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Early warning signs include persistent fatigue that does not improve with rest, difficulty concentrating or brain fog, tingling or numbness in hands and feet, weakness in the legs, dizziness when standing up, pale or yellowish skin, and a sore or swollen tongue

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Thus, while 6-MAM is undoubtedly the main metabolite present in the first few minutes following heroin administration, it is reasonable to assume that also morphine and M6G play a part in the subjective and behavioral effects of heroin
