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These datasets underpin the analysis presented in the agency's work. Most data may be viewed interactively on screen and downloaded in Excel format. All countries. Topics A-Z. The content in this section is aimed at anyone involved in planning, implementing or making decisions about health and social responses. Best practice. We have developed a systemic approach that brings together the human networks, processes and scientific tools necessary for collecting, analysing and reporting on the many aspects of the European drugs phenomenon. Explore our wide range of publications, videos and infographics on the drugs problem and how Europe is responding to it. All publications. More events. More news. We are your source of drug-related expertise in Europe. We prepare and share independent, scientifically validated knowledge, alerts and recommendations. About the EUDA. On this page, you can find the latest analysis of the drug situation for heroin and other opioids in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more. European Drug Report — home. The drug situation in Europe up to Drug supply, production and precursors. Synthetic stimulants. Heroin and other opioids. New psychoactive substances. Other drugs. Injecting drug use in Europe. Drug-related infectious diseases. Drug-induced deaths. Opioid agonist treatment. Harm reduction. Between and , the mean age of all clients entering specialist drug treatment for heroin use and for those doing so for the first time increased, as did the proportion of older clients see the figures Age distribution of all clients entering treatment with heroin as their primary drug, and and Age distribution of never previously treated clients entering treatment with heroin as their primary drug, and , below. These changes in the characteristics of those seeking help raise important policy and service-level challenges. Services are faced with the need to respond to clients who present with a more complex and more chronic set of mental and physical health, employment and social care needs. As well as directly responding to drug-related problems, services are also increasingly faced with the need to provide care for older opioid users who may require additional support to prevent or treat age-related illness and disability. This signals the need to reorient existing models of care and services to these challenges and for increased emphasis on establishing effective multi-agency partnerships and referral pathways with general health and social support services. While heroin continues to be involved in the majority of opioid-related deaths overall, the number of countries in which this is the case has decreased; at the same time, other opioids have become more prominent. Acute drug toxicity presentations to sentinel hospital emergency departments show that, in , in some cities, other opioids — often those used for opioid agonist treatment — have overtaken heroin as a driver of presentations. In addition, in presentations to treatment services, a move away from injecting see the Injecting drug use section among both first-time and previously treated heroin clients has also been observed over the last decade, possibly reflecting the effect of safer-use messaging and harm reduction and prevention efforts see the figure Trends in the main route of administration of clients entering treatment with heroin as primary drug, by treatment status. This is important, as this mode of administration is particularly associated with a range of negative health outcomes. Although demand side data are not indicative of any observable increase in heroin prevalence, supply side indicators of availability have returned to or even surpassed the pre-pandemic levels. These increases are associated with large amounts of this drug trafficked in individual shipments, reflecting a more general trend in drug trafficking practices. Despite the greater quantities seized in , there is little evidence to suggest that this has significantly reduced availability, as only marginal changes are observable in indexed trends on retail level prices or purity, and the drug remains relatively affordable by historical standards. While heroin or, to a lesser extent, medications used for opioid agonist treatment remains the focus for discussion on opioid-related problems in Europe, there are concerns that synthetic opioids may represent a growing threat for the future. New synthetic opioids see the New psychoactive substances section currently play a relatively small role in the drug market in Europe overall, although they are a significant problem in some countries. There is, for example, information to suggest an increase during in availability and harms, including drug-related deaths, associated with synthetic opioids in some northern and Baltic countries. Up to now, most concern in this area has been focused on the availability and use of fentanyl derivatives, such as carfentanil. However, more recently, the appearance of highly potent benzimidazole nitazene opioids, including protonitazene, metonitazene and isotonitazene, has been noted, as well as the detection of opioid mixtures containing new benzodiazepines and tranquilisers, albeit on small scale. These substances are discussed in more detail in the new psychoactive substance section of this report. Data are for all treatment entrants with heroin as the primary drug — or the most recent year available. Trends in first-time entrants are based on 25 countries. Only countries with data for at least 5 of the 6 years are included in the trends analysis. Missing values are interpolated from adjacent years. Because of disruptions to services due to COVID, data for and should be interpreted with caution. Missing data were imputed with values from the previous year for Spain and France and Germany Due to COVID restrictions within specialised drug treatment services, and data should be interpreted with caution. Trends are based the 19 EU Member States providing data over the period; only those with data for at least 8 of the 9 years are included. Price and purity of 'brown' heroin: national mean values — minimum, maximum and interquartile range. Countries covered vary by indicator. Show source tables. Back to list of tables. Not enough sample points were available to provide interquartile values for wholesale heroin prices. Homepage Quick links Quick links. GO Results hosted on duckduckgo. Main navigation Data Open related submenu Data. Latest data Prevalence of drug use Drug-induced deaths Infectious diseases Problem drug use Treatment demand Seizures of drugs Price, purity and potency. Drug use and prison Drug law offences Health and social responses Drug checking Hospital emergencies data Syringe residues data Wastewater analysis Data catalogue. Selected topics Alternatives to coercive sanctions Cannabis Cannabis policy Cocaine Darknet markets Drug checking Drug consumption facilities Drug markets Drug-related deaths Drug-related infectious diseases. Recently published Findings from a scoping literature…. Penalties at a glance. Frequently asked questions FAQ : drug…. FAQ: therapeutic use of psychedelic…. Viral hepatitis elimination barometer…. EU Drug Market: New psychoactive…. EU Drug Market: Drivers and facilitators. Statistical Bulletin home. Quick links Search news Subscribe newsletter for recent news Subscribe to news releases. This make take up to a minute. Once the PDF is ready it will appear in this tab. Sorry, the download of the PDF failed. A more recent version of this page exists: Heroin and other opioids — the current situation in Europe European Drug Report Table of contents Search within the book. Search within the book Operator Any match. Exact term match only. List of tables Table 1 age distribution of all clients entering treatment with heroin as their primary drug, and Table 2 age distribution of never previously treated clients entering treatment with heroin as their primary drug, and Table 3 users entering treatment Table 4 trends in first-time heroin entrants for treatment Table 5 Trends in the main route of administration of clients Table 6 heroin market seizures data Table 7 heroin market seizures trends — numbers Table 8 heroin market seizures trends — weight Table 9 heroin market price and purity data Table 10 heroin market price and purity indexed trends Table 11 hospital emergencies: proportion of the acute drug toxicity presentations with heroin Table 1. Table 2. Table 3. Percentages except where otherwise stated. Table 4. Trends in first-time cannabis treatment entrants Country Germany Spain Italy France Other Table 5. Table 6. Table 7. Table 8. Table 9. Heroin wholesale price range EUR Substance Low High Heroin Not enough sample points were available to provide interquartile values for wholesale heroin prices. Table Table 11a. Trends in the proportion of the acute drug toxicity presentations with heroin involved in selected hospitals in Europe Hospital Dublin For the latest data and detailed methodological information please see the Statistical Bulletin Prevalence of drug use. Graphics showing the most recent data for a country are based on studies carried out between and Main subject. Target audience. Publication type. European Drug Report main page. On this page. Prevalence data presented here are based on general populaton surveys submitted to the EMCDDA by national focal points.

History of Heroin

Munich buy Heroin

The great advances in medical therapy in the past century have been due largely to the rapid development of chemistry and pharmacology. During this period innumerable compounds obtained in chemical laboratories, were tested for their pharmacological activity. Those proving satisfactory were then produced commercially. The extent of public acceptance and usage of any one drug has usually been determined by the medical profession. The use of many of the new compounds was only of short duration; they were frequently replaced by other compounds found to be more effective, or which did not provoke inconvenient side reactions. The case of 'Heroin' diacetylmorphine is almost unique. Hailed as a wonder drug, it was received with enthusiasm by the medical profession. Inevitably, the deleterious effects of the drug were discovered. Although many doctors discontinued prescribing heroin and all warned against careless use of the drug, the market for it continued to flourish. A dangerous addiction-producing drug, it was not easy to curtail its usage. This paper proposes to trace the story of heroin from its discovery and enthusiastic acceptance until its present doubtful status to-day. Although diacetylmorphine was not prescribed as a medicine much before its preparation had already been reported in by C. Wright at St. Mary's Hospital in London. By boiling anhydrous morphine alkaloid for several hours with acetic anhydride he was able to isolate acetylated morphine derivatives. The general conception of the morphine molecule in those days was that it was represented by the double empirical formula \[ 2 \] which gave rise to the rather confusing nomenclature in his article. The extreme acetylated derivative which he obtained, he called ' Tetra acetyl morphine. This 'Tetra acetyl morphine' was sent to F. Pierce, Associate at Owens College, London, for biological assay. After having tested the compound in animal experiments he reported the following results to Wright. The effects were:1' Respiration was at first quickened, but subsequently reduced, and the heart's action was diminished and rendered irregular. From a medical point of view the interest in this new morphine derivative was not very high for the first twenty years. In , a German scientist, W. Dankwortt, \[ 3 \] prepared diacetylmorphine by heating anhydrous morphine with excess acetylchloride. The result of his work is important, not from the pharmacological, but from the chemical point of view. Because of the nature of the compounds he was able to isolate, he concluded that the morphine molecule had a simple empirical formula rather than the double one. In the last decade of the 19th century Dreser \[ 4 \] and other investigators studied the physiological effects of diacetylmorphine. The favourable reports of these investigators along with the growing interest in the drug shown by the medical profession of that time, led the Bayer Company in Eberfeld, Germany, to start production of the compound on a commercial scale The new compound was marketed by Bayer under the name 'Heroin. Later this name became a synonym for the drug. The new remedy received a spontaneous and widespread acceptance comparable to the acceptance of drugs like penicillin or cortisone in the past few years. The high frequency of tuberculosis and other respiratory diseases had created a great demand for an effective remedy and it was hoped that heroin would meet this need. Prescribed for almost all illnesses in which codeine or morphine had been found, heroin was also considered to be effective in combating addiction to these two drugs. This enthusiasm for the new drug is best illustrated in the medical literature of the time. Though by no means exhaustive, these following excerpts are typical of the writings of the day. Testing heroin on 50 patients afflicted with phthisis, he found it effective in relieving their cough and in producing sleep. Though Strube observed no adverse effects, he felt that further observations were necessary to determine whether continual use might be harmful or lead to chronic 'heroinism'. At the request of Dreser, Floret experimented with the drug in the Poliklinik der Farbenfabriken For cases of dry bronchitis where codeine has been ineffective, Floret reported that heroin was unusually prompt and dependable. These were among the experiments that led to Dreser's \[ 7 \] endorsement of heroin at the congress of German Naturalists and Physicians in Claiming that heroin was ten times as effective as codeine in the treatment of respiratory diseases, he estimated that it had only one-tenth of the toxic effects. Leo \[ 8 \] in reporting the frequent success he had observed in administering the drug, gave a detailed case history of one of his patients. In , the patient, then 71 years of age, developed a severe cough with expectoration and suffered from dyspnea. After being hospitalized in the summer of , and again in the summer of , the patient was finally sent to a sanatorium in November By this time his condition had become considerably worse. Respiration was rapid and difficult, fat and muscular tissue had deteriorated, the lungs were enlarged and heart action was poor. By February , drugs no longer afforded the patient any relief and he was unable to sleep at night. Heroin was then prescribed. The description of the treatment follows:. The patient had been given the first dose the evening before. The night was still without sleep, but the cough was looser and effortless. Also the dyspnea was not so pronounced. After he had taken the drug he felt very comfortable and stated that he no longer felt sick. The action of the heart was somewhat more regular. The appetite was better. The patient had obtained some sleep. The sensation of fear that was always with him was gone. The respiratory frequency in the morning was The cough was without difficulty. The patient slept soundly most of the night, in a reclining position. The respiratory frequency in the morning: The action of the heart was regular. The ailments he had suffered before gradually returned. Heroin was again administered and had the same beneficial action as before. Manges \[ 9 \] who had previously reported on the advantages of heroin over morphine in the treatment of coughs, phthisis and asthma, reiterated his confidence in the drug in Where most of the cases included in Manges report did not show habituation, in two cases it had also been found to be successful in breaking addiction to morphine. Prompted by Harnack's \[ 11 \] warning in , that heroin might be a dangerous poison, Turnauer \[ 12 \] tested the drug for the possibility of harmful after effects. After treating 48 cases of phthisis, bronchitis and dyspnea, Turnauer noted a tolerance to the drug. After administering heroin for a long period, he found that the dosage needed to be increased. He stated that he found 'No harmful results, especially as I observed no abstinence symptoms whatever. Generally it appeared that in all cases in which period of time was allowed to elapse the full effect could again be obtained with small doses It may be concluded that, regarding tolerance to heroin, certain individuals react peculiarly and it is recommended that in the case of old and feeble persons, the initial dose should not be over 0. Horatio C. Wood \[ 13 \] Jr. He warned that experimentation was still not adequate to warrant the conclusion that heroin was not addiction producing. Many other investigators recommended the use of heroin at the turn of the century. Most of them failed to refer to the danger in its usage or implicitly stated that it did not lead to tolerance. In , Joseph Jacobi, basing himself on the use of heroin in 85 cases, claimed the drug as superior as a cough-soothing remedy. Although he found its use more effective with patients who had never used strong narcotic drugs, he reported that any tendency towards tolerance could be averted if dosage was curtailed for several weeks. He also recommended that its use should be alternated with morphine or codeine. At about this time the enthusiasm for heroin started to wane. His practice was criticized by Jarrige \[ 16 \] in who claimed that physicians would thus make 'heroinists' of their patients. Citing several cases of heroinism, he was emphatic in his contention that the withdrawal of heroin was much more painful than that of morphine. Rather than reducing the use of narcotics, the advocation of heroin was responsible for many persons becoming drug addicts. In Pettey \[ 17 \] reported that of the last cases he had treated for drug addiction, eight were heroin users and of these, three had first become addicts through the use of heroin. He further reported that the heroin habit was just as difficult to cure as the morphine habit. Sollier, \[ 18 \] in , deplored the use of heroin in the treatment of morphinism. This practice, he claimed, had resulted in the number of heroin addicts becoming as great as that of morphine addicts. Heroin was extremely toxic and the extent of poisoning in the heroinists he had seen, was much greater than it would have been for the same amount of morphine. Sollier found that the mental and physical deterioration from the use of heroin was very rapid. He opposed its use in the treatment of both morphinism and respiratory diseases. In the same year Atwood \[ 19 \] reported a case of heroinism in a woman who had become addicted to heroin after its use in surgery. Although not as vehement as Sollier and Jarrige, Atwood advised caution in prescribing the drug. Atwood believed cases of heroin addiction to be rare, but he pointed out that such cases would become more common if no discretion was used by the medical profession and he was against its prescription for coughs, recurring headaches, rheumatism and other chronic diseases. At that time, however, there was no other drug that could fully replace heroin for some medical indications, and the medical profession was still in favour of it in spite of knowing many of its disadvantages. Trawick \[ 20 \] of Kentucky expressed it : 'I feel that bringing charges against heroin is almost like questioning the fidelity of a good friend. I have used it with good results, and I have gotten some bad results, such as a peculiar bandlike feeling around the head, dizziness, etc. It took a long time for the medical profession to realize the full danger of heroin addiction. On the other hand, very little time passed after the drug had become readily available before the underworld and smugglers discovered that heroin possessed properties even beyond those of other narcotics, which have since made it the main drug of addiction in many parts of the world. The analgesic and euphoric properties of heroin are much greater per gram than those of morphine. Whereas morphine usually is administered by a hypodermic needle, heroin can be sniffed into the system. However, persons addicted to heroin soon come to use it hypodermically and even intravenously. As the sensible effect wanes with increasing addiction, they try larger doses and more drastic methods of self-administration, always trying to recapture the stimulation of the drug. The addiction-forming properties of heroin are more pronounced even than those of morphine. It produces a disregard for the conventions and morals of civilization and these symptoms progress more rapidly than with other habit- forming drugs. Heroin addiction is the most difficult to cure; sudden withdrawal may lead to cramps, convulsions, and even to death from respiratory failure. The post-convalescent treatment, both psychological and physical, is longer and more difficult than with morphine. Drug addiction is an international problem. The addicts preference however seems to vary greatly in different regions. In the Far East opium has been used as a narcotic for centuries, \[ 23 \] in the middle East hashish. In other places heroin addiction has been more sporadic. The first place where heroin addiction seems to have been a major problem was the United States of America. The main site of the addiction was New York where 98 per cent of all drug addicts were reported at the time to be heroin addicts. The Public Health Service Hospitals in the United States discontinued dispensing heroin at its relief stations in In the House of Delegates of the American Medical Association at its 71st annual session adopted the following resolution: 'that heroin be eliminated from all medicinal preparations and that it should not be administered, prescribed, nor dispensed; and that the importation, manufacture, and sale of heroin should be prohibited in the United States. Several other authorities, especially the police, supported this resolution. The growing number of crimes in the larger cities in the United States alarmed the public. In while there were seventeen murders committed in London there were in New York City and heroin addiction was blamed for a number of the New York murders. Placing the consumers receiving their drugs from the illicit narcotic street venders in New York City at a minimum of 10, based upon statistics of arrests , using at an average of ten grains a day per individual, we have a total of 76, ounces as the yearly quantity of heroin used by the narcotic addicts who procure their drugs on the streets in New York City alone. The result of these observations was a congressional law that prohibited the import of crude opium for the purpose of manufacturing heroin June The production of heroin by pharmaceutical factories ceased within a very short time. As a substitute for heroin, the factories concentrated their efforts on the production of codeine. The quantity of codeine substituted for heroin must be about two to six times the weight of the quantity of heroin originally used if a similar medicinal effect is to be obtained. Since there is little difference between the quantities of heroin and codeine produceable from a given quantity of opium, the quantity of opium required to be imported into the United States had to be greater after the enactment of the law. This is the main reason for the high opium import of the United States shortly after Although the legitimate production of heroin practically ceased after , the addicts' demand for the drug continued to be supplied by smugglers. The heroin traffic in United States reached its peak in the last part of the 's. By , there was a sharp drop in the traffic due mainly to international restrictions. The heroin still in the illicit traffic was generally adulterated. When World War II started, stricter border controls and lack of shipping lessened the illicit supplies of heroin. To stretch the supplies the traffickers resorted to more and more adulteration and dilution of the drug. The heroin finally obtained by the addict often contained less than two per cent of heroin. Many addicts were involuntarily cured, some without even realizing it. Others broke off the habit at least temporarily. As one stated: 'If I could get good heroin or morphine again I would probably go back to using the drugs. As it is, I won't touch it as it has so much other stuff mixed with it that it is dangerous. The following figures show the amount of seized heroin in the United States from till \[ 34 \]. Another part of the world where heroin addiction attracted attention was Egypt. From ancient times hashish had been used as a narcotic in this country. The use of narcotics was however not such a serious problem before the 'white drugs' came into the picture. This started in , cocaine first being sold non-medically and shortly afterwards heroin. The price of the new narcotic was kept low to start with, until the vice had spread and caught large numbers of victims in its grip. There were even instances when contractors were paying their labourers with heroin. The hygienic conditions among the addicts were often beyond description and all sorts of sicknesses followed in the wake of heroin. Thus a great epidemic of malignant malaria started among the addicts in , spread by the hypodermic syringe, which was injected into one person to the other without being disinfected after the use. Taking into consideration that the total population of Egypt at that time was about 14 million, the extent of the problem may be realized. Before the first World War, there had been no drastic narcotic regulations in Egypt. The maximum penalty was 7 days' imprisonment or a fine of LE 1. When it became evident that the heroin habit had become a serious problem, a new law was enacted which became effective in During the first twelve months after the enactment of the new law, 5, prosecutions were made under it in Cairo alone. Within the year the maximum penalties were increased to 5 years' imprisonment and LE 1, fine. The new law made the drug traffic much more difficult in Egypt, but wholesale smuggling of the heroin began and increased in intensity until It is interesting to compare the number of seized heroin samples with the other narcotics in Egypt after the narcotic law in The number of seizures is a good indication of the traffic in narcotics. It seems from the table that the addiction to heroin in Egypt reached its peak in and from then on it dropped rapidly. This drop after was due to two causes. The Convention on Narcotic Drugs had just come into effect and international measures quickly cut down the supply from all sources that made any pretense of legality. Also, new and vigorous legislation was enacted by the Turkish Government, and three big factories in Turkey were closed down. To start with, most of the illegal heroin in Egypt came from Europe, \[ 41 \] but through stricter control these sources were closed and Turkey became the main source of supply. The manufacturers in Turkey transferred their equipment to other countries they thought to be more safe. Most of it went to Bulgaria where in a short time three or four larger factories were in operation. This new site of heroin production was discussed by the League of Nations Advisory Committee on traffic in opium and other dangerous drugs in with the result that the Bulgarian Government closed down the factories and made the manufacturers once again homeless. China now became a center of heroin production and the epidemic spread of heroin addiction. This country was already suffering from the use of smoking opium and the Chinese authorities had with varying results tried to stamp out opium addiction. Around the beginning of the century, the 'white drugs' began to arrive in China from Europe. The greater potency of morphine and heroin was discovered by an increasing number of former opium addicts, especially in the coastal cities. In addition to products from the western world, Japanese pharmaceutical firms also started the manufacture of great quantities of heroin, and sent it to the Chinese market to fulfil the growing demand of the newly created addicts. The cheapness and the potency of heroin attracted the Chinese addict. A few cents would buy a dose of heroin or a heroin cigarette. In pill form the consumption of the drug is more secret and consumes less time than the opium smoking. Whenever the prohibition on smoking opium was periodically enforced by the Chinese Government; the consumption of the white drugs would increase since the absence of the opium odor and the opium pipe made it easier to evade the law. Even when opium smoking was tolerated on condition of registration, the white drugs retained their popularity, for the addicts feared to register because they would then be known and the government might at any time decide to cut off their supplies. The laws relating to the white drugs are the strictest that China has ever tried to enforce. The Provisional Regulations for the Drastic Prohibition of Highpowered Narcotic Drugs were promulgated in May \[ 46 \] to deal with the increasingly serious danger of manufactured drugs. According to these regulations, the penalty for the manufacture, transportation, and sale of highpowered narcotic drugs containing morphine, cocaine or heroin was death. The penalty for giving protection to those who manufacture, transport, or sell such drugs was also death. After January 1, even uncured addicts were given life imprisonment or executed. The goal of the government was the suppression of the addiction in a six-year period. The progress obtained under the new laws was abruptly interrupted by the outbreak of the war between China and Japan in In the unoccupied part of China efforts were still made to suppress the drug habit. When the six-year plan for the suppression of narcotics terminated January 1, , the Chinese Government circulated a statement throughout Free China warning against all further indulgence of opium. The same law provided that heroin addicts were to be shot if apprehended taking injections or smoking heroin pills and that opium smokers were to be imprisoned from one to five years. Before and during World War II it was commonly reported that the Japanese occupying forces had protected the manufacture and trade with heroin in their territories. This was confirmed after the war when large heroin factories were discovered by the Allies. The Commissioner of Narcotics of the United States reported that in one factory at Seoul, Korea, operated by the militarist Japanese Government of that time, 1, kilos of heroin were manufactured in ; and in , 1, kilos. During these two years, while the Japanese occupied Manchuria, 2, kilos of this heroin were consigned to the Manchukuo Monopoly Bureau. The normal annual heroin requirements for China, including Manchuria, prior to were 15 kilos. The total world medical needs for heroin for and were not more than 1, kilos for each year. Accordingly, the output of this one heroin factory alone was more than the total world medical needs for heroin. The Hague Opium Convention of placed heroin in the same category as morphine and cocaine. A control was to be instituted over all persons manufacturing, importing, selling, distributing and exporting the drug and its salts. Registers of the amounts manufactured, imported, and exported were to be kept. Furthermore, dealings with unauthorized persons in the international trade of these drugs were forbidden. All preparations containing more than 0. There was however no indication how the control over production and distribution should be implemented. Every country was allowed to decide for itself the best method. By the time of the outbreak of the first World War, only eleven countries had ratified the Convention, although seven others had notified their willingness to do so. The peace treaties after the end of the war, however, automatically brought the Hague Convention into force between the parties to the treaties. The main defect of the Hague Convention was that it created no administrative machinery for the implementation of the principles agreed on. The Geneva Convention of \[ 51 \] attempted to get rid of the defects of the Hague Convention and as far as heroin is concerned confined the manufacture to those establishments and premises alone which were licensed for the purpose. It required that all persons engaged in the manufacture, sale, distribution, or export of the drug should obtain a licence or permit to engage in these operations. It required also that such persons should enter into their books the quantities manufactured, imports, exports, sales and all other distribution of the drug. Under the system created by the Convention, the exporter is obliged to obtain from his government an export licence which will only be issued on production of the copy of an import certificate issued by the government of the importing country. A copy of the export authorization accompanies the consignment and must state the number and date of the import certificate so that it can be linked with it. Transit through a third country and the diversion of a consignment were also strictly controlled. By these means a strict check was made possible over the international trade in narcotic drugs. The Convention also abolished under the supervision of the Permanent Central Opium Board set up by the new International Instrument the exemption in the Hague Convention of for preparations containing not more than 0. The Geneva Convention came into force on 28 September, See graphs on page 8 and on page 9. However, the controls brought about under this Convention did not limit directly the quantities of drugs to be manufactured. When in and the Egyp- tian Government reported the serious situation that had been created in the Middle East by the existence of uncontrolled factories in Turkey see page 9 , the tenth Assembly of the League adopted unanimously a resolution in favour of a system of limiting the manufacture of dangerous drugs. The system of limitation finally embodied in the Limitation Convention of \[ 53 \] is based upon estimates which contracting and non-contracting parties are asked to furnish of the drugs required during the coming year. The estimates are based solely on the medical and scientific requirements of the country furnishing them and are designed to include:. The quantity necessary for use as such for medical and scientific needs, including the quantity required for the manufacture of preparations for the export of which export authorizations are not required, whether such preparations are intended for domestic consumption or for export. The quantity necessary for the purpose of conversion, whether for domestic consumption or for export. These estimates are examined and endorsed by a Supervisory Body set up by the Convention. In cases where the national estimates seem excessive, the Supervisory Body has the right to make recommendations to the governments concerned, with a view to their reduction. In case estimates are not furnished by any country, the Supervisory Body is empowered by Article 2 of the Convention to make the estimates itself. Special restrictions were laid on diacetylmor-phine and its preparations by Article 10 of the Convention. Exports were prohibited, except on the request of the government of a country not manufacturing diacetylmorphine accompanied by an import certificate. The effect of the and Conventions will be seen from the production figures given below and the graph on page The Permanent Central Opium Board reviews the progress of international control of drugs as follows: \[ 55 \]. This fact Nevertheless, the Board feels justified in stating even on the basis of the short period for which it has complete statistics, that some of the chief aims of the two conventions on the control of manufactured drugs-namely, a complete account of the supplies available Geneva Convention of and the limitation of the manufacture to medical and scientific requirements Limitation Convention of have been to a large extent and subject to one exception attained. The exception mentioned concerned the illegal manufacture of heroin in Japan and Korea discussed previously. See page It was estimated that from to , 94 per cent of the world supply was accounted for. As between pre-war and post-war there has been some changes in the proportion of the world's output produced by the heroin-manufacturing countries. It is also interesting to note the pre- and post-war legal consumption of heroin in the various countries. See graphs on pages Whereas in most countries, there has been a decrease in the consumption per million inhabitants, in a few others there has been a marked increase. Due to the fact that in various parts of the world the heroin traffic has increased since World War II, creating conditions which have attracted the public's attention, such as the addiction among teen-agers in New York and other large cities in the United States, \[ 58 \] the question of total suppression of heroin is being discussed by international organizations. The question of world-wide suppression of heroin production is not however of recent date. Such a proposal was made as early as in the Opium Advisory Committee which recommended the Council to request Governments to communicate their views as to the possibility of total suppression of the manufacture of heroin. The proposal for abolition was rejected by the Conference in At the Limitation Conference \[ 61 \] a proposal was first moved for the total abolition of the use of heroin. This was objected to on the grounds that the drug was of medical value; that practically none was escaping into the illicit traffic for the amounts exported by manufacturing countries on the basis of import certificates, and that, even if heroin were abolished, it could be manufactured from morphine by any trafficker without any particular difficulty. In the result, the legal use of heroin was not forbidden, but special restrictions were put on heroin, in Article 10 of the Convention. In reply to a circular letter sent by the League of Nations to governments in \[ 62 \] requesting opinions on the possibility of abolishing or restricting the use of diacetylmorphine, 12 countries communicated reasons why they did not feel able to consider abolishing or restricting the use of the drug. Four countries answered that they were in favour of restricting the use of diacetylmorphine, 8 countries stated that the use of the drug was already restricted de jure or de facto in their territories, 9 countries stated that they were in favour of completely abolishing the use of diacetylmorphine. Finally, 7 countries stated that the use of diacetylmorphine was in fact already prohibited in their territories by various measures. The United States Government had already in prohibited the import of opium for the manufacture of heroin see page 7. The Bulgarian Government had prohibited the importation, manufacture of and trade in heroin 25 July By decree of August 3, , \[ 64 \] the Spanish Govern- ment had prohibited the manufacture, import, distribution and consumption of diacetylmorphine. In Costa-Rica \[ 65 \] the use of diacetylmorphine had been entirely prohibited from October 24, According to the Mexican Health Code \[ 66 \] from the import, export, preparation, possession, use and consumption of the drug was prohibited. In Greece, heroin was excluded from the list of narcotic drugs whose use was permitted by the Greek State Monopoly From , the Polish Government \[ 66 \] prohibited in its territory the manufacture, import and export of diacetylmorphine. The indispensability of heroin from the point of view of the medical profession has largely decreased since the introduction of dihydrocodeinone, dihydromorphinone and some of the new synthetic analgesics. In reply to a similar inquiry by the World Health Organization in , \[ 67 \] 38 member States have replied that they are in favour of dispensing with heroin, while 9 States are in favour of retaining it. The latter, however, includes several of the chief manufacturing countries of the world. Wright, C. Dreser, H. Strube, G. Leo, H. Harnack, E. Wood, Horatio C. Payne, E. Wolff, P. Morphinismus, Kokainismus, u. Sonderabdruck aus der 'Apotheker-Zeitung , f. Treasury Department, Bureau of Narcotics. Traffic in Opium and other dangerous Drugs for the year ended December 31, Printing Office, Washington, , Government Printing Office, Washington D. Treasury Department, Bureau of Narcotics, U. Government Printing Office, Washington: , Bulaq, Cairo, , Merril, Frederick T. League of Nations document : O. League of Nations document: C. Geneva, May 27th-July 13th, C. Anslinger, H. Ordinance No. Report from Bulgaria United Nations. Office on Drugs and Crime. Site Search. Topics Crime prevention and criminal justice. The description of the treatment follows: 'February 4. United Nations Office on Drugs and Crime.

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