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| {{short description|Impure form of heroin}} | |||
| ] | ] | ||
| '''Black tar heroin''', also known as '''black dragon''', is a form of ] that is sticky like ] or hard like ]. Its dark color is the result of crude processing methods that leave behind impurities. Despite its name, black tar heroin can also be dark orange or dark brown in appearance.<ref>{{Cite web |date=2014 |title=Types of Heroin |url=http://iprc.iu.edu/training/courses/heroin/a_01_04_01.html |website=Indiana Prevention Resource Center}}</ref> | |||
| '''Black Tar Heroin''' is a variety of ] produced primarily in ]. It is one of the most prevalent forms of heroin in the western United States, while occasionally found in western Canada and Europe. Mexican heroin has a hashish-like, non-powdery consistency (though it can also appear as a dark brown or dark orange powder and adulterated), which distinguishes itself from other forms of heroin. | |||
| Black tar heroin is impure diacetylmorphine. Other forms of heroin require additional steps of purification post ]. With black tar, the product's processing stops immediately after acetylation. Its unique consistency however is due to acetylation without a ]. As in ] in ] and ] the crude acetylation results in a gelatinous mass. | |||
| "Black tar heroin" is the typical street term for the drug,<ref name="cdc">See the ]'s from 2003, for example.</ref> but it has many other street (colloquial) names, such as: | |||
| * ''Pigment'' | |||
| * "Black" | |||
| * "Ache": the ] Pronunciation of the letter H. "H" is silent in Spanish so "ache" is pronounced "atchay" | |||
| * ''Negro'': the Spanish word for black | |||
| * ''Piedra'': the Spanish word for stone | |||
| * ''Chiva'': a Spanish word for a young goat | |||
| * ''Nut Job'' | |||
| * ''Capital B'' | |||
| * ''Cheesums'' | |||
| ⚫ | * |
||
| ==History== | |||
| {{Unreferenced section|date=March 2009}} | |||
| Mexican drug syndicates were producing heroin by the mid-1950s. Lacking the experience in chemistry that other syndicates had gained through years of illicit heroin production, Mexican organizations producing Tar substitute Acetyl Chloride or other less efficient glacial acetic acids for the usual acetylating agent, ]. | |||
| Black tar as a type holds a variable admixture of ] derivatives—predominantly ] (6-monoacetylmorphine), which is another result of crude acetylation. The lack of proper reflux during acetylation fails to remove much of the moisture retained in the acetylating agent, acetic anhydride. The acetic anhydride reacts with the moisture to produce the milder acetylating agent glacial acetic acid which is unable to acetylate the 3 position of the morphine molecule. | |||
| Pure morphine and heroin are both fine white and odorless powders. Tar's unique appearance and texture is due to its acetylation without benefit of the usual reflux apparatus. It should also be noted that the percent of the remainder of black tar heroin is often other psychoactive opiate substances, like ] & 3-MAM in addition to the usual adulterants and dilutents found in other forms of illicit heroin. | |||
| Black tar heroin is often produced in ],<ref name="Mexican Drug Exports">, retrieved 2015/04/04</ref><ref name="Heroin by Area of Origin"> {{Webarchive|url=https://web.archive.org/web/20150410170114/http://heroin.net/types-of-heroin/by-area-of-origin/ |date=2015-04-10 }}, retrieved 2015/04/04</ref> and is most commonly found in the western and southern parts of the ], while also being occasionally found in ]. It has a varying consistency depending on manufacturing methods, cutting agents, and moisture levels, from tarry goo in the unrefined form to a uniform, light-brown powder when further processed and cut with a variety of agents. One of the more notable compounds added to heroin is ].<ref>{{Cite web |date=2020-07-08 |title=What Is Heroin Cut With? - Sunshine Behavioral Health |url=https://www.sunshinebehavioralhealth.com/opioid/heroin/what-is-heroin-cut-with/ |access-date=2023-07-01 |website=Sunshine Behavioral Health |language=en-US}}</ref> | |||
| The abnormally high 3-MAM content is due to the less than optimum acetylating agent combined with a different reaction time for the acetylation procedure. Varying levels of 6-MAM are due to the process of ], a natural decomposition of heroin, though is accelerated when the heroin comes into contact with moisture. | |||
| ==Composition== | |||
| The mistaken assumption that Tar has less adulterants and dilutents is a misconception. The most common adulterant is lactose which is added to Tar via dissolution of both substances in a liquid medium, reheating and filtering, and then recrystallizing. This process is very simple and can be accomplished in any kitchen with no level of expertise needed. | |||
| Pure morphine and heroin are both fine white powders. Black tar heroin's unique appearance and texture are due to its acetylation without the benefit of the usual reflux apparatus.<ref>{{Cite web |year=1992 |title=Opium Poppy' Cultivation and Heroin Processing in Southeast Asia |url=https://www.ojp.gov/pdffiles1/Digitization/141189NCJRS.pdf |url-status=live |archive-url=https://web.archive.org/web/20231216202229/https://www.ojp.gov/pdffiles1/Digitization/141189NCJRS.pdf |archive-date=2023-12-16 |archive-format=PDF |access-date=2023-12-16 |website=] |pages=32–34 |language=en }}</ref> | |||
| The assumption that tar has fewer adulterants and diluents is a misconception.<ref>{{Cite book |last=Coomber |first=Ross |title=Pusher myths: re-situating the drug dealer |date=2006 |publisher=Free Association Books |isbn=978-1-85343-948-3 |location=London}}</ref> The most common adulterant is lactose,<ref>{{Cite journal |last1=Kumar |first1=Virkeshwar |last2=Dash |first2=Susmita |date=2021-10-07 |title=Evaporation-Based Low-Cost Method for the Detection of Adulterant in Milk |journal=ACS Omega |volume=6 |issue=41 |pages=27200–27207 |doi=10.1021/acsomega.1c03887 |issn=2470-1343 |pmc=8529649 |pmid=34693139}}</ref> which is added to tar via dissolving of both substances in a liquid medium, reheating and filtering, and then recrystallizing. This process is very simple and can be accomplished in any kitchen with no level of expertise needed.{{Citation needed|date=December 2023}} | |||
| ⚫ | The price per kilogram of black tar heroin has increased from one-tenth that of South American powder heroin in the mid-1990s to between one-half and three-quarters in 2003 due to increased distributional acumen combined with increased demand in |
||
| ⚫ | The price per kilogram of black tar heroin has increased from one-tenth that of South American powder heroin in the mid-1990s to between one-half and three-quarters in 2003 due to increased distributional acumen combined with increased demand in black tar's traditional realm of distribution. Black tar heroin distribution has steadily risen in recent years, while that of U.S. East Coast powder varieties has dropped; heroin production in Colombia decreased from the late 1990s into the early 2000s.<ref><https://web.archive.org/web/20101206095810/http://www.justice.gov/ndic/pubs31/31379/heroin.htm</ref> | ||
| ==Drug components and effects== | |||
| ==Adverse effects== | |||
| The effects of black tar heroin are identical to those of powder ]. This is because, although less refined than powder forms, black tar makes up for purity in potency through excess alkaloids left in its creation process which affect its course of action.{{Fact|date=March 2009}} Black tar heroin is found to contain byproducts such as ], U.S. ] microanalysis of seized black tar heroin was shown to contain over 50% and as much as 63% 6-MAM.<ref></ref> | |||
| People who ] black tar heroin are at higher | |||
| risk of venous ] than those injecting powder heroin. In this condition, the ]s narrow and harden which makes repeated injection there nearly impossible.<ref>{{Cite journal |last1=Pieper |first1=Barbara |last2=Templin |first2=Thomas N. |last3=Kirsner |first3=Robert S. |last4=Birk |first4=Thomas J. |date=2009 |title=Impact of injection drug use on distribution and severity of chronic venous disorders |journal=Wound Repair and Regeneration |volume=17 |issue=4 |pages=485–491 |doi=10.1111/j.1524-475X.2009.00513.x |issn=1067-1927 |pmc=2748060 |pmid=19614913}}</ref> | |||
| The presence of ] found in tar heroin has not been tested in humans but has been shown to be toxic alone and more toxic when mixed with mono- or di- acetyl morphine, potentially making tar more toxic than refined diamorphine.<ref>{{Cite journal |last1=Jones |first1=Joseph T. |last2=Jones |first2=Mary |last3=Jones |first3=Brian |last4=Sulaiman |first4=Kristin |last5=Plate |first5=Charles |last6=Lewis |first6=Douglas |year=2015 |title=Detection of Codeine, Morphine, 6-Monoacetylmorphine, and Meconin in Human Umbilical Cord Tissue: Method Validation and Evidence of In Utero Heroin Exposure |journal=Therapeutic Drug Monitoring |volume=37 |issue=1 |pages=45–52 |doi=10.1097/FTD.0000000000000104 |issn=0163-4356 |pmc=4297219 |pmid=24901495}}</ref><ref>{{Citation |last=Murrin |first=L. Charles |title=Heroin |date=2008-01-01 |url=https://www.sciencedirect.com/science/article/pii/B9780080552323638917 |work=xPharm: The Comprehensive Pharmacology Reference |pages=1–9 |editor-last=Enna |editor-first=S. J. |access-date=2023-12-16 |place=New York |publisher=Elsevier |isbn=978-0-08-055232-3 |editor2-last=Bylund |editor2-first=David B.}}</ref> | |||
| 6-monoacetylmorphine is more potent by weight, with less of a negative side effect per milligram, than heroin.{{Fact|date=March 2009}} Because of the consistency of black tar heroin, it is usually injected or smoked from strips of tinfoil. It can also be ground into powder or dissolved in water and snorted. Rectal administration is also possible after it has been dissolved in water. | |||
| Black tar heroin injectors can be at increased risk of life-threatening bacterial infections, in particular ] soft tissue infection.<ref>{{Cite journal |last1=Saldana |first1=Carlos S. |last2=Vyas |first2=Darshali A. |last3=Wurcel |first3=Alysse G. |date=2020-08-08 |title=Soft Tissue, Bone, and Joint Infections in People Who Inject Drugs |journal=Infectious Disease Clinics of North America |volume=34 |issue=3 |pages=495–509 |doi=10.1016/j.idc.2020.06.007 |issn=0891-5520 |pmc=8757538 |pmid=32782098}}</ref> The practice of "skin-popping" or subcutaneous injection predisposes to ] or necrotizing cellulitis from '']'', while deep intramuscular injection predisposes to necrotizing ].<ref>{{Cite journal |last1=Gonzales y Tucker |first1=Richard Diego |last2=Frazee |first2=Bradley |date=2014-12-01 |title=View from the front lines: An emergency medicine perspective on clostridial infections in injection drug users |url=https://www.sciencedirect.com/science/article/pii/S1075996414001267 |journal=Anaerobe |volume=30 |pages=108–115 |doi=10.1016/j.anaerobe.2014.09.005 |pmid=25230330 |issn=1075-9964}}</ref> | |||
| ==Health matters specific to black tar heroin== | |||
| Users who ] black tar heroin are at higher risk of venous ] (a condition where the veins narrow and harden, making injection there nearly impossible) than users of powder heroin. Researchers at ] have found that the rapidity with which black tar heroin destroys veins (forcing users to inject ]), along with its gummier consistency (requiring that needles be thoroughly rinsed between use), may put users at a lower risk of ] infection.<ref name="ucsf"> Although the decrease in HIV risk among IDU is maximised by the availability of clean injecting equipment and education around safer using and BBV </ref> | |||
| Tar heroin injection can also be associated with '']'' infection. Since the final stage of black tar heroin production would kill any spores (a combination of high temperature and strong acid), contamination is likely due to choice of cutting agent.<ref>{{Cite journal|last=Passaro|first=Douglas J.|date=1998-03-18|title=Wound Botulism Associated with Black Tar Heroin Among Injecting Drug Users|url=https://jamanetwork.com/journals/jama/fullarticle/187346|journal=JAMA|language=en|volume=279|issue=11|pages=859–863|doi=10.1001/jama.279.11.859|pmid=9516001|issn=0098-7484|doi-access=free}}</ref> Almost all cases occur in users who inject intramuscularly or subcutaneously, rather than injecting intravenously.<ref>{{Cite web|date=2018-10-09|title=Injection Drug Use and Wound Botulism |url=https://www.cdc.gov/botulism/wound-botulism.html|access-date=2021-06-19 |publisher=Centers for Disease Control and Prevention |language=en-us}}</ref> | |||
| ==Documentary== | |||
| The lifestyles of users are captured on the 1999 documentary ]. | |||
| Black tar heroin users can also be at increased risk of bone and joint infections that stem from ] seeding or local extension of the skin and soft tissue infections. Any joint can be infected, though previous studies have shown that the knee and hip are most commonly affected in heroin injectors. Associated bone infections can include septic ], septic ], and ]. ] and skin and soft tissue infections often present visible and/or systematic symptoms, while ] usually presents localized pain.<ref>{{cite journal |author1=Saldana, Carlos S. |author2=Vyas, Darshali, A. |author3=Wurcel, Alysse G. |title=Soft Tissue, Bone, and Joint Infections in People Who Inject Drugs |journal=Infectious Disease Clinics of North America |date=1 September 2020 |volume=34 |issue=3 |pages=495–509 |publisher=Elsevier Inc.|doi=10.1016/j.idc.2020.06.007 |pmid=32782098 |pmc=8757538 }}</ref> | |||
| ==Alternative routes of administration== | |||
| In some parts of the United States, black tar may be the only form of heroin that is available. Many users do not inject. | |||
| * Grinding into a powder form: This is one of the more popular ways of consuming black tar for those who do not wish to use needles. The black tar heroin is put into some sort of blender and mixed in with lactose. This creates a fine black powder product that can be easily snorted.<ref>{{Cite journal |last1=Maxwell |first1=Jane Carlisle |last2=Spence |first2=Richard T. |date=2006-01-01 |title=An Exploratory Study of Inhalers and Injectors Who Used Black Tar Heroin |journal=Journal of Maintenance in the Addictions |volume=3 |issue=1 |pages=61–82 |doi=10.1300/J126v03n01_06 |issn=1091-1332 |pmc=3088121 |pmid=21552428}}</ref> | |||
| * Water looping: Water looping is when a user places the heroin in an empty eye dropper bottle, or a syringe with the needle removed. The user allows the heroin to completely dissolve into water and the solution is dropped into the nose. This at times can be wasteful if a user allows too much of the solution to go down the throat.<ref>{{Citation |last=de Virgilio |first=Christian |title=Question Sets and Answers |date=2015 |url=https://doi.org/10.1007/978-1-4939-1726-6_59 |work=Surgery: A Case Based Clinical Review |volume=156 |issue=3 |pages=591–699 |editor-last=de Virgilio |editor-first=Christian |access-date=2023-12-16 |place=New York, NY |publisher=Springer |language=en |doi=10.1007/978-1-4939-1726-6_59 |isbn=978-1-4939-1726-6 |pmc=7120678 |pmid=25061003 |editor2-last=Frank |editor2-first=Paul N. |editor3-last=Grigorian |editor3-first=Areg}}</ref> | |||
| * Vaporizing (]): A user puts the heroin on a piece of foil and heats the foil with a lighter underneath it. The user uses a straw or similar apparatus and inhales the vapor.<ref>{{Cite journal |last1=Strang |first1=J. |last2=Griffiths |first2=P. |last3=Gossop |first3=M. |date=June 1997 |title=Heroin smoking by 'chasing the dragon': origins and history |url=https://pubmed.ncbi.nlm.nih.gov/9246796/ |journal=Addiction |volume=92 |issue=6 |pages=673–683; discussion 685–695 |doi=10.1046/j.1360-0443.1997.9266734.x |doi-broken-date=22 December 2024 |issn=0965-2140 |pmid=9246796}}</ref> | |||
| * Drinking: This is done similar to the water looping method. Instead of being delivered through the nose, the solution is swallowed.<ref>{{Cite journal |last=Ciccarone |first=Daniel |date=May 2009 |title=Heroin in brown, black and white: Structural factors and medical consequences in the US heroin market |journal=The International Journal on Drug Policy |volume=20 |issue=3 |pages=277–282 |doi=10.1016/j.drugpo.2008.08.003 |issn=0955-3959 |pmc=2704563 |pmid=18945606}}</ref> | |||
| * Suppository: The most effective route of administration which does not require a needle, is accomplished by delivering a solution (via syringe) or lubricated mass of the narcotic deep into the rectum or vagina.<ref>{{Cite journal |last1=Mars |first1=Sarah G. |last2=Ondocsin |first2=Jeff |last3=Ciccarone |first3=Daniel |date=2018-05-16 |title=Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency |journal=Harm Reduction Journal |volume=15 |issue=1 |pages=26 |doi=10.1186/s12954-018-0232-z |issn=1477-7517 |pmc=5956544 |pmid=29769132 |doi-access=free }}</ref> | |||
| ==See also== | |||
| ⚫ | * ] | ||
| ==References== | ==References== | ||
| {{Reflist|2}} | |||
| <references /> | |||
| ⚫ | *, National Drug Intelligence Center. Accessed |
||
| ==External links== | |||
| ⚫ | * |
||
| ⚫ | * , ]. Accessed 30 December 2019. | ||
| ⚫ | * {{webarchive |url=http://webarchive.loc.gov/all/20010924215045/http://www.interpol.int/public/drugs/heroin/default.asp |title=''Heroin'', Interpol Drugs Sub-Directorate |date=2001-09-24}}. Accessed 15 December 2005. | ||
| {{Opioidergics}} | |||
| ] | ] | ||
| ] | |||
| ] | |||
Latest revision as of 00:52, 22 December 2024
Impure form of heroin
Black tar heroin, also known as black dragon, is a form of heroin that is sticky like tar or hard like coal. Its dark color is the result of crude processing methods that leave behind impurities. Despite its name, black tar heroin can also be dark orange or dark brown in appearance.
Black tar heroin is impure diacetylmorphine. Other forms of heroin require additional steps of purification post acetylation. With black tar, the product's processing stops immediately after acetylation. Its unique consistency however is due to acetylation without a reflux apparatus. As in homebake heroin in Australia and New Zealand the crude acetylation results in a gelatinous mass.
Black tar as a type holds a variable admixture of morphine derivatives—predominantly 6-MAM (6-monoacetylmorphine), which is another result of crude acetylation. The lack of proper reflux during acetylation fails to remove much of the moisture retained in the acetylating agent, acetic anhydride. The acetic anhydride reacts with the moisture to produce the milder acetylating agent glacial acetic acid which is unable to acetylate the 3 position of the morphine molecule.
Black tar heroin is often produced in Latin America, and is most commonly found in the western and southern parts of the United States, while also being occasionally found in Western Africa. It has a varying consistency depending on manufacturing methods, cutting agents, and moisture levels, from tarry goo in the unrefined form to a uniform, light-brown powder when further processed and cut with a variety of agents. One of the more notable compounds added to heroin is lactose.
Composition
Pure morphine and heroin are both fine white powders. Black tar heroin's unique appearance and texture are due to its acetylation without the benefit of the usual reflux apparatus.
The assumption that tar has fewer adulterants and diluents is a misconception. The most common adulterant is lactose, which is added to tar via dissolving of both substances in a liquid medium, reheating and filtering, and then recrystallizing. This process is very simple and can be accomplished in any kitchen with no level of expertise needed.
The price per kilogram of black tar heroin has increased from one-tenth that of South American powder heroin in the mid-1990s to between one-half and three-quarters in 2003 due to increased distributional acumen combined with increased demand in black tar's traditional realm of distribution. Black tar heroin distribution has steadily risen in recent years, while that of U.S. East Coast powder varieties has dropped; heroin production in Colombia decreased from the late 1990s into the early 2000s.
Adverse effects
People who intravenously inject black tar heroin are at higher risk of venous sclerosis than those injecting powder heroin. In this condition, the veins narrow and harden which makes repeated injection there nearly impossible.
The presence of 6-monoacetylcodeine found in tar heroin has not been tested in humans but has been shown to be toxic alone and more toxic when mixed with mono- or di- acetyl morphine, potentially making tar more toxic than refined diamorphine.
Black tar heroin injectors can be at increased risk of life-threatening bacterial infections, in particular necrotizing soft tissue infection. The practice of "skin-popping" or subcutaneous injection predisposes to necrotizing fasciitis or necrotizing cellulitis from Clostridium perfringens, while deep intramuscular injection predisposes to necrotizing myositis.
Tar heroin injection can also be associated with Clostridium botulinum infection. Since the final stage of black tar heroin production would kill any spores (a combination of high temperature and strong acid), contamination is likely due to choice of cutting agent. Almost all cases occur in users who inject intramuscularly or subcutaneously, rather than injecting intravenously.
Black tar heroin users can also be at increased risk of bone and joint infections that stem from hematogenous seeding or local extension of the skin and soft tissue infections. Any joint can be infected, though previous studies have shown that the knee and hip are most commonly affected in heroin injectors. Associated bone infections can include septic bursitis, septic tenosynovitis, and osteomyelitis. Septic arthritis and skin and soft tissue infections often present visible and/or systematic symptoms, while osteomyelitis usually presents localized pain.
Alternative routes of administration
In some parts of the United States, black tar may be the only form of heroin that is available. Many users do not inject.
- Grinding into a powder form: This is one of the more popular ways of consuming black tar for those who do not wish to use needles. The black tar heroin is put into some sort of blender and mixed in with lactose. This creates a fine black powder product that can be easily snorted.
- Water looping: Water looping is when a user places the heroin in an empty eye dropper bottle, or a syringe with the needle removed. The user allows the heroin to completely dissolve into water and the solution is dropped into the nose. This at times can be wasteful if a user allows too much of the solution to go down the throat.
- Vaporizing (Chasing the dragon): A user puts the heroin on a piece of foil and heats the foil with a lighter underneath it. The user uses a straw or similar apparatus and inhales the vapor.
- Drinking: This is done similar to the water looping method. Instead of being delivered through the nose, the solution is swallowed.
- Suppository: The most effective route of administration which does not require a needle, is accomplished by delivering a solution (via syringe) or lubricated mass of the narcotic deep into the rectum or vagina.
See also
References
- "Types of Heroin". Indiana Prevention Resource Center. 2014.
- "Mexican Drug Exports", retrieved 2015/04/04
- "Heroin by Area of Origin" Archived 2015-04-10 at the Wayback Machine, retrieved 2015/04/04
- "What Is Heroin Cut With? - Sunshine Behavioral Health". Sunshine Behavioral Health. 2020-07-08. Retrieved 2023-07-01.
- "Opium Poppy' Cultivation and Heroin Processing in Southeast Asia" (PDF). Department of Justice. 1992. pp. 32–34. Archived (PDF) from the original on 2023-12-16. Retrieved 2023-12-16.
- Coomber, Ross (2006). Pusher myths: re-situating the drug dealer. London: Free Association Books. ISBN 978-1-85343-948-3.
- Kumar, Virkeshwar; Dash, Susmita (2021-10-07). "Evaporation-Based Low-Cost Method for the Detection of Adulterant in Milk". ACS Omega. 6 (41): 27200–27207. doi:10.1021/acsomega.1c03887. ISSN 2470-1343. PMC 8529649. PMID 34693139.
- <https://web.archive.org/web/20101206095810/http://www.justice.gov/ndic/pubs31/31379/heroin.htm
- Pieper, Barbara; Templin, Thomas N.; Kirsner, Robert S.; Birk, Thomas J. (2009). "Impact of injection drug use on distribution and severity of chronic venous disorders". Wound Repair and Regeneration. 17 (4): 485–491. doi:10.1111/j.1524-475X.2009.00513.x. ISSN 1067-1927. PMC 2748060. PMID 19614913.
- Jones, Joseph T.; Jones, Mary; Jones, Brian; Sulaiman, Kristin; Plate, Charles; Lewis, Douglas (2015). "Detection of Codeine, Morphine, 6-Monoacetylmorphine, and Meconin in Human Umbilical Cord Tissue: Method Validation and Evidence of In Utero Heroin Exposure". Therapeutic Drug Monitoring. 37 (1): 45–52. doi:10.1097/FTD.0000000000000104. ISSN 0163-4356. PMC 4297219. PMID 24901495.
- Murrin, L. Charles (2008-01-01), Enna, S. J.; Bylund, David B. (eds.), "Heroin", xPharm: The Comprehensive Pharmacology Reference, New York: Elsevier, pp. 1–9, ISBN 978-0-08-055232-3, retrieved 2023-12-16
- Saldana, Carlos S.; Vyas, Darshali A.; Wurcel, Alysse G. (2020-08-08). "Soft Tissue, Bone, and Joint Infections in People Who Inject Drugs". Infectious Disease Clinics of North America. 34 (3): 495–509. doi:10.1016/j.idc.2020.06.007. ISSN 0891-5520. PMC 8757538. PMID 32782098.
- Gonzales y Tucker, Richard Diego; Frazee, Bradley (2014-12-01). "View from the front lines: An emergency medicine perspective on clostridial infections in injection drug users". Anaerobe. 30: 108–115. doi:10.1016/j.anaerobe.2014.09.005. ISSN 1075-9964. PMID 25230330.
- Passaro, Douglas J. (1998-03-18). "Wound Botulism Associated with Black Tar Heroin Among Injecting Drug Users". JAMA. 279 (11): 859–863. doi:10.1001/jama.279.11.859. ISSN 0098-7484. PMID 9516001.
- "Injection Drug Use and Wound Botulism". Centers for Disease Control and Prevention. 2018-10-09. Retrieved 2021-06-19.
- Saldana, Carlos S.; Vyas, Darshali, A.; Wurcel, Alysse G. (1 September 2020). "Soft Tissue, Bone, and Joint Infections in People Who Inject Drugs". Infectious Disease Clinics of North America. 34 (3). Elsevier Inc.: 495–509. doi:10.1016/j.idc.2020.06.007. PMC 8757538. PMID 32782098.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - Maxwell, Jane Carlisle; Spence, Richard T. (2006-01-01). "An Exploratory Study of Inhalers and Injectors Who Used Black Tar Heroin". Journal of Maintenance in the Addictions. 3 (1): 61–82. doi:10.1300/J126v03n01_06. ISSN 1091-1332. PMC 3088121. PMID 21552428.
- de Virgilio, Christian (2015), de Virgilio, Christian; Frank, Paul N.; Grigorian, Areg (eds.), "Question Sets and Answers", Surgery: A Case Based Clinical Review, vol. 156, no. 3, New York, NY: Springer, pp. 591–699, doi:10.1007/978-1-4939-1726-6_59, ISBN 978-1-4939-1726-6, PMC 7120678, PMID 25061003, retrieved 2023-12-16
- Strang, J.; Griffiths, P.; Gossop, M. (June 1997). "Heroin smoking by 'chasing the dragon': origins and history". Addiction. 92 (6): 673–683, discussion 685–695. doi:10.1046/j.1360-0443.1997.9266734.x (inactive 22 December 2024). ISSN 0965-2140. PMID 9246796.
{{cite journal}}: CS1 maint: DOI inactive as of December 2024 (link) - Ciccarone, Daniel (May 2009). "Heroin in brown, black and white: Structural factors and medical consequences in the US heroin market". The International Journal on Drug Policy. 20 (3): 277–282. doi:10.1016/j.drugpo.2008.08.003. ISSN 0955-3959. PMC 2704563. PMID 18945606.
- Mars, Sarah G.; Ondocsin, Jeff; Ciccarone, Daniel (2018-05-16). "Toots, tastes and tester shots: user accounts of drug sampling methods for gauging heroin potency". Harm Reduction Journal. 15 (1): 26. doi:10.1186/s12954-018-0232-z. ISSN 1477-7517. PMC 5956544. PMID 29769132.
External links
- National Drug Threat Assessment 2005, National Drug Intelligence Center. Accessed 30 December 2019.
- Heroin, Interpol Drugs Sub-Directorate at the Library of Congress Web Archives (archived 2001-09-24). Accessed 15 December 2005.