From history’s earliest civilizations to today, societies have been faced with balancing the medicinal properties of opiates in treating pain with the euphoric effects that have induced its misuse and abuse.1The earliest reference to opium (the “natural” source of opiates) dates back to 3400 B.C., when poppies were cultivated in lower Mesopotamia. The Sumerians called the opium poppy “Hul Gil” (the “Joy Plant”). Around 460-357 B.C., Hippocrates, the “father of medicine,” acknowledged opium’s usefulness as a narcotic. He prescribed drinking the juice of the white poppy mixed with the seed of nettle.
Alexander the Great took opium with him as he expanded his empire. Arabs, Greeks and Romans used it as a sedative. In the 15th and 16th centuries, Arabic traders brought opium to the Far East. From there, opium made its way to Europe, where it was used as a curative for a wide variety of illnesses and psychological problems.2
Opiate Use in the 1800s
In 1806 the German chemist Friedrich Wilhelm Adam Sertürner isolated a substance from opium, which he labeled “morphine” after the god of dreams, Morpheus. Morphine soon became the mainstay of U.S. doctors for treating pain, anxiety and respiratory problems, as well as consumption and female ailments. Morphine was commonly used as a painkiller during the Civil War.
However, so many soldiers came to become dependent on opiates that the post-war morphine addiction was known as “soldier’s disease.”
In 1853, the hypodermic needle was invented, after which morphine began to be used in minor surgical procedures to treat neuralgia; this gave rise to the medicalization of opioids. Heroin was synthesized as a derivative of morphine in 1898, and the German chemical company Bayer offered heroin as a cough suppressant. It was offered as a “non-addictive”substitute for morphine. By the end of the 19th Century, the United States focused on ending the non-medicinal use of opium.2
Opiate Use in Early 20th Century
In 1909, Congress passed the Opium Exclusion Act barring importation of opium for the purpose of smoking. This legislation is considered by many to be the official start of the war on drugs in the U.S.In a similar manner, the Harrison Narcotics Tax Act of 1914 placed a nominal tax on opiates and required physician and pharmacist registration for its distribution; in effect, this was a de facto prohibition of the drug.
While sales of heroin virtually stopped with the passage of The Heroin Act in 1924, mixed views on addiction and opiates existed in the medical community. Then, in 1938, the U.S. Food and Drug Administration (FDA) was given power to oversee the safety of food, drugs and cosmetics; drugs needed to be proven safe in order to be sold. Many opioid-derived medicines being sold, such as codeine, morphine and oxycodone, were still allowed to be prescribed, despite their negative consequences.1
Mid 20th Century: Abuse on the Rise
Oxycodone became widely available when it was approved by the FDA in 1950 as Percodan® (mix of oxycodone and aspirin). Since the early 1960s, abuse of prescription opioids containing oxycodone has been a major concern in the U.S.
Following a lull, the smuggling of illegal heroin into the U.S. rose dramatically. This was, in large part, attributable to our nation’s military presence in Vietnam in the 1960s.
In 1969, the World Health Organization (WHO) abandoned the belief that the medical use of morphine inevitably led patients to dependence, stating that drug tolerance and physical dependence do not, in themselves, constitute “drug dependence.”
The American medical landscape in the 1980s was characterized by “opiophobia” – a fear of prescribing opiates and other opioids, with President Reagan asking Americans to join a national crusade not to tolerate drugs by anyone, anytime, anyplace. In response to the growing recognition of the need for pain management, the pendulum then swung the other way with a significant increase in opioid use for all types of pain. Then, in the 1990s, time-release prescription opioids hit the market, continuing into the 2000s.1
Opiate Use in the 21st Century
A seismic shock was felt in the 2000s when Purdue’s aggressive marketing of its controlled-release opioid Oxycontin – described as “safe” for chronic pain – intersected with the trafficking of cheap, pure heroin in smaller cities across the West, Midwest and Appalachia. Purdue advertised Oxycontin as non-addictive because the drug was designed to be released within the body over a 12-hour period; however, recreational drug users quickly learned to get “high” by crushing or dissolving these time-release pills.
In March 2016, the Centers for Disease Control and Prevention (CDC) issued a new set of guidelines for prescribing opioids for chronic pain. The following month, several health care organizations – led by Physicians for Responsible Opioid Prescribing – petitioned the Joint Commission for Accreditation of Health Care Organizations, calling for “an end to mandatory pain assessment,” suggesting that this practice “fosters dangerous pain control practices” and leads to over-prescription of opioids.3
There is Help for Opiate Abuse Today
It is imperative that we strive to achieve a balanced approach to ensure that people suffering from chronic pain can get the relief they need while minimizing the potential for negative consequences, including a substance use disorder involving opiates and other opioids.
The staff of trained professionals at Michael’s House understands opiates, opioids, addictions and today’s best treatment practices. Michael’s House is here to help you get free from addiction’s power and usher in a return to your “authentic self.” Call us on our 24/7 toll-free line, 760-548-4032 at your convenience for expert advice, professional services and caring support – all the help you need in the battle against opiate addiction.
1 “A Brief History of Opioids.” Newsweek.
2 “Opium Throughout History.” FRONTLINE, PBS. 1998. Web. Accessed June 2017.
3 Meldrum, Marcia L., Ph.D., “The Ongoing Opioid Prescription Epidemic: Historical Context.” American Journal of Public Health, Volume 106, Issue 8, Pages 1365-1366, August 2016.