Heroin is More Than Just Diamorphine

Abstract

Heroin isn't just heroin anymore. Over the last two decades, there has been diversification in the forms and ‘brands’ of heroin which exist in both the domestic as well as international marketplaces. Closer examination reveals important differences between these ‘brands’. Black market heroin may now be obtained in either the form of salt (hydrochloride) or the separated base. Importantly, the different forms have different suitabilities for use by injection or by ‘chasing the dragon’, with the salt form being most suitable for injecting, whilst many of the base forms are either used by ‘chasing’ or are chemically transformed to the salt before injection. Country of origin and obvious physical characteristics such as colour are strong predictors of ‘salt’ or ‘base’ status. When consideration is given to the more recent technique of chasing the dragon, a new interpretation can be attached to some of the other drugs found in samples of black market heroin (often described as ‘impurities’). New data have identified that several of these additional drugs increase substantially the proportion of heroin which sublimates and can successfully be recovered by the heroin ‘chaser’, and these increases can be seen in the extent of recovery of both salt and base forms of heroin. Finally, new policy options are explored in the light of this new evidence-options that include the proposed development and promotion of NIROAs (non-injectable routes of administration), and the possible constructive manipulation of the heroin marketplace through differential application of interdiction efforts so as to promote the move from injecting to ‘chasing’ as the chosen method of heroin use.