A Time-Release History of the Opioid Epidemic (SpringerBriefs in Molecular Science)

This Brief takes the reader on a chemical journey by following the history for over two centuries of how an opiate became an opioid, thus spawning an empire and a series of crises. These imperfect resemblances of alkaloids are both natural and synthetic substances that, particularly in America, are continually part of a growing concern about overuse. This seemed an inviting prospect for those in pain, but as the ubiquitous media coverage continues to lay bare, the levels of abuse point to the fact that perhaps an epidemic is upon us, if not a culture war. Seeking answers to how and why this addiction crisis transpired over two hundred years of long development, this Brief examines the role that the chemistry laboratory played in turning patients into consumers. By utilizing a host of diverse sources, this Brief seeks to trace the design and the production of opioids and their antecedents over the past two centuries. From the isolation and development of the first alkaloids with morphine that relieved pain within the home and on the battlefield, to the widespread use of nostrums and the addiction crisis that ensued, to the dissemination of drugs by what became known as Big Pharma after the World Wars; and finally, to competition from home-made pharmaceuticals, the progenitor was always, in some form, a type of chemistry lab. At times, the laboratory pressed science to think deeply about society's maladies, such as curing disease and alleviating pain, in order to look for new opportunities in the name of progress. Despite the best intentions opioids have created a paradox of pain as they were manipulated by creating relief with synthetic precision and influencing a dystopian vision. Thus, influence came in many forms, from governments, from the medical community, and from the entrepreneurial aspirations of the general populace. For better, but mostly for worse, all played a role in changing forever the trajectory of what started with the isolation of a compound in Germany. Combining chemistry and history in a rousing new long-form narrative that even broadens the definition of a laboratory, the origins and future of this complicated topic are carefully examined. This Brief takes the reader on a chemical journey by following the history for over two centuries of how an opiate became an opioid, thus spawning an empire and a series of crises. These imperfect resemblances of alkaloids are both natural and synthetic substances that, particularly in America, are continually part of a growing concern about overuse. This seemed an inviting prospect for those in pain, but as the ubiquitous media coverage continues to lay bare, the levels of abuse point to the fact that perhaps an epidemic is upon us, if not a culture war. Seeking answers to how and why this addiction crisis transpired over two hundred years of long development, this Brief examines the role that the chemistry laboratory played in turning patients into consumers. By utilizing a host of diverse sources, this Brief seeks to trace the design and the production of opioids and their antecedents over the past two centuries. From the isolation and development of the first alkaloids with morphine that relieved pain within the home and on the battlefield, to the widespread use of nostrums and the addiction crisis that ensued, to the dissemination of drugs by what became known as Big Pharma after the World Wars; and finally, to competition from home-made pharmaceuticals, the progenitor was always, in some form, a type of chemistry lab. At times, the laboratory pressed science to think deeply about society's maladies, such as curing disease and alleviating pain, in order to look for new opportunities in the name of progress. Despite the best intentions opioids have created a paradox of pain as they were manipulated by creating relief with synthetic precision and influencing a dystopian vision. Thus, influence came in many forms, from governments, from the medical community, and from the entrepreneurial aspirations of the general populace. For better, but mostly for worse, all played a role in changing forever the trajectory of what started with the isolation of a compound in Ger many. Combining chemistry and history in a rousing new long-form narrative that even broadens the definition of a laboratory, the origins and future of this complicated topic are carefully examined Preface 8 Reference 9 Acknowledgements 10 Contents 12 About the Authors 14 Abstract 15 1 Introduction: Chemical Heterotopias 17 1.1 An Imperfect Resemblance 17 1.2 Defining a Heterotopia: The Laboratory Application 19 1.3 Scope of Current Volume 20 References 24 2 Part One: Alkaloid Heterotopias 25 2.1 The Roots of the Modern Opioid Empire 25 2.1.1 Lavoisier’s Vision Obscura 25 2.1.2 Sertürner’s Best Friend 27 2.1.3 Gay-Lussac’s Stock Tip for the Ages 34 2.1.4 The First -Oid’s Makeup 37 2.1.5 The Valley of Chemicals 38 2.2 Cooks as Chemists: America’s Test Kitchen and the First Opioid Addiction Crisis 42 2.2.1 Just What the Doctor Didn’t Order 42 2.2.2 Nostrum Republic 43 2.2.3 Kiss the Cook 45 2.2.4 Eat Me, Drink Me 48 2.2.5 Doctors Without Borders 50 2.3 What the Networked Industrial Laboratories Produced: A Heroic Decision? 53 2.3.1 American Backwater 53 2.3.2 Liebig’s Dream 55 2.3.3 Lab Ethnography 56 2.3.4 Chemical Nexus: A Framework 60 2.3.5 The Learners Become the Masters 62 2.3.6 Bayer Goes Public 64 2.3.7 A Chemical Rising Star 65 2.3.8 Dreser’s Dystopian Dream 67 2.3.9 Follow the White Rabbit 69 2.3.10 Gateway to a Synthetic Age 71 References 72 3 Part Two: Synthetic Opiate Heterotopias 75 3.1 The Age of Synthetics 75 3.1.1 A New Laboratory of Progress 75 3.1.2 The Social Drug Network 77 3.1.3 How They Made Heroin Sound Healthy 84 3.1.4 The Costs of Slaying the Dragon: An Orwellian Tour of Therapeutic Reform 90 3.2 Roots of Modern American Big Pharma Takes Hold 98 3.2.1 The State of the Chemical Teutonic Nexus, c. 1914 98 3.2.2 An Alkaloid Empire, For Sale: The 25 Minutes that Saved Merck 104 3.2.3 War as Catalyst 108 3.3 Designing Numbness: Not Your Father’s Opiates 116 3.3.1 Lab Coats of Grey Flannel: Dawn of the Opioid 116 3.3.2 Risk-Averse Chemistry: Nazi Drugs and Massengill Deaths 118 3.3.3 The Education of the Company Man (and Woman) 121 3.3.4 The Man Who Knew Better: The Case of Dr. Small 123 3.3.5 The Last Great Advocate of Reason Falls 130 References 134 4 Epilogue: Opioid Heterotopias 137 4.1 Sackler’s Ghost: The Tale of OxyContin’s Failed Chemistry 137 4.2 Time-Release: The Story Continues 143 References 145 Index 147 Front Matter ....Pages i-xviii Introduction: Chemical Heterotopias (J. N. Campbell, Steven M. Rooney)....Pages 1-8 Part One: Alkaloid Heterotopias (J. N. Campbell, Steven M. Rooney)....Pages 9-58 Part Two: Synthetic Opiate Heterotopias (J. N. Campbell, Steven M. Rooney)....Pages 59-120 Epilogue: Opioid Heterotopias (J. N. Campbell, Steven M. Rooney)....Pages 121-130 Back Matter ....Pages 131-134