David Herzberg's "White Market Drugs"

David Herzberg is associate professor of history at the University at Buffalo. He is the author of Happy Pills in America: From Miltown to Prozac.

He applied the “Page 99 Test” to his new book, White Market Drugs: Big Pharma and the Hidden History of Addiction in America, and reported the following:

Page 99 tells the origin story of Pantopon, a would-be miracle opioid introduced in the U.S. by Roche Pharmaceuticals around 1910. Pantopon was supposed to be a sort of organic, all-natural opioid. Most opioids were either a single alkaloid extracted from opium (like morphine) or were produced by tinkering with one of those alkaloids (like heroin or diacetylmorphine). Pantopon was an injectable form of opium, containing all its alkaloids in their natural proportions and thus offering patients what advertisers called “the full therapeutic value of the mother drug, opium.” But like all other opioid wonder drugs before OxyContin, Pantopon was swatted down by federal regulators who insisted that even the “mother” opioid needed to be sold with great caution.

From page 99 browsers will get a great sense of one of the book’s main threads: the century long game of cat and mouse played between Big Pharma trying to make a killing from selling psychoactive (and addictive) drugs, and federal regulators trying to restrict all that potential profit and instead harness the market to medical purposes. This is a crucial story for anyone interested in drug policy, and readers of page 99 would get a good start on it.

What page 99 readers would miss, however, is the other half of this story, equally crucial for drug policy. A story not about supply-side restrictions, but about drug availability and access. For over a century we have been testing out various ways to sell potentially addictive drugs safely, at scale, to millions of Americans in medical “white markets.” We can apply the lessons learned from this historical laboratory to our other drug policy, punitive prohibition, which America has also tested, with radically worse results, for over a century.

Page 99 thus gives a glimpse at part—but only part—of a central argument in the book. Psychoactive drugs are highly desirable and highly dangerous. Access to them should be determined neither by profit (as would happen with libertarian legalization) or by social hierarchies of race, class, and gender (as happens with punitive prohibition). To protect the public health, we need to chart a path between prohibition and free markets. Remembering the forgotten history of pharmaceutical opioids before OxyContin gives us a chance to be guided by experience as we do so.

Visit David Herzberg's website.

--Marshal Zeringue