Medical advancements are constantly changing and improving the state of human health. As doctors learn more about the human body, they improve standards of care. But did you know that once upon a time, many drugs that are now considered addictive and illegal were everyday medical remedies? Consumed by people young and old seeking to improve their health or cure illness, drugs such as cocaine and heroin were in everyone’s medicine cabinet. Substances that are today called hard drugs and shunned by society were once thought to save lives and improve patient well-being. What changed?
1. Amped Up on Amphetamines
First marketed under the brand name Benzedrine, amphetamine was discovered and synthesized in the early twentieth century. Brought to the open market in 1935, Benzedrine was used as a treatment for narcolepsy, nasal congestion, depression, and other disorders.
Amphetamine is a stimulant that can induce insomnia, reverse anesthesia effects, and enhance cognition. However, side effects can also include increased blood pressure, a higher pulse rate, loss of appetite, and exhaustion.
During World War II, amphetamines were used as wakefulness aids, with hundreds of thousands of Benzedrine pills and inhalers disbursed to US troops. By the end of the war, it is estimated that 16 million Americans had been exposed to Benzedrine, and its use was normalized. Once word got out about Benzedrine’s stimulant effects, it was reverted to a prescription-only. As time went on, these stimulant properties were sought for clandestine uses as an “upper.” With effects similar to cocaine, amphetamines are unique in that they last longer in the central nervous system, extending the reaction the user feels.
Despite the crackdown on non-prescription use, it was estimated that at least 9.7 million Americans, about 5% of the population, were using prescription amphetamines by 1970. That year, the Controlled Substances Act was passed, making amphetamine a Schedule III drug, and it was switched to Schedule II a year later. Schedule II drugs are those with a “high potential for abuse,” and today include not only amphetamines but opioids. Common street names for amphetamines include “bennies,” “crank,” and “speed,” and this class of drugs is still prescribed for a variety of ailments.
2. Medicinal Cocaine: Not Your Grandma’s Coca-Cola
Cocaine is a naturally occurring compound derived from the coca plant, which is native to South America. It was first isolated from its natural state in the mid-nineteenth century and first used in medical applications in the United States in the 1880s. Cocaine was historically prescribed to German soldiers to combat fatigue and soon became popular, particularly in the form of coca wine.
Coca-Cola, a syrupy drink made from coca and kola nuts, much different from the soda pop that is enjoyed worldwide today, began to be marketed in Georgia in 1886. That same year, the Surgeon General of the US Army endorsed cocaine for medical use. Throughout history, the drug was used to treat depression and exhaustion and was used as replacement therapy for morphine addicts, much like methadone is used today.
Later in the century, cocaine was used as a local anesthetic. It helped surgeons make breakthroughs in many areas of surgical application. Cocaine also came in pill form, used by doctors to treat diseases of the digestive tract. Still, even in the nineteenth century, at the height of its popularity, some healthcare professionals began to warn of the dangers associated with the compound and its side effects.
In 1914, the Harrison Narcotic Act outlawed cocaine in the United States. Its usage began to decline but saw a resurgence for recreational use in the 1970s counterculture era. Its illegality makes it hard to gauge its popularity, but it is believed that usage of cocaine in the United States reached its peak in the early 1980s, with over 10 million users. Today, cocaine is most commonly used in its powder form, though it is also used in its base rock-like form, known as “crack.” Users commonly binge on the drug until they reach exhaustion or run out of drugs, and the human body builds a tolerance to it quickly.
3. Opiates & Opioids Have Killed Thousands
Opiates and opioids are a class of substances that include numerous illegal drugs and legal prescription medications. The natural form of the drug family is known as “opiates,” while “opioids” are manufactured from synthetic or partly synthetic materials. Commonly abused opiates and opioids include heroin, morphine, fentanyl, hydromorphone, and opium. They can often be abused in a variety of ways, including smoking, intravenous use, and in pill form.
These compounds are extracted from the opium poppy and can cause euphoric effects, pain relief, and relaxation. In fact, no other substance on earth has been found to be as effective as opiates for difficult pain. However, opiates and opioids can also cause constipation, slurred speech, increased pressure in the brain, dry mouth, and more. They are extremely addictive.
When it was first synthesized, morphine was considered “God’s own medicine.” The first references to opium cultivation and use date back to 3400 BCE in Mesopotamia. It was a popular product traded along the Silk Road, and has even caused wars.
Its popularity increased when opium smoking was introduced to the United States in the nineteenth century by Chinese railroad workers. It was a common additive to tonics and elixirs that were available to the public for a variety of applications.
The US has experienced several waves of high rates of opiate and opioid addiction among its population. The first took place during the American Civil War when morphine was used heavily to alleviate pain. Hypodermic needles were invented around this time, enabling the injection of the drug.
During the post-World War II era, heroin became ingrained in the cultural identity of many cultural movements and was rampantly abused by US service members in the Vietnam conflict.
Currently, the US is experiencing its worst and deadliest drug crisis, and opioids are to blame. The popularity of prescription painkillers in the past 30-40 years has increased the number of addictions to opioids. Though in the last few years, prescription rates have declined, overdose rates have risen steadily over the past decades, with those attributed to opioids, particularly synthetic opioids like fentanyl, the main cause. In 2022, almost 74,000 deaths were attributed to synthetic opioids. These increases remain fairly consistent across age groups and genders, indicating that these drugs can affect anyone.
4. GHB Infiltrates Numerous Circles
GHB, short for Gamma-Hydroxybutyric acid, is a prescription drug used to treat narcolepsy, a sleep disorder. However, the discovery of GHB’s other effects quickly led to its mistreatment and definition as a Schedule I controlled substance alongside heroin.
GHB and its analogs are abused in either a white powder or clear liquid form, primarily by young people. GHB provides euphoric, anesthetic, and sedative effects but can also cause nausea, vomiting, depression, dizziness, hallucinations, memory impairment, and respiratory distress. It is also used illicitly for bodybuilding and weight loss. Routine toxicology screens do not detect GHB, increasing its risk for use compared to other illegal drugs. This, along with its sedative effects, also makes GHB a popular “date rape drug” used by sexual predators to subdue victims.
5. Ecstasy: The World’s Favorite Party Drug
Developed in Germany in the early twentieth century, ecstasy, also known as MDMA, Molly, or X, was intended for use as an appetite suppressant. However, its stimulant properties and hallucinogenic side effects have turned this substance from a prescription medication to the most popular party drug in the world.
A derivative of amphetamine, ecstasy gets the name MDMA from its chemical makeup: 3,4-methylenedioxy-N-methamphetamine. Many ecstasy users utilize it to enhance their experience at parties and clubs. During the 1970s and 1980s, it first became popular as a recreational drug in the United States and could even be purchased directly from establishments like bars and clubs.
The drug promotes euphoria, reduces inhibitions, and enhances tactile experiences. It is popular in pill form, often featuring rainbow colors, different shapes, and unique logos, but it is also abused in powder or liquid form. While it is most often taken in pill form, it can also be snorted and occasionally smoked.
While MDMA might not seem as inherently dangerous as other illegal drugs due to its party reputation, it can contribute to poor decision-making, cause chills, anxiety, and paranoia, and, at high doses, interfere with the body’s ability to regulate temperature. Sharp increases in body temperature can lead to brain swelling, major organ system failure, and even death. The drug has a complex metabolism, so repeated use in a short period of time can lead to increased concentrations and boost the risk of dangerous complications. Users also risk dehydration, as the use of ecstasy is often in conjunction with physical exertion in confined, warm environments like dance floors.
Most ecstasy users are young people, with more than 10% of high school seniors admitting to trying the drug at least once. MDMA has been classified as illegal since 1985 when it was defined as a Schedule I substance. Despite this, it is currently being used in drug trials for therapeutic applications in other parts of the world. Some entities, such as Australia’s Queensland Productivity Commission, a major government organization, have even called for the legalization of recreational ecstasy. Some argue that the legalization of recreational ecstasy, along with some other drugs, would rechannel resources, and rather than spending money on enforcing drug laws, government funds could be spent on treatment opportunities and education to keep people safe.
