Drugs for Pleasure, Drugs for Pain?

Drugs for Pleasure, Drugs for Pain?
Developing Treatments with Controlled
Drugs
Part One: Cannabis, Coca, & Cocaine
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Introduction
Would you take a medicine containing morphine or cocaine if you were suffering from
morning sickness? Sniff a cocaine based powder if you had catarrh? Take heroin if you
had bronchitis? The answer, if you are sensible and law abiding, is most likely to be no.
However, medicines containing these substances were in the past viewed by medical
professionals as legitimate and effective medicinal treatments.
Many drugs that are now widely considered to be a threat to society were initially viewed
as „wonder drugs‟ believed by medical professionals to have no harmful side effects.
This display explores how substances such as cocaine, cannabis, opium, morphine, and
heroin were originally used as pharmaceutical treatments for a wide range of medical
ailments.
The display reveals how their use as treatments was increasingly restricted during the
20th century as knowledge about their side effects and addictive qualities become more
widely known.
However, some of these substances are now being developed for use in 21st century
pharmacy for treating a new range of medical conditions.
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„Out of Control‟ - Controlling Illicit Drugs in Victorian &
Edwardian Britain
Prior to the late 1860‟s addictive and poisonous drugs were freely available to buy in
pharmacies around Great Britain. However, growing awareness among medical
professionals regarding the addictive and poisonous nature of certain medicines, and the
dangers of abuse and overdoses led to a succession of acts to limit their sale and use.
Pharmacy Act, 1868: „Opium and all Preparations of Opium or of Poppies‟ were among the
first group of medicines to be regulated by law. The act made it illegal for anybody apart
from registered pharmacists to sell or prepare the poisons listed in the act.
The act also ensured that these medicines had to be labelled a „Poison‟; to ensure public
awareness regarding the dangers of over dosage.
Poisons and Pharmacy Act, 1908: The 1908 act added „Coca, any preparation or
admixture of, containing 1 or more per cent of coca alkaloids‟ (including cocaine) to the list
of regulated drugs.
The 1908 act also redefined the restrictions on opium preparations to include „Opium, and all
preparations or admixtures containing 1 or more per cent of morphine‟ (including heroin).
Dangerous Drugs Act, 1922: The Dangerous Drugs Act (D.D.A) was brought in as result
of the problems of opium use and trade (to control the trade and use of raw and prepared
opium in the East)
The D.D.A restricted the production, export, and import of opium and its preparations,
morphine, cocaine, and diamorphine (heroin). The act also included any preparation
containing not less than one-fifth per cent of morphine or one-tenth per cent of cocaine or
diamorphine (heroin). Cannabis, cannabis resins and preparations of the resins were
included in the 1925 D.D.A.
In addition to being labelled a „Poison‟ all regulated medicines had to also be labelled
„D.D.A.‟
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CANNABIS
Cannabis has been used for pain
relief for thousands of years. In
Britain however, it was most
extensively used in the 1800s, as
an alternative to more addictive
drugs like opium and morphine.
Allegedly, Queen Victoria took it
for period pain for years. Aside
from pain relief, cannabis
preparations were also used as a
sedative to treat insomnia and
mania, while cannabis cigarettes
were smoked to treat asthma and
bronchitis.
By the 20th century, cannabis
was becoming viewed more as
an intoxicant than a medicine.
Pure cannabis preparations
became illegal in the United
Kingdom in 1925, when under an
amendment to the Dangerous
Drugs Act it was classified as a
class B drug. As a result all
cannabis preparations were
removed from the British
Pharmacopeia by 1930. However
preparations containing small
amounts of cannabis, along with
other medicinal ingredients, were
not included in the act.
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Specimen Jar - Indian Hemp / Cannabis Indica B.P.,
around 1864-1914.
This specimen jar contains Indian Hemp / Cannabis Indica
B.P. (Labelled 'Tops of female plant of Cannabis sativa).
The British Pharmacopoeia (B.P.) defined Cannabis Indica
as 'The flowering tops of the female plant from which the
resin has not yet been removed, dried; cultivated in India'.
Cannabis Indica was used to prepare cannabis extracts
and tinctures.
Specimen Jar - Cannabis Sativa seeds, around
1900.
“Children are said to greatly improve under the
treatment”. British Medical Journal, 1907
In the early 1900s Cannabis sativa seeds were
used to prepare a concentrated liquid. The
preparation contained 1.5% phosphorus and was
given to children in food as a tonic to build them
up.
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Parke Davis and Company Powdered Extract No. 16 - Indian
Cannabis.
Manufactured by Parke Davis and
Company, 1906- 1920
This bottle contains Indian cannabis in powdered form. The
preparation is promoted on the label as a preferable painkiller to
opium since “Like opium, it relieves pains and spasms, but it does
not diminish the appetite or check secretions”.
Tinct. Cannab. Ind. B.P. (Tincture of Cannabis Indica)
Manufactured by Wright, Layman & Umney, 1912 – 1930
Tincture of Cannabis Indica B.P. was prepared by dissolving extract
of cannabis in 90% strength alcohol. All cannabis preparations were
removed from the British Pharmacopoeia by 1930.
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B.D.H. Cannabin. Tannas.
Manufactured by The British Drug Houses Limited, 1936 -1941
Cannabinae Tannas powder was mixed with water or alcohol. It was used as
a hypnotic to treat nervous insomnia and acute mania. While its pain relieving
properties were used to treat period pains.
Grimault's Cigarettes Indiennes
Manufactured by Grimault and Cie.,
Pharmaciens, Paris, 1897-1939
Grimault's Cigarettes Indiennes
combined the active ingredients
belladonna and cannabis Indica
extract. The cigarettes would have
been smoked by the patient to relieve
the symptoms of asthma, bronchitis
and coughs. Belladonna is powerful
anti-spasmodic once used to treat
spasmodic asthma.
Celandine ointment
Manufactured by Chave and Jackson
Limited, Hereford, 1915-1941
Celandine ointment is promoted on the label
as “A certain cure for corns, painless and
effectual”. The ointment contained 1.5 per
cent of extract of Cannabis Sativa. Cannabis
was often included in the formulas for corn
paints, ointments, and plasters. However, by
the 1920s medical professionals were
questioning its inclusion since there was no
scientific evidence that cannabis worked topically to relieve pain.
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Bromidia
Manufactured by Roberts and Company, 1941 - 1943
Bromidia was a proprietary medicine with a hypnotic and
sedative action. It was used to treat insomnia and contained
chloral hydrate, potassium bromide, cannabis extract, and dried
hyoscyamus extract. Chloral hydrate and potassium bromide
were used in combination to treat insomnia caused by worry or
overwork; while cannabis was included to treat mental worry and
restlessness. Cannabis had been removed from the formula by
1955.
Green glass shop round: 'BROMIDIA (POISON)'
Used at Allen and Hanbury's Pharmacy, Vere Street,
London, around 1888 - 1950
This glass shop round was used for storing the proprietary
medicine Bromidia. The bottle is ribbed and labelled „Poison‟
because Bromidia contained cannabis. The shop round is
one of a set that was used at Allen and Hanbury's Vere
Street Pharmacy in London.
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The Use of Cannabis in Modern Medicine
Cannabis started to make a return into therapeutic use in the 1980s.
Scientific research has revealed that cannabis has pain relieving properties, is a muscle
relaxant, and has appetite stimulant effects. As a result, cannabis is being developed as
a possible treatment for a variety of medical conditions including glaucoma, multiple
sclerosis, and wasting syndrome (loss of muscle and fat tissue) in patients with AIDS and
cancer.
Cannabis contains around 60 active chemicals, known as cannabinoids. The main active
constituent, tetrahydrocannabinol, is now used as an anti-emetic to prevent sickness in
patients receiving chemotherapy and to stimulate appetite in HIV patients, so as to
prevent wasting syndrome.
Multiple sclerosis patients in the UK
are now able to obtain cannabisbased treatment on the NHS. The
drug is a mouth spray called
Sativex. It contains two chemicals
found in cannabis;
tetrahydrocannabinol (THC) and
cannabidiol (CBD) and is used to
provide relief from neuropathic
(nerve) pain.
Cannabinoids are also being researched for other potential therapeutic uses, including
relief of muscle spasms in multiple sclerosis and pain associated with rheumatoid
arthritis. Cannabis also reduces intraocular pressure (pressure of fluid in the eye) and is
being researched as a treatment for glaucoma (an eye disorder causing damage to the
optic nerve).
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COCA
Coca is derived from the leaves of Erythroxylon coca, a shrub growing on the mountains
of Bolivia and Peru. Coca leaves contain the crystalline alkaloid cocaine. Traditionally
coca was used by South Americans as a stimulant of overcome tiredness, thirst, and
hunger. It was also considered especially effective for preventing altitude sickness. The
leaves would have been either chewed or made into a tea.
“A party climbing Mont Blanc, each chewing 80 grains of Coca during ten hours,
were much relieved from thirst by its use. They drank no water, tea, or coffee, and
but a limited amount of wine, yet Coca enabled them to make the trip with
comparative comfort”.
Article on the benefits of Coca use; The Extra Pharmacopoeia, 1883
Advertisement for Armbrecht Coca
Wine
Manufactured by Armbrecht, Nelson
and Company, London.
Published in The Chemist and Druggist
Diary, 1891
When coca was adopted by western medicine many of its traditional uses were applied to
western medical conditions. From the mid 1800s coca was used for its stimulant
properties, and as result it was promoted to climbers, sportsmen, and military men and
others undergoing long periods of physical endurance. Coca was also recommended for
relieving gastric pain, nausea and vomiting; and as a cure for opium, morphine, and
alcohol addiction; until medical professionals discovered it could lead to „coca craving‟.
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“Coca is recommended for vomiting or discomfort caused by ... pregnancy, and as
a cure for morphine and alcohol craving”. The Extra Pharmacopoeia, 1888 - 1928
From the 1880s to the 1920s coca was even recommended by pharmacists for relieving
vomiting in pregnancy. However, scientists now know that using cocaine during pregnancy
increases the risk of abortion, still birth, premature labour and other birth complications.
This may be due to cocaine narrowing the blood vessels (vasoconstriction), increasing the
mother‟s blood pressure and reducing blood flow to the placenta.
Today medical professionals view coca as having no place in modern medicine.
Glass specimen jar containing Erythroxylum coca leaves
Dating from 1889
Specimen jar containing the dried leaves of the Erythroxylum coca
plant.
'COCA : ER' (Liquid Extract of Coca)
Dating from around 1880 - 1910
This green glass bottle labelled 'COCA : ER' contains Liquid Extract of
Coca. The liquid was prepared by soaking powdered Erythroxylum coca
leaves in alcohol for 2 days; the mixture was then percolated (filtered).
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Ext. Cocae Liq. B.P. 1898
Manufactured by Evans Sons Lescher and Webb, 1903 1920
Liquid Extract of Coca B.P. 1898 was prepared using coca
leaves and 60% strength alcohol.
Kola Compound Elixir No. 122
Manufactured by Parke, Davis and Company, 1921-1928
Kola Compound Elixir contains kola nut, celery seed, and
coca. The manufacturer claimed that “Besides being
actively stimulant to the respiratory, circulatory, and
general nervous systems this elixir provides an agreeable
tonic”. The soft drink Coca-Cola also combined the active
principles of kola nut and coca leaves, until the cocaine
was removed in 1902.
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Advertisement for Armbrecht Coca Wine
Manufactured by Armbrecht, Nelson and Company, London.
Coca Wine was a popular and widely available preparation in Victorian and Edwardian England.
Armbrecht Coca Wine was promoted “For fatigue of mind and body”. The company stated that “In large
quantities it is said that this drug produces a general exultation of the circulatory and nervous systems –
imparting increased vigour to the muscles as well as to the intellect, with an indescribable feeling of
satisfaction”. For teetotallers Armbrecht manufactured alcohol–free coca extract and coca lozenges.
Published in The Chemist and Druggist Diary, 1891
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Tabloid' Brand 'Forced March' tablets
Manufactured by Burroughs Wellcome and Company, 1897 - 1907
„Tabloid' Brand 'Forced March' tablets combined the active
principles of Kola Nut and Coca Leaves (i.e. cocaine). Promoted on
the label; “Allays hunger and prolongs the power of endurance”.
The directions on the bottle advised that one tablet should “be
dissolved in the mouth every hour when undergoing continued
mental strain or physical exertion”.
„Forced March‟ tablets were taken on some of the British
expeditions exploring Antarctica in the early 1900s and are
believed to have been taken by British troops during World War I
(1914-1918).
Savory and Moore's Patent
Medicated Gelatine Lamels, for
Internal Use – Coca Extract
Manufactured by Savory and Moore,
1915-1919
Lamels are small squares of gelatine
impregnated with an active ingredient.
Savory and Moore's Patent Medicated
Gelatine Lamels, containing coca
extract, were to be taken as a
restorative, when exhausted or
suffering from nervous strain or shock.
This packet originally belonged to an army Captain who served in the Glamorgan Yeomanry in Egypt
and Palestine from 1916-1917, and France from 1917-1919.
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COCAINE
“No injurious effects, either local or constitutional, seem to follow its use”. Cocaine
and its Salts, by William Martindale; Supplement to The Extra Pharmacopoeia, 1884
Cocaine, an alkaloid derived from the leaves of the coca plant, was first isolated in 1860
by Albert Niemann, a German scientist. When first used medicinally, cocaine was
believed to be a drug with no harmful side effects.
In medicine the main use for cocaine has mainly been used as a local anaesthetic.
Cocaine numbs the surface of the mucous membrane to which it is applied, producing
local anesthesia. It was used as a local anesthetic in eye surgery, dentistry, and minor
operations on the ear, nose and throat. Cocaine, in the form of lozenges and pastilles,
was used to relieve the symptoms of sore throats.
Because of the risk of side effects and its potential for abuse, therapeutic use of cocaine
is now very restricted. Adverse effects from cocaine use derive from its stimulant effect
on the central nervous system; including agitation, abnormally high blood pressure, and
an increased heart beat.
Cocaine is now only used as a local anesthetic in ear, nose and throat surgery.
Bottle of „Cocain. Hydrochl.‟
German origin, around 1870 – 1920
This bottle contains pure cocaine hydrochloride crystals.
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Freud on Cocaine
One of the most famous users
and proponents of cocaine in the
late 1800s was the psychoanalyst
Sigmund Freud.
Freud initially viewed cocaine as
a wonder drug with no negative
side effects. As a result, in the
1880s, Freud wrote a number of
articles praising cocaine‟s
stimulant and pain relieving
properties.
Consequently Freud
recommended cocaine in the
treatment of a number of physical
and mental conditions, including
depression.
In Uber Coca, published in 1884, Freud
wrote that cocaine causes “exhilaration
and lasting euphoria, which in no way differs from the normal euphoria of the
healthy person...You perceive an increase of self-control and possess more vitality
and capacity for work....In other words, you are simply normal, and it is soon hard
to believe you are under the influence of any drug....Long intensive physical work
is performed without any fatigue...This result is enjoyed without any of the
unpleasant after-effects that follow exhilaration brought about by
alcohol....Absolutely no craving for the further use of cocaine appears after the
first, or even after repeated taking of the drug...”
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COCAINE – For the Nasal Passages
The damage heavy cocaine use causes to the nasal passages is today widely known.
Therefore it may seem surprising that cocaine was once used to treat many medical
ailments of the nasal passages. During the late 1800s and early 1900s cocaine was
frequently included in proprietary medicines that were to be sniffed in either powdered or
liquid form up the nostrils to relieve the symptoms of catarrh, hay fever, and colds.
'Soloid' Brand Naso-Pharyngeal Compound
Manufactured by Burroughs Wellcome and Company, 1884 1917
'Soloid' Brand Naso-Pharyngeal Compound tablets are labelled a
poison since they contain cocaine hydrochloride. The rest of the
ingredients are not known. The directions state; “One powdered
and dissolved in one to three ounces of tepid water, forms a
solution of suitable strength for sniffing up the nostrils, and for
use as a gargle or spray”.
Nasal, R 'B' (with Cocaine)
Manufactured by Parke, Davis and Company, around 1921
Nasal, R 'B' (with Cocaine) tablets were to be dissolved in warm
distilled water.
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Dr Agnew's Catarrhal Powder
Manufactured by Anglo-American Medical Company, 1903 - 1915
Dr Agnew's Catarrhal Powder contained nearly 3% cocaine. To
administer the powder up the nostrils the box also contained a
'Powder Blower' for sniffing the powder. The manufacturer‟s
claimed on the box that “This modern remedy gives relief in 10 to
60 minutes in the worst cases of catarrh, hayfever, cold in head,
sore throat, tonsilitis or headache”.
By 1910 medical professionals were becoming aware of the
growing problem of cocaine abusers sniffing cocaine based catarrh
snuffs, leading to damage to the nose.
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COCAINE – For the Throat and Voice
The local anaesthetic action of cocaine led it to be used in lozenges and pastilles to
relieve the symptoms of sore throats.
From the late 1800s to the mid 1900s cocaine voice tablets, lozenges, and pastilles were
also advertised as being beneficial to singers and public speakers for removing vocal
huskiness or hoarseness.
Cocaine throat lozenges and pastilles were available in pharmacies until the 1960s.
However, due to the growing awareness around abuse and addiction the amount of
cocaine in them had been steadily reduced since the 1920s.
Richardson's Medicated Lozenges - Troch. Cocainae.
Manufactured by John Richardson and Company, around 1888
Cocaine lozenges were indicated in The Extra Pharmacopoeia, 1888
as being; “Useful in allaying irritation of the throat and hoarseness.
They invigorate the vocal organs of singers and public speakers”.
Each lozenge contains 1/6 grain of cocaine hydrochloride.
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Voice Tablets of Chlorate of Potash, Borax and Cocain.
Manufactured by Hooper and Company – around 1895-1908
Hooper and Company‟s Voice Tablets consisted of the active ingredients chlorate of
potash, borax and cocaine. Indicated on the label 'They allay irritation and quickly
restore clearness to the Voice'.
Voice, R 'B' Compressed Tablets - No. 291
Manufactured by Parke, Davis and Company, 1922-1928
Voice, R 'B' Compressed Tablets contain cocaine hydrochloride,
along with the antiseptics potassium chlorate and sodium biborate.
The "Allenburys" Throat Pastilles No.24
Cocaine
Manufactured by Allen and Hanburys, Limited,
1921-1925
The "Allenburys" Throat Pastilles No.24 Cocaine
were advertised in The Chemists and Druggists
Diary from 1899-1903 as a “Sedative to the
mucous membrane”. Each pastille contains 1/40
grain of cocaine hydrochloride.
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Meggeson's Pastill.
Cocain. Hydrochlor. N.F.
Manufactured by
Meggeson and Company,
Limited, 1935 – 1952
Pastilli Cocainae
Hydrochloridi (Cocaine
Hydrochloride pastilles)
were listed in the National
Formulary (N.F.) for the
last time in 1952.
'Tabloid' Brand Voice Compound
Manufactured by Burroughs Wellcome and Company,
around 1952
'Tabloid' Brand Voice Compound tablets contain
potassium chlorate, borax, benzoic acid, boric acid,
and cocaine hydrochloride. The directions state
“Dissolve one slowly in the mouth when required to
remove huskiness or hoarseness”.
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COCAINE – Use in Dentistry
Cocaine‟s ability to anaesthetise nerve endings, and thereby numb pain (in the area it
was applied to), was also used in dentistry for relieving toothache and pain following
tooth extractions.
Cocaine Wool
Manufacturer unknown, around 1895-1920
The manufacturer‟s claimed on the label that the cocaine wool,
'Instantly relieves toothache'. A small amount of cocaine wool
would have been inserted into the tooth cavity to relieve
toothache.
Codrenine
Manufactured by Parke, Davis and Company, 1936 -1958
Codrenine solution for injection combined cocaine hydrochloride with
adrenalin chloride. The solution was used as a 'Local anaesthetic and
haemostatic'. Cocaine hydrochloride, a local anaesthetic, was used to
relieve pain in dental and minor surgical operations. Adrenalin chloride,
a haemostatic, causes constriction of blood vessels and was used for
checking bleeding after tooth extractions.
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Savory and Moore's Patent Medicated
Gelatine Lamels - Cocaine
Manufactured by Savory and Moore, 1915-1919
Lamels are small squares of gelatine
impregnated with an active ingredient. Savory
and Moore's Patent Medicated Gelatine Lamels,
containing cocaine, were to be applied to the gum
to relieve toothache. They were also used to
relieve the symptoms of a tickling cough or sore
throat.
COCAINE – Use in Eye Surgery and Treatments
The use of cocaine as a local anesthetic in eye surgery was developed in the 1880s by
Carl Koller, an Austrian ophthalmologist (a medical professional who studies and treats
disorders and diseases of the eye). Koller was aware of the tissue-numbing properties of
cocaine and experimented with it for use in eye surgery. In addition to having local
anesthetic properties, Koller discovered that cocaine also dilates the pupil of the eye and
paralyses eye movement.
Koller‟s findings revolutionized eye surgery. Prior to the use of cocaine operating on the
eye was extremely difficult because the eyes respond to the slightest stimuli, causing
involuntary reflex motions. Cocaine allowed surgeons to operate on the eye without the
eye reacting.
Cocaine is now rarely used in eye surgery because it now known to cause corneal toxicity,
leading to damage to the cornea.
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Solution No. 1 - The Eye Drops
Manufactured by Burroughs Wellcome and Company, 1908 - 1920
These eye drops contain 0.5% of cocaine alkaloid. The directions
state 'To be applied to the affected eyeball by means of the camel
hair brush in the bottle'.
Guttilin Ophthalmic Drops - No. 10 Cocaine Hydrochloride 4% w/v
Manufactured by Bengue and Company Limited, 1940 -1969
The glass dropper contains cocaine hydrochloride in the form of liquid for
ophthalmic (eye) drops. The dropper has a bulb at one end, which would be
held and the heat of a hand would increase the air pressure to push out a drop.
Savory and Moore's Ophthalmic Gelatin Discs
containing Cocaine Hydrochloride B.P.
Manufactured by Savory and Moore Limited,
1941-1945
Gelatin discs, containing cocaine, would have
dissolved in the eye providing local anesthesia
prior to removing foreign bodies, such as grit, from
the eye. The directions state “Direct the patient to
gaze upwards, and while the eye is maintained in
this position, draw down the lower lid, and apply
the disc of gelatin with the camel hair brush to the
ball of the eye as low as possible”.
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Vaporole' brand 'Epinine'
and Cocaine
Manufactured by Burroughs
Wellcome and Company,
1924 – 1941
Vaporole' brand 'Epinine'
and Cocaine solution for
hypodermic injection was
used in minor operations on
the eye and nose; and
bleeding wounds and cuts.
'Epinine' is a styptic, causing
constriction of blood vessels, thereby reducing bleeding; while cocaine was used for its anaesthetic
action.
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