Drugs, legal and oth­er­wise, have long been part of human his­to­ry, with both ben­e­fi­cial and harm­ful effects. One such drug is hero­in, a sub­stance whose name was coined by the Ger­man phar­ma­ceu­ti­cal com­pa­ny Bay­er in the late 1800s. The name derives from the Ger­man word “hero­isch,” mean­ing “strong” or “hero­ic,” reflect­ing the drug’s ini­tial appeal as a pow­er­ful painkiller. While orig­i­nal­ly mar­ket­ed for ther­a­peu­tic use, hero­in’s addic­tive prop­er­ties became evi­dent, and it was lat­er banned. In con­trast, oth­er drugs like Val­i­um, a pop­u­lar ben­zo­di­azepine, were designed with spe­cif­ic ther­a­peu­tic effects in mind. The name “Val­i­um” is derived from the Latin word “vale,” which trans­lates to “good­night,” high­light­ing its intend­ed use as a seda­tive to help indi­vid­u­als sleep.

Many sub­stances, both legal and ille­gal, have been used in unique ways through­out his­to­ry, some of which car­ry dan­ger­ous con­se­quences. Scopo­lamine, a drug often pre­scribed to treat motion sick­ness, has been abused in more sin­is­ter ways. In Colom­bia, for instance, it has been used to ren­der vic­tims uncon­scious for rob­bery pur­pos­es, with more than 50,000 cas­es report­ed. While this drug was ini­tial­ly intend­ed for med­i­c­i­nal use, its abil­i­ty to cause amne­sia and dis­ori­en­ta­tion made it a tool for crim­i­nal activ­i­ty. Such cas­es under­score the impor­tance of mon­i­tor­ing drug use and the poten­tial for abuse when sub­stances are not care­ful­ly reg­u­lat­ed. Mean­while, the glob­al phar­ma­ceu­ti­cal indus­try has grown immense­ly, with its mar­ket val­ue reach­ing $1.27 tril­lion by the end of 2020, up from just $390 bil­lion in 2001, show­ing the ris­ing demand for med­ica­tions, both ben­e­fi­cial and harm­ful.

The use of hal­lu­cino­gens in reli­gious and cul­tur­al prac­tices has been doc­u­ment­ed for cen­turies, with var­i­ous sub­stances play­ing a cen­tral role in rit­u­als. For exam­ple, Amer­i­can Indi­an tribes used psilo­cy­bin mush­rooms in spir­i­tu­al cer­e­monies, and the Aztecs referred to a par­tic­u­lar species of mush­room as the “divine mush­room.” These mush­rooms con­tain com­pounds that can cause vivid hal­lu­ci­na­tions, mak­ing them valu­able in spir­i­tu­al prac­tices where altered states of con­scious­ness are sought. In a more casu­al set­ting, even com­mon kitchen items like nut­meg have been found to con­tain psy­choac­tive prop­er­ties. Nut­meg con­tains myris­ticin, a com­pound that can pro­duce hal­lu­cino­genic effects if con­sumed in large enough quan­ti­ties. How­ev­er, it’s impor­tant to note that most indi­vid­u­als would need to con­sume an exces­sive amount to expe­ri­ence any form of high, mak­ing it a rel­a­tive­ly mild psy­choac­tive sub­stance.

As the world’s under­stand­ing of drugs evolves, so too do the laws sur­round­ing their use. The Nether­lands is often mis­tak­en­ly cred­it­ed as the first coun­try to legal­ize recre­ation­al cannabis use, though Uruguay actu­al­ly became the first in 2013 to pass such leg­is­la­tion. The move was a sig­nif­i­cant mile­stone in glob­al drug pol­i­cy, influ­enc­ing oth­er coun­tries to recon­sid­er their own stances on cannabis. How­ev­er, some drugs have con­tin­ued to be heav­i­ly reg­u­lat­ed, such as tobac­co. In 1995, the U.S. Food and Drug Admin­is­tra­tion (FDA) declared cig­a­rettes to be “drug deliv­ery devices,” but the Supreme Court over­turned this deci­sion in 2000, rul­ing that the FDA lacked the author­i­ty to reg­u­late tobac­co as a drug. This legal bat­tle reflects the ongo­ing debate about how sub­stances should be clas­si­fied and reg­u­lat­ed.

While some drugs are cre­at­ed with the inten­tion of improv­ing health, oth­ers have result­ed in unin­tend­ed harm­ful effects. Rimon­a­bant, a pre­scrip­tion drug used to treat severe obe­si­ty, was intro­duced in 2006 but was pulled from the mar­ket two years lat­er after it caused severe side effects in patients. Reports showed that 10% of users expe­ri­enced depres­sion, and 1% had sui­ci­dal thoughts, high­light­ing the risks asso­ci­at­ed with cer­tain phar­ma­ceu­ti­cals. The phar­ma­ceu­ti­cal indus­try, dom­i­nat­ed by com­pa­nies like John­son & John­son, con­tin­ues to gen­er­ate sub­stan­tial rev­enue, with J&J being the largest phar­ma­ceu­ti­cal com­pa­ny glob­al­ly by mar­ket cap­i­tal­iza­tion, val­ued at $473.06 bil­lion in 2021. This under­scores the pow­er­ful role that phar­ma­ceu­ti­cal com­pa­nies play in both pub­lic health and the econ­o­my, as well as the respon­si­bil­i­ty they bear to ensure the safe­ty of their prod­ucts.

His­tor­i­cal­ly, some drugs have been mar­ket­ed for uses that were lat­er deemed inap­pro­pri­ate due to their addic­tive prop­er­ties. Hero­in, for exam­ple, was mar­ket­ed in the U.S. as a cough sup­pres­sant from 1895 until 1924. Although it was effec­tive in treat­ing coughs, the addic­tive nature of hero­in led Con­gress to rec­og­nize its dan­gers, and it was sub­se­quent­ly banned. This ear­ly mis­step in drug reg­u­la­tion serves as a reminder of the impor­tance of thor­ough­ly under­stand­ing the poten­tial risks of new sub­stances before they are wide­ly dis­trib­uted. Sim­i­lar­ly, mor­phine, an opi­oid named after the Greek god Mor­pheus, was used for pain man­age­ment but also led to wide­spread addic­tion, con­tribut­ing to the ongo­ing opi­oid cri­sis that has affect­ed many com­mu­ni­ties world­wide.

The CIA’s involve­ment in drug exper­i­men­ta­tion is anoth­er dark chap­ter in the his­to­ry of drugs, legal and oth­er­wise. From 1953 to 1973, the agency con­duct­ed the MKUl­tra project, dos­ing unknow­ing sub­jects with LSD in exper­i­ments designed to explore mind con­trol. The project result­ed in sev­er­al deaths and numer­ous eth­i­cal vio­la­tions, reveal­ing the dan­gers of uncon­trolled drug exper­i­men­ta­tion. This dis­turb­ing episode demon­strates the pow­er­ful effects drugs can have on the human mind, as well as the lengths to which gov­ern­ments and orga­ni­za­tions may go in the name of exper­i­men­ta­tion. Despite these dark moments in his­to­ry, the devel­op­ment and reg­u­la­tion of drugs con­tin­ue to evolve, with mod­ern sci­ence striv­ing to bal­ance their ther­a­peu­tic ben­e­fits against their poten­tial for abuse. As we con­tin­ue to learn more about the effects of var­i­ous sub­stances, respon­si­ble reg­u­la­tion remains essen­tial to safe­guard­ing pub­lic health.