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From: dyer@spdcc.UUCP (Steve Dyer)
Newsgroups: sci.med
Subject: Re: Aspirin vs. [sic] Codine
Message-ID: <433@spdcc.UUCP>
Date: Fri, 17-Oct-86 01:35:45 EDT
Article-I.D.: spdcc.433
Posted: Fri Oct 17 01:35:45 1986
Date-Received: Fri, 17-Oct-86 22:20:23 EDT
References: <1823@bu-cs.bu-cs.BU.EDU> <529@cci632.UUCP>
Reply-To: dyer@spdcc.UUCP (Steve Dyer)
Organization: S.P. Dyer Computer Consulting, Cambridge MA
Lines: 51
Summary: (was) Aspirin a potential controlled substance.

>In several interviews with officials of the F.D.A., there was a clear
>indication that if aspirin had to be cleared today, that the F.D.A.
>would make aspirin a controlled substance.

Strictly speaking, which is what we like to do in sci.med, a "controlled
substance" is a drug listed on one of the five Drug Enforcement Administration
schedules which are numbered from I to V, roughly in order of decreasing
abuse potential (at least as viewed by the medico-political bureaucracy.)
The assignment of a drug to one of these schedules imposes strict controls
on its manufacture, distribution and dispensing, and limits the number of
refills allowed on its prescriptions.

Now, the FDA can allow a drug to be sold over the counter or be restricted
to use on prescription.  A prescription-only drug, while certainly
"controlled" is not necessarily a "controlled substance", and
its status as prescription-only says nothing about its abuse liability.
I have a tube of antibiotic eye ointment in my medicine cabinet which can
be sold only on prescription, but it is not going to fetch much on the street.

In the case of aspirin, were it introduced and approved today, it almost
certainly would be limited to sale on a prescription.  This is just standard
practice for any new drug.  If long-term experience demonstrates a drug's
safety and efficacy in conditions for which self-medication is thought
safe, then the drug may be allowed to be sold over the counter.  Recently,
drugs such as ibuprofen (analgesic), miconazole (anti-fungal), diphenhydramine
(antihistamine) and others have been moved to OTC status.

Aspirin is a powerful drug with effects on many different biochemical
pathways, and it's worth keeping that in mind, if only for the added
placebo effect, when you take it in the future.  But, its abuse potential
is just about NIL.  There's no way it could ever be a controlled substance
in the way that phrase is used.  There is plenty of precedent for
making an old drug a (more) controlled substance, however.  In the early 70's,
paregoric, a tincture of opium used for decades for treating diarrhea and
easing teething pain, was moved from Schedule V to Schedule III, a move which
automatically restricted it to be sold only on prescription.

>There is a more "effective" form of the active ingredient in aspirin
>which is made from boiling birch or aspen bark.  Before "modern
>medicine", this "tea" was often given to patients for fever and
>pain.  The instability and impurities however made the practice
>very dangerous.  It was not uncommon to get the equivelant of
>2000 mg. (4 extra strength tablets) in a single cup.  Two or three
>cups of this "tea" could be quite interesting.

Yeah, if salicylate intoxication is considered interesting.  Maybe to
a med student or intern; NOT to the victim!
-- 
Steve Dyer
dyer@harvard.HARVARD.EDU
{linus,wanginst,bbnccv,harvard,ima,ihnp4}!spdcc!dyer