Why you should care
It’s not always easy to tell the difference between good drugs and bad drugs.
In 1896, a frail-looking 71-year-old man walked into the doctor’s office in Berlin with a severe cough. After a rudimentary examination, he left the office, prescription in hand: the note read “Heroin.”
Today, over a century later, it seems absurd to think of heroin as anything other than a social tragedy. Heroin is one of the world’s most dangerous drugs, wreaking havoc from the streets of Nairobi, where it’s a leading cause of HIV transmission, to New York back alleys, where the death toll due to the drug has more than doubled in the last three years.
But this hasn’t always been the case. Once upon a time — at the turn of the 20th century — heroin was hailed as a miracle drug and universal cure-all.
It wasn’t long until some doctors began noticing the not-so-wonderful side effects of the wonder drug.
It started in 1898, when Heinrich Dreser, working for the Bayer pharmaceutical company, spotted the commercial potential of diacetylmorphine, a white, crystalline variation of morphine first synthesized in 1874 by London chemist, Charles Romley Wright.
While Wright had not found any particular advantages to his invention, Dreser performed several tests and declared this new compound constituted a non-addictive substitute for morphine – a then widely used painkiller – as well as an efficient treatment of respiratory diseases. With tuberculosis and pneumonia the leading causes of death at the time, heroin, which is a sedative and slows down breathing, gave patients quick acting relief. He’d hit the pharmaceutical jackpot.
Bayer employees who tested it claimed the treatment made them feel “heroic” – heroisch in German – giving the drug its name. The new compound was soon being marketed by the future pharmaceutical giant as “Heroin”: a cutting-edge cough medicine and cure for morphine addiction.
Many doctors where quick to praise the benefits of the new drug. “It possesses many advantages over morphine. It’s not hypnotic, and there’s no danger of acquiring a habit,” declared the Boston Medical and Surgical Journal in 1900.
The market was soon flooded with heroin tablets, water-soluble heroin salts, heroin gels and even cough syrup brands laced with heroin. Old people were using it for pneumonia, mothers where giving it to their young children to help sleep and during World War I, British women could order a special hamper from a high-end shop in London containing heroin to send to their “boys at the front.”
Of course it wasn’t long until some doctors began noticing the not-so-wonderful side effects of the wonder drug. In 1899, German doctor E. Harnack warned that it might be a poison, and B. Turnauer soon after noted some of his patients building a tolerance to the drug.
Still, many physicians were reluctant to let go of their fix, in spite of knowing its disadvantages. “I feel that bringing charges against heroin is almost like questioning the fidelity of a good friend,” said Kentucky doctor J. D. Trawick in 1911.
It wasn’t long until addiction, along with a surge in heroin-related admissions to hospitals, rose to alarming rates. As a result, Bayer stopped producing heroin in 1913 and, in 1914, its use without prescription was banned in the U.S. In 1920, the House of Delegates of the American Medical Association adopted a resolution “that heroin should be eliminated from all medicinal preparations and prohibited in the United States.”
The heroin gel that women were sending to their sweethearts in the trenches was undermining good order and discipline among the troops.
But the problem didn’t vanish overnight and many addicts began turning to crime to bankroll their habit. In 1924, 94 percent of the criminal drug addicts arrested in New York City were heroin users. That same year a congressional law prohibited the import of crude opium for the purpose of manufacturing heroin, finally forcing the whole industry to go cold turkey.
The U.K. government also took action during the First World War, enacting serious anti-drug legislation after noticing that the heroin gel that women were sending to their sweethearts in the trenches was undermining good order and discipline among the troops.
The Dangerous Drugs Act was signed in 1920, banning the use of heroin except in medical applications, where it continues to be used to this day. This is also the case in countries like Germany, Switzerland and the Netherlands, where it continues to be prescribed — not for coughs though, but as a last-resort treatment for long-term addicts.
Thinking back to the early days of heroin use, the naivety of medical professionals seems almost funny, but their mistakes taught us something: it can be a very fine line between antidote and poison.