Brompton’s Cocktail?
August 24, 2023 12:21 AM Subscribe
I came across an end of life drug in Victorian England called Brompton’s Cocktail which is basically a speedball. Wikipedia indicates it is not unheard of to be used today, though rare. Is this true in palliative care? I assume some of the ingredients like cocaine and heroin are replaced by modern equivalents. I still never heard of this.
I’m guessing we have far higher potency equivalents to cocaine and heroin, and I have no idea why gin was used other than it was Victorian England. I’ve come across some old medical textbooks that basically say it was a way for patients to say goodbye while not being in pain, which makes sense. At the same time I’ve never heard of this being used in America or anywhere else in modern times.
I’m guessing we have far higher potency equivalents to cocaine and heroin, and I have no idea why gin was used other than it was Victorian England. I’ve come across some old medical textbooks that basically say it was a way for patients to say goodbye while not being in pain, which makes sense. At the same time I’ve never heard of this being used in America or anywhere else in modern times.
Not just Victorian. My mother was a nurse at Kingston Hospital (south London) in the 80s, and it was regularly used then.
posted by Fuchsoid at 4:43 AM on August 24, 2023 [1 favorite]
posted by Fuchsoid at 4:43 AM on August 24, 2023 [1 favorite]
Fascinating - I’d never heard of it, but there seem to be plenty of articles about it online.
This one says it was indeed used in the USA, and remained in use in some places into the 1980s.
But it says that ultimately, studies showed that it was a myth that the cocktail in combination was somehow more effective than the sum of its parts (which was a belief which had fuelled its usage). They’ve since largely reverted to using morphine and/or cocaine as individual drugs as needed, rather than mixing them into some kind of mysterious “elixir” with alcohol and syrup. That makes it easier to tirate, and to store.
posted by penguin pie at 6:14 AM on August 24, 2023
This one says it was indeed used in the USA, and remained in use in some places into the 1980s.
But it says that ultimately, studies showed that it was a myth that the cocktail in combination was somehow more effective than the sum of its parts (which was a belief which had fuelled its usage). They’ve since largely reverted to using morphine and/or cocaine as individual drugs as needed, rather than mixing them into some kind of mysterious “elixir” with alcohol and syrup. That makes it easier to tirate, and to store.
posted by penguin pie at 6:14 AM on August 24, 2023
My grandfather was a pharmacist in very rural UK into the 1970's and my Grandmother who worked alongside him talked about having mixed up Bromptons Cocktail (and they definitely had cocaine as a clinical ingredient on hand, as when the glass bottle was accidentally dropped the 'drugs squad' came and vacumned it up from the wooden plank floor) for patients.
He also would make what was known as 'Heavenly Drops' which was some kind of ultra-high potency opiate mixture which would be sent out to very palliative patients in the (then basically inaccessible except by walking or perhaps farm wagon) most rural parts. The instructions were literally 1-2 drops under the tongue for pain as needed, for patients who were unable to swallow/families who were unable to reliably measure/read instructions for more complex medication regimes.
I wish I'd had a chance to know him as he had worked through truly revolutionary years in pharmacy, but I am fortunate to have heard many of the stories from my Gran and Mom, who both worked as pharmacy assistants by his side.
Medically speaking now, cocaine has very limited uses in medicine; most in ENT surgeries I believe, and I have never seen it used as an ingredient in palliative meds, probably because as people have suggested above, we have more/better choices available with more targeted effects.
posted by Northbysomewhatcrazy at 11:16 AM on August 24, 2023 [2 favorites]
He also would make what was known as 'Heavenly Drops' which was some kind of ultra-high potency opiate mixture which would be sent out to very palliative patients in the (then basically inaccessible except by walking or perhaps farm wagon) most rural parts. The instructions were literally 1-2 drops under the tongue for pain as needed, for patients who were unable to swallow/families who were unable to reliably measure/read instructions for more complex medication regimes.
I wish I'd had a chance to know him as he had worked through truly revolutionary years in pharmacy, but I am fortunate to have heard many of the stories from my Gran and Mom, who both worked as pharmacy assistants by his side.
Medically speaking now, cocaine has very limited uses in medicine; most in ENT surgeries I believe, and I have never seen it used as an ingredient in palliative meds, probably because as people have suggested above, we have more/better choices available with more targeted effects.
posted by Northbysomewhatcrazy at 11:16 AM on August 24, 2023 [2 favorites]
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posted by Mizu at 1:35 AM on August 24, 2023 [6 favorites]