[Heroin: a useful analgesic?].
BACKGROUND
In some countries, heroin is widely used as an analgesic agent.


METHODS
The literature describing the history, pharmacology and analgesic use of heroin was reviewed.


RESULTS
Heroin is a semi-synthetic morphine derivative. A century ago it was considered a panacea with numerous indications. Today it is best known as a drug of abuse, but is still in use as an analgesic. Most studies that compare heroin with other analgesics have methodological shortcomings; however, they generally indicate that heroin has a clinical effect not very different from morphine. An better aqueous solubility as compared to morphine may in some situations be advantageous. Because of a proposed incomplete cross-tolerance between heroin and other opioid analgesics, it may be used if the patient shows sub-therapeutic response to first-line opioids.


CONCLUSIONS
Although not well documented, heroin appears to be an effective analgesic with certain properties different from those of morphine. It may be of clinical value in conditions with acute and/or terminal pain.
Furunes
Håvard
H
Institutt for laboratoriemedisin, Det medisinske fakultet, Norges teknisk-naturvitenskapelige universitet, 7489 Trondheim. lars.slordal@medisin.ntnu.no
Spigset
Olav
O
Slørdal
Lars
L
D000328:Adult; D016362:Analgesia, Obstetrical; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D002648:Child; D005260:Female; D003932:Heroin / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D010146:Pain / Q000188:drug therapy; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control; D011247:Pregnancy; D013727:Terminal Care
D000701:Analgesics, Opioid; D003932:Heroin