Talk:Heroin/Archive 1

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Form on ingestion

Maybe i missed it but which form of ingestion is safer between snorting and smoking.. as we know, injection is what mainly causes problems.

Who is "we"? What is your source suggesting that any form of administering heroin is safer than another? JFW | T@lk 13:10, 13 December 2005 (UTC)

It has been proven that injection of heroin is alot dangerous than smoking or snorting. As overdose and withdrawals are more likely.

I'd agree with the claim that injection is the most dangerous, because of the danger of sharing needles (and thus potentially blood-born ilnesses like HIV). Between clean needles, snorting, and smoking, any claim to relative safety would have to have an external source to be credible. ----

Use of addictive drugs is dangerous, regardless of method of ingestion. Original anon above seems to be erroneously attributing the problems of drug addiction to one method of use (injection). If you are a cocaine addict you will run into many problems even if you never touch a hypodermic syringe. Anyway, this is all irrelevant. An encyclopedia has no business prescribing what is more or less dangerous, just externally sourced facts. --Bk0 (Talk)

Yes, the use of addictive drugs is dangerous, regardless of method of ingestion, but additional risk may be added by the route of administration. The danger posed by different routes is relevant information for an encyclopaedia to provide. Oh, and also, ingestion is defined as taking into the body by swallowing or absorbing (Oxford). Since this does not include injection the terminology should probably be changed here.Ben Di Luca 10:22, 27 August 2006 (UTC)

The person who said that injection is only bad because of dirty needles. Isnt there a danger of ingesting a drug in an impractical way? I mean isnt overdose because you have put too much into your system? Is there a toxicity/overdose difference when smoking compared to injecting heroin?

The dashes above are me - sorry, new to Wikipedia. For the dedicated person, http://www.drugpolicy.org/library/bibliography/overdose/index.cfm seems like a good starting place for the overdose question. http://www.drugpolicy.org/library/darke2.cfm states:

One behavioural factor that may become of increasing relevance in relation to overdose is route of administration. In the last decade, the smoking of heroin appears to have become more widespread as the preferred route of administration (e.g. Grund, 1993; Griffiths et al., 1994). Smoking heroin may be a less dangerous route of administration because the drug effect is achieved by repeated small doses rather than a single injection. In a Dutch study of non-fatal overdoses, only 6% of Surinamese heroin users reported having overdosed, compared to 29% of Dutch born users (cf. Grund, 1993). The relative levels of injecting for these groups were 4% and 37%, respectively, suggesting a link with route of administration and overdose.

http://www.drugpolicy.org/library/mcgregor2.cfm agrees that injection is linked to an increased risk of overdose, and also emphasises that the evidence suggests the highest risk is a combination of heroin and depressants ("Of those subjects who had ever experienced an overdose, almost two-thirds (62%) had been using other drugs, principally other central nervous system depressants (52% used alcohol, benzodiazepines, methadone and/or other opiates, with some overlap in usage) in addition to heroin at the time of their most recent overdose."). JohnWhitlock

Im the person who wrote the original question. Im new here but is there anyway this new information can be added.

Endorphins

Whoever has written this page needs to re-evaluate his or her "scientific" background. Much of the information is ill-conceived, incomplete, or just plain WRONG. Take, for instance, the the last sentence- where the author says that herion addiction can be "easily relieved" with acupuncture.

I bet the person writing this article owns an acupuncture clinic or something.

Heroin is very similar to endorphins, the natural opiates of the body, but less potent. The body responds by stopping the production of endorphins after heroin consumption. Endorphins are regularly released in the brain and nerves to attenuate pain. The body's response in stopping endorphin production results in the slighest pains not being attenuated by the brain and therefore becoming an horrible agony. This is what causes the horrible withdrawal symptoms, although they can be easily relieved with the help of acupuncture.

That stuff was added by ,now banned user:Susan Mason aka Lir etc.. Mintguy 12:26, 16 Aug 2003 (UTC)

Acupuncture has been proven to release endorphins... http://opioids.com/acupuncture/endorphin.html (follow on relavent links) - jungboho

Be bold in updating. If you think there are things that need to be changed, please change them. However, be sure to follow the Wikipedia policy of neutral point of view.

Isn't the word "Heroin" a trade mark? -- Zoe

It started out as one, but I believe the Bayer Company has let it lapse. --Infrogmation 03:18 15 Jun 2003 (UTC)

This article repeats a claim I've seen elsewhere, that opioid withdrawal is caused by the opioid having suppressed natural endorphin production. If this were true, then administering an opioid antagonist like Narcan should trigger opioid withdrawal symptoms in all persons, not just those with opioid dependence. Narcan *does* block natural endorphins, such as are released by alcohol consumption or under stress. But Narcan has little or no effect on non-stressed, non-opioid-dependent persons, and this property is commonly used as a definitive clinical test for opioid dependence. Even if endorphin suppression is a factor, this would seem to be a minor mechanism compared with other mechanisms such as receptor up- and down-regulation in the parts of the brain indirectly affected by opioid use, such as the nucleus accumbens, the brain's "pleasure center". Does anyone have more authoritative information? User:Karn 27 Mar 2004

The paragraph beginning 'Heroin is chemically very similar to endorphins...' is not good. Heroin is chemically totally unlike endorphins which are peptides. I'm not convinced about the other points about withdrawal either but I don't know either way. I started revising that paragraph but it seemed like I was practically removing it. I realise it has been modified before but it is an awful paragraph. Perhaps the points raised can be blended elsewhere in the section. Any thoughts?

Agreed, "heroin is chemically very similar to endorphins..." is horribly wrong.

Heroin is NOT chemically similar to natural occurring endorphines, BUT its action, once converted into morphine, closely mimics that of endorphines. In other words, it doesn't look like endorphines but acts like them to explain it in simple terms. 81.178.110.181 19:16, 7 January 2007 (UTC)

I was a heroin addict for seven years, and let me tell you, nothing relieved my withdrawal. I was offered Methdone but refused it because I knew too many people who got clean with the help of Methadone only to become addicted to Methadone. The only thing that alleviated my symptoms in the least was taking Aleve for the muscle pain, an anti-nausea med for the vomiting, ativan for the shaking, but even so, after a day of being so medicated, I refused any medication for my withdrawal, as I wanted to have nothing in my system (nothing wrong with Aleve and an anti-nausea, but I didn't really like the side effects of the ativan.) And under the watchful eyes of my care team in rehab, I detoxed, and I've been clean for 3 years. Acupuncture as a withdrawal aid? I doubt it, but whatever helps someone to get through it. It's quite possible it did help a few people, but I doubt it will help everyone.

NPOV comment

While heroin is a dangerous drug, since it is a central nervous system depressant, it is the lack of available quality information, lack of quality control and infected syringes, which can transmit diseases such as AIDS, and hepatitis that cause the most trouble for heroin users. The money which can be made in supplying heroin addicts encourages a continuous supply, and the need to finance purchases generates considerable property crime.

Critics of drug prohibition contend that since addiction can be treated, primarily by counseling and methadone substitution, most of the suffering surrounding heroin is indirectly caused by prohibition, not by the drug itself. Others argue that legalising drug use, to the level of tobacco and alcohol, will eliminate the organized crime associated with it.

This section is POV, has no counterpoint, and is segued into from a more factual (presumably) topic. I moved the text here to let someone else deal with it. 192.249.47.11 16:41, 22 Dec 2004 (UTC)

This article has an anti-Americo-centric point of view when using phrases like "Unfortunately, the US public and government has not yet accepted the concept of clean needle exchanges to reduce heroin related deaths."

This phrase points out the author's bias towards needle exchange programs and singles out the US its lack of such programs. I would suggest that the fairest way to treat this topic would be a separate article on needle exchange, including a comparison of the needle exchange policies of various countries.

--Carej 13:54, 15 Jul 2004 (UTC)

The offending sentence has been removed. What is the justification for this page having "disputed neutrality"? -- AdamH 16:04, 19 Aug 2004 (UTC)

If treatments are to be discussed, I think opiod antagonist treatments like naltrexone should be talked about

Heroin-in-lollipops pic

Does this pic belong in this article: Image:Lollipops with h.jpg? The image is already in smuggling and Drug Enforcement Administration, but I was wondering if it should be placed here too? – Quadell ^{(talk) (help)}[[]] 20:14, Oct 15, 2004 (UTC)

Confusion over di / 3 / tetra, and "we now make"

The first paragraph of "History" doesn't make sense, and I don't have the chemical knowledge to fix it. This section is very unclear, and doesn't even make grammatical sense:

He boiled anhydrous morphine alkaloid with acetic anhydride over a stove for several hours and produced a compound that he called tetra acetyl morphine (morphine with 3 acetyl groups, a different, weaker form of acetylated morphine.) we now make diacetylmorphine, a more potent form of acetylated morphine. The compound was sent to F.M. Pierce of Owens College, Manchester, for analysis. He reported the following to Wright.

Even given the factor of two that can be off in acetyl prefixes (eg tetraacetyl- could be the same thing as diacetyl-), where does the 3 come in? And the "we now make" sounds completely wrong. --AlexChurchill 18:01, Nov 11, 2004 (UTC)

CRA Wright called it 'tetra-acetylmorphine', but it was a mistake. Axl 14:57, 15 Nov 2004 (UTC)

Legal matters

Heroin is a controlled substance

Legal matters tend to be local to jurisdictions. I'd think that heroin is a controlled substance in all jurisdictions, but I am not sure of it. David.Monniaux 10:34, 5 Mar 2005 (UTC)

It is a controlled substance in all jurisdictions that subscribe to the Single Convention on Narcotic Drugs. There are individual variations, though. Some jurisdictions allow the use of heroin in terminal cancer, for example, whereas others (like the US) consider it to have no redeeming features (including research, medical use, etc.)

Cultural References

I removed some of the songs from the list, until somebody can give explanations as to why they should be included:

• "Space Oddity" and "China Girl" by David Bowie (seems to me like the first one is about some astronaut experiencing a problem with his spaceship, is there some hidden meaning?)
• "Master of Puppets" by Metallica

David.Monniaux 10:45, 5 Mar 2005 (UTC)

"Comfortably Numb" by Pink Floyd

Adding and removing. Removing and adding... Is it about heroin? Lyrics suggest so, movie makes it even clearer. Do we agree? --Zealander 19:18, 19 May 2005 (UTC)

• OK ... just a little pinprick / There'll be no more AAAAAAAAAGGGGGHHHH / But you may feel a little sick / Can you stand up? / I do believe it's working; good / That'll keep you going through the show / Come on it's time to go / There is no pain, you are receding / A distant ship smoke on the horizon / Your lips move but I cannot hear what you're saying ...

I'd say they do more than suggest so. Daniel Case 29 June 2005 06:15 (UTC)

The implication that it's been given by a doctor suggests the drug in question is Morphine, not Heroin per se, but it's probably not worth getting worked up over. (The one drug is a derivative of the other anyway.) Collabi 07:08, 5 August 2005 (UTC)

I take it that the character singing has overdosed on heroin and the Doctor gives him an Adrenaline Shot which makes him scream suddenly. To me, the song is called Comfortably Numb because that's how he's feeling taking it. I say it is about heroin.--681dragon 20:23, 17 August 2005 (UTC) Note: It should be naloxone/naltrexone, not adrenaline. Too much Pulp Fiction? :)

The song was written before the movie was created. The story behind The Wall album is about both Syd Barrett and Roger Waters. The pinprick is something that was given to Waters after he learned that he had contracted Hepatitis and didn't know it. When he got the symptoms before a concert in Philadelphia, a physician gave him a sedative that numbed the pain and permitted him to perform the show. This information was from a 1980 interview with Waters himself and a radio host from KLOS in Los Angeles. [[1]] Realize that the movie was released two years after the album, allowing for a backstory to be created. Just because the song takes on a seperate, albeit very logical, meaning in the movie, doesn't mean that was the initial intention. Sahaiata 03:27, 24 August 2005 (UTC)

-As a former heroin user I can tell you that, not even as a fan of Pink Floyd, the lyrics to the song are a very accurate representation of the voice in your head that gives up trying to fight with itself over the self medication, when the opposing voice is coaxing you along. Oh, and the Hepeatitis thing is bull.

-This pink floyd song plain sucks.

NIN - Hurt?

In regards to the Nine Inch Nails song "Hurt" in the list of "Heroin inspired artistic works", is there any evidence to suggest the song has anything to do with heroin? I'm a fairly large fan of the band and have never heard H come up at all.

Is there any evidence to prove me wrong?

Cheers

MrHate 06:53, Sep 22, 2004 (UTC)

I guess not, I'll remove it MrHate

The needle tears a hole / The old familiar sting is almost certainly a reference to heroin. It implies habitual intravenous drug use, and the remainder of the song suggests that the substance of choice in this case is heroin.

--Dachannien 00:58, 11 Dec 2004 (UTC)

I think "the needle tears a hole" is a refrence to self-mutilation. How exactly does the rest of the song suggest heroin?--68.188.66.195 05:17, 7 April 2006 (UTC)

It's pretty obvious that the song is about heroin abuse. Even before I started using, I'd known that that song was about the downward spiral of dope addiction. It's been publicly known that Trent battled heroin addiction for a time and even had a near-fatal heroin overdose. Do a search for "Trent Reznor" and "heroin" on Google, and you'll find plenty of references to verify this. Also, in a live performance after he'd gotten clean he said that this song wasn't his anymore, further confirming that the song is indeed about his battle with scag.--71.108.173.45 11:16, 2 June 2006 (UTC)

The "not mine anymore" comment tends to imply that it's someone *else's*, the interpretation I'm familiar with being a reference to the Johnny Cash version of the song. In any case, considering the overt self-mutilation theme of the song ("I hurt myself today to see if I still feel"), I don't see where we need to look for a covert meaning. And unless such an interpretation can be authoritatively sourced it doesn't belong in Wikipedia. --Stellmach 00:23, 31 July 2006 (UTC)

Happiness is a warm gun

Tells about making love, not shooting heroin. --Tmh 23:16, 25 Oct 2004 (UTC)

I need a fix cause I'm going down,down to the abyss that I've left up town. I need a fix cause I'm going down.

That lyric alone, combined with the fact that Lennon was a known heroin user, is more than enough justification. The song has multiple meanings, because there are also references to sex, as you said, but you cannot deny that it clearly references drug use as well. The phrase "Happiness is a Warm Gun" could even be symbolic of a syringe. I am going to re-add it.

I figured "I need a fix..." was straight forward and guessed "Mother Superior" was some slang for one's dealer of smack or other substance (see Trainspotting). I coupled this with the common knowledge that John Lennon used H and concluded that it was the topic of the song. But I suppose the same argument of content ambiguity can be applied to most of the song list. More opinions would be welcome. — FREAK OF NUR_xTURE (TALK) 10:58, Feb 17, 2005 (UTC)

David Bowie

I don't see what "Space Oddity" or "China Girl" have to do with heroin, even if China Girl is a name for heroin. not familiar with other song 67.124.101.93 03:12, 11 Dec 2004 (UTC)

• In my opinion, "China Girl" is fairly obviously about heroin. ("China White" is a street nickname for heroin.) Lyrics: I’m a mess without my, little china girl / Wake up mornings, where’s my little china girl.
• As for "Space Oddity", I am as confused as you. There has been some idle speculation that the spaceship journey might be symbolic of a drug trip, but that seems a big stretch to me. -- FP 12:09, Mar 5, 2005 (UTC)

• The album "Space Oddity" was influenced by (and contains references to) Bowie's heroin use. However, the individual song "Space Oddity" doesn't really make any references. -- FP 12:20, Mar 5, 2005 (UTC)

Many sources think that the segment on the Space Oddity song (from "Lift Off!" to "This is ground control...") where the music rises and rises is to mimic the rush one gets from injecting heroin. One such source is the book that followed the Inside DB 69-74 2-DVD. Bjarne Hansen, Oslo, 150606

What about tying "Ashes to Ashes" in with "Space Oddity" since both refer to Major Tom, and in "Ashes to Ashes" Bowie which I believe states: Ashes to ashes, funk to funky/We know Major Tom's a junkie/Strung out in Heavens high/Feeling an all time low There's more about how, each night he'll tell him self he'll stay clean, a flash of light but no smoking pistol. I just can't look it up through a filter. Regards, Nautafoeda

Metallica

• Similarly, "Master of Puppets"" is also obviously about drugs (specifically cocaine and heroin). I believe the band have even explicitly stated this. The users are the "puppets"; the drugs are the "master", twisting your mind and smashing your dreams.

• Re: "Master of Puppets" -- Add'l lyrical hints: "Veins that pump with fear," "Needlework," "Ritual misery/chop your breakfast on a mirror/Taste me you will see/more is all you need"... Maybe not necessarily describing heroin, but obviously some drug. Perhaps cocaine, as many do inject it rather than snorting. The song clearly does not describe Punch and Judy. — FREAK OF NUR_xTURE (TALK) 10:45, Mar 13, 2005 (UTC)

Mmmh. About Master of Puppets, I must admit that, once I read the lyrics again, I now think it discusses drugs. I used to think it was about some kind of leader that manipulates people and sends them into some war (as in the Assassin sect etc.). David.Monniaux 12:46, 5 Mar 2005 (UTC)

I removed Master of Puppets from the list, it implies use of cocaine from the line "Chop your breakfast on a mirror".--Guy 10:54, Mar 22, 2005 (UTC)

And I restored it again because it also refers to heroin, as discussed above. -- FP 22:56, Mar 22, 2005 (UTC)

Whoever thinks that "Chop your breakfast on a mirror" refers to just cocaine is full of it. I snorted heroin for seven years. A lot of people who don't like needles snort heroin. Don't discredit the song just because the stereotype says that cocaine is snorted and heroin is injected. You can inject cocaine (with heroin it's called a speedball but you can inject cocain by itself) and snort heroin. Kudos to whoever put it back up.

Master of Puppets is not about only heroin. It's about drug use in general and dependancy on drugs and shouldn't be pigeon holed into heroin abuse. Needlework does not imply only heroin as other drugs can be injected and neither does the line chop your breakfast one a mirror.

The Salton Sea

It's been awhile since I've seen this film, but wasn't it primarily about amphetamines?

Erowid pictures

once again i implore that pictures be placed in this article. Content is very important, but a drug article without multiple visual examples of said drug is not a drug article. I have e-mailed erowid with no reply yet (only a week ago or so) asking for permission to use their images on wikipedia. I hope we can eventually do so, as it will create higher quality, more aesthetically pleasing articles. Lockeownzj00 18:39, 5 Mar 2005 (UTC)

Feel free to use these public domain images, if desired:
File:BlackTarHeroin.jpg File:ChinaWhiteHeroin.jpg
-- FP 03:11, Mar 6, 2005 (UTC)

Content on erowid is generally not free for use here or available under a suitable license. Virtually all images are either copyright their original photographers or erowid.org, and free use is explicitly denied on their copyright page ([2]) unless prior permission is granted. --Bk0 21:27, 21 September 2005 (UTC)

There are excellent images on the DEA web site. David.Monniaux 08:45, 6 Mar 2005 (UTC)

Modus operandi

When discussing heroin addiction, there are frequent references to the practice of preparing the drug in a spoon over a lighter. Maybe this should be discussed. David.Monniaux 08:25, 6 Mar 2005 (UTC) Additionally, cotton fever should have its place here. Many[could use a citated stat here] IV drug users contract cotton fever during their time with the needle.

Yes, David. Also, the use of a cotton filter (A piece of cotton is rolled in a tiny, tight, ball, and then placed in the spoon containing the solution. The needle is then inserted into the cotton, and the solution is drawn up into the syringe). Also, the common slang term for mixing the H with water and then either snorting it with a tube or dropping/squiring it into the nose is, "monkey piss". This is due to the burning/stinging sensation and terrible taste. - -Chuck 12 Sept 2006

Duplication in page

I intend to take care of the duplication in the page's contents or revert it to an unduplicated edition. Well done. User:Sandbody 2230, 27 Mar 05

Dangers and legality

I reverted the insertion of this paragraph from the text:

(It should be noted that Diacetylmorphine HCl (Heroin) in it's pure form is a very safe drug. Constipation is Heroin's only known side-effect. All the risks mentioned above are a product of Heroin's legal status.)

I though this was blatant POV. Nonetheless, I'm sympathetic to the overall point of view, and I'd welcome a suitably NPOV edit that clarifies the role of heroin's legal status in the dangers associated with it. &emdash;ciphergoth 12:33, 2005 Mar 29 (UTC)

Are you referring to the idea that heroin's side effects come principally from its adulterants? That adulterants are added to heroin because of the illegalization of heroin and that, thus, the illegalization of heroin is responsible for its side effects? Or do you mean that illegalization literally causes these side effects? I'm an ED tech, and I think I speak from experience when I say that the adverse effects of narcotic analgesics are similar regardless of their purity; seizures occur in completely pure meperidine administration, completely pure morphine sulfate administration, and also in heroin use/abuse (I don't consider self-medication abuse, but some people do since it's illegal). Regardless of my own personal feelings about the illegalization of drugs - which is to say, that it causes more problems than it solves - narcotics' side effects present with administration across the class. We expect respiratory depression and arrest with heroin use as much as with meperidine; we expect nausea and vomiting with heroin use as much as with morphine sulfate. I also disagree that heroin is a "safe" drug - not because "it kills" or "OMG cuz yuo cna get addcted!!!1!" but because its rapid onset and short duration make withdrawal dangerous for the user and those around them; and because its adverse effects are intense esp. with the inexact doses self-administered by heroin users. Just because it has some cachet in the community doesn't make it safe: hell, if I had my way, meperidine (Demerol) would be completely banned, forever, except in cases of trauma to the abdominal viscera. This isn't because I think "drugs r bad SXE," but because meperidine requires huge and inexact dosages and because people go bugfuck if they can't get some after they've had a bit of it. Wishful thinking won't take away the adverse effects of this group of medications as a whole; I wonder what sort of NPOV addition regarding the "legislative causes of heroin side effects" you would like to see. Sandbody 16:32, 30 Mar 2005 (UTC)

To look at it again, I realize that the end question of my message seems a little bit more rhetorical and less like an actual question, which it was. I'm not trying to chap you here - I really do wonder what you're getting at.Sandbody 07:32, 31 Mar 2005 (UTC)

That sounds a lot more plausible than the idea that all problems associated with heroin would disappear if it were made legal. But it sounds like you agree with me that its legal status causes more problems than it solves, and the article should make it clear that many problems that heroin users experience (such as adulterants) stem from its legal status. For the record, I consider heroin use, even as a one-off, to be incredibly inadvisable. &emdash;ciphergoth 10:07, 2005 Apr 1 (UTC)

Regular heroin users have a mortality rate of more than 14x their age and gender matched peers. Fatal overdose involving heroin is caused principally by the repiratory depressant effects of the opioid itself. Additional effects from adultreants are rare and the section on risks of non-medical which states that "The overwhelmingly vast majority of reported heroin overdoses are actually adulterant poisonings or fatal interactions with alcohol or methadone" is misleading. It is true that alcohol and other concomitant drugs are frequently present in heroin overdose fatalities and that such drugs may potentiaate the effects of heroin during overdose however these effects are weak in comparison and the pharmacological mechanisms underlying any potential interactions are not fully understood at present. Methadone is also dangerous in overdose for similar reasons and before the introduction of safer prescribing practices was associated with significant numbers of fatalities in UK and elsewhere. However less than 10% of heroin overdose fatalities also have methadone detected. Deaths 'on-the-end-of-a-needle' are also rarely anything to do with adulterants in my expereince - IV heroin can cause an immediate loss of consciousness. Happy to edit this section if my view is supported. Pogrsh 14:37, 13 January 2006 (UTC)

If the potential actions are not fully understood, then how can one be sure that the opioid should be declared to be the only reason for an opioid related death? A much more accurate picture could be taken if excluding deaths involving other drugs. Dying from a heroin/alcohol combination could just as easily be considered an alcohol overdose, while saying that "heroin may have been present, but the effects are weak in comparison". It seems like the fact that heroin is illegal makes it the drug to point blame towards. Peoplesunionpro 17:25, 2 February 2007 (UTC)

Methadone is very rarely implicated in overdose considering its usage. Also, universally describing heroin overdose as a lengthy process is inaccurate. While users do occasionally die after a relatively long period of time, many (especially when administering the drug IV in a new context) die within a minute of administration. Many are found with the needle still sticking in the arm. This is faster than any other commonly used illicit psychoactive drug. Also, cocaine and heroin do not combine additively or synergistically.

Price and dosage

It would be nice to have a couple of paragraph in the article that name typical doses used by addicts, lethal dose, and average market prices in civilized countries like United States. --Itinerant1 06:07, 28 Apr 2005 (UTC)

How would one be able to do that accuratly without citing inaccurate sources, or any sources for that matter?--Sublimemtb 11:29, 5 May 2006 (UTC)

Heroin is typically sold in dime bags, or $10 hits, on the street. You can also get jabs/bundles (12~13 bags) for ~$100. Unless you're buying weight, it is rarely sold by mass, and mass doesn't really matter in the end since purity varies so much. I've had huge bags of dope that were weaker than tiny ones less than 1/20th the size, and there's really no way to tell how strong the dope is before actually trying it. If you do manage to find a hook-up that sells in grams, it is typically between $100-200 a gram, usually closer to $200 for pure, although I've gotten some for ~$70/gram and I've heard of people paying ~$200 for half a gram in some places.

Dosages are kinda pointless to talk about since you will rarely encounter 100% pure heroin, and dosages vary so much depending on purity and one's tolerance (which can fluctuate greatly). Since you can't tell how pure one batch is from the next, you just have to hope that the dealer cut the dope and packaged it appropriately. This is part of the danger of IVing street drugs. Atleast if you smoke it, you can guage how high you are getting as you smoke, but if you mainline it, you sort of just have to take a guess at how strong you think it is.

Also, I think the term you are looking for is "developed countries" not "civilized countries." It's rather ethnocentric to believe one's nation is more "civilized" than another.--71.108.173.45 08:37, 2 June 2006 (UTC)

Dental effects?

I'm curious to know if there is a direct effect on the teeth from long-term heroin use. While I've heard that dental rot is caused chiefly from the general lack of preventative care and junk food consumption exhibited by herion users, I have also heard that the drug itself (even in the pure form) has some direct effect on the teeth, causing them to turn black. Or, is this caused by non-heroin additives or contaminants used in preparing the drug for illicit street sales? Any dentists or doctors care to chime in? --NightMonkey 08:56, July 24, 2005 (UTC)

Opiates themselfes have no pharmacological effect on teeth or oral hygiene. This is supported by lifelong non-drug scene users - physicians and medical staff are probably the largest group of them. Cacycle 14:07, 24 July 2005 (UTC)

-- Heroin does not biologically affect the teeth. However, smoking any chemical substance is going to be damaging to several things, one of which is the teeth. When you smoke heroin (be it black tar, brown powder, etc) you are attaching a chemical to a sensative area. Smoking heroin is bad injestion, along with smoking most other things.

Lots of normal heroin addicts (showing the other side of the picture here, adding to the previous comment) have bad teeth. This is mainly because heroin is mildly expensive (expensive when you consider the circumstances of normal heroin use), and heroin addicts are often discriminated against as 'the worst' drug users. Most people have a hidden stigma about heroin. Result is that heroin addicts are denied care, and in turn deny care for themselves (since they assume they cannot function in society because of the addiction that they have obtained).--Ddhix 2002 07:58, 31 July 2005 (UTC)

In addition the dry mouth reported by some users may contribute as a lack of saliva can apparently result in dental issues. In Australia methadone clinics encourage chewing gum to increase saliva production and thus reduce this risk.

Methadone is presently the treatment of choice for heroin dependence and one of the more common preparations is methadone mixture which I believe contains glucose syrup. It's also worth bearing in mind that dental hygeine is perhaps not as good as it could be in this population. Pogrsh 14:55, 13 January 2006 (UTC)

Although I have nothing to support this except expierence, most junkies have bad teeth not just due to poor hygene, but from crack and crystal meth, which i think cuts blood flow to the gums, and makes teeth decay faster.--Sublimemtb 11:30, 5 May 2006 (UTC)

Heroin as medicine

This article is missing the point in a way. Heroin is an incredibly efficacious analgesic.

You might list pain relief in the "Direct short and long term effects of heroin use" table.

Maybe a nice little topic to add to this article is an answer to the question of why it is rarely used medicinally. It always seemed to me that original policy to fight its recreational use made it to be unused medically, even though it might be a better alternative to morphine. Peoplesunionpro 22:58, 17 September 2005 (UTC)

It's efficacy as an analgesic is exactly equal to that of morphine. Its effects are manifested through deacetylation into morphine in the brain (see prodrug). The main difference is in heroin's greater therapeutic index due to the increase in quantitative potency. So for opioid tolerant patients it is a somewhat safer alternative to morphine, but its analgesic efficacy is no different. Fentanyl is typically used in such situations in modern medicine. --Bk0 23:08, 17 September 2005 (UTC)

Well I recently had kidney stones, and being a junkie, the percocet they gave me at the hospital was useless. I had IV morphine and IV heroin at my disposal at home, and for that much pain I was in your, you can bet your bottom dollar I chose the heroin over the morphine until the pain went away. I am not disagreeing with you, simply stating my experience. Also, they gave my dad (also opioid tolerance, moreso than myself) fentanyl-sublimaze when he busted his hip/femur, a custom batch of it that was probably stronger than what they've ever given some one in that family-and it still didn't do much for him...poor guy. --Azrayl 09:12, 15 July 2006 (UTC)

It's also missing the crucial historical link between 1910 (when it was last sold as a children's cough medicine) and 1914 (when it was outlawed in the US). We need a short paragraph along the lines of: "Although highly(?) effective as a cough-suppressant and pain-killer, it was determined by the U.S. DEA(?) in 1910(?) that, despite its marketing claims, Heroin was also highly addictive." --Tysto 15:06, 18 December 2005 (UTC)

It's really sad that heroin can't be used medically in most countries nowadays though. It really works heaps better than morphine and apparently, studies show that side effects relative to the analgesic effect are greater for morphine than heroin ie. heroin is safer. maybe one day,someone can rebrand the drug and sneak it back into the market (with approval of course!) i guess it's all to do with the stigma of drug abuse and all. Kenkoo1987 12:55, 30 August 2006 (UTC)

Pulp fiction?

Hey people, I guess you all know what my following question is going to be if you read the title.

Mia clearly Overdosed on Heroine, is it true that a shot of adrenalin straight into your heart can save your life that way?

causes an immediate return of consciousness and start of withdrawal symptoms when administered intraveneously.

usually treated with an opioid antagonist, such as naloxone (Narcan) or naltrexone

Doesn't say adrenalin anyway.

Adrenalin (epinephrine) would not be used in real life in the way it was used in the movie. Naltrexone/naloxone causes near-instant revival and withdrawal symptoms when administered intravenously to overdose victims, ephinephrine would only be used in the event of cardiac arrest as part of standard CPR procedures. Still, once the patient's heart was beating again Narcan would still need to be administered if it hadn't been already. --Bk0 21:23, 21 September 2005 (UTC)

Withdrawal symptoms

I removed:

There is also a significant risk of tonic-clonic or grand mal seizures (although less so than during withdrawal from sedatives such as barbiturates), which can lead to stroke possibly resulting in permanent disability including blindness or paralysis, or heart attacks,

which can potentially be fatal.

Alcohol withdrawal carries these symptoms, but none of the sources I checked indicated that they apply to heroin. (See the NLM's page on opiate withdrawal [3], Purves et al.'s Neuroscience (the NCBI has the appropriate section online at [4], and the NCBI's online HSTAT book [5].

I can't make much sense of this sentence..

"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-tolerance."

..Wouldn't cross-tolerance be better described like this: Patient develops tolerance to Heroin, patient finds he is also tolerant to Morphine although he has never used morphine, this is known as cross-tolerance. If the patient started using say, cocaine, (which is also considered a hard drug) what would that have to do with cross-tolerance?

General Risks from non-medical use

I've restructured the " General risks from non-medical use" section into 3 sections: =

• General risks from non-medical use
• General risks from use of any illicit drug
• Risks from use of poorly administered injectiable drugs

I've done this because most of the risks are actually a result of the drugs illicit nature and the unskilled/improper injecting practises of many illicit users.

I have done this because I beleive it is important not to demonize the drug by directly associating issues which are at best only indirectly attributable the drug itself (as opposed to it's illicit status) . I also note that every one of those risks are present in the use of any powerful drug and mopst oft eh risks are present in the use of all drugs, illicit or otherwise.

List of songs etc

It seems the impact of Heroin on culture has now been well documented. Is there any reason why we cannot stick with the most notable examples, and move the remainder to a List of songs about heroin? JFW | T@lk 17:18, 8 September 2005 (UTC)

Why not move them all? There's bound to be lots of conflict over what qualifies as notable enough for the main article, I'd just as soon see the whole thing moved somewhere else. --Bk0 23:56, 8 September 2005 (UTC)

Entire Cultural influences section moved to Influence of Heroin on Popular Culture. It was big enough to warrant its own article, and the main Heroin article is now a more manageable length. --Bk0 17:23, 9 October 2005 (UTC)

US and historical references

I noticed that a reference to the taliban and poppy production was removed, as well as some information on GI heroin use in vietnam. why was this, and should it be replaced? Dreamer.redeemer 05:02, 18 October 2005 (UTC)

Benzo treatment and Medical use

Does anyone have sources for treatment with benzos? It seems very peculiar to treat one addictive drug with another very addictive one, performing a substitution of sorts. I'd also be interested to see information on comparative addictive properties of benzos. Also, there has been recent discussion in the UK about the clinical trials for heroin and its use as a prescription drug for detox purposes: [6], [7] and [8]. I think it was also legal in the UK for prescription back in the 70s, but I'm not sure since that was based on tertiary sources. Nathan J. Yoder 19:28, 5 November 2005 (UTC)

Use or abuse

I think that in the article on heroin (and all other drugs respectively) one should replace the word ABUSE/ABUSER with USE or recreational use, respectively. Per definitionem, ABUSE is the harmful use of a drug, which doesn't depend on if it's illegal or not, but only if it causes damage when used. And this is, in all cases except one in the heroin article, not the case. (neutral point of view) Heroin itself causes no damage to the organs, but that should be known to someone who changes the wiki. I've already done the change (with a few others) yesterday, but someone thought he'd better revert my changes, so I'm trying to convince you this way. Also, according to newer research, heroin isn't only a prodrug because also the heroin itself docks on the µ-receptors, especially dimers and trimers of opioid-receptors play a role in that.

This follows with the abuse/use point above. I don't think terms like addict should be used to simply describe "user". ie

"Though "speedballs" (when injected) or "moonrocks" (when smoked) are a popular mix of the two drugs used among addicts..."

Not being an addict in no way precludes someone from engaging in certain activities, as in the speedball example above -- Papaver 02:08, 10 March 2006 (UTC)

Schedule I or II?

Heroin is currently categorized as both a schedule I and schedule II drug. Is that true? If so, it's probably worth some explanation. Samw 04:31, 9 December 2005 (UTC)

It's scedule I only. See: http://www.dea.gov/pubs/scheduling.html Samw 20:17, 9 December 2005 (UTC)

That's only true in the US. I believe heroin is classified as Schedule II internationally, some countries (the UK and perhaps others) allow heroin for medical use.

It is Schedule 1. Heroin is used medically in UK, but it is not "schedule I" because the UK does not have a numbered schedule system. --Bk0 (Talk) 23:57, 9 December 2005 (UTC)

Actually there are numbered schedules in UK law; the Misuse of Drugs Act 1971 divides into the familiar class A, B or C, relating to legal issues surrounding misuse, but the Misuse of Drugs Regulations 2001 divides drugs into five numbered schedules, relating to e.g. requirements to keep records, safe custody etc. Diamorphine is schedule 2. (see http://www.rpsgb.org/pdfs/shipmaninqrep4respapp1.pdf) PeteThePill 22:27, 25 September 2006 (UTC)

Issues with table of effects on right side of page

- "Liver disease (chronic use)" under "Hepatological"
- "Spontaneous abortion" under "Severe"
- "Respiratory arrest" under "Severe" (a conditional side-effect in the event of an overdose, yet is not referenced as such)
- "Pneumonia" under "Respiratory"
- "Abscesses" under "Skin"

previously to viewing this page, with the exception of "respiratory arrest" and "abscesses" i have not heard of any of those effects.

"respiratory arrest" is not an effect of the drug, it is an effect of the drug when administered in excessive dosages.  "abscesses" are also not a result of the drug, but a result of improperly performed injection, which is not relevant to the drug in medical settings.  

"liver disease", "spontaneous abortion", and "pneumonia", if even true, are either quite rare side effects or unrelated to heroin at all.  i may be wrong about the effects mentioned in this paragraph, but the rest i'm sure on.

Image Float

Is it just my browser, or do the floating Bayer images on the left hand side overlap the text for anyone else? It looks fine for me in Internet Explorer, but in Firefox and Opera the images overlap the text. -Dawson 22:18, 7 February 2006 (UTC)

History

This paragraph here:

"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. The opium trade sparked the two Opium Wars that resulted in a series of Unequal Treaties that ceded Hong Kong to Britain in mid 19th century. Later in the 20th century, Chinese triad gangs would eventually come to play a major role in the heroin trade, most of which are based in Hong Kong and Southern China."

Although my history of the Opium trade is spotty, this paragraph does not provide me with any connection as to how the Opium wars and their subsequent treaties in the early 19th century had anything to do with the Chinese Triad gangs of the late 20th century. It simply jumps 150 years from the first statement to the last, sounding rather preachy the whole way. The only thing the Opium trade has in common with today's heroin trade is that they were both opiates. The opium trade and the heroin trade were carried by completely different means. The Opium trade was supported by national governments whereas the heroin trade is illegal and is distributed by underground criminal organizations. In this paragraph it sounds like another problem that someone has decided to attribute to the 19th century imperialism. - Anonymous 14:04, 25 February 2006 (UTC)

Shipman paragraph

Coming as it does after the paragraph on British medical uses, the paragraph on Shipman is unclear. I suggest either removing, relocating, or at the least clarifying where Shipman was from. Evan Donovan 03:22, 25 March 2006 (UTC) (sorry forgot to sign my comment)

"His critics are not convinced that the actions were those of the agency rather than the actions of individuals. They also point out that North Vietnamese and Viet Cong officials were equally complicit in the trade. Italic textIndeed, it is difficult to find anyone during the war who was not participating in some way.Italic text"

I'm no vietnam apologist but the italicised statement sounds very suspect. Its unsupported and sounds like an generalistion.

Rumour & Inaccuracies

While this article is generally very good, I notice that there is a lot of assertions made about the heroin black market and illegal users that provides no sources. A lot of the 'common knowledge' about illegal drugs is very inaccurate and as such I think we need to start insisting on sources for any statements and chop anything that doesn't get sourced. Ashmoo 06:27, 2 June 2006 (UTC)

irrelevant information?

“The serial killer and general practitioner Harold Shipman obtained large quantities of diamorphine by writing prescriptions for his cancer patients and keeping the drugs. Shipman was convicted of killing 15 patients with diamorphine, though an enquiry later estimated that between 220 and 240 were murdered[2].”

i'm not sure how this is at all relevant to a general heroin article; perhaps it would fit in an article on murders executed by means of poison?

history of the illegal trade

I've rewritten the section on the history of illegal trafficing. The version I replaced had several flaws. First, it confused the illegal trade in opium (including the opium wars) with the illegal trade in heroin. While they are certainly related issues, the illegal trade in heroin developed in a totally different way. Second, it depended too much on McCoy's narrative. I've seperated out McCoy's narrative from a more NPOV discussion of the development of the heroin trade internationally.

For sources, see the timeline at [9]. The timeline there gets several details right that this article currently has wrong. Specifically, people misunderstand the nature of the harrison act in the US and how that related to the development of the illegal trade.

I would not mind if someone weaved a more NPOV version of the McCoy content into the main history section, but whoever does it should try to carefully seperate the history McCoy presents from the political thesis he develops in the book. I dont think its wrong for the political thesis to be on the page, but it should be there to compliment the actual history of the trade.168.127.0.51 18:50, 29 June 2006 (UTC)

Conformity with other drug Articles

It seems to me that "Heroin" would benifit from rewriting to conform with articles other pharmacological agents. See dextromethorphan for example. The social and humanistic aspects of the drug a treated in a separate article, Non-medical_use_of_dextromethorphan, which enables the main article to focus on the unbiased scientific facts of the said agent. I believe that "Heroin" would be better organized if it followed that model. As it is now information about how the drug works, what its pharamcological effects are, and about its chemical status, is over shadowed by the anti-use, anit-addiction oriented focus of the remainder of the article. Such a configuration almost approaches POV through its selective presentation of information. I may rewrite the article myself to correct this.

—Preceding unsigned comment added by 24.177.12.102 (talk • contribs) 03:03, 13 July 2006

heroin-induced leukoencephalopathy

the problem of heroin-induced leukoencephalopathy needs to be discussed in this article.

there is information at heroinhelper here: http://www.heroinhelper.com/user/health/leukoencephalopathy.shtml

also there are various news stories to be found on google news or elsewhere.

apparently the disease effects only those who ingest heroin by means of smoking because of an uncommon adulterant that is activated by heating.

Harlequence 10:29, 29 July 2006 (UTC)

metabolism of opiates/opioids/semi-synthetics

The article incorrectly states that all opiates are converted 'to the identical molecule', unless you do not consider semi-synthetic opiates to be opiates.

Quote:

All opiates are converted by the human liver into the identical molecule with varying degrees of concentration in the blood stream. The company felt somewhat embarrassed by this new finding and it became a historical blunder for Bayer [1].

I must assume they mean morphine by 'the identical molecule'. While codeine, diacetylmorphine, and others are converted to morphine in the body, others like oxycodone, oxymorphine, and hydromorphone are to my knowledge not converted to morphine, and even if they were converted to it by some small metabolic pathway, this is not an important aspect of how they work.

For the record I am a highly educated person as well as a long time abuser of heroin, other opiates, and many other licit and illicit drugs.

P.S. I found it laughable that one person on this discussion page thinks that heroin is usally sold in $10 amounts, and rarely in weight, and blah blah. This sounds like the very competitive New York City scene. The particualars of heroin sale differ across the world. In my community in urban Wisconsin, heroin is often sold user to user in $20 amounts or 'bags'. The term bindle is not used often. Serious dealers sell in fixed amounts usually contained in the corner of a plastic bag which is cut up and tied off. The knot is known as a 'nig know' because many dealers are black and the knots are very hard to open, thus making it hard to tamper with the heroin quickly (A runner might take someones money, buy the heroin, then try to take some heroin before returning it to the finnancier) The amounts are often called a mass, such as a half gram but might often weight 300-400 milligrams and vary in purity, selling for say $50 each, with price breaks for larger quantities. Most dealers sell a fairly consistent quantity, at 50-80 dollars per, sometimes staying in the bussiness for more than a decade. Almost everyone I know injects the drug, unless they began snorting the drug at first, eventually moving on to injecting (intravenously always).—Preceding unsigned comment added by 66.222.31.244 (talk • contribs)

--In Chicago, on the street (which is the major market), you purchase 'blows' for $10 a pop. 1/10 of a gram. But grams are usually sold as a bakers dozen called 'packs' for $100-120.

But what I really want to know is: Does the sort of molecular conversion that heroin and the like undergo in the liver occur in the same manner with other drugs, legal and/or illegal? I am very interested in the metabolization process, if that's what it would be called, this is the first I've heard of it. It that a regular thing for a drug to do, or is it only in opiates that you see that type of conversion?

I find it laughable that you seem to think that the heroin trade in urban Wisconsin is the same as it is in every area throughout the world. I live in Connecticut, and here a "bag" is from $5 to $10 depending on what kind of deal you get. We also have "bundles", which consist of 10 bags a piece and cost anywhere from $50 to $100, again depending on how good of a deal you get. In addition, a very large percentage of young heroin users in this area insufflate, or sniff, their heroin rather than shoot it. It has become rather en vogue in certain areas actually, and authorities are very worried about the significant rise in heroin use (primarily sniffing) among adolescents and young adults in this region over the past few years. It has become a middle and upper class problem as well, and is prominent in more affluent suburbs across the state- not just in the ghetto. I for one know about sniffing dope all too well, as I sniffed it pretty much daily for 2+ years without ever "moving on to injecting." My dealer, as a matter of fact, claims to have sniffed dope for the past 18 years and has never shot up. I don't know how true that is, however, but it doesn't matter anyway. I just figured that needed some sort of rebuttal.

Price?

In the article it says "..a pound of heroin powder can cost from $US5,000 to $US7,000.." This seems very wrong to me. This is about 10-15$/gram which can't be right. In Denmark the price is more like 100$/gram, and I can't see it being that much lower in the US. Am I misunderstanding something, or should I fix this? antabus 22:53, 24 August 2006 (UTC)

Usually things are a lot cheaper in bulk, so the price could be around there. I'd find a source before changing it. --Rory096 06:19, 27 August 2006 (UTC)

Smiles notation, I dunno if anyone likes this, but here ya go "CC(=O)OC1\C=C/[C@H]5[C@H]2Cc4ccc(OC(C)=O)c3OC1[C@]5(CCN2C)c34"

That's right I just edited this part but my efforts to put the reference to my small contibution are useless, can somebody put this link on the US $200K cost?

http://www.whitehousedrugpolicy.gov/publications/factsht/drugdata/index.html

thanks guys! —The preceding unsigned comment was added by Mquiroz (talk • contribs) .

That source you found, Mquiroz, is based on information that is at least five years old. Giving a price seems meaningless to me anyway because it fluctuates too much between regions, purity, sources etc. The price has been fact tagged since June 2. That is way too long. So I've removed the sentence. If anyone wants to put it back, please find us a reliable up-to-date source first. Sarah Ewart (Talk) 19:55, 17 October 2006 (UTC)

Solubility?

"Heroin is also widely and illegally used as a powerful and addictive drug that produces intense euphoria, which often disappears with increasing tolerance. It is thought that heroin's popularity with recreational users, compared to morphine or other opiates, comes from its somewhat different perceived effects[5]. 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."

Wouldn't the acetyl groups increase aqueous solubility instead of lipid solubility because of free electron pairs on the oxygen atoms?

No, because the acetyl groups mask alcohol groups which contribute to aqueous solubility through hydrogen bonding. Esters are, in general, less soluble in water than comparable alcohols. --Ed (Edgar181) 20:55, 11 September 2006 (UTC)

Origin of the word "Heroin"

Article states: "Afraid of the possible side effects of aspirin, Bayer registered heroin (probably from heroisch, German for heroic, chosen because in field studies people using the medicine felt "heroic""

Actually I thought the origin of the name came from the fact that it was the "Heroine" which was supposed to cure other addictions, e.g. morphine, cocaine, etc.? This is why sometimes you will see people spell the drug (incorrectly) as "heroine"... ? - Abscissa 14:01, 15 October 2006 (UTC)

-No, people are just idiots. Every dictionary I have ever seen traces the origins of the word to Heroisch.

Cost

I've searched this article, and nowhere does it mention the damage that heroin is doing. It seems to be missing a lot of statistics such as the number of people killed by heroin in the past few years, how many take it in the U.S., how big a portion of crime it is, the economic damage, etc. Could any of you put some statistics on the drug? Standing as it is, we don't know whether 10 people or a million people have died from heroin in the past year.Hadoren 05:16, 7 November 2006 (UTC)

Unless there are global statistics available, I don't think it is appropriate to insert a whole lot of domestic American statistics. This is meant to be an international article. Perhaps a new, separate article, eg "Heroin in the US," could be created if there is a need for us to publish those kinds of statistics. But I am very strongly against making this article American-centric. Sarah Ewart (Talk) 10:43, 14 November 2006 (UTC)

I agree with you that this article shouldn't be American-centric - it's already too focused on America as it is. But the problem still remains that you don't know anything about how much economic and social damage heroin does. For example, there's a gigantic section about overdosing. But it never says how many people die from overdoses or what the chance of dying is. Another example is about people going into rehab, and how the withdrawal symptoms make it so difficult. But it never says what percentage of people relapse or how many. It's a choice between these two evils, and I'd choose to have more information. Hadoren 07:02, 17 November 2006 (UTC)

removing this part "It is yummy and makes me feel good, also good with coke"

This is found under the heading about side effects "It is yummy and makes me feel good, also good with coke" i tried to edit the page, but it wouldn't let me. Didn't know how else to get rid of it PharmerJess 20:27, 12 December 2006 (UTC)

removing "Heroin is one of the most profitable illicit drugs since it is compact and easily concealed."

I'm not so sure about this. LSD is much more compact but is not profitable. Heroin is not much more compact than many other common illicit drugs anyway. I think the profitability of heroin is more a case of demand and ease of production. I'm gonna remove it.

Assessment comment

The comment(s) below were originally left at Talk:Heroin/Comments, and are posted here for posterity. Following several discussions in past years, these subpages are now deprecated. The comments may be irrelevant or outdated; if so, please feel free to remove this section.

As there is no GA-Class in the WP:Chem quality rating for historical reasons, this article is B-Class in the Chemicals WikiProject. Wim van Dorst (talk) 21:26, 11 June 2008 (UTC).

Last edited at 21:26, 11 June 2008 (UTC). Substituted at 20:30, 3 May 2016 (UTC)