Heroin

HEROIN, Heroinum, Diacetylmorphinum, a derivative of morphine, was first obtained in 1874 by Wright, and then, in 1883, by Hesse artificially, by replacing two hydroxyl groups of morphine with acetyl groups-C₁₇H₂₁NO₄; a white crystalline powder without odor, with a slightly bitter taste, almost insoluble in water, difficult in ether and alcohol, easy in chloroform. It melts at t° 170-173°. When boiled with water or diluted acids and especially with caustic alkalis, it hydrolyzes and easily splits into morphine and acetic acid. In medicine it is applied in the form of hydrochloride salt. - Acetic acid salt of H. (Ph VII) - a colorless or crystalline powder, bitter taste, easily soluble in water (1:3), slightly soluble in alcohol, insoluble in ether; melts at t° 230-231°. The aqueous solution has a weakly acidic reaction. The presence of acetyl groups in H. makes it possible to identify this alkaloid: 0.1 g of hydrochloride H. is heated in a test tube with 1 cm³ of alcohol and a few drops of sulfuric acid; a smell of acetic ether is obtained (difference between H. and morphine and codeine). From hydrochloride H. solutions it is precipitated by alkalis. - The action of H. on the organism in general is similar to the influence of morphine and codeine, but differs by much greater strength. The narcotic and soporific action of H. in man and higher animals is not as pronounced as with morphine; animals under the influence of H. do not sleep, but are in a certain special state of paralytic weakness and depression (Kraevsky). H. acts much more strongly on the respiratory center than morphine and other its derivatives. Dreser emphasizes the specific influence of H. on respiration: the frequency of respiration decreases, but at the same time the volume of each respiratory movement increases. With small and moderate doses of heroin the lungs are ventilated quite sufficiently due to the significant stretching of the lungs with each deep inspiration, which more than covers the decrease in the volume of inhaled air per unit of time. The respiratory center in this case normally reacts to irritation by carbon dioxide and to a lack of oxygen; however, sensitivity to irritation from mechanical stretching of the lungs falls somewhat, as a result of which a patient with bronchitis can breathe deeply without hindrance. - However, a number of authors reject the main positions of Dreser on H. Winternitz (H. Winternitz) pointed out that H. reduces both the magnitude of respiratory excursions and the excitability of the respiratory center. Lewandowsky (Lewandowsky) was convinced that heroin lowers the excitability of the respiratory center and does not cause an increase in the volume of respiratory movements. Harnack (E. Harnack) proved that the weakening influence of heroin on respiration is more significant than with morphine, that H. slows and weakens heartbeats, causes salivation and a tendency to diarrhea, trembling, convulsions, fibrillary muscle contractions, nausea, vomiting, weakness, fainting, collapse. M. Lodyzhensky saw in animals after medium and large doses of H. excitement, stupor, convulsions, loss of consciousness, lowered reflexes, difficulty of movements, ataxia, muscle rigidity, dilated pupils, and from small doses - slowing of respiratory movements, decrease in minute volume of exhaled air, volume of individual respiratory movements, insufficient ventilation of the lungs, weakening of oxidative processes in the organism, decrease in t°, depression and paralysis of motor nerve nodes in the heart, decrease in blood pressure, depression of the vasomotor center, dilation of vessels. Death from H. occurs as a result of paralysis of the respiratory center. H. is absorbed faster than morphine, and in the organism it is partly split. With prolonged application of H. patients get used to this remedy, and a disease - heroinism - sets in, which is cured more difficult than morphinism. H. was previously very widely applied in various diseases for the replacement of morphine or codeine: in pulmonary tuberculosis, in laryngitis, bronchitis, pneumonia, bronchial asthma, in cardiac asthma, in heart neuroses, in influenza, emphysema, whooping cough, catarrh of the stomach and gastralgia, in oophoritis, etc. However, with greater acquaintance with the properties and action of H., this remedy began to be used less often as more toxic than morphine and codeine, not always reliable in action and with severe side effects. The maximum therapeutic dose of H. is 0.005 (Ph VII). H. is most often applied in powders and pills. In cases of poisoning with H. - aid, as in morphine poisoning. To identify heroin in legal cases, internal organs, urine, etc. are examined for alkaloids. Heroin is identified together with morphine, into which it transforms under the influence of acids and alkalis with the separation of acetic acid. H. gives all the reactions of morphine, but ferric chloride does not give a blue coloration with H. (difference from morphine). H. gives the smell of acetic ethyl ether upon weak heating with ethyl alcohol and concentrated sulfuric acid.