NCJ Number
154381
Date Published
1988
Length
7 pages
Annotation
This paper presents the pro and con arguments for the limited legalization of heroin for use in the medical treatment of intractable pain and compares heroin's analgesic qualities to those of currently available and equivalent pharmaceutical alternatives.
Abstract
The principal argument for the use of heroin as an analgesic is that it is more potent than other pain killers and can therefore be administered in smaller doses than most other narcotic analgesics, including morphine. Those who oppose the limited legal use of heroin in this manner argue that the action of morphine in larger doses is generally equivalent to that of heroin, and in either case, dosage must be below that which would produce respiratory arrest. Narcotics control authorities do not want addictive heroin to be legalized for medical use, since this would require careful surveillance of lockup cabinets in hospitals. To determine the possible value of heroin compared to other powerful analgesics, the Federal Government has sponsored controlled studies by researchers at the Vincent T. Lombardi Cancer Research Center of Georgetown University in Washington, D.C., and the Memorial Sloan-Kettering Cancer Center in New York. The Sloan-Kettering study was designed to determine the relative potency of intramuscular heroin and morphine in cancer patients with postoperative pain. Based on these studies, apparently heroin has no analgesic superiority over morphine or even some other powerful narcotics such as hydromorphine or methadone. Also, the Food and Drug Administration (FDA) approved a high potency formulation of hydromorphone named Dilaudid HP on January 11, 1984. The FDA noted in its press release that the drug "will provide pain relief as great as can be obtained with any other narcotic, including heroin, and can be delivered in a very small volume." 6 footnotes