Historical Events that Shaped Contemporary Opioid Trends

Abstract

Abstract Opioid products originate in Papaver somniferum (e.g., the poppy plant), a naturally occurring botanical plant whose psychoactive ingredient (opium) has been used for centuries for its analgesic and reinforcing properties. In the mid-1800s that the psychoactive ingredient of opium, morphine, was isolated and identified, leading to the medicalization of opioid products. In the 1900s, opioids were viewed primarily as useful therapeutics that were often compounded with other psychoactive ingredients and sold as elixirs. Within 20 years there was strong recognition of their potential for problematic use related to high rates of opioid-related problems. While the scientific field continued to focus on the identification and synthesis of new opioid analgesics, at a Federal level a series of acts were passed that sought to restrict access to opioids. This made for a complex environment to enact treatment programs, and many of the laws passed during those periods continue to shape our modern-day treatment infrastructure. Nonmedical opioid use continued throughout the 20th century, though it changed in important ways beginning around the 1980s when a series of landmark events occurred, each of which are believed to have played a role in shaping the current state of opioid use in the United States. This chapter provides a historical review of the experience of opioids, primarily in the United States, from the 1800s to today and discusses in detail how these events established a foundation upon which our contemporary medical, treatment, and societal approaches are premised.