Pubdate: Mon, 14 Sep 1998 Source: Dallas Morning News (TX) Contact: http://www.dallasnews.com/ Author: Laura Beil 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