Forensic Testing of Drugs – III: Lethal Horrors of Heroin – ‘God’s Own Medicine’

Forensic Testing of Drugs – III: Lethal Horrors of Heroin – ‘God’s Own Medicine’

Mangalore Today News Network

By Dr. G. Shreekumar Menon & Dr. Nirmal Krishnan

Mangaluru, Jan 31, 2022: Heroin gets its name from the German word “heroisch,” which in English means heroic.When it made its advent, it was hailed by one and all as ‘God’s own medicine’, because it was believed to cure all ills.It is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin(diacetylmorphine)is a white or brown powder, or a black sticky substance known as black tar heroin. People inject, sniff, snort, or smoke heroin. It enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.

Heroin use is dangerous due to its immediate life-threatening properties related to a reduction in both breathing and heart rate.Heroin is extremely addictive no matter how it is administered; injection and smoking allow it to reach the brain the fastest and leads to heroin use disorder.Once Heroin enters the brain, it is converted to Morphine and binds rapidly to Opioid receptors. People who use Heroin report feeling a surge of pleasurable sensation—a "rush." The intensity of the rush is an indication of how much drug is taken and how rapidly the drug enters the brain and binds to the Opioid receptors. The rush is usually accompanied by a warm flushing of the skin, dry mouth, nausea, vomiting, and severe itching may also occur. After the initial effects, users will be drowsy for several hours; mental function gets clouded; heart function slows; and breathing is also severely slowed, sometimes it can become life-threatening. Slowed breathing can also lead to coma and permanent brain damage.

Once a person developsHeroin use disorder, seeking and using the drug becomes their sole purpose in life. Constant Heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that is difficult to reverse. Deterioration of the brain’s white matter due to Heroin use, affects decision-making abilities, the ability to regulate behaviour, and responses to stressful situations.

With any drug, not just Heroin specifically, there is a likelihood of violence. The person may become violent as part of their drug-seeking habits.  Addicts will go to any extent to get their regular dose of Heroin.

Withdrawal from Heroin is physically and mentally painful, and can have many unpleasant side effects. Psychosis is one potential side effect of withdrawal from Heroin. When this happens, the person will lose touch with reality and behave very irrationally. Psychosis is marked by symptoms like hallucinations, delusions, false beliefs, agitation, anxiety and mood changes.

Pure Heroin is difficult to obtain in the illicit drug market. Adulteration is done to make Heroin affordable to a large clientele, as also to deceive enforcement agencies.Hence, Forensic testing, becomes extremely challenging and complicated.

When Heroin enters the body, it is rapidly broken down into other substances called Metabolites. The half-life of Heroin in blood is just about three minutes.The half-life of a drug is the time it takes for the amount of a drug’s active substance in the human body to reduce by half. This depends on how the body processes and gets rid of the drug. It can vary from a few hours to a few days, or sometimes weeks. Usually,Heroin itself will be undetectable in the blood after about 15 minutes of consumption. However, Heroin’s Metabolites have longer half-lives, meaning they can be detected for a much longertime after consumption. 6-MAM (6 Mono Acetyl Morphine) is a Metabolite that is unique to Heroin. Drug tests will test for 6-MAM to confirm Heroin use specifically, as opposed to the use of other Opioids. The half-life of 6-MAM is 30 minutes, so it stays in the system for around 150 minutes — much longer than its parent drug, Heroin.

Since Heroin (Diacetyl Morphine) is a semi-synthetic opioid, which is manufactured by acetylation of Morphine, which is a natural compound, it rapidly gets metabolised inside the body by deacetylation of 1 acetyl group and forms 6-Mono Acetyl Morphine. Other metabolic products which may be produced are 3-Mono Acetyl Morphine, Morphine-3-Glucouronide and Morphine-6-Glucouronide. This rapid metabolism is a major hurdle for the detection of the drug inside the human body. Metabolites also are not stable compounds and this also gets broken down to Morphine or codeine, which is the natural counterpart of the synthetic compound and will be remaining in circulation for a little longer time before finally getting excreted in urine. Hence, the detection window is quite narrow and impractical, when it comes to the law enforcement agencies, seeking a positive test result from the laboratory, on apprehending a suspected Heroin consumption offender. The detection of the above-mentionedMetabolites is possible from body fluids like blood, urine and saliva which may give a positive test result.

Many a times, the issue faced in laboratories is that most of the tests cross-reacts,as the metabolic by products are similar for many other Opioid drugs and detection of street grade Heroin becomes difficult. Street grade Heroin is normally adulterated, purity is unknownand identity of adulterants is secret. Hence, laboratories find it tough to determine and confirm Heroin consumption.

The best possible way to detect presence of Heroin in blood sample is with immune assays like specific ELISA kits called as 6-AM assay kits. Spectroscopic assessment also can show positive results if done within a few hours of consumption of Heroin. Other methods involved in detection from blood arechromatography which again can detect stable Metabolites than Heroin itself.

Metabolites can be detected in the body fluids like saliva and sweat for up to24 hoursof the last usage. But it depends on the dosage and the regularity of the person using it. If it is done in an individual who is a habitual abuser, the detection is much easier in the body fluids that an occasional user. The methods involved are almost similar to the blood tests like immune assays and chromatography.
In urine, Metabolites can be detected for an extended period especially in a habituated person. Studies have shown positive results in spectrometry and chromatographic analysis even after a period of 72 to 96 hours after the last usage.

Hair is a very common sample which gives positive tests for a longer period. The reason being, the hair growth is a slower process and shows positive results for about three months in case of some drugs. But detection of Heroin from hair is still non-specific and inconclusive as the concentration is very low to be detected and tests can be inadequate todifferentiate between Heroin and other Opioids.
The rapid metabolism of Heroin is the main hurdle in detection of the drug in the body and many tests can give false positive if any related opioid (like Morphine a pain killer, Codeine containing cough syrup, or even if raw poppy seeds) are consumed by the person.

Heroin detection and confirmation can be a very tricky process and challenge for testing laboratories and enforcement agencies. Securing a conviction verdict from an NDPS (Narcotic Drugs and Psychotropic Substances) Court, for a suspected Heroin offender, on the basis of a vague laboratory test result, is a formidable task for the Prosecution. Hence, drug abusers prefer Heroin as the risk of detection is considerably less as compared to other drugs. Heroin continues to be the drug of choice for many drug abusers, and, putting an end to one of the most abused chemicals in the world,remains a distant dream.

Writers can be contacted at: shreemenon48@gmail.com and drnirmalknambiar@gmail.com