The Heroin Miracle (Part One of Three)

It seemed like such a good idea.

By the late 19th century, the pharmaceutical industry as we know it today was being born.   Instead of crude preparations taken directly from plants, chemists were learning to use applied chemical analysis to purify and refine the chemical ingredients found in nature.  This meant that these plant-derived drugs could be modified to form new molecules that might produce drugs that were faster and more effective than anything that had been used before.

This new era had actually began in 1805 when German pharmacist, Friedrich Serturner first synthesized morphine, the main active ingredient of opium.  By developing better ways of mass-producing morphine, a German pharmacy owned by the Merck family became one of the first pharmaceutical giants which, in turn, inspired other companies to do the same.

One of these new pharmaceutical companies was founded in 1863 by German industrialist Friedrich Bayer.   Though Bayer had made his fortune by developing and manufacturing new cloth dyes made from coal-tar, the changing economy meant that Bayer’s company needed to diversify its product line.  Investing in pharmaceutical research made good business sense and Bayer’s chemists soon went to work finding new drugs for various medical ailments.   In many ways, Bayer and its dynamic new CEO Carl Duisberg would reinvent the pharmaceutical industry and lead to the creation of what we now call Big Pharma.

Among the many new products discovered by the hundreds of chemists working in Bayer’s newly expanded laboratories included various drugs for anxiety, sleep, anti-arthritis medication, drugs for treating tuberculosis, and even a sugar substitute (Sycose).   But Duisberg and his chemists knew that the big profits lay in new pain remedies.  Everyone experienced pain, whether in childbirth, during surgery, after injuries, or simply through the diseases of old age.  Relieving pain had always been one of the big drivers for medical innovation.

While Merck and other companies owned the patents for morphine and the other big opium derivative, codeine, growing concerns about addiction associated with laudanum, codeine, and morphine inspired Bayer to launch the search for a non-addictive pain reliever.   A pain remedy that could be freely sold or prescribed by doctors without worrying about drug dependency became the Holy Grail of pharmaceutical research and Bayer was hardly the only company searching for it.   Eager for new products to sell, Bayer hired talented chemist, Heinrich Dreser (1860-1924) to head up their pharmaceutical laboratory.    

After years of research and false starts, 1897 proved to be a banner year for the Bayer company.  In that year, Heinrich Dreser and his chemists produced two pain relievers that would transform the world (although in different ways).  Ironically, both products had actually been invented years earlier by othr chemists though they had been largely ignored until Dreser’s laboratory rediscovered them.  The first of these pain relievers was derived from the salicylic acid found in willow bark and had actually been discovered by a French chemist years before.  When one of Bayer’s chemists, Felix Hoffman, learned of this earlier discovery, he then developed a purer refinement method that allowed Bayer to convert it into what would eventually become their most profitable product, aspirin.  As for the second product, diacetylmorphine, it had been discovered in the 1870s by English chemist, C.R.A. Wright though it had remained in obscurity for years until Bayer repackaged it with a new name, heroin.

 This new, improved pain reliever, which he promptly tested on himself and his fellow workers, was so effective that he regarded it as being a “heroic” drug (hence the name, heroin).  He even arranged for heroin to be prescribed to workers at Bayer’s main plant for just about any complaint you could name.  Anyone with a persistent cough, whether it was  janitor, secretary, engineer, or industrial chemist, became part of the first wave of heroin users.

And it worked, at least for a while.  In first presenting his discovery to the Congress of German Naturalists and Physicians in 1898, Dreser declared it to be a cough, chest, and lung remedy for treating painful respiratory diseases.   In a pre-antibiotic era, pneumonia and tuberculosis were deadly diseases and the only real treatment doctors could provide involved prescribing narcotics to help patients sleep.

Considering that heroin is more fast-acting and potent than even morphine (because it passes through the blood-brain barrier so readily), heroin was widely hailed as a valuable tool for medical doctors.  Dreser also proudly announced that the lethal dose for heroin was far higher than for morphine or codeine which made overdoses far more unlikely  You can likely guess how much clinical testing the new drug received from the fact that Bayer released it for commercial use in that same year. 

To spread the word about their new product, Bayer  advertised their new drug in English, Italian, French, German, Russian, and as many other languages as they could arrange.   In an ingenious marketing ploy, Bayer released what would be informally known as the “Bayer Bible” which was printed by Bayer and sent to every medical doctor in Germany.  The book contained descriptions of all medications then in use (with Bayer’s own products being prominently displayed.    Released along with the introduction of aspirin and heroin, the book also included circulars for doctors to request free samples.   It would be so effective that many other pharmaceutical companies later did the same.

Along with the marking came new medical research (mostly conducted directly or sponsored by Bayer) showing that heroin could be used instead of codeine and morphine with none of the unpleasant reactions associated with those other drugs.  In the United States alone, there were more than a dozen studies published between 1900 and 1901 reporting favourably on this new wonder drug.  

Though one doctor noted ominously that heroin dosages needed to be increased over time to make sure that it remained effective, the prospect of a non-addictive alternative to morphine (emphasis mine), was viewed with considerable enthusiasm by the drug-buying public.  Bayer even offered a children’s version of heroin to be used with a doctor’s prescription.  Pharmacies would provide heroin over the counter to anyone asking for it while doctors prescribed it freely to their patients, usually without any kind of follow-up to see if addiction problems developed.

Newspaper stories describing this new wonder cure were certainly enthusiastic enough.   One story I found in a Phoenix, Arizona paper dated February 14, 1900 appeared to have been largely based on a press release provided by Bayer.   It described heroin as “a substance that seems to possess all the soothing principles of morphine while, at the same time, as a medicine, it is unaccompanied by the evil consequences that makes that drug a curse.”  The article goes on to describe the various beneficial qualities of heroin including its ability to “deaden sensibility without causing mental exaltation.   In this latter respect it differs entirely from morphine which acts first as a stimulant and then may put the patient to sleep.   Heroin has no after effects.  It leaves no trace behind.”   Not only did patients tested with heroin overcome their violent coughing fits, but they were put to sleep with only small doses of heroin and, the article concludes, “the sleep seemed to do them good.”    

With this kind of publicity, it hardly seems surprising that doctors and their patients would be eager to give heroin a try.  By 1906, heroin was included in the American Medical Association's Council on Pharmacy and Chemistry annual “New and Non-official Remedies” list which described it as safe to use in  small doses.  In that same year, the “Materia Medica” released by Squibb declared heroin to be a “as a "remedy of much value. It is also used as a mild anodyne and as a substitute for morphine combating the morphine habit." 

In the meantime, Bayer was busy advertising their two new wonder products, aspirin and heroin.  In much the same way that you can buy aspirin in any pharmacy or corner store today, that was how easy it was to buy heroin to treat any ache or pain imaginable.  After all, Bayer had already established itself as a trustworthy company producing safe and effective medicine, how could anything sold under the Bayer label be unhealthy? 

To be continued

           

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