mdaniel80
Bluelighter
- Joined
- Dec 5, 2022
- Messages
- 160
great response. I should clarify, Im aware that needles were used in the 1800s. Im referring to people injecting heroin "recreationally" (as stated) at home daily, not someone being given it for childbirth.The interesting thing is that not all opioids are created equal. The TI (therapeutic index) of M is 76 - which it is why the 'gold standard' of opioids. But fentanyl has a YI of 400... so why all the fentanyl deaths? Well, because it's so potent and because you have to get to the far end of the TI to get any euphoria. But sufentanil has a TI of ~27,000 while also being some 7.5x more potent.
So why isn't sufentanil (or better, α-methyl sufentanil (some x10 fentanyl with similar TI and duration of 4 hours) THE synthetic opioid of choice? Well, it's not because the precursors are watched. You don't need a single controlled precursor to make it. What you DO need is some pretty practices synthetic technique.
And the people with THAT ability can live quite well without breaking the law.
I did calculate the cost based on a 1kg scale and it works out at about 39¢ per dose, even allowing for paying the chemist some $500 per 8 hour shift.
Sufentanil is the backbone of balanced anesthesia BUT I have seen used in cases of cancer patients whose pain-control window had almost closed.
Sufentanil is the DLR (given it's short duration) but it CAN be used without respiratory support. I've seen people for whom a 500mg dry-amp of diamorphine did not stop the 'unacceptable suffering' (as defined by the RCP. An anesthetist set up a timed-release system so every 10 minutes the patient got another dose.
The patient lived a further 6 weeks. Doesn't sound much, but it's the difference between dying alone and having time to say goodbye and to die with dignity. Opioids are a truly amazing tool and we have gone a long way to perfecting them... because in the UK at least, we rarely use them unless we do not see the patient having an indeterminate life expectancy. Even then, UK doctors are VERY keen that any unused medication is taken back.
BTW the modern hypodermic syringe was invented in 1859, morphine having been isolated in 1803. Morphine was first administered via the hypodermic syringe in 1853. Of course, diacetyl morphine (heroin) was only discovered in 1874 but it was trialled via hypodermic syringe in 1875.
So most certainly those rich and connected to the right doctors COULD IV heroin as early as 1875. I believe Queen Victoria was given IV morphine during childbirth. Even now details are scant but it's QUITE possible that she received IV heroin. It was, of course, only the rich who could. In the Victorian era, laudanum and other opium/morphine medicines were much more common - due to price. Don't forget, by then we KNEW of germ theory but had yet to master truly reliable sterile conditions so poking holes in oneself was risky.
There is a 1916 report on IV heroin abuse, but how long it took to surface, I don't know.
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