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Thank you so much for posting your blog. I’ve been throat clearing and coughing for 11-12 years I can recall the episode that started it. I used to perform in amateur theatre. During rehearsals for a show I developed a respiratory infection and laryngitis. I continued to try and sing (against the suggestion of a fellow cast member and doctor). When the respiratory infection had cleared up I noticed that my voice continued to sound lower and ‘flu like’. It never went back to normal. I’ve had the throat clearing and cough ever since. A year ago I had my thyroid disabled with radioactive iodine due to Graves Disease and developed radioactive thyroiditis. I also have GERD, IBS and Barrett’s Syndrome. I have coughed violently since then. I can’t work as the cough is so debilitating. I’m currently taking 50mg of Amiltryptaline at night to treat chronic insomnia and general anxiety. The cough is alleviated to a certain extent at night. I feel sick and tired constantly. You have shed some well needed light at the end of a very dark tunnel. I have a Dr appointment tomorrow to start the next series of testing. I won’t stop now until I get some relief from this nightmare. My thoughts are with everyone who suffers this horrid ailment.

Thebaine ( paramorphine ), also known as codeine methyl enol ether , is an opiate alkaloid , its name coming from the Greek Θῆβαι, Thēbai (Thebes), an ancient city in Upper Egypt . A minor constituent of opium , thebaine is chemically similar to both morphine and codeine , but has stimulatory rather than depressant effects. At high doses, it causes convulsions similar to strychnine poisoning. The synthetic enantiomer (+)-thebaine does show analgesic effects apparently mediated through opioid receptors, unlike the inactive natural enantiomer (−)-thebaine. [3] While thebaine is not used therapeutically, it is the main alkaloid extracted from Papaver bracteatum (Iranian poppy) and can be converted industrially into a variety of compounds, including oxycodone , oxymorphone , nalbuphine , naloxone , naltrexone , buprenorphine and etorphine . Butorphanol can also be derived from thebaine and is scheduled separately from butorphanol derived by other processes. [4]

Other notable derivatives then result from further modification of this template, with saturation of the 7,8-double bond of etorphine resulting in the even more potent dihydroetorphine (up to 12,000× potency of morphine) and acetylation of the 3-hydroxy group of etorphine resulting in acetorphine (8700× morphine)—although while the isopentyl homologue of etorphine is nearly three times more potent, its 7,8-dihydro and 3-acetyl derivatives are less potent than the corresponding derivatives of etorphine at 11000× and 1300× morphine respectively. Replacing the N-methyl group with cyclopropylmethyl results in opioid antagonists such as diprenorphine (M5050, which is used as an antidote to reverse the effects of etorphine, M99), and partial agonists such as buprenorphine , which is widely used in the treatment of opioid addiction .

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