Nitazenes

This week we talk about OxyContin, opium, and the British East India Company.

We also discuss isotonitazene, fentanyl, and Perdue.

Recommended Book: The Thinking Machine by Stephen Witt

Transcript

Opioids have been used as painkillers by humans since at least the Neolithic period; there’s evidence that people living in the Iberian and Italian Peninsulas kept opium poppy seeds with them, and there’s even more evidence that the Ancient Greeks were big fans of opium, using it to treat pain and as a sleep aid.

Opium was the only available opioid for most of human history, and it was almost always considered to be a net-positive, despite its downsides. It was incorporated into a mixture called laudanum, which was a blend of opium and alcohol, in the 17th century, and that helped it spread globally as Europeans spread globally, though it was also in use locally, elsewhere, especially in regions where the opium poppy grew naturally.

In India, for instance, opium was grown and often used for its painkilling properties, but when the British East India Company took over, they decided to double-down on the substance as a product they could monopolize and grow into a globe-spanning enterprise.

They went to great lengths to expand production and prevent the rise of potential competitors, in India and elsewhere, and they created new markets for opium in China by forcing the product onto Chinese markets, initially via smuggling, and then eventually, after fighting a series of wars focused on whether or not the British should be allowed to sell opium on the Chinese market, the British defeated the Chinese. And among other severely unbalanced new treaties, including the ceding of the Kowloon peninsula to the British as part of Hong Kong, which they controlled as a trading port, and the legalization of Christians coming into the country, proselytizing, and owning property, the Chinese were forced to accept the opium trade. This led to generations of addicts, even more so than before, when opium was available only illicitly, and it became a major bone of contention between the two countries, and informed China’s relationship with the world in general, especially other Europeans and the US, moving forward.

A little bit later, in the early 1800s, a German pharmacist was able to isolate a substance called morphine from opium. He published a paper on this process in 1817, and in addition to this being the first alkaloid, the first organic compound of this kind to be isolated from a medicinal plant, which was a milestone in the development of modern drug discovery, it also marked the arrival of a new seeming wonder drug, that could ease pain, but also help control cold-related symptoms like coughing and gut issues, like diarrhea. Like many such substances back in the day, it was also often used to treat women who were demonstrating ‘nervous character,’ which was code for ‘behaving in ways men didn’t like or understand.’

Initially, it was thought that, unlike with opium, morphine wasn’t addictive. And this thinking was premised on the novel application method often used for morphine, the hypermedia needle, which arrived a half-century after that early 1800s isolation of morphine from opium, but which became a major driver of the new drug’s success and utility. Such drugs, derived scientifically rather than just processing a plant, could be administered at specific, controllable doses. So surely, it was thought, this would alleviate those pesky addictive symptoms that many people experienced when using opioids in a more natural, less science-y way.

That, of course, turned out not to be the case. But it didn’t stop the progression of this drug type, and the further development of more derivations of it, including powerful synthetic opioids, which first hit the scene in the mid-20th century.

What I’d like to talk about today is the recent wave of opioid addictions, especially but not exclusively in the US, and the newest concern in this space, which is massively more powerful than anything that’s come before.

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As I mentioned, there have been surges in opioid use, latent and externally forced, throughout modern human history.

The Chinese saw an intense wave of opioid addiction after the British forced opium onto their markets, to the point that there was a commonly held belief that the British were trying to overthrow and enslave the Chinese by weighing them down with so many addicts who were incapable of doing much of anything; which, while not backed by the documentation we have from the era—it seems like they were just chasing profits—is not impossible, given what the Brits were up to around the world at that point in history.

That said, there was a huge influx in opioid use in the late-1980s, when a US-based company called Purdue Pharma began p