Drug Injection - History - Origin and Early Use

Origin and Early Use

The hypodermic needle & syringe in its current form was invented by the French scientist Pravaz in 1851 and became especially known during the wars of that and the subsequent decade, although the first well-known attempt to inject drugs into the body was a 1667 attempt to inject a solution of opium into a dog, and some had suspected that parenteral administration of drugs may work better based on the practise of rubbing opium and other drugs into sores or cuts on the skin for the purpose of causing systemic absorption and the beginnings of scientific understanding of the functioning of the lungs.

During most of the 1850s, the previously-held belief that opiate dependence and addiction, often called "the opium appetite," (or when relevant the "morphine appetite" or "codeine appetite") was due to the drug's action on the digestive system—just like any hunger or thirst—caused doctors to opt to inject morphine rather than administer it orally in the hope that addiction would not develop; certainly by c.a. 1870 or earlier it was manifest that this was not the case and the title of earliest morphine addict as the term is currently understood is often given to Dr Pravaz' wife although habituation through orally ingesting the drug was known before this time, including Sertürner and associates, followers, and his wife and dog. To some extent, it was also believed early on that bypassing the lungs would prevent opium addiction as well as habituation to tobacco. Ethanol in its usual form generally is not injected and can be very damaging by most routes of injection; in modern times it is used as an alternative or potentiator of phenol (carbolic acid) in procedures to ablate damaged nerves.

In or shortly after 1851 the drugs which had been discovered and extracted from their plants of origin and refined into pure crystalline salts soluble in water included morphine (1804 or late 1803), codeine (1832), narcotine/noscapine (1803-1805?), papaverine (1814), cocaine (1855), caffeine (1819), quinine (1820), atropine (1831), scopolamine aka hyoscine aka laevo-duboisine (1833?), hyoscyamine or laevo-atropine (1831), opium salts mixtures (c.a. 1840s) chloral derivatives (1831 et seq.), ephedrine (1836?), nicotine (1828) and many others of all types, psychoactive and not. Morphine in particular was used much more widely after the invention of the hypodermic syringe, and the practise of local anaesthesia by infiltration was another step forward in medicine resulting from the hypodermic needle, discovered at around the same time that it was determined that cocaine produced useful numbing of the mucous membranes and eye.

A wide variety of drugs are injected, among the most popular in many countries are morphine, heroin, cocaine, amphetamine and methamphetamine. Prescription drugs, including tablets, capsules, or even liquids or suppositories, are also occasionally injected, especially prescription opioids, since some opioid addicts already inject heroin. Injecting preparations not intended for this purpose is particularly dangerous because of the presence of excipients (fillers), which can cause blood clots. Injecting codeine into the bloodstream directly is dangerous because it causes a rapid histamine release, which can lead to potentially fatal anaphylaxis and pulmonary edema. Dihydrocodeine, hydrocodone, nicocodeine, and other codeine-based products carry similar risks. Codeine may instead be injected by the intramuscular or subcutaneous route. The effect will not be instant but the dangerous and unpleasant massive histamine release from the intravenous injection of codeine is avoided. To minimize the amount of undissolved material in fluids prepared for injection, a filter of cotton or synthetic fiber is typically used, such as a cotton-swab tip or a small piece of cigarette filter.

Some manufacturers add the narcotic antagonist naloxone or the anticholinergics atropine and homatropine (in lower than therapeutic doses) to their pills to prevent injection. Unlike naloxone, atropine does indeed help morphine and other narcotics combat neuralgia. The atropine may very well not present a problem, and there is the possibility of atropine content reduction of soluble tablets by placing them on an ink blotter with a drop of water on top, then preparing a shot from the remainder of the pill. Canada and many other countries prohibit manufacturers from including secondary active ingredients for the above reason; their Talwin PX does not contain naloxone. However, as a narcotic agonist–antagonist, pentazocine and its relatives can cause withdrawal in those physically dependent upon narcotics.