It’s no secret that the U.S. is caught in the grips of an opioid addiction crisis. In 2018, (1) approximately 10.3 million people aged 12 or older misused opioids. In 2017, more than 70,000 American’s died from drug overdoses, including illicit drugs and prescription opioids.
Opioids are a class of drugs that are usually prescribed by doctors to treat moderate to severe pain, but also come in illicit forms. They are often used during major surgeries, treatment for cancer-related pain, and to keep patients comfortable at their end of life. Prescription of opioids for chronic or ongoing pain has decreased in recent years as knowledge of opioid dependence has increased and better non-narcotic solutions appear.
The oldest man-made opiate, Morphine was invented in the early 1800s and derived directly from opium. America’s first opiate epidemic occurred following The Civil War. Thousands of soldiers returned home with opiate dependencies after having been treated with morphine for injuries. Addiction was little understood in the 19th century, but it soon became clear that anyone who took morphine for more than a few days would feel quite ill if they abruptly stopped.
Morphine is still used in medicine but is generally limited to hospitalized patients or specific circumstances, including severe pain that is persistent and around the clock. For most other applications, one of the dozens of modern semi-synthetic opioid compounds is used instead. Part of the reason why is that more processed and refined opioids have fewer side-effects.
During the 1850s, addiction to opioids became a major problem in the United States. Civil War veterans addicted to morphine made up the largest part of the addicted population. Diacetylmorphine was developed in 1874 and was intended to be a non-addictive alternative to morphine. Sold by Bayer under the brand name Heroin, it soon grew in popularity in Europe and the United States. Heroin is 2-3 times as powerful as morphine and ironically turned out to be even more addictive. Instead of halting the opioid addiction wave spreading across the country, heroin only made matters worse. Our understanding of addiction was minimal at best during this time and it wouldn’t be until 1924 when the law finally caught up. The manufacture and distribution of heroin and its derivatives became illegal in the U.S. and Europe in 1925.
Prohibition didn’t do anything to reduce the demand of course, so a black market soon developed. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin. Other common names for heroin include H, horse, hell dust, and smack. It is made from opium taken from the flower pod of the opium poppy. These plants are typically grown in Southeast and Southwest Asia, Afghanistan, Mexico, and Colombia.
The main differences between morphine and heroin are in potency, heroin being on average 3 times as potent as morphine. Morphine is rarely found in the black market and is almost exclusively in the medical field. Heroin is the opposite; it has no recognized medical use in the United States. Heroin is entirely a black-market commodity and manufactured without pharmaceutical controls for quality, potency or purity. In the last 10 years, an alarming trend has arisen that has an extremely powerful synthetic opioid called fentanyl being mixed with heroin. This has led to a dramatic spike in overdose deaths and only magnifies the peril of heroin use.
If you or a loved one is suffering from opioid dependency, we can help.