The Blockbuster Wonder Drug of 1899

: Medicine is energized by a miraculous new drug that quickly becomes a blockbuster in the vein of Viagra and Lipitor.

Tuberculosis and Pneumonia are the leading killers of the day (after those two old standards, war and hunger). With antibiotics yet to be invented, patients either suffer, or temper their suffering with cough suppressing syrups and lozenges, before eventually dying. The most effective remedies are laced with the leading cough suppressant: codeine. The market for medicines that target respiratory illnesses is booming.

Not surprisingly, the exciting newcomer is also a cough suppressant. Like codeine, it is derived from opium, but is far more effective and appears to have fewer toxic side effects. And because it is also an excellent sedative, the new drug gives patients the added benefit of a good night’s rest! The manufacturer, Bayer, markets it aggressively, mailing free samples to thousands of doctors. And the doctors love the drug, because it actually works. They make it an overnight sensation. By the end of 1899, Bayer produces over a ton of the new medicine, exporting its curative powers to over 23 countries.

The drug simultaneously emerges as the strongest painkiller known, about thrice as effective as its close relative, morphine, and faster acting. And though both medicines are derived from opium, Bayer’s new wonder is widely thought to be non-addictive! More than anything, the new drug just makes you feel good. In fact, the medicine makes you feel so good, you feel positively heroic. “It makes us feel heroisch”, say Bayer’s German employees on whom the drug is first tested. A name, brand and trademark are born in a flash: Heroin.

Heroin really explodes in the United States, which has the world’s largest unregulated market for snake oil ‘patent’ medicines (this is still the case, although the unregulated medicines are now called ‘supplements’ and ‘herbal remedies’). The US public readily accepts magic cure-alls of any kind and Heroin rapidly finds its way into cough syrups, lozenges, tablets, salts and elixirs. The medical community is just as impressed by heroin’s wide ranging benefits and even prescribes it to cure colic in babies!

Heroin also earns the growing support of the estimated 250,000 morphine addicts in the United States (a per capita addiction rate that is double that of today). Heroin has thrice the buzz of morphine. It is cheaper, easier to use and extremely easy to buy – just pick up a cough lozenge at the local drugstore. Best of all, it is widely hailed as a non-addictive morphine substitute. What could be better?

Bayer literally stumbles upon Heroin. In 1897, Felix Hoffman, a Bayer chemist, is working on synthesizing codeine from opium. Hoffman is on a roll. Only two weeks earlier, he has invented a technique to transform salicylic acid into acetylsalicylic acid (ASA). Salicylic acid, derived from willow bark, has long been used as a painkiller and anti-inflammatory agent, but is severe on digestive systems. Hoffman’s new compound provides the same benefits, but is gentler on the stomach. In a pattern common to medical discoveries, Felix Hoffman fails in his original goal of synthesizing codeine, but instead rediscovers a compound first found 25 years earlier – diacetylmorphine.

It is remarkable that in the span of 2 weeks, one man formulates the compounds that will become the two most commonly used drugs on the planet. In the 21st century, ASA – Aspirin – remains the world’s most heavily used legal drug, with over 40 billion doses consumed each year. Diacetylmorphine – Heroin – is the most heavily used illegal drug.

Bayer immediately recognizes that Heroin is special and is confident that it will be popular. But it is not impressed with ASA at first and shelves it. Bayer executives worry that ASA will steal Heroin’s thunder, which they believe will be extraordinarily successful. They also worry that ASA may not be good for the heart! Fortunately for the world, Bayer bigwigs acknowledge the value of ASA as a painkiller – and in early 1899, trademark the compound under the name Aspirin. Ironically, over 80 years later, a British scientist named John Robert Vane will win the Nobel Prize for showing that Aspirin is actually good for the heart, and Aspirin will become a key weapon against cardiac disease.

As 1899 draws to a close, Heroin’s medical future looks bright. So does Bayer’s, with profits surging. The only hitch on the horizon is the occasional report of a patient developing a “tolerance” to Heroin. And some doctors are wondering why their patients have taken to drinking so much cough syrup. But no one is too concerned and the issues with Heroin, if they are such, seem like a small price to pay for just feeling good.

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