Paradigm Shift In Opioids: Heroin

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History of the opioid crisis:

There is a long history of opioid dependencies, dating back to 1806 when German chemist Friedrich Wilhelm Adam Sertürner isolated a substance from opium. This was later named “morphine” after the god of dreams, Morpheus. Morphine soon became a regular treatment for doctors in the United States when treating pain, anxiety and respiratory problems. Frequently used as an aid for consumption and female ailments, Morphine became a common painkiller during the Civil War. However, many soldiers became dependent on opiates. This was common enough that the post-war morphine addiction was commonly known as “soldier’s disease.” In 1853, the hypodermic needle was invented, after which morphine was put to use in minor surgical procedures to treat neuralgia; this gave rise to the medicalization of opioids. Heroin was synthesized as a derivative of morphine in 1898. The German chemical company Bayer offered heroin as a cough suppressant. It was offered as a “non-addictive” substitute for morphine. This “non- addictive” substitute ended up being even more addictive than the previous drug and by the end of the 19th Century, the United States focused on ending the non-medicinal use of opium.

In 1909, Congress passed the Opium Exclusion Act stopping the importation of opium for the the use of smoking. This legislation is considered by many to be the official start of the war on drugs in the United States. In a similar manner, the Harrison Narcotics Tax Act of 1914 placed a nominal tax on opiates and required physician and pharmacist registration for its distribution; in effect, this was a de facto prohibition of the drug.

In 1916, Bayer had completely halted the mass production of heroin. Mass production created an unforeseen dependence, one people started they simply could not stop. German scientists at the University of Frankfurt developed a new opiod, oxycodone. The intention was that it would retain the analgesic effects of morphine and heroin, but with less physical dependence.

While sales of heroin virtually stopped with the passage of The Heroin Act in 1924, mixed views on addiction and opiates existed in the medical community., Furthermore, in 1938, the U.S. Food and Drug Administration (FDA) was granted the power to oversee the safety of food, drugs and cosmetics; drugs needed to be proven safe in order to be sold. Many opioid-derived medicines being sold, such as codeine, morphine and oxycodone, were still allowed to be prescribed, despite their negative consequences.

Oxycodone became widely available when it was approved by the FDA in 1950 as Percodan, classified as a mix of oxycodone and aspirin. Since the early 1960s, abuse of prescription opioids containing oxycodone has been a major concern in the U.S.

Following a lull, the smuggling of illegal heroin into the U.S. rose dramatically. This was, in large part, attributable to our nation’s military presence in Vietnam in the 1960s.

In 1969, the World Health Organization abandoned the belief that the medical use of morphine inevitably led patients to dependence, stating that drug tolerance and physical dependence do not, constitute “drug dependence.”

The Controlled Substances Act which passed in 1970, began to consolidate all of the regulated prescription narcotic/opioid drugs under existing federal law into five separate “schedules.” These schedules were based upon the substance’s medicinal value, harmfulness and potential for abuse or addiction. Then, a Drug Enforcement Agency was created by Executive Order in 1973; by this action, President Nixon officially initiated the “War on Drugs,” which is promoted in the U.S. to this day.

The American medical landscape in the 1980s was characterized by “opiophobia” – a fear of prescribing opiates and other opioids, with President Reagan asking Americans to join a national crusade not to tolerate drugs by anyone, anytime, anyplace. President Reagan was had two problems with the country in his mind, the hippies and the African Americans. He associated the hippies with marijuana and African Americans with heroin. His no drug tolerance was more politically motivated and criminalized drug dependency inserted of treating it as a health issue.In response to the growing recognition of the need for pain management, the pendulum then swung the other way with a significant increase in opioid use for all types of pain.

Oxycontin seismic shock was felt in the 2000s when Purdue’s aggressive marketing of its controlled-release opioid Oxycontin – described as “safe” for chronic pain – intersected with the trafficking of cheap, pure heroin in smaller cities across the West, Midwest and Appalachia. Purdue advertised Oxycontin as non-addictive because the drug was designed to be released within the body over a 12-hour period; however, recreational drug users quickly learned to get “high” by crushing or dissolving these time-release pills.

In March 2016, the Centers for Disease Control and Prevention (CDC) issued a new set of guidelines for prescribing opioids for chronic pain. The following month, several health care organizations – led by Physicians for Responsible Opioid Prescribing – petitioned the Joint Commission for Accreditation of Healthcare Organizations, calling for “an end to mandatory pain assessment,” suggesting that this practice “fosters dangerous pain control practices” and leads to over-prescription of opioids.

Effects that opioids have on the Brain:

Opioids are a medication that were created to relieve pain. Some drugs like morphine, codeine and heroin are procured straight from the opium poppy plant which makes them a natural substance. In addition, there are drugs that are semi-synthetic, which are mixture of the poppy plant and molecules created in the lab.

Synthetic pills have become very popular in our rapidly expanding global society due to the extreme pain of depression which is often not by tamed by natural opioids, leading people to become addicted to prescription pills or heroin. The synthetic opioid drugs work by rushing the users system, flooding it with molecule called dopamine. Dopamine is a neurotransmitter, a chemical signal that passes information from one neuron to another. When flooding the reward circuit with drugs it gives the person an intense feeling of excitement and lowers the perception of pain. So that is why there are estimated to be one million opioid users in the U.S. and nearly 500,000 heroin users.

An opioids ability to bind to the brain’s pleasure receptors makes it very easy to managing pain. But this also makes whoever is taking them more prone to abuse because the opioids also attach to non-pleasure receptors in the brain and on the spinal cord. When they bind in these other spots, they eliminate the sensation of pain. Because of some of the same pathways, opioids also cause people to experience drowsiness, mental confusion and nausea. Since opioids impact the brain regions related to reward, some people experience euphoria. While it can take a while before heavy use leads to a physical dependence, psychological addiction can take place in under three days.

There are a number of factors contributing to why someone might be especially prone to opioid addiction. The more risk factors a person has, the more likely they are to develop an addiction. Genetics, for example, accounts for about half a person’s risk for addiction. The environment and social context in which a person is raised account for the rest of the risk. And if people don’t have access to educational tools on drug abuse and addiction, they may be more prone to making uninformed decisions about opioid alternatives and addiction-control methods.

The stage of development in which a person begins to experiment with drugs plays an important role in their likelihood of becoming addicted. Adolescents are especially vulnerable, according to James J. Galligan, a pharmacologist and neuroscientist at Michigan State University. Because a teen’s reward pathways are still maturing when they begin using opioids, their brains may develop differently. Cognitive processes associated with planning and strategy may become almost completely focused on how to get pleasure by finding more drugs, instead of on more challenging routes to happiness, like studying for a test. Adolescents between 12 and 17 living in rural communities are 35 percent more likely to abuse prescription opioids than teens living elsewhere, according to the National Survey on Drug Use and Health.

Opioids and their effect on Art:

A Google search for “drug-related celebrity deaths” returns nearly 65 million results. The perceived increase in substance abuse by famous people has paralleled trends in the general public. In the United States, the rate of drug overdose deaths from prescription drugs has tripled since the year 2000. However, regrettably, the creative community has historically relied on substance abuse to bring out a creative side.

What are the reasons for famous artists turning to drugs? Steven Tyler, the lead singer of the popular rock music band Aerosmith, described being “unaware” of his performances while on drugs. During an interview with Oprah Winfrey in 2012, he admitted that “heroin felt like a warm, comfortable cloak.” This would imply that musicians are vulnerable individuals, seeking safety and comfort. This need makes them easy victims for addictive behaviors. In addition, the pressure of performing in front of a large audience is immense. Artists abuse illicit substances to reduce stress and boost confidence. Drugs help them escape reality and immerse themselves in an artificial world where they feel unencumbered to exhibit their talent.

In his book The Compass of Pleasure, neuroscientist David Linden explains that although there is no direct link between creativity and addiction, there is a link between addiction and factors that promote creativity. Linden’s theory is that addicts have a poorly-functioning dopamine system of the brain. Dopamine is a neurotransmitter that signals pleasure and reward. He believes addicts experience weak pleasure, which leads them to seek more pleasure through artificial means such as psychoactive drugs.

It is well known that a predisposition to addiction is genetically determined. Individuals who are risk-taking, compulsive, impulsive, and novelty-seeking are more likely to experiment with drugs. Interestingly, these are the very attributes that spur creativity. Creative people have a different look on the world, this can mean they think differently about what is an excepted and appropriate way to live life . There is also a view that psychiatric illnesses among artists and writers are common and that these individuals abuse substances to mask the symptoms of conditions such as bipolar disorder.

In conclusion, A drug that was created to help pain has become something that people fear. The fear of this drug comes from the dependency that one’s body craves after taking it. The drug that was supposed to cure all pain has caused a long history of death and horrible withdrawals. Some artist have used opioids as part of the creative process but most artist use psychedelics for their creative process and not opioids. This being said artist are known to be more prone to addiction because of the way they view the world.

Work Cited:

https://addictionresource.com/substance-abuse-among-artists/
https://www.michaelshouse.com/opiate-rehab/history-of-opiates/
https://m.youtube.com/watch?reload=9&v=4MIseokXcxY
The Compass of Pleasure, David Linden, Penguin, 2014 https://nsduhweb.rti.org/respweb/homepage.cfm

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Paradigm Shift In Opioids: Heroin

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