Part II: Emergence of Heroin, Criminalization and the Harm of Prohibition
Heroin emerged in the 19th century
In the first part of this series we examined Britain’s sordid past as the world’s greatest opiate pusher, and the widespread use of opium in 19th century England. In order to understand how the cultural attitudes in Britain toward opiate use have so markedly shifted, it is worth exploring the emergence of perhaps the most well known derivative -- heroin -- and its criminalization during the 20th century. In the final part, we will look at just how destructive these changes have been.
The Evolution of Opiates and Criminalization
In 1805 the German pharmacist Friedrich Sertürner, through the application of chemical analysis to the opium poppy, successfully purified the active ingredient of opium -- morphine. For the first time plant-derived drugs could be purified and chemists began to modify them to form new drugs. In 1874 heroin was synthesized from morphine in Britain, and was put into commercial production by the German pharmaceutical company Bayer some two decades later in 1898.
The name heroin stems from the German word heroisch, one which directly translates to heroic. This naming of the drug is perhaps unsurprising in light of its power; the substance is four to eight times as potent as morphine, and its addictive and destructive potential exceed a number of other opiates used for centuries by humans. With the invention of the hypodermic syringe in 1853, the tools were in place for heroin to achieve the aforementioned potential via widespread intravenous use.
By the beginning of the 20th century criticisms of the global trade in opium and its derivatives were growing around the world, and culminated in the signing of the International Opium Convention in 1912. The convention -- signed initially by a handful of nations -- agreed to control international narcotics trafficking and would form the foundation of the 1961 UN Single Convention on Narcotic Drugs.
The United States officially outlawed the legal sale of opiates -- along with numerous other substances -- in 1923, pushing the trade underground. The reasoning behind the move, according to a BBC Magazine article from 2006, was that heroin use was viewed as a “major social problem.” This is not necessarily because of the levels of harm associated with use, but because it was cynically associated with social deviance and counter culture; for example, Jazz, bohemian and Black culture. Later, the likes of Miles Davis, Charlie Parker and Billie Holiday would be know to frequent the substance.
Historian Dr James Mills decries how despite the hysteria, opiate users were, in fact, largely doctors and middle-class patients; "In the 1930s, it was really the well-to-do crowd. The working classes might have a bit of heroin in the medicine prescribed to them but it wouldn't be enough to form a dependency."
Pinpointing the exact date of heroin's criminalization in the UK is less clear than it is with the US. Needless to say, following the 1912 Opium Convention, the wheels were very much in motion that would bring about its eventual illegality.
During this period in Britain, a large number of opiate users were people who became dependent following operations, including thousands of soldiers returning home. Heroin was prescribed fairly liberally, something which began to be stopped in the 1950s. The Times newspaper even ran an opinion piece in June 1955 titled "The Case for Heroin," which argued that Britain was not suffering from widespread drug misuse and that the number of people addicted to heroin nationwide was less than 50 (likely an underestimate).
The Times’ call was not heeded. Halfway through the decade a global clampdown on heroin was gathering pace and in 1956 the US made supply to minors a capital offence. That same year the UK government of Anthony Eden acted to ban imports and exports of opium. The global attitude was firmly set and the UK felt the pressure. Yet Eden stopped short of banning domestic manufacture of opiates, likely in response to doctors' protests. Morphine, diamorphine (medical heroine) and codeine remain in medical use. Heroin, on the other hand, is now a different animal altogether in the public's eyes, something which has had profound implications for people caught up in its use.
A 20th Century Attitudinal Shift
Following the legal changes concerning opiates, public attitudes began to switch compared to the not too distant past, and the stigmatization of heroin users grew. Media coverage -- particularly among the tabloids -- of heroin-related stories is quite unanimous in its disgust. Rod Liddle even unapologetically wrote in 2010, “My daily fix is to stigmatise these smackheads - It is not a good thing to be a junkie. That is why we stigmatize it …” So often in recent history heroin has been cast as the “demon drug,” the “poison of society,” (see image, below). We are told to fear the very substance, but the devastation we see in our societies -- addiction, homelessness and crime, the ugly destruction of users, the HIV epidemic, overdoses -- are the product of myriad factors, most prominent among them socio-economic marginalization. This is not the work of a drug in isolation.
Contrary to popular belief, heroin alone is not the violently dangerous force we think we know it as today. Heroin is a highly addictive drug and has associated harms like every narcotic, licit or otherwise, but when opiates are taken in doses a doctor would advise, they can potentially do less harm to the body and mind than many common legal drugs. “Like heroin … paracetamol is quite a dangerous drug ... It has a fixed upper limit ... and if you exceed that, perhaps doubling it, you can certainly put yourself at great risk of liver failure and death,” says Dr Teresa Tate, a medical adviser to Marie Curie Cancer Care.
"The available evidence indicates that heroin, when provided in pure form, is a relatively safe drug. Hence it is primarily the illegal nature of the drug, rather than its pharmacological properties, which leads to the health and social problems associated with its use," wrote Ostini et al. in the Journal of Medical Ethics in 1993.
Despite popular belief and society's pernicious stereotype of all heroin users as the typical "junky," there are in fact users of heroin who live relatively “normal” lives. A study commissioned by the Joseph Rowntree Foundation in 2005 examined such “non-problematic” users. The study, “describes how this largely hidden population maintain stable and controlled patterns of heroin use,” and showed that, “some people, in some circumstances can effectively manage and regulate their use.” Those circumstances, however, are largely dependent on the social standing of the user in question.
One of the most noteworthy of such users in recent decades is Dr Clive Froggatt. For three years as a GP he illegally forged himself prescriptions to obtain a regular dose of diamorphine. The doctor was aware of the danger posed by his addiction, stating: “As an addict, I knew that if I got too much in one go that I would tend to over use it. So, basically, I had to go to the pharmacy every morning.”
Because he had the right knowledge, affluence and access to safer forms of heroin, Froggatt was comparatively safer in his use of opiates. He was a consultant to a number of Tory health secretaries and an advisor to Margaret Thatcher on NHS reform. Even when under the influence of heroin he regularly met with government officials, even the prime minister.
While this article is by no means seeking to champion heroin use in any shape or form, Dr Froggatt serves as a prime example of how the use of opiates in and of themselves do not necessarily constitute the scourge society deems them to be today. Rather, their destructiveness are wrapped up in a host of other factors.
In the final part we examine just how dangerous this stigmatization of heroin users was when Britain experienced a so-called epidemic during the 1980s and 1990s, before looking at where Britain's attitude toward use rests now and what steps could be made in the future to combat the harms associated with problematic use.
Read Part I in this series here
Read Part III in this series here