88 Sentences With "diamorphine" | Random Sentence Generator

In 1895 scientists at Bayer, a German pharmaceutical firm, began selling a strong morphine compound called diamorphine.

Shipman dispatched his victims -- mostly elderly women -- with large amounts of diamorphine from 1975 to 1998, a report said.

These include the bladder cancer therapy BCG and even diamorphine, or heroin, the powerful painkiller sometimes given to end-stage cancer patients.

Over the course of 11 years, from 1989 to 2000, at least 456 people died after being given diamorphine -- synthetic heroin -- as a painkiller, under the direction of Barton, the report said.

Despite far stricter monitoring of controlled drugs since the conviction of GP Harold Shipman, who stockpiled the diamorphine he used to kill at least 211 patients using fake prescriptions, medics are still stealing drugs.

In the mid-22014s, it was discovered that while he was working as Margaret Thatcher's senior adviser on NHS reform, Dr. Clive Froggatt was faking hundreds of diamorphine (pharmaceutical heroin) prescriptions to feed his secret habit.

It aims to reduce the risk of overdoses and the spread of viruses such as H.I.V. by prescribing diamorphine — the clinical name for pharmaceutical-grade heroin — for patients to inject in a secure clinical room under the supervision of trained medics.

From 1989 to 2000, doctors at Gosport War Memorial Hospital — and one doctor in particular — routinely prescribed heroin, also called diamorphine, and other opioids for patients who were not in any pain, and for others whose pain should have been handled with much milder drugs, in blatant violation of accepted medical practice, the panel found.

In Hong Kong, diamorphine is regulated under Schedule 1 of Hong Kong's Chapter 134 Dangerous Drugs Ordinance. It is available by prescription. Anyone supplying diamorphine without a valid prescription can be fined $5,000,000 (HKD) and imprisoned for life. The penalty for trafficking or manufacturing diamorphine is a $5,000,000 (HKD) fine and life imprisonment.

It was supposed that around 230 addicts would be able to receive free diamorphine. However, Danish addicts would only be able to inject heroin according to the policy set by Danish National Board of Health. Of the estimated 1500 drug users who did not benefit from the then-current oral substitution treatment, approximately 900 would not be in the target group for treatment with injectable diamorphine, either because of "massive multiple drug abuse of non-opioids" or "not wanting treatment with injectable diamorphine". In July 2009, the German Bundestag passed a law allowing diamorphine prescription as a standard treatment for addicts; a large-scale trial of diamorphine prescription had been authorized in the country in 2002.

Some Australian cities (such as Sydney) have instituted legal diamorphine supervised injecting centers, in line with other wider harm minimization programs. Since January 2009, Denmark has prescribed diamorphine to a few addicts that have tried methadone and buprenorphine without success. Beginning in February 2010, addicts in Copenhagen and Odense became eligible to receive free diamorphine. Later in 2010, other cities including Århus and Esbjerg joined the scheme.

21 CFR 1308.11 (CSA Sched I) with changes through (18 October 2012) Possession of more than 100 grams of diamorphine or a mixture containing diamorphine is punishable with a minimum mandatory sentence of 5 years of imprisonment in a federal prison.

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. For women who have had intrathecal opioids, there should be a minimum hourly observation of respiratory rate, sedation and pain scores for at least 12 hours for diamorphine and 24 hours for morphine. Women should be offered diamorphine (0.3–0.4 mg intrathecally) for intra- and postoperative analgesia because it reduces the need for supplemental analgesia after a caesarean section. Epidural diamorphine (2.5–5 mg) is a suitable alternative.

In Canada, diamorphine is a controlled substance under Schedule I of the Controlled Drugs and Substances Act (CDSA). Any person seeking or obtaining diamorphine without disclosing authorization 30 days before obtaining another prescription from a practitioner is guilty of an indictable offense and subject to imprisonment for a term not exceeding seven years. Possession of diamorphine for the purpose of trafficking is an indictable offense and subject to imprisonment for life. In the United States, diamorphine is a Schedule I drug according to the Controlled Substances Act of 1970, making it illegal to possess without a DEA license.

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, which was 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 specialized centres be allowed to prescribe diamorphine and cocaine to users.

Diacetyldihydromorphine is quickly metabolized by plasma esterase enzymes into dihydromorphine, in the same way that diamorphine is metabolized into morphine. Diamorphine is 1.50–1.80 times the potency of morphine. It shares with other opioids the risk of overdose or (potentially life-threatening) respiratory depression. When strong narcotics are required, and morphine and diamorphine are not an option, it is more common to use better known drugs such as nicomorphine, hydromorphone, levorphanol, oxymorphone or fentanyl which doctors will be more familiar with, and which do not share the stigma associated with either heroin or morphine.

The law was made more restrictive in 1968. Beginning in the 1970s, the emphasis shifted to abstinence and the use of methadone; currently, only a small number of users in the UK are prescribed diamorphine. In 1994, Switzerland began a trial diamorphine maintenance program for users that had failed multiple withdrawal programs. The aim of this program was to maintain the health of the user by avoiding medical problems stemming from the illicit use of diamorphine. The first trial in 1994 involved 340 users, although enrollment was later expanded to 1000, based on the apparent success of the program.

Diamorphine is produced from acetylation of morphine derived from natural opium sources, generally using acetic anhydride. The major metabolites of diamorphine, 6-MAM, morphine, morphine-3-glucuronide, and morphine-6-glucuronide, may be quantitated in blood, plasma or urine to monitor for abuse, confirm a diagnosis of poisoning, or assist in a medicolegal death investigation. Most commercial opiate screening tests cross-react appreciably with these metabolites, as well as with other biotransformation products likely to be present following usage of street-grade diamorphine such as 6-acetylcholine and codeine. However, chromatographic techniques can easily distinguish and measure each of these substances.

He wrote that "There was no direct evidence that [Amara Tochi] knew the capsules contained diamorphine. There was nothing to suggest that Smith had told him they contained diamorphine, or that he had found that out of his own." paragraph 42 SGHC 233. However, Kan found that the large sum promised should have raised suspicion. Smith was not a rich man.

Moor prescribed 5 mg of diamorphine to be taken at intervals, but this had to be doubled when the pain got worse. It was agreed by his carers he was "terminally ill". It was agreed to send Liddell to a hospice. Moor set the diamorphine level at a rate of 30 mg per 24-hours by means of a syringe driver.

In the Netherlands, diamorphine is a List I drug of the Opium Law. It is available for prescription under tight regulation exclusively to long-term addicts for whom methadone maintenance treatment has failed. It cannot be used to treat severe pain or other illnesses. In the United Kingdom, diamorphine is available by prescription, though it is a restricted Class A drug.

Possession of diamorphine without a license from the Department of Health is illegal with a $1,000,000 (HKD) fine and 7 years of jail time.

They are required to contribute about 450 Swiss francs per month to the treatment costs. A national referendum in November 2008 showed 68% of voters supported the plan, introducing diamorphine prescription into federal law. The previous trials were based on time-limited executive ordinances. The success of the Swiss trials led German, Dutch, and Canadian cities to try out their own diamorphine prescription programs.

Heroin, also known as diacetylmorphine and diamorphine among other names, is an opioid used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt which is distinguished from black tar heroin, a variable admixture of morphine derivatives—predominantly 6-MAM (6-monoacetylmorphine), which is the result of crude acetylation during clandestine production of street heroin. Diamorphine is used medically in several countries to relieve pain, such as during childbirth or a heart attack, as well as in opioid replacement therapy. It is typically injected, usually into a vein, but it can also be smoked, snorted, or inhaled.

Diamorphine continues to be widely used in palliative care in the UK, where it is commonly given by the subcutaneous route, often via a syringe driver if patients cannot easily 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, which is often necessary for palliative care. It is also used in the palliative management of bone fractures and other trauma, especially in children.

The trials proved diamorphine maintenance to be superior to other forms of treatment in improving the social and health situation for this group of patients. It has also been shown to save money, despite high treatment expenses, as it significantly reduces costs incurred by trials, incarceration, health interventions and delinquency. Patients appear twice daily at a treatment center, where they inject their dose of diamorphine under the supervision of medical staff.

537, paras. 117–118. The Court disagreed with Yong's fifth argument that an offender who did not know the amount of pure diamorphine in the substance he was trafficking had not voluntarily assumed the risk of trafficking. A drug trafficker would know his act was illegal and that he would be punished if caught, regardless of his knowledge of the precise amount of pure diamorphine he was trafficking.Yong Vui Kong (substantive appeal), p.

Liddell's breathing got worse and on 19 July 1997 Moor gave him an injection of diamorphine and chlorpromazine. Within about 20 minutes Liddell was dead. The case would have gone unnoticed, but when The Sunday Times published an article by Michael Irwin on euthanasia, a journalist Rachel Ellis asked Moor his opinion on the subject. Moor said that he had given many patients overdoses of diamorphine, a comment he repeated in an interview on television.

According to the 50th edition of the British National Formulary (BNF), diamorphine hydrochloride may be used in the treatment of acute pain, myocardial infarction, acute pulmonary oedema, and chronic pain. The treatment of chronic non-malignant pain must be supervised by a specialist. The BNF notes that all opioid analgesics cause dependence and tolerance but that this is "no deterrent in the control of pain in terminal illness". When used in the palliative care of cancer patients, diamorphine is often injected using a syringe driver.

Trafficking in more than of diamorphine attracts a mandatory death penalty. The Court was of the view that Yong must have known that he had been carrying drugs.P.P. v. Yong Vui Kong (2009, H.C.), paras. 4–5.

Since the diamorphine in street heroin is the same as the pharmaceutical diamorphine, examination of the contaminants is the only way to test whether street heroin has been used. Other contaminants used in urine samples alongside noscapine include papaverine and acetylcodeine. Noscapine is metabolised by the body, and is itself rarely found in urine, instead being present as the primary metabolites, cotarnine and meconine. Detection is performed by gas chromatography-mass spectrometry or liquid chromatography- mass spectrometry (LCMS) but can also use a variety of other analytical techniques.

"Diamorphine" is the Recommended International Nonproprietary Name and British Approved Name. Other synonyms for heroin include: diacetylmorphine, and morphine diacetate. Heroin is also known by many street names including dope, H, smack, junk, horse, and brown, among others.

Singaporean laws against drug trafficking are to the effect that if a person is found with more than 2 grams of diamorphine, then the court will presume that he is trafficking, unless it is proved that the drug is not for that purpose. If more than 15 grams of diamorphine is found in his possession, the person faces the mandatory death penalty if found guilty. These two aspects of Singapore law, the non- requirement for proof of mens rea (guilty intention) and mandatory sentencing, have been criticised for being inconsistent with international legal standards. Tochi's lawyers put up a spirited defence.

Diacetyldihydromorphine (also known as Paralaudin, dihydroheroin, acetylmorphinol) is a potent opiate derivative developed in Germany in 1929 which is rarely used in some countries for the treatment of severe pain such as that caused by terminal cancer, as another form of diamorphine (also commonly known as Heroin). Diacetyldihydromorphine is fast-acting and longer- lasting than diamorphine, with a duration of action of around 4-7 hours. As an ester/analogue of dihydromorphine, diacetyldihydromorphine is presumably a Schedule I/Narcotic controlled substance in the United States but does not have its own ACSCN or annual production quota. It does appear in the German Betäubungsmittelgesetz and other European controlled-substances laws.

Rather, he stayed in the transit area of the airport until about 20 minutes later when the police arrived. Thus the conduct of the young man was consistent with his mistaken belief that he was only in possession of African herbs meant for a sick man as opposed to being in possession of diamorphine. Tochi admitted in his statements that he knew he had the capsules in his possession; and that he had agreed with Smith to deliver the capsules to Marshal for a promised payment of US$2000. In his judgement, Justice Kan Ting Chiu noted that Tochi might not have known that the capsules contained diamorphine.

Bupivacaine (Marcaine) is the local anaesthetic most commonly used, although lidocaine (lignocaine), tetracaine, procaine, ropivacaine, levobupivicaine, prilocaine, or cinchocaine may also be used. Commonly opioids are added to improve the block and provide post-operative pain relief, examples include morphine, fentanyl, diamorphine, and buprenorphine. Non-opioids like clonidine or epinephrine may also be added to prolong the duration of analgesia (although Clonidine may cause hypotension). In the United Kingdom, since 2004 the National Institute for Health and Care Excellence recommends that spinal anaesthesia for Caesarean section is supplemented with intrathecal diamorphine and this combination is now the modal form of anaesthesia for this indication in that country.

International drug routes Traffic is heavy worldwide, with the biggest producer being Afghanistan. According to a U.N. sponsored survey, in 2004, Afghanistan accounted for production of 87 percent of the world's diamorphine. Afghan opium kills around 100,000 people annually. In 2003 The Independent reported:Andy McSmith and Phil Reeves.

Narcotics laws established by the Misuse of Drugs Act are very strict. Anyone caught with more than of heroin (diamorphine), of cocaine or morphine, of methamphetamine, or of cannabis faces mandatory capital punishment, as they are deemed to be trafficking in these substances., ss. 5 and 33 read with the 2nd Sch.

Okeke Nelson Malachy (1972 - 26 January 2007, Changi Prison, Singapore) was found guilty of drug offences and subsequently executed by the government of Singapore.IOL, 2007-01-26 Malachy was convicted of capital drug offenses related to a scheme for the movement of a large quantity of diamorphine, which also resulted in the execution of Iwuchukwu Amara Tochi.

Nicomorphine (Vilan, Subellan, Gevilan, MorZet) is the 3,6-dinicotinate ester of morphine. It is a strong opioid agonist analgesic two to three times as potent as morphine with a side effect profile similar to that of dihydromorphine, morphine, and diamorphine. Nicomorphine was first synthesized in 1904 and was patented as Vilan by Lannacher Heilmittel G.m.b.H. of Austria in 1957.

537, para. 114. Yong's sixth argument was also dismissed, the Court explaining that the reason why the trafficking of a quantity of diamorphine greatly exceeding the 15-gram threshold did not incur a more severe sentence was because it would be impossible to impose a punishment more severe than the death penalty.Yong Vui Kong (substantive appeal), p. 537, para. 115.

Singapore enforces the death penalty by hanging. It is mandatory for premeditated and aggravated murder and for the possession or trafficking of more than of heroin in its pure form (diamorphine). According to Amnesty International, Singapore has one of the world's highest execution rates relative to its population. Some 400 criminals were hanged between 1991 and 2003, for a population of 5 million.

But the company fortunes were made from 1855, when the first Morphine injection was developed. T&H; Smith was the first company to produce commercial quantities of Apomorphine, and then Diamorphine in 1887. In 1906 the company moved from Canongate to the suburban outskirts of Edinburgh at Gorgie. During World War I, the company supplied Morphine and over of Lint-based medical dressings to the British Army.

Charles Romley Alder Wright FCS, FRS (7 September 1844 - 25 June 1894) was an English lecturer in chemistry and physics researcher at St. Mary's Hospital Medical School in London, England. He was a founder of the Royal Institute of Chemistry. Alder Wright developed hundreds of new opiate compounds and was the first person to synthesize diamorphine (heroin), in 1874. He also discovered AlSb (aluminium antimonide).

Noscapine can survive the manufacturing processes of heroin and can be found in street heroin. This is useful for law enforcement agencies, as the amounts of contaminants can identify the source of seized drugs. In 2005 in Liège, Belgium, the average noscapine concentration was around 8%. Noscapine has also been used to identify drug users who are taking street heroin at the same time as prescribed diamorphine.

Advertisement for Bayer Heroin The opium poppy was cultivated in lower Mesopotamia as long ago as 3400 BC. The chemical analysis of opium in the 19th century revealed that most of its activity could be ascribed to the alkaloids codeine and morphine. Diamorphine was first synthesized in 1874 by C. R. Alder Wright, an English chemist working at St. Mary's Hospital Medical School in London who had been experimenting combining morphine with various acids. He boiled anhydrous morphine alkaloid with acetic anhydride for several hours and produced a more potent, acetylated form of morphine which is now called diacetylmorphine or morphine diacetate. He sent the compound to F. M. Pierce of Owens College in Manchester for analysis. Pierce told Wright: Bayer Heroin bottle Wright's invention did not lead to any further developments, and diamorphine became popular only after it was independently re-synthesized 23 years later by chemist Felix Hoffmann.

Short-acting tablets, capsules, syrups and ampules which contain OxyContin are available making it suitable for acute intractable pain or breakthrough pain. Diamorphine, and methadone are used less frequently. Clinical studies have shown that transdermal Buprenorphine is effective at reducing chronic pain. Pethidine, known in North America as meperidine, is not recommended for pain management due to its low potency, short duration of action, and toxicity associated with repeated use.

Diamorphine is produced from acetylation of morphine derived from natural opium sources. One such method of heroin production involves isolation of the water-soluble components of raw opium, including morphine, in a strongly basic aqueous solution, followed by recrystallization of the morphine base by addition of ammonium chloride. The solid morphine base is then filtered out. The morphine base is then reacted with acetic anhydride, which forms heroin.

The recreational drug purple drank can be created with codeine syrup (pictured). A heroin (diamorphine) or other opiate/opioid addict may use codeine to ward off the effects of withdrawal during periods where their preferred drug is unavailable or unaffordable. Codeine is also available in conjunction with the anti-nausea medication promethazine in the form of a syrup. Brand named as Phenergan with Codeine or in generic form as promethazine with codeine.

In quest of a non-addictive alternative to morphine, Wright experimented with combining morphine with various acids. He boiled anhydrous morphine alkaloid with acetic anhydride over a stove for several hours and produced a more potent, acetylated form of morphine, now called diamorphine (or diacetylmorphine), also known as heroin. After Wright's death, Heinrich Dreser, a chemist at Bayer Laboratories, continued to test heroin. Bayer marketed it as an analgesic and 'sedative for coughs' in 1898.

The company then worked to develop a cost-effective production process that would facilitate the promising active ingredient to be supplied as a pharmaceutical product. In 1899 it was marketed for the first time under the trade name "Aspirin", initially as a powder supplied in glass bottles. He also synthesized diamorphine (heroin), previously achieved by Charles Romley Alder Wright. Following the synthesis of aspirin, Hoffmann moved to the pharmaceutical marketing department where he stayed until his retirement in 1928.

Due to the lipid solubility of diacetylmorphine, it can cross the blood–brain barrier faster than morphine, subsequently increasing the reinforcing component of addiction. Using a variety of subjective and objective measures, one study estimated the relative potency of heroin to morphine administered intravenously to post-addicts to be 1.80–2.66 mg of morphine sulfate to 1 mg of diamorphine hydrochloride (heroin). Advertisement for curing morphine addiction, ca. 1900 An ampoule of morphine with integral needle for immediate use.

In that case, the differentiating factor was found in the Misuse of Drugs Act ("MDA"), ("MDA"). which stipulated that an accused trafficking in more than of diamorphine (heroin) would result in him or her facing a mandatory death penalty upon conviction. Following its previous decision in Nguyen Tuong Van v. Public Prosecutor (2005),Nguyen Tuong Van v. Public Prosecutor [2004] SGCA 47, [2005] 1 S.L.R.(R.) 103, C.A. (Singapore), archived from the original on 15 November 2010.

Dipropanoylmorphine is slightly slower acting than diamorphine and morphine, but longer lasting, and is slightly more potent by weight due to its higher lipophilicity. Side effects are generally relatively mild for an opioid with a similar profile to morphine/heroin and typical of other opioids. The most common side effects associated with dipropanoylmorphine are itching, nausea and respiratory depression. Dipropanoylmorphine is prepared by reacting morphine with propionic anhydride, in an analogous manner to how heroin is produced by reacting morphine with acetic anhydride.

Tochi was arrested on 28 November 2004, in Changi Airport in Singapore while in transit. Authorities became suspicious after discovering that he had spent more than 24 hours in transit. One hundred capsules of diamorphine were found on him with a total weight of 727.02 grammes (a bit over a pound and a half), estimated by authorities to be worth S$1.5m (US$970,000). Tochi claimed that the capsules he carried were for a friend and insisted they were African herbs that tasted like chocolate.

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, subcutaneous, intramuscular, intrathecal, 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 morphine or other strong opioids in these situations.

When interpreting the results of a test, it is important to consider the diamorphine usage history of the individual, since a chronic user can develop tolerance to doses that would incapacitate an opiate-naive individual, and the chronic user often has high baseline values of these metabolites in his system. Furthermore, some testing procedures employ a hydrolysis step before quantitation that converts many of the metabolic products to morphine, yielding a result that may be 2 times larger than with a method that examines each product individually.

Grundy's body was exhumed and found to contain traces of diamorphine (heroin), often used for pain control in terminal cancer patients. Shipman claimed that Grundy had been an addict, and showed them comments he had written to that effect in his computerised medical journal; however, examination of his computer showed that they were written after her death. Shipman was arrested on 7 September 1998, and was found to own a Brother typewriter of the kind used to make the forged will. The police investigated other deaths Shipman had certified and investigated 15 specimen cases.

A number of European countries prescribe heroin for treatment of heroin addiction. The initial Swiss HAT (Heroin-assisted treatment) trial (“PROVE” study) was conducted as a prospective cohort study with some 1,000 participants in 18 treatment centers between 1994 and 1996, at the end of 2004, 1,200 patients were enrolled in HAT in 23 treatment centers across Switzerland. Diamorphine may be used as a maintenance drug to assist the treatment of opiate addiction, normally in long-term chronic intravenous (IV) heroin users. It is only prescribed following exhaustive efforts at treatment via other means.

The contribution of these receptors to the overall pharmacology of heroin remains unknown. A subclass of morphine derivatives, namely the 3,6 esters of morphine, with similar effects and uses, includes the clinically used strong analgesics nicomorphine (Vilan), and dipropanoylmorphine; there is also the latter's dihydromorphine analogue, diacetyldihydromorphine (Paralaudin). Two other 3,6 diesters of morphine invented in 1874–75 along with diamorphine, dibenzoylmorphine and acetylpropionylmorphine, were made as substitutes after it was outlawed in 1925 and, therefore, sold as the first "designer drugs" until they were outlawed by the League of Nations in 1930.

People who intravenously inject black tar heroin are at higher risk of venous sclerosis than those injecting powder heroin. In this condition, the veins narrow and harden which makes repeated injection there nearly impossible. The presence of 6-monoacetylcodeine found in tar heroin has not been tested in humans but has been shown to be toxic alone and more toxic when mixed with mono- or di- acetyl morphine potentially making tar more toxic than refined diamorphine. Black tar heroin injectors can be at increased risk of life-threatening bacterial infections, in particular necrotizing soft tissue infection.

In 2010, she acted for the family of David Gray at the inquest into Mr Gray's death following an overdose of Diamorphine, administered by locum German doctor Daniel Ubani, who had been recruited by Take Care Now. Coroner William Morris gave a verdict of gross negligence manslaughter, and made 11 Recommendations to the Department of Health to improve out-of-hours GP services. The Times profiled Hewson as its Lawyer of the Week on 11 February 2010. She was named as a Band 1 Junior for Court of Protection – Health & Welfare in Chambers Legal Directory (2015).

Dipropanoylmorphine (Dipropionylmorphine in U.S. English) is an opiate derivative, the 3,6-dipropanoyl ester of morphine. It was developed in 1972 as an analgesic. It is rarely used in some countries for the relief of severe pain such as that caused by terminal cancer, as an alternative to diamorphine (heroin) and morphine. The drug was first synthesised circa or about 1875 in Great Britain along with many other esters of morphine, all of which were shelved at the time, some of which were later developed such as heroin (1898), acetylpropionylmorphine (1923), dibenzoylmorphine (1900 and/or 1924), and so on.

Dr Twycross was educated at St John's School, Leatherhead,WHO'S WHO and WHO WAS WHO 2020, Online, Published by A & C Black Limited, an imprint of Bloomsbury Publishing plc and graduated from Oxford University with a BM BCh in 1965. After completing his MRCP, in 1971 he was appointed as a Clinical Research Fellow at St Christopher's Hospice by Dame Cicely Saunders. During his tenure there, Dr Twycross completed studies on the effectiveness of morphine, diamorphine and methadone in managing cancer pain. These studies helped standardize and simplify the treatment of pain, eliminating more complicated treatments such as the Brompton cocktail.

Synthetic opioids were invented, and biological mechanisms for their actions discovered, in the 20th century. Scientists have searched for non-addictive forms of opioids, but have created stronger ones instead. In England Charles Romley Alder Wright developed hundreds of opiate compounds in his search for a nonaddictive opium derivative. In 1874 he became the first person to synthesize diamorphine (heroin), using a process called acetylation which involved boiling morphine with acetic anhydride for several hours. Heroin received little attention until it was independently synthesized by Felix Hoffmann (1868–1946), working for Heinrich Dreser (1860–1924) at Bayer Laboratories.

They discovered a pattern of his administering lethal doses of diamorphine, signing patients' death certificates, and then falsifying medical records to indicate that they had been in poor health. Prescription For Murder, a 2000 book by journalists Brian Whittle and Jean Ritchie, suggested that Shipman forged the will either because he wanted to be caught because his life was out of control, or because he planned to retire at 55 and leave the UK.Whittle, B and Richie, J. Prescription for Murder: The True Story of Dr. Harold Frederick Shipman. Little Brown (2000), pp. 348–9. . In 2003, David Spiegelhalter et al.

In the United States Morphine is used for cesareans for the same purpose since diamorphine (heroin) is not used in clinical practice in the US. Baricity refers to the density of a substance compared to the density of human cerebrospinal fluid. Baricity is used in anaesthesia to determine the manner in which a particular drug will spread in the intrathecal space. Usually, the hyperbaric, (for example, hyperbaric bupivacaine) is chosen, as its spread can be effectively and predictably controlled by the Anaesthesiologist, by tilting the patient. Hyperbaric solutions are made more dense by adding glucose to the mixture.

Some specifications for variants of Brompton cocktail call for methadone, hydromorphone, diamorphine (heroin), or other strong opioids in the place of morphine; diphenhydramine or tincture of cannabis in place of the chlorpromazine; and methamphetamine, amphetamine, dextroamphetamine, co- phenylcaine (lidocaine and phenylephrine hydrochloride), methylphenidate, or other stimulants in the place of cocaine. The original recipe for Brompton cocktail also calls for chloroform, cherry syrup to help mask the bitter taste of some of the components, and distilled water in some quantity to dilute the chloroform (hence, chloroform water) or to add volume to allow for more precise titration of doses.

Results of two major clinical studies involving 547 heroin treatment patients are available from the CCBH (Central Committee on the Treatment of Heroin Addicts) website. A German study of long-term heroin addicts demonstrated that diamorphine was significantly more effective than methadone in keeping patients in treatment and in improving their health and social situation. Many participants were able to find employment, some even started a family after years of homelessness and delinquency. Since then, treatment had continued in the cities that participated in the pilot study, until heroin maintenance was permanently included into the national health system in May 2009.

Anti-Heroin Act of 1924 is a United States federal law prohibiting the importation and possession of opium for the chemical synthesis of an addictive narcotic known as diamorphine or heroin. The Act of Congress amended the Smoking Opium Exclusion Act of 1909 which authorized the importation of the poppy plant for medicinal purposes utilizing an opium pipe or vaporization to consume the euphoric opiate. The H.R. 7079 legislation was passed by the 68th United States Congressional session and enacted into law by the 30th President of the United States Calvin Coolidge on June 7, 1924.

For instance, oxycodone and diamorphine may be tested, both sedative analgesics. If such a test is not requested specifically, the more general test (in the preceding case, the test for opioids) will detect most of the drugs of a class, but the employer or physician will not have the benefit of the identity of the drug. Employment- related test results are relayed to a medical review office (MRO) where a medical physician reviews the results. If the result of the screen is negative, the MRO informs the employer that the employee has no detectable drug in the urine, typically within 24 hours.

Due to Yong's young age, and since execution is mandatory for a person convicted of trafficking in more than of diamorphine, the trial judge Justice Choo Han Teck asked the prosecution to consider reducing the charge against him. The prosecution declined, and Yong was found guilty and sentenced to death.Save Vui Kong: Yong Vui Kong's journey. Through his then lawyer, Yong filed an appeal against the conviction and sentence, but withdrew it on 29 April 2009, the day of the appeal hearing. He then petitioned to President S. R. Nathan for clemency on 11 August 2009, but this was declined on 20 November 2009.

Pethidine is the most widely used opioid in labour and delivery but has fallen out of favour in some countries such as the United States in favour of other opioids, due to its potential drug interactions (especially with serotonergics) and its neurotoxic metabolite, norpethidine. It is still commonly used in the United Kingdom and New Zealand, and was the preferred opioid in the United Kingdom for use during labour, but has been superseded somewhat by diamorphine (heroin) and other strong semi-synthetic opioids (e.g. hydromorphone) to avoid serotonin interactions since the mid-2000s. Pethidine is the preferred painkiller for diverticulitis, because it decreases intestinal intraluminal pressure.

Since the basic element of crime is mens rea, the defence sought to prove that Tochi has no mens rea, that he was just an 18-year-old from a Nigerian village who just wanted to further his career in football and came across Mr. Smith who took advantage of him. More so, there was enough evidence that Tochi was not aware that he was in possession of diamorphine. According to the defence, if Tochi was aware of that, he would have fled when he was notified by the hotel staff that the police was called. He never did, neither did he even attempt to dispose the substances.

An immigration card issued by the Immigration and Checkpoints Authority reminding travellers to Singapore that the death penalty is imposed for drug trafficking The appellant, Yong Vui Kong, was a 19-year-old Malaysian national who was arrested in Singapore on 13 June 2007 and charged with trafficking in of diamorphine (heroin), a Class A controlled drug under the Misuse of Drugs Act ("MDA"). ("MDA"). ("P.P. v. Yong Vui Kong (2009, H.C.)"). Yong told investigators that he had not been aware of the contents of the packages which he was asked to handle, maintaining instead that he had been delivering packages for his boss, a man known as "Ah Hiang", for whom he was working as a debt-collector.

The Office of Fair Trading has alerted the government to their monopoly position on growing in the UK and worldwide production of diamorphine and recommended consideration. The government's response advocated the status quo, being concerned interference might cause the company to stop production. The British government has since contradicted the Home Office's suggestion that opium cultivation can be legalized in Afghanistan for exports to the United Kingdom, helping lower poverty and internal fighting whilst helping the National Health Service to meet the high demand for morphine and heroin. Opium poppy cultivation in the United Kingdom does not need a licence, but a licence is required for those wishing to extract opium for medicinal products.

Patients arriving to the emergency department with a myocardial infarction (heart attack) are likely to be triaged to the resuscitation area. They will receive oxygen and monitoring and have an early ECG; aspirin will be given if not contraindicated or not already administered by the ambulance team; morphine or diamorphine will be given for pain; sub lingual (under the tongue) or buccal (between cheek and upper gum) glyceryl trinitrate (nitroglycerin) (GTN or NTG) will be given, unless contraindicated by the presence of other drugs. An ECG that reveals ST segment elevation suggests complete blockage of one of the main coronary arteries. These patients require immediate reperfusion (re- opening) of the occluded vessel.

The Court of Appeal also held that the mandatory death penalty does not violate Article 12(1) of the Constitution, which states: "All persons are equal before the law and entitled to the equal protection of the law." In its opinion, the differentia used in the MDA to determine whether the death penalty should be imposed for trafficking in diamorphine (heroin) cannot be said to be purely arbitrary, and bears a rational relation to the social object of the Act which is to prevent the growth of drug addiction in Singapore by stamping out the illicit drug trade. Following this case, the appellant Yong Vui Kong unsuccessfully challenged the process by which the President grants clemency to convicted persons on the advice of the Cabinet.

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, oxycodone, and pethidine/meperidine, former addicts showed a strong preference for heroin and morphine, suggesting that heroin and morphine are particularly susceptible to abuse and addiction. Morphine and heroin were also much more likely to produce euphoria and other positive subjective effects when compared to these other opioids. The choice of heroin and morphine over other opioids by former drug addicts may also be because heroin (also known as morphine diacetate, diamorphine, or diacetyl morphine) is an ester of morphine and a morphine prodrug, essentially meaning they are identical drugs in vivo.

A recent initiative to extend opium production for medicinal purposes called Poppy for Medicine was launched by The Senlis Council which proposes that Afghanistan could produce medicinal opium under a scheme similar to that operating in Turkey and India. In late 2007, the British government permitted the pharmaceutical company Macfarlan Smith (a Johnson Matthey company, FTSE 100) to cultivate opium poppies in England for medicinal reasons after Macfarlan Smith's primary source, India, decided to increase the price of export opium latex. The Office of Fair Trading has alerted the government to their monopoly position on growing in the UK and worldwide production of diamorphine and recommended consideration. The government's response advocated the status quo, being concerned interference might cause the company to stop production.

Heroin-assisted treatment (HAT), or diamorphine assisted treatment, refers to the prescribing of semi-synthetic heroin to opiate addicts who do not benefit from or cannot tolerate treatment with one of the established drugs used in opiate replacement therapy like methadone or buprenorphine (brand name Subutex). For this group of patients, heroin- assisted treatment has proven superior in improving their social and health situation. It has also been shown to save money, as it significantly reduces costs incurred by trials, incarceration, health interventions and delinquency. It has also drastically reduced overdose deaths in the countries utilizing it, as patients take their dose in a controlled, professionally supervised setting, and Narcan (naloxone) is on hand in the case of an accidental overdose.

Short-term effects of usage Users report an intense rush, an acute transcendent state of euphoria, which occurs while diamorphine is being metabolized into 6-monoacetylmorphine (6-MAM) and morphine in the brain. Some believe that heroin produces more euphoria than other opioids; one possible explanation is the presence of 6-monoacetylmorphine, a metabolite unique to heroin – although a more likely explanation is the rapidity of onset. While other opioids of recreational use produce only morphine, heroin also leaves 6-MAM, also a psycho-active metabolite. However, this perception is not supported by the results of clinical studies comparing the physiological and subjective effects of injected heroin and morphine in individuals formerly addicted to opioids; these subjects showed no preference for one drug over the other.

DextromoramideGB Patent 822055 Improvements in or relating to new analgesically active substituted alpha, alpha-diphenyl--y-amino-butyramides and the manufacture thereof (Palfium, Palphium, Jetrium, Dimorlin)GB Patent 822055 is a powerful opioid analgesic approximately three times more potent than morphine but shorter acting. It is subject to drug prohibition regimes, both internationally through UN treaties and by the criminal law of individual states. The abuse potential by those who only have mild or no pain does exist, thus responsibility over supply, prescription, and dosage is a touchy subject among the international communities. Usually, it is marketed solely in the Netherlands, while in the UK Diamorphine or morphine are preferred, in the US, hydrocodone and oxycodone are sometimes used, and in the Scandinavian countries, medicines like ketobemidone are available to doctors in such dire cases.

The original block in Norfolk Place St Mary's Hospital QEQM building (above) and old section (below) The chapel of St Mary's Hospital The Messenger, by Allan Sly St Mary's hospital entrance arch of the older section The original block of St Mary's Hospital in Norfolk Place was designed by Thomas Hopper in the classical style. It first opened its doors to patients in 1851, the last of the great voluntary hospitals to be founded. Among St Mary's founders was the surgeon Isaac Baker Brown, a controversial figure who performed numerous clitoridectomies at the London Surgical Home, his hospital for women, and who "immediately set to work to remove the clitoris whenever he had the opportunity of doing so." It was at St Mary's Hospital that C.R. Alder Wright first synthesized diamorphine in 1874.

Among the first staff at St. Christopher's was Florence Wald, who took Saunders' philosophies back to the United States to become the founder of the hospice movement in the United States.Florence Wald , Connecticut Women's Hall of Fame; Accessed 5 February 2009Rierden, Andi "A Calling for Care Of the Terminally Ill", The New York Times, 19 April 1998; Accessed 5 February 2009 In 1971 Robert Twycross was appointed as a Clinical Research Fellow by Saunders. During his tenure there, his studies on the effectiveness of morphine, diamorphine and methadone helped standardize and simplify the management of cancer pain.25 Years in Palliative Medicine at Sir Michael Sobell House: A Festschrift for Robert Twycross, Radcliffe Medical Press, 2003; Szeloch H.,Hospice as a place of pastoral and palliative care over a badly ill person. Wyd.

In 2011 Liberal Youth Scotland campaigned for a review of sentencing for drug possession, and an amendment by LYS member and founder of 'Liberal Democrats for Drug Policy Reform' Ewan Hoyle ensured that specialist diamorphine treatment could be considered in the review. In their manifesto for the 2011 election, the Scottish Liberal Democrats included many policies introduced by LYS: ending the gay blood ban, equal marriage rights, and the review of drug possession sentencing. In late 2011 and early 2012 Liberal Youth Scotland led the fight for Equal Marriage through their 'Separate isn't Equal Campaign'. In September LYS and NUS Scotland protested outside John Mason MSP’s Constituency Office, to highlight the fearmongering nature of his motion which stated, "no person or organisation should be forced to be involved in or to approve of same-sex marriages".

He should have asked to be shown and be assured of the contents before agreeing to deliver them, and he could have used the ample opportunities he had when he was in possession of the capsules to check them himself, but he did nothing. Kan also found that he had wilfully turned a blind eye on the contents of the capsules because he was tempted by the US$2000, which was a large sum to him. When Smith, who had befriended him and had appeared to help him get out of Pakistan, also offered him the US$2000, he did not want to ask any questions or check the capsules himself. Consequently, even if he may not have actual knowledge that he was carrying diamorphine, his ignorance did not exculpate him because it is well established that ignorance is a defence only when there is no reason for suspicion and no right and opportunity of examination.

Dimethylthiambutene (N,N-Dimethyl-1-methyl-3,3-di-2-thienylallylamine, DMTB, trade names Ohton, Aminobutene, Dimethibutin, Kobaton, Takaton, Dimethibutin) is an opioid analgesic drug, most often used in veterinary medicine in Japan and to a lesser extent in other countries in the region and around the world. It is the most prominent and widely used of the thiambutenes, a series of open-chain opioids structurally related to methadone which are also called the thienyl derivative opioids which also includes diethylthiambutene and ethylmethylthiambutene, as well as the non-opioid cough suppressant tipepidine. Dimethylthiambutene was developed in the United Kingdom in the late 1940s \- Dithienyl Allyl Amines and introduced to the market by Burroughs-Wellcome in 1951. Dimethylthiambutene is now under international control under the UN Single Convention on Narcotic Drugs 1961, the laws governing habit-forming substances in virtually all countries and Schedule I of the US Controlled Substances Act of 1970 due to high abuse potential and never being introduced clinically in the United States; other countries regulate it much as morphine or diamorphine.