Ironically, heroin was initially touted as less addictive and more effective than morphine and was legally marketed in the early 20th century in pill form. The young hipsters of the age began snorting crushed pills, enjoying the euphoric feeling induced by the wonder drug. Of course, in a nation where stern moralists would soon enact Prohibition, this use of the drug was quickly quelled.

Noticing that people were beginning to use opiates for more than medicinal purposes, moves were made to regulate their distribution among populations of several nations. This moralism prevailed for much of the 20th century, causing suffering among those who could have benefited from long-term treatment under medical supervision. But in the 1990s, this attitude began to change among medical professionals.

Unfortunately, the loosening of attitudes by the medical professionals in their legitimate pursuit of palliative relief for their patients was also accompanied by a rise in non-medical uses by the general population. From 1990 to 2004, the number of those identified as abusers of opiates rose from more than 600,000 to about 2.4 million, while emergency room visits for opiate abuse rose 45 percent. Treatment admission for opiate abuse also rose 186 percent. This, of course, led to intense debate among the medical community as it sought a balance between treatment and addiction, a debate that is ongoing today.

One dilemma facing physicians is assessing which patients are making legitimate complaints about chronic pain and which are merely expressing discomfort that comes from withdrawal from opiates. They both present similar complaints, and experienced drug abusers know how to make their cases more convincing. There is much evidence to suggest that hyperalgesia, the increased sensitivity to the pain being experienced upon withdrawal from drugs, is a very real condition for those truly suffering from chronic pain and not just a drug abuser hoping to get a prescription renewal at a higher dosage.