Brompton cocktail

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Brompton cocktail is an elixir meant for use as a pain suppressant, and dosed for prophylaxis. Made from morphine or diacetylmorphine (heroin), cocaine, highly-pure ethyl alcohol (some recipes specify gin), and sometimes chlorpromazine (Thorazine), it was given to terminally-ill individuals (especially cancer patients) to relieve pain and promote sociability near death. The chlorpromazine suppresses nausea from whatever source, and tincture of cannabis was once used for this purpose.

The Brompton cocktail is named after the Royal Brompton Hospital in London, England, where it was invented in the late 1920s for patients with tuberculosis. While its use is rare in the 21st century, it is not unheard of. It was far more common in the late 19th and early 20th centuries. The original idea for an oral mixture of morphine and cocaine helping patients in agony with advanced disease is credited to surgeon Dr Herbert Snow in 1896.

While each of the ingredients combat pain and other problems that occur with it in those who may be nauseous from effects of chemotherapy, radiation, and/or high and escalating doses of morphine (which can also cause somnolence or sleepiness, hence the stimulant), it is also generally acknowledged that the whole is greater than the sum of its parts with the various active ingredients all potentiating the morphine or other opioid in their own ways. The synergy between opioid analgesics and centrally-acting stimulants is well-known and is taken advantage of everything from the caffeine content of many codeine-based pain relievers to prescribing dextroamphetamine or methylphenidate to patients on high doses of opioids to both combat the somnolence from the painkillers and boost their pain-killing ability.

Some specifications for variants of Brompton Mixture call for methadone, hydromorphone, or other strong opioids in the place of morphine, diphenhydramine in place of the chlorpromazine, and/or methamphetamine, amphetamine, dextroamphetamine, co-phenylcaine, methylphenidate or other stimulants in the place of cocaine. The original recipe for Brompton Mixture also calls for chloroform, cherry syrup to help mask the bitter taste of some of the components, and distilled water in some quantity as a dilutant for the chloroform and/or to add volume to allow for more precise titration of doses.