Friday, October 10, 2014

What's Old is New Again: The Real Opioid Wars

Addiction is not a new phenomenon.  Opioid analgesics aren't new either.  And as we fight our current war against the man-made epidemic of opioid misuse and abuse, let's not forget that actual wars have been fought over opium.  The Chinese and the British, in fact, fought two wars in the 19th century that hinged, at least in part, on the alarming growth in the number of opium addicts in China.  In fact, the first Opium War started when the Chinese government seized 20,000 chests of opium (or about 2.7 million pounds) belonging to the British East India Company.  The opium had been grown in India and transported to China by British traders who were making lots of money selling it to Chinese merchants.  (As an aside, the treaty that ended this war resulted in the cessation of Hong Kong to the British in 1841... the beginning of the political drama still playing out in Hong Kong to this very day).

Opium isn't new to the US either (see photo below).  In the early 20th century, opium addiction had become a sufficiently important public health issue that the Harrison Act of 1914 required doctors and pharmacists that prescribed and dispensed opium to register with the government and pay taxes on the sale of opium.  Nine years later in 1923, the US Treasury Department's Narcotics Division banned the sale of opium and other narcotics altogether (creating a vibrant black market for drugs that still thrives today).

Our public health and regulatory response to today's crisis is more nuanced and more measured than in the early 20th century, as it should be.  Opioid analgesics absolutely have a role to play in contemporary treatment of pain.  The challenge today remains how to balance the real needs of people in pain with the public health crisis that is the opioid epidemic.  But we've been here before and we'll figure it out.

Don't think history repeats itself?  Here's a "selfie"... 1920s style.

Have a great weekend.

On Twitter @PRIUM1

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