rn=561-27-3","Name":"Diacetylmorphine","Sub":false}]},{"Name":"KEGG","Urls":[{"Link":"https://www.kegg.jp/entry/C06534","Name":"Diacetylmorphine","Sub":false}]},{"Name":"UNII","Urls":[{"Link":"https://gsrs.ncats.nih.gov/ginas/app/ui/substances/70D95007SX","Name":"Diacetylmorphine","Sub":false}]},{"Name":"EPA DSSTox","Urls":[{"Link":"https://comptox.epa.gov/dashboard/chemical/details/DTXSID6046761","Name":"Diacetylmorphine","Sub":false}]}],"Refs":["National Center for Biotechnology Information. PubChem Compound Summary for CID 5462328, Heroin. Accessed April 16, 2026. \u003ca href=https://pubchem.ncbi.nlm.nih.gov/compound/5462328\u003ehttps://pubchem.ncbi.nlm.nih.gov/compound/5462328\u003c/a\u003e","U.S. Food and Drug Administration; National Center for Advancing Translational Sciences. Diacetylmorphine. UNII: 70D95007SX. Global Substance Registration System. Accessed April 16, 2026. \u003ca href=https://gsrs.ncats.nih.gov/ginas/app/beta/substances/70D95007SX\u003ehttps://gsrs.ncats.nih.gov/ginas/app/beta/substances/70D95007SX\u003c/a\u003e","Diamorphine Hydrochloride 10mg for Injection. May 6, 2020. Accessed April 16, 2026. \u003ca href=https://www.medicines.org.uk/emc/product/1466/smpc\u003ehttps://www.medicines.org.uk/emc/product/1466/smpc\u003c/a\u003e","Field J. The Textbook of Emergency Cardiovascular Care and CPR. Lippincott Williams \u0026 Wilkins. 2012. Accessed April 16, 2026. \u003ca href=https://books.google.com/books?id=o3m4oNRB4D4C\u0026pg=PA447\u003ehttps://books.google.com/books?id=o3m4oNRB4D4C\u0026pg=PA447\u003c/a\u003e"],"Reported Fatal Dose":"The fatal dose is between 1/6 and 2 grains.","SMILES":"CC(=O)O[C@H]1C=C[C@H]2[C@H]3CC4=C5[C@]2([C@H]1OC5=C(C=C4)OC(=O)C)CCN3C","SaltData":[],"Salts":[],"Scheduling":[{"gov":"Australia","ref":[],"schedule":"S9 substance"},{"gov":"Brazil","ref":[],"schedule":"F1 substance"},{"gov":"Canada","ref":[],"schedule":"Schedule I controlled substance|Schedule I substance"},{"gov":"Germany","ref":[],"schedule":"Anlage I, Anlage II|II and Anlage III|III substance"},{"gov":"New Zealand","ref":[],"schedule":"Class A substance"},{"gov":"United Kingdom","ref":[],"schedule":"Class A substance"},{"act":"Controlled Substances Act (CSA)","gov":"United States","ref":[],"schedule":"Schedule I"},{"gov":"United Nations","ref":[],"schedule":"Narcotic Schedules I and IV substance"}],"Slang":["Boy ","Crap ","Scag ","Hairy ","Harry ","Horse ","Noise ","Rufus ","Smack ","Joy powder ","White stuff ","Black tar  ","Indian Pink ","Penang Pink ","White junk  ","Persian brown ","Mexican Brown ","Malaysian Pink "],"Solubility":"In water, 60 mg/L at 25 °C","Stability/Shelf Life":"Stable under recommended storage conditions.","StereoisomerData":[],"Stereoisomers":[],"Structure":"\u003csvg xmlns=\"http://www.w3.org/2000/svg\" preserveAspectRatio=\"none\" style=\"display:block\" viewBox=\"0 0 88.445 127.968\"\u003e\u003crect width=\"100%\" height=\"100%\" fill=\"#fff\"/\u003e\u003cdesc\u003eGenerated by the Chemistry Development Kit (http://github.com/cdk)\u003c/desc\u003e\u003cg fill=\"#ff0d0d\" stroke=\"#000\" stroke-linecap=\"round\" stroke-linejoin=\"round\" stroke-width=\".7\"\u003e\u003cpath fill=\"#fff\" stroke=\"none\" d=\"M0 0h89v128H0z\"/\u003e\u003cg class=\"mol\"\u003e\u003cpath d=\"m1.77 124.891 13.195-7.621\" class=\"bond\"/\u003e\u003cg class=\"bond\"\u003e\u003cpath d=\"m14.965 115.862 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depression","Pain relief","Itchiness","Constipation","Cough suppression","Sedation","Nausea","Pupil constriction","Stomach cramp","Difficulty urinating"],"Visual Effects":["Double vision"]},"Taste":"Bitter","Therapeutic Uses":"Analgesics, Opioid; Narcotics","Title":"Diacetylmorphine","UNII":"70D95007SX","Wikidata":"Q60168","Wikipedia":"Heroin","XLogP":1.5}