ROOTS OF AN ADDICTION

Scientists To Meet, Explore The History Of Heroin

In 1898, a year before the debut of aspirin, the Bayer company
trademarked a pain reliever and cough remedy so potent that its name
drew on the German word for "heroic."

Heroin, as the drug was called, did indeed change the world - just not
in the way the German drug company intended.

Scientists and historians will gather later this week at Yale
University School of Medicine in New Haven, Conn., to observe 100
years of a prolonged and painful history with heroin. The meeting
isn't meant to celebrate the past, but to learn from it, organizers
say.

"There's very little attention paid to the history of the drug
problem," said Dr. David Musto, a physician and historian who is
organizing the conference.

"It's not that people don't want to know the history," Dr. Musto said.
"It doesn't occur to them that there is a history."

Ironically, heroin was first put on the market as a safe alternative
to morphine, whose addictive danger already was well-known by the turn
of the century. Technically called diacetylmorphine, heroin had been
synthesized but little noticed back in 1874. It is a modified version
of morphine, with two additional chemical accessories called acetyl
groups.

In 1898, Dr. Musto said, "the Bayer company was looking for a better
cough medicine, because most people died with diseases that involved
coughing." Within months of its introduction, the medicine was
dispersed all over the world.

And within the first few years, the darker side of heroin began to
emerge. By 1915, Dr. Musto said, heroin had surpassed its cousin,
morphine, as the most common reason addicts were committed to New
York's Bellevue hospital.

The United States has experienced two major waves of heroin addiction.
The first one began around 1910 and tapered off about 1930. The second
was the infamous epidemic of the late 1960s and early 1970s, which
afflicted many Vietnam veterans and other young adults. The country
now appears to be on the brink of a third, Dr. Musto said.

In the decades since the last wave, scientists have discovered more
about the tactics, down to the molecular level, that heroin uses to
hijack the brain.

"We've learned a phenomenal amount about drugs and the brain, and the
way drugs affect the brain," said Alan Leshner, director of the
National Institute on Drug Abuse in Maryland. Researchers know how
heroin produces its psychoactive effects and understand more about why
people relapse after treatment.

Dr. Leshner hopes the new findings eventually will help people to more
easily overcome addiction to the drug. For example, it is now thought
that people relapse not because of physical withdrawal symptoms, but
because of the tremendous craving that wells up inside them.

One lesson from history is that people should have easy access to
treatment for heroin addiction, and that these programs should include
a variety of methods, said Dr. Jerome Jaffe, who will speak to the
Yale conference on his experiences as the nation's first official
leader of the drug war in the early 1970s.

"We made treatment widely available," said Dr. Jaffe, who is now a
psychiatrist with the University of Maryland in Baltimore. However, he
said, treatment programs appear to have been de-emphasized in the
current war on drugs, with decision makers instead focusing on law
enforcement.

In terms of funding, he said, "It was a Yugo treatment then, and now
it's a Rent A Wreck."

And the current epidemic has new facets that were not part of the wave
of the 1960s and '70s. For one thing, many abusers who inject drugs
now have AIDS and other chronic diseases unheard of a generation ago.

Also, heroin is now purer and cheaper, so it can be easily sniffed or
smoked. This lures many young people into its grip, because snorting a
drug doesn't seem quite as reckless as injecting it.

It is, however, addictive in any form. People who use heroin often say
that it brings them to a place of peace and euphoria. They then try to
recapture that first experience, needing more and more drug to get
them to a similar level.

"The problem with this, of course, is that no one starts out intending
to become an addict," Dr. Musto said.

He hopes that this week's conference will call attention to the past,
just as the Bayer Corp. is planning a large 100th anniversary
celebration next year for its most famous invention.

"I think they're more happy being identified with aspirin," said Dr.
Musto, adding that "they don't have anything in any way to apologize
for. They came up with a powerful cough suppressant when it was needed.

"The question is," he said, "Have we learned enough about drug abuse
so we don't have another epidemic like the one we had around 1970?"

Checked-by: Patrick Henry