Sunday, October 14, 2012

Perception of Opium Throughout the Ages

     It is generally accepted that the narcotic analgesics do not in fact interfere with the pain as such; rather, these compounds change the perception of the pain. In other words, the patient may come to regard pain with detachment. This very mechanism may be responsible for one of the major drawbacks of the narcotic analgesics as a class; since not all pain is physical, there are always a sizable number of individuals who like nothing better than to gain a sense of detachment from their psychic pain. The euphoriant properties exhibited by some of the narcotics, of course, aggravate this problem…There has therefore been a major effort of some duration to develop analgesics without this addiction potential…If it were not for the importance of these drugs in the clinic, some progress might have been made in eradication of the plant.
Lednicer and Mitscher, The Organic Chemistry of Drug Synthesis pp286-287

     A new thought came to Zeus-born Helen; into the bowl that their wine was drawn from she threw a drug that dispelled all grief and anger and banished remembrance of every trouble.  Once it was mingled in the wine-bowl, any man who drank it down would never on that same day let a tear fall down his cheeks, no, not if his father and mother died, or if his brother or his own son were slain with the sword before his eyes.
Homer, Odyssey

     Among the remedies which it has pleased almighty God to give man to relieve his sufferings, none is so universal and so efficacious as opium.
Thomas Sydenham, 1680

            The three authors quoted above are all describing the same phenomenon, the body’s response of opiates upon “psychic” or emotional (non-physical) pain.  The time periods span from ancient Greece, through Sydenham in the beginning of the scientific revolution to a quote from a modern textbook on organic chemistry of drug synthesis.  In the ancient world wherever opium was known, which was a large area including much on Europe, the Middle East, Africa and Asia, there exists praise for its medical and mood-elevating properties.  This is in direct contrast to modern attitudes, which grudging accepts opiates for treating physical pain but is vehemently opposed to using opiates to lessen the impact of emotional pain or to elevate mood (“euphoria”).  The “major drawbacks of the narcotic analgesics,” mistakenly referred to as side effects, are the very same effects for which opium was celebrated and praised in centuries past.  As Szasz has pointed out, the pharmacology of opium has no changed over time, but people’s attitudes toward it have.
The opiates have alternatively been hailed as panaceas (cure-alls), as in 19th century medicine, or panapathogens (causes of all evil), as in 20th century medicine.  Morphine, whether in opium preparations or in the form of semi-synthetics or fully synthetic equivalents, are unparalleled in their analgesic (pain-relieving) properties and thus have always been appropriated by the medical profession.  In some cultures opium is also the dominant recreational drug, although the Western war against the opium has seen this aspect supplanted by alcohol and illicit heroin, oftentimes with disastrous consequences for this “civilizing” influence.
People who use opiates in certain ways are systematically discriminated against, stigmatized as addicts and “dope fiends,” have their motivations pathologized as “drug abuse” and made into criminals.  Many people use opiates for ludible (recreational) purposes, but only a minority go on to develop a pattern of opiate use that has been called habitual, compulsive or addictive.
Those most likely to be drawn to opiate drugs are also likely to be in great pain, either physically or emotionally.  Some doctors like Gabor Mate believe much of this emotional pain derives from early traumatic childhood experiences, people who are some of societies most vulnerable citizens.  Under the assault on their liberty from the combined forces of the criminal justice system, which defines their drug use as a criminal vice, and the modern medical establishment which defines their drug use as a mental illness, most habitual opiate users are unable to even articulate reasoned defenses for their right to use the drug use much less resist their tormentors.
            The modern campaign against the opiates includes finding the pharmacological holy grail of the non-addictive painkiller.  This is a fool’s quest; as long as there exists drugs that can relieve pain people will want to use them, some habitually.  If some opioids show less “abuse” potential it is because they do not work as well.  The more efficacious a drug acts in relieving pain and anxiety, and thereby elevating mood, the more people will seek it out.  Furthermore efforts to reformulate the drugs in “abuse-deterrent” formulations often have the unfortunate consequence of making the experience of circumventing the “abuse-deterrent” (such as the process of injecting pills) much more dangerous than it needs to be. 
            Eradication of the opium poppy would be a great tragedy and crime against nature (some would say God).  Modern civilization, in contrast to primitive man, “knows” that opium is an evil.  Like the devil in Christian religion, opium’s power to confound, bewitch and seduce people is unparalleled.  Since the average person is completely unable to resist unbridled access to opium, control must be given to those who know better.  Like Odysseus filling his sailors’ ears with wax to resist the siren’s call, so modern man must restrict unfettered access to such a corrupting influence lest the vessel of civilization end up crashed on rocks.  In the same way that religious clergy determine proscriptions against unholy activities (ie banned foods such as pork, working on the sabbath) and prescriptions for holy activities (ie communion, attending church), so does the medical establishment determine proscriptions against certain types of self-medication (drug “abuse”) and prescriptions for therapeutic uses of drug use.  In both cases the activities of the individual is determined by authorities, whether theological or medical, to be either holy (therapeutic) or unholy (drug abuse).  The sanctions for violating religious or medical dogma can be severe, including loss of property, livelihood or even life.  Only by controlling access to opium through pharmaceutical companies, governmental organizations and the medical establishment can “civilized” man control such evil.
            The choice of drug a particular culture chooses is a reflection of the values and traditions of that culture.  The Western war against coca and opium shows shocking intolerance for indigenous cultures’ religion and way of life.  The view espoused under the guise of drug treaties (of which the culture is of course neither a signatory nor has any meaningful representation on the world stage) is that if everyone would just give up their culture’s own drug use rituals and instead adopt the “civilized” American ritual of narcotizing oneself with alcohol, and stimulating oneself with caffeine and tobacco and give up the shameful, backward habits of using coca, opium, peyote or other psychoactive drug use the world would be a better place.  Implicit in this view is that along with renouncing the drugs they may also adopt the Christian religion and open their lives and land to the American Capitalism.

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