BACKGROUND Because heroin supply changes cannot be measured directly, their impact on populations is poorly understood. British Columbia has experienced an injection drug use epidemic since the 1980s that resulted in 2,590 illicit drug deaths from 1990-1999. Since previous work indicates heroin seizures can correlate with supply and B.C. receives heroin only from Southeast Asia, this study exam...

OBJECTIVE To determine the cost utility of medical co-prescription of heroin compared with methadone maintenance treatment for chronic, treatment resistant heroin addicts. DESIGN Cost utility analysis of two pooled open label randomised controlled trials. SETTING Methadone maintenance programmes in six cities in the Netherlands. PARTICIPANTS 430 heroin addicts. INTERVENTIONS Inhalable o...

As an ever-increasing heroin epidemic pervades the cities and suburbs of America, attempts to tackle the issue have taken prominence in the White House. To fight the ‘war on drugs’ an in depth understanding of the process of production, heroin trafficking routes and previous political policy failures is required. This review focuses on how the production of Mexican heroin dominates the U.S. ill...

Heroin overdose deaths are preventable. Overdose prevention in Australia has largely rested on opioid substitution treatment supplemented with outreach services and education for injecting drug users (IDUs) about overdose risks and responses. We believe now is the time to make naloxone hydrochloride (Narcan ®) available to Australian IDUs to help prevent overdose deaths. At the end of 2000 hero...

BACKGROUND Switzerland has been criticised for its liberal drug policy, which could attract new users and lengthen periods of heroin addiction. We sought to estimate incidence trends and prevalence of problem heroin use in Switzerland. METHODS We obtained information about first year of regular heroin use from the case register of substitution treatments in the canton of Zurich for 7256 patie...

HIV risk through needle sharing is now an emerging phenomenon in Africa. This article describes the practices that heroin users are producing as they establish the rules and organization surrounding their drug use. Their practices and interactions reveal the ways that they become initiated into its use, how they progress to injecting, and the important role of local neighbourhood hangouts in fa...

Heroin use is postulated to act as a cofactor in the neuropathogenesis of human immunodeficiency virus (HIV-1) infection. Astrocytes, integral components of the CNS, are reported to be susceptible to HIV-1 infection. Upon activation, astrocytes release a number of immunoregulatory products or modulate the expression of a number of proteins that foster the immunopathogenesis of HIV-1 infection. ...

BACKGROUND Acetylcodeine (AC), an impurity of illicit heroin synthesis, has been suggested as an interesting biomarker of illicit heroin use. METHODS Procedures were developed for quantification of (a) morphine, 6-monoacetylmorphine (6-AM), and codeine in urine and (b) diacetylmorphine and AC in urine. Solid-phase extraction of the analytes was performed, and the extracted analytes were analy...

AIMS To compare heroin and other opiate use of heroin overdose fatalities, current street heroin users and drug-free therapeutic community clients. DESIGN Hair morphine concentrations that assess heroin use and other opiate use in the 2 months preceding interview or death were compared between heroin overdose fatalities diagnosed by forensic pathologists (FOD) (n = 42), current street heroin ...

Immunotherapy against drugs of abuse is being studied as an alternative treatment option in addiction medicine and is based on antibodies sequestering the drug in the bloodstream and blocking its entry into the brain. Producing an efficient vaccine against heroin has been considered particularly challenging because of the rapid metabolism of heroin to multiple psychoactive molecules. We have pr...