Heroin history

This letter is in response to the article by Lucas Richert in CMAJ.1 In the 1890s, diacetylmorphine was resynthesized at Bayer and then for almost 20 years, it was marketed as heroin, a safe and nonaddicting substitute for morphine. I first learned this while reading Goodman and Gilman’s “The Pharmacological Basis of Therapeutics”2 in 1959 while I was a medical student at the University of British Columbia; this led to a repeatedly reaffirmed life-long skepticism of claims made by drug companies.

Because heroin generally has fewer adverse effects than morphine, however, legalization for end-of-life use in patients with intractable pain would be a useful addition to our limited armamentarium. Apart from lessening suffering, it could allow some patients to delay or avoid assisted suicide. Because heroin and fentanyl are already easily available on the street, there is no risk of worsening law enforcement or mortality issues related to illicit drug use.