The Zohydro Controversy: Background (Part I)

The use of opioid medications is certainly not a new, or novel approach to pain management. Some of the properties of opium, produced from poppies and a predecessor to modern day opioids, were recognized as long before the time of Christ.  Historical records indicate knowledge/use of opium in Europe around 4200 BC. In these early times, the use of opium was primarily ritualistic or medicinal. Some of the ancient Greek and Egyptian myths mention opium, indicating that is was known to civilizations of those times.

A field of poppies  (Papaver somniferum).

Around the time of the fall of the Roman Empire, opium became known to Islamic society for its medicinal properties; its utility in pain management and anesthesia was now being recognized. Writings from this time indicate its use in the treatment of melancholy, migraine, and sciatica by the time of the Ottoman Empire (14th Century).

Between 400-1200 AD, Arab traders introduced the Chinese to opium, .  By the 15th century, the Chinese were using opium in a recreational sense although it was expensive and rare. This led to more widespread abuse, and in the early 1700s the Chinese government began efforts to prohibit importation.  Over the course of the next 200 years, opium abuse continued in China. At this point the recognition of addiction as we know it today had begun to emerge. 

During the years that followed, opium use continued to spread around the world, both for recreational and medicinal purposes.  In the USA, opium recreation use of opium was problematic. In 1882 legislation went into effect and smoking of opium was restricted to "opium dens." The Harrison Tax Act was passed in 1914 in an attempt to eliminate the use of opium for treatment of addiction.

In the meantime morphine and heroin became reality, and all the modern day opioids emerged after that. The DEA (Drug Enforcement Agency) came into being in 1973 in an effort by the US government to control substances with abuse potential. By the mid 1990s, the long acting opioids came onto the market place.  The grandaddy of these products is OxyContin, which is still widely used in modern day.

I have to ask...if anything has really changed in all these years. More regulations...yet more addicts..and more people who have legitimate pain issues but little or no access to these medications.

In preparing this post, I found some very interesting reads that I wish to share with you. If you have time and are interested, have a look at "Timeline: The story of OxyContin" and "What happened to the poster children of OxyContin?"

Sources: Wikipedia, Wikimedia, JSOnline