Esters of Morphine

Abstract

The International Opium Convention of 1912, signed at The Hague, attempted to establish control over opium, morphine, cocaine, and heroin. It was not, however, very effective. Certainly the manufacture of heroin continued to increase, and huge quantities manufactured "legitimately" were easily diverted into the illicit traffic.

Details

Pages: 36 to 38
Creation Date: 1953/01/01

Esters of Morphine

The International Opium Convention of 1912, signed at The Hague, attempted to establish control over opium, morphine, cocaine, and heroin. It was not, however, very effective. Certainly the manufacture of heroin continued to increase, and huge quantities manufactured "legitimately" were easily diverted into the illicit traffic.

After World War I the Opium Advisory Committee of the League of Nations was greatly concerned about the diversion of narcotic drugs into illicit channels. Whole countries were being debauched. In 1925 a new Convention was signed at Geneva. In some respects it represented a great advance, yet, so far as alkaloids manufactured from opium were concerned, those specifically included in the control measures were still only morphine and diacetylmorphine (heroin). Moreover, this Convention did not come into effect until 1928.

In these circumstances there sprang up a very considerable manufacture of other esters of morphine, analogous in every way to heroin, and having no medical advantages whatsoever. The other esters were in fact simply manufactured to supply narcotics for addiction. The chief one was benzoylmorphine;[*] another was acetylpropionylmorphine.

At the time, international control over heroin was still very weak, but was being established in the European manufacturing countries; whereas control over the manufacture of the new morphine esters in those countries was completely non-existent, and the esters also, for a time, escaped control of the national laws in some other countries, where they were distributed into the illicit traffic, or finally consumed.

Of course, some attempt had been made in the Conventions to forestall such a transparent subterfuge on the part of drug traffickers. However the slowness of countries to react when the drug use was not within their own borders made the weak provisions of the Conventions almost completely ineffective for some time.

The 1912 Convention had made its control measures applicable "To all new derivatives of morphine, of cocaine, or of their respective salts, and to every other alkaloid of opium, which may be shown by scientific research, generally recognized, to be liable to similar abuse and productive of like ill-effects." The requirement that the scientific research be "generally recognized," without any machinery provided by which this could be done, almost cancelled the significance of this provision.

Furthermore, the control measures of the 1912 Convention intended "to limit exclusively to medical and legitimate purposes the manufacture, sale, and use" of the drugs concerned (Article 9). In this Article, the word "legitimate" completely nullified the real meaning and gave some excuse for inaction. The manufacture was "legitimate" in that it was not contrary to the laws of the manufacturing country, but it loosed a flood of poison on other parts of the world.

The new Convention of 1925 was, on the point of the morphine esters, even weaker than the Convention of 1912, for it omitted any reference to "derivatives of morphine" other than the one-diacetylmorphine (heroin)-which was specifically named. Moreover, it seemed to be held by some that the 1925 Convention, when accepted, superseded that of 1912, as the following exchange will show:

(Minutes of the Eleventh Session of the Advisory Committee on Traffic in Opium and Other Dangerous Drugs, 1928, pages 36-37)

"The Chairman recalled the well-known fact that, when a narcotic had been declared subject to the provisions of the Conventions, manufacturers hastened to manufacture another narcotic which might escape the consequences of these provisions, at any rate momentarily. Thus they had adroitly taken advantage of the fact that Article 4 of the 1925 Convention related Only to morphine and its salts to put on the market a product which was not a salt of morphine but a derivative of it, and which, as such, was not under control .... The Chairman added that the question would not arise if the text of article 4 of the 1925 Convention covered, not morphine and its salts, but morphine and its derivatives. This was a question that should be examined when the Convention was submitted for revision ....

"Mr. Lyall pointed out that all derivatives of morphine came within the scope of the Hague Opium Convention of 1912. He was under the impression that Convention was in force. Was he wrong?

"Mr. Bourgois (France) pointed out that the obligations of the Hague Opium Convention of 1912 would still remain when the Geneva Convention of 1925 was in force in the case of those States which had not adopted the latter Convention. States which had adopted both Conventions would continue to apply the Convention of 1912 in the case of those States which were not applying the Convention of 1925."

The provision by which the Convention of 1925 undertook to meet such a situation was its Article 10. This read as follows:

"In the event of the Health Committee of the League of Nations, after having submitted the question for advice and report to the Permanent Committee of the Office international d'Hygiene publique in Paris, finding that any narcotic drug to which the present Convention does not apply is liable to similar abuse and productive of similar ill-effects as the substances to which this Chapter of the Convention applies, the Health Committee shall inform the Council of the League accordingly and recommend that the provisions of the present Convention shall be applied to such drug.

"The Council of the League shall communicate the said recommendation to the Contracting Parties. Any contracting Party which is prepared to accept the recommendation shall notify the Secretary-General of the League, who will inform the other contracting Parties.

"The provisions of the present Convention shall thereupon apply to the substance in question as between the Contracting Parties who had accepted the recommendation referred to above."

This procedure was so cumbersome that it took at least a year and a half to reach the decision, and then it was only a recommendation, which, moreover, had to be affirmatively accepted before it had any effect. And finally, the 1925 Convention did not even take effect until 1928. Thus the decade of the 1920's came to an end before the flood of poison was stopped in all the manufacturing countries, in spite of the moral obligation which, it would seem, had already been expressed in the 1912 Hague Convention.

The situation developed rapidly after 1925: the drug manufacturers were making hay while the sun still shone. The remarks of the Chairman of the Advisory Committee of the League of Nations in 1928 have already been quoted. As a result of the discussion, and consideration of a report by Professor Knaffl-Lenz[**] summarizing the earlier medical and pharmacological evidence and his own observations, the Committee adopted the following resolution:

"The Committee desires to draw the attention of the Council to the attempt which has been successfully made to evade the existing system of control over the traffic in drugs by the manufacture of benzoyl-morphine and other esters of morphine which fall outside the provisions of most national laws but from which morphine can easily be recovered and which, so far as known, are liable to give rise to the same abuse; and it would urgently recommend that, pending the completion of the procedure under Article 10 of the Geneva Convention for bringing such substances within the scope of the Convention, the Governments should immediately apply to benzoyl-morphine, and possibly other similar substances if manufactured, the same control over manufacture, distribution, export and import as in the case of morphine."

Also in 1928, at its 13th session, the Health Committee of the League adopted the following resolution, designed to bring benzoylmorphine and other morphine esters under the control of the 1925 Convention:

"The Health Committee:

"Having taken note of the opinion formulated by the Permanent Committee of the Office international d'Hygiene publique on its report of May 15th, 1928;

"Having noted that dilaudide, on the one hand, and benzoylmorphine and, in general, the morphine esters, on the other hand, are capable of producing toxicomania;

"Decides to inform the Council of the League of Nations, in conformity with Article 10 of the International Opium Convention of February 19th, 1925, that dilaudide, on the one hand, and benzoyl-morphine and the morphine esters generally are narcotics capable of producing harmful effects similar to those produced by products envisaged by the Convention, and that they should, in consequence, be brought within the scope of the Convention."

At its 14th session, in 1929, the Health Committee supplemented this with another resolution, which:

"Places on record that the recommendation made at its thirteenth session concerning the application of Article 10 of the International Opium Convention to 'benzoylmorphine and the morphine esters generally,' should apply to all morphine esters without exception. The possibility of exempting, in conformity with Article 8 of the Convention, those esters, the innocuous character of which may hereafter be clearly demonstrated, is, however, reserved."

At its 15th session, in 1930, the Health Committee again supplemented its previous decisions with the following resolution:

"The Health Committee,

"Consider that preparations which contain esters of morphine, di-hydro-oxycodeinone, di-hydro-codeinone (dicodide), di-hydro-morphinone (dilaudide) should be treated in the same manner as those which contain diacetylmorphine, that is to say, they should come within the scope of the Convention, whatever the percentage of narcotic substances contained may be.

"It also considers that all salts of these substances should come within the scope of the Convention according to the provisions of Article 10 of the said Convention."

This virtually completed (5 years late) the slow process of bringing the morphine esters under full control, so far as this was possible under the 1925 Convention.

What the situation was like at its height may be judged from the following excerpt from the report of the Permanent Central Opium Board on its work during its sixth and seventh sessions:

"Large quantities of these drugs [esters of morphine] were manufactured, and as they are not, as far as is known, used for either medical or scientific purposes, they can only have been intended for the illicit traffic. The Board cannot affirm that its calculations in this matter have any claim to accuracy; but, as far as the information at its disposal allows it to form a judgment, it would seem...that some 12 tons of morphine were manufactured in 1929 and became available for the illicit traffic in the form of esters." (Italics ours.) (C.629.M.250.1930.XI.)

In 1928 six tons of benzoylmorphine were sent to Dairen, destined for China. 1350 kg were seized, but over 4? tons got through, and presumably were used by addicts. Mr. Lyall (Assessor) at the eighteenth session of the Advisory Committee on Opium and other Dangerous Drugs, while commenting on the small penalties imposed on the traffickers (page 67), remarked that "He understood that 1350 kg was equivalent to 270 million maximum medical doses of heroin. If this were so, and if, as he believed, 2700 doses were sufficient to destroy one person body and soul, the quantity in question was enough to bring destruction on 100,000 people." Actually this was the smaller of the quantities referred to, which was seized; the quantity which completely disappeared in the illicit traffic, on this one occasion, was three times as great.

An analysis by the League Secretariat of the international trade in morphine, diacetylmorphine, and cocaine, for the years 1925-1929, indicated that some 36 tons of morphine had been made available for the illicit traffic in the form of morphine esters, or possibly in some cases other drugs not covered by the 1925 Convention. (Report to the Council, Advisory Committee on Traffic in Opium and Other Dangerous Drugs, 14th session, 1931, page 3.) These esters had no medical use and their manufacture was abandoned when controls were imposed.

Full control was imposed in Switzerland as of 1 February 1930; the conversion of morphine into drugs "not covered by the Convention" promptly dropped from 5475 kg in 1929 to 1875 kg in 1930, plus a mere 123 kg of benzoylmorphine, reported separately for the first time in that year.

The most enormous manufacture was in Germany. There the manufacturers converted the prodigious amount of 18620 kg of morphine into drugs "not covered by the Convention" in 1929. With the imposition of controls by the German Government, this amount promptly dropped to 9060 kg in 1930 and to 4060 kg in 1931, where it held fairly steady (5195 kg in 1932 and 4861 kg in 1933). These later figures represented the medical demand for codeine and ethylmorphine, the manufacture of which has been reported as 3890 kg in 1921. To the later figures would also have to be added any conversion of morphine for medical needs into dihydromorphinone, as this was only reported separately after controls were imposed; but the amount only averaged 50 kg annually from 1930 to 1933. It would appear therefore that the medical needs supplied by the German manufacturers could easily have been met by some 6 tons of morphine converted into the products in question, whereas some 18.6 tons were converted in 1929, more than twice as much, it would seem, for addiction as for medical needs.

It is seen that the outpouring of narcotics from Europe in the latter half of the 1920's resulted from several factors: reluctance in some cases to accept international obligations in the narcotics field, defects in the Conventions when strictly construed, the existence of a few utterly unscrupulous manufacturers who were ready to supply the drug traffickers, and the slowness of countries to react when the drug use was in some other part of the world.

It may be pointed out that in spite of the vastly improved provisions of the 1931 Convention for manufactured narcotics, and the 1948 Protocol for new narcotics, some similarity can be seen in the post-war world to the situation described in the preceding paragraph. The factors cited have continued to operate, to some extent and in some countries, both in regard to the manufacture of heroin and also as regards the advent of new analgesics of addicting capacity. Nothing, however, has yet approached the earlier exploitation of heroin or the morphine esters which were used as substitutes for heroin

r001

* Benzoylmorphine must be distinguished from benzylmorphine (Peronin). The latter is a morphine ether, and resembles codeine rather than heroin.

r002

** See the second article by Dr. Knaffl-Lenz in Bulletin, No. 4, Volume IV.