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October 6, 1978

Will heroin eventually see the light of day for treating chronic pain?

JAMA. 1978;240(15):1567-1570. doi:10.1001/jama.1978.03290150013002

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If any drug ever brought to many Americans' minds the metaphoric skeletal figure of death—cloaked and hooded in darkness and with swift scythe in hand— surely that drug was heroin, long feared as the most addictive of all pharmacologic agents.

Rending that metaphoric cloak from heroin suddenly has become a political pastime at the White House, at the grass roots level, and among scientists and physicians in and out of cancer wards. Nearly everyone, it seems, wants to know if heroin is really such a vile character.

Some would like to see heroin become available and legal for physicians to prescribe for patients in intractable pain, especially those who are terminally ill. The Washington, DC—based National Committee on the Treatment of Intractable Pain is the dominant voice for this viewpoint. Included on its roster of consultants and supporters is John J. Bonica, MD, president of the International Association for the