Heroin

For a female hero, see Heroine

Diamorphine chemical structure Diacetylmorphine
IUPAC name: (5α,6α)-7,8-didehydro-4,5-epoxy- 17-methylmorphinan-3,6-diol diacetate (ester)
CAS number 561-27-3	ATC code N02AA09
Chemical formula	C21H23NO5
Molecular weight	369.42
Bioavailability	?
Metabolism	?
Elimination half life	3 minutes
Excretion	?
Pregnancy category	?
Legal status	Schedule I (USA); Class A (UK)
Delivery	Vaporized, Insufflated, Injected, Taken Orally

Heroin or diacetylmorphine (INN) is an alkaloid opioid. It is the 3,6-diacetyl derivative of morphine (hence diacetylmorphine) and is synthesised from it by acetylation. The white crystalline form is commonly the hydrochloride salt, diamorphine hydrochloride. It is highly addictive when compared to other substances, although occasional use without symptoms of withdrawal has been noted. Heroin is controlled under Schedules I and IV of the Single Convention on Narcotic Drugs[1]. It is not legal to manufacture, possess, or sell heroin in the United States, but diamorphine is a legal prescription drug in the United Kingdom.

Heroin may be colloquially referred to as junk, smack, horse, brown sugar, babania, golden brown, black tar, montega, H, big H, lady H, dope, skag, juice, jude, diesel, boy, blows, or by a multitude of other slang terms.

History

Asian heroin

Heroin was first synthesised in 1874 by C.R.A. Wright, a British chemist working at St. Mary's Hospital Medical School, London. He had been experimenting with combining morphine with various acids. He boiled anhydrous morphine alkaloid with acetic anhydride over a stove for several hours and produced a more potent, acetylated form of morphine. We now call it diacetylmorphine. The compound was sent to F.M. Pierce of Owens College, Manchester, for analysis. He reported the following to Wright:

Doses ... were subcutaneously injected into young dogs and rabbits ... with the following general results ... great prostration, fear, and sleepiness speedily following the administration, the eyes being sensitive, and pupils dilated, considerable salivation being produced in dogs, and slight tendency to vomiting in some cases, but no actual emesis. Respiration was at first quickened, but subsequently reduced, and the heart's action was diminished, and rendered irregular. Marked want of coordinating power over the muscular movements, and loss of power in the pelvis and hind limbs, together with a diminution of temperature in the rectum of about 4° [2]

Heinrich Dreser, of Bayer in Elberfeld, Germany, noticed that diacetylmorphine was more potent than morphine. Bayer registered Heroin (meaning 'heroic treatment' from the German word heroisch) as a trademark. From 1898 through to 1910 it was marketed as a non-addictive morphine substitute and cough medicine for children. As with Aspirin, Bayer lost some of its trademark rights to Heroin following World War I.

In 1914 the Harrison Narcotics Tax Act made it illegal to manufacture or possess heroin in the United States.

Usage and effects

Indicated for: Relief of extreme pain Recreational uses: Euphoria Relaxation Other uses: Pain relief Cough suppressant

Contraindications: Alcohol Barbiturates Stimulants Other opioids

Side effects: Severe: Atypical sensations: ? Cardiovascular: Lowered heart rate Ear, nose, and throat: ? Endocrinal: ? Eye: Pupil constriction Gastrointestinal: Nausea Constipation Hematological: ? Musculoskeletal: ? Neurological: Analgesia Psychological: Confusion Euphoria Sedation Respiratory: Slow respiration Shallow respiration Respiratory arrest Skin: Itchiness Urogenital and reproductive: ? Miscellaneous: ?

Heroin is a μ-opioid (mu-opioid) agonist. Like all drugs of its class, it binds to and activates μ-opioid receptors found in the brain, spinal cord and gut. As a medicine, it is administered usually in the form of its hydrochloride as an analgesic for severe pain. It is illegal for any purpose in the United States, but it is legally used by cancer patients in the United Kingdom and other countries.

Heroin is also widely and illegally used as a powerful and addictive drug producing intense euphoria, which often disappears with increasing tolerance. Although many other μ-opioid agonists (e.g., morphine) can produce essentially the same effects, it is thought that heroin's popularity with recreational users comes from its especially rapid onset. This in turn comes from its high lipid solubility provided by the two acetyl groups, resulting in a very rapid penetration of the blood-brain barrier after use. Heroin can be taken or administered in a number of ways, including snorting it, and injecting it. It may also be smoked by inhaling the vapors produced when heated from below (known as "chasing the dragon"). Once in the brain, heroin is rapidly metabolized into morphine by removal of the acetyl groups. It is the morphine molecule which then binds with opioid receptors and produces the subjective effects of the heroin high. Heroin is therefore a prodrug.

Methadone is another μ-opioid agonist often used to substitute for heroin in treatment for heroin addiction. Compared to heroin, methadone is well (but slowly) absorbed orally and has a much longer duration of action. Thus methadone maintenance avoids the rapid cycling between intoxication and withdrawal associated with heroin addiction. Also, by keeping the addict physically tolerant to opioids, methadone effectively blocks the euphoric effects of heroin. In this way, methadone has shown some success as a "less harmful substitute"; it is perhaps the most effective treatment known for opioid addiction, despite being much more addictive than heroin, and is recommended for those who have repeatedly failed complete detoxification. As of 2005, the μ-opioid agonist buprenorphine is also being used to manage heroin addiction, being a less easily abused though still imperfect alternative to methadone.

Heroin is similar in effects on brain chemistry to endorphins, the natural (endogenous) opioids of the body and less potent. It competes with the endorphins for the specialized endorphine (opioid) receptors found on the surfaces of some body cells. The body responds by reducing (or even stopping) production of endorphins when heroin is consumed. Endorphins are regularly released in the brain and nerves and attenuate pain. Their other functions, if any, are still obscure. The reduced endorphin production in heroin users makes them dependent on the heroin since a lack of either endorphins or heroin results in the extreme symptoms including pain (even in the absence of physical trauma). This is what causes the withdrawal symptoms in heroin addicts as the body takes some time to restore endorphin production.

The University of Chicago undertook preliminary development of a heroin vaccine in monkeys during the 1970s, but it was abandoned. There were two main reasons for this. Firstly, when immunised monkeys had an increase in dose of x16, their antibodies became saturated and the monkey had the same effect from heroin as non-immunised monkeys. Secondly, until they reached the x16 point immunised monkeys would substitute other drugs to get a heroin-like effect. These factors suggested that immunised human addicts would simply either take massive quantities of heroin, or switch to other hard drugs, which is known as cross-addiction.

Production and trafficking

Primary worldwide producers of heroin.

The origins of the present international illegal heroin trade can be traced back to the forcible imposition of the opium trade on China by Britain in the late 1700s, a move which helped to fuel the rise of the Chinese triad gangs that would eventually come to play a major role in the heroin trade.

Although it remained legal in some countries until after World War II, the anti-drug activism of the United States led most western countries to declare heroin a controlled substance in the latter half of the 20th century. It is produced for the black market through opium refinement processes.

Prior to the 1970s, much of the world's opium came from Turkey, but in the late Sixties, under pressure from the U.S. and the United Nations, Turkey agreed to eliminate its opium growing, leading to the development of a major new production base in the so-called "Golden Triangle region in South East Asia in the late 1960s.

Heroin use first appeared as a sub-cultural addiction problem in several countries in the early 20th century, but like the opium trade from which it developed, it was mainly restricted to small and fairly well-defined groups, such as Chinese migrants in western cities.

Although it was beginning to become more prevalent by the 1930s, Asian historian and drug traffic expert Dr Alfred W. McCoy reports that heroin trafficking was virtually eliminated in the U.S. during World War II. But, McCoy contends, the Mafia was able to gain control of the heroin trade thanks in large measure to a covert deal between top Mafia leader Lucky Luciano and American military intelligence.

McCoy claims that Luciano was asked to provide Mafia assistance in rooting out communist and/or Nazi influence on the waterfronts, and that the Army wanted Luciano to provide their forces with local Mafia assistance during America's planned invasions of Sicily and Italy; in return the jailed mobster was allowed to run his operations unhindered from his cell, and he was deported back to Sicily after the war, where he oversaw a massive expansion in his organisation's drug operations before his death.

Luciano, who visited Vietnam, forged an alliance between his American Mafia family and the tough Corsican Mafia, establishing a wide-ranging heroin shipping, refining and distribution network based in the port town of Marseilles in France. He allegedly masterminded the network that was portrayed (semi-fictionally) in the film The French Connection.

Thanks to Coriscan Mafia connections in the former French colony of Vietnam, the operation was able to forge new alliances with underworld forces there, and with triad gangs and organised crime figures in Hong Kong, Shanghai, New York City and Sydney. As opium production in Turkey waned, the Mafia established a lucrative new source of supply in the Golden Triangle region and funnelled the production out via South Vietnam. McCoy's most controversial assertion is that the C.I.A. pursued a policy, which he describes as "radical pragmatism", and that in the name of the fight against Communism, the Agency was covertly making expedient alliances with local warlords, Mafiosi and corrupt South Vietnamese officials.

The battalions of American servicemen in Vietnam provided a perfect test market for the Asian syndicates, and heroin use among soldiers rapidly reached near-epidemic proportions in 1970-71, with some unit medical officers reporting that as many as 15% percent of G.I.s in some units were regular users.

In 1971 the first large consignments of South East Asian heroin were intercepted in Europe and America, and by the mid-1970s heroin addiction was emerging as a serious social problem in the United States, Australia, Great Britain and many other nations, notably among youth and particularly in the African-American population in the U.S. Based on the success of this network, organised crime groups began to establish illegal trades in other highly addictive drugs, notably cocaine.

Traffic is heavy worldwide, with the biggest producer being Afghanistan, which after a ban on poppy growing by the Taliban in 2001 dropped its production by 95% but revived it to record numbers following the U.S. military occupation and fall of the Taliban government. Currently, an estimated 86% of the global heroin supply is cultivated in Afghanistan, up from 75% in 2003 according to the UN Office of Drugs and Crime. The estimated value of the 2003 harvest is 2.8 billion U.S. dollars.

Some observers, particularly political conservatives in the United States, have accused China of being a leading producer of heroin, but evidence in support of this is questionable. Conversely, some radical critics have pointed the finger at the United States, citing the work of Dr Alfred W. McCoy, who alleges that the C.I.A. secretly collaborated with drug syndicates and was complicit in the expansion of the global heroin trade in the late 20th century.

Heroin is one of the most profitable illicit drugs since it is compact and easily concealed. At present, opium poppies are mostly grown in the Middle East, Pakistan, and Afghanistan, and in Asia, especially in the region known as the Golden Triangle straddling Myanmar, Thailand, Vietnam, Laos and Yunnan province in China. There is also cultivation of opium poppies in the Sinaloa region of Mexico and in Colombia. The majority of the heroin consumed in the United States comes from Mexico and Colombia.

Direct short and long term effects of heroin use

• mental confusion
• euphoria
• slow and shallow respiration leading to respiratory arrest
• nausea and vomiting
• constipation
• death as result of overdose

Risks of non-medical abuse of heroin

• overdose, sometimes fatal
• for intravenous abusers (people who inject) of heroin, the use of non-sterile needles and syringes and other materials leads to the risk of contracting blood-borne pathogens such as HIV and/or hepatitis infections as well as the risk of contracting bacterial or fungal endocarditis
• poisoning from contaminants added to "cut" or dilute heroin

Many countries and local governments have instituted programs to supply sterile needles to people who inject illegal drugs in order to reduce some of these contingent risks. While needle exchanges have demonstrated an immediate public health benefit, some see such programs as tacit acceptance of illicit drug use. The United States does not support needle exchanges federally by law, though some of its state and local governments do.

A heroin overdose is usually treated with an opioid antagonist, such as naloxone (Narcan) or naltrexone, which have a high affinity for opioid receptors but do not activate them. This blocks heroin and other opioid agonists and causes an immediate return of consciousness and start of withdrawal symptoms when administered intraveneously. The half-life of these antagonists is usually much shorter than that of the opiate drugs they are used to block, so the antagonist usually has to be re-administered multiple times until the opiate has been metabolized by the body.

Contrary to popular belief, a heroin overdose is not fast-acting. Stories about people who "OD with the needle still in their arm" and the like are not attributable to heroin overdoses, but rather they are very often the result of a fatal reaction with the adulterant. Quinine is notorious for causing such deaths. In the case of an actual heroin overdose, it very often takes many hours to die.

Heroin overdoses are more rare than one might first expect. As noted above, an overdose is immediately reversible with an opioid antagonist injection. The overwhelmingly vast majority of reported heroin overdoses are actually adulterant poisonings or fatal interactions with alcohol or methadone. True overdoses are rare because the LD50 for a person already addicted is prohibitively high, to the point that there is no general medical concensus on where to place it. Several studies done in the 1920s gave addicts doses of 1600mg-1800mg of heroin in one sitting, and no adverse effects were reported. This is approximately 160-180 times a normal recreational dose. Even for a non-addict, the LD50 can be credibly placed above 350mg.

Withdrawal symptoms

Black tar heroin

The withdrawal syndrome from heroin (or any other short-acting opioid) can begin within 12 hours of discontinuation of sustained use of the drug: sweating, malaise, anxiety, depression, emesis, persistent and intense penile erection in males (priapism), general feeling of heaviness, cramp-like pains in the limbs, yawning and lachrymation, sleep difficulties, cold sweats, chills, severe muscle and bone aches not precipitated by any physical trauma, nausea and vomiting, diarrhea, gooseflesh (hence, the term "cold turkey"), cramps, and fever occur. Many addicts also complain of a painful condition, the so-called "itchy blood", which often results in compulsive scratching that causes bruises and sometimes ruptures the skin leaving scabs. Abrupt termination of heroin use causes muscle spasms in the legs of the user (restless leg syndrome), hence the term "kicking the habit". However, it must be noted that each person's symptoms can be unique. Users seeking to take the "cold turkey" (without any preparation or accompaniments) approach are generally more likely to experience the negative effects of withdrawal in a more pronounced manner.

Two general approaches are available to ease opioid withdrawal. The first is to substitute a longer-acting opioid such as methadone or buprenorphine for heroin or another short-acting opioid and then slowly taper the dose. The other approach, which can be used alone or in combination, is to relieve withdrawal symptoms with non-opioid medications.

In the second approach, benzodiazepines such as diazepam (Valium) ease the often extreme anxiety of opioid withdrawal. The most common benzodiazepine employed as part of the detox protocol in these situations is oxazepam (Serax). However, it is important to note that benzodiazepines are highly addictive, and many opiate addicts also abuse other Central Nervous System Depressants including benzodiazepines and barbituates. Also, though unpleasant, opiate withdrawal seldom has potential to become fatal, whereas complications related to withdrawal from benzodiazepines, barbituates and alcohol (such as seizures, cardiac arrest, and delirium tremens) can prove hazardous and potentially fatal. Many symptoms of opioid withdrawal are due to rebound hyperactivity of the sympathetic nervous system, and this can be effectively suppressed with clonidine (Catapres), a centrally-acting alpha-2 agonist primarily used to treat hypertension. Many addicts who have been through these programs say that the agony of withdrawal is very much attenuated.

For those who repeatedly fail attempts at complete detoxification and relapse to heroin use, maintenance with regular doses of methadone is recommended. The newer alternative to methadone maintenance employs use of the drug buprenorphine.

Drug interactions

Opiates are strong central nervous system depressants, but regular users develop physiological tolerance allowing gradually increased dosages. In combination with other central nervous system depressants, heroin may still kill experienced users.

Toxicology studies of heroin-related deaths reveal frequent involvement of other central nervous system depressants, including alcohol, benzodiazepines such as diazepam (valium), and occasionally methadone. Ironically, benzodiazepines and methadone are often used in the treatment of heroin addiction.

Cocaine also proves to be often fatal when used in combination with heroin. Though "speedballs" (when injected) or "moonrocks" (when smoked) are a popular mix of the two drugs used among addicts, combinations of stimulants and depressants can have unpredictable and sometimes fatal results.

Cultural influences

Heroin began to appear as a cultural artefact within a few years of its discovery, although in that relatively short period it has come to occupy a paradoxical cultural position, being both demonised and glamorised, often in the same text. There are clear precursors to heroin's present cultural role in the late 18th and 19th centuries, notably in works like Thomas de Quincy's Confessions of an English Opium Eater. But, due to its high cost, its powerful narcotic and addictive characteristics and the dramatic effects of the drug on users' lives, over the last century there have been frequent and often highly sensational depictions of heroin use amongst artists, musicians and the like.

The rigorously negative portrayal of heroin use became a precept for American law and drug enforcement agencies, and the U.S. exerted considerable pressure on other nations to follow suit, as part of its anti-drug policy. But although governments have also striven both to portray heroin as totally destructive, and to apprise the public of the very real dangers, heroin has acquired a powerful illicit mystique.

One of the first popular portrayals of heroin use was (probably) in the Sherlock Holmes stories written by Sir Arthur Conan Doyle. Although the references are not precise, and it is widely considered that the references in the Holmes stories suggest that Holmes had become addicted to another recently discovered "wonder drug", cocaine, many believe that Doyle may have been in fact referring to heroin. Although the drug references were deleted in earlier filmed versions, they re-appeared in later dramatisations, such as the Nicholas Meyer feature film The Seven Percent Solution and in the popular 1980s British TV adaptations of the Homes stories, starring Jeremy Brett.

Heroin has long been closely linked with music and the music industry. It first emerged as a major social problem after World War II whe it began to cut a swathe through the jazz world. Many leading musicians -- particularly those identified as belonging to the bebop school -- became addicts, and the image of the junkie jazz musician was soon elevated to the level of archetype by newspaper reports and movies like The Man With The Golden Arm -- which was, ironically, one of the first Hollywood films to deal with the subject of drug addiction in a relatively non-sensational and non-propagandist style.

Marijuana had been a popular recreational drug with jazz musicians for some decades, and it is possible that this cannabis subculture predisposed users to trying heroin, but the most likely explanation is one relating to milieu -- it was arguably the emergence of Mafia-run drug rings, which appeared cocurrently with the infiltration of organised crime into the music industry, that placed heroin within reach of vulnerable performers, and there is little doubt that dealers and mobsters actively exploited the plight of these musicians in order to glamorise the drug.

Saxophonist Charlie Parker, pianist Thelonious Monk and singer Billie Holiday were all the subjects of highly publicised drug busts, with Holiday spending eight months in goal at the height of her career. Holiday and Parker (or at least the cult that grew up around them) have been blamed for glamorising the drug, and Bird disciples Miles Davis and John Coltrane both became celebrity addicts, as did many of their contemporaries, including singer Anita O'Day. Jast around the start of the rock era in the mid-Sixties, the overdose death of iconoclastic satirist Lenny Bruce generated lurid headlines around the world.

Due to their close connections with the jazz scene, many writers of the so-called Beat Movement also experimented with or used heroin. The most notable was undoubtedly William S. Burroughs, who wrote extensively about the drug in his books as well as being a regular user himself for many years.

Thanks to its strong foothold in jazz, heroin quickly penetrated the emerging rock music scene in the late 1960s. Keith Richards of The Rolling Stones is probably the best-known rock junkie, and he was an addict for most of the 1970s. He was probably introduced to the drug by the band's friend and associate, art dealer Robert Fraser, who was using heroin regularly by the mid-Sixties. Richards, who somehow managed to avoid death and eventually kick the drug, arguably inherited the heroin glamour that had surrounded Charlie Parker, and his addiction was heavily romanticised by the rock press.

The Lou Reed song "Heroin", first recorded and performed by The Velvet Underground in 1967, marked one of the first attempts to explore heroin use in the rock idiom, and heroin and the culture surrounding its use featured in many of Reed's songs. However, performers in the folk genre had already hen been writing and singing about it for several years by the time it emerged as subject matter in the rock genre.

Although it was less publicly influential than their use of cannabis and LSD, heroin also featured in the story of The Beatles. The name "Henry the horse" in the song "Being For The Benefit of Mr Kite" (1967) is reputed to refer to heroin, and the song "Happiness is a warm gun" is also thought to contain coded references to it. In 1970 John Lennon admitted that he and Yoko Ono had used heroin during the latter days of the group's career, around the time of their drug busts and Ono's subsequent miscarriage.

At the turn of the 70s, heroin brought aboubt the deaths of two of the major rock stars of the day -- singer Janis Joplin and (allegedly) Doors frontman Jim Morrison -- and guitar legend Jimi Hendrix was also charged with possession not long before his death. The history of rock culture in the 1970s and beyond has been littered with celebrity junkies and OD victims, including Free guitarist Paul Kossoff, Dr John (a longtime addict) and singer-songwriters Tim Hardin and Tim Buckley, both of whom also died of overdoses. The drug has continued to exert a hold over the entertainment world, with recent celebrity addicts including singer Boy George and actor Robert Downey Jr. Overdose fatalities sadly also continue, such as the the widely reported deaths of actor River Phoenix and musician Kurt Cobain.

Heroin consumption and addiction has been featured in numerous works of art, ranging from songs and films to novels. Amongst these are:

Novels

Bayer Heroin (TM)

• African Safari Papers, The by Robert Sedlack
• Basketball Diaries, The by Jim Carroll
• Candy by Luke Davies
• Cain's Book by Alexander Trocchi
• Diary of a drug fiend by Aleister Crowley
• Drawing Of The Three, The, book 2 of The Dark Tower series by Stephen King
• Jesus' Son by Denis Johnson
• Junk by Melvin Burgess
• Junky by William S. Burroughs
• Less Than Zero by Bret Easton Ellis
• Man With the Golden Arm, The by Nelson Algren
• Naked Lunch by William S. Burroughs
• Requiem for a Dream by Hubert Selby
• Sonny´s Blues by James Baldwin
• Smack by Melvin Burgess
• Trainspotting by Irvine Welsh

Factual accounts

• Getting off Right: A Safety Manual for Injection Drug Users by Harm Reduction Coalition
• Harrowing Heroin by Geoff Morton
• Heroin User's Handbook, The by Dr. Francis Moraes
• How to Stop Time, Heroin from A-Z by Anne Marlowe
• Paranoid by Mick Wall
• Permanent Midnight by Jerry Stahl
• Scar Tissue by Anthony Kiedis
• Survival of the Coolest, The by William Pryor
• Wir Kinder vom Bahnhof Zoo (life story of Christiane F., a teenage German addict)

Films

• Bad Lieutenant directed by Abel Ferrara
• Basketball Diaries directed by Scott Kalvert
• Basquiat directed by Julian Schnabel
• Chelsea Girls directed by Andy Warhol
• Christiane F.-Wir Kinder vom Bahnhof Zoo directed by Uli Edel
• Crow, The directed by Alex Proyas
• Dogs In Space, directed by Richard Lowenstein
• Drugstore Cowboy directed by Gus Van Sant
• French Connection II directed by John Frankenheimer
• Gift directed by Perry Farrell and Casey Niccoli of Jane's Addiction
• Gridlock'd directed by Vondie Curtis-Hall
• High Art directed by Lisa Cholodenko
• Live and Let Die directed by Guy Hamilton
• London Kills Me directed by Hanif Kureishi
• Man with the Golden Arm, The directed by Otto Preminger
• Maria Full Of Grace directed by Joshua Marston
• More directed by Barbet Schroeder
• Naked Lunch directed by David Cronenberg
• Panic in Needle Park, The directed by Jerry Schatzberg
• Payback directed by Brian Helgeland
• Permanent Midnight directed by David Veloz
• Pulp Fiction directed by Quentin Tarantino
• Requiem for a Dream directed by Darren Aronofsky
• Rush directed by Lili Zanuck
• Salton Sea, The directed by D.J. Caruso
• Traffic directed by Steven Soderberg
• Sid and Nancy directed by Alex Cox
• Story Of A Junkie directed by Lech Kowalski
• Trainspotting directed by Danny Boyle
• Wasted directed by Stephen T. Kay

Songs

• "13th Step, The" album by A Perfect Circle
• "2x4" by Blind Melon
• "A Baltimore Love Thing" by 50 Cent
• "A Horse With No Name" by America
• "Addition, The" by Frank DeBlasi
• "Adios" by Rammstein
• "Angel" by Sarah McLachlan
• "Ashes to Ashes", "Bewlay Brothers, The", and "China Girl" by David Bowie
• "Aux enfants de la chance" and "My Lady Heroine" by Serge Gainsbourg
• "Bad" and "Running to Stand Still" by U2
• "Beast, The" by The Only Ones
• "Beetlebum" by Blur
• "Billy" by Bad Religion
• "Black Balloon" by the Goo Goo Dolls
• "Blue Lady" by Hello Sailor
• "Bombed", "Fix", "Juarez", "She Done Too Much", and "Waiting on a Train" (most all solo recordings contain multiple heroin references) by Mark Lanegan
• "Braindead", "Sandbox" by Red Red Meat
• "Carmelita" by Warren Zevon
• "Chase The Dragon" by The Beasts of Bourbon
• "China Girl" and "Lust for Life" by Iggy Pop
• "Chinese Rock" by The Heartbreakers and The Ramones (written by Richard Hell and Dee Dee Ramone)
• "Cold Turkey" by John Lennon
• "Come Together", "I Think I'm In Love", "Medication", and "Cop Shoot Cop" by Spiritualized
• "Dead Flowers", "Brown Sugar", "Gimme Shelter", "Sister Morphine", "Monkey Man", "Coming Down Again" and "Before They Make Me Run" by The Rolling Stones (Dead Flowers covered by GG Allin, also by Steve Earle)
• "Dead Men Tell No Tales" by Motörhead
• "Diamonds and Guns" by The Transplants
• "Doctor Wu" and "Time Out of Mind" by Steely Dan
• "Dumb" by Nirvana
• "Esther" by Phish
• "Fall to Pieces" by Velvet Revolver
• "Getting High Down Below" by Marty Willson-Piper
• "Gimme Heroin" By Morning Glory
• "Givin' Up" by The Darkness
• "Golden Brown" and "Skin Deep" by The Stranglers
• "Groovy Dead" by Rusty
• "Habit" by Pearl Jam
• "Hand of Doom" by Black Sabbath
• "Happiness is a Warm Gun" by The Beatles
• "Hateful" by The Clash
• "Heroin" by Q-Strange
• "Heroin," "I'm Waiting for the Man," "I Heard Her Call My Name," "After Hours," "Oh! Sweet Nuthin'," and "Sister Ray" by The Velvet Underground
• "Heroin (It's All Over)" by the Lurkers
• "Heroin" by John Frusciante
• "Heroin Girl" by Everclear
• "Heroin or Suicide" by Leftover Crack
• "Horrorshow" and "Skag and Bone Man" by The Libertines
• "Hurt" by Nine Inch Nails (Covered by Johnny Cash}
• "Hypodermic" by The Offspring
• "I Believe in You" by Talk Talk
• "I Can't Hide" by Pantera
• "Jane Says" by Jane's Addiction
• "Jesus Shootin' Heroin" by The Flaming Lips
• "Junkie Man" by Tim Armstrong
• "Junkie's Promise" by Sonic Youth
• "Junkhead", "Real Thing", and "God Smack", by Alice in Chains
• "Just One Fix" by Ministry
• "Ljubav kao heroin" ("Love Like Heroin") by Laufer (Croatia)
• "Love In Vein" by Skinny Puppy
• "Macarthur Park" covered by Donna Summer
• "Mainliner" by Social Distortion
• "Master of Puppets" by Metallica
• "Mojo Pin" by Jeff Buckley
• "Mountain Song" by Jane's Addiction
• "Mr. Brownstone" by Guns N' Roses
• "Mutiny in heaven" by The Birthday Party
• "My Sweet Prince" by Placebo
• "Needle and the Damage Done, The" and "Tonight's the Night" by Neil Young
• "Needle and the Spoon, The" by Lynyrd Skynyrd
• "Needle in the Hay", "The White Lady Loves You More", "Ballad of Big Nothing", and "King's Crossing" by Elliott Smith
• "Needle of Death" by Bert Jansch
• "Nice Boys" by Rose Tattoo
• "Not an Addict" by K's Choice
• "Not If You Were the Last Junkie on Earth (Heroin Is So Passe)" by The Dandy Warhols
• "Opium" by Jump, Little Children
• "Opium Trail" by Thin Lizzy
• "Perfect Blue Buildings" by Counting Crows
• "Perfect Day," "Goodnight Ladies" by Lou Reed
• "Pool Shark" by Sublime
• "Poppies" by Marcy Playground
• "Red Balloon" by Tim Hardin
• "Ride the White Horse" by Laid Back
• "She Talks To Angels" by The Black Crowes
• "Signed D.C." by Love
• "Some Candy Talking" by The Jesus and Mary Chain
• "Sunday's Slave" by Nick Cave and the Bad Seeds
• "Surfin' on Heroin" by Forgotten Rebels
• "Sweetest Perfection" by Depeche Mode
• "Tension Head" by Queens of the Stone Age
• "Taking Drugs to Make Music To Take Drugs To" (album) and "Perfect Prescription" (album) by Spacemen 3
• "Theme From a Nod", "Year Of The Horse" by White Star Line
• "Times of Trouble" by Temple of the Dog
• "True Faith" by New Order
• "Under the Bridge" by Red Hot Chili Peppers
• "Use the Man" and "Poison Was the Cure" by Megadeth
• "Voodoo" by Godsmack
• "Wild Riding," "Convulsions", "Carmelita," "Outskirts of Life," "Borrowed Time," "No Rights," "Bad Habits," "Dope Money," "Sitting in this Room (with my needle & my spoon)," "Crash and Burn," "Family," "OD'd in Denver," "Dead or Alive," "Kissing The Flames," "Dead Flowers (Rolling Stones cover)," Snakeman's Dance," "Drug Whore," "Darkness and a Bottle to Hold" by GG Allin

See also

• Black Tar Heroin
• Hillbilly Heroin
• China White
• Methadone
• Recreational drug use
• List of famous opiate addicts

External links

• Forum about opiate addiction
• Geopium: Geopolitics of Illicit Drugs in Asia (French)
• Good Drugs Guide
• Heroin Helper
• From Flowers to Heroin, CIA publication.
• The mismanagement of methadone
• Erowid heroin vault
• Harrowing Heroin by Geoff Morton
• The Consumers Union Report - Licit and Illicit Drugs

Books

• Heroin (1998) ISBN 1568381530
• Heroin Century (2002) ISBN 0415278996
• This is Heroin (2002) ISBN 1860744249