75 Americans will die today from a prescription drug overdose. In fact, prescription drug overdose is rated as the second most frequent cause of accidental death. It’s not just a problem for adults — every hour a baby is born in the U.S. with symptoms of withdrawal from opiates — meaning 13,500 babies a year.
How did we get here?
Nowadays, almost all prescription drugs that are misused come from doctors’ prescriptions, and end up in the wrong hands through theft or sale. Insurance companies often pay for prescriptions.
But painkillers have existed long before prescriptions or insurance companies have. In 5000 B.C., Sumerian tablets named opium poppies HulGil, or “joy plant”. Egyptian Papyrus from 1550 B.C, archives instructions on using grains of poppy plant as medicine.
With pain relief came the drug’s euphoric feelings, and an onset of steady addiction. Non-addictive painkillers became the holy grail of chemists, who set about toying with molecular structures of opioids to get the perfect combination of maximum benefit with minimum risk. In time, they developed several close calls.
Codeine (1830), heroin (1874), and oxycodone (1916) were all advertised immediately after their discoveries as the perfect painkillers, noted for their ‘non-addictive’ properties, and ability to replace their antecedents in the painkiller world.
Morphine, developed in the early 1800s, remains the gold standard for treating severe pain, and is given to cancer patients to this day. The first civil war (1861 – 1865) in America largely depended on the availability of morphine, with one general quoted saying “You can’t fight wars without morphine.”
As the problem of addiction became a growing concern, the Bureau of Social Hygiene created a Committee on Drug Addiction. In 1929, the committee decided upon a research plan that involved three components — chemical, pharmacological, and clinical. After the first decade of research, 500 compounds were ready for testing in animals. Three were tested on humans for pain relief and dependence liability.
Seeking to help existing addicts and understand the root of the problem, the narcotic farm (U.S. Public Health Service Hospital) in Lexington, Ky. was opened in 1935. Prisons that had been flooded with addicts now sent drug-addicted criminals to Lexington for treatment. The Addiction Research Center (ARC) inside the farm was open until 1970 and is today known for accomplishing many of the landmark studies in the field of drug abuse.
Hundreds of prisoners were recruited to volunteer in the ARC as guinea pigs for groundbreaking drug experiments. Scientists would administer heroin, morphine, and other drugs, and take note of what effects it had on the addict. In other experiments, they abruptly stopped dispensing heroin to cause withdrawal symptoms, and then introduce dan experimental drug to see if it would effectively relieve withdrawal symptoms.
Then, Analgesic Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) was established as a “public-private partnership with the United States Food and Drug Administration (FDA) to identify, prioritize, sponsor, coordinate, and promote innovative activities — with a special interest in optimizing clinical trials — that will expedite the discovery and development of improved analgesic treatments for the benefit of the public health.”
In the 1940s, the opiate program at the National Institutes of Health (NIH) began, and has resulted in more than 750 research papers and patents. Some 59 drugs identified as painkillers were introduced from 1960 to 2009, and remain in use today. From 1960 to 2009, pain-related publications grew exponentially: The number of articles almost tripled during the first and second decades, and then doubled during each of the next three decades until 2009. Intensive research has produced thousands of publications, but none of these efforts has yielded new painkillers that can significantly change the scope of the opioid addiction problem.
Today, various laboratories are synthesizing different molecules in hope of finding the perfect cure. Though progress has been made, the answer has not yet been found. It will take a national database where researchers can share their results, more funding, and certainly more time before we may ever reach painkillers’ holy grail.
About the author: Jennifer Tchinnosian is communications specialist for the Coalition Against Insurance Fraud.