Oxidation diamorphine

A 23-year-old man presented with a 5-day history of gait disturbance and incoordination. He had severe loss of proprioception in his legs and could not walk. He was hypomanic. Severe posterior column myelopathy was diagnosed using MRI scanning. His nitrous oxide use had consisted of 40-60 whipped cream bulbs per day for 6 months. He also admitted to intermittent diamorphine abuse, but not for the 3 weeks before admission. He was treated with hydroxocobalamin and methionine, but still had minor abnormalities 3 months later. 

A close inspection of the structure of diamorphine will show that the molecule also contains benzylic hydrogen atoms, on the CH2 adjacent to the benzene ring. This site is susceptible to oxidation and, for this reason, diamorphine should be stored in a well-closed container protected from light. 

Simultaneous acetylcodeine, amphetamine, benzphetamine, benzylmorphine, bromo-STP, buprenorphine, chlorphentermine, codeine, codeine-N-oxide, dextromoramide, dextropro-poxyphene, diamorphine, diethylpropion, dihydrocodeine, dihydromorphine, dimethylam-phetamine, dipipanone, ephedrine, epinephrine, ethoheptazine, ethylmorphine, etorphine, fencamfamin, fenfluramine, fentanyl, hydrocodone, 4-hydroxyamphetamine, levorphanol, mazindol, meperidine, mephentermine, mescaline, methadone, methamphetamine, meth-ylenediojQramphetamine, methylephedrine, monoacetylmorphine, morphine, morphine-3-glucuronide, morphine-N-oxide, naloxone, norcodeine, norlevorphanol, normetanephrine, normethadone, normorphine, norpethidine, norpseudoephedrine, noscapine, o codone, papaverine, pemoline, pentazocine, 2-phenethylamine, phenoperidine, phentermine, phenylephrine, phenylpropanolamine, pholcodeine, pipradol, piritramide, prolintane, pseudoephedrine, STP, thebacon, thebaine, trimethoxyamphetamine, tyramine... 

---