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Pathways of Addiction: Opportunities in Drug Abuse Research
illicit drugs and drug users and also provide insights into the relationship between scientific findings and drug policy.
Most of the modern problems, as well as the benefits, resulting from drug use are the outcome of scientific and technological progress. Excluding distilled spirits, the first addictive ingredient isolated from a natural product was morphine, which was extracted from crude opium by F.W.A. Serturner, a German pharmacist, in 1806. Increasingly widespread use of morphine, which constitutes roughly 10 percent of crude opium, revolutionized pain control.
One of the first careful studies of morphine addiction was made in 1875 by Levinstein, who identified key elements in opiate addiction that would interest researchers: the fixation on the drug that made it the highest priority even when the user's life situation was deteriorating, and the curious phenomenon of withdrawal that could be reversed quickly by giving more opiate (Levinstein, 1878).
Around the turn of the century, several new medical research issues attracted investigators: communicable diseases, bacteria, and viruses; the immune system, with its antibodies and antigens; autointoxication, or the body poisoning itself; the endocrine glands and their production of hormones; and the rapidly developing fields of biochemistry and pharmacology. A number of researchers in the United States and abroad attempted to apply those contemporary approaches to the study of illicit drug abuse, addiction (specifically, opiate addiction), and its treatment.
A particularly popular line of research related to discoveries about the immune system and concerned the possible creation in the user's body of either antibodies or a toxin to morphine. This research attempted to parallel the success of antitoxins to diphtheria and tetanus. Gioffredi reported in 1897 that serum from addicted dogs could be injected into kittens, who were then protected against large doses of morphine (Gioffredi, 1897). In 1914, Valenti stated that he had extracted serum from dogs undergoing the abstinence reaction and was able to produce similar effects by injecting the serum into normal animals—giving support for the hypothesis that a toxin produced abstinence effects (Valenti, 1914).
Application of the concept of ''autointoxication" to research on narcotic dependence emerged from the theories of Elie Metchnikoff, who won a Nobel Prize in medicine in 1908 for his work on toxins thought to be the product of fermentation in the large intestine (Metchnikoff, 1901). Other theories applied to drug addiction in the early 1900s included the blockage of endocrine gland passages (Sollier, 1898), changes in cell protoplasm (Cloetta, 1903), degenerative changes in brain cells (Wilcox, 1923), or changes in cell permeability (Fauser and Ottenstein, 1924). One other approach, exemplified by the New York physician Dr. Ernest S. Bishop, led to the claim that as long as the toxin or antibodies were balanced by a