SPRINGER BRIEFS IN MOLECULAR SCIENCE HISTORY OF CHEMISTRY J. N. Campbell · Steven M. Rooney A Time-Release History of the Opioid Epidemic SpringerBriefs in Molecular Science History of Chemistry Series editor Seth C. Rasmussen, Department of Chemistry and Biochemistry, North Dakota State University, Fargo, ND, USA More information about this series at http://www.springer.com/series/10127 J. N. Campbell • Steven M. Rooney A Time-Release History of the Opioid Epidemic 123 J. N. Campbell Steven M. Rooney Independent Scholar Independent Scholar Spring, TX, USA Irving, TX, USA ISSN 2191-5407 ISSN 2191-5415 (electronic) SpringerBriefs in Molecular Science ISSN 2212-991X SpringerBriefs in History of Chemistry ISBN 978-3-319-91787-0 ISBN 978-3-319-91788-7 (eBook) https://doi.org/10.1007/978-3-319-91788-7 Library of Congress Control Number: 2018941231 © The Author(s) 2018 This work is subject to copyright. 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Though it may hurt, loyal criticism will have beneficial effects. —Sima Qian, Han Chinese Historian (c. 145–86 BCE) For Nik and her elegant deductions Preface History, Stephen said, is a nightmare from which I am trying to awake. —James Joyce, Ulysses, 1922 [1] Many a comic book poses the question: what if you could go back in time and find the exact point where some major catastrophe originated, could you make a dif- ference by altering it? Marvel’s Days of Future Past or DC’s Flashpoint Paradox serve as examples of what we create for ourselves when we go back in history and change something in order to suit our own needs. Would it make a difference? These scenarios present a conundrum for those perceived to be so powerful because, as the theoretical physics goes, if you change one thing, you change everything. These stories are like the search to be modern; something that seems like a great plan, but questions abound. What other ripples does it generate when we devote ourselves to all the wonderful promises and innovations that come with it? Then, we might ask: Where in the long history did opioids and their influence go wrong? In the media, we hear regularly that America is in the midst of a recent crisis because, since the 1990s, big pharmaceutical companies, distributors, and even drugstore chains are pumping out too many of these products. Doctors are also complicit as their over-prescription has driven people from all walks of life to addiction. The government remains powerless even though it has legislated on similar issues for over a century. In addendum, what of the academic departments in biochemistry, chemistry, physiology, and in the medical schools of the country, are they complicit? As this brief will argue, it is not one person, one entity’s fault, one type opioid, per se, and there is no one point in history where all this devolved. The modern fully synthetic opioid possesses a literal time-release capability as it enters the body; but, these drugs, which have always exercised power once ingested, also have had the same effect historically. That is, their evolution, slowly, carefully, and frequently subtly, has also unfolded progressively over time. To put it another way, the current crisis when examined from a broader set of historical evidence over a wide expanse of time, assists us with understanding how the USA arrived at such a crossroads. What a macro-approach in this monograph posits is that we can deliver ix x Preface perspective by returning to the beginning, which will assist in adequately tracing the origins of this paradox of pain relief. The chemical story or treatment, if you will, behind these drugs that we examine in A Time-Release History of the Opioid Epidemic is dedicated to the chemists and the staffs in the laboratories that were trying to solve an age-old issue—relieving pain. We have heard through news agencies, doctors, and other specialists that opioids are the root of all sorts of social maladies and that a culture war in America is raging: The employed becoming unemployed, slowly destroying neighborhoods, wrecking families; and yet, they have become central to mainstream healthcare delivery for those seeking pain relief. The media has done much to publicize and demonize the numbing (a term used in the nineteenth century) opioid effect. However, we have seen little in the way of scholarship from the chemical com- munity to try and explain its origins; other than highlighting parts of its history and relating stories of addiction which do little except to frighten us with tales of misery and woe. If this truly is an epidemic, then we as a collective must seek to under- stand the causes of this crisis in both the distant and the recent past. Spring, TX, USA J. N. Campbell Irving, TX, USA Steven M. Rooney Reference 1. Joyce J (1986) Ulysses, 1st edn. Vintage, New York, p 158 Acknowledgements In our last brief, How Aspirin Entered Our Medicine Cabinet, we set out to produce a highly readable piece of scholarship that drew not only from chemistry and science, but a variety of fields that engaged socioeconomic history, ethnography, psychology, material thought and culture, and architecture and the built environ- ment. What we found at the center of this modern story was a complex synthetic medicine that was born during the Industrial Revolution and accelerated in usage during the period of the Great War. Repeatedly, nations across the West turned to aspirin to solve maladies that they did not understand. They blundered through extreme body counts racked up by bullets and a Great Pandemic that produced unintended consequences. After so much destruction and conflict at the end of the Second World War, a host of chemists, doctors, pharmacists, drug companies, government entities, and advertising firms combined to wage what became known as the “aspirin wars” during the 1950s through the 1970s. Though American society evolved and matured, digressed and faltered, aspirin's chemistry remained. In its purest form, aspirin was just that, aspirin. Nevertheless, it was far from just another member of the medicine cabinet. Thus, its chemical construct stood silently waiting while trials and cause/effect attempted to liberate its secrets. The innovations in the chemistry laboratory were integral in making aspirin a wonder drug, but it took those studies and manipulations to solve the riddle of things like heart attacks and strokes. Aspirin was, once the correct dosage tested in trials by scientists and doctors alike over successive generations, a drug that could enter mainstream use, without debate over how it could be harmful. Our next brief, A Time-Release History of the Opioid Epidemic runs along a much different arc than aspirin. It seems to be the anti-aspirin, so to speak. To put it another way, if aspirin could be billed as the utopia, then opioids appear to range into the realm of something dystopian, especially when abused. This brief in long-form, spotlights what has been described by the media and the federal government as an opioid epidemic. In 2018, the USA is embroiled in a highly emotional and volatile situation that is tearing families and communities apart. As historians of science, our task is to enliven chemistry by interpreting the past. Inspired by science and xi xii Acknowledgements technology studies (STS), we acknowledge that politics and social concerns cloud current discussions about history and create anachronisms. The opiates of the nineteenth century are not the opioids of today; however, their ecological devel- opment and influence are inextricably linked to their subsequent descendants. Over the past 200-plus years, claims of the arrival of a panacea occurred in a cyclical fashion. What we can do is analyze those patterns is explore the origins of these drugs in order to figure out what role the chemistry laboratory has played in the making of such a horrendous situation. The lab holds the key moving forward. Part science and social process, our story pertains to humanity; after all, it is individuals who built the laboratory and produced the opioids that emerged from it. While on the subject of humans, we want to extend our gratitude to several significant people who have inspired, read, and commented on our work. They include: Michael Wintroub and Helen Mialet, whose scholarship concerning heterotopias and ethnographic approaches to all kinds of laboratories has been seminal to our thinking.