OPIOIDS AND PAIN RELIEF: A HISTORICAL PERSPECTIVE.
Progress in Pain Research and Management, Vol. 25. IASP Press, 2003
Marcia L. Meldrum (Ed)
This is a fascinating collection of essays outlining the history of the use of opioids for pain relief. The authors are a mix of clinicians, laboratory scientists, historians and sociologists,
providing a broad range of perspectives.
Although opioids have been used for thousands of years, it is only recently that we have learned a little about how they should be used to treat pain. Several of the essays describe the prolonged
(and sometimes heated) debates that occurred within the profession only forty years ago until the facts we now take for granted emerged, principally due to the work of Cicely Saunders: that morphine
is effective given orally; that morphine works by relieving the pain, not just by causing indifference to it; and that morphine given to patients with advanced cancer and pain is not associated
with psychological dependence or significant tolerance. I found reading about the recent evolution of our knowledge about the use of opioids to relieve pain both educational and enjoyable.
The shadow cast by the problems of drug diversion and addiction are apparent in a number of the essays. But, examined in a historical perspective, they are not new. Caroline Acker, the leading
historian of addiction science, argues convincingly that an examination of history would have revealed ‘ample precedents’ that OxyContin would be misused.
Informative and enjoyable.
Roger Woodruff
Director of Palliative Care, Austin Health, Melbourne, Australia
August 2004
Author Information
Marcia L. Meldrum works in the John C. Liebeskind History of Pain Collection in the Louise M. Darling Biomedical Library and the Department of History, University of California Los Angeles,
Los Angeles, California, USA
Table of Contents
1. Opiophobia and Opiophilia. John D. Loeser
2. To Market, to Market: The Theory and Practice of Opiates in the Middle Ages. Walton O.
Schalick III
3. "The Grandest Badge of His Art": Three Victorian Doctors, Pain Relief, and the Art of
Medicine. Martha Stoddard Holmes
4. Take as Directed: The Dilemmas of Regulating Addictive Analgesics and Other
Psychoactive Drugs. Caroline J. Acker
5. Analgesic Research at the National Institutes of Health: State of the Art 1930s to the
Present. Kenner C. Rice
6. The Rise and Demise of the Brompton Cocktail. David Clark
7. The Dawn of Endorphins. Huda Akil
8. Taking the Myths out of the Magic: Establishing the Use of Opioids in the Management
of Cancer Pain. Christina Faull and Alexander Nicholson
9. The Opiate Receptor: Scientific Treasure Trove. Marcia L. Meldrum
10. History of the Development of Pain Management with Spinal Opioid and Non-Opioid
Drugs. Michael J. Cousins
11. The World Health Organization Cancer Pain Relief Program. Mark Swerdlow
12. The State Cancer Pain Initiative Movement in the United States: Successes and
Challenges. June L. Dahl
13. Opioids, Cancer Pain, Quality of Life, and Quality of Death: Patient Narratives and a
Clinician’s Comments. Nessa Coyle
14. The Property of Euphoria: Research and the Cancer Patient. Marcia L. Meldrum
