Opioids are unique and strange compounds. On one hand, they are feared because of the possibility of abuse, addiction and the worst consequences; while on the other hand, they are one of the most effective compounds when used as painkillers.
Although the use of opioids in some form can be traced back to ancient times (the cultivation of opium poppy plants can be traced back to about 5000 years), its widespread use began in late 1800s when morphine addiction was one of the gravest concerns of various societies. Later, ‘heroin’ was marketed at a huge level as an alternative for morphine that was used in treatment of pain and used often for injuries of Civil War veterans. Its usage as a cough suppressant was also promoted.
After the initial clinical trials, heroine was labeled as a ‘wonder drug’, which lead to its commercial production and sale.
Although the negative effects of heroine soon became evident and The Heroine Act was passed by the US government in 1924 to prohibit the manufacture, import and possession of the drug, opioids continued to be used by a large number of people, illegally. Smuggling of heroin in the US reached its peak during the Vietnam War in the 1960s.
As awareness regarding the harmful effects of morphine and heroine spread, scientists tried to find alternatives to treat conditions of chronic pain. In 1937, ‘methadone’ was produced by German scientists in an attempt to find a painkiller that could be used during surgeries and is not as addictive as morphine and heroin. However, it was later claimed by many scientists and healthcare practitioners that methadone had more potential for addiction than the two opioids.
During the later 1900s, illegal production and trade of opium reached to such a high level that Southeast Asia alone was producing as much as 2500 tons per year. At the same time, some other synthetic opiates were introduced to the public as painkillers, with the approval of the Food and Drug Administration. The drugs included Vicodin, OxyContin and Percocet.
In late 1990s, as the pharmaceutical companies continued to formulate new opioid medicines and market them as effective for treating conditions of chronic pain, the medical community was hit by a storm. This coupled with some successes achieved in surgical, palliative and cancer procedures and treatments lead to the emergence of a new set of researchers that was comprised of pain specialists. They were of the opinion that opioid analgesics are highly effective for the treatment of chronic pain and can be used for that purpose.
The resulting increase in opioid prescriptions and their easy availability ultimately lead to opioid abuse, dependence, addiction and overdose deaths. The opioid epidemic that the US has been going through lately, does not only include the abuse of illegal drugs, but also the abuse of prescription opioid drugs.