Heroin cough syrup

Figure 7.1 Heroin cough syrup. Bettmann/CORBIS...

Users also have specific trends regarding how and with what they consume Ecstasy. Though generally taken orally in pill form, Boston users in their late teens and early twenties sometimes inject MDMA and ketamine intramuscularly, and Sioux Falls users increasingly crush and snort it. Ecstasy is also frequently taken in combination with or sequentially with alcohol, marijuana, or both. Other drugs are also taken with MDMA (LSD, GHB, ketamine, prescription pills, heroin, cough syrup, camphor/menthol inhalants, Viagra , and nitrous oxide). 

Ecstasy-related visits to hospital emergency rooms have skyrocketed in recent years, with approximately 250 reports of Ecstasy-related emergencies in 1994 to more than 4,500 in 2000. The majority of the visits are Ecstasy-induced malignant hyperthermia, the risk of which is increased when Ecstasy is combined with other drugs such as LSD ( candy flipping ), psychedelic mushrooms ( hippie flipping ), methamphetamine ( up Ecstasy ), heroin ( down Ecstasy ), and cocaine, Rohypnol, cough syrup, and antidepressants. 

Insom-X see GBL GHB Invigorate see GBL GHB Ionamin see Diet pills Iophen DM NR see Dextromethorphan Ischott see Catha edulis Isobutyl nitrite see Inhalants Isocarboxazid Marplan see Antidepressants Isosorbide see Diuretics Iubulu see Catha edulis J La rocha see Rohypnol La salade see Catha edulis LA turnarounds see Dextroamphetamine Lady see Heroin Lady K see Ketamine Laevoamphetamine see Amphetamines Laudanum see Opium Laughing gas see Nitrous oxide LBJ see PCP (phencyclidine) Leaky bolla see PCP (phencyclidine) Leaky leak see PCP (phencyclidine) Lean (codeine cough syrup) see Codeine... 

Morphine is also stiU in use today for extreme pain, as in cases of severe burns or open fractures, where its application is limited to emergencies, because of the significant risk of addiction. Conversely (+)-morphine, like (+)-codeine or (+)-heroin, possesses no analgesic effect. By comparison with (-)-morphine, (-)-codeine is much less effective however, it inhibits selectively the cough centre, and has a substantially lower potential for addiction. It is therefore the main component of many cough syrups. Thebaine, on the other hand, produces like strychnine severe convulsions, and finds therefore no therapeutic applica-... 

Heroin, the diacetate ester of morphine, does not occur in nature but can be synthesized from morphine. As shown in Figure 17.5, their structures differ in only one kind of functional group. Heroin is much more addictive than morphine and for that reason has no legal use in the United States. Codeine, a methyl ether of morphine, is one of the alkaloids in opium and is used in cough syrup and for relief of moderate pain. Codeine is less addictive than morphine, but its analgesic activity is only about one-fifth that of morphine. One of the most effective substitutes for morphine is meperidine, whose structure was identified in 1931, is now sold as Demerol. It is less addictive than morphine. 

For many centuries morphine and codeine, alkaloids found in the oriental poppy plant, have been used as effective painkillers. Codeine, which is structurally similar to morphine, is used in some prescription painkillers and cough syrups. Heroin, obtained by a chemical modification of morphine, is strongly addicting and is not used medically. The structure of the prescription drug OxyContin (oxycodone) used to relieve severe pain is similar to heroin. Today, there are an increasing number of deaths from OxyContin abuse because its physiological effects are also similar to those of heroin. 

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