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The Shipman files Monday, 31 January, 2000, 16:45 GMT
Diamorphine factfile
Injection
Diamorphine can be taken intravenously
Dr Harold Shipman used diamorphine to murder his victims. Diamorphine, or heroin, is used in medicine as a very effective and powerful painkiller. However, it is highly addictive and is fatal in large doses.


What is diamorphine?

Diamorphine is an opiate, a type of drug extracted from the unripe seed capsules of the Asian poppy. It belongs to a group of drugs called the narcotic analgesics.

These drugs have been used medically and non-medically for centuries.

Diamorphine resembles morphine, another opiate, in its actions and uses, but produces better pain relief with less severe side effects when given intravenously.

The drug relieves the severe pain that can be caused by injury, surgery, heart attack or chronic diseases such as cancer.

It is also used to relieve distress in acute heart failure and occasionally as a cough suppressant when other remedies have been ineffective.

It can come in tablet or liquid form. For severe pain a dose of 5-10mg intravenously is recommended.

What is its effect?

Diamorphine kills pain by depressing the action of the central nervous system.

It causes drowsiness in those who take it, and slows many of the body's functions.

Other effects include relaxation, relief of anxiety, decreased alertness and impaired coordination.

Its pain relieving effect wears off quickly, unlike some other narcotic analgesics.

Nausea, vomiting and constipation are common side effects, especially with high doses.

Can diamorphine be dangerous?

Most patients taking this drug for pain relief over brief periods of time do not become dependent, and are able to stop taking the drug without difficulty.

However, people who use this drug for its euphoric effects are highly likely to become addicted.

Diamorphine may reach the street by criminal diversion of legitimate sources.

What happens when diamorphine is misused?

As with all the opiates, the drug-dependent user builds up a tolerance to greater and greater amounts of the drug.

As the body adapts, the effects of the drug become weaker, and the user requires larger amounts to get a high.

If the drug is misused for extended periods, the user is likely to become physically dependent.

There are definite and often dramatic withdrawal symptoms when diamorphine is discontinued.

Diamorphine users who are withdrawing should seek medical help.

People who overdose on the drug may experience slow or irregular breathing, severe drowsiness and loss of consciousness.

Death from overdose is not common. It can happen, however, when a user who has withdrawn from the drug takes the same dosage to which he was accustomed before withdrawal.

Overdose then results in stupor, coma and death.

What happens if a massive amount is injected?

Rapid intravenous injection of narcotic analgesics is likely to spark off a range of adverse reactions.

These include severe depression of the respiratory system, leading to difficulty breathing, a drop in blood pressure, the collapse of the peripheral parts of the circulatory system, and heart attack.

Find out more about the Shipman murders

Trial and reaction

AUDIO VIDEO
See also:

31 Jan 00 | The Shipman files
31 Jan 00 | The Shipman files
31 Jan 00 | The Shipman files
31 Jan 00 | The Shipman files
Links to more The Shipman files stories are at the foot of the page.


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