Medicinal Use of Opium in the 19th Century by

Who is the Docet?

krall45 — 2024-02-07 18:19:30 UTC

Thomas De Quincey was an English essayist and critic who is well-known for his memoir, Confessions of an English Opium-Eater. While he was not a neuroscientist, he would be the best individual to show you around this exhibit because of his direct experience with opium. In 1804, De Quincey took his first opium to relieve the pain of his facial neuralgia¹. Years later, he became "a regular and confirmed opium-eater," or as we know today, an addict¹. In 1821, he published his memoir which was meant as a warning to the public on the dangers of the escalating prescription of opioids. As we will learn throughout this exhibit, the 19th century was a critical time period of accessibility and prescribing of opium without much implication of its addictive properties or reduce in cognitive functions over time.

Sources:

The Isolation of Morphine (1803)

krall45 — 2024-02-08 00:17:50 UTC

While the opium plant was used for medicinal purposes for centuries prior to the 19th century, Friedrich Serturner was the first chemists to derive the compound known as morphine from opium in its purest form¹. By testing on himself, Serturner was able to suggest an appropriate dosage that would be beneficial to patients that did not result in extreme delirium or overdose¹. Morphine was administered orally at the time and used for pain relief and cough suppression. Additionally, it was used as a safer substitution than pure opium because of its less additive properties².

Sources:

Opioid Use During the Civil War (1861-1865)

krall45 — 2024-02-08 00:44:36 UTC

During the American Civil War, doctors began prescribing morphine, administered subcutaneously, to soldiers for pain relief to their injuries¹. While opium was known to be an addictive substance, there was little to none alternatives available. Nearly 10 million opium pills were distributed soldiers, which in turn resulted in a large number of individuals who became addicted within this short period of time^1,2.

Additionally, the invention of the hypodermic syringe allowed this drug to be administered subcutaneously, which allowed it to enter the bloodstream and for the relief to take into effect almost immediately².

Sources:

Opium to cure "Diseases of a Nervous Character" or Neurasthenia

krall45 — 2024-02-08 01:10:29 UTC

As the act of prescribing opium and morphine greatly increased throughout the 1800s, one subgroup of individuals were the common recipients of this treatment. Male physicians at the time would diagnosed female patients with "diseases of a nervous character," (known today as neurasthenia) which encapsulates mental and physical symptoms caused by anxiety or depression¹. As a result, middle to upper-class women became the leading percentage of opium addicts². Doctors reported seeing female patients who were failing into "haunted, sleepless depression," to improving back to their old selves after being prescribed morphine¹. In addition to this diagnosis, women were also prescribed opium to cure menstrual cramp pain or uterine and ovarian complications¹.

However, the severe addictive properties of opium quickly proved to become more harmful than beneficial over time. Female patients began to become completely reliant on morphine to improve the symptoms of neurasthenia, exhaustion, hysteria, or their diagnoses at the time¹.

Sources:

Speculation on Opium as a Treatment for Psychiatric Disorders

krall45 — 2024-02-08 01:38:21 UTC

As opium began to be administered for various diagnoses or symptoms, mostly for pain relief, physicians and philosophers in the mid-1800s argued over whether it was a beneficial treatment for psychiatric disorders. This is because there was both sedative and "exciting" qualities produced by opium dependent on the dosage, which lead to contradictory approaches to treating various psychic disorders¹. High doses of opium could be prescribed and administered to patients with mania, while low doses could be given to those with depression or anxiety; however, physicians began to divide into "psychists" and "somaticists" which affected how they used opium as a treatment therapy¹. Somaticists believed that opium should not be used as a treatment for depression or mania, while psychists believed that these illnesses warranted opium therapy¹.

Sources:

https://journals.lww.com/intclinpsychopharm/abstract/1988/07000/current_and_historical_concepts_of_opiate.7.aspx

Addiction is Acknowledge as a "Brain Disease"

krall45 — 2024-02-08 01:49:43 UTC

Beginning in the 19th century, scientists and medicinal professionals began to look at addiction as a "brain disease" or as a neurological disorder¹. Dr. Leslie E. Keeley was the most well-known American physician who focused on alcohol, tobacco, and drug addiction and finding a cure known as the "Gold Cure"¹. In 1894, Keeley had described opium treatments as a method of diminishing the "natural forces of the nervous system" and wrote about how prolonged usage would cause "isomeric change" in the structure of the nervous system¹. This was a fundamental acknowledgement and observation prior to the 20th century that slowed the prescribing and distribution of opioids for medicinal purposes. This observation was also confirmed later in 1997 when Alan Lechner, the director of the United State's National Institute on Drug Abuse, explained that drug addiction caused structural and functional modifications in the brain¹.

Sources:

https://onlinelibrary.wiley.com/doi/10.1111/add.14222

Opioid Dependency Found to Permanently Alter Brains of Rats

krall45 — 2024-02-08 02:00:33 UTC

Recent research by scientists at the University of California Sand Diego have shown that repetitive and prolonged use of oxycodone, a derivative of opium used for pain relief, leads to the permanent "neuro-adaptations" of the central nucleus of the amygdala (CeA)¹. The nociceptin system of the CeA, which is responsible for processing pain stimuli, was shown to be suppressed and downregulated which in turn increased the activation of GABA receptors¹. Increased activation of the GABA receptors is what lead the rats to continue opioid dependency and addiction, because it was shown that restoring GABAergic transmission significantly reduces the rats opioid consumption¹.

This discovery will allow scientists to target their research towards the nociception system to reduce the drug-seeking and opioid dependency in patients with addictions.

Sources:

1. https://today.ucsd.edu/story/opioid-dependence-found-to-permanently-change-brains-of-rats