The strange history of opiates in America: from morphine for kids to heroin for soldiers | James Nevius

They went from common analgesics to blacklisted substances, and now theyre criterion again. Along the route, efforts to criminalize havent stemmed usage

Americas burgeoning opiate problem is a tragedy, but it shouldnt come as a surprise: it stretches back to the arrival of the Mayflower in 1620.

Among the Pilgrims was physician Samuel Fuller, and in his kit bag he likely carried an early form of laudanum, the opium/ alcohol tincture first created by famed chemist Paracelsus.

Like other opiates, laudanum is derived from the opium poppy( the joy plant as the Sumerians called it 5,000 years ago ). Like all opiates, it was an effective pain killer, an anti-diarrheal and a soporific. In the rough frontier of early America, opiates helped ease the pain brought on by such ailments as smallpox, cholera and dysentery.

By the American Revolution, opium was a common medical tool. Thomas Jefferson, though generally skeptical of the medical treatments of his day, turned to laudanum in his later years to help ease his chronic diarrhea an affliction that probably helped kill him.

He felt so much better on the drug that he wrote to a friend, with care and laudanum I may consider myself in what is to be my habitual state. Jeffersons utilize of the word habitual is say. He ultimately grew his own poppies on his Monticello estate.

By the middle of the 19 th century, recreational opiate utilize was becoming more common. The scaremongering press denounced Chinese opium dens, playing up the drugs immigrant associations and planting the idea that Chinese men were use opium to entice white women into having sex.

Most Americans didnt require an opium den to get their fix, though. By then, opiates were the main ingredient in everything from teething powders to analgesics for menstrual cramps. Patent medicines so-called because they often contained secret patented ingredients inundated the market. Some served a useful intent, but they also became easy methods to get high.

One famous product was Mrs Winslows Soothing Syrup, a morphine and alcohol concoction that was marketed to parents of fussy children as a perfectly harmless and pleasant way to produce a natural quiet sleep, by relieving the child from pain. After the civil war, even more potent drugs entered the market, including the opiate heroin( introduced by Bayer around the same time as aspirin) and the stimulant cocaine, which was used in everything from coughing syrups to Coca-Cola( despite the companys stringent denials ).

Opium imports hit their peak in the 1890 s, right around the rise of the temperance movement, perhaps because of the demonization of alcohol, or perhaps because opiate utilize was easier to hide .

This was the status quo until 1906, when the federal government under Teddy Roosevelt stepped in with its landmark Pure Food and Drug Act, which required any dangerous or addictive medications to appear on the label of products. Three years later, the Smoking Opium Exclusion Act Americas first stab at medication proscription banned the importation of opiates that were to be used strictly for recreational use, though its unclear if this was really a measure to kerb drug use or simply anti-Chinese legislation.

The next big medication law came in 1914, when the Harrison Narcotics Tax Act both made a federal registry of all persons who creates, importations, fabricates, compounds, bargains in, dispenses, distributes, or devotes away opium or coca leaves or any compound, manufacture, salt, derivative, or preparation thereof, and levied taxes on them.

While physicians were supposedly excluded if the drugs were deemed medically necessary, the law severely limited the capacities of physicians to prescribe opiates. The act singled out addiction as a moral failing , not a medical disease, which constructed it nearly impossible for physicians to treat anyone with an opiate dependency.

Cocaine
Photograph: Corbis

Drugs became a matter of law enforcement , not public health. That still holds a century later. Endeavors by doctors to change the public dialogue stimulated little headway, and those who continued to prescribe opiates to junkies as part of therapy programs were incarcerated. Drug utilize further spiked when alcohol was banned by the passage of the 18 th amendment in 1919.

When prohibition was overturned by the 21 st amendment in 1933, the cocktail culture that had been created in speakeasies across the nation made drinking more socially acceptable than it ever had been. As heroin had been banned in the interim, this only further served to stigmatize recreational opiate users, who were marginalized as junkies.

After the second world war, opioids synthetic opiates began to enter the market in greater numbers, including medications devised utilizing Hydrocodone( subsequently popularise in the 1970 s as the narcotic in Vicodin) and Oxycodone( the opiate best known today as food ingredients in Oxycontin ). Many doctors knowing health risks of addiction and dependency embraced a sort of opiophobia, which caused them to shy away from prescribing pain pills frequently.

The increase in recreational drug use in the 1960 s including a spike in heroin use by soldiers in Vietnam gave rise to both the Controlled Substances Act in 1970 and the Drug Enforcement Agency in 1973, both of which were designed to limit access to opiates. However, as doctors became increasingly convinced that they were under-treating pain and new opioids entered the market prescriptions for analgesics took off.

Its no coincidence that this move was heavily endorsed by pharmaceutical companies, which had helped fund the studies that showed that physicians were under-prescribing pain medications. Meanwhile, pharmaceutical reps aggressively lobbied physicians on the value of their pills, and as Dr Celine Gounder noted in the New Yorker: By 2010, the United States, with about five per cent of the worlds population, was eating ninety-nine per cent of the worlds hydrocodone.

Today, there are medical answers to opiate addiction, but until America stops stigmatizing drug users as degenerates, those answers arent doing much good. Regulatory obstacles avoid many physicians from being able to prescribe buprenorphine, a medication presented to effectively treat opioid dependency.

And the DEA has done little to stem heroin in the United States. Since heroin is cheaper than prescription opiates, it is all too easy to switch from a legal prescription to illegal street drugs. On 10 March, the Senate passed a major drug treatment and prevention bill; the question remains whether it will make it into law and, if so, if it will do any good.

Tomorrow, 44 more Americans will die from prescription analgesics, according to the Centres for Disease Control and Prevention. And if history is any show, attempting to legislate an illness away will do little other than force-out addicts to search for yet another way to find their fix.

Read more: www.theguardian.com

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