Should H be allowed to control pain in terminally ill?

[OxyContinuously]

Guys, this is an interesting subject. Should people suffering from terminal illnesses (like cancer just to name one the everyone knows about) or other chronic pain ilnesses that are not necessarily fatal, but just as debilitating, be allowed access to drugs such as Heroin for example as part of doctor supervised pain management? Ordo you guys think that the scheduling is a good thing and CI's for ex. are indeed dangerous drugs "with no legitimate medical purpose?" and what we have in place now ie orph, fent etc etc works just fine? Don't get me wrong, heroin is not a cure all for every kind of pain, but it is unequivicollay more powerful than morph, for example, with less side effects.

My answer(s) are that for the terminally ill: they should have access to whatever pain meds they need to control pain because if it is indeed a known fact that the person in question will pass away as a direct consequence of the illness, then why shouldn't they be allowed to live their remaining days comfortably? I use cancer as an example (knowing full well that there are a myriad of illnesses producing pain comparable and greater than cancer, but cancer is well kown and common.) And I think the drugs are only labeled "dangerous" because the gov't isn't making money on them and therefore has no use for them, regardless of their efficacy; lets face it people, Schedule I or not, diacetylmorphine HCl has a much greater pain killing ability than regular Morphine. What do you guys think?

[nick]

diamorphine (H) is used extensively in the UK for terminal pain.Bottom line is it's not so much which opiate,but how much and how often that matters.

[moviebuff927]

diamorphine (H) is used extensively in the UK for terminal pain.Bottom line is it's not so much which opiate,but how much and how often that matters.

I learned something else about the prescription Diamorphine the other day...they also prescribe it for heroin addicts because it's potency is printed on the label, and is a lot safer than street heroin. Hell, the doctors even prescribe the ampoules to addicts! I think over there they have taken the right course of action as far as legalizing opiates goes...there's a lot less overdose deaths because you know how much you're taking. The U.S. and the rest of the world could learn a lot about this system and implement it in our society...it's a damn shame we have this powerful pain killer and the only way you can get it is copping on the streets...

[OxyContinuously]

Really, Nick? I didn't know that. Is it a legal substance in Great Britain, in the sense of how morphine and Fentanyl are here? (ie controlled by the gov't but accessible through prescription)?

[HistoryofMadness]

Heroin's design makes unequivically more powerful than morph for euphoria, or getting high, because its structure allows it to 'rush' in the brain much more quickly than morphine.. but I don't think its going to be a better pain killer than morph and the other chronic pain meds...

On the other hand, this structure would also make it perfect for "break-through pain" because it would hit hard and fast... and that would no doubt work wonders WITH morphine and the others...


And my thoughts are "yes" to using heroin for chronic illness, but I also think that ANY drug with medical value (not all of them have that, but many do) should be available to doctors to treat patients...

Pot's a good example: can someone explain to me (seriously) why the 'official' fed gov (US) position on mary jane is that it has no medicinal value, while at the same time allowing a drug to be dispensed (a drug that US also approved) that is basically a synthetic pot pill???

I digress...

[PRIZEFIGHTERINFERNO]

yes
My view is that diacetylmorphine should be allowed to control pain in patients with Debilitating Chronic Pain

[jab]

I think it should be available to anyone who wants it, so as you can guess, I'd support it 100% for terminaly ill patients.

[oxymoron]

The terminally ill ought to be allowed ANYTHING they want, as long as it doesn't hurt anyone else. Although I beleive we should all get what we want, but feel especially strongly where the terminally ill are concerned.

[superman]

The terminally ill ought to be allowed ANYTHING they want, as long as it doesn't hurt anyone else. Although I beleive we should all get what we want, but feel especially strongly where the terminally ill are concerned.

I couldn't have said it better myself. they could call it the 'terminal platter'. complete with 57 pure drugs and all required paraphernalia.

[AWOL]

H should be allowed to control pain by anyone who wants to use it.

[AWOL]

Pot's a good example: can someone explain to me (seriously) why the 'official' fed gov (US) position on mary jane is that it has no medicinal value, while at the same time allowing a drug to be dispensed (a drug that US also approved) that is basically a synthetic pot pill???

I digress...

The synthetic pot pill costs $500 a month and pharmacutical companies make generous campaign contributions.

[AWOL]

they also prescribe it for heroin addicts because it's potency is printed on the label, and is a lot safer than street heroin. Hell, the doctors even prescribe the ampoules to addicts!

Only to very very few, and tomorrow who knows.

[nick]

I learned something else about the prescription Diamorphine the other day...they also prescribe it for heroin addicts because it's potency is printed on the label, and is a lot safer than street heroin. Hell, the doctors even prescribe the ampoules to addicts! I think over there they have taken the right course of action as far as legalizing opiates goes...there's a lot less overdose deaths because you know how much you're taking. The U.S. and the rest of the world could learn a lot about this system and implement it in our society...it's a damn shame we have this powerful pain killer and the only way you can get it is copping on the streets...
I used to get the 30mg diamorphine amps and there at least 440 other addicts getting dry amps,but there are 345,000 hard drug users in the UK.So getting amps is like winning the lotto.
It used to be prescribed a lot in terminal care,but about 5 years ago DR Shipman used diamorphine to murder about 250 and possibly 500 of his elderly patients.Since then the law has been tightened and many Docs are scared to prescribe it to anyone.Bastards.
Diamorphine is a class one drug here.Along with coke,E and LSD.Plus a load of synthetic opiate pills.

[reddragon3668]

I agree... H should be available for terminal patients for use as a breakthrough medication... I doubt it would be useful for anythign else, except maybe giving the patient a sense of well being, which definitely should NOT be denied someone who knows they are going to die... with that said, I'm not sure how helpful it really would be. I may be wrong here, but I think I read recently where H has a 3.5 minute half-life? Is that true? If it is, and I was dying, even for breakthrough pain, I don't think I would want it.. but that's a matter of personal preference, and should not be put in the hands of the federal government, or anyone for that matter other than the patient. Its subjects like these that bring the whole "right to die with dignity" into better perspective. Although "patient's rights" issues in the US have gotten much better in recent years, there is a whole lot of work yet to be done. But, that's another issue...

[nick]

diamorphine has a short half life.I needed a fix every 6 hours.However it's very soluable so for cp users it's easier to take regularly by IV.Plus without wanting to sound like a degenerate,it's a really nice hit.

[HistoryofMadness]

The terminally ill ought to be allowed ANYTHING they want, as long as it doesn't hurt anyone else. Although I beleive we should all get what we want, but feel especially strongly where the terminally ill are concerned.

hey while you're dreaming i want a magic carpet ride!

[exitwound]

I think that it should be available to ANYONE with legitimate, severe pain.

[alowishus]

Why shouldn't anything that anyone wants to take/use/put in THIER body for what ever reason be able to.
Why should it be just for the terminal or cp peeps to have the freedom of to do w/ themselves what they want and not the rest of the human race?

Let's forget drugs, legal or otherwise, there's a bigger issue, freedom of self, we have given over that rule to our g-ment, willingly or not.

If you want to drink drain-o, and you know what it is and are of sound mind and are fine w/ that......here, I'll get the glass. (killing oneself is another thread)

We need to stop making junkies, pot heads, etc, criminals, we're not.
What criminal act have I done in the eyes of REAL crime* by getting high?





* Look into it.

[repeek]

I think that it should be available to ANYONE with legitimate, severe pain.

Ditto

[Coddfish]

i was under the impression that heroin's half-life was about 4 hours. in any case, it's gotta by more than a few minutes; junkies would have to shoot up every 15 minutes if that were the case.

and to answer the quetsion that started this thread: of course. i doubt anyone on this forum will say otherwise.

[devilsdrug]

dreamin exactly do u also make a list for the 400 mill lotto that u dont play, ------ ido

[SpecialGuy69]

I think what you heard about heroin's short life is that it turns to Morphine within 5 minutes. That's not the same as a half-life.

[WarmCyanide]

the terminally ill should not be bound by what they can and cannot take for pain. PERIOD

[Badly Drawn Girl]

I believe that people have the right to put what they want into their own bodies, regardless of the reason. Certainly terminally ill/chronic pain patients should have access to whatever substance is going to help them the most. It's cruel to withhold pain meds from people that need them.

[Woods]

I honestly don’t think it’s all that important, because of stuff like hydromorphone and oxymorphone. Still, it wouldn’t be a bad idea to have legal heroin for terminally ill patients.

Now, what should really be made legal for terminally ill patients is ecstasy. Various studies have shown that MDMA potentates opiates like almost nothing else, and that it works in such a way as to leave the recipient far more lucid then someone who just took a lot of morphine or whatever on its own.
I personally once took 80mg of oxycontin and 2 really good pills of MDMA. Now, I know that 80mg of oxycontin isn’t that much, but the MDMA made it like an experience I’ve never had before. I was sitting down, listening to music, without a care in the world.

It was impossible for me to feel pain at that point, and I swear that if you had’ve doused be in gasoline and lit me on fire, I would have wondered where the smell of burning flesh was coming from before it even started to hurt, In fact, I don’t know if I would have felt any pain at work.

[Paregoric Kid]

why the hell not?
it's used like that in the UK, it used to be prescribed here in the US too. it is wrongly demonized, it is no stronger than legal pain killers like hydro/oxymorphone or fentanyl.
it should be an option for doctors and individuals who want to use it. not every drug works the same for everyone and there are a lot of situations where heroin would be the better analgesic to choose for different reasons. it could be more effective at pain relief than what the patient is using, it could act faster during breakthrough pain, it could be a less expensive alternative to the newer synthetics and semi-synthetics, there are so many different reasons it should be an option for people.
there is no reason the government should be telling doctors and individuals what drugs they are allowed to use. the government does not know what is best for everyone and they certainly shouldn't be telling doctors what medicines they are allowed to prescribe (and for that matter telling individuals what medicines they are allowed to buy or possess). in the US the federal government isn't given the power to regulate medicine in the constitution so it should be illegal for the government to do such things but it hasn't stopped them.

[OxyContinuously]

I am in agreement with all you guys so far. Thanks for making this a productive post 'cause i think it is a very important and relevant topic. Paregoric Kid, I really liked your response, you seemed to hit the nail right on the head.

Oh I saw that there was a little bit of confusion regarding heroin's half life. I'll give you the breakdown real quick (take this as friendly, not as me trying to be an ass or anything like that; it's just that my job/career is being a chemist--a "synthetic organic chemist" technically so i really like all this technical shit so on that note here's the scoop, to the best of my chemical knowledge. Heroin (diacetylmorphine, diamorphine, smack, junk, etc.) is simply, a molecule of morphine, with two extra groups, different than the OH's on the morphine. It's called a 3,6 diacetyl derivative of straight 'morph made by acetylization of the parent compound (morphine) w a little help from a pickle smelling, corrosive and seriously dangerous chemical called acetic anhydride, which all of my fellow Opiophiles already know. You guys are a smart group, don't get it twisted.
Instead of the hydroxys, there are two acetyl groups (COCH3--methyl and carbonyl instead of OH {negatively charged}). Okay, fine. Now it gets interesting.
Diacetylmorphine, as a molecule cannot be used "as is" by the human body. In other words it has to be converted into s'thg else before it is effective very similar to the mechanics of codeine in which it has to be converted, in the liver, to morphine before it can take effect. Heroin, gets metabolized to a compound known as "6-monoacetylmorphine" an active metabolite, and also the substance that drug tests test for to differentiate from other opiate abuse, and determine 100 percent that you have taken heroin itself and not morph or codeine just to name 2 of many examples, because 6mono is only created from heroin in the body, but I digress. Anyway, once the dope is converted, it is ready for use by the body as an analgesic, painkiller, etc. Keep in mind that it undergoes one more bodily conversion, from 6mono to morphine itself. Heroin, like other pure opiate agonists, has a very high affinity for the mu, kappa , and delta receptors. Action on the mu receptor is what is responsble for euphoria, slower breathing and the change in pain perception. As a matter of fact, heroin's affinity, especially at mu, is VERY powerful and this is what makes it so effective. Now the matter of half life. There is a difference between the duration of the "rush" and the duration of analgesic effects, which consequently would be of the most value for someone suffering in severe pain. The "rush" part typically lasts around maybe fifteen to thirty minutes, give or take a little because of body weight, individual metabolism, tolerance obviously and liver function, etc. It is true that the first bang, so to speak, is indeed very short like someone said but the efficacy of intravenously injected heroin, used as a painkiller, by moderately tolerant patients seeking it for pain relief, not for fun, or a "fix," is about 4 to six hours. So yes, it is true that the initial phase comes to an end fairly quickly, but it's painkilling abilities remain for the duration of activity (4 to 6 hrs depending). I think that may have been an item of confusion, so yes it is true that the half life is quite short, but it's effects are consistent with similar strong opiates like oxymorphone, or possibly Dilly-dallys (hydromorphone) as far as pain killing ability, maybe even a tad better because of its insanely high affinity for good ol mu. Hope this helps. talk to you all soon...

[OxyContinuously]

sorry about that guys

[Paregoric Kid]

also, even if you believe in the authority of the unconstitutional, rights trampling devil that is the Controlled Substance Act it's clearly in the wrong schedule; because there is tons of evidence that proves it DOES have medical value and that it CAN be used safely. there are 3 required criteria a drug must meet in order for it to qualify as schedule I (and even if you just went by the last factor, that it CAN be used safely, excludes it from being eligible for CI). it belongs in schedule II. of course the CSA is shit so it doesn't really matter anyways.
unrelated: does the schedule of a drug effect sentencing in criminal cases? (ie if you're busted for a CIII drug as opposed to a CI)

[Dilaudid]

Hello,

Should Diacetylmorphine be allowed to control pain in terminally ill patients?

Yes, H can be used for pain control and not only in terminally ill patients as every pure agonists opiates/opioids.
Diacetylmorphine has a short half life in itself but has many actives metabolites like 6-MAM, Morphine, Morphine-3-glucuronide and Morphine-6-glucuronide.
6-MAM is suspected to be an causal agent of "sudden death" in diacetylmorphine users, Morphine-6-glucuronide is subject to bioaccumulation (long half life) and often induce an dysphoric state (by kappa agonism).
So yes Diacetylmorphin can be used because it's a great pain killer like many full mu agonist but I think there are better alternatives to Diacetylmorphine in palliative care.
Hydomorphone induce less nausea, lower histaminoliberation, no long half life active metabolites offer a good biodisponibility by parentheral administration.
Fentanyl can be more usefull too in tolerant patient it's a very selective and potent µ agonist.
Hydromorphone or Fentanyl and ultra low doses of naloxone (and low doses of Ketamine an NMDA antagonist can prevent hyperalgesia and tolerance; ultra low doses of an antagonist can provide an better analgesia with a reduced tolerance).
I think Hydromorphone and Fentanyl are more expensive but better alternatives to Morphine and Diacetylmorphine in palliative care.

[stvip]

6-MAM is suspected to be an causal agent of "sudden death" in diacetylmorphine users, Morphine-6-glucuronide is subject to bioaccumulation (long half life) and often induce an dysphoric state (by kappa agonism).

Give me a 'W", give me a 'T', give me an 'F'. Gooo... F! What miasma of misinformation is your source for those statements?

[greenfox]

Guys, this is an interesting subject. Should people suffering from terminal illnesses (like cancer just to name one the everyone knows about) or other chronic pain ilnesses that are not necessarily fatal, but just as debilitating, be allowed access to drugs such as Heroin for example as part of doctor supervised pain management? Ordo you guys think that the scheduling is a good thing and CI's for ex. are indeed dangerous drugs "with no legitimate medical purpose?" and what we have in place now ie orph, fent etc etc works just fine? Don't get me wrong, heroin is not a cure all for every kind of pain, but it is unequivicollay more powerful than morph, for example, with less side effects.


OK, honestly, here's what I think: I think H should only be allowed to be used on terminally FOXY patients. That is to say, if you don't have a fat green foxy tail coming straight out of your ass, you shouldn't be allowed to use H at all. I think governments should punish first time, small possesion, non-violent offenders with death. I think the only exception should be the one-time "get out of jail not-so-free" clause whereas if you are a male, you should be forced to undergo estrogen therapy and have penile inversion. If you are a female, you should be forced to undergo female circumscision (sp?) - ie, the removal of the clit. I also think that smiling while around someone who is high should be punishable by caning. I think that CP patients should be allowed 1 oz of .1% beer for their pain- NOTHING else- I think our government (the same people who brought you CRACK! ©® ) should genetically engineer mutants that can ONLY survive by eating their body weight in poppies each and every day (and also engineered not to get high from doing so!) so that no one else may have any. I think everything should be illegal and punishable by death, (including human shit) which means when you give birth to your child the first diper squirt they lay lands them the electric chair.

Finally, I think NEEDLES should be illegal to get for any reason, including insulin, and I also think that HIV should be manatory with any legal (uinder my system their is no legal so it doesn't matter) injection. People should be forced to sit up straight, eat their meat (how can you have any pudding if you don't eat your meat?) and fart clones of Bush. Failure to do so results in instant death ( we should have death V/d chips installed in our brains and in our left nut/right ovary)./

and that's what I think.

so there.

[AWOL]

^ Dude I make some stupid posts but ... are you fucking retarded?

[Dilaudid]

Give me a 'W", give me a 'T', give me an 'F'. Gooo... F! What miasma of misinformation is your source for those statements?

I Think you'll have the W the T and the F here:

Read those little refs

M-6-G bioaccumulation can produce dysphoria by KOR binding.

Fugelstad A; Ahlner J; Brandt L; Ceder G; Eksborg S; Rajs J et al. Use of morphine and 6-monoacetylmorphine in blood for the evaluation of possible risk factors for sudden death in 192 heroin users. Addiction 98(4): 463-470, 2003.



Antonilli L, Semeraro F, Suriano C, Signore L, and Nencini P (2003) High levels of morphine-6-glucuronide in street heroin addicts. Psychopharmacology (Berl), in press.

Pharmacokinetics of morphine and plasma concentrations of morphine-6-glucuronide following morphine administration to dogs

Source: Journal of Veterinary Pharmacology & Therapeutics (http://www.ingentaconnect.com/content/bsc/jvpt), Volume 28, Number 4, August 2005, pp. 371-376(6)

Authors: KUKANICH, B.1 (http://www.ingentaconnect.com/content/bsc/jvpt/2005/00000028/00000004/art00006#aff_1); LASCELLES, B. D. X.2 (http://www.ingentaconnect.com/content/bsc/jvpt/2005/00000028/00000004/art00006#aff_2); PAPICH, M. G.1 (http://www.ingentaconnect.com/content/bsc/jvpt/2005/00000028/00000004/art00006#aff_1)


Inturrisi CE, Max MB, Foley KM, Schultz M, Shin SU, and Houde RW (1984) The pharmacokinetics of heroin in patients with chronic pain. N Engl J Med 310: 1213-1217


Milne RW, Nation RL, and Somogyi AA (1996) The disposition of morphine and its 3 and 6-glucuronide metabolites in humans and animals and the importance of the metabolites to the pharmacological effects of morphine. Drug Metab Rev 28: 345-472



Penson RT, Joel SP, Bakhshi K, Clark SJ, Langford RM, and Slevin ML (2000) Randomized placebo-controlled trial of the activity of the morphine glucuronides. Clin Pharmacol Ther 68: 667-676


Tschacher W, Haemmig R, and Jacobshagen N (2003) Time series modeling of heroin and morphine drug action. Psychopharmacology 165: 188-193


Ulens C, Baker L, Ratka A, Waumans D, and Tytgat J (2001) Morphine-6betaglucuronide and morphine-3-glucuronide, opioid receptor agonists with different potencies. Biochem Pharmacol 62:
1273-1282


J.Pain management 1991 Apr;6(3):125-8Chronic nausea and morphine-6-glucuronide.
Intranasal Diamorphine as an Alternative to Intramuscular Morphine: Pharmacokinetic and Pharmacodynamic Aspects Authors: Kendall J.M Latter V.S Clinical Pharmacokinetics (http://www.ingentaconnect.com/content/adis/cpk), Volume 42, Number 6, 2003, pp. 501-513(13)

[stvip]

You've just listed a bunch of references which mention those compounds. They don't actually support your claims.

[nick]

^ Dude I make some stupid posts but ... are you fucking retarded?
Yeah bro you make some stupid posts,but I love you.

[greenfox]

Yeah bro you make some stupid posts,but I love you.


it's strange ... they call me "hippie __(my name)___" and all my friends know me to be eccentric. :p ]

s'ok, sometimes I just get so damn low that I'll spin on my bun and make chimp noises, whilist scratching my bards with dope lards.... BUT in the end it's all good fun'n, and some people understand the complex mindframe fillied with useless vocabulary (that is yours truly) finds its way into the language corridor of certain peoples brains... and they like it. :)

[SpecialGuy69]

it's strange ... they call me "hippie __(my name)___" and all my friends know me to be eccentric. :p ]

s'ok, sometimes I just get so damn low that I'll spin on my bun and make chimp noises, whilist scratching my bards with dope lards.... BUT in the end it's all good fun'n, and some people understand the complex mindframe fillied with useless vocabulary (that is yours truly) finds its way into the language corridor of certain peoples brains... and they like it. :)Do you ever look at a post you're writing and think "this doesn't make any sense", and then delete it? Didn't think so.

You're a strange one, GF.

*as a crayon-eater, I can't be trusted to make sense, either. It's just best left to Duckfeet and ZK and Shaun, etc.

[candyshop]

I think it should be available to anyone who wants it, so as you can guess, I'd support it 100% for terminaly ill patients.
hell yeah

[greenfox]

Do you ever look at a post you're writing and think "this doesn't make any sense", and then delete it? Didn't think so.

You're a strange one, GF.

*as a crayon-eater, I can't be trusted to make sense, either. It's just best left to Duckfeet and ZK and Shaun, etc.

now if I analyzed every post I wrote and asked if it made sense, I'd probably never post. :rolleyes:

it's ok, tho... because I know that this fox lives in a tollerent community. We aren't a bunch of raving, alpha-male alcoholics here so I don't worry much. Sure, I could catch a flame for a nonsense post, but isn't that all part of the fun?

[SpecialGuy69]

I have enough trouble deciphering DD's incomprehensible posts. My drug-addled brain doesn't need another source of aches. Remember- your brain after snorting heroin is an egg smashed w/ a frying pan. And your family, and your money, and your friends... That chick was hot. Too bad she wasn't convincing enough to get me to say no to dope. I think she owes me a blowjob.

[greenfox]

I have enough trouble deciphering DD's incomprehensible posts. My drug-addled brain doesn't need another source of aches. Remember- your brain after snorting heroin is an egg smashed w/ a frying pan. And your family, and your money, and your friends... That chick was hot. Too bad she wasn't convincing enough to get me to say no to dope. I think she owes me a blowjob.

LOL! I remember that one. You remember the one where the bitch was all hot and then she pulled out all her teeth? Fucking NASTY! haha!

oh well. That's life.

And i'll try to keep the incomprehendable posts on the "low", but you folks gotta cut me some slack. When i'm all low-ed out and I dont give a fuck well... u know...sometimes the babbling banter just FLOWS... heh... I love this place
i love you all

peace

[AWOL]

LOL! I remember that one. You remember the one where the bitch was all hot and then she pulled out all her teeth? Fucking NASTY! haha!

oh well. That's life.

And i'll try to keep the incomprehendable posts on the "low", but you folks gotta cut me some slack. When i'm all low-ed out and I dont give a fuck well... u know...sometimes the babbling banter just FLOWS... heh... I love this place
i love you all

peace

Yeah I cut ya slack. Everybody else cuts me slack and I deffinetly am a complete fucking retard. Nobody's going to argue that one. I MADE A THREAD ABOUT SHITTING YOURSLEF!

[greenfox]

Yeah I cut ya slack. Everybody else cuts me slack and I deffinetly am a complete fucking retard. Nobody's going to argue that one. I MADE A THREAD ABOUT SHITTING YOURSLEF!

i don't think I ever shat myself.... I think I pissed myself a couple times, tho...

[KiloByte]

I learned something else about the prescription Diamorphine the other day...they also prescribe it for heroin addicts because it's potency is printed on the label, and is a lot safer than street heroin. Hell, the doctors even prescribe the ampoules to addicts! I think over there they have taken the right course of action as far as legalizing opiates goes...there's a lot less overdose deaths because you know how much you're taking. The U.S. and the rest of the world could learn a lot about this system and implement it in our society...it's a damn shame we have this powerful pain killer and the only way you can get it is copping on the streets...

So heroin is illegal but if you get yourself addicted you can goto a doc and get a legit script for it? Doesn't make any sense.

[flipside]

To the OP, yes but it's not gonna happen..nit in the US

As for the statement about fent...unless they start giving it IV , I'll take the H anyday hand down, and yes I've had much exerience with bott..one legally the other out of necessity for many reasons.

[euphoria2002]

The answer to the question is yes, provided it works better to control pain.

We actually do have it up here in Canada. It's called Diamorph. The problem is it's so much of a hassle to Rx, and it's so expensive basically nobody ever Rx's it.

It's funny, you could be dead from cancer in 5 months, and somebody else is worried about giving H for whatever reason. Esp when there's so much stuff out there as it is.