Meperidine - Nazis, needles, and how to give yourself Parkinson's

Meperidine (aka pethidine or Demerol) is an an opioid analgesic (morphine-like painkiller) that was apparently first synthesized in 1939, deep in the drug laboratories of Nazi Germany [1]. Unlike morphine or codeine, which are naturally present in the opium poppy (Papaver somniferum), or heroin, which is made by acetylating morphine, meperidine is synthesized from organic precursors via complicated chemical reactions (i.e. more or less from scratch). If you're interested, you can make it yourself starting with an isomer of vitamin B3 and menthol. Isn't Erowid such a lovely thing?

For much of the 20th century, doctors and scientists somehow got it into their heads that meperidine was safer and less addictive than morphine, neither of which are true [1]. The drug also has relatively low potency, a relatively short duration of action, and causes a bunch of fairly terrible side effects not typically seen with other opioids (e.g yucky anticholinergic effects) [1]. When meperidine was first introduced, it was made available as a solution in ampules or vials. Since morphine was only available as a hypodermic tablet at the time, necessitating the preparation of a solution prior to injection, meperidine quickly became one of the most widely used painkillers for treating moderate to severe pain [1].

The great (or terrible, depending on your view) thing about meperidine is that it doesn't constrict your pupils (miosis, or pinpoint pupils), a telltale sign of morphine/heroin/oxycodone use [2]. This property apparently makes it popular among junkie health care professionals who want to keep things on the DL. Meperidine is also infamous for being the drug that a bunch of illicit users were attempting to make when they accidentally made 1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP) and gave themselves parkinsonism [3]. A heartwarming tale to say the least.

[1] Latta KS, Ginsberg B, Barkin RL. (2002). Meperidine: a critical review. Am J Ther 9: 53-68.
[2] Mistovich JJ, Krost W, Limmer DD. (2006). Beyond the basics: patient assessment. Emerg Med Serv 35: 72-77.
[3] Langston JW, Ballard P, Tetrud JW, Irwin I. (1983). Chronic Parkinsonism in humans due to a product of meperidine-analog synthesis. Science 219: 979-980.

Medical terminology can get overwhelming, so use a free online medical dictionary. As those with nursing careers know, it is important to be properly trained in first aid in order to be able to help save lives. Having some first aid products around the home is a good idea as well.

Atenolol is taken separately or in mixture with other drugs to treat high blood pressure. For the treatment of angina, and heart attacks atenolol is prescribed. It's classified among the beta blockers; a class of drugs that works by slowing down the activity of heart rate so the heart pumps slowly, same effects can be generated by taking darvocet.

3 chemically inspired comments:

Anonymous said...

There's a serial killer in Neuromancer whose drug mixture of choice is like methamphetamine and demerol mixed together and IVed. That's one of those things that sounds like a really awesome idea but also one of those things you can imagine reading in a forensic tox report on a mysterious death. Like: FOUND IN SYSTEM: DEMEROL, METHAMPHETAMINE. CASE CLOSED. GOOD WORK ASSHOLE WAY TO KNOCK YOURSELF OFF

Margaret said...

It also has a nasty metabolite normeperidine, which can cause seizures.

In addition, it acts an SSRI and when given in combination with an MAO inhibitor, can cause a fatal serotoin syndrome. It was this mistake, by a sleep-deprived resident, that caused the death of Libby Zion in the 1980s, which was the impetus for limiting the number of consecutive hours doctors can work.

Anyway, Demerol is a nasty drug, and there's very little reason to prescribe it anymore.

bfulda said...

I use it to for my migraines. It takes al little while to work, longer than an IM, but once it kicks in it takes the pain away nicely. I've been taking 20 pills every month or so for the last 10 years. It works, I just wish it didn't make me sleepy.