Not available in the U.S.
Heroin
diamorphine
“Heroine”
What it isDiacetylmorphine, a rapidly penetrating prodrug of morphine; palliative care in the UK, illicit in the US.
Why this oneIts lipid solubility gives faster CNS entry than morphine, which is both the clinical and the addictive property.
What limits itNo US medical use. Overdose deaths are driven by fentanyl adulteration rather than heroin itself.
Pearls
- Supervised injectable heroin improves retention in refractory opioid use disorder.
Used for
- diamorphine: pain/palliative (UK); illicit in US
- severe pain and palliative care as diamorphine (approved in the UK)
⚠ BOXED WARNINGS
- Addiction, abuse and misuse
- Life-threatening respiratory depression
Classes and tags
Clinical profile
Defining liabilityRapid respiratory depression, overdose and dependence
Active metabolites
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Self-check
- Why does heroin enter the CNS faster than morphine?
Greater lipid solubility. - Does heroin have a US medical use?
No.