Heroin, also known as diamorphine among other names, is an opioid most commonly used as a recreational drug for its euphoric effects. Medically it is used in several countries to relieve pain or in opioid replacement therapy. Heroin is typically injected, usually into a vein; however, it can also be smoked, snorted or inhaled. 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. Side effects of use by injection can include abscesses, infected heart valves, blood borne infections, and pneumonia. After a history of long-term use, withdrawal symptoms can begin within hours of last use. When given by injection into a vein, heroin has two to three times the effect as a similar dose of morphine. It typically comes as 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 as of 2015 use opiates of which heroin is the most common. Together with other opioids, they resulted in 122,000 deaths. The total number of heroin users as of 2015 is believed to have increased in Africa, the Americas, and Asia since 2000. In the United States about 1.6 percent of people have used heroin at some point in time with about 950,000 using in the last year. 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. It is generally illegal to make, possess, or sell heroin without a license. About 448 tons of heroin were made in 2016. In 2015 Afghanistan produced about 66% of the world's opium. Heroin, which is illegally sold, is sometimes mixed with other substances such as sugar, starch, quinine, or strychnine.