Possessed By Morphine, by Stcinicn

Possessed By Morphine, by Stcinicn

"At (lie clinic, at five o'clock, tlie old bull Jog who is dying is given a fatal injection of morphine. One hour later he is playing in the garden, jumping and rolling about,. The following day. at five, be scratched at the doctor's door and asked for his injection."

Jean Coeteau Opium, I'WO

community. It certainly was a remarkable achievement, but the blessings were decidedly mixed. On the positive side, a measured dose of a pure drug could now be given for the first time, and accurate research could he done on the differences between specific doses. On the other hand, far more potent substances were now available, and they could be administered in ways that further increased their potency. TSoth factors led to drug problems far mote serious than had previously been experienced. To begin with, if we have learned anything from observing drug use in various societies, it is that people who use drugs in their natural forms have far fewer problems with them than those who use refined drugs. And the more potent the drugs, the greater the problems. With opium it is not unusual for a person to keep his dosage level stabilized for years. With morphine, a substance ten times mote potent, such equilibrium is far more difficult . to maintain. Tolerance builds much more rapidly, and with it dosage levels. And when the still more potent heroin is in the drug of choice, the problems seem to multiply.

Equally important is the fact that the alkaloids are amenable to unnatural modes of administration. Pure opium, for example, cannot be injected into a vein. Pure morphine can, and the troubles with morphine increased dramatically after the hypodermic syringe came into general use in the mid-1850s. The veins, after all, form a closed system, and rupturing this system is rarely to our benefit. . The repeated invasions of it practiced by those who mainline drugs frequently lead to collapsed veins and the introduction of contaminants the system is not designed to handle. Moreover, intravenous injection increases the blood levels of the drug far faster than does any other route. As a consequence, the subjective experience of the drug is markedly more intense in every respect. . The rush experienced on injected opiates, for example, is not available when they are smoked, swallowed or snorted. And experience shows that lot those who like intense drug effects, the intensity is directly related to their pattern of use: the more intense the experience, the more frequently they seek it. And of course the mote frequently a tolerance building drug i.s used, the quicker tolerance builds, and

HOPHEAD ETIQUETTE "I found later a man that's hooked on hop [opium] will never lay the first pill |opium] on a beginner, because he doesn't want it oil his mind in case you become a hophcad. This is a strong superstition among the 'legion of the condemned.'. Dope fiends arc full of nice little rules and regulations like that; Emily Post could write a book just on hophcad etiquette."

Mc/z Mc/./rhv and licrn.m' Wolfe Hi'oili Hit- Blues. 1972

with it the escalation of dosage. A major result,, therefore, of the isolation of drug alkaloids and the introduction of the hypodermic syringe was a pattern of drug-dependent behavior we are all now familiar with hut which had not been seen before.

The promoters of the horseless buggy didn't foresee such consequences as air pollution and traffic jams, nor did the medical profession of the nineteenth century sec that the power of morphine would lead to results, no one could consider desirable. To physicians it was simply the most potent analgesic yet available, a panacea so great that no one accused Sir William Osier of blasphemy when be called it God's Own Medicine. And they dispensed it quite as if it were a gill from heaven, it was prescribed for all the symptoms formerly treated with opium, and its administration was automatic for chronic pain and insomnia. And if patients were not warned of its addiction potential, , neither were the doctors. Medical textbooks seldom mentioned the possibility, nor did professors of medicine. Indeed, morphine was promoted as a cure for opium

Army "druj; store" of (he Civil War era

addiction until well past the middle of the century. (If getting off opium was tlie criterion for success, (lie cure worked. Most opium users given the morphine treatment slopped using opium and switched to morphine.) Physicians didn't wake up to morphine's addiction possibilities until 45,000 soldier's came liome from tlie Civil War dependent on the dmg. Even then, tlie large majority of them appeared not to have thought it a very serious matter. Nor did the average citizen who purchased it in patent medicines or over the counter in pure form. All the evidence indicates that if there was any fear of addiction, it in no way affected morphine's ever-growing popularity.. The amount of crude opium, the raw material for the manufacture. of morphine, imported to America skyrocketed from 24,000 pounds in 1840 to 417,000 pounds in 1872. And between 1860 and 19LI, while tlie population increased 133 percent, the consumption of opiates increased by 351 percent. .

Given these figures, it seems reasonable to assume that the addiction rate was climbing pretty steadily, too. According to the newspapers of the time it was, but despite several head counts of addicts in various slates, there is no reliable figure on the overall number. The estimates for 1900 range from 269,000 to 1,000.000 in a population of approximately 80 million. (By contrast, the current number of heroin addicts is estimated at between 600,000 and 750,000.)

CODEINE Codeine, the other major alkaloid of opium used extensively in medicine, was first isolated in 1832. In equal doses it is about one-sixth as potent as morphine. Tolerance is built, to it, and withdrawal symptoms are evident when regular use is stopped. But in tlie small doses needed for effective action against coughs and diarrhea its addiction potential is very slight. . In most slates it cannot be purchased without a prescription. and for reasons that are difficultto determine, doctor's seem reluctant to prescribe il in pure form. Instead they write prescriptions for products which contain it-Actifed-C, Empirin Compound wi Codeine, Novahistine-DH and so on. These are more expensive than plain codeine and usually less effective.

HEROIN Tlie concern over morphine addiction which had developed by the 1890s led to a search for a nonaddicting narcotic. That this was as misdirected and foolish a quest as the alcliemists' attempts to transmute base metals into gold seemed to have occurred to very few physicians. Their experience using morphine to cure opium addiction lauglil tlie profession, as a whole, nothing. Doctor's wanted a drug which would do the work of God's Own Medicine without incurring its liabilities and, like chronic gamblers, their desire for the big score drowned out the nagging voice of experience. Otherwise it's hard to explain their enthusiasm when heroin was introduced commercially by the Bayer Co. in 1898. Named from the German heroisch, ("tuge," "powerful"), it was a semisynthetic derivative of morphine two to three limes as potent as its source. Il had been first reported by an English physician in 1874, but no one paid any attention to it for the next 20 years. Then some German researchers wrote encouraging words about it, and Bayer decided it had commercial possibilities.

They were right.. The new drug was immediately hailed as a marvel which could do everything morphine could do but without inducing addiction. And as morphine had once been used to "cure" opium addiction, heroin was now prescribed for morphine addiction-and extensively advertised by the patent medicine makers as a nonaddicting substitute for morphine. The bulk of the'medical profession didn't abandon its belief in heroin's nonaddicting status until around 1910, but drug users understood all about it considerably sooner. They quickly made it the opiate of choice, and the newspapers ran stories

San Francisco moiphine addicis

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