HEROIN A BRIEF HISTORY
The great advances in medical therapy in the past century have been due largely to the rapid development of chemistry and pharmacology. During this period innumerable compounds obtained in chemical laboratories, were tested for their pharmacological activity. Those proving satisfactory were then produced commercially.
The extent of public acceptance and usage of any one drug has usually been determined by the medical profession. The use of many of the new compounds was only of short duration; they were frequently replaced by other compounds found to be more effective, or which did not provoke inconvenient side reactions.
The case of "Heroin" (diacetylmorphine) is almost unique. Hailed as a wonder drug, it was received with enthusiasm by the medical profession. Inevitably, the deleterious effects of the drug were discovered. Although many doctors discontinued prescribing heroin and all warned against careless use of the drug, the market for it continued to flourish. A dangerous addiction-producing drug, it was not easy to curtail its usage.
HEROIN AS A WONDER DRUG
Although diacetylmorphine was not prescribed as a medicine much before 1900 its preparation had already been reported in 1874 by C. R. Wright at St. Mary's Hospital in London. The main purpose of his work was to determine the constitution of some natural and purified alkaloids. By boiling anhydrous morphine alkaloid for several hours with acetic anhydride he was able to isolate acetylated morphine derivatives. The general conception of the morphine molecule in those days was that it was represented by the double empirical formula which gave rise to the rather confusing nomenclature in his article. The extreme acetylated derivative which he obtained, he called " Tetra acetyl morphine." This compound corresponds to diacetylmorphine according to our present nomenclature. This "Tetra acetyl morphine" was sent to F. M. Pierce, Associate at Owens College, London, for biological assay. After having tested the compound in animal experiments he reported the following results to Wright. The effects were:1"... great prostration, fear, sleepiness speedily following the administration, the eyes being sensitive and pupils dilated, consider able salivation being produced in dogs, and slight tendency to vomiting in some cases, but no actual emesis. Respiration was at first quickened, but subsequently reduced, and the heart's action was diminished and rendered irregular. Marked want of coordinating power over the muscular movements and the loss of power in the pelvis and hind limbs, together with a diminution of temperature in the rectum of about 4°, were the most noticeable effects." From a medical point of view the interest in this new morphine derivative was not very high for the first twenty years. In 1890, a German scientist, W. Dankwortt, prepared diacetylmorphine by heating anhydrous morphine with excess acetylchloride. The result of his work is important, not from the pharmacological, but from the chemical point of view. Because of the nature of the compounds he was able to isolate, he concluded that the morphine molecule had a simple empirical formula rather than the double one.
TERMINOLOGY
In the last decade of the 19th century Dreser and other investigators studied the physiological effects of diacetylmorphine. The favourable reports of these investigators along with the growing interest in the drug shown by the medical profession of that time, led the Bayer Company in Eberfeld, Germany, to start production of the compound on a commercial scale (1898).
The new compound was marketed by Bayer under the name "Heroin." (The name is probably derived from "heroisch" which in German medical terminology means large, powerful, extreme, one with pronounced effect even in small doses.) Later this name became a synonym for the drug.
The new remedy received a spontaneous and widespread acceptance comparable to the acceptance of drugs like penicillin or cortisone in the past few years. The high frequency of tuberculosis and other respiratory diseases had created a great demand for an effective remedy and it was hoped that heroin would meet this need.
Prescribed for almost all illnesses in which codeine or morphine had been found, heroin was also considered to be effective in combating addiction to these two drugs. This enthusiasm for the new drug is best illustrated in the medical literature of the time. Though by no means exhaustive, these following excerpts are typical of the writings of the day.
In 1898, Strube reported on the results of studies at the Medical University Clinic of Berlin. Testing heroin on 50 patients afflicted with phthisis, he found it effective in relieving their cough and in producing sleep. Though Strube observed no adverse effects, he felt that further observations were necessary to determine whether continual use might be harmful or lead to chronic "heroinism".
Adipiscing egestas curabitur
Adipiscing egestas curabitur
