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Heroin

Heroin, also known as diacetylmorphine and diamorphine among other names, is a morphinan opioid substance synthesized from the dried latex of the Papaver somniferum plant; it is mainly used as a recreational drug for its euphoric effects. Medical-grade diamorphine is used as a pure hydrochloride salt. Various white and brown powders sold illegally around the world as heroin are routinely diluted with cutting agents. Black tar heroin is a variable admixture of morphine derivatives—predominantly 6-MAM (6-monoacetylmorphine), which is the result of crude acetylation during clandestine production of street heroin. Heroin is used medically in several countries to relieve pain, such as during childbirth or a heart attack, as well as in opioid replacement therapy.

It is typically injected, usually into a vein, but it can also be snorted, smoked, or inhaled. In a clinical context, the route of administration is most commonly intravenous injection; it may also be given by intramuscular or subcutaneous injection, as well as orally in the form of tablets. The onset of effects is usually rapid and lasts for a few hours.

Common side effects include respiratory depression (decreased breathing), dry mouth, drowsiness, impaired mental function, constipation, and addiction. Use by injection can also result in abscesses, infected heart valves, blood-borne infections, and pneumonia. After a history of long-term use, opioid withdrawal symptoms can begin within hours of the last use. When given by injection into a vein, heroin has two to three times the effect of a similar dose of morphine. It typically appears in the form of a white or brown powder.

Treatment of heroin addiction often includes behavioral therapy and medications. Medications can include buprenorphine, methadone, or naltrexone. A heroin overdose may be treated with naloxone. An estimated 17 million people use opiates, of which heroin is the most common, and opioid use resulted in 122,000 deaths. The total number of heroin users worldwide as of 2015 is believed to have increased in Africa, the Americas, and Asia since 2000. In the United States, approximately 1.6 percent of people have used heroin at some point. When people die from overdosing on a drug, the drug is usually an opioid and often heroin.

Heroin was first made by C. R. Alder Wright in 1874 from morphine, a natural product of the opium poppy. Internationally, heroin is controlled under Schedules I and IV of the Single Convention on Narcotic Drugs, and it is generally illegal to make, possess, or sell without a license. About 448 tons of heroin were made in 2016. In 2015, Afghanistan produced about 66% of the world's opium. Illegal heroin is often mixed with other substances such as sugar, starch, caffeine, quinine, or other opioids like fentanyl.

Recreational
Bayer's original trade name of heroin is typically used in non-medical settings. It is used as a recreational drug for the euphoria it induces. Anthropologist Michael Agar once described heroin as "the perfect whatever drug." Tolerance develops quickly, and increased doses are needed in order to achieve the same effects. Its popularity with recreational drug users, compared to morphine, reportedly stems from its perceived different effects.

Short-term addiction studies by the same researchers demonstrated that tolerance developed at a similar rate to both heroin and morphine. When compared to the opioids hydromorphone, fentanyl, oxycodone, and pethidine (meperidine), former addicts showed a strong preference for heroin and morphine, suggesting that heroin and morphine are particularly susceptible to misuse and causing dependence. Morphine and heroin were also much more likely to produce euphoria and other positive subjective effects when compared to these other opioids.

Medical uses
In the United States, heroin is not accepted as medically useful. Under the generic name diamorphine, heroin is prescribed as a strong pain medication in the United Kingdom, where it is administered via oral, subcutaneous, intramuscular, intrathecal, intranasal or intravenous routes. It may be prescribed for the treatment of acute pain, such as in severe physical trauma, myocardial infarction, post-surgical pain and chronic pain, including end-stage terminal illnesses. In other countries it is more common to use morphine or other strong opioids in these situations. In 2004, the National Institute for Health and Clinical Excellence produced guidance on the management of caesarean section, which recommended the use of intrathecal or epidural diamorphine for post-operative pain relief. For women who have had intrathecal opioids, there should be a minimum hourly observation of respiratory rate, sedation and pain scores for at least 12 hours for diamorphine and 24 hours for morphine. Women should be offered diamorphine (0.3–0.4 mg intrathecally) for intra- and postoperative analgesia because it reduces the need for supplemental analgesia after a caesarean section. Epidural diamorphine (2.5–5 mg) is a suitable alternative.

Diamorphine continues to be widely used in palliative care in the UK, where it is commonly given by the subcutaneous route, often via a syringe driver if patients cannot easily swallow morphine solution. The advantage of diamorphine over morphine is that diamorphine is more fat soluble and therefore more potent by injection, so smaller doses of it are needed for the same effect on pain. Both of these factors are advantageous if giving high doses of opioids via the subcutaneous route, which is often necessary for palliative care.

It is also used in the palliative management of bone fractures and other trauma, especially in children. In the trauma context, it is primarily given by nose in hospital; although a prepared nasal spray is available. It has traditionally been made by the attending physician, generally from the same "dry" ampoules as used for injection. In children, Ayendi nasal spray is available at 720 micrograms and 1600 micrograms per 50 microlitres actuation of the spray, which may be preferable as a non-invasive alternative in pediatric care, avoiding the fear of injection in children.

Maintenance therapy
A number of European countries prescribe heroin for treatment of heroin addiction. The initial Swiss HAT (heroin-assisted treatment) trial ("PROVE" study) was conducted as a prospective cohort study with some 1,000 participants in 18 treatment centers between 1994 and 1996, at the end of 2004, 1,200 patients were enrolled in HAT in 23 treatment centers across Switzerland. Diamorphine may be used as a maintenance drug to assist the treatment of opiate addiction, normally in long-term chronic intravenous (IV) heroin users. It is only prescribed following exhaustive efforts at treatment via other means. It is sometimes thought that heroin users can walk into a clinic and walk out with a prescription, but the process takes many weeks before a prescription for diamorphine is issued. Though this is somewhat controversial among proponents of a zero-tolerance drug policy, it has proven superior to methadone in improving the social and health situations of addicts.

The UK Department of Health's Rolleston Committee Report in 1926 established the British approach to diamorphine prescription to users, which was maintained for the next 40 years: dealers were prosecuted, but doctors could prescribe diamorphine to users when withdrawing. In 1964, the Brain Committee recommended that only selected approved doctors working at approved specialized centres be allowed to prescribe diamorphine and cocaine to users. The law was made more restrictive in 1968. Beginning in the 1970s, the emphasis shifted to abstinence and the use of methadone; currently, only a small number of users in the UK are prescribed diamorphine.

In 1994, Switzerland began a trial diamorphine maintenance program for users that had failed multiple withdrawal programs. The aim of this program was to maintain the health of the user by avoiding medical problems stemming from the illicit use of diamorphine. The first trial in 1994 involved 340 users, although enrollment was later expanded to 1000, based on the apparent success of the program. The trials proved diamorphine maintenance to be superior to other forms of treatment in improving the social and health situation for this group of patients. It has also been shown to save money, despite high treatment expenses, as it significantly reduces costs incurred by trials, incarceration, health interventions and delinquency. Patients appear twice daily at a treatment center, where they inject their dose of diamorphine under the supervision of medical staff. They are required to contribute about 450 Swiss francs per month to the treatment costs. A national referendum in November 2008 showed 68% of voters supported the plan, introducing diamorphine prescription into federal law. The previous trials were based on time-limited executive ordinances. The success of the Swiss trials led German, Dutch, and Canadian cities to try out their own diamorphine prescription programs. Some Australian cities (such as Sydney) have instituted legal diamorphine supervised injecting centers, in line with other wider harm minimization programs.

Since January 2009, Denmark has prescribed diamorphine to a few addicts who have tried methadone and buprenorphine without success. Beginning in February 2010, addicts in Copenhagen and Odense became eligible to receive free diamorphine. Later in 2010, other cities including Århus and Esbjerg joined the scheme. It was estimated that around 230 addicts would be able to receive free diamorphine.

However, Danish addicts would only be able to inject heroin according to the policy set by Danish National Board of Health. Of the estimated 1500 drug users who did not benefit from the then-current oral substitution treatment, approximately 900 would not be in the target group for treatment with injectable diamorphine, either because of "massive multiple drug abuse of non-opioids" or "not wanting treatment with injectable diamorphine".

In July 2009, the German Bundestag passed a law allowing diamorphine prescription as a standard treatment for addicts; a large-scale trial of diamorphine prescription had been authorized in the country in 2002.

On 26 August 2016, Health Canada issued regulations amending prior regulations it had issued under the Controlled Drugs and Substances Act; the "New Classes of Practitioners Regulations", the "Narcotic Control Regulations", and the "Food and Drug Regulations", to allow doctors to prescribe diamorphine to people who have a severe opioid addiction who have not responded to other treatments. The prescription heroin can be accessed by doctors through Health Canada's Special Access Programme (SAP) for "emergency access to drugs for patients with serious or life-threatening conditions when conventional treatments have failed, are unsuitable, or are unavailable."

Routes of administration
The onset of heroin's effects depends upon the route of administration. Smoking is the fastest route of drug administration, although intravenous injection results in a quicker rise in blood concentration. These are followed by suppository (anal or vaginal insertion), insufflation (snorting), and ingestion (swallowing).

A 2002 study suggests that a fast onset of action increases the reinforcing effects of addictive drugs. Ingestion does not produce a rush as a forerunner to the high experienced with the use of heroin, which is most pronounced with intravenous use. While the onset of the rush induced by injection can occur in as little as a few seconds, the oral route of administration requires approximately half an hour before the high sets in. Thus, with both higher the dosage of heroin used and faster the route of administration used, the higher the potential risk for psychological dependence/addiction.

Large doses of heroin can cause fatal respiratory depression, and the drug has been used for suicide or as a murder weapon. The serial killer Harold Shipman used diamorphine on his victims, and the subsequent Shipman Inquiry led to a tightening of the regulations surrounding the storage, prescribing and destruction of controlled drugs in the UK.

Because significant tolerance to respiratory depression develops quickly with continued use and is lost just as quickly during withdrawal, it is often difficult to determine whether a heroin lethal overdose was accidental, suicide or homicide. Examples include the overdose deaths of Sid Vicious, Janis Joplin, Tim Buckley, Hillel Slovak, Layne Staley, Bradley Nowell, Ted Binion, and River Phoenix.

By mouth
Use of heroin by mouth is less common than other methods of administration, mainly because there is little to no "rush", and the effects are less potent. Heroin is entirely converted to morphine by means of first-pass metabolism, resulting in deacetylation when ingested. Heroin's oral bioavailability is both dose-dependent (as is morphine's) and significantly higher than oral use of morphine itself, reaching up to 64.2% for high doses and 45.6% for low doses; opiate-naive users showed far less absorption of the drug at low doses, having bioavailabilities of only up to 22.9%. The maximum plasma concentration of morphine following oral administration of heroin was around twice as much as that of oral morphine.

Injection
Injection, also known as "slamming", "banging", "shooting up", "digging" or "mainlining", is a popular method which carries relatively greater risks than other methods of administration. Heroin base (commonly found in Europe), when prepared for injection, will only dissolve in water when mixed with an acid (most commonly citric acid powder or lemon juice) and heated. Heroin in the east-coast United States is most commonly found in the hydrochloride salt form, requiring just water (and no heat) to dissolve. Users tend to initially inject in the easily accessible arm veins, but as these veins collapse over time, users resort to more dangerous areas of the body, such as the femoral vein in the groin. Some medical professionals have expressed concern over this route of administration, as they suspect that it can lead to deep vein thrombosis.

Intravenous users can use a variable single dose range using a hypodermic needle. The dose of heroin used for recreational purposes is dependent on the frequency and level of use.

As with the injection of any drug, if a group of users share a common needle without sterilization procedures, blood-borne diseases, such as HIV/AIDS or hepatitis, can be transmitted. The use of a common dispenser for water for the use in the preparation of the injection, as well as the sharing of spoons and filters can also cause the spread of blood-borne diseases. Many countries now supply small sterile spoons and filters for single use in order to prevent the spread of disease.

Smoking
Smoking heroin refers to vaporizing it to inhale the resulting fumes, rather than burning and inhaling the smoke. It is commonly smoked in glass pipes made from glassblown Pyrex tubes and light bulbs. Heroin may be smoked from aluminium foil that is heated by a flame underneath it, with the resulting smoke inhaled through a tube of rolled up foil, a method also known as "chasing the dragon".

Insufflation
Another popular route to intake heroin is insufflation (snorting), where a user crushes the heroin into a fine powder and then gently inhales it (sometimes with a straw or a rolled-up banknote, as with cocaine) into the nose, where heroin is absorbed through the soft tissue in the mucous membrane of the sinus cavity and straight into the bloodstream. This method of administration redirects first-pass metabolism, with a quicker onset and higher bioavailability than oral administration, though the duration of action is shortened. This method is sometimes preferred by users who do not want to prepare and administer heroin for injection or smoking but still want to experience a fast onset. Snorting heroin becomes an often unwanted route, once a user begins to inject the drug. The user may still get high on the drug from snorting, and experience a nod, but will not get a rush. A "rush" is caused by a large amount of heroin entering the body at once. When the drug is taken in through the nose, the user does not get the rush because the drug is absorbed slowly rather than instantly.

Heroin for pain has been mixed with sterile water on site by the attending physician, and administered using a syringe with a nebulizer tip. Heroin may be used for fractures, burns, finger-tip injuries, suturing, and wound re-dressing, but is inappropriate in head injuries.

Suppository
Little research has been focused on the suppository (anal insertion) or pessary (vaginal insertion) methods of administration, also known as "plugging". These methods of administration are commonly carried out using an oral syringe. Heroin can be dissolved and withdrawn into an oral syringe which may then be lubricated and inserted into the anus or vagina before the plunger is pushed. The rectum or the vaginal canal is where the majority of the drug would likely be taken up, through the membranes lining their walls.

Adverse effects

Heroin is classified as a hard drug in terms of drug harmfulness. Like most opioids, unadulterated heroin may lead to adverse effects. The purity of street heroin varies greatly, leading to overdoses when the purity is higher than expected.

Short-term effects
Users report an intense rush, an acute transcendent state of euphoria, which occurs while diamorphine is being metabolized into 6-monoacetylmorphine (6-MAM) and morphine in the brain. Some believe that heroin produces more euphoria than other opioids; one possible explanation is the presence of 6-monoacetylmorphine, a metabolite unique to heroin – although a more likely explanation is the rapidity of onset. While other opioids of recreational use produce only morphine, heroin also leaves 6-MAM, also a psycho-active metabolite.

However, this perception is not supported by the results of clinical studies comparing the physiological and subjective effects of injected heroin and morphine in individuals formerly addicted to opioids; these subjects showed no preference for one drug over the other. Equipotent injected doses had comparable action courses, with no difference in subjects' self-rated feelings of euphoria, ambition, nervousness, relaxation, drowsiness, or sleepiness.

The rush is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities. Nausea, vomiting, and severe itching may also occur. After the initial effects, users usually will be drowsy for several hours; mental function is clouded; heart function slows, and breathing is also severely slowed, sometimes enough to be life-threatening. Slowed breathing can also lead to coma and permanent brain damage. Heroin use has also been associated with myocardial infarction.

Long-term effects
Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of the brain's white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations. Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence, the body adapts to the presence of the drug, and withdrawal symptoms occur if use is reduced abruptly.

Injection
Intravenous use of heroin (and any other substance) with needles and syringes or other related equipment may lead to:

 * Contracting blood-borne pathogens such as HIV and hepatitis via the sharing of needles
 * Contracting bacterial or fungal endocarditis and possibly venous sclerosis
 * Abscesses
 * Poisoning from contaminants added to "cut" or dilute heroin
 * Decreased kidney function (nephropathy), although it is not currently known if this is because of adulterants or infectious diseases

Withdrawal
The withdrawal syndrome from heroin may begin within as little as two hours of discontinuation of the drug; however, this time frame can fluctuate with the degree of tolerance as well as the amount of the last consumed dose, and more typically begins within 6–24 hours after cessation. Symptoms may include sweating, malaise, anxiety, depression, akathisia, priapism, extra sensitivity of the genitals in females, general feeling of heaviness, excessive yawning or sneezing, rhinorrhea, insomnia, cold sweats, chills, severe muscle and bone aches, nausea, vomiting, diarrhea, cramps, watery eyes, fever, cramp-like pains, and involuntary spasms in the limbs (thought to be an origin of the term "kicking the habit" ).

Overdose
Heroin overdose is usually treated with the opioid antagonist naloxone. This reverses the effects of heroin and causes an immediate return of consciousness but may result in withdrawal symptoms. The half-life of naloxone is shorter than some opioids, such that it may need to be given multiple times until the opioid has been metabolized by the body.

Between 2012 and 2015, heroin was the leading cause of drug-related deaths in the United States. Since then, fentanyl has been a more common cause of drug-related deaths.

Depending on drug interactions and numerous other factors, death from overdose can take anywhere from several minutes to several hours. Death usually occurs due to lack of oxygen resulting from the lack of breathing caused by the opioid. Heroin overdoses can occur because of an unexpected increase in the dose or purity or because of diminished opioid tolerance. However, many fatalities reported as overdoses are probably caused by interactions with other depressant drugs such as alcohol or benzodiazepines. Since heroin can cause nausea and vomiting, a significant number of deaths attributed to heroin overdose are caused by aspiration of vomit by an unconscious person. Some sources quote the median lethal dose (for an average 75 kg opiate-naive individual) as being between 75 and 600 mg. Illicit heroin is of widely varying and unpredictable purity. This means that the user may prepare what they consider to be a moderate dose while actually taking far more than intended. Also, tolerance typically decreases after a period of abstinence. If this occurs and the user takes a dose comparable to their previous use, the user may experience drug effects that are much greater than expected, potentially resulting in an overdose. It has been speculated that an unknown portion of heroin-related deaths are the result of an overdose or allergic reaction to quinine, which may sometimes be used as a cutting agent.

Pharmacology
When taken orally, heroin undergoes extensive first-pass metabolism via deacetylation, making it a prodrug for the systemic delivery of morphine. When the drug is injected, however, it avoids this first-pass effect, very rapidly crossing the blood–brain barrier because of the presence of the acetyl groups, which render it much more fat soluble than morphine itself. Once in the brain, it then is deacetylated variously into the inactive 3-monoacetylmorphine and the active 6-monoacetylmorphine (6-MAM), and then to morphine, which bind to μ-opioid receptors, resulting in the drug's euphoric, analgesic (pain relief), and anxiolytic (anti-anxiety) effects; heroin itself exhibits relatively low affinity for the μ receptor. Analgesia follows from the activation of the μ receptor G-protein coupled receptor, which indirectly hyperpolarizes the neuron, reducing the release of nociceptive neurotransmitters, and hence, causes analgesia and increased pain tolerance.

Unlike hydromorphone and oxymorphone, however, administered intravenously, heroin creates a larger histamine release, similar to morphine, resulting in the feeling of a greater subjective "body high" to some, but also instances of pruritus (itching) when they first start using.

Normally, GABA, which is released from inhibitory neurones, inhibits the release of dopamine. Opiates, like heroin and morphine, decrease the inhibitory activity of such neurones. This causes increased release of dopamine in the brain which is the reason for euphoric and rewarding effects of heroin.

Both morphine and 6-MAM are μ-opioid agonists that bind to receptors present throughout the brain, spinal cord, and gut of all mammals. The μ-opioid receptor also binds endogenous opioid peptides such as β-endorphin, leu-enkephalin, and met-enkephalin. Repeated use of heroin results in a number of physiological changes, including an increase in the production of μ-opioid receptors (upregulation). These physiological alterations lead to tolerance and dependence, so that stopping heroin use results in uncomfortable symptoms including pain, anxiety, muscle spasms, and insomnia called the opioid withdrawal syndrome. Depending on usage it has an onset 4–24 hours after the last dose of heroin. Morphine also binds to δ- and κ-opioid receptors.

There is also evidence that 6-MAM binds to a subtype of μ-opioid receptors that are also activated by the morphine metabolite morphine-6β-glucuronide but not morphine itself. The third subtype of third opioid type is the mu-3 receptor, which may be a commonality to other six-position monoesters of morphine. The contribution of these receptors to the overall pharmacology of heroin remains unknown.

A subclass of morphine derivatives, namely the 3,6 esters of morphine, with similar effects and uses, includes the clinically used strong analgesics nicomorphine (Vilan), and dipropanoylmorphine; there is also the latter's dihydromorphine analogue, diacetyldihydromorphine (Paralaudin). Two other 3,6 diesters of morphine invented in 1874–75 along with diamorphine, dibenzoylmorphine and acetylpropionylmorphine, were made as substitutes after it was outlawed in 1925 and, therefore, sold as the first "designer drugs" until they were outlawed by the League of Nations in 1930.

Chemistry
Diamorphine is produced from acetylation of morphine derived from natural opium sources, generally using acetic anhydride.

The major metabolites of diamorphine, 6-MAM, morphine, morphine-3-glucuronide, and morphine-6-glucuronide, may be quantitated in blood, plasma or urine to monitor for use, confirm a diagnosis of poisoning, or assist in a medicolegal death investigation. Most commercial opiate screening tests cross-react appreciably with these metabolites, as well as with other biotransformation products likely to be present following usage of street-grade diamorphine such as 6-Monoacetylcodeine and codeine. However, chromatographic techniques can easily distinguish and measure each of these substances. When interpreting the results of a test, it is important to consider the diamorphine usage history of the individual, since a chronic user can develop tolerance to doses that would incapacitate an opiate-naive individual, and the chronic user often has high baseline values of these metabolites in his system. Furthermore, some testing procedures employ a hydrolysis step before quantitation that converts many of the metabolic products to morphine, yielding a result that may be 2 times larger than with a method that examines each product individually.

History

The opium poppy was cultivated in lower Mesopotamia as long ago as 3400 BC. The chemical analysis of opium in the 19th century revealed that most of its activity could be ascribed to the alkaloids codeine and morphine.

Diamorphine was first synthesized in 1874 by C. R. Alder Wright, an English chemist working at St. Mary's Hospital Medical School in London who had been experimenting combining morphine with various acids. He boiled anhydrous morphine alkaloid with acetic anhydride for several hours and produced a more potent, acetylated form of morphine which is now called diacetylmorphine or morphine diacetate. He sent the compound to F. M. Pierce of Owens College in Manchester for analysis. Pierce told Wright:

"Doses… were subcutaneously injected into young dogs and rabbit… with the following general results… great prostration, fear, and sleepiness speedily following the administration, the eyes being sensitive, and pupils constrict, considerable salivation being produced in dogs, and a slight tendency to vomiting in some cases, but no actual emesis. Respiration was at first quickened, but subsequently reduced, and the heart's action was diminished and rendered irregular. Marked want of coordinating power over the muscular movements, and loss of power in the pelvis and hind limbs, together with a diminution of temperature in the rectum of about 4°."

Wright's invention did not lead to any further developments, and diamorphine became popular only after it was independently re-synthesized 23 years later by chemist Felix Hoffmann. Hoffmann was working at Bayer pharmaceutical company in Elberfeld, Germany, and his supervisor Heinrich Dreser instructed him to acetylate morphine with the objective of producing codeine, a constituent of the opium poppy that is pharmacologically similar to morphine but less potent and less addictive. Instead, the experiment produced an acetylated form of morphine one and a half to two times more potent than morphine itself. Hoffmann synthesized heroin on August 21, 1897, just eleven days after he had synthesized aspirin.

The head of Bayer's research department reputedly coined the drug's new name of "heroin", based on the German heroisch which means "heroic, strong" (from the ancient Greek word "heros, ήρως"). Bayer scientists were not the first to make heroin, but their scientists discovered ways to make it, and Bayer led the commercialization of heroin.

Bayer marketed diacetylmorphine as an over-the-counter drug under the trademark name Heroin. It was developed chiefly as a morphine substitute for cough suppressants that did not have morphine's addictive side-effects. Morphine at the time was a popular recreational drug, and Bayer wished to find a similar but non-addictive substitute to market. However, contrary to Bayer's advertising as a "non-addictive morphine substitute", heroin would soon have one of the highest rates of addiction among its users.

From 1898 through to 1910, diamorphine was marketed under the trademark name Heroin as a non-addictive morphine substitute and cough suppressant. In the 11th edition of Encyclopædia Britannica (1910), the article on morphine states: "In the cough of phthisis minute doses [of morphine] are of service, but in this particular disease morphine is frequently better replaced by codeine or by heroin, which checks irritable coughs without the narcotism following upon the administration of morphine."

In the US, the Harrison Narcotics Tax Act was passed in 1914 to control the sale and distribution of diacetylmorphine and other opioids, which allowed the drug to be prescribed and sold for medical purposes. In 1924, the United States Congress banned its sale, importation, or manufacture. It is now a Schedule I substance, which makes it illegal for non-medical use in signatory nations of the Single Convention on Narcotic Drugs treaty, including the United States.

The Health Committee of the League of Nations banned diacetylmorphine in 1925, although it took more than three years for this to be implemented. In the meantime, the first designer drugs, viz. 3,6 diesters and 6 monoesters of morphine and acetylated analogues of closely related drugs like hydromorphone and dihydromorphine, were produced in massive quantities to fill the worldwide demand for diacetylmorphine—this continued until 1930 when the Committee banned diacetylmorphine analogues with no therapeutic advantage over drugs already in use, the first major legislation of this type.

Bayer lost some of its trademark rights to heroin (as well as aspirin) under the 1919 Treaty of Versailles following the German defeat in World War I.

Use of heroin by jazz musicians in particular was prevalent in the mid-twentieth century, including Billie Holiday, saxophonists Charlie Parker and Art Pepper, trumpeter and vocalist Chet Baker, guitarist Joe Pass and piano player/singer Ray Charles; a "staggering number of jazz musicians were addicts". It was also a problem with many rock musicians, particularly from the late 1960s through the 1990s. Pete Doherty is also a self-confessed user of heroin. Nirvana lead singer Kurt Cobain's heroin addiction was well documented. Pantera frontman Phil Anselmo turned to heroin while touring during the 1990s to cope with his back pain. James Taylor, Jimmy Page, John Lennon, Eric Clapton, Johnny Winter, Keith Richards, Shaun Ryder, Shane MacGowan and Janis Joplin also used heroin. Many musicians have made songs referencing their heroin usage.

Names
"Diamorphine" is the Recommended International Nonproprietary Name and British Approved Name. Other synonyms for heroin include: diacetylmorphine, and morphine diacetate. Heroin is also known by many street names including dope, H, smack, junk, horse, scag, brown, and unga, among others.

Asia
In Hong Kong, diamorphine is regulated under Schedule 1 of Hong Kong's Chapter 134 Dangerous Drugs Ordinance. It is available by prescription. Anyone supplying diamorphine without a valid prescription can be fined $5,000,000 (HKD) and imprisoned for life. The penalty for trafficking or manufacturing diamorphine is a $5,000,000 (HKD) fine and life imprisonment. Possession of diamorphine without a license from the Department of Health is illegal with a $1,000,000 (HKD) fine and 7 years of jail time.

Europe
In the Netherlands, diamorphine is a List I drug of the Opium Law. It is available for prescription under tight regulation exclusively to long-term addicts for whom methadone maintenance treatment has failed. It cannot be used to treat severe pain or other illnesses.

In the United Kingdom, diamorphine is available by prescription, though it is a restricted Class A drug. According to the 50th edition of the British National Formulary (BNF), diamorphine hydrochloride may be used in the treatment of acute pain, myocardial infarction, acute pulmonary oedema, and chronic pain. The treatment of chronic non-malignant pain must be supervised by a specialist. The BNF notes that all opioid analgesics cause dependence and tolerance but that this is "no deterrent in the control of pain in terminal illness". When used in the palliative care of cancer patients, diamorphine is often injected using a syringe driver.

In Switzerland, heroin is produced in injectable or tablet form under the name Diaphin by a private company under contract to the Swiss government. Swiss-produced heroin has been imported into Canada with government approval.

Australia
In Australia, diamorphine is listed as a schedule 9 prohibited substance under the Poisons Standard (October 2015). The state of Western Australia, in its Poisons Act 1964 (Reprint 6: amendments as at 10 Sep 2004), described a schedule 9 drug as: "Poisons that are drugs of abuse, the manufacture, possession, sale or use of which should be prohibited by law except for amounts which may be necessary for educational, experimental or research purposes conducted with the approval of the Governor."

North America
In Canada, diamorphine is a controlled substance under Schedule I of the Controlled Drugs and Substances Act (CDSA). Any person seeking or obtaining diamorphine without disclosing authorization 30 days before obtaining another prescription from a practitioner is guilty of an indictable offense and subject to imprisonment for a term not exceeding seven years. Possession of diamorphine for the purpose of trafficking is an indictable offense and subject to imprisonment for life.

In the United States, diamorphine is a Schedule I drug according to the Controlled Substances Act of 1970, making it illegal to possess without a DEA license. Possession of more than 100 grams of diamorphine or a mixture containing diamorphine is punishable with a minimum mandatory sentence of 5 years of imprisonment in a federal prison.

In 2021, the US state of Oregon became the first state to decriminalize the use of heroin after voters passed Ballot Measure 110 in 2020. This measure will allow people with small amounts to avoid arrest.

Turkey
Turkey maintains strict laws against the use, possession or trafficking of illegal drugs. If convicted under these offences, one could receive a heavy fine or a prison sentence of 4 to 24 years.

Misuse of prescription medication
Misused prescription medicine, such as opioids, can lead to heroin use and dependence. The number of death from illegal opioid overdose follows the increasing number of death caused by prescription opioid overdoses. Prescription opioids are relatively easy to obtain. This may ultimately lead to heroin injection because heroin is cheaper than prescribed pills.

Production
Diamorphine is produced from acetylation of morphine derived from natural opium sources. One such method of heroin production involves isolation of the water-soluble components of raw opium, including morphine, in a strongly basic aqueous solution, followed by recrystallization of the morphine base by addition of ammonium chloride. The solid morphine base is then filtered out. The morphine base is then reacted with acetic anhydride, which forms heroin. This highly impure brown heroin base may then undergo further purification steps, which produces a white-colored product; the final products have a different appearance depending on purity and have different names. Heroin purity has been classified into four grades. No.4 is the purest form – white powder (salt) to be easily dissolved and injected. No.3 is "brown sugar" for smoking (base). No.1 and No.2 are unprocessed raw heroin (salt or base).

Trafficking

Traffic is heavy worldwide, with the biggest producer being Afghanistan. According to a U.N. sponsored survey, in 2004, Afghanistan accounted for production of 87 percent of the world's diamorphine. Afghan opium kills around 100,000 people annually.

In 2003 The Independent reported: "The cultivation of opium [in Afghanistan] reached its peak in 1999, when 350 sqmi of poppies were sown ... The following year the Taliban banned poppy cultivation, ... a move which cut production by 94 percent ... By 2001 only 30 sqmi of land were in use for growing opium poppies. A year later, after American and British troops had removed the Taliban and installed the interim government, the land under cultivation leapt back to 285 sqmi, with Afghanistan supplanting Burma to become the world's largest opium producer once more."

Opium production in that country has increased rapidly since, reaching an all-time high in 2006. War in Afghanistan once again appeared as a facilitator of the trade. Some 3.3 million Afghans are involved in producing opium. At present, opium poppies are mostly grown in Afghanistan (224000 hectare), and in Southeast Asia, especially in the region known as the Golden Triangle straddling Burma (57600 hectare), Thailand, Vietnam, Laos (6200 hectare) and Yunnan province in China. There is also cultivation of opium poppies in Pakistan (493 hectare), Mexico (12000 hectare) and in Colombia (378 hectare). According to the DEA, the majority of the heroin consumed in the United States comes from Mexico (50%) and Colombia (43–45%) via Mexican criminal cartels such as Sinaloa Cartel. However, these statistics may be significantly unreliable, the DEA's 50/50 split between Colombia and Mexico is contradicted by the amount of hectares cultivated in each country and in 2014, the DEA claimed most of the heroin in the US came from Colombia. , the Sinaloa Cartel is the most active drug cartel involved in smuggling illicit drugs such as heroin into the United States and trafficking them throughout the United States. According to the Royal Canadian Mounted Police, 90% of the heroin seized in Canada (where the origin was known) came from Afghanistan. Pakistan is the destination and transit point for 40 percent of the opiates produced in Afghanistan, other destinations of Afghan opiates are Russia, Europe and Iran.

A conviction for trafficking heroin carries the death penalty in most Southeast Asian, some East Asian and Middle Eastern countries (see Use of death penalty worldwide for details), among which Malaysia, Singapore and Thailand are the strictest. The penalty applies even to citizens of countries where the penalty is not in place, sometimes causing controversy when foreign visitors are arrested for trafficking, for example, the arrest of nine Australians in Bali, the death sentence given to Nola Blake in Thailand in 1987, or the hanging of an Australian citizen Van Tuong Nguyen in Singapore.

Trafficking history

The origins of the present international illegal heroin trade can be traced back to laws passed in many countries in the early 1900s that closely regulated the production and sale of opium and its derivatives including heroin. At first, heroin flowed from countries where it was still legal into countries where it was no longer legal. By the mid-1920s, heroin production had been made illegal in many parts of the world. An illegal trade developed at that time between heroin labs in China (mostly in Shanghai and Tianjin) and other nations. The weakness of the government in China and conditions of civil war enabled heroin production to take root there. Chinese triad gangs eventually came to play a major role in the illicit heroin trade. The French Connection route started in the 1930s.

Heroin trafficking was virtually eliminated in the US during World War II because of temporary trade disruptions caused by the war. Japan's war with China had cut the normal distribution routes for heroin and the war had generally disrupted the movement of opium. After World War II, the Mafia took advantage of the weakness of the postwar Italian government and set up heroin labs in Sicily which was located along the historic route opium took westward into Europe and the United States. Large-scale international heroin production effectively ended in China with the victory of the communists in the civil war in the late 1940s. The elimination of Chinese production happened at the same time that Sicily's role in the trade developed.

Although it remained legal in some countries until after World War II, health risks, addiction, and widespread recreational use led most western countries to declare heroin a controlled substance by the latter half of the 20th century. In the late 1960s and early 1970s, the CIA supported anti-Communist Chinese Nationalists settled near the Sino-Burmese border and Hmong tribesmen in Laos. This helped the development of the Golden Triangle opium production region, which supplied about one-third of heroin consumed in the US after the 1973 American withdrawal from Vietnam. In 1999, Burma, the heartland of the Golden Triangle, was the second-largest producer of heroin, after Afghanistan.

The Soviet-Afghan war led to increased production in the Pakistani-Afghan border regions, as US-backed mujaheddin militants raised money for arms from selling opium, contributing heavily to the modern Golden Crescent creation. By 1980, 60 percent of the heroin sold in the US originated in Afghanistan. It increased international production of heroin at lower prices in the 1980s. The trade shifted away from Sicily in the late 1970s as various criminal organizations violently fought with each other over the trade. The fighting also led to a stepped-up government law enforcement presence in Sicily.

Following the discovery at a Jordanian airport of a toner cartridge that had been modified into an improvised explosive device, the resultant increased level of airfreight scrutiny led to a major shortage (drought) of heroin from October 2010 until April 2011. This was reported in most of mainland Europe and the UK which led to a price increase of approximately 30 percent in the cost of street heroin and increased demand for diverted methadone. The number of addicts seeking treatment also increased significantly during this period. Other heroin droughts (shortages) have been attributed to cartels restricting supply in order to force a price increase and also to a fungus that attacked the opium crop of 2009. Many people thought that the American government had introduced pathogens into the Afghanistan atmosphere in order to destroy the opium crop and thus starve insurgents of income.

On 13 March 2012, Haji Bagcho, with ties to the Taliban, was convicted by a US District Court of conspiracy, distribution of heroin for importation into the United States and narco-terrorism. Based on heroin production statistics compiled by the United Nations Office on Drugs and Crime, in 2006, Bagcho's activities accounted for approximately 20 percent of the world's total production for that year.

Street price
The European Monitoring Centre for Drugs and Drug Addiction reports that the retail price of brown heroin varies from €14.5 per gram in Turkey to €110 per gram in Sweden, with most European countries reporting typical prices of €35–40 per gram. The price of white heroin is reported only by a few European countries and ranged between €27 and €110 per gram.

The United Nations Office on Drugs and Crime claims in its 2008 World Drug Report that typical US retail prices are US$172 per gram.

Research
Researchers are attempting to reproduce the biosynthetic pathway that produces morphine in genetically engineered yeast. In June 2015 the S-reticuline could be produced from sugar and R-reticuline could be converted to morphine, but the intermediate reaction could not be performed.

title: Heroin


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Hellas Verona FC

Hellas Verona Football Club, commonly referred to as Hellas Verona, is an Italian professional football club based in Verona, Veneto, that currently plays in Serie A. The team won the Serie A championship in the 1984–85 season.

Origins and early history
Founded in 1903 by a group of University students, the club was named Hellas (the Greek word for Greece), at the request of a professor of classics. At a time in which football was played seriously only in the larger cities of northwestern Italy, most of Verona was indifferent to the growing sport. However, when in 1906 two city teams chose the city's Roman amphitheatre as a venue to showcase the game, crowd enthusiasm and media interest began to rise.

During these first few years, Hellas was one of three or four area teams playing at a municipal level while fighting against city rivals Bentegodi to become the city's premier football outfit. By the 1907–08 season, Hellas was playing against regional teams, and an intense rivalry with Vicenza that has lasted to this day was born. From 1898 to 1926, Italian football was organised into regional groups. In this period, Hellas was one of the founding teams of the early league and often among its top final contenders. In 1911, the city helped Hellas replace the early, gritty football fields with a proper venue. This allowed the team to take part in its first regional tournament, which until 1926, was the qualifying stage for the national title.

In 1919, following a return to activity after a four-year suspension of all football competition in Italy during World War I, the team merged with city rival Verona and changed its name to Hellas Verona. Between 1926 and 1929, the elite "Campionato Nazionale" assimilated the top sides from the various regional groups. Hellas Verona joined the privileged teams, yet struggled to remain competitive.

Serie A, as it is structured today, began in 1929, when the Campionato Nazionale turned into a professional league. Still an amateur team, Hellas merged with two city rivals, Bentegodi and Scaligera, to form AC Verona. Hoping to build a first class contender for future years, the new team debuted in Serie B in 1929. It would take the gialloblu 28 years to finally achieve their goal. After first being promoted to Serie A for one season in 1957–58, in 1959, the team merged with another city rival (called Hellas) and commemorated its beginnings by changing its name to Hellas Verona AC.

Success in the 1970s and 1980s
Coached by Nils Liedholm, the team returned to Serie A in 1968 and remained in the elite league almost without interruption until 1990. Along the way, it scored a famous 5–3 win in the 1972–73 season that cost Milan the scudetto (the Serie A title). The fact that the result came late during the last matchday of the season makes the sudden and unexpected end to the rossoneri's title ambitions all the more memorable.

In 1973–74, Hellas finished the season in fourth-last, just narrowly avoiding relegation, but were nonetheless sent down to Serie B during the summer months as a result of a scandal involving team president Saverio Garonzi. After a year in Serie B, Hellas returned to Serie A.

In the 1975–76 season, the team had a successful run in the Coppa Italia, eliminating highly rated teams such as Torino, Cagliari and Internazionale from the tournament. However, in their first ever final in the competition, Hellas were trounced 4–0 by Napoli. Under the leadership of coach Osvaldo Bagnoli, in 1982–83 the team secured a fourth-place in Serie A (its highest finish at the time) and even led the Serie A standings for a few weeks. The same season Hellas again reached the Coppa Italia final. After a 2–0 home victory, Hellas then travelled to Turin to play Juventus but were defeated 3–0 after extra time.

Further disappointment followed in the 1983–84 season when the team again reached the Coppa Italia final, only to lose the Cup in the final minutes of the return match against defending Serie A champions Roma.

The team made its first European appearance in the 1983–84 UEFA Cup and were knocked out in the second round of the tournament by Sturm Graz. Hellas were eliminated from the 1985–86 European Cup in the second round by defending champions and fellow Serie A side Juventus after a contested game, the result of a scandalous arbitrage by the French Wurtz, having beaten PAOK of Greece in the first round.

In 1988, the team had their best international result when they reached the UEFA Cup quarterfinals with four victories and three draws. The decisive defeat came from German side Werder Bremen.

1984–1985 Scudetto
Although the 1984–85 season squad was made up of a mix of emerging players and mature stars, at the beginning of the season no one would have regarded the team as having the necessary ingredients to make it to the end. Certainly, the additions of Hans-Peter Briegel in midfield and of Danish striker Preben Elkjær to an attack that already featured the wing play of Pietro Fanna, the creative abilities of Antonio Di Gennaro and the scoring touch of Giuseppe Galderisi were to prove crucial.

To mention a few of the memorable milestones on the road to the scudetto: a decisive win against Juventus (2–0), with a goal scored by Elkjær after having lost a boot in a tackle just outside the box, set the stage early in the championship; an away win over Udinese (5–3) ended any speculation that the team was losing energy at the midway point; three straight wins (including a hard-fought 1–0 victory against a strong Roma side) served notice that the team had kept its polish and focus intact during their rival's final surge; and a 1–1 draw in Bergamo against Atalanta secured the title with a game in hand.

Hellas finished the year with a 15–13–2 record and 43 points, four points ahead of Torino with Internazionale and Sampdoria rounding out the top four spots. This unusual final table of the Serie A (with the most successful Italian teams of the time, Juventus and Roma, ending up much lower than expected) has led to many speculations. The 1984–85 season was the only season when referees were assigned to matches by way of a random draw. Before then each referee had always been assigned to a specific match by a special commission of referees (designatori arbitrali). After the betting scandal of the early 1980 (the Calcio Scommesse scandal), it was decided to clean up the image of Italian football by assigning referees randomly instead of picking them, to clear up all the suspicions and accusations always accompanying Italy's football life. This resulted in a quieter championship and in a completely unexpected final table.

In the following season, won again by Juventus, the choice of the referees went back in the hands of the designatori arbitrali. In 2006, a major scandal in Italian football revealed that certain clubs had been illegally influencing the referee selection process in an attempt to ensure that certain referees were assigned to their matches.

Between Serie A and Serie B
These were more than mere modest achievements for a mid-size city with a limited appeal to fans across the nation. But soon enough financial difficulties caught up with team managers. In 1991 the team folded and was reborn as Verona, regularly moving to and fro between Serie A and Serie B for several seasons. In 1995 the name was officially returned to Hellas Verona.

After a three-year stay, their last stint in Serie A ended in grief in 2002. That season emerging international talents such as Adrian Mutu, Mauro Camoranesi, Alberto Gilardino, Martin Laursen, Massimo Oddo, Marco Cassetti and coach Alberto Malesani failed to capitalise on an excellent start and eventually dropped into fourth-to-last place for the first time all season on the final match day, enforcing relegation into Serie B.

Decline and Serie C (2002–2011)
Following the 2002 relegation to Serie B, team fortunes continued to slip throughout the decade. In the 2003–04 season Hellas Verona struggled in Serie B and spent most of the season fighting off an unthinkable relegation to Serie C1. Undeterred, the fans supported their team and a string of late season wins eventually warded off the danger. Over 5,000 of them followed Hellas to Como on the final day of the season to celebrate.

In 2004–05, things looked much brighter for the team. After a rocky start, Hellas put together a string of results and climbed to third spot. The gialloblù held on to the position until January 2005, when transfers weakened the team, yet they managed to take the battle for Serie A to the last day of the season.

The 2006–07 Serie B seemed to start well, due to the club takeover by Pietro Arvedi D'Emilei, which ended nine years of controversial leadership under chairman Gianbattista Pastorello, heavily contested by the supporters in his later years at Verona. However, Verona was immediately involved in the relegation battle, and Massimo Ficcadenti was replaced in December 2006 by Giampiero Ventura. Despite a recovery in the results, Verona ended in an 18th place, thus being forced to play a two-legged playoff against 19th-placed Spezia to avert relegation. A 2–1 away loss in the first leg at La Spezia was followed by a 0–0 home tie, and Verona were relegated to Serie C1 after 64 years of play in the two highest divisions.

Verona appointed experienced coach Franco Colomba for the new season with the aim to return to Serie B as soon as possible. However, despite being widely considered the division favourite, the gialloblù spent almost the entire season in last place. After seven matches, club management sacked Colomba in early October and replaced him with youth team coach (and former Verona player) Davide Pellegrini. A new owner acquired the club in late 2007, appointing Giovanni Galli in December as new director of football and Maurizio Sarri as new head coach. Halfway through the 2007–08 season, the team remained at the bottom of Serie C1, on the brink of relegation to the fourth level (Serie C2). In response, club management sacked Sarri and brought back Pellegrini. Thanks to a late-season surge the scaligeri avoided direct relegation by qualifying for the relegation play-off, and narrowly averted dropping to Lega Pro Seconda Divisione in the final game, beating Pro Patria 2–1 on aggregate. However, despite the decline in results, attendance and season ticket sales remained at 15,000 on average.

For the 2008–09 season, Verona appointed former Sassuolo and Piacenza manager Gian Marco Remondina with the aim to win promotion to Serie B. However, the season did not start impressively, with Verona being out of the playoff zone by mid-season, and club chairman Pietro Arvedi D'Emilei entering into a coma after being involved in a car crash on his way back from a league match in December 2008. Arvedi died in March 2009, two months after the club was bought by new chairman Giovanni Martinelli.

The following season looked promising, as new transfer players were brought aboard, and fans enthusiastically embraced the new campaign. Season ticket figures climbed to over 10,000, placing Verona ahead of several Serie A teams and all but Torino in Serie B attendance. The team led the standings for much of the season, accumulating a seven-point lead by early in the spring. However, the advantage was gradually squandered, and the team dropped to second place on the second-last day of the season, with a chance to regain first place in the final regular season match against Portogruaro on home soil. Verona, however, disappointed a crowd of over 25,000 fans and, with the loss, dropped to third place and headed towards the play-offs. A managerial change for the post-season saw the firing of Remondina and the arrival of Giovanni Vavassori. After eliminating Rimini in the semi-finals (1–0; 0–0) Verona lost the final to Pescara (2–2 on home soil and 0–1 in the return match) and were condemned to a fourth-straight year of third division football.

Rising again and Serie A comeback (2012–present)
Former 1990 World Cup star Giuseppe Giannini (a famous captain of Roma for many years) signed as manager for the 2010–11 campaign. Once again, the team was almost entirely revamped during the transfer season. The squad struggled in the early months and Giannini was eventually sacked and replaced by former Internazionale defender Andrea Mandorlini, who succeeded in reorganising the team's play and bringing discipline both on and off the pitch. In the second half of the season, Verona climbed back from the bottom of the division to clinch a play-off berth (fifth place) on the last day of the regular season. The team advanced to the play-off final after eliminating Sorrento in the semi-finals 3–1 on aggregate. Following the play-off final, after four years of Lega Pro football, Verona were promoted back to Serie B after a 2–1 aggregate win over Salernitana on 19 June 2011.

On 18 May 2013, Verona finished second in Serie B and were promoted to Serie A after an eleven-year absence. Their return to the top flight began against title contenders Milan and Roma, beating the former 2–1 and losing to the latter 3–0. The team continued at a steady pace, finishing the first half of the season with 32 points and sitting in sixth place, eleven points behind the closest UEFA Champions League spot—and tied with Internazionale for the final UEFA Europa League spot. Verona, however, ultimately finished the year in tenth.

During the 2015–16 season, Verona had not won a single match since the beginning of the campaign until the club edged Atalanta 2–1 on 3 February 2016 in a win at home; coming twenty-three games into the season. Consequently, Verona were relegated from Serie A.

In the 2016–17 Serie B season, Hellas Verona finished second on the table and were automatically promoted back to Serie A. Hellas lasted one season back in the top division after finishing second last during the 2017–18 Serie A season and were relegated back to Serie B. At the end of the 2018–19 season, Hellas finished in fifth position and achieved promotion back to Serie A after defeating Cittadella 3–0 in the second leg of their promotion play-off to win 3–2 on aggregate.

The club's return to the top flight in the 2019–20 Serie A season, in which it was considered a strong relegation candidate at the beginning of the campaign, was a successful one, with a ninth-placed finish. Heavily reliant on the defensive solidity of 20-year-old centre-back Marash Kumbulla, Amir Rrahmani and goalkeeper Marco Silvestri, along with the consistent performances of midfielder Sofyan Amrabat, Verona was a surprise contender for Europa League qualification but fell out of the race after a downturn in form after the coronavirus break which temporarily halted the season. A 2–1 win at home against eventual title winners Juventus in February was a highlight of a season in which the club achieved 10 clean sheets and punched towards the higher end of the table despite its modest budget.

Ahead of Verona's second consecutive year in Serie A, key players Amrabat, Rrahmani and Kumbulla were poached by Fiorentina, Napoli and Roma respectively, and loanee Matteo Pessina returned to Atalanta. This left the club with a heavily weakened squad and it was once again expected to struggle in the league prior to the season-opening match. Despite these losses in the transfer window, Verona again finished in the top half of the league table, ending the season in 10th place with 45 points. Successful breakout seasons for attacking midfielder Mattia Zaccagni, who was eventually called up to the Italy national team as a reward for his performances, as well as wing-backs Federico Dimarco and Davide Faraoni, were partly the reason for this achievement. At the end of the season, coach Ivan Jurić was appointed by Torino following his two impressive Serie A seasons with Verona, with the Gialloblu replacing him with Eusebio Di Francesco.

Following another summer transfer window in which several of the club's star players were sold to Serie A rivals, namely Zaccagni transferring to Lazio, Marco Silvestri to Udinese and Dimarco returning to Inter, the beginning of the 2021-22 season proved to be much more difficult for Verona, as Di Francesco was fired and replaced with Igor Tudor after just three matches, all of which were defeats. This poor early-season form had left the club at the bottom of the table. Under the guidance of Tudor, the team regains competitiveness obtaining in the next eight matches three wins – including victories with Lazio and Juventus – four draws and only one defeat.

Colours and badge
The team's colours are yellow and blue. As a result, the clubs most widely used nickname is gialloblu literally "yellow-blue" in Italian. The colours represent the city itself and Verona's emblem (a yellow cross on a blue shield) appears on most team apparel. Home kits are traditionally blue, sometimes of a navy shade, combined with yellow details and trim, although the club has used a blue and yellow striped design on occasion. Two more team nicknames are Mastini (the mastiffs) and Scaligeri, both references to Mastino I della Scala of the Della Scala princes that ruled the city during the 13th and 14th centuries.

The Scala family coat of arms is depicted on the team's jersey and on its trademark logo as a stylised image of two large, powerful mastiffs facing opposite directions, introduced in 1995. In essence, the term "scaligeri" is synonymous with Veronese, and therefore can describe anything or anyone from Verona (e.g., Chievo Verona, a different team that also links itself to the Scala family – specifically to Cangrande I della Scala).

Stadium
Since 1963, the club have played at the Stadio Marc'Antonio Bentegodi, which has a capacity of 39,211. It is the eighth-largest stadium in Italy by capacity. The stadium is named after the historic benefactor of Veronese sport, Marcantonio Bentegodi.

The ground was shared with Hellas's rivals, Chievo Verona until 2021. It was used as a venue for some matches of the 1990 FIFA World Cup and renovations prior to the tournament included an extra tier and a roof to cover all sections, improved visibility, public transport connections, an urban motorway connecting the city centre with the stadium and the Verona Nord motorway exit and services.

Derby with Chievo Verona
The intercity fixtures against Chievo Verona are known as the "Derby della Scala". The name refers to the Scaligeri or della Scala aristocratic family, who were rulers of Verona during the Middle Ages and early Renaissance.

Hellas, founded in 1903, were traditionally the main club in Verona. Chievo, founded in 1929, historically represented the small Verona suburb of the same name, using a small parish field as their home ground, and did not become a professional side until 1986. At that time, Chievo became tenants of Hellas at the Bentegodi, and began rising up the league ladder. By the mid-1990s, Chievo had joined Hellas in Serie B, creating the derby. During the teams' early Serie B meetings, Hellas supporters taunted Chievo with the chant Quando i mussi volara, il Ceo in Serie A – "Donkeys will fly before Chievo are in Serie A." Once Chievo earned promotion to Serie A at the end of the 2000–01 season, their fans started calling the team i Mussi Volanti (The Flying Donkeys). A 2014 story in the British football magazine Late Tackle remarked that "Hellas fans didn’t so much have their words rammed down their throat as forced through every orifice with a barge pole."

In the season 2001–02, both Hellas Verona and the city rivals of Chievo Verona were playing in the Serie A. The first ever derby of Verona in Serie A took place on 18 November 2001, while both teams were ranked among the top four. The match was won by Hellas, 3–2. Chievo got revenge in the return match in spring 2002, winning 2–1. Verona thus became the fifth city in Italy, after Milan, Rome, Turin and Genoa to host a cross-town derby in Serie A.

Honours

 * Serie A
 * Winners (1): 1984–85
 * Serie B
 * Winners (3): 1956–57, 1981–82, 1998–99

Most appearances

 * Competitive, professional matches only.

Top goalscorers

 * Competitive, professional matches only.

Kit sponsors

 * 1980–87: Adidas
 * 1987–89: Hummel
 * 1989–91: Adidas
 * 1991–95: Uhlsport
 * 1995–00: Errea
 * 2000–03: Lotto
 * 2003–06: Legea
 * 2006–13: Asics
 * 2013–18: Nike
 * 2018–23: Macron
 * 2023–: Joma

Official sponsors

 * 1982–86: Canon
 * 1989–96: Rana
 * 1996–97: Ferroli
 * 1997–98: ZG Camini Inox
 * 1998–99: Atreyu Immobiliare
 * 1999–00: Salumi Marsilli
 * 2000–01: Net Business
 * 2001–02: Amica Chips
 * 2002–06: Clerman
 * 2006–07: Unika
 * 2007–08: No sponsor
 * 2008–10: Giallo
 * 2010–11: Banca Di Verona/Sicurint Group, Protec/Consorzio Asimov
 * 2011–12: AGSM/Sicurint Group, Protec/Leaderform
 * 2012–13: AGSM, Leaderform
 * 2013–14: Franklin & Marshall/Manila Grace, AGSM/Leaderform
 * 2014–15: Franklin & Marshall, AGSM/Leaderform
 * 2015–2018: Metano Nord, Leaderform
 * 2018–2020: AirDolomiti, Gruppo Sinergy
 * 2020–2021: Kiratech S.P.A.
 * 2021–2022: Gruppo Sinergy, Omega, Vetrocar (back), LeasePlan (sleeve)
 * 2022–2023: Gruppo Sinergy, Dr Automobiles, Vetrocar (back), Drivalia (sleeve)
 * 2023–2024: Gruppo Sinergy, Conforama, Vetrocar (back), Drivalia (sleeve)
 * 2024–2025: Conforama, Vetrocar (back), Drivalia (sleeve)

Out on loan
.

Other players under contract
.

Board of directors

 * Last updated: 23 March 2023
 * Source:

Current technical staff

 * Last updated: 13 June 2024
 * Source:

Managers

 * 🇭🇺 Ferenc Molnár (1 July 1924 – 30 June 1925)
 * 🇭🇺 Imre Schöffer (1 July 1925 – 30 June 1926)
 * 🇮🇹 Aldo Fagiuoli (1 July 1926 – 26 December 1927)
 * 🇭🇺 Imre János Bekey (27 December 1927 – 30 June 1928)
 * 🇮🇹 Alessandro Bascheni (1 July 1928 – 30 June 1929)
 * 🇭🇺 András Kuttik (1 July 1929 – 30 June 1932)
 * 🇦🇹 Rudolf Stanzel (1 July 1932 – 30 June 1933)
 * 🇭🇺 Imre János Bekey (1 July 1933 – 30 June 1934)
 * 🇭🇺 Sándor Peics (1939)
 * 🇦🇹 Karl Stürmer (1941–1942)
 * 🇮🇹 Bruno Biagini (1 July 1948 – 6 November 1949)
 * 🇭🇺 László Székely (8 November 1949 – 16 January 1950)
 * 🇮🇹 Angelo Piccioli (17 January 1950 – 23 March 1953)
 * 🇭🇺 Gyula Lelovics (23 March 1953 – 30 June 1953)
 * 🇮🇹 Luigi Rossetto (1 July 1953 – 31 January 1954)
 * 🇮🇹 Luigi Ferrero (4 February 1954 – 11 October 1954)
 * 🇮🇹 Angelo Piccioli (11 October 1954 – 1 February 1955)
 * 🇮🇹 Federico Allasio (6 February 1955 – 11 December 1955)
 * 🇮🇹 Angelo Piccioli (25 December 1955 – 5 May 1958)
 * 🇮🇹 Luigi Bonizzoni (6 May 1958 – 30 June 1958)
 * 🇮🇹 Vinicio Viani (1 July 1958 – 18 January 1959)
 * 🇮🇹 Guido Tavellin (25 January 1959 – 5 November 1959)
 * 🇮🇹 Aldo Olivieri (5 November 1959 – 26 September 1960)
 * 🇮🇹 Romolo Bizzotto (2 October 1960 – 30 June 1961)
 * 🇮🇹 Bruno Biagini (1 July 1961 – 30 June 1962)
 * 🇮🇹 Guido Tavellin (1 July 1962 – 25 November 1962)
 * 🇮🇹 Carlo Facchini (2 December 1962 – 17 May 1964)
 * 🇮🇹 Bruno Biagini (24 May 1964 – 30 June 1964)
 * 🇮🇹 Giancarlo Cadé (1 July 1964 – 30 June 1965)
 * 🇮🇹 Omero Tognon (1 July 1965 – 20 November 1966)
 * 🇮🇹 Ugo Pozzan (20 November 1966 – 15 January 1967)
 * 🇸🇪 Nils Liedholm (23 January 1967– 30 June 1968)
 * 🇮🇹 Ugo Pozzan (1 July 1967 – 30 June 1968)
 * 🇮🇹 Giancarlo Cadé (1 July 1968 – 30 June 1969)
 * 🇮🇹 Renato Lucchi (1 July 1969 – 30 November 1970)
 * 🇮🇹 Ugo Pozzan (1 July 1971 – 30 June 1972)
 * 🇮🇹 Giancarlo Cadé (1 July 1972 – 10 March 1975)
 * 🇮🇹 Luigi Mascalaito (10 March 1975 – 30 June 1975)
 * 🇮🇹 Ferruccio Valcareggi (1 July 1975 – 30 June 1978)
 * 🇮🇹 Luigi Mascalaito (1 July 1978 – 13 November 1978)
 * 🇮🇹 Giuseppe Chiappella (13 November 1978 – 30 June 1979)
 * 🇮🇹 Fernando Veneranda (1 July 1979 – 30 June 1980)
 * 🇮🇹 Giancarlo Cadé (1 July 1980 – 30 June 1981)
 * 🇮🇹 Osvaldo Bagnoli (1 July 1981 – 30 June 1990)
 * 🇮🇹 Eugenio Fascetti (1 July 1990 – 28 March 1992)
 * 🇸🇪 Nils Liedholm (29 March 1992 – 30 June 1992)
 * 🇮🇹 Edoardo Reja (1 July 1992 – 30 June 1993)
 * 🇮🇹 Franco Fontana (1 July 1993 – 30 June 1994)
 * 🇮🇹 Bortolo Mutti (1 July 1994 – 30 June 1995)
 * 🇮🇹 Attilio Perotti (1 July 1995 – 30 June 1996)
 * 🇮🇹 Luigi Cagni (1 July 1996 – 4 April 1998)
 * 🇮🇹 Sergio Maddè (4 April 1998 – 30 June 1998)
 * 🇮🇹 Cesare Prandelli (1 July 1998 – 30 June 2000)
 * 🇮🇹 Attilio Perotti (1 July 2000 – 30 June 2001)
 * 🇮🇹 Alberto Malesani (4 July 2001 – 10 June 2003)
 * 🇮🇹 Sandro Salvioni (1 July 2003 – 23 December 2003)
 * 🇮🇹 Sergio Maddè (24 December 2003 – 30 June 2004)
 * 🇮🇹 Massimo Ficcadenti (20 July 2004 – 24 December 2006)
 * 🇮🇹 Giampiero Ventura (24 December 2006 – 30 June 2007)
 * 🇮🇹 Franco Colomba (1 July 2007 – 8 October 2007)
 * 🇮🇹 Davide Pellegrini (9 October 2007 – 30 December 2007)
 * 🇮🇹 Maurizio Sarri (31 December 2007 – 27 February 2008)
 * 🇮🇹 Davide Pellegrini (28 February 2008 – 11 June 2008)
 * 🇮🇹 Gian Marco Remondina (12 June 2008 – 10 May 2010)
 * 🇮🇹 Giovanni Vavassori (10 May 2010 – 21 June 2010)
 * 🇮🇹 Giuseppe Giannini (22 June 2010 – 8 November 2010)
 * 🇮🇹 Andrea Mandorlini (9 November 2010 – 30 November 2015)
 * 🇮🇹 Luigi Delneri (1 December 2015 – 23 May 2016)
 * 🇮🇹 Fabio Pecchia (1 June 2016 – 21 June 2018)
 * 🇮🇹 Fabio Grosso (21 June 2018 – 1 May 2019)
 * 🇮🇹 Alfredo Aglietti (2 May 2019 – 14 June 2019)
 * Ivan Jurić (14 June 2019 – 28 May 2021)
 * 🇮🇹 Eusebio Di Francesco (7 June 2021 – 14 September 2021)
 * Igor Tudor (14 September 2021 – 28 May 2022)
 * 🇮🇹 Gabriele Cioffi (1 June 2022 – 11 October 2022)
 * 🇮🇹 Salvatore Bocchetti (13 October 2022 – 2 December 2022)
 * 🇮🇹 Marco Zaffaroni (3 December 2022 – 30 June 2023)
 * 🇮🇹 Marco Baroni (1 July 2023 – 10 June 2024)

World Cup players
The following players have been selected by their country for the FIFA World Cup finals while playing for Hellas Verona.

 * 🇮🇹 Roberto Tricella (1986)
 * 🇮🇹 Antonio Di Gennaro (1986)
 * 🇮🇹 Giuseppe Galderisi (1986)
 * Preben Elkjær (1986)
 * Hans-Peter Briegel (1986)
 * Nelson Gutiérrez (1990)
 * 🇷🇺 Ruslan Nigmatullin (2002)
 * Anthony Šerić (2002)
 * 🇲🇽 Rafael Márquez (2014)
 * 🇰🇷 Lee Seung-woo (2018)
 * 🇦🇺 Ajdin Hrustic (2022)
 * 🇷🇸 Ivan Ilić (2022)
 * 🇷🇸 Darko Lazović (2022)
 * 🇨🇲 Martin Hongla (2022)

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Hellas Verona FC


text:
Hinayana

Hīnayāna is a Sanskrit term that was at one time applied collectively to the Śrāvakayāna and Pratyekabuddhayāna paths of Buddhism. This term appeared around the first or second century. Hīnayāna is considered as the preliminary or small (hina) vehicle (yana) of the Buddha's teachings. It is often contrasted with Mahāyāna, the second vehicle of the Buddha's teachings, or the great (maha) vehicle (yana). The third vehicle of the Buddha's teachings is the Vajrayana, the indestructible (vajra) vehicle (yana).

Western scholars used the term Hīnayāna to describe the early teachings of Buddhism, as the Mahāyāna teachings were generally given later. Modern Buddhist scholarship has deprecated the pejorative term, and instead uses the term Nikaya Buddhism to refer to early Buddhist schools. Hinayana has also been inappropriately used as a synonym for Theravada, which is the main tradition of Buddhism in Sri Lanka and Southeast Asia.

In Sanskrit, "Hīnayāna" (, हीनयान) is a term literally meaning the "small/deficient vehicle" or "small path." Adherents of non-Mahayana traditions were said to be obliged to adhere to only the Five precepts.

Etymology
The word hīnayāna is formed of hīna: "little", "poor", "inferior", "abandoned", "deficient", "defective"; and yāna (यान): "vehicle", where "vehicle" or "path" what means "a way of going to enlightenment". The Pali Text Society's Pali-English Dictionary (1921–25) defines hīna in even stronger terms, with a semantic field that includes "poor, miserable; vile, base, abject, contemptible", and "despicable".

The term was translated by Kumārajīva and others into Classical Chinese as "small vehicle" (小 meaning "small", 乘 meaning "vehicle"), although earlier and more accurate translations of the term also exist. In Mongolian (Baga Holgon) the term for hinayana also means "small" or "lesser" vehicle or better called path, while in Tibetan there are at least two words to designate the term, theg chung meaning "small vehicle" and theg dman meaning "inferior vehicle" or "inferior spiritual approach".

Thrangu Rinpoche has emphasized that hinayana is in no way implying "inferior". In his translation and commentary of Asanga's Distinguishing Dharma from Dharmata, he writes, "all three traditions of hinayana, mahayana, and vajrayana were practiced in Tibet and that the hinayana which literally means "lesser vehicle" is in no way inferior to the mahayana."

According to the World Fellowship of Buddhists, the term Hīnayāna should not be used to refer to any extant form of Buddhism.

Origins
According to Jan Nattier, it is most likely that the term Hīnayāna postdates the term Mahāyāna and was only added at a later date due to antagonism and conflict between the bodhisattva and śrāvaka ideals. The sequence of terms then began with the term Bodhisattvayāna "bodhisattva-vehicle", which was given the epithet Mahāyāna "Great Vehicle". It was only later, after attitudes toward the bodhisattva teachings had become more critical, that the term Hīnayāna was created as a back-formation, contrasting with the already established term Mahāyāna. The earliest Mahāyāna texts often use the term Mahāyāna as an epithet and synonym for Bodhisattvayāna, but the term Hīnayāna is comparatively rare in early texts, and is usually not found at all in the earliest translations. Therefore, the often-perceived symmetry between Mahāyāna and Hīnayāna can be deceptive, as the terms were not actually coined in relation to one another in the same era.

According to Paul Williams, "the deep-rooted misconception concerning an unfailing, ubiquitous fierce criticism of the Lesser Vehicle by the [Mahāyāna] is not supported by our texts." Williams states that while evidence of conflict is present in some cases, there is also substantial evidence demonstrating peaceful coexistence between the two traditions.

Mahāyāna members of the early Buddhist schools
Although the 18–20 early Buddhist schools are sometimes loosely classified as Hīnayāna in modern times, this is not necessarily accurate. There is no evidence that Mahāyāna ever referred to a separate formal school of Buddhism but rather as a certain set of ideals, and later doctrines. Paul Williams has also noted that the Mahāyāna never had nor ever attempted to have a separate vinaya or ordination lineage from the early Buddhist schools, and therefore bhikṣus and bhikṣuṇīs adhering to the Mahāyāna formally adheres to the vinaya of an early school. This continues today with the Dharmaguptaka ordination lineage in East Asia and the Mūlasarvāstivāda ordination lineage in Tibetan Buddhism. Mahāyāna was never a separate sect of the early schools. From Chinese monks visiting India, we now know that both Mahāyāna and non-Mahāyāna monks in India often lived in the same monasteries side by side.

The seventh-century Chinese Buddhist monk and pilgrim Yijing wrote about the relationship between the various "vehicles" and the early Buddhist schools in India. He wrote, "There exist in the West numerous subdivisions of the schools which have different origins, but there are only four principal schools of continuous tradition." These schools are the Mahāsāṃghika Nikāya, Sthavira nikāya, Mūlasarvāstivāda Nikāya, and Saṃmitīya Nikāya. Explaining their doctrinal affiliations, he then writes, "Which of the four schools should be grouped with the Mahāyāna or with the Hīnayāna is not determined." That is to say, there was no simple correspondence between a Buddhist school and whether its members learn "Hīnayāna" or "Mahāyāna" teachings.

To identify entire schools as "Hīnayāna" that contained not only śrāvakas and pratyekabuddhas but also Mahāyāna bodhisattvas would be attacking the schools of their fellow Mahāyānists as well as their own. Instead, what is demonstrated in the definition of Hīnayāna given by Yijing is that the term referred to individuals based on doctrinal differences.

Hīnayāna as Śrāvakayāna
Scholar Isabelle Onians asserts that although "the Mahāyāna ... very occasionally referred to earlier Buddhism as the Hinayāna, the Inferior Way, [...] the preponderance of this name in the secondary literature is far out of proportion to occurrences in the Indian texts." She notes that the term Śrāvakayāna was "the more politically correct and much more usual" term used by Mahāyānists. Jonathan Silk has argued that the term "Hinayana" was used to refer to whomever one wanted to criticize on any given occasion, and did not refer to any definite grouping of Buddhists.

Views of Chinese pilgrims
The Chinese monk Yijing, who visited India in the 7th century, distinguished Mahāyāna from Hīnayāna as follows:

"Both adopt one and the same Vinaya, and they have in common the prohibitions of the five offenses, and also the practice of the Four Noble Truths. Those who venerate (regard with great respect) the bodhisattvas and read the Mahāyāna sūtras are called the Mahāyānists, while those who do not perform these are called the Hīnayānists."

In the 7th century, the Chinese Buddhist monk Xuanzang describes the concurrent existence of the Mahāvihara and the Abhayagiri vihāra in Sri Lanka. He refers to the monks of the Mahāvihara as the "Hīnayāna Sthaviras" and the monks of Abhayagiri vihāra as the "Mahāyāna Sthaviras". Xuanzang further writes, "The Mahāvihāravāsins reject the Mahāyāna and practice the Hīnayāna, while the Abhayagirivihāravāsins study both Hīnayāna and Mahāyāna teachings and propagate the Tripiṭaka."

Philosophical differences
Mahayanists were primarily in philosophical dialectic with the Vaibhāṣika school of Sarvāstivāda, which had by far the most "comprehensive edifice of doctrinal systematics" of the nikāya schools. With this in mind it is sometimes argued that the Theravada would not have been considered a "Hinayana" school by Mahayanists because, unlike the now-extinct Sarvastivada school, the primary object of Mahayana criticism, the Theravada school does not claim the existence of independent dharmas; in this it maintains the attitude of early Buddhism. Additionally, the concept of the bodhisattva as one who puts off enlightenment rather than reaching awakening as soon as possible, has no roots in Theravada textual or cultural contexts, current or historical. Aside from the Theravada schools being geographically distant from the Mahayana, the Hinayana distinction is used in reference to certain views and practices that had become found within the Mahayana tradition itself. Theravada, as well as Mahayana schools stress the urgency of one's own awakening in order to end suffering. Some contemporary Theravadin figures have thus indicated a sympathetic stance toward the Mahayana philosophy found in the Heart Sutra and the Mūlamadhyamakakārikā.

The Mahayanists were bothered by the substantialist thought of the Sarvāstivādins and Sautrāntikins, and in emphasizing the doctrine of śūnyatā, David Kalupahana holds that they endeavored to preserve the early teaching. The Theravadins too refuted the Sarvāstivādins and Sautrāntikins (and followers of other schools) on the grounds that their theories were in conflict with the non-substantialism of the canon. The Theravada arguments are preserved in the Kathavatthu.

Opinions of scholars
Some western scholars still regard the Theravada school to be one of the Hinayana schools referred to in Mahayana literature, or regard Hinayana as a synonym for Theravada. These scholars understand the term to refer to schools of Buddhism that did not accept the teachings of the Mahāyāna sūtras as authentic teachings of the Buddha. At the same time, scholars have objected to the pejorative connotation of the term Hinayana and some scholars do not use it for any school.

Robert Thurman writes, "'Nikaya Buddhism' is a coinage of Professor Masatoshi Nagatomi of Harvard University, who suggested it to me as a usage for the eighteen schools of Indian Buddhism to avoid the term 'Hinayana Buddhism,' which is found offensive by some members of the Theravada tradition."

Within Mahayana Buddhism, there were a variety of interpretations as to whom or to what the term Hinayana referred. Kalu Rinpoche stated the "lesser" or "greater" designation "did not refer to economic or social status, but concerned the spiritual capacities of the practitioner". Rinpoche states:"The Small Vehicle is based on becoming aware of the fact that all we experience in samsara is marked by suffering. Being aware of this engenders the will to rid ourselves of this suffering, to liberate ourselves on an individual level, and to attain happiness. We are moved by our own interest. Renunciation and perseverance allow us to attain our goal."

title: Hinayana