- Opium and its derivatives like morphine and heroin have been used medically for thousands of years to relieve pain. In the early 19th century, morphine was isolated from opium and its medical uses grew. - By the late 19th century, laudanum (an opium tincture) was commonly used and misused as an analgesic, antidiarrheal, and antispasmodic in patent medicines. Its widespread use led to addiction and abuse problems. - In the 1800s, scientists began to recognize withdrawal symptoms and the potential for dependence and compulsion with long-term opiate use. However, opiates remained a mainstay of medical treatment for pain and other

2. Opiates, Opioids A rose by any other name… Larry Lombard, BA History of Medicine, BPharm, CDP, NCAC II Quality Assurance Manager Serenity Lane April 19, 2011

8. Opium poppy – Papaver somniferum

15. 1400 BCE Crete Poppy goddess The poppy heads are cut to extract the opium before the pods ripen in the same way as they are now

75. This new instrument was developed with the promise to reduce morphine addiction By the reduced doses required via interjection compared to oral use. Many, if not all “new tools” in the treatment of addiction, started as “cures” and ended as curses.

78. Dr. Alexander Wood

96. Harper’s is the second-oldest continuously published monthly magazine in the U.S. ( Scientific American is the oldest)

158. Found on admission

171. O OH OH N CH 3 morphine

172. O OH OH N CH 3 morphine

173. O O OH N CH 3 morphine H C 3 codeine

174. O O OH N CH 3 H C 3 codeine

175. O O O N CH 3 H C 3 codeine H hydrocodone

176. O O O N CH 3 H C 3 hydrocodone

177. O O O N CH 3 H C 3 H codone hydro oxy OH

178. O O O N CH 3 H C 3 H codone oxy OH

179. O O O N CH 3 H morphine H H hydromorphone

180. O O O N CH 3 H H hydromorphone O N

181. O O O N CH 3 H H morphone OH hydro oxy

182. O O O N CH 3 H H morphone OH oxy

183. O O O N CH H H H morphine CH=CH 2 3 2 OH naloxone

184. O O O N CH H H CH=CH 2 2 OH naloxone Narcan

185. O O O N CH H H CH=CH 2 3 2 OH naloxone naltrexone

186. O O O N CH H H 2 OH naltrexone Revia, Vivitrol

187. O O O N CH H H H 2 OH naltrexone C CH 3 C(CH 3 ) 3 OH 3 buprenorphine

188. O O O N CH H H H 2 OH C CH 3 C(CH 3 ) 3 OH 3 buprenorphine

189. CH 3 CH 2 OC O N-CH 3 meperidine

190. CH 3 CH 2 OC O N-CH 3 meperidine

191. CH 3 CH 2 O N-CH 3 2 CH 2 - O N C fentanyl

192. C O C CH 3 CH 2 CH 2 CH CH 3 N CH 3 CH 3 methadone

193. A persistent but untrue urban legend claims that the trade name of Methadone "Dolophine" was coined in tribute to Adolf Hitler by its German creators, and it is sometimes even claimed that the drug was originally named "adolphine" or "adolophine" or "Dolphamine". The claim is still presented as fact by Church of Scientology literature and was repeated by actor and vocal Scientologist Tom Cruise in a 2005 Entertainment Weekly interview.

195. C O C CH 3 CH 2 CH 2 CH CH 3 N CH 3 CH 3 2 O methadone propoxyphene

197. O O O N CH 3 H H COC COC 3 3 diacetyl morphine heroin

199. Capsaicin

202. Qutenza® has proven, long-lasting pain relief in two 12-week, pivotal postherpetic neuralgia trials