Heroin known as diamorphine among other names, is an opioid most used as a recreational drug for its euphoric effects. It is used medically in opioid replacement therapy, it is injected into a vein, but it can be smoked, snorted, or inhaled. The onset of effects is rapid and lasts for a few hours. Common side effects include respiratory depression, dry mouth, impaired mental function and addiction. Side effects of use by injection can include abscesses, infected heart valves, blood-borne infections, 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 comes as a white or brown powder. Treatment of heroin addiction includes behavioral therapy and medications. Medications can include 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, 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, Asia since 2000. In the United States 1.6 percent of people have used heroin at some point, with 950,000 using it in the last year. When people die from overdosing on a drug, the drug is an opioid and 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 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 mixed with other substances such as sugar, quinine, or strychnine; the original trade name of heroin is 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 and increased doses are needed in order to achieve the same effects.

Its popularity with recreational drug users, compared to morphine 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 and pethidine, former addicts showed a strong preference for heroin and morphine, suggesting that heroin and morphine are susceptible to abuse and addiction. Morphine and heroin were much more to produce euphoria and other "positive" subjective effects when compared to these other opioids. 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, intramuscular, 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 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. Diamorphine continues to be used in palliative care in the UK, where it is given by the subcutaneous route via a syringe driver, if patients cannot 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, necessary in palliative care, it is used in the palliative management of bone fractures and other trauma in children. In the trauma context, it is given by nose in hospital, it has traditionally been made by the attending physician from the same "dry" ampoules as used for injection.

A number of European countries prescribe heroin for treatment of heroin addiction. Diamorphine may be used as a maintenance drug to assist the treatment of opiate addiction in long-term chronic intravenous 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, 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 specialised centres be allowed to prescribe diamorphine and benzoylmethylecgonine to users.

The law was made more restrictive in 1968. Beginning in the 1970s, the emphasis shifted to the use of methadone.

La Crosse, Washington

La Crosse is a town in Whitman County, United States. The population was 313 at the 2010 census. With the completion in 1888 of the O. R. & N railroad line between Riparia and La Crosse, George Dawson and his wife built a shack constructed from railroad ties. By 1889, La Crosse had a population of 12; the first real store was constructed in 1899 by Tom Shobe. La Crosse was incorporated on February 19, 1917. La Crosse is located at 46°48′51″N 117°52′48″W. According to the United States Census Bureau, the town has a total area of 0.78 square miles, all of it land. According to the Köppen Climate Classification system, La Crosse has a warm-summer Mediterranean climate, abbreviated "Csb" on climate maps; as of the census of 2010, there were 313 people, 153 households, 96 families residing in the town. The population density was 401.3 inhabitants per square mile. There were 181 housing units at an average density of 232.1 per square mile. The racial makeup of the town was 95.8% White, 0.3% African American, 0.6% Native American, 0.3% Asian, 0.3% from other races, 2.6% from two or more races.

Hispanic or Latino of any race were 0.3% of the population. There were 153 households of which 19.6% had children under the age of 18 living with them, 52.9% were married couples living together, 5.2% had a female householder with no husband present, 4.6% had a male householder with no wife present, 37.3% were non-families. 33.3% of all households were made up of individuals and 22.9% had someone living alone, 65 years of age or older. The average household size was 2.05 and the average family size was 2.53. The median age in the town was 51.8 years. 15.7% of residents were under the age of 18. The gender makeup of the town was 49.8 % female. As of the census of 2000, there were 380 people, 164 households, 105 families residing in the town; the population density was 1,101.6 people per square mile. There were 187 housing units at an average density of 542.1 per square mile. The racial makeup of the town was 93.42% White, 3.16% Native American, 0.26% Asian, 0.53% from other races, 2.63% from two or more races.

Hispanic or Latino of any race were 0.53% of the population. There were 164 households out of which 31.1% had children under the age of 18 living with them, 54.3% were married couples living together, 9.1% had a female householder with no husband present, 35.4% were non-families. 32.9% of all households were made up of individuals and 19.5% had someone living alone, 65 years of age or older. The average household size was 2.32 and the average family size was 2.90. In the town, the age distribution of the population shows 28.2% under the age of 18, 1.6% from 18 to 24, 26.6% from 25 to 44, 21.1% from 45 to 64, 22.6% who were 65 years of age or older. The median age was 42 years. For every 100 females, there were 99.0 males. For every 100 females age 18 and over, there were 88.3 males. The median income for a household in the town was $30,893, the median income for a family was $40,833. Males had a median income of $30,972 versus $20,313 for females; the per capita income for the town was $16,656. About 2.1% of families and 5.9% of the population were below the poverty line, including 4.5% of those under age 18 and 6.0% of those age 65 or over.

The La Crosse Arts and Beautification Council was created in 2005 with aspirations of renovating downtown La Crosse while promoting the arts, local culture, history of La Crosse and the Palouse. Events have included the Spring Faire; the Council was disbanded in 2008 after sexual assault allegations against head chairman Barbara DeSmall. The La Crosse Gun Club holds an annual "Crab Shooting" event at the end of January; the La Crosse Farmers Festival, held in mid-June, is celebrated with a parade and live entertainment. Town of LaCrosse LaCrosse Arts & Beautification Council

Barrio De Analco Historic District

The Barrio de Analco Historic District is a National Historic Landmark District centered at the junction of East De Vargas Street and Old Santa Fe Trail in Santa Fe, New Mexico. The seven buildings of the district represent one of the oldest clusters of what were working-class or lower-class residences in North America, are in a cross-section of pre-statehood architectural styles, it includes two of the oldest colonial-era buildings in the southwest, the San Miguel Mission church, the "Oldest House", built in 1620 and now a museum. The district was declared a National Historic Landmark in 1968; the Barrio de Analco is located on the south side of the Santa Fe River, across the river from the main downtown area that includes the Santa Fe Plaza and the Palace of the Governors. The district is anchored at the junction of Old Santa Fe Trail and East De Vargas Street, extends a short way to the south and west; the San Miguel Mission church, on a site occupied by a church since the 1610s, is at the southeast corner, the 1620 "Oldest House", a two-story adobe construction, is at the northeast corner.

South of the mission is the Lamy Building known as St. Michael's Dormitory, an 1878 school building that exemplifies the Territorial style, common in the pre-statehood era. West of the main junction, separated from it by the Santa Fe Playhouse, are the Gregorio Crespin House and the Roque Tudesqui House, both built in the Spanish Pueblo style; the Crespin House was built in the mid-18th century. Separated from the rest of the district near the junction of East De Vargas and Paseo de Peralta are the Boyle House a mid-18th century Spanish Pueblo building, the Bandelier House, an 1867 Territorial style house, further notable as a home of archaeologist Adolph Bandelier; the name "Analco" comes from the Nahuatl language spoken by the Tlaxcalteca people who accompanied the Spanish. "A" = water + "nal" = next to + "co" place of = next to the water. The barrio was established not long after Santa Fe's founding in 1609-10, as a district for artists and servants, while the area north of the river was occupied by the wealthy and powerful.

The buildings in this district built to serve that type of community through several centuries, document the changes in architecture from a nearly pure native adobe construction, to the Spanish Pueblo style, the Territorial. National Register of Historic Places listings in Santa Fe County, New Mexico List of National Historic Landmarks in New Mexico Historic American Buildings Survey No. NM-1, "San Miguel Church, Santa Fe, Santa Fe County, NM", 11 photos, 19 measured drawings, 4 data pages, supplemental material