ABSTRACT
The variety of opioid derivatives encountered in the twentieth century reßects the cyclical appearance and disappearance of individual compounds, mostly because of popularity among users and availability. In the 1980s, opioid addicts inadvertently ingested what they thought was a designer derivative of meperidine (4’-methyl-apyrrolidinopropiophenone, MPPP). Instead, synthesis and contamination with 1methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) lead to the development of an idiopathic Parkinson-like state in these patients. In the same decade, a new more potent form of heroin from Mexico (Black tar heroin) made its appearance, resulting in an increase in acute overdose fatalities. Simultaneously during this period, heroin usage began to wane, only to be replaced with the more versatile forms of cocaine. Despite the counter-effects of narcotic law enforcement efforts to remove or dissuade its nontherapeutic use, opioid use is still a major public health problem.
