Most reports on heroin preparation focus on the “standard” method, which consists in mixing the heroin powder with an acid, adding water or physiological saline solution and applying heat to dissolve the powder, without notable color changes.

The new, so-called “Turkish” heroin preparation method leads to more severe clinical side effects, i.e., abscesses and serious epidermal necrosis, but it is highly appreciated by many heroin consumers because of its very intense effects.

This method consists in heating heroin powder and ascorbic acid without addition of water to obtain a dark liquid slurry. Only then is saline water added and the resulting solution is sucked up in a syringe for intravenous injection. The LNS’s Technical Platform for Analytical Toxicology and Pharmaceutical Chemistry, together with the Abrigado (the drug consumption room in Luxembourg City) investigated the chemical reactions taking place when preparing heroin using this “Turkish” method.

Comparison of non-processed and processed material

Comparisons of the concentrations of heroin (diacetylmorphine or DAM), its degradation products 6-monoacetylmorphine (MAM) and morphine, and the common diluents paracetamol and caffeine were performed between the non-processed material, after processing according to the standard method and after processing according to the “Turkish” method. The standard and “Turkish” preparation methods had in common decreased levels of DAM as compared to the starting material, but significantly more MAM was produced using the “Turkish” method than using the standard method.

Turkish method produces high amount of psychoactive MAM

“The high amount of psychoactive MAM may be responsible for the reportedly more intense effects of heroin when using the “Turkish” preparation procedure, since it crosses the blood brain barrier almost as fast as heroin.” says Serge Schneider, Head of the Platform. He concludes by saying that “consumer awareness-raising of the hazardous effects of this specific preparation method must be considered by healthcare workers.”

The study was published in the open access “Harm Reduction Journal” and is available under: https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-020-00457-1

On the picture: “Standard” preparation (left), so-called “Turkish” preparation before (middle) and after (right) saline water addition.