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Addiction and Opiates

Addiction and Opiates

CHAPTER 8 CONCLUSIONS,

CHAPTER 8 CONCLUSIONS, IMPLICATIONS, PROBLEMS 4. Jean Piaget, The Child's Conception of Physical Causality (New York: Harcourt, Brace, 1930), P. 242. 5. Ibid., p. 286. 6. R. F. Bales, The "Fixation Factor" in Alcohol Addiction (unpublished doctoral dissertation, Harvard University, 1944). 7. D. 0. Hebb, The Organization of Behavior (New York: John Wiley, 1949), P. 199. 8. Charles E. Sceleth and Sidney Kuh, "Drug Addiction," Journal of the American Medical Association (1924), 82: 68o. 9. Paul Wolff, "Wann ist die Verschreibung von Opiaten artzlich Begrundet?" Deutsche Medizinische Wochenschrift (1931), 57: 266. Wolff reported the results of the inquiry in a series of five articles beginning on pages 133, 178, 223, 266, and 318 of the volume cited. 10. Ibid., p. 181. 11. Ibid., P. 223. 12. Vincent P. Dole and Marie E. Nyswander, "A Medical Treatment for Diacetylmorphine (Heroin) Addiction, A Clinical Trial with Methadone Hydrochloride," Journal of the American Medical Association (August 23, 1965), 193 (8): 8o-84, and by the same authors, "Rehabilitation of Heroin Addicts after Blockade with Methadone," New York State Journal of Medicine (August 1, 1966), 66 (15): 2011-17. This description is based in part on my conversations with Dole and Nyswander. file:///I|/drugtext/local/library/books/adopiates/chapter8.htm[24-8-2010 14:23:39]

CHAPTER 9 THE PROBLEM IN THE UNITED STATES DURING THE NINETEENTH CENTURY file:///I|/drugtext/local/library/books/adopiates/chapter9.htm[24-8-2010 14:23:39] PART II Opiate Addiction as a Social Problem CHAPTER 9 THE PROBLEM IN THE UNITED STATES DURING THE NINETEENTH CENTURY Before tracing the development of the narcotics problem in the United States, it is appropriate to consider briefly the broader historical aspects of the problem. Morphine and heroin are derivatives of opium developed during the nineteenth century, but the history of opium itself and of its use by man begins at least several thousand years before the birth of Christ. Mesopotamia is believed to have been the original home of the opium poppy. The Sumerians, who settled there in 5000 or 6ooo B.C., developed an ideogram for opium.(1) This ideogram has been translated as HUL GIL, the HUL meaning "joy" or "rejoicing." Methods of obtaining opium from the poppy were about the same then as they are now. The cultivation of the poppy and the use of opium spread from Mesopotamia to other parts of the ancient world. The Greeks, Romans, Persians, and Egyptians became acquainted with the drug. Homer mentioned it in the ninth century B.C. Arab traders are believed to have introduced it into the Orient, which is now the principal source .(2) In as much as opium was used as a remedy for human ills even before the Christian era and constituted the main therapeutic agent of medical men for more than two thousand years (through the nineteenth century),(3) it is not surprising that the people of the East, where the poppy is grown, should have suffered more than their share from addiction. Nor is it unusual that for a long time opium addiction was regarded in the West as something peculiar to the Orient. In 1804, Friedrich Wilhelm Adam Serturner, a German chemist at Einbeck, discovered in opium meconic acid and an alkaline base which he named morphium This discovery, which marked the beginning of modern alkaloidal medicine, gave great impetus to the development of the type of drug addiction which was to prevail in the West. Other opium alkaloids and derivatives were developed in rapid succession, often in the hope or belief that the new compounds would be free from the habit-forming propensities of previous ones. The climax was reached with the isolation of heroin, or diacetylmorphine, in 1898. This was the last opiate preparation to be hailed by medical men as a non-habitforming substitute for opium or morphine or as a cure for drug addiction. Heroin turned out to be approximately three. times as powerful as morphine (which was more potent than opium) and just as habit-forming. While Orientals have, in general, persisted in smoking opium or using it orally, another tendency has appeared among them in recent decades as a consequence of efforts made to stamp out smoking. The West, returning favor for favor, has supplied the East with hypodermic needles and with more potent opiates, particularly morphine and heroin. As it becomes more difficult for Chinese addicts to continue their smoking habits it is to be expected that the hypodermic needle will become more popular among them and that they-like the addicts of the United States -will become "vein shooters." ( Thomas DeQuincey's Confessions of an English Opium Eater, published in 1821, set the style and provided the terms which dominated discussions of opiate addiction for many decades thereafter. DeQuincey drank his opium in the form of laudanum. As a result of his widely read work, addicts were called "opium eaters," regardless of the manner in which they consumed the drug, except that opium smokers were apparently never so designated. The users of morphine, who began to appear in increasing numbers in the 1820's and 1830's, were also referred to as 11 opium eaters." It is popularly believed today that most addicts are criminals or derelicts prior to addiction. As we have seen, this impression requires considerable qualification as it applies to contemporary drug users. It is even more inaccurate with respect to the opium eaters of the nineteenth century. In 1889 B. A. Hartwell solicited opinions from druggists in 18o Massachusetts cities concerning the economic and social status of the addicts they knew. Twentytwo per cent of those who replied said addicts were to be found in all classes, another 22 per cent said that the tipper classes were principally involved, 3 per cent named the middle classes, and only 6 per cent the lower classes. (4) Addiction during the nineteenth century, except opium smoking, was not linked tip with crime to any appreciable extent. There are a few references to the use of laudanum by prostitutes, but it was not suggested that women became

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