Health & Welfare: The Latest Dope on Opiates

Before 1914 and the passage of the Harrison Act, Americans were free to purchase any drug, including heroin and other opiates. (By 1914, heroin had been available for about 16 years.) Because sale and purchase of heroin was legal before 1914, there was no black market and no reason to hide importation and sales figures. Approximately 1–2 percent of the US population was addicted to heroin and other opiates at that time.

Nowadays, it is much more difficult to gauge the extent of opiate addiction because of opiates' universal illegality, but the best estimates are probably around 1–2 percent. It is ironic that the immense burden of opiate controls has succeeded only in greatly increasing the cost to society of opiate addiction—especially to many victims of crime—while failing to clearly reduce the percentage of the population that is addicted.

Most people given opiates have no interest in repeating the experience. In fact, heroin was originally developed by the Bayer Pharmaceutical Company as a nonaddictive cure for morphine addiction. The team of scientists and physicians who developed heroin at Bayer took it every day for a month, then suddenly stopped. None of them had any desire to continue using the narcotic.

Nor is heroin as physiologically hazardous as most people think. Even with unclean needles and contaminated and unknown doses of heroin, the death rate for heroin addicts is about 1 percent per year. By comparison, at least 5 percent of alcohol addicts die every year!

What is known about opiates and addiction to them? How can an addict kick the habit without unpleasant withdrawal symptoms?

Methadone, an alternative to heroin, is promoted in the United States. Unfortunately, methadone is also addicting and is much more difficult to stop using than is heroin. This is a factor in the reluctance of many heroin addicts to embark on methadone "therapy." It is not surprising, however, that methadone clinics receiving thousands of dollars of government money for each addict "treated" are loathe to discontinue its use or admit its deficiencies.

Dr. Irwin Stone, the man who first interested Linus Pauling in vitamin C, has found a way to withdraw addicts from heroin without withdrawal symptoms. He gives addicts 30 grams a day of sodium ascorbate, a nonacidic form of vitamin C, tapering the dose to a maintenance dose of 10 grams a day. (These large doses do not cause diarrhea in heroin withdrawal but do in methadone withdrawal.) One plausible explanation for this withdrawal therapy: vitamin C has been shown experimentally to inhibit the breakdown of natural opiates—the endorphins—by specific enzymes in the brain; so it may prevent the desire for a fix (to increase brain opiate levels).

Another treatment recently discovered is a combination of naloxone (which blocks opiate receptors in the brain) and clonidine (a medication for high blood pressure). If naloxone alone is given to an addict, withdrawal symptoms are immediately precipitated, but the addition of clonidine results in the absence of symptoms. It is not yet well understood how clonidine is able to do this. It is thought to mimic certain of the actions of the opiates, occupying brain receptors that would otherwise be occupied by opiates. Clonidine itself is nonaddictive.

Also effective in greatly reducing opiate withdrawal symptoms is delta-9-tetrahydrocannabinol, the main psychoactive chemical in marijuana. Opiate addicts have claimed for years that marijuana aids withdrawal, ironically acting as a stepping stone away from rather than to heroin, as conventional wisdom would have it.

There are natural opiate-like compounds, the endorphins and enkephalins, in all of our brains. In a real sense, we all use opiates daily. The effects of some of these natural opiates are sometimes very similar to those of heroin, including the need for regular "fixes" and the occurrence of withdrawal symptoms. Some people seem to be more susceptible than others.

For example, animals and people can be induced to eat by putting them under stress. In one study, stress-induced eating in rats was blocked by administering the opiate antagonist naloxone. In another study, it was found that some obese humans released much more endorphin in response to eating than do normal-weight persons. Naloxone also reduced food intake in experiments with rats, cats, and rabbits. Thus, some overweight people may be addicted to their own endorphins.

Jogging has been shown to release endorphins in the brain. Many regular joggers describe a high typical of opiates. The development of tolerance, typical of opiates, also occurs; joggers report the need to run longer and longer distances in order to get the high. Withdrawal symptoms (nervousness, agitation, and even diarrhea, insomnia, and cold sweat shakes) may occur when regular heavy jogging is prevented by bad weather or injury.

The apparent role of opiate-like compounds in our lives has been expanded by the finding recently reported in Science that human mother's milk contains morphine. The quantity is enough to have a drug effect on the infant. Possibly it is there to keep the infant calm and euphoric. It is known that endorphins are involved in the bond between mother and infant; separation distress in infant monkeys has been precipitated by naloxone (which blocks the effects of endorphins).

Cow's milk, alfalfa, and lettuce also contain heroin. During the Civil War, when opium was unavailable, lettuce was boiled down into a gum called "lettuce opium" that was used like opium. We used to think this was a fanciful case of the placebo effect. But, these are not mere trace amounts; an adult milk drinker may get as much morphine in a day as 10 percent of the dose prescribed for severe pain.

We recently learned at the Symposium on Stress, Immunity, and Aging (October 27–29, 1982, at UCLA) that endorphins, which can be released from the adrenal glands in very large quantities during stress and trauma, depress the immune system (particularly the T-cells, responsible for locating, killing, and eating bacteria, viruses, and cancer cells). This could be one reason why chronic stress is a health hazard.

Endorphins released during traumatic accidents decrease blood pressure (presumably as a defense against bleeding to death), which seriously exacerbates the damage done in injuries to the brain and spinal cord. Under these conditions, blood flow to these organs is reduced, resulting in a tremendous increase in the creation of free radicals (which are partially controlled by oxygen itself). It was recently reported that injecting massive doses of naloxone into the damaged area of the spinal cord of cats very soon after severe injuries (within an hour or two) could help prevent such serious consequences as paraplegia.

Evidence is growing that endorphins and other opiate-like compounds play an important role in our health and behavior—even social behavior. Eventually, we'll know enough about how they work to control their effects. And we'll understand why some people become addicts, while most of us don't.

A list of scientific literature on this topic is available through REASON. Send a stamped, self-addressed envelope and ask for H&W references, March.

Sandy Shaw and Durk Pearson are consulting scientists and authors of Life Extension (Warner Books). Copyright © 1983 by Sandy Shaw and Durk Pearson.