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psx:substance/heroin/claim/e2868f2b-cc9f-46f0-9c6c-2ec029da44b5

claim2026-04-20workinginconclusive

derived from · upstream

feeds · downstream

Closure of psx:substance/heroin/claim/e2868f2b-cc9f-46f0-9c6c-2ec029da44b5: 69 upstream, 72 downstream.

psx:substance/heroin/claim/e2868f2b-cc9f-46f0-9c6c-2ec029da44b5
├─ used  src/doi:10.1056/NEJMoa0810635
  ├─ informed_by  claim/8a9ada86-864a-42a9-84a8-d5b64b507519  Claim in history — inconclusive  working
  ├─ informed_by  claim/324fdc7a-a168-4183-8f55-f1bc6a56ff9a  Claim in history — inconclusive  working
  ├─ informed_by  claim/abac4b1f-9710-4e17-b494-77f62b1983f6  Claim in history — inconclusive  working
  ├─ informed_by  claim/f4530bd4-42dc-4225-ab8f-df3d2089a360  Claim in history — inconclusive  working
  ├─ informed_by  claim/8329cb53-690c-4b7b-8640-ae2e0a618050  Claim in history — supported
  ├─ informed_by  claim/ed3036cd-35ba-4f07-9b22-170ab428bdb5  Claim in history — inconclusive  working
  ├─ informed_by  claim/f2ed6566-57ed-4b4f-9f6c-e389a6e14bd6  Claim in history — inconclusive  working
  ├─ informed_by  claim/8e6c7642-3e17-44c3-a6a3-bc1a28c608fd  Claim in history — inconclusive  working
    ├─ used  src/url:53cdc84b596dcbe1  Heroin drug profile
    ├─ used  src/doi:10.1097/aia.0000000000000270  Opioid-free and opioid-sparing anesthesia
    ├─ used  src/doi:10.1192/bjp.bp.114.149195  Heroin on trial: systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addiction
    ├─ used  src/doi:10.15585/mmwr.mm7217a2  Rapid Analysis of Drugs: Pilot Surveillance System to Detect Changes in the Illicit Drug Supply - Eight Syringe Services Programs, Maryland, 2021-2022
    ├─ used  src/doi:10.1038/s41398-023-02406-5  Heroin and its metabolites: relevance to heroin use disorder
    ├─ used  src/doi:10.1111/bcpt.13926  Heroin metabolism in human blood and its impact for the design of an immunotherapeutic approach against heroin effects
    ├─ used  src/doi:10.1038/srep08126  Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach
    ├─ used  src/doi:10.1523/jneurosci.20-12-04555.2000  Chronic Heroin Self-Administration Desensitizes mu Opioid Receptor-Activated G-Proteins in Specific Regions of Rat Brain
    ├─ used  src/doi:10.1136/bmj.j1550  Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies
    ├─ used  src/doi:10.1016/s0140-6736(16)00619-x  Public health and international drug policy
    ├─ used  src/url:3f26882996785e95  Heroin legal scheduling: Schedule I (US), Class A Schedule 2 (UK)
    ├─ used  src/pmid:12644733  Evaluating long-term effects of heroin-assisted treatment: the results of a 6-year follow-up
    ├─ used  src/pmid:14665805  Dosage regimes in the prescription of heroin and other narcotics to chronic opioid addicts in Switzerland - Swiss national cohort study
    ├─ used  src/url:ec6a997c8b8d7efa  NIST WebBook: Diacetylmorphine CAS 561-27-3 Physical Properties
    ├─ used  src/doi:10.1021/acschemneuro.9b00305  6-Monoacetylmorphine (6-MAM), Not Morphine, Is Responsible for the Rapid Neural Effects Induced by Intravenous Heroin
    ├─ used  src/doi:10.1007/s40263-025-01189-1  Pharmacokinetics and Pharmacodynamics of Intranasal Diacetylmorphine in Heroin-Assisted Treatment for Severe Opioid Use Disorder
    ├─ used  src/doi:10.1002/dta.2492  Postmortem tissue distribution of morphine and its metabolites in a series of heroin-related deaths
    ├─ used  src/doi:10.1016/j.yrtph.2010.12.007  Uniform assessment and ranking of opioid mu receptor binding constants for selected opioid drugs
    ├─ used  src/doi:10.1177/1740774509105222  Scientific and political challenges in North America's first randomized controlled trial of heroin-assisted treatment for severe heroin addiction: rationale and design of the NAOMI study
    ├─ used  src/doi:10.1002/14651858.cd002207.pub4  Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence
    ├─ used  src/doi:10.1371/journal.pone.0140995  Understanding Heroin Overdose: A Study of the Acute Respiratory Depressant Effects of Injected Pharmaceutical Heroin
    ├─ used  src/doi:10.12968/hmed.2024.0941  Recent Innovations to Detect and Intervene to Prevent Opioid Overdose Deaths
    ├─ used  src/pmid:953867  Duration of analgesia in mice after heroin by two testing methods
    ├─ used  src/doi:10.1007/s00415-018-9131-1  Different routes of heroin intake cause various heroin-induced leukoencephalopathies
    ├─ used  src/doi:10.7759/cureus.97318  Chasing the Dragon Syndrome: A Case of Toxic Leukoencephalopathy and Response to Intravenous Immunoglobulin
    ├─ used  src/doi:10.7326/0003-4819-67-1-1  The Major Medical Complications of Heroin Addiction
    ├─ used  src/doi:10.1016/j.drugpo.2022.103872  Interventions to prevent HIV and Hepatitis C among people who inject drugs: Latest evidence of effectiveness from a systematic review (2011 to 2020)
    ├─ used  src/doi:10.1002/14651858.CD006318.pub4
    ├─ used  src/doi:10.1097/ANA.0000000000000876
    ├─ used  src/doi:10.1002/14651858.CD002025.pub5
    ├─ used  src/doi:10.1016/j.forsciint.2015.01.004  Evaluation of poly-drug use in methadone-related fatalities using segmental hair analysis
    ├─ derived_from  gen/dd9d2d24-e044-4253-b21e-bdc25fe76fc4  Generation — pipeline-v5
    ├─ generated_by  pub/5a221b6e-85a2-4d45-bec5-9597b7a0b935  Publication — backfill
      ├─ used  search/97b3a6fc-147a-4e23-9c45-3025a7e829cc  Searched PubChem for "heroin"
      ├─ used  search/f5a0f875-f7ec-4952-a9e2-8c7b5877c2af  Searched PubMed for "heroin diacetylmorphine pharmacology receptor binding opioid"
      ├─ used  search/97b3dd07-5380-4aa1-b2f0-f7f2b6999ac6  Searched OpenAlex for "heroin diacetylmorphine pharmacology opioid receptor"
      ├─ used  search/68428a81-934b-4049-b0d2-52deddbe938f  Searched PubMed for "heroin diacetylmorphine pharmacokinetics metabolism 6-monoacetylmorphine morphine human"
      ├─ used  search/4be294a7-e4e1-44e0-b85d-2f1716dcb856  Searched PubMed for "heroin overdose respiratory depression naloxone treatment mortality"
      ├─ used  search/6b01c8b3-645a-4477-8fff-f91fb24f2d6a  Searched PubMed for "heroin synthesis history Heinrich Dreser Bayer 1898 diacetylmorphine"
      ├─ used  search/8c5dc19b-347f-49ca-b190-f0a3e41d4297  Searched OpenAlex for "heroin diacetylmorphine history synthesis discovery 1898 Bayer"
      ├─ used  search/1acfb577-e887-4984-89bf-0dc34f09098b  Searched ClinicalTrials.gov for "heroin diacetylmorphine opioid use disorder treatment"
      ├─ used  search/6d66b01b-533f-46ac-9c7c-0e2fe2dd73d8  Searched PubMed for "NAOMI heroin assisted treatment randomized trial injectable diamorphine Canada"
      ├─ used  search/df0b9cb1-5b3a-43a7-8cd4-da4df2efe1e3  Searched PubMed for "heroin toxicity LD50 lethal dose lethality pharmacology"
      ├─ used  search/09b064ac-cb90-461b-a3fe-67e754203581  Searched PubMed for "heroin needle exchange harm reduction supervised injection overdose prevention"
      ├─ used  search/615cd4c0-edc9-4cc0-a95e-c5eb4f522309  Searched OpenAlex for "heroin Schedule I controlled substance legal status international drug policy prohibition"
      ├─ used  search/bbc03b29-bfb2-41b0-b988-2303fe27b051  Searched PubMed for "heroin fentanyl contamination adulteration street drug supply overdose"
      ├─ used  search/508eeb69-1734-43a3-be73-0213ef2802b8  Searched WebSearch + DEA for "heroin diacetylmorphine legal status Schedule I US UK Class A Controlled Substances Act scheduling"
      ├─ used  search/b3d61c63-f238-4199-a978-bceed6fd5dbd  Searched WebSearch for "heroin diacetylmorphine CAS number 561-27-3 SMILES synthesis Alder Wright 1874"
      ├─ used  search/7f2ee087-8713-41ec-8cbb-2754320e85e3  Searched WebSearch for "heroin pharmacokinetics half-life 6-MAM IV intranasal bioavailability"
      ├─ used  search/d44cc13d-cb20-40a2-b167-4548f4f60b9d  Searched EUDA Drug Profile
      ├─ used  search/7d63b969-71a8-493a-bf19-fce6aa186ba1  Searched PubMed for "diamorphine prescribed heroin randomized controlled trial outcomes response"
      ├─ used  search/d8f89855-8527-45f0-a21f-ec3d285f0790  Searched PubMed for "heroin opioid use disorder epidemiology global prevalence burden disease"
      ├─ used  search/43b27c03-2bef-44ba-9852-697f95e6c3a4  Searched OpenAlex for "heroin diacetylmorphine opioid tolerance physical dependence withdrawal mechanism"
      ├─ used  search/7df7d9f9-5ca5-4694-8dff-a129c33fd17b  Searched NIST WebBook for "diacetylmorphine CAS 561-27-3 physical properties"
      ├─ used  search/6a3c2534-fe9f-471a-b12a-ed83cd694dcc  Searched PubMed for "Oviedo-Joekes NAOMI diacetylmorphine versus methadone NEJM 2009"
      ├─ used  search/82ad01b8-69da-438a-b622-6b087e54c1a4  Searched Guide to Pharmacology IUPHAR/BPS for "diamorphine binding affinity opioid receptor Ki"
      ├─ used  search/1329c283-7688-467b-b236-cc9df6973e94  Searched WebSearch - Australia/Canada/Germany for "heroin legal status Australia Canada Germany Schedule classification 2024"
      ├─ used  search/d86fa827-b1b0-460e-9e18-d12aa219cb67  Searched PubMed for "leukoencephalopathy heroin inhalation toxic white matter brain MRI"
      ├─ used  search/db7fe79c-8002-4d29-957f-f348d49958b4  Searched PubMed for "xylazine veterinary sedative illicit drug supply opioid combination wounds overdose 2023"
      └─ used  search/e38d0a61-151d-4a5d-ac89-6c39cf6a3248  Searched PubMed for "heroin pregnancy fetal maternal opioid placenta neonatal abstinence"
├─ informed_by  section/history.full@1
  ├─ used  version/1  Revision 1
  ├─ used  claim/1d50b261-90e3-41a3-b4b9-7cb201fe82cb  Claim in clinical-evidence — inconclusive  working
  ├─ used  claim/c0236532-28c5-4d9c-a0e1-7f26b1e02adb  Claim in comparative-pharmacology — inconclusive  working
    ├─ derived_from  issue/notice@d31320da6719  Issued notice
    ├─ derived_from  issue/info_card@041e0b414482  Issued info_card
    ├─ derived_from  issue/emergency@f85b2d2362c9  Issued emergency
    ├─ derived_from  issue/info_card@3d5afa5bbd8d  Issued info_card
    ├─ informed_by  section/clinical-evidence.full@1
    ├─ informed_by  section/comparative-pharmacology.full@1
      ├─ used  claim/6da05e79-ef01-4098-9269-c3f2ec0338d5  Claim in summary — partially_supported
      ├─ used  claim/294195fe-ab87-42f3-984a-90ad9febd577  Claim in summary — inconclusive  working
      ├─ used  claim/2b7c6c5a-3436-463b-8da7-702bc9ae939a  Claim in clinical-evidence — inconclusive  working
      ├─ used  claim/d307eb8a-5f97-4340-8c11-e27eb5097154  Claim in summary — inconclusive  working
      ├─ used  claim/f0003477-6482-4f69-bca6-3366d4a4878f  Claim in comparative-pharmacology — inconclusive  working
      ├─ used  claim/6bf9a440-f45e-40fa-876f-e322d8d476cb  Claim in safety — inconclusive  working
      ├─ used  claim/c1d76ce0-e335-488c-9774-5d94f2f609f3  Claim in summary — supported
      ├─ used  claim/8d218fb9-a431-4745-ab8c-e52d7323533a  Claim in pharmacology — supported
      ├─ used  claim/b484e625-8ee4-4655-a247-2f645155d305  Claim in pharmacology — supported
      ├─ used  claim/09ef6e93-6e9a-461f-b736-69ed94c87d80  Claim in pharmacology — supported
      ├─ used  claim/7ba0651f-8a46-4fdb-a3b7-9c4c1854ad15  Claim in pharmacology — inconclusive  working
      ├─ used  claim/ed48d420-52a0-4121-9a15-6656a32ae6ff  Claim in receptor-pharmacology — not_supported  working
      ├─ used  claim/7bd5cd0e-8df8-4784-93b9-f9eb9fd4e6b6  Claim in receptor-pharmacology — supported
      ├─ used  claim/18f1ee6d-9bdd-4236-8eef-5b960c4c4862  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/4f2ad0c1-8f5a-4829-8123-4bf5e36466c2  Claim in comparative-pharmacology — supported
      ├─ used  claim/f8f2ba0e-01b9-4c05-b128-9b6b8c006a68  Claim in pharmacology — supported
      ├─ used  claim/ebea86c2-eada-44db-b3f0-5060c4a1d5e1  Claim in summary — supported
      ├─ used  claim/62751b3a-de47-4797-8699-0bc75162ac38  Claim in pharmacology — inconclusive  working
      ├─ used  claim/8dd4c6e7-f4f6-4684-b15e-c8cc792028fe  Claim in pharmacology — supported
      ├─ used  claim/d064847b-8b30-42a6-ae54-ccd29a5cc0f9  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/53dc658a-9e59-4058-b741-a267afa27de0  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/211931cf-b4b6-48d4-90f1-dd9cac4cf398  Claim in pharmacokinetic-detail — inconclusive  working
      ├─ used  claim/0addeae2-5af9-4ec5-9b79-19098a923ff8  Claim in summary — inconclusive  working
      ├─ used  claim/0afaaa2a-0886-4ed8-8526-38bfd904a294  Claim in comparative-pharmacology — inconclusive  working
      ├─ used  claim/16c4a774-eaeb-4dff-86bb-ca7d0e4b568c  Claim in safety — inconclusive  working
      ├─ used  claim/4c2c0cc4-b98d-464f-9c15-7295a17313f0  Claim in summary — inconclusive  working
      ├─ used  claim/f1a92678-c5ef-4ad6-ad48-695dba9066dc  Claim in safety — inconclusive  working
      ├─ used  claim/d611a990-40c2-475e-9182-328730265588  Claim in neuroscience — inconclusive  working
      ├─ used  claim/de02afc9-3886-4bdd-bb61-ef9f2b9cf5ba  Claim in summary — inconclusive  working
      ├─ used  claim/68bfffb8-7dbb-4fd9-883f-2a23f1550264  Claim in clinical-evidence — inconclusive  working
      ├─ used  claim/1b87b806-1bec-4580-ab36-5c46bcb8ad0f  Claim in safety — inconclusive  working
      ├─ used  claim/96d1db45-0236-405c-a756-1d4a27dd3491  Claim in legal-status — inconclusive  working
      ├─ used  claim/315a4aba-9dab-415c-be8f-093385828cbc  Claim in clinical-evidence — inconclusive  working
      ├─ used  claim/6d692d86-7bcb-42cb-9dea-c4b1c15bc270  Claim in clinical-evidence — inconclusive  working
      ├─ used  claim/fa31a872-a181-466e-8048-01525988ffe9  Claim in clinical-evidence — inconclusive  working
      ├─ used  claim/86c610d1-6bfe-4ddc-8199-18f5bcafab78  Claim in pharmacology — inconclusive  working
      ├─ used  claim/da5f7e2b-3346-4e37-abeb-2b33b3596058  Claim in receptor-pharmacology — inconclusive  working
      ├─ used  claim/ce7b00f8-5e0a-41fe-b8cc-f2f35b212cfb  Claim in comparative-pharmacology — supported
      ├─ used  claim/0f0cdcfb-66cd-4383-a570-28be00bfab34  Claim in neuroscience — supported
      ├─ used  claim/1612ce4a-3bd1-4d77-b5c2-60b94e4a301f  Claim in pharmacology — inconclusive  working
      ├─ used  claim/907400b7-036d-45d8-b610-4b5dd2d095b8  Claim in pharmacokinetic-detail — supported
      ├─ used  claim/1e8a30d7-dcf7-4338-b701-86d59cc2f9bb  Claim in pharmacology — supported
      ├─ used  claim/fb8b1d13-e005-4f52-9291-a2684e0249a1  Claim in pharmacology — supported
      ├─ used  claim/c3b1d08e-3c94-4418-90c2-1cbab3ab81f2  Claim in receptor-pharmacology — inconclusive  working
      ├─ used  claim/807cc1d8-d351-410c-a00a-c492d6b365b6  Claim in clinical-evidence — inconclusive  working
      ├─ used  claim/a8909021-f779-4b59-bb2e-d55095bec3f2  Claim in clinical-evidence — not_supported  working
      ├─ used  claim/15b25a81-a0de-41b3-81f0-c4f36334b784  Claim in safety — supported
      ├─ used  claim/b93e066e-f17a-4c3c-bc09-a43b0cbbf2b4  Claim in neuroscience — supported
      ├─ used  claim/d3a680c5-465d-407b-bac1-2f960b0e9725  Claim in safety — inconclusive  working
      ├─ used  claim/0d65dbad-9d04-4936-9741-3f7d1f7b6ce2  Claim in safety — inconclusive  working
      ├─ used  claim/e77c813a-8398-4321-a53c-a33ecd626c97  Claim in safety — inconclusive  working
      ├─ used  claim/af6f5a75-d99d-46ca-9b7b-79aa41424292  Claim in safety — inconclusive  working
      ├─ used  claim/72353166-f047-4141-9cd7-82f4ece85963  Claim in safety — supported
      ├─ used  claim/ecdfe02a-ee43-44c5-b9f0-51aeb156ee8a  Claim in safety — supported
      ├─ used  claim/d844052d-dad8-48cf-b263-57a3418a6c2e  Claim in safety — inconclusive  working
      ├─ used  claim/1d2e3399-af04-44d5-8e00-ae091de52f5c  Claim in safety — inconclusive  working
      ├─ used  claim/2b272636-f271-48b9-a0d1-dd11043c3e33  Claim in safety — inconclusive  working
      ├─ used  claim/92aa2ef7-cf66-4857-b7f1-73eff2ac6bdb  Claim in safety — inconclusive  working
      ├─ used  claim/5718ac1f-55d2-40b6-8f7b-f4532663d729  Claim in safety — inconclusive  working
      ├─ used  claim/59f77e77-66f1-4648-883e-a54da5a9d359  Claim in safety — inconclusive  working
      ├─ used  claim/ef7d542b-fd94-4083-ac57-e64942e31d0c  Claim in safety — inconclusive  working
      └─ used  claim/7ab7662e-d322-4e6a-bb75-df4d31220a61  Claim in safety — inconclusive  working
… closure truncated at 200 nodes

indented by distance from this node, not by parentage

1Provenance card

the boundary, as counts

Sources

3226 with DOI

15 strong · 13 moderate · 4 weak

Compilations

12026-04-20T11:42:41.827Z

pipeline-v5 · prompt hash not recorded — run predates 2026-09 · 1 other run

Decisions

54last ruled 2026-06-04

1 awaiting a ruling

Issued documents

42026-10-19T20:32:12.274Z

notice · info card · emergency

Searches

271 with no results

queries and counts on the build

Claims checked

7323 supported

23 supported · 50 not

Correspondence

0received

consent field ships in Phase 4

Edges

270

derivations recorded for this entity

Complete over 32 sources, 1 compilation, and 54 decisions.Not here: the private journal (never); 1 proposal awaiting a ruling (listed as pending only).Working material — drafts, discards, unsupported claims — is listed below and readable on the working page.Cite: psychedex.org/substances/heroin/archive

2Build

one panel per compilation run

generation run 2026-04-20

60 min completedmodel pipeline-v5plan not recordedrun/3685b523…

Selection

results seen180
selected by the model49
consumed as sources32

Verification

claims checked73
supported22
partially supported1
not supported2
inconclusive48
  • record
  • seen / partial
  • working

The model's own caveats

  • taper_protocol_is_substitution_based
  • post_abstinence_overdose_risk

Reproduce

inputs
32 source keys (listed under Sources)
plan
not recorded — template version, prompt hash and git SHA are written from 2026-09 onward
model
pipeline-v5
streams
none — agent transcripts are persisted from 2026-09 onward
27 searches — query, source, results, what was kept and why
27 searches for this run
#sourcequeryseenkeptrationale
1ClinicalTrials.govheroin diacetylmorphine opioid use disorder treatment103—
2PubMedheroin overdose respiratory depression naloxone treatment mortality103—
3PubMedheroin diacetylmorphine pharmacokinetics metabolism 6-monoacetylmorphine morphine human106—
4PubMed · absenceheroin synthesis history Heinrich Dreser Bayer 1898 diacetylmorphine0—Will search OpenAlex and web for history
5OpenAlexheroin diacetylmorphine history synthesis discovery 1898 Bayer81Useful historical timeline embedded in this review article
6PubChemheroin11All chemical identity data selected for verification of seed data
7OpenAlexheroin diacetylmorphine pharmacology opioid receptor102Selected landmark papers on heroin treatment and complications
8PubMedheroin diacetylmorphine pharmacology receptor binding opioid112—
9PubMedheroin needle exchange harm reduction supervised injection overdose prevention83—
10OpenAlexheroin Schedule I controlled substance legal status international drug policy prohibition82—
11PubMedNAOMI heroin assisted treatment randomized trial injectable diamorphine Canada42—
12PubMedheroin fentanyl contamination adulteration street drug supply overdose81—
13PubMedheroin toxicity LD50 lethal dose lethality pharmacology82—
14OpenAlexheroin diacetylmorphine opioid tolerance physical dependence withdrawal mechanism81—
15WebSearch + DEAheroin diacetylmorphine legal status Schedule I US UK Class A Controlled Substances Act scheduling103Key legal status data for all major jurisdictions
16PubMeddiamorphine prescribed heroin randomized controlled trial outcomes response81—
17WebSearchheroin pharmacokinetics half-life 6-MAM IV intranasal bioavailability103Critical PK data for all ROAs
18WebSearchheroin diacetylmorphine CAS number 561-27-3 SMILES synthesis Alder Wright 1874103Essential chemical identity and history data
19EUDA Drug Profile———Official EU agency drug profile with verified pharmacological data
20PubMedheroin opioid use disorder epidemiology global prevalence burden disease81—
21WebSearch - Australia/Canada/Germanyheroin legal status Australia Canada Germany Schedule classification 2024153Multi-jurisdictional legal status coverage
22PubMedOviedo-Joekes NAOMI diacetylmorphine versus methadone NEJM 200911Landmark RCT for heroin-assisted treatment
23NIST WebBookdiacetylmorphine CAS 561-27-3 physical properties1—Key physical property data for heroin article
24Guide to Pharmacology IUPHAR/BPSdiamorphine binding affinity opioid receptor Ki1—Confirms prodrug mechanism; no direct receptor affinity data available from this source
25PubMedleukoencephalopathy heroin inhalation toxic white matter brain MRI62—
26PubMedxylazine veterinary sedative illicit drug supply opioid combination wounds overdose 202311—
27PubMedheroin pregnancy fetal maternal opioid placenta neonatal abstinence52—
73 claims by section — every cited sentence, checked against its source
safety19 · 3 ok
  • Claim in safety — inconclusiveinconclusiveworking →

  • Significant respiratory depression (elevated ETCO₂) occurs in the majority of patients at therapeutic doses — Jolley et al. (2015) observed clinically meaningful hypoventilation in 8 of 10 HAT patients within 30 minutes of supervised injectionsupported

    Significant respiratory depression (increased ETCO2%) following IOT in 8/10 patients at 30 minutes. Hypoventilation reliably detected by capnography but not SpO2 alone. journal.pone.0140995

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Infective endocarditis: right-sided predominance, Staphylococcus aureus and Candida speciessupported

    Landmark review of medical complications of heroin addiction including endocarditis, pulmonary edema, hepatitis, tetanus, and malaria from shared needles. 0003-4819-67-1-1

  • Claim in safety — inconclusiveinconclusiveworking →

  • Septicemia, skin and soft tissue abscesses, tetanussupported

    Landmark review of medical complications of heroin addiction including endocarditis, pulmonary edema, hepatitis, tetanus, and malaria from shared needles. 0003-4819-67-1-1

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

  • Claim in safety — inconclusiveinconclusiveworking →

pharmacology11 · 7 ok
  • At concentrations attainable shortly after IV injection, approximately 70% of heroin transforms to 6-MAM within 3 minutessupported

    About 70% transformed to 6-MAM within 3 min after IV injection. bcpt.13926

  • Vitreous humor is the optimal postmortem matrix for confirming heroin usesupported

    Vitreous humor best for detecting 6-MAM (100% of cases). dta.2492

  • Morphine is subsequently glucuronidated to morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G).supported

    Reviews pharmacokinetics and pharmacodynamics of heroin and metabolites (6-MAM, morphine, M6G). s41398-023-02406-5

  • Current evidence supports a more complex interplay: heroin itself may possess some direct CNS activity, and the sequential actions of heroin, 6-MAM, morphine, and M6G only partially overlap in time, producing the distinctive temporal pattern of heroin's effects that distinguishes it from equivalent doses of morphine.supported

    arguing heroin is not merely a prodrug but has distinct pharmacological effects. s41398-023-02406-5

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Both 6-MAM and heroin are substantially more lipid-soluble than morphine, enabling faster and more complete blood-brain barrier transit.supported

    Reviews pharmacokinetics and pharmacodynamics of heroin and metabolites (6-MAM, morphine, M6G). s41398-023-02406-5

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Claim in pharmacology — inconclusiveinconclusiveworking →

  • Heroin plasma half-life: Highly concentration-dependent — 1.2–1.7 minutes at concentrations ≥25 μM, increasing to approximately 20 minutes at 1 μM concentrationssupported

    Half-life of heroin in human blood was highly concentration dependent, ranging from 1.2–1.7 min for concentrations ≥25 μM to ~20 min for 1 μM. bcpt.13926

  • Co-present markers of illicit heroin include papaverine, noscapine, and codeine — opium alkaloid impurities carried through illicit manufacture.supported

    Papaverine, noscapine, codeine as markers of illicit heroin use. dta.2492

history9 · 1 ok
  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • 1924: The US Anti-Heroin Act banned heroin entirely, including for medical use — making the United States the first country to prohibit the substance outrightsupported

    banned by federal government in 1924. aia.0000000000000270

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

  • Claim in history — inconclusiveinconclusiveworking →

clinical-evidence8 · 0 ok
  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • Claim in clinical-evidence — not_supportednot supportedworking →

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

  • Claim in clinical-evidence — inconclusiveinconclusiveworking →

summary8 · 3 ok
  • Alder Wright in 1874 and commercialized by Bayer in 1898 as a cough suppressant, heroin became the most widely studied substance of abuse in the 20th centurypartially supported

    Mentions diacetylmorphine synthesized in 1897, marketed as heroin in 1898 by Bayer, banned by federal government in 1924. aia.0000000000000270

  • Claim in summary — inconclusiveinconclusiveworking →

  • Claim in summary — inconclusiveinconclusiveworking →

  • Sequential deacetylation produces 6-monoacetylmorphine (6-MAM) — the primary mediator of rapid neural effects — followed by morphine and morphine-6-glucuronide (M6G)supported

    Reviews pharmacokinetics and pharmacodynamics of heroin and metabolites (6-MAM, morphine, M6G), arguing heroin is not merely a prodrug but has distinct pharmacological effects. s41398-023-02406-5

  • The plasma half-life is concentration-dependent (1.2–1.7 minutes at concentrations ≥25 μM), with approximately 70% converting to 6-MAM within 3 minutes of intravenous injectionsupported

    Half-life of heroin in human blood was highly concentration dependent, ranging from 1.2–1.7 min for concentrations ≥25 μM to ~20 min for 1 μM. About 70% transformed to 6-MAM within 3 min after IV injection. bcpt.13926

  • Claim in summary — inconclusiveinconclusiveworking →

  • Claim in summary — inconclusiveinconclusiveworking →

  • Claim in summary — inconclusiveinconclusiveworking →

comparative-pharmacology5 · 2 ok
  • Claim in comparative-pharmacology — inconclusiveinconclusiveworking →

  • Claim in comparative-pharmacology — inconclusiveinconclusiveworking →

  • 6-MAM mediation: The rapid neural effects of IV heroin are attributable to 6-MAM, not morphine — morphine alone cannot replicate the characteristic rushsupported

    demonstrates that 6-MAM (not morphine) mediates the rapid neural effects of IV heroin, including respiratory depression and cerebral vasodilation. acschemneuro.9b00305

  • Temporal cascade: Sequential metabolite formation produces a temporal effect profile distinct from equianalgesic morphinesupported

    arguing heroin is not merely a prodrug but has distinct pharmacological effects. s41398-023-02406-5

  • Claim in comparative-pharmacology — inconclusiveinconclusiveworking →

pharmacokinetic-detail5 · 4 ok
  • Data sources: IV parameters from Bogen et al. 2023; intranasal bioavailability from Guessoum et al. 2025; BBB penetration from EUDA.supported

    Half-life of heroin in human blood was highly concentration dependent... About 70% transformed to 6-MAM within 3 min after IV injection. bcpt.13926

  • Data sources: IV parameters from Bogen et al. 2023; intranasal bioavailability from Guessoum et al. 2025; BBB penetration from EUDA.supported

    Characterizes PK/PD of therapeutically-relevant intranasal doses of diacetylmorphine and metabolites. s40263-025-01189-1

  • As concentrations fall to ~1 μM, the half-life extends to approximately 20 minutessupported

    ranging from 1.2–1.7 min for concentrations ≥25 μM to ~20 min for 1 μM. bcpt.13926

  • Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →

  • The sequential metabolite formation follows overlapping time-concentration profiles:supported

    Reviews pharmacokinetics and pharmacodynamics of heroin and metabolites (6-MAM, morphine, M6G). s41398-023-02406-5

receptor-pharmacology4 · 1 ok
  • Claim in receptor-pharmacology — not_supportednot supportedworking →

  • Claim in receptor-pharmacology — inconclusiveinconclusiveworking →

  • Claim in receptor-pharmacology — inconclusiveinconclusiveworking →

  • This cascade model explains why heroin's subjective effects differ qualitatively from equianalgesic doses of morphine despite shared receptor targets.supported

    arguing heroin is not merely a prodrug but has distinct pharmacological effects. s41398-023-02406-5

neuroscience3 · 2 ok
  • This biphasic pattern was absent with equimolar morphine, confirming 6-MAM as the critical mediator of heroin's rewarding onset.supported

    Using oxygen sensors in nucleus accumbens, demonstrates that 6-MAM (not morphine) mediates the rapid neural effects of IV heroin. acschemneuro.9b00305

  • Jolley et al. (2015) documented significant increases in end-tidal CO₂ (ETCO₂) in 8 of 10 HAT patients within 30 minutes of supervised injection, indicating clinically meaningful hypoventilation that was reliably detected by capnography but not by pulse oximetry alone in early stages.supported

    Significant respiratory depression (increased ETCO2%) following IOT in 8/10 patients at 30 minutes. Hypoventilation reliably detected by capnography but not SpO2 alone. journal.pone.0140995

  • Claim in neuroscience — inconclusiveinconclusiveworking →

legal-status1 · 0 ok
  • Claim in legal-status — inconclusiveinconclusiveworking →

Other runs

  1. brief run2026-09-27completed4 minrun/e9c2511a…

3Sources

32 consumed · sorted by year · feeds = sections resting on it

Sources 1 to 30
yearsourcetierstatusfeeds
2025Chasing the Dragon Syndrome: A Case of Toxic Leukoencephalopathy and Response to Intravenous ImmunoglobulinPuri P, Shadan J, Akhavan M, Farrukh M, Durrani R · Cureusdoi:10.7759/cureus.97318weakconsumed1 section
2025Pharmacokinetics and Pharmacodynamics of Intranasal Diacetylmorphine in Heroin-Assisted Treatment for Severe Opioid Use DisorderGuessoum A, Vogt SB, Meyer M, et al. · CNS Drugsdoi:10.1007/s40263-025-01189-1strongconsumed2 sections
2025Recent Innovations to Detect and Intervene to Prevent Opioid Overdose DeathsStrang J, Appiah-Kusi E, Chesney E, et al. · British Journal of Hospital Medicinedoi:10.12968/hmed.2024.0941strongconsumed1 section
2024Heroin drug profileEuropean Union Drugs Agency (EUDA)url:53cdc84b596dcbe1weakconsumedcited only
2024Heroin legal scheduling: Schedule I (US), Class A Schedule 2 (UK)DEA Drug Scheduling; UK Misuse of Drugs Acturl:3f26882996785e95weakconsumedcited only
2024NIST WebBook: Diacetylmorphine CAS 561-27-3 Physical PropertiesNational Institute of Standards and Technologyurl:ec6a997c8b8d7efaweakconsumedcited only
2023Heroin and its metabolites: relevance to heroin use disorderMilella MS, D'Ottavio G, De Pirro S, Barra M, Caprioli D, Badiani A · Translational Psychiatrydoi:10.1038/s41398-023-02406-5strongconsumed5 sections
2023Heroin metabolism in human blood and its impact for the design of an immunotherapeutic approach against heroin effectsBogen IL, Boix F, Andersen JM, Steinsland S, Nerem E, Mørland J · Basic & Clinical Pharmacology & Toxicologydoi:10.1111/bcpt.13926moderateconsumed3 sections
2023Prenatal Opioid Exposure and Neurodevelopmental OutcomesLee JJ, Saraiya N, Kuzniewicz MW · Journal of Neurosurgical Anesthesiologydoi:10.1097/ana.0000000000000876strongconsumedcited only
2023Rapid Analysis of Drugs: Pilot Surveillance System to Detect Changes in the Illicit Drug Supply - Eight Syringe Services Programs, Maryland, 2021-2022Russell E, Sisco E, Thomson A, et al. · MMWR Morbidity and Mortality Weekly Reportdoi:10.15585/mmwr.mm7217a2moderateconsumed3 sections
2022Interventions to prevent HIV and Hepatitis C among people who inject drugs: Latest evidence of effectiveness from a systematic review (2011 to 2020)Palmateer N, Hamill V, Bergenstrom A, et al. · International Journal on Drug Policydoi:10.1016/j.drugpo.2022.103872strongconsumed1 section
2020Maintenance agonist treatments for opiate-dependent pregnant womenMinozzi S, Amato L, Jahanfar S, et al. · Cochrane Database of Systematic Reviewsdoi:10.1002/14651858.cd006318.pub4strongconsumedcited only
2020Opioid-free and opioid-sparing anesthesiaSiu EY, Moon TS · International Anesthesiology Clinicsdoi:10.1097/aia.0000000000000270moderateconsumed2 sections
20196-Monoacetylmorphine (6-MAM), Not Morphine, Is Responsible for the Rapid Neural Effects Induced by Intravenous HeroinPerekopskiy D, Kiyatkin EA · ACS Chemical Neurosciencedoi:10.1021/acschemneuro.9b00305moderateconsumed4 sections
2019Different routes of heroin intake cause various heroin-induced leukoencephalopathiesCheng MY, Chin SC, Chang YC, et al. · Journal of Neurologydoi:10.1007/s00415-018-9131-1moderateconsumed1 section
2019Postmortem tissue distribution of morphine and its metabolites in a series of heroin-related deathsMaskell PD, Wilson NE, Seetohul LN, et al. · Drug Testing and Analysisdoi:10.1002/dta.2492moderateconsumed1 section
2017Buprenorphine for managing opioid withdrawalGowing L, Ali R, White JM, Mbewe D · Cochrane Database of Systematic Reviewsdoi:10.1002/14651858.cd002025.pub5strongconsumedcited only
2017Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studiesSordo L, Barrio G, Bravo MJ, et al. · BMJdoi:10.1136/bmj.j1550strongconsumed3 sections
2016Public health and international drug policyCsete J, Kamarulzaman A, Kazatchkine M, et al. · The Lancetdoi:10.1016/s0140-6736(16)00619-xstrongconsumed2 sections
2015Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approachLachenmeier DW, Rehm J · Scientific Reportsdoi:10.1038/srep08126strongconsumed3 sections
2015Evaluation of poly-drug use in methadone-related fatalities using segmental hair analysisNielsen MK, Johansen SS, Linnet K · Forensic Science Internationaldoi:10.1016/j.forsciint.2015.01.004moderateconsumed1 section
2015Heroin on trial: systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addictionStrang J, Groshkova T, Uchtenhagen A, et al. · British Journal of Psychiatrydoi:10.1192/bjp.bp.114.149195strongconsumed3 sections
2015Understanding Heroin Overdose: A Study of the Acute Respiratory Depressant Effects of Injected Pharmaceutical HeroinJolley CJ, Bell J, Rafferty GF, Moxham J, Strang J · PLoS ONEdoi:10.1371/journal.pone.0140995moderateconsumed2 sections
2014Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependenceMattick RP, Breen C, Kimber J, Davoli M · Cochrane Database of Systematic Reviewsdoi:10.1002/14651858.cd002207.pub4strongconsumed1 section
2011Uniform assessment and ranking of opioid mu receptor binding constants for selected opioid drugsVolpe DA, McMahon Tobin GA, Mellon RD, et al. · Regulatory Toxicology and Pharmacologydoi:10.1016/j.yrtph.2010.12.007moderateconsumed1 section
2009Diacetylmorphine versus methadone for the treatment of opioid addictionOviedo-Joekes E, Brissette S, Marsh DC, et al. · New England Journal of Medicinedoi:10.1056/nejmoa0810635strongconsumedcited only
2009Scientific and political challenges in North America's first randomized controlled trial of heroin-assisted treatment for severe heroin addiction: rationale and design of the NAOMI studyOviedo-Joekes E, Nosyk B, Marsh DC, et al. · Clinical Trialsdoi:10.1177/1740774509105222strongconsumed1 section
2004Dosage regimes in the prescription of heroin and other narcotics to chronic opioid addicts in Switzerland - Swiss national cohort studyGschwend P, Rehm J, Blattler R, et al. · European Addiction Researchpmid:14665805moderateconsumed2 sections
2003Evaluating long-term effects of heroin-assisted treatment: the results of a 6-year follow-upGuettinger F, Gschwend P, Schulte B, Rehm J, Uchtenhagen A · European Addiction Researchpmid:12644733moderateconsumed2 sections
2000Chronic Heroin Self-Administration Desensitizes mu Opioid Receptor-Activated G-Proteins in Specific Regions of Rat BrainSim-Selley LJ, Selley DE, Vogt LJ, et al. · Journal of Neurosciencedoi:10.1523/jneurosci.20-12-04555.2000moderateconsumed3 sections
Show all 33 sources — 3 more
Sources 31 to 33
yearsourcetierstatusfeeds
1976Duration of analgesia in mice after heroin by two testing methodsBrands B, Hirst M, Gowdey CW · Canadian Journal of Physiology and Pharmacologypmid:953867moderateconsumed1 section
1967The Major Medical Complications of Heroin AddictionLouria DB, Hensle T, Rose J · Annals of Internal Medicinedoi:10.7326/0003-4819-67-1-1strongconsumed1 section
—Searched PubMed for "heroin synthesis history Heinrich Dreser Bayer 1898 diacetylmorphine" — no resultsabsenceno results—

4Docket

one filing per activity — decisions, correspondence, reports

awaiting ruling — 1

  • dependence · taper2026-07-03
  1. 0012026-04-20revisionRevision 1

    Initial LLM generation (v5 pipeline, wiki)

    psx:substance/heroin/version/1
  2. 0022026-06-04proposal50 value proposals approved together

    one review action inferred from a shared reviewer and instant — the graph records one activity per proposal

    50 items in this filing

    • dose_tier · light
    • dose_tier · common
    • dose_tier · strong
    • dose_tier · heavy
    • timeline · intravenous · onset
    • timeline · intravenous · come_up
    • timeline · intravenous · peak
    • timeline · intravenous · plateau
    • timeline · intravenous · resolution
    • timeline · intravenous · afterglow
    • timeline · insufflated · onset
    • timeline · insufflated · come_up
    • timeline · insufflated · peak
    • timeline · insufflated · resolution
    • timeline · insufflated · afterglow
    • timeline · smoked · onset
    • timeline · smoked · come_up
    • timeline · smoked · peak
    • timeline · smoked · resolution
    • timeline · smoked · afterglow
    • toxicity
    • dependence · full
    • withdrawal
    • tolerance
    • dosage · intravenous
    • dosage · insufflated
    • dosage · smoked
    • duration · intravenous · onset
    • duration · intravenous · come_up
    • duration · intravenous · peak
    • duration · intravenous · offset
    • duration · intravenous · total
    • duration · intravenous · aftereffects
    • duration · insufflated · onset
    • duration · insufflated · come_up
    • duration · insufflated · peak
    • duration · insufflated · total
    • duration · insufflated · aftereffects
    • duration · smoked · onset
    • duration · smoked · total
    • duration · smoked · aftereffects
    • contraindication · respiratory
    • contraindication · respiratory
    • contraindication · pregnancy_breastfeeding
    • contraindication · hepatic
    • contraindication · neurological
    • contraindication · psychiatric
    • contraindication · other
    • contraindication · other
    psx:substance/heroin/proposal/dose_tier/d0e2128d-4042-4a9f-b08e-e27a5df3d517
  3. 0032026-06-04publicationPublication — backfill
  4. 0042026-09-27revisionr1.a1

    brief-overview retired 2026-09-30 (founder): Description reads the essential summary for every substance.

    psx:substance/heroin/version/2

5Issued documents

what the notice, info card and emergency page said, by hash

Issued documents
documentcontent hashissuedfrom versionsuperseded
info_card3d5afa5bbd8d80ea9e8877fa…2026-10-19 20:32Revision 1current
emergencyf85b2d2362c98030e2585598…2026-09-04 04:30Revision 1current
info_card041e0b4144824b2bdb7e7656…2026-09-04 04:30Revision 1superseded2026-10-19
noticed31320da67194892361a041e…2026-09-04 04:30Revision 1current