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Diamorphine hydrochloride BP amps

django47

django47

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Joined
Mar 19, 2010
Messages
64
Location
colchester uk
I've no idea where this belongs so I'll go for the easy way out and stick it in the, 'homeless threads'.
Basically I was wondering how many heroin addicts these days are being prescribed injectable, either amps of Physeptone or amps of Diamorphine, wet or dry amps. My main interest is in UK where I live, so that would be most relevent.
It doesn't seem like so many years ago when their was loads of 'amps' on the streets of London because they were being prescribed. I knew quite a few guys who were getting them but I was never that lucky. I know most went private and the Docs' were not taking on any new patients, the law was slowly changing and at the time I couldn't afford to go private. But about 20 years ago(very rough guess) you could always buy amps in London as a last resort. Especially round the West End. They were never affected by droughts or big busts. You could always guarentee to get amps, Mon-Fri come hell or high water. All that is a thing of the past now. Shame because although it was quite expensive, it was well clean and you could always be sure of the quality, and it was well nice and you could always feel it, like really nice rush. Unlike the street shit going round these days. I would so love to read any posts by anyone who is lucky enough to be getting amps prescribed (not street). Or even know if they are being prescribed anywhere in the UK. Their is a good argument for prescribing it on the NHS, but thats for another post.
 
i came across some amps of diamorphine not so long ago i smashed the vials and took the white crystals outts them i placed the crystals on some tin foil and chased them using a 20 pound note the drug kicks in right away and leaves u with a mellow buzz for 2 hours straight its best too sit around whilst smoking his shit cause it makes your chest heavy and makes breathing more difficult
 
Diamorphine is diacetylmorphine or pure pharmaceutical heroin. Eat your heart out, tar.

It's not prescribed anymore in general because "HEROIN=BAD" is a common attitude among the public.
 
yes tar is shitty, why bring up that nasty shit in a conversation about pharm. heroin?
lol..most of the heroin in The US is good very pure #4 powder heroin from Colombia, with tar being a western US mexcian made product of shitty byproducts but can be as pure as 80% or so on kilogram levels. I personally do not like even the look of tar, but luckily I am in a city where high purity #4 heroin that is 60-70% pure for a 1/10th gram bag is common. Although In places like NJ some retail amounts of heroin are as high as 90% pure!! That is some pure heroin, for street level especially, and it's very cheap there also!!! lol..wish I was getting the NJ stuff thats cheaper, but I get fairly high quality #4 powder from that area,although it is cut to 60-70% purity and the price is higher!! lol..oh well I'm just glad to have access to good heroin for a decent price, and not tar heroin which is sold at 30%-50% tops on the streets..
 
In the UK it's prescribed mainly in palliative care from what I've seen. I have only heard of one case locally where a man is prescribed Diamorphine on a Blue MDA Rx for his addiction but I've never personally seen it. I've only seen it prescribed for people that usually only have a couple of days until they pass away.

I'm personally for using Diamorphine for addiction rather than Methadone but I don't think it will become wide spread any time soon, even though all the trials I've heard about show that it reduces crime rates, is safer than Methadone and is better in all ways. But public opinion and government policies in the UK make it unlikely to be prescribed widely.
 
In England it was moderately available for maintenence until 2007 when the NHS' only importer had a sourcing issue. In desperation those getting prescription heroin had to switch to methadone. When the sourcing issue was solved 4 months later the government, which had lost interest in the issue, simply relegated those who had switched (most patients had been switched) to methadone.

As for crime rates, methadone provides the same data and has highly vested interest groups supporting it so its not likely that heroin will ever be prescribed as widely as it was in England, in the late 80s. Since then it has taken a spiral downward. The 1 area that will preserve its niche in maintenence is long term addicts who have never been able to gain stability despite repeated tries on methadone. Despite the VERY stiff opposition from very well funded special interest groups (the only private maintenence clinics in Israel are a chain owned by a single woman co-incidentally is married to nation's richest citizen, ergo she plowed a small fortune in trying to stop alternative substances like heroin) it has continued to find new venues. In terms of the number of nations heroin has never been more widely prescribed Israel, Slovenia and Kosovo joined the club in 2010.

I think the trend towards alternatives will continue, probably dihydrocodeine will be the next "magic bullet" (judging by thr number of ongoing dtudies employing it.

To the OP. I am a bit confused. Diamorphine amps are always aqueous. How would you insufflate "crystals?" If the vial was. Old it would have been weak (or alternatively totally inactive) due to hydrolysis.
 
know of someone who gets weekly take homes of diamorphine amps for addiction and they are powder form you add sterile water then shoot em up, he had to go thru the whole bollox of tryin methadone failures and not beeing able to stop shooting etc. there is uk gov document about the checklist needed to be considered for this type of prescribing will post if find it.


the following describes the medical uses of these white to off-white, sterile, freeze dried powder of Diamorphine Hydrochloride BP for reconstitution for injection powder ampuoles:

http://www.mhra.gov.uk/home/groups/l-unit1/documents/websiteresources/con014539.pdf
 
Haven't seen any 4 a while . Used 2 get them around Bristol way when i started using n pretty much took em 4 granted along with Peach Palfium. I was scripted the methadone 50ml concerntrate amps in the 90's but the Doc got in a bit of bother and basicly about 40 users had 2 switch from amps 2 juice in a month!! it was fukin crazy alot of peeps didn't come out the other side R.I.P.
 
Its long gone now i should think! Last time i saw pharm. grade smack was wayyyy back in the 90's. Used to come in the glass "nipple" top vials ready for injection...

If anyone is still producing it i doubt that it is in any quantity, and i would expect that it is limited to supervised usage only.

On an interesting historical note, i have an ampuole of WW1 morphine (the stab into your leg type) that has been passed down through my family - i would never attempt to use it though, far too interesting/valuable!
 
http://www.bluelight.ru/vb/showthread.php?t=442310

This has info on the swiss opiate scene in general but towards the end of the first page has some historical info on the british scene. Will edit when I find post- and how the Americans took the puritanical criminalization approach- throwing docs in jail. Her majesty's government allowed narcotics Rx as a big "Fuck you" to the prohibitionist Americans who arrested docs for providing opiates to maintain addicts in the 20s. At the time there were 3 clinics- 2 in Louisiana and 1 in NY. Latter they opened the Federal Clinic in Lexington KY which is descrbed in the Novel Junkie. Aleiter Crowley's Diary of a Drug Fiend Is a great read about british junkies in the 1920s. Anyway,

The next section provides a brief review of Britain's long experience with heroin
maintenance, highlighting the fact that British doctors have made very little use of their right to
provide the drug in the last quarter century. The following section summarizes the
implementation of the Swiss field trials and describes the reaction to it, in Switzerland, the US
and elsewhere. That is followed by a discussion of normative and political issues. Finally, we
identify the potential for a heroin trial in the US.
The British Experience
In a 1926 report, the blue-ribbon Rolleston Committee concluded "that morphine and
heroin addiction … must be regarded as a manifestation of disease and not as a mere form of
vicious indulgence, Thus, if repeated attempts to withdraw a patient from cocaine or heroin were
unsuccessful, "the indefinitely prolonged administration of morphine and heroin (might) be
necessary (for) those (patients) who are capable of leading a useful and normal life so long as
they take a certain quantity, usually small, of their drug of addiction, but not otherwise." (as
quoted in Stears, 1997; 123). This led Britain to adopt, or at least formalize, a system in which
physicians could prescribe heroin to addicted patients for maintenance purposes (Judson, 1973).
federal efforts to close them.
4
With a small population of iatrogenically addicted opiate users (numbering in the hundreds) the
system muddled along for four decades with few problems (Spear, 1994).
The system was not very controversial through most of that period. When the Tory
government in 1955 considered banning heroin completely, in response to international pressures
rather than because of any domestic complaints about the system, the British medical
establishment fought back effectively and the government eventually abandoned the effort.
However, in detail the incident seemed to say more about the power of the medical establishment
and its dedication to physician autonomy than about the success of heroin maintenance (Judson,
1973, pp. 29-34).
Then, in the early 1960s, a very small number of physicians began to prescribe
irresponsibly and a few heroin users began using the drug purely for recreational purposes,
recruiting others like themselves (Spear, 1994). The result was a sharp proportionate increase in
heroin addiction in the mid-1960s, still leaving the nation with a very small heroin problem; there
were only about 1500 known addicts in 1967 (Johnson, 1975). In response to the increase, the
Dangerous Drugs Act of 1967 greatly curtailed access to heroin maintenance, limiting long-term
prescriptions to a small number of specially licensed drug-treatment specialists7. General
practitioners were not unhappy to be rid of the responsibility for dealing with a population of
long-term patients who were difficult to manage and showed only modest improvements in health
over the course of treatment.
Addicts could now be maintained long-term only in clinics. At the same time oral
methadone became available as a substitute pharmacotherapy. British specialists proved as
enthusiastic about this alternative as did their US counterparts, though initially they did not
7 The British have long complained about foreign descriptions of their system and in particular
the nature of the 1967 changes (Strang and Gossop, 1994). The nuances of a system largely
dependent on informal social controls are difficult to capture. Pearson (1991) provides a succinct
version; Stimson and Oppenheimer (1982; Chapter 6) provide a fuller account. For current
practice, see Strang et al. (1996).
5
expect long-term maintenance to be the norm and injectable methadone played a significant role.
The fraction of maintained addicts receiving heroin fell rapidly. By 1975, just 4 percent of
maintained opiate addicts were receiving only heroin; another 8 percent were receiving both
methadone and heroin (Johnson, 1977). That reluctance to prescribe heroin remains true today;
less than 1 percent of those being maintained on an opiate receive heroin (Stears, 1997). The
strong and continued antipathy of British addiction specialists to the provision of heroin is a
curious and troubling phenomenon for those who advocate its use8.
British research on the efficacy of heroin maintenance is quite limited. One classic study
(Hartnoll et al., 1980) found that those being maintained on heroin did only moderately better
than those receiving oral methadone. "[W]hile heroin-prescribed patients attended the clinic
more regularly and showed some reduction in the extent of their criminal activities, nevertheless
they showed no change in their other social activities such as work, stable accommodation or diet,
nor did they differ significantly in the physical complications of drug use from those denied such
a prescription" (Mitcheson, 1994; p.182). There was moderate leakage of heroin from the trial;
37 percent of those receiving heroin admitted that they at least occasionally sold some of their
supply on the black market. An important factor in explaining the relatively weak results for
heroin maintenance may have been the effort to limit doses; the average dose received by the
patients, who had to bargain aggressively with their doctors, was 60 mg. of pure heroin daily9.
Mostly though there has been indifference in Britain for the last twenty-five years. This
may in part reflect the much greater cost of providing heroin to a maintained patient; NHS
reimbursement rules make this more difficult for the practitioner. The claims of one British
practitioner (John Marks, operating in the Liverpool metropolitan area) as to the efficacy of
heroin in reducing criminal involvement aroused controversy and hostility but little curiosity in
8 Trebach (1982; Chapter 7) provides an interesting account of why the shift to oral methadone
occurred, emphasizing the discomfort of medical personnel with supporting the act of injection
itself.
6
the British establishment. Observers from other nations, including Switzerland, were more
interested (Ulrigh-Votglin, 1997).
Click to expand...

Anyway, this article, most of the way down on the first page of the thread compares and contrasts the UK experience with the American and Swiss, the swiss modern experience, and the American consideration to support trails with diamorphine in New york endorsed by the American Medical Association and American Bar Association. Historical notes of Zurich's "Needle Park" were hard drugs were decriminalized 1986-1992 , the evolution of their current heroin RX/ safe injection/ harm reduction scheme. Also the discussion of cocaine Rx to augment heroin Rx are described. The swiss learned from the brits and raised the dose ceiling. The decrease in crime and other benefits to society was so tangible and evident that the swiss voted in direct election to make heroin Rx the law of the land even while note voting in legal cannabis.

ps: somebody on BL pointed out that british diamorph is more expensive than the swiss powder making the swiss system more cost effective in this world of diminishing health care resources and changes of priorities.
 
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django47 said:
I've no idea where this belongs so I'll go for the easy way out and stick it in the, 'homeless threads'.
Basically I was wondering how many heroin addicts these days are being prescribed injectable, either amps of Physeptone or amps of Diamorphine, wet or dry amps. My main interest is in UK where I live, so that would be most relevent.
It doesn't seem like so many years ago when their was loads of 'amps' on the streets of London because they were being prescribed. I knew quite a few guys who were getting them but I was never that lucky. I know most went private and the Docs' were not taking on any new patients, the law was slowly changing and at the time I couldn't afford to go private. But about 20 years ago(very rough guess) you could always buy amps in London as a last resort. Especially round the West End. They were never affected by droughts or big busts. You could always guarentee to get amps, Mon-Fri come hell or high water. All that is a thing of the past now. Shame because although it was quite expensive, it was well clean and you could always be sure of the quality, and it was well nice and you could always feel it, like really nice rush. Unlike the street shit going round these days. I would so love to read any posts by anyone who is lucky enough to be getting amps prescribed (not street). Or even know if they are being prescribed anywhere in the UK. Their is a good argument for prescribing it on the NHS, but thats for another post.
Click to expand...

OK mate, I have spent quite a fair amount of time researching this and the whole idea of heroin (Diamorphine Hydrochloride) being prescribed to addicts.
I'll give you a quick summary of exactly what I found out and provide you with some links so that you can read up on it yourself.

To start I'd just like to say that with regards to the below quote... this information is totally false and based upon no factual information. In fact, I think this is just the opinion of the OP.
sekio said:
Diamorphine is diacetylmorphine or pure pharmaceutical heroin. Eat your heart out, tar.
It's not prescribed anymore in general because "HEROIN=BAD" is a common attitude among the public.
Click to expand...

OK, at first I was just looking around the internet for information about the prescription of heroin to addicts and I stumbled across the following article on a treamtment trial:

which seemed to link me to the results/summary of the trial:

From here I decided to look into the UK drug strategy and found out that in 2008, the treatment of addicts where all of the traditional treatments have totally failed them and they have an extremely large habit that results in them committing other crimes to fund their habit and/or are massively putting their health at risk by using the street heroin (due to vein damage thanks to impurities in the heroin found on the street) was ADDED to the drugs policy:
  • UK Drugs Strategy (2008)
    In specific, the second bullet point in the right hand column on page 30 refers to this treatment of addicts with pharmaceutical heroin (diamorphine hydrochloride)

So I decided to follow on from here and verify that this was still in the 2010 strategy and to my suprise it still was:
  • UK Drugs Strategy (2010)
    In specific, see page 18 in the 'Recovery is an individual, person-centred journey' section. The exact wording is "We will continue to examine the potential role of diamorphine prescribing for the small number who may benefit, and in the light of this consider what further steps could be taken, particularly to help reduce their re-offending. "

I didn't bother to clarify that it was in the 2009 strategy as I made the assumption if it was in both 2008 and 2010, it is probably also in the 2009 strategy. However, the 2009 strategy document may be a useful read as the information provided in the 2008 and 2010 strategy documents is a little vague and the success from the start of the trial in 2008 may be detailed in here (I will update this post with information on this shortly, after I make myself some food)

Also, I can't find a 2011 strategy yet. So I have presumed that the 2010 is the most recent for the time being and all information supplied within it is still valid.

Anyway, the final bit of my search was looking for any open trials and (thanks to a friend) I came across one which appears to be open and accepting patients.
Infromation can be found on this in the following links:
Just in case, you don't want to read the above pages. The trial is located in Marina House, Camberwell, London (SE5 8RS)... 9 miles north of Croydon.

The following is the eligibility criteria (which I have copied and pasted directly from their website)
  • Eligibility
    1. 21+ years
    2. Male or female
    3. Opiate dependent
    4. Six or more year history of injecting heroin
    5. Daily injecting heroin use in the past six months, despite already receiving treatment
    6. Continuous methadone or buprenorphine treatment for at least two years, and for at least six months this episode
    7. Ability and willingness to attend the clinic twice a day, seven days a week
  • Exclusion
    1. Significant medical or psychiatric condition
    2. Severe alcohol dependence
    3. Benzodiazepine misuse in an erratic manner
    4. Pregnant

Finally, anyone on this trial would NOT be able to sell the heroin (diamorphine hydrochloride) they are given as they have to inject this while on the premises.

I hope this gives you some useful information and answers your question. Apologies for the extremely long post but this information is no doubt of use to some people... especially someone who meets the above criteria and lives near to Norword/Croydon/Camberwell as they could end up on the trial and get treated for pharmaceutical heroin!! (Good luck to anyone lucky enough to be in that situation!)

Oh, please don't quote me on this BUT I believe one of the most well known private opiate addiction clinics got into some major trouble about a decade back for prescribing pharmaceutical grade heroin (diamorphine hydrochloride) to a number of patients [specifically because the doctor's didn't have the home office license that is required to prescribe heroin (diamorphine hydrochloride) to addicts]
Seven doctors were charged with various offences by the GMC (General Medical Counsel) with some charges relating the what I said above. I'm not sure of the actual result and if I am 100% correct on this but this would be one of the MAIN reasons why private clinics no longer prescribe pharmaceutical grade heroin (diamorphine hydrochloride) to patients on maintenance programs.
Link to the Stapleford Centre website: HERE
And another link to their page specifically for Maintenance Treatment Program: HERE (Please note the explicit mention that they "are not able to provide a maintenance Heroin / Diamorphine or Diconal prescription.")
 
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There are thousands of over-21s (most over 41), with over six years (and often 26 years) of opiate dependence, who have been through crime, prison, begging and homelessness countless times and tried methadone anything up to 20 times without success.

Unfortunately, they don't fit on the trial because they are not *still* injecting (due to the simple problem of vein collapse!) and are not *still* on meth or Subutex- as 15 years of physeptone amps is enough to show that they're not going to get you clean, so many just stopped taking their scripts and went back to street gear full time.

I personally know a few 40-60 year old heroin users who would like diamorphine scripting but no longer qualify for it because they lost all their veins years ago injecting diconal, tuinal, seconal and other pills loaded with dangerous fillers. They dropped their scripts and started smoking heroin instead. Some have seen their veins become more viable again after years of not shooting up, but to get on the programme they would need to start injecting again AND go back on methadone for six months (most have already used it throughout the late 80s and 90s without success). Obviously not a good bargain.

The only script that could reasonably help them would be daily supervised Diconal or high dose morphine sulphate (to prevent sale/injection) and/or smokable diamorphine cigarettes, known as "reefers" but the NHS are unwilling to consider either of these. I can understand the health concerns around smoking-and the smoking ban means that reefer prescribing could only be supervised if the pharmacist would go outside in the rain. But as for not offering oral tablets on a daily supervised basis I'm not sure why. If you can give the most inveterate junkies pure heroin to inject supervised, why not give them pure opiates to swallow supervised? Is swallowing more dangerous than injecting or something? As I described below,most of the people who remember the "old British system" simply can't or don't want to inject any more.
 
in my part of the world they are only perscribed if you are a total lost cause, (failed methadone subtex rehab and have other issues) which is a real shame as honest addicts never need to be a lost cause if they were given the right treatment.

IMHO its the price that is prohibitive look at these figures:-

Parenteral Preparations

First Choice: Diamorphine injection (G) (CD): 5mg [amp £2.56], 10mg [amp £3.58], 30mg [amp £3.82], 100mg [amp £9.35], 500mg [amp £42.03].
Dose:
Prescribing notes: Parenteral diamorphine is approximately three times a strong as oral morphine.

Source :http://www.northdevonhealth.nhs.uk/...armacy/FORMULARIES/PCT - ch4 main.htm#opiates



Methadone (CD), an opioid agonist, can be substituted for opioids such as diamorphine (heroin) to prevent withdrawal symptoms in the addicted . It can cause addiction itself but the aim of treatment is gradual dose reduction titrated against withdrawal symptoms. As a guideline 1mg methadone can be substituted for 2mg pure heroin, 4mg morphine or 30mg codeine.
The purity of street heroin varies so widely that equivalent doses cannot be stated.
Lofexidine alleviates symptoms of opioid withdrawal. Like clonidine it acts centrally to reduce sympathetic tone but the fall in blood pressure is less marked.
Naltrexone, also an opioid antagonist, is given to former addicts as an aid to prevent relapse. It blocks the action of opioids such as diamorphine and precipitates withdrawal symptoms in the dependent.
First choice: Methadone mixture (sugar free): 1mg in 1ml (CD). Dose: initially 10-20mg daily given as a single or 2 divided doses then increased by 10-20mg daily until there is no signs of withdrawal or intoxication; max usually 40-60mg daily [100ml £2.08].
NB The methadone equivalence to street heroin cannot accurately be estimated because street drugs vary in purity. 1g of street heroin is roughly equivalent to 50 to 80mg of methadone. Titrate dose against withdrawal symptoms starting with the lower dose. Liason with the Quay Centre (01271 344454) is a good idea the next working day. Unless advised otherwise, patients should be issued with no more than one day’s dose to take home.
For expert use:
Buprenorphine sublingual tablets (CD). 400microgram [7 tabs £1.83]; 2mg [7 tabs £7.88]; 8mg [7 tabs £22.37]. Dose: according to preprinted dosing schedules.
Lofexidine tabs: 200microgram [60 tabs £61.79]. Dose: as per printed regimen.
Naltrexone tabs: 50mg [7 tabs £5.59]. Dose: 25mg initially then 50mg daily. The total weekly dose may be divided and given on 3 days of the week to improve compliance, eg 100mg on Monday and Wednesday, 150mg on Friday.

Source ::http://www.northdevonhealth.nhs.uk/...rmacy/FORMULARIES/HF - ch4 main.htm#methadone



Notice £9.35 per DRY amp and the average addict needs 4 a day 7 days a week 52 weeks per year and notice Methadone 100ml £2.08 once daily, Buprenorphine (subutex) £22.37 per week, you do the math...


If only they realised if addicts had regular access to quality Herion they would leed productive lives benefiting society and not costing the tax payer so much in law inforcement and victim compensation, very narrow minded..
 
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Morphine Sulphate

I'm 45 from Devon in Uk, and have been as society describes a Heroin addict for 15ish years,

I'm currently perscribed MST (morphine sulphate) for addiction. It is possible to get despite some comments on here. I'm very involved in Treatment Service User involvement/consultation and advocacy. Several of my coleagues are prescribed injectable diamorphine although since the issue of the 2010 drugs strategy (which to confirm we are still working within) Services are looking to withdraw support for injectable DM. The Buzz words being "recovery agenda" I have never been an injecting user though I have tried methadone (several times!) Withdrawl from/ reducing MST is so much more comfortable and sustainable. I was on 280mg daily.. now from choice I'm on 60mg. Methadone has had more negative impact on my health and mental state for the time that I took it. If you want Morphine put together a coherent argument to your local Drug agency/ Presrciber. That's all it takes.. Injectable DM is harder in 2011 but still possible.

happy for anyone to contact me for information.

Stay safe.. thats the key!! ;);)
 
Welcome to EADD moonunit. Nice to have you around. :)

We have quite a few long-term addicts around here who might be very interested in what you mentioned. Have a scan of this thread (though you may have done so already) for some accounts from members of the highs and lows of UK addiction treatment.

Hope to see more of your contributions in the future.
 
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