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April 21, 1978

No Opium for Pain

Author Affiliations

Columbus, Ohio

JAMA. 1978;239(16):1610. doi:10.1001/jama.1978.03280430026008

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To the Editor.—  This letter is an update of my COMMENTARY "Medical Preparedness—A Must" (233:1171, 1975) and my editorial "No Opium for Pain—A Threatening Medical Crisis" (N Engl J Med 291:1411,1974), both of which detail the fact that the painkiller medicinal opium stockpile in the United States is woefully inadequate for use in the event of a grave national emergency. Recent events indicate that this stockpile will soon be much more depleted. It is important to preface this worrisome prediction with several facts. First, there is no synthetic medicine that combines the potent pain-relieving and tranquilizing effect of morphine, the medicinal drug extracted from the opium poppy flower. Second, there is no synthetic medicine that combines the painkilling, cough-relieving, and sedative effect of codeine, also extracted from the opium poppy flower. Third, the pharmaceutical industry and academic sources are not optimistic about their ability, within the foreseeable future, to replace