Opium Epidemics: A Pattern in History

We are currently in an opiate epidemic that kills 72,000 people per year.  Although we might think this a new phenomenon, we have suffered opiate epidemics every couple of decades since the mid 1800's.  Britain, in its delightful wisdom, cultivated the opium trade after conquering an opium-growing region in India in the 1700's.  Instead of suppressing opium's growth, it used it as an empire-building tool to suppress China in the east and promote its own wealth in trade.  The resulting two Opium wars (1839-1842 and 1856-1860), inflicted incredible devastation on China and resulted in mass immigration of Chinese to America to work on the railroads under incredibly horrible conditions that we are still studying to this day.

Friedrich Sert├╝rner in 1804 from Sert├╝rner and Company was the first person to extract morphine from opium.  That company survives today and is called Merck.  Morphine was about 10 times stronger than raw opium extractions and its use led to widespread addiction.  He developed it as a medication in 1817 despite experiments on human subjects that nearly resulted in their deaths.  Morphine addiction in this time led to over 400,000 soldiers suffering from addiction in a population that was only a tenth it is today (~31,000,000).

After the American Civil War, morphine addiction became widespread in the southern US as slave-owning wealthy elites lost their labor force and fell into a deep economic and otherwise depression.  Whites were the predominant users of morphine, simply obtaining the drug from their doctors.  In 1874, Bayer marketed heroin (or diamorphine) as the "safe alternative" to morphine with no "narcotic" side-effects.  Their marketing was incredibly successful, and like the marketing of Oxycontin in recent history, it was incredibly dishonest and deadly.

The result was decades of addiction that eventually led to many of the laws we see today surrounding morphine and its derivatives.  Yet, despite this, every couple of decades, we suffer yet another opiate epidemic.  Today's epidemic is no less devastating but pharmaceutical companies have regularly promoted the use of opiates well outside their medical usefulness for one reason: it's incredibly profitable.  Purdue, the manufacturer of Oxycontin, is also owned by a single family who has secretly built an empire on addiction.  This is despite the fact that oxycodone, the ingredient in their drug, was invented in 1916.  Somehow, with miraculous working of patent law, Oxycontin is still brand-name to this day and sold for incredible prices.  What is really quite interesting is that this family owns a second company they have sought to keep secret called Rhodes Pharma that manufactures MS Contin, Dilaudid, and other opiates.  They are now being sued by many states alleging their deceptive and unusually aggressive marketing tactics led to this current opiate crisis. 

We have been suffering an opiate crisis every couple of decades since the mid 1800's and wealthy companies like Bayer, Merck, and Purdue Pharma have always been at the center of them.  They have paid doctors incredible sums of money to make sure that they are prescribing these incredibly addictive substances even when they don't really have a reason.  Even today, 30% of prescriptions for opiates and benzodiazepines have no medically justifiable reason.  

Medical cannabis, despite some small potential for abuse, is nowhere near as addictive or deadly as opiates and is likely very useful in treating many people's pain with no danger of overdose death.  If we treated people for pain using medical cannabis rather than opiates, we might be able to save some of the 72,000 who die each year from opiate overdose.  It seems absurd that although we have a potential tool for reducing opiate use while also treating patients' pain, the US government is still unduly hostile to legalizing the use of medical cannabis.

Ethan Carruthers