An 8,000-year History of Use and Abuse of Opium and Opioids: How That Matters For A Successful Control Of The Epidemic ? (P4.9-055)

Objective: To study the roots of opioid use. Background: The recent declaration of opioid-abuse crisis in the US, with 33,091 deaths in 2015 from overdosing, warrants cross-sectional and longitudinal surveys. Design/Methods: Analyzing published information. Results: 8000 year-old hardened Sumerian clay-tablets are the earliest prescriptions of opium. Ancient Greeks, Indians, Chinese, Egyptians, Romans, Arabs, people in middle ages, Europeans from renaissance to now, knew opium as an ever-approved next-door medicine-a panacea for all maladies. References in the Odyssey and the Bible, and use by known leaders and minds like Homer, Franklin, Napoleon, Coleridge, Poe, Shelly, Quincy, Hitler and many more, have removed the label of immorality from its use. Wounded soldiers, from the American Civil, British Crimean, and Prussian French wars, were allowed to abuse the drug. By 1830s one third of all lethal poisoning was due to opium-marking the first recognition of a social evil. Isolation of Morphine from opium by Serterner in Germany in 1805, hypodermic syringe by Pranez in 1850s, synthesis of morphine by Tschudi in 1952, and manufacturing of synthetic derivatives-called opioids and Heroin eased the use. Recognition of subjective pain as the fifth vital sign, with pressure on providers to prescribe scheduled medicines, added additional strokes to this menace of prehistoric dimensions-the OPIOID EPIDEMIC, which shreds 13% high school seniors every year. Discovery of mu receptors-the mouthpiece of opioids in virtually all animals and plants high-up from yeasts, endogenous endorphin and encephalin in humans as the quintessential stress and pain disposal systems, link opium to our survival. Genetic factors for opioid specific heritable vulnerability contributes to nearly 50% of abuse. Prevalence of mood disorders in today’s world, add substantial susceptibility. Conclusions: This nemesis has anchors on history, culture, mythology, religion, biology, genetics and psychology. A thorough knowledge of the upstream is necessary for a successful downstream regulation. Disclosure: Dr. Bandyopadhyay has nothing to disclose.