Printing Drugs & the Autopharm
The United States has approved the first 3D-printed drug, spritam levetitracetam. This drug is intended to control epilepsy and is an early step on the road to highly customized printed pharmaceuticals.
Since there are already well-established methods of manufacturing pills, it might be wondered what 3D printing brings to the process—other than the obvious fact that 3D printing is hot and great for hype. Fortunately, there is more here than just hype. One advantage of 3D drugs is that specific doses can be custom printed for the patient rather than relying on standard doses—which can easily be too much or too little for the individual.
A second advantage is that custom “mixes” of medication can be easily printed, thus reducing the number of pills a person needs to take. This makes it easier for the patient and caregivers to manage the regimen of medications. For example, a person might only need two custom pills per day rather than six.
A third advantage is that customized shapes can be created for pills. These shapes are not to make the pills look cool (though I am sure that creating cool pill shapes will become a thing). The intent is to change the surface area relative to the pill volume and thus control the time it takes for the drug to be released in the body.
While pills with customized doses and shapes will have an important impact on medicine, what will have a far greater impact in the use of specialized 3D-printers that can function as automated chemistry sets. The idea is that just as users of normal 3D printers can download custom designs and print them, users of the chemistry printers would be able to able to download designs for drugs and print them at home. In short, it would bring small scale chemical creation to the home.
Boringly enough, I made up just such a device in a Traveller role playing game campaign I ran years ago. The players had “acquired” a ship and were pleased that it had an autodoc (a robotic doctor that looks a bit like a tanning booth) since they, like all space adventurers, had a tendency to accumulate laser burns and alien parasites. One of the players inquired if there was also machine for making drugs, so I made up the autopharm on the spot: it would dispense pharmaceuticals like a bartender bot dispensed booze. Like all game masters, I like to encourage players to use things in dangerous ways—especially if I can also make up a random chart to roll for effects.
As expected, the players quickly worked out good and (mostly) bad uses for their autopharm. I am confident that people will do the same in the real world. On the good side, an autopharm can allow the user to create highly personalized medicines in terms of dose, composition, and release time. Assuming that the machine worked reasonably quickly, it would also allow the user to acquire drugs rapidly, perhaps even during a medical emergency. Since the device would “mix” the chemicals, users would not need to stock up on specific medications—just raw materials that could be used to create a variety of drugs.
The players did use the device in these good ways, creating medicines to deal with the specific nasty things they encountered or picked up on alien worlds. Responsible people in the real world will certainly use their real autopharms in this way—to create legitimate medicines in accord with the law and their legitimate prescriptions.
On the bad side, the players quickly realized their autopharm could be used to make dangerous substances (“hey, we can synthesize Ceti spider venom and use that in our needlers!”) and, obviously enough, recreational drugs (“dudes, we can make plutonian nyborg!”). While real autopharms will probably be equipped with “safety” features and heavily regulated, people will rather quickly figure out how to overcome these obstacles and use the autopharms to generate recreational drugs. Since the “legitimate” pharmaceutical industry has developed some of the most popular recreational drugs, users will probably stick with such recipes—though more enterprising folks will try creating their own recipes (expect fatalities). As always, an arms race between those trying to ensure the autopharms are used properly and those who want to “misuse” them will occur.
While people have been mixing their own recreational drugs for quite some time, an autopharm would make it much easier to create these drugs. Making high grade pain killers could be as simple as downloading a recipe and pushing the “print” button. On the plus side, this could increase the purity and quality of the drugs, thus reducing the number of people getting sick or dying from contaminated drugs. They could also change the nature of drug crime: instead of murderous cartels, each person could be his own supplier, thus reducing drug violence considerably.
On the minus side, this could make powerful drugs readily available at low costs—an exponential version of the bathtub gin of prohibition. There is also the worry that people will unintentionally create toxic mixes or drugs with awful side-effects. While autopharms will probably have some safety features that would include a list of known poisons, some users will certainly override these features and there will be many harmful substances that will not be on the lists.
Another point of concern is that autopharms will inevitably be connected to the internet and hackers will target them—either out of malice or as a form of prank (which might end up being a fatal prank). Having someone hack your PC can be a serious problem. Having someone hack the autopharm that prints all your medicine could be a fatal problem.