Although Heroin is a highly addictive opiate narcotic, it is an extremely effective pain killer and anxiolytic. In fact, in the United Kingdom, it is used the same way in which we physicians in the United States use Morphine.
That's right. In the UK, Heroin is manufactured and prescribed as the drug, Dimorphine. We U.S. physicians feel this is unnecessary, and potentially risky, as Dimorphine is quickly metabolized by the liver into Morphine, the so called, “ultimate warm blanket" of the opiate world.
It seems, however, that the side effects to Heroin make it an "electric warm blanket" when talking about it with IV Heroin users. Having interviewed many former intravenous Heroin users, they consistently tell me that they feel the euphoria from Heroin is much more intense than Morphine. Interestingly, because of this more intense effect, many have started thinking outside the box regarding this medication's ability to treat the hospice patient.
Certainly, Europe is leaning in this direction concerning palliative therapy in terminal patients with malignant pain. Germany, Switzerland, Denmark and the Netherlands have legalized its use in this regard, and currently Norway and other European Union nations are considering a move in this direction.
It seems that of the first world nations, the Union of Europe always leads with the Caduceus first. In a humanitarian effort to make a more dignified and comfortable place for the dying patient, one should not be surprised that Europe made the first move, moreover, Germany, the worlds engineering guru, would be first. It is very interesting that Germany advances this particular type of therapy. As you may have guessed, Heroin is a German Invention.
Historically, Heroin had an interesting birth. After Dr. Bayer of Bayer Laboratories (a German company to this day) isolated acetylsalicylic acid from willow bark, he was able to move forward with other work. Aspirin, the very first in an important class of medications now known as Non Steroidal Anti-Inflammatory Drugs, is what he isolated from willow bark. After this great discovery, his now wealthy laboratory went to work isolating isomers of the central nervous system’s mu receptor agonists we call opiate compounds.
What Bayer Labs isolated was diacetylmorphine. You guessed it, Heroin. The company went to work immediately, packaged the drug in liquid form, and began selling it over the counter in the United States as a non-addictive cough medicine patented with the brand name, Heroin, meaning “hero within”. That's right. Heroin is a registered trademark of Bayer Laboratories. Go figure.
This marketing campaign went on from 1895 to 1910. Then, reports from the U.S. began to mount from a concerned American public, and undermine Bayer's marketing efforts, warning of the morphine metabolite and addiction.
You must remember that at that time most Americans were already aware of the severe problem with morphine and its evil hold, as we were taking care of hundreds of thousands of Civil War Veterans wounded in combat who had become addicted to it.
Bayer capitulated with embarrassment and removed the product from the marketplace.
Of interest, is that the U.S. Congress would install the Harrison Narcotics and Tax Act, making Heroin illegal, 4 years later. By 1924, it was a felony to even possess the drug, and has been ever since.
Chances are, Americans in general, will never accept this drug for any therapy, no matter what argument is laid on the table. Americans, the first industrialized people to have dealt with this dragon on a gigantic scale, at war with cartels who push it through our southern borders, and dealing with a monster which runs wild in our streets to this day, will probably never accept or tolerate its presence in our pharmacopeia.