6-Monoacetylmorphine

6-Monoacetylmorphine (6-MAM) is one of three active metabolites of heroin (diacetylmorphine), the others being morphine and the much less active 3-monoacetylmorphine (3-MAM).

Pharmacology

6-MAM is rapidly created from heroin in the body, and then is either metabolized into morphine or excreted in the urine. Since 6-MAM is a unique metabolite to heroin, its presence in the urine confirms heroin use.

The presence of 6-MAM, which is only a metabolite of heroin, is used as a diagnostic marker in clinical settings to determine if a patient has injected heroin, as opposed to using prescription morphine.

Metabolism

6-MAM remains in the body for only a short time, making it difficult to detect. Heroin is metabolized by enzymes in the liver to 6-MAM, which is then further metabolized to morphine or excreted in the urine.

Effects

The effects of 6-MAM are largely due to its conversion to morphine in the body. Morphine can cause euphoria, desensitization to physical and emotional pain, relaxation, satisfaction, and lethargy. 6-MAM binds to and activates mu-opioid receptors in the brain, spinal cord, and gut.

Toxicity

The toxicity of 6-MAM is due to its metabolites. Morphine, a metabolite of 6-MAM, is toxic and can cause respiratory depression, coma, and death.

See also

• Opioid
• Opioid receptor
• Opioid overdose
• Drug metabolism