Heroin metabolism

Diamorphine (half-life 2 min) is rapidly metabolized to the psychoactive intermediate 6-mono-acetyl-morphine (the only metabolite that indicates the consumption of heroin specifically as opposed to other opiates) by blood esterases before being converted to morphine (half-life 3 h). Morphine is subsequently metabolized by the cytochrome P-450 system (Cyp2D6) in the liver to codeine which undergoes conjugation before excretion in the urine. In most subjects, about 10 per cent of ingested codeine is converted into morphine, thereby giving a clinically false-positive test result for heroin/morphine. (3)

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