Drug Control Policy of United Kingdom - Essay Example

Why were opiates and cannabis acceptable as medicines in 1800 and yet the of considerable controversy by 1900 in the United Kingdom Introduction The term opioid refers broadly to all compounds related to opium. The word opium is derived from opos, the Greek word for "juice," the drug being derived from the juice of the opium poppy, Papaver somniferum. Opiates are drugs derived from opium. Opioids have been the mainstay of pain treatment for thousands of years, and they remain so today. Opioids such as heroin and morphine exert their effects by mimicking naturally occurring substances, called endogenous opioid peptides or endorphins. The diverse functions of this system include the best known sensory role, prominent in inhibiting responses to painful stimuli; a modulatory role in gastrointestinal, endocrine, and autonomic functions; an emotional role, evident in the powerful rewarding and addicting properties of opioids; and a cognitive role in the modulation of learning and memory. The first undisputed reference to opium is found in the writings of Theophrastus in the third century B.C. Arab physicians were well versed in the uses of opium; Arab traders introduced the drug to the Orient, where it was employed mainly for the control of dysenteries. During the Middle Ages, many of the uses of opium were appreciated. In 1680, Sydenham wrote: "Among the remedies which it has pleased Almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium." Opium contains more than 20 distinct alkaloids. In 1806, Sertrner reported the isolation of a pure substance in opium that he named morphine, after Morpheus, the Greek god of dreams. By the middle of the nineteenth century, the use of pure alkaloids in place of crude opium preparations began to spread throughout the medical world. In addition to the remarkable beneficial effects of opioids, the toxic side effects and addictive potential of these drugs also have been known for centuries. These problems stimulated a search for potent synthetic opioid analgesics free of addictive potential and other side effects. Unfortunately, all synthetic compounds that have been introduced into clinical use share the liabilities of classical opioids (Booth, 1996). Since the earliest times, people have used opium, which is the parent drug of a group of chemicals called narcotics. Narcotics can be used for good or bad purposes. When used in appropriate indications, narcotics are important medications in the treatment of pain. They are the standard against which the effectiveness of other pain treatments is measured. People who suffer from long-term or excruciating pain must be treated with medically prescribed narcotics. Narcotics are a group of drugs with chemical structures similar to that of opium, a medicine derived from the sap of the opium poppy. Some are isolated directly from the opium poppy, but others can be made in the laboratory. Narcotics derived from the natural plant source are called opiates, and they include opium and its active ingredients, morphine and codeine. Any drug that is made in the laboratory is described as synthetic, or man-made. Synthetic narcotics are collectively known as opioids and they include heroin, hydrocodone, and fentanyl (Booth, 1996). These drugs relieve pain and produce great satisfaction in pain relief. Along with relief of pain, these also induce a change in the mood and behaviour, enhancing the sense of wellbeing or relief. All pain is associated with some anxiety, and they work in this area very satisfactorily. It is questionable whether these have any analgesic effect at all, but it is certain that it eases the pain to the limit of tolerability leading to an alteration of pain perception. Opiates have several other effects on the body. These constrict the pupils of the eye, slow respiratory rate, and dilate the veins of the skin, making the body look flushed and feel warm. They slow down the digestive system, including the activity of the intestines, and have been used for centuries to treat diarrhea. They have a calming action on coughs and can be administered in their treatment. Narcotics can also cause nausea and vomiting. At high doses, they affect consciousness, making it difficult for a patient to maintain a train of thought without some form of external stimulation. Extremely large amounts can bring on coma or a state of unconsciousness. During the 1800s opium was generally looked on as a treatment and a cure, not a drug of addiction. In fact, at that time the word addiction had little or no meaning to most people. Vials containing opium were cheap and readily available. Even though some people considered it to be as unrespectable as alcohol, many others embraced the drug enthusiastically. D.J. Collis Browne's Chlorodyne was an opium-based formula for treatment of cholera. The medicine survives today with modified ingredients. In its footsteps followed Godfrey's Cordial, one of several opium-based soothing baby syrups. Sales of this baby syrup were enormous. In 1862 a pharmacist in Nottingham estimated that he sold twelve thousand doses a week. Most were bought by poor women who had to work long hours and take care of children. Soothing syrups helped keep the children quiet. In poverty-stricken families, the syrups may have had an additional positive side effect. They suppressed hunger and therefore saved on food (Berridge, 1999) (Jay, 2005). This indicates that in the 1800s these medications were not only used by people with pain, these were culturally very much acceptable to the English population. This has been a power painkiller in the sense that these are respected as drugs of choice in the painful conditions that are not amenable to usual treatments. Quite a number of people suffer from the pain of headaches, backaches, muscle pains, neck pains, and long-term health problems without being effectively treated by other medications. Physicians reserve opiates to treat the most serious of these painful conditions because they are extremely effective in reducing pain. However, to extract the maximum benefits, it needs skillful prescriptions, and only then, the patients are not sleepy or confused. Therefore thousands of people benefit from treatment with opiates, and whether used medically or illegally, opiates are part of life for these people. However, many do not understand the dangers of narcotics (Booth, 1996). Anyone who uses opiates or cannabis can face addiction, overdoses, and other negative consequences whether the drugs are prescribed or used recreationally. The dangers of opiate or cannabis addiction are many, and they include death. Taking a fatal overdose is easy to do. Accidental overdosing can happen if a drug addict uses opiates of unexpected high quality. Moreover even though these fatalities would not occur, these can cause addiction or dependence. Addiction can consume a person, changing personality so drastically that some narcotic addicts have suffered loss of families, friends, jobs, and homes (Mills, 2003). The other opiate of concern is cannabis, which is functionally related to the opiates. It has a history of centuries of use that continued into the 1800s. The 1764 edition of The New England Dispensatory recommended hemp roots to treat inflamed skin. The 1794 Edinburgh New Dispensary prescribed marijuana oil for many problems, including incontinence, coughs, and venereal disease. Nevertheless, it was very rarely professionally used in England or Europe may be due to the reason the treatments were not optimal. As more case studies attested to the drug's utility, the demands for it increased. Financial incentives grew with the demand, and soon quality preparations became more accessible. Much of this credit goes to the Irish physician, William O'Shaughnessy, whose experiments aroused great interests in its therapeutic use (Mills, 2003). In 1883, Dr. O'Shaughnessy conducted some studies while in his position in Medical College of Calcutta in the British East India, due mainly to the fact that medical care in India was in its infancy, and he came to know that indigenous medicine used cannabis as a common remedy for many conditions. He wanted to further probe into the matter and therefore to investigate its impact in many diseases. The results of his study were published in the year 1842 in the Journal Transactions of the Medical and Physical Society of Bombay. His animal experiments demonstrated greater intoxication in carnivorous animals, but with these he was certain that this drug was potentially safe. Subsequently his researches on humans have demonstrated benefits in people with rheumatism. The treatment with cannabis was demonstrated to be useful for pain along with enhancement of mood and appetite. Dr. O'Shaughnessy included in his study patients with rabies, cholera, tetanus, and epilepsy, and this was limitedly successful in alleviating the discomfort (Berridge, 1999) (Jay, 2005). It had no actions on the disease process, but it could demonstrably ease the pain, nausea, and spasticity with these diseases. When this information reached England, it became increasingly popular there. Later cannabis was used mainly as a medicine in England. Even Queen Victoria was prescribed cannabis by her doctor in 1890. Consequently, cannabis was declared harmless and legalized in 1901.However, in 1925, the Geneva Convention included cannabis and hashish in the list of dangerous and illicit drugs. In the last 40 years, the debate on the safety and legal status of cannabis-based medical treatments is becoming increasingly intense at both political and scientific levels. Even now, the general use of marijuana to treat the pain and eating problems of cancer patients as well as to reduce intraocular pressure in glaucoma is still not legalized. The alcoholic extract of cannabis was reported to improve appetite, sexual interest, mental disorders, gout, cholera, hydrophobia, and insomnia. It was a very reputed drug medically, and in 1890, Sir J. Russell Reynolds, the chief physician of the queen praised the drug in the Lancet (Berridge, 1999) (Jay, 2005). J. J. Moreau, the first nineteenth-century psychiatrist with an interest in psychopharmacology, described in great detail his experiments with hashish. The effects on one of his assistants, who swallowed 16 g of an extract, presumably containing several hundred milligrams of tetrahydrocannabinol (THC) which we know today to be the major psychotropic principal of cannabis, were intense agitation, incoherence, delirium and hallucinations. Moreau declared that 'there is not a single, elementary manifestation of mental illness that cannot be found in the mental changes caused by hashish, from simple manic excitement to frenzied delirium, from the feeblest impulse, the simplest fixation, the merest injury to the senses, to the most irresistible drive, the wildest delirium, the most varied disorders of feelings'. He considered hashish intoxication to be a model of endogenous psychoses, which could offer an insight into the nature of psychiatric diseases. Some of the effects described by Moreau were obsessive ideas, irresistible impulses, persecutory delusions and many others. These are certainly seen in psychiatric patients. About the same time O'Shaughnessy in India experimented with charas, the local brand of cannabis, as a therapeutic drug. As mentioned earlier, ethanol extracts or tincture of cannabis resin were administered to patients with rheumatism, tetanus, rabies, infantile convulsions, cholera and delirium tremens. These diseases were chosen in order to confirm well-established local medical traditions. Further trials with lower doses gave closely analogous effects: 'alleviation of pain in most - remarkable increase of appetite in all - unequivocal aphrodisia, and great mental cheerfulness. The disposition developed was uniform in all'. O'Shaugnessy also noted that cannabis was a potent antiemetic agent. Donovan confirmed many of O'Shaugnessy's observations, in particular the potent anti-inflammatory effects. He also observed the effect of causing hunger and suggested its use in anorexia. Russell Reynolds recorded that cannabis is 'absolutely successful for months, without any increasing dose, in cases of senile insomnia'. In mania, cannabis was 'worse than useless'. He found no effect in depression. However, subsequently many studies have been conducted that indicate that exposure to cannabis may precipitate the onset of psychosis in vulnerable subjects. Investigations of the short- and long-term effects of cannabis exposure demonstrate that cannabis interacts with psychosis vulnerability not only in the acute induction of psychotic experiences, but also in the onset of clinical psychosis. Cumulative exposure to cannabis may induce persistent psychotic symptoms in vulnerable subjects, and the subsequent course of these symptoms may become at least in part independent of the exposure to cannabis (Berridge, 1999) (Jay, 2005). The Opium Wars Thus, although the practice of using opiates as a medicine has been around for many years, the non-therapeutic qualities of this drug were realized early in its history. With no other drug available to match their potency and efficacy using opiates as a medicine to treat ailments like pain, dysentery, and insomnia would remain popular for years. Cannabis was not much used in this time; however, although it gained no parallel popularity as opiates, the addictive potential of the drug was also known from the earlier times. As the population of the world expanded and became more interconnected and industrialized over time, the medicinal use and subsequent abuse of opium or other narcotic agents reached its zenith in the 18th to 19th Century England. During this time period, there were several factors that contributed to the rapid spread of opium use and abuse throughout Asia, Europe, and North America including United Kingdom. In the 18th century, the British loved Chinese tea, but had great difficulties obtaining this product. Given that the Chinese viewed all things foreign as barbaric, the value of British-borne products was somewhat limited to the Chinese. The answer to the British-Chinese trading problem would come in 1773, when British forces conquered the Bengal Province in India, then the world's leading producer of opium. With this victory, the British had a monopoly on the production and sale of opium. As such, the British now had an ideal commodity for trade with the Chinese. Trading opium to China for Chinese goods proved quite a lucrative business for the British. The Chinese not only desired opium for its medicinal value, but soon for recreational purposes. Not surprisingly, as use of opium increased within the Chinese population, an opium epidemic would soon grip China. The Chinese Emperor responded to this problem by issuing an edict banning all opium use by the population. Unfortunately, this failed to curb the problem and, in 1839, the Emperor ordered Chinese forces to confiscate and burn all opium brought in by British ships. Thus, the Opium Wars began (Harding, 1988). Importance For approximately 3 years, the British and Chinese fought until, finally, British artillery and warships overwhelmed the Chinese forces. As a result of the loss, the Chinese were forced to capitulate both land and trading rights to the British. In fact, as a result of the Opium Wars, the island of Hong Kong would become a British colony until it was returned to Chinese control in the year 2000. In the United Kingdom, however, anti-opium agitation in the later nineteenth century evolved. A constellation of additional factors, centered on the industrializing west, brought the opium question to governmental attention. Occidental developments in medical practice and organization, technological advances, commercial interests, social reform movements, cultural anxieties, the advent of international organizations, religious sentiment, and the world's geopolitical configuration all shaped the manner in which drug control became an issue of importance (Harding, 1988). Mass Opinions British and American missionaries, who occupied the leading positions among those proselytizing in China, became stalwart opponents of the international opium trade. Missionaries cited opium as a key impediment. Addiction ruined lives and deadened morals; Westerners' association with the drug damaged churches' reputations among the people. In the second half of the nineteenth century, British clergy founded several anti-opium societies dedicated to ending India's role in debauching China, and the anti-opiumists publicized the immorality of the trade. Generating numerous petitions to lay before the government, they secured Parliamentary allies who vigorously interrogated the Queen's ministers. Women provided crucial support in the anti-opium campaigns, exercising their maternalist prerogatives for a cause they believed morally just. Agitation crested in the 1890s, culminating in an official investigation. It is noteworthy that although these movements could not do much to revert the trade relationships, they indicated a change in the perception of population about the opiates. In the second half of 19th century, an emergent English mass culture became the site of conflict over British opium regimes. This English mass public sphere contained material that contradicted or compromised official British apologies for opium. One example is the Friend of China. This was a small newspaper and represented a set of minority views. However, in relation to opium trade, it could create a sensation movement at that time. The Friend of China was the official voice of the Society for the Suppression of the Opium Trade or SSOT. This was, in turn, a reform group founded by the wealthy Quakers in 1874. As has been mentioned earlier, this society supported a Christian outlook, tactics, and supporter base among the elite English. They spread the message that the British Government had forced opium on China. They generated a continuous and repetitive propaganda against opium and presented it to the British public and English speaking countries. They intensified their agenda with anti-opium meetings, petitions, signatures, posters, and leaflets. These have generated general mass opinion against opium or its use, and this had a considerable impact on the prior fabric of a culture where self-medication was the norm and access to formal medical care extremely limited. Opium was a commodity like any other in a largely unregulated system. Other issues were overdosage, adulteration, and variability of control (Harding, 1988). Changes These and other issues were what lay behind the transition to the second British System in the middle of the nineteenth century. This was the system of pharmaceutical regulation. The question of professional status in the pharmacists also played important roles. Pharmacists were establishing a profession of pharmaceutical chemists at this time, based on the existing chemists and druggists and apothecaries, whose main concern was dispensing. Specialist status meant preventing unqualified people from selling drugs, and trying also to regulate the ways in which the general public controlled their own medication. Opium, as such a widely used commodity, naturally came into the story. The 1868 Pharmacy Act subjected opium to pharmaceutical control, but with minimal restrictions. The Act specifically excluded patent medicines, many of which were opium based. Further controls over patent medicines were put in place in the 1890s. So the century ended not with one system replacing another, but rather with overlapping systems. There was still a lay commercial system; and a pharmaceutical one as well, also with a strong commercial element. Within Britain, opium gradually lost its cultural acceptibility, and with advent of new technologies and new discoveries, such as syringes and needles, synthesis of morphine, and later heroin impacted the situation further towards a change. With this, the medical profession was changing its role visibly. Outside Britain, the role of opium as an international commodity kept changing with the influence of international regulatory control system (Berridge, 1999) (Jay, 2005). Discovery of Morphine Although there is some dispute as to the exact date of the discovery, it is generally accepted by medical historians that the basis for opium's potent effects was discovered somewhere between the years 1805 and 1816 by Friedrich Wilhelm Sertrner. He was a pharmacist's assistant who was intent on learning why opium produced the effects that it did, that is, its underlying principle. As the story goes, Sertrner was able to isolate a yellowish-white crystalline compound from raw opium by immersing the drug in hot water and ammonia. He experimented on the product that he had synthesized, and he found that this new compound like opium, could relieve pain and induce euphoria. However, it was also clear that, in sufficient doses, this compound would produce a dysphoric feeling, respiratory depression, nausea, vomiting, depression of the cough reflex, and constipation. The most significant finding perhaps related to this assignment is that it was approximately ten times as potent as opium in relieving pain, so that less of the drug was needed to produce the same effect. It was named morphine for the reasons described before. The findings about morphine's potency and potential as a medicine was grabbed by the pharmaceutical companies, the commercial production of this drug quickly began in the mid-19th century. It was not only touted as an alternative to opium, but, surprisingly enough, as a cure for opium addiction and dependence. The public reaction to this product was different from earlier. Their resistance to acceptance was tremendous, since they thought that it would be another that would have addictive and dependence potentials. During this time, both opium and cocaine addiction were widespread during this era. Further, at this time it was believed that addiction and dependence were phenomena that resulted from ingesting and digesting drugs rather than by the direct effects of the drugs in the brain. In fact, most medicines of that time were administered as tonics like laudanum or as snuffs like cocaine and produced high degrees of addiction and dependence. Thus, morphine was not going to be accepted as a medicine until a suitable and alternative delivery method for the drug could be found (Parssinen, 1983). Hypodermic Needle The situation with morphine changed in 1853 when a new invention called the hypodermic needle was perfected. Back in the 1800s, hypodermic needles were made of a combination of glass and metal. Specifically, the original hypodermic needles comprised a large glass tube, which held the drug solution, with a wide opening at one end and a narrow opening at the other end. At the narrow opening of the tube, a needle would be attached that was sharp enough to puncture the skin with minimal damage. At the large opening of the tube, either a metal or glass plunger would be inserted to push the drug solution through the needle. Thus, drugs would no longer have to be taken orally but could rather be injected directly into the body at a specific location. Surprisingly, such an invention lessened the public's skepticism about taking newly developed drugs like morphine. With the advent of the hypodermic needle, morphine as a medicine was quite effective and acceptable; for example, it was used to relieve pain and diarrhea experienced by soldiers living in deplorable conditions while at war. It was neither long nor surprising, however, before the addictive potential of morphine began to appear. Soldiers who were given morphine during times of war would come back to society addicted and dependent on the drug. In fact, morphine dependence would soon earn the nickname "Soldier's Disease." Furthermore, morphine addiction and dependence would quickly spread throughout the general public. In fact, as acceptance of morphine and its new delivery method grew, vials of morphine and hypodermic needle kits would begin popping up in medicine cabinets throughout society. Morphine addiction and dependence knew no social class or boundaries. As such, another drug pandemic gripped society, but this time, it was with morphine. For a doctor using controlled medicine, hypodermic needle was a method for delivering a dose with precision, whereas, for an addict, it was an avenue to abuse as much amount as possible (Parssinen, 1983). Addiction For the next several decades, as international laws became tougher and the licit opium trade significantly curtailed, crime syndicates increasingly emerged as the new movers and sellers of opium. Even with harsh new laws, the demand for opium continued, and the only real change was the name of the seller. Nevertheless, by the early twentieth century, the public no longer viewed opium as a gift from the heavens. Instead, the majority regarded it as a most terrible demon. Scientists have conducted a never-ending search for effective cures for opium addiction, morphine addiction or morphinism, and heroin addiction. For most of its history, opium addiction was treated as a disease with no cure, and doctors concerned themselves with treating the symptoms of addiction rather than the root cause. As a result, other opiates were used to lessen the effects of withdrawal. The addict is placed on a regimen of opiates that slowly decrease over time, weaning the addict from his or her addiction. This process of treatment is still used today. Over the years, scores of seemingly counterintuitive methods have been tried to cure the addict. When morphine was first isolated and synthesized, it was considered to be, and utilized as, a cure for opium addiction. Later, heroin was created, and used as a treatment for morphinism (Courtwright, 2007). Heroin When the antiopium movement was taking a peak, scientists convinced of opium's great medicinal potential began to study the drug more closely. Scientists were trying to discover and isolate opium's central chemical, which was unknown at the time. Over the following decades, many of the other alkaloids in opium were isolated, including codeine in 1832, thebaine in 1835, and papaverine in 1848. Morphine, however, became increasingly more popular as both a medicinal and recreational product. By the latter half of the eighteenth century, as morphine revealed itself to be a menacing drug creating countless addicts, scientists again examined and manipulated the compound in an effort to find a cure for morphinism. In 1874, pharmacist C. R. Alder Wright stumbled across a new, more powerful formulation of morphine. Through a process of boiling morphine with acetic anhydride, a new chemical called tetra-ethyl morphine was created. Years later, in 1898,Heinrich Dreser, a chemist working for Bayer Laboratories, conducted a series of clinical tests with the previously discovered tetra-ethyl morphine. Dreser found that the new compound had incredibly strong pain-relieving qualities. Now officially under the marketing control of Bayer Laboratories, the drug was mass produced and advertised as the new wonder drug. In coining a brand name for the new product, Dreser used the German word "heroisch", meaning heroic, and called the product heroin . Addiction and British Response Heroin was at first welcome as a new wonder drug that could effectively reduce coughs and control respiratory problems. Later, although it is much more potent than morphine, heroin was advertised as a cure for morphine addiction. Originally, heroin was distributed in pills and even as cough lozenges. Within just a few years, heroin became a popular drug, widely used throughout the United States and Europe including UK. It did not take long, however, for medical professionals to realize the addictive nature of the drug, and they quickly stopped pronouncing heroin to be a useful drug and began to speak out against its use. General Medical Council was very much active since they observed that heroin was hitting communities who had never been hit before. Heroin was no longer restricted to London or other major cities. Towns were touched by heroin addiction for the first time, and this socially infectious condition could be tracked as it spread like an infectious disease. Cultural positioning is an important variable underpinning the acceptability of any substance. There is some evidence that by the early years of the twentieth century, opium was less a part of everyday culture. Counter prescribing and self-medication with opium-based remedies continued, as the reminiscences of pharmacists indicate. But access to medical treatment was easier-in particular for insured workers, primarily men, after the 1911 National Health Insurance Act (NHI Act). Other drugs were favoured as more modern - aspirin and the barbiturates. In hospital practice, there was greater resistance to using opiates which were considered to be 'old fashioned', but research on medical case books has shown that their use continued to be widespread among grass-roots medical practitioners in the early decades of the century. With the strict regulations, factually opiates were not accessible to people without prescription outside a pharmacy. As expected, the number of regular users reduced, and the opiate-related mortality rate reflected a decline. There were still regular opium-using customers in pharmacists' shops, and also a middle-class morphine-using population, generally of a higher social status. But numbers of the former were not as high as they had been (Berridge, 1999) (Jay, 2005). Role of Medical Profession At the same time, the role of the medical profession as a means of control was also increasingly important. Regulation by means of the prescription pad assumed enhanced importance after the 1911 NHI Act, which in general gave doctors a heightened role in terms of access to medicines. New technology also impacted on this situation. The arrival of the hypodermic syringe at midcentury was associated with the injection of morphine, the alkaloid of opium. Although hypodermic injection of the drug was by no means a medical monopoly, the profession was, via this technology, beginning to re-position its relationship to the drug. It was a significant 'gateway' for controlling medical treatment. At the same time, the emergence of theories of disease in relation to the continued use of opiates, including that of hypodermic morphine, gave the profession a dual role. Doctors were establishing control of access for the treatment of medical conditions, which needed opiates; and, at the same time, establishing the theoretical basis for seeing continued 'non-medical' use of these substances as a condition, which also required medical treatment. This medical 'British system' was emergent by the last quarter of the nineteenth century, but given heightened importance by the changed relationship between the state and the profession after the 1911 Act (Berridge, 1999) (Jay, 2005). Conclusion Laws have become stricter and limited success has been made in raising public awareness concerning the dangerous nature of opium and its constituents. The trade has not stopped, however; it has only changed hands. In the past, the demand for opium created a large and complex distribution chain, complete with opium producers, suppliers, manufacturers, distributors, and consumers. Today, that trade, while now primarily in the form of nonmedical pharmaceutical use and heroin, is equally complex and perhaps even more profitable than ever. Reference List Berridge, V., 1999. Opium and the people: opiate use and drug control policy in 19th and early 20th century England. London & New York: Free Association Books. Booth, M., 1996. Opium a history. London & New York : Simon & Schuster. Courtwright, D, T., 2007. Forces of habit: drugs and the making of the modern world. Cambridge mass', London: Harvard University Press. Harding, G., 1988. Opiate addiction, morality and medicine. Basingstoke & New York: The MacMillan Press Ltd. Jay, M., 2005. Emperors of dreams: drugs in the 19th century. Sawtry: Dedalus. McKenna, T., 1992. Food of the Gods. London, Sydney, Auckland, Johannesburg: Rider. Mills, J, M,. 2003. Cannabis Britannica: Empire , trade, and prohibition 1800-1928. Oxford: Oxford University Press. Parssinen, T, M., 1983. Secret passions, secret remedies: narcotic drugs in British Society 1820 1930. Manchester: Manchester University Press. Read More