Narcotic analgesics.

There is documentation of the use of opium derived products in the ancient history of the Assyrians: the Egyptians; in the sixth century AD by the Roman Dioscorides; and by Avicenna (980-1037). Reference to opium like products is made by Paracelsus and by Shakespeare. Charles Louis Derosne and Fredrich Wilhelm Adam Serturner isolated morphine from raw opium in 1802 and 1806 respectively, and it was Sertürner who named the substance morphine, after Morpheus, the Greek God of dreams. By the middle 1800s, Opium and related opioid derived products were the source of a major addiction in USA, and to some extent in the United Kingdom. Opioid products are of major therapeutic value in the treatment of pain from injury, post surgery, intractable pain conditions, and some forms of terminal cancer.

Twenty years of the methadone treatment protocol in Ireland: reflections on the role of general practice.

BACKGROUND: Opioid dependence, characterised by socio economic disadvantage and significant morbidity and mortality, remains a major public health problem in Ireland. Through the methadone treatment protocol (MTP), Irish general practice has been a leader in the introduction and expansion of Irish harm reduction services, including opioid substitution treatment (OST), needle and syringe programs (NSP) and naloxone provision. These services have been effective in engaging opiate users in treatment, reducing human deficiency virus (HIV) and hepatitis C virus (HCV) transmission and reducing-drug related morbidities. Challenges remain in relation to choice of substitution treatments, timely access to OST services, adequate coverage of NSP, naloxone provision and increasing drug-related deaths. METHODS: A narrative review was conducted and designed to present a broad perspective on the Irish MTP and to describe its history and development in terms of clinical care, stakeholder views and changing trends. RESULTS: Three themes emerged from the analysis; The History of the Methadone Treatment Protocol, Service User and Provider Views and Challenges and Developments. Despite the initial concern about methadone maintenance treatment (MMT) in Ireland, increased participation by Irish GPs in the treatment of opioid dependence is observed over the last two decades. There are now over 10,000 people on methadone treatment in Ireland, with 40% treated in general practice. The MTP provides structure, remuneration and guidance to GPs and is underpinned by training, ongoing education and a system of quality assurance provided by the Irish College of General Practice (ICGP). Challenges include the negative views of patients around how methadone services are delivered, the stigma associated with methadone treatment, the lack of choice around substitution medication, waiting lists for treatment in certain areas and rates of fatal overdose. CONCLUSION: Twenty years of the MTP has been the mainstay of harm reduction services in Ireland. It has provided a network of specially trained GPs who provide methadone to over 10,000 patients across Ireland within a structured framework of training, quality assurance and remuneration. With the ongoing commitment of Irish specialists in the field of addiction medicine, further improvements to support and treat patients can be made.

The Historical Face of Narcotic Revisited: A Chinese City's Fifty-Year Quest for Hygienic Modernity, 1900-49.

For decades, people have viewed narcotics as a devil impeding the modernisation of China, but they have recently been faced with the challenge of declaring that narcotics are harmless in some instances. A deeper understanding of this issue requires historical approaches which show that the demonisation of narcotics has mainly been a political pursuit. In re-examining the drug problem and its correlation to political and socio-economic issues, data statistics based on substantial archives in modern China play a crucial role. Discovered in 2007 in Longquan, a city in southeast China, Judicial Records of Longquan remains the largest judicial record in modern China by far. Data analysis reveals government efforts regarding drug control were not in line with the peak periods of drug-related cases in Longquan. Drawing on previously unexamined documents, it can be shown that anti-drug mobilisation and hygienic conditions have been overstated to legitimise the authority of governments in modern China. However, the knowledge of local residents regarding medicine and health was indirectly promoted in this agenda. Compared with the negative image of drugs constructed under the biopower of government, the role of narcotics was a positive vehicle for accelerating health mobilization during the Republic of China.

Pharmaceuticals and modern statecraft in South Africa: the cases of opium, thalidomide and contraception.

This article provides a history of three pharmaceuticals in the making of modern South Africa. Borrowing and adapting Arthur Daemmrich's term 'pharmacopolitics', we examine how forms of pharmaceutical governance became integral to the creation and institutional practices of this state. Through case studies of three medicaments: opium (late 19th to early 20th century), thalidomide (late 1950s to early 1960s) and contraception (1970s to 2010s), we explore the intertwining of pharmaceutical regulation, provision and consumption. Our focus is on the modernist imperative towards the rationalisation of pharmaceutical oversight, as an extension of the state's bureaucratic and ideological objectives, and, importantly, as its obligation. We also explore adaptive and illicit uses of medicines, both by purveyors of pharmaceuticals, and among consumers. The historical sweep of our study allows for an analysis of continuities and changes in pharmaceutical governance. The focus on South Africa highlights how the concept of pharmacopolitics can usefully be extended to transnational-as well as local-medical histories. Through the diversity of our sources, and the breadth of their chronology, we aim to historicise modern pharmaceutical practices in South Africa, from the late colonial era to the Post-Apartheid present.

DARK Classics in Chemical Neuroscience: Opium, a Historical Perspective.

Opium is the latex from the opium poppy Papaver somniferum L., which humankind has utilized since ancient Mesopotamia all the way to modern times. Opium used to be surrounded in divine mystery or magic-like abilities and was given to cure a wide variety of diseases until its analgesic, antitussive, and antidiarrheal properties were understood, the resulting alkaloids were isolated, and their structure and properties unmasked. Opium went from being sold in any store front in the form of pills or tinctures with no prescription necessary for purchase or smoked in an opium den down the street, to then bringing about consumer advocacy and the right to know what is in a medication. Legislation was created to limit the prescribing and selling of medications to doctors and pharmacists as well as outlawing opium dens and smoking opium. This review focuses primarily on the uses of opium throughout history, the isolation of the principle alkaloids, and their structure elucidation.

On analgesic and narcotic plants: Pliny and his Greek sources, the history of a complex graft.

Grafting is an important concept in the study of Pliny the Elder, who is a compiler of written sources. We intend to examine how this grafting works in Pliny's discussion of analgesic and narcotic plants, especially the most famous: opium poppy, henbane, mandrake, and hound's berry. We will study Pliny's use of Greek sources and ask how he took up his predecessors' works while integrating the changes that took place during the centuries in the diagnosis and treatment of pain. This cultural graft remains elusive because we do not have access to all of Pliny's Greek sources. When Pliny speaks about these plants, he sometimes copies out information, adding or removing details, and occasionally makes significant mistakes. The graft was particularly difficult in this case because these analgesic plants were considered so special and poisonous that they were sometimes rejected or even condemned. Nevertheless, we can say that this cultural graft succeeded, despite some obstacles, because Pliny assimilated and adapted these old Greek materials to his own time, society, and project.

"Poppies are democracy!" A critical geopolitics of opium eradication and reintroduction in Turkey.

Historical scholarship in traditional geopolitics often relied on documents authored by states and by other influential actors. Although much work in the subfield of critical geopolitics thus far has addressed imbalances constructed in official, academic, and popular media due to a privileging of such narratives, priority might also be given to unearthing and bringing to light alternative geopolitical perspectives from otherwise marginalized populations. Utilizing the early-1970s case of the United States' first "war on drugs," this article examines the geopolitics of opium-poppy eradication and its consequences within Turkey. Employing not only archival and secondary sources but also oral histories from now-retired poppy farmers, this study examines the diffusion of U.S. antinarcotics policies into the Anatolian countryside and the enduring impressions that the United States and Turkish government created. In doing so, this research gives voice to those farmers targeted by eradication policies and speaks more broadly to matters of narcotics control, sentiments of anti-Americanism, and notions of democracy in Turkey and the region, past and present.

[Nepenthe].

Iliad and Odyssey are two major literary sources on various phenomena related to human experience and knowledge. In the Odyssey we find references to the nepenthes, a mythical substance which can change the mood, causing sorrow and anger to be forgotten. We can not identify it with any of the well known substances that have these properties, such as opium from the opium poppy, the Egyptian kyfi or cannabis in the Scythians. Ancient Greeks used various anxiolytic, hypnotic and narcotic substances, but phenomena of addiction or withdrawal are not clearly described, with the exception of wine. Wine was used to lighten peoples minds and hearts, as well as a vehicle for drugs. Many ancient sources describe the negative effects of wine abuse. The study of ancient texts, from Homer's epics to Christian literature, allows a fundamental insight into the influence of psychotropic substances and alcohol on the human psyche.

[A short history of anti-rheumatic therapy--V. analgesics]. / Piccola storia della terapia antireumatica--V. Gli analgesici.

The pharmacological treatment of pain has very ancient origins, when plant-derived products were used, including mandrake extracts and opium, a dried latex obtained from Papaver somniferum. In the XVI and XVII centuries opium came into the preparation of two compounds widely used for pain relief: laudanum and Dover's powder. The analgesic properties of extracts of willow bark were then recognized and later, in the second half of the XIX century, experimental studies on chemically synthesized analgesics were planned, thus promoting the marketing of some derivatives of para-amino-phenol and pyrazole, the predecessors of paracetamol and metamizol. In the XX century, nonsteroidal anti-inflammatory drugs were synthesized, such as phenylbutazone, which was initially considered primarily a pain medication. The introduction on the market of centrally acting analgesics, such as tramadol, sometimes used in the treatment of rheumatic pain, is quite recent.

[Origins of legislation on narcotics in France]. / Les origines de la législation sur les stupéfiants en France.

History of pharmacology intermingled with the history of poisons. The main alkaloids were discovered between 1817 and 1860. In 1845 purchase and sell of poisons were regulated and in 1884 cocaine appeared on the market and heroin in 1898. World War I contributed to the use of heroin and was at the start of toxicomania; the law 1916 made out 3 lists of venomous matters (A.B.C.) and the list B. was that of stupefacient drugs. The strict law will create misunderstanding between ill-patients and drug addicts, physicians and dealers, druggists and drug traffickers.

A 50-year-old woman addicted to heroin: review of treatment of heroin addiction.

Heroin addiction is a complicated medical and psychiatric issue, with well-established as well as newer modes of treatment. The case of Ms W, a 50-year-old woman with a long history of opiate addiction who has been treated successfully with methadone for 9 years and who now would like to consider newer alternatives, illustrates the complex issues of heroin addiction. The treatment of heroin addiction as a chronic disease is reviewed, including social, medical, and cultural issues and pharmacologic treatment with methadone and the more experimental medication options of buprenorphine and naltrexone.

[Henri Moissan and opium]. / Henri Moissan et l'opium.

As professor of toxicology at the Ecole supérieure de pharmacie de Paris, Moissan analyzed the smoke of opium. He characterized morphine at 250 degrees C. This alkaloid was accompanied by pyrrole, acetone and pyridine derivatives at higher temperature. He concluded that the smoke of chandôo only brought small amounts of morphine in the smokers' lungs, whereas dross, obtained by scraping partly combusted residues of opium from the pipe bowls, generated toxic compounds since it had to be smoked at 300 degrees C.

Women, harm reduction and history: gender perspectives on the emergence of the 'British System' of drug control.

Taking Kohn's classic book Dope Girls as its starting point, this paper explores the particular place of women and gender issues in the emergence of the 'British System' of drug control in the early twentieth century. The 'British System' refers to the approach put in place in the 1920s in Britain, notably by the 1926 Rolleston Report. In essence, it involved the medically based prescription of opiates to addicts, often on a long-term basis. It is viewed by many as one of the beginnings of the general principle of harm reduction within drug policy. This paper will examine how female figures - chorus girls, actresses, night club girls, prostitutes - were central to British drugs discourse in the 1920s, with the representation of some individual women in particular, most famously the actress Billie Carleton, featuring very prominently. It will be argued that this gendering of drugs discourse can be best understood in the wider context of social change, namely the transition from liberalism to welfarism at the turn of the twentieth century. It is suggested that this historical analysis provides a radical new perspective on some fundamental issues for contemporary approaches to harm reduction for women, a perspective that has far-reaching implications and challenges some 'taken-for-granted' assumptions.