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by Edward M. Brecher and the Editors of Consumer Reports Magazine, 1972
The United States of America during the nineteenth century could quite properly be described as a "dope fiend's paradise."
Opium was on legal sale conveniently and at low prices throughout the century; morphine came into common use during and after the Civil War; and heroin was marketed toward the end of the century. These opiates and countless pharmaceutical preparations containing them "were as freely accessible as aspirin is today." 1 They flowed mostly through five broad channels of distribution, all of them quite legal:
1) Physicians dispensed opiates directly to patients, or wrote prescriptions for them.
(2) Drugstores sold opiates over the counter to customers without a prescription.
(3) Grocery and general stores as well as pharmacies stocked and sold opiates. An 1883-1885 survey of the state of Iowa, which then had a population of less than 2,000,000, found 3,000 stores in the state where opiates were on sale--- and this did not include the physicians who dispensed opiates directly. 2
(4) For users unable or unwilling to patronize a nearby store, opiates could be ordered by mail.
(5) Finally, there were countless patent medicines on the market containing opium or morphine. They were sold under such names as Ayer's Cherry Pectoral, Mrs. Winslow's Soothing Syrup, Darby's Carminative, Godfrey's Cordial, McMunn's Elixir of Opium, Dover's Powder, 3 and so on. Some were teething syrups for young children, some were "soothing syrups," some were recommended for diarrhea and dysentery or for "women's trouble." They were widely advertised in newspapers and magazines and on billboards as "pain-killers," "cough mixtures," "women's friends, "consumption cures," and so on. 4 One wholesale drug house, it is said, distributed more than 600 proprietary medicines and other products containing opiates. 5
Most of the opium consumed in the United States during the nineteenth century was legally imported. Morphine was legally manufactured here from the imported opium. 6 But opium poppies were also legally grown within the United States. One early reference--- perhaps the earliest--- was in a letter from a Philadelphia physician, Dr. Thomas Bond, who wrote to a Pennsylvania farmer on August 24, 1781: "The opium you sent is pure and of good quality. I hope you will take care of the seed." 7 During the War of 1812, opium was scarce, but "some parties produced it in New Hampshire and sold the product at from $10 to $12 per pound." 8
In 1871 a Massachusetts official reported:
There are so many channels through which the drug may be brought into the State, that I suppose it would be almost impossible to determine how much foreign opium is used here; but it may easily be shown that the home production increases every year. Opium has been recently made from white poppies, cultivated for the purpose, in Vermont, New Hampshire, and Connecticut, the annual production being estimated by hundreds of pounds, and this has generally been absorbed in the communities where it is made. It has also been brought here from Florida and Louisiana, while comparatively large quantities are regularly sent east from California and Arizona, where its cultivation is becoming an important branch of industry, ten acres of poppies being said to yield, in Arizona, twelve hundred pounds of opium. 9
Opium was also produced in the Confederate states (Virginia, Tennessee, South Carolina, Georgia) 10 during the Civil War--- and perhaps thereafter. Though some states outlawed it earlier, Congress did not ban the cultivation of opium poppies nationally until 1942. 11
The nineteenth-century distribution system reached into towns, villages, and hamlets as well as the large cities. A New England physician-druggist wrote about 1870:
In this town I began business twenty years since. The population then at 10,000 has increased only inconsiderably, but my sales have advanced from 50 pounds of opium the first year to 300 pounds now; and of laudanum [opium in alcohol] four times upon what was formerly required. About 50 regular purchasers come to my shop, and as many more, perhaps, are divided among the other three apothecaries in the place. Some country dealers also have their quota of dependents. 12
A correspondent for the Portland (Maine) Press had this to say about opium users in 1868: "In the little village of Auburn ... at least fifty such (as counted up by a resident apothecary) regularly purchase their supplies hereabouts; and the country grocers too, not a few of them, find occasion for keeping themselves supplied with a stock." 13
A survey of 10,000 prescriptions filled by thirty-five Boston drugstores in 1888 revealed that 1,481 of them contained opiates. Among prescriptions refilled three or more times, 78 percent contained opiates . 14
One Massachusetts druggist, asked to review his opiate sales, added a picturesque detail. He had only one steady customer, he reported - and that a noted temperance lecturer." 15
Nor was the Middle West different from New England. The Annual Report of the Michigan State Board of Health for 1878 reported three opium eaters in the village of Huron (population 437), four opium eaters and one morphine eater in the village of Otisville (population 1,365), 18 opium eaters and 20 morphine eaters in the town of Hillsdale (population 4,189), and so on around the state. 16 Some children were included in the statistics.
Though called "opium eaters" in the medical literature, most nineteenth century opium users (including Thomas De Quincey, author of Confessions of an English Opium-Eater) were in fact opium drinkers; they drank laudanum or other opiate liquids. Similarly "morphine eaters" included many who took morphine by injection or in other ways. In a number of the quotations which follow, "opium eaters" refers generally to morphine as well as opium users. Opium smokers, however, were considered to be in a separate category (see Chapter 6).
The nineteenth-century use of opiates was more or less the same in Britain. A classic report on the English industrial system, The Factory System Illustrated (1842), by W. Dodd, noted that factory workers of the time used opiates--- notably laudanum--- to quiet crying babies. 17
In the official Report of the Medical Officer of the Privy Council for 1864 it was observed: "To push the sale of opiate ... is the great aim of some enterprising wholesale merchants. By druggists it is considered the leading article." 18 The report also noted the giving of opiates to infants; 19 Karl Marx, citing this report in Capital (1867), spoke of the English working-class custom of "dosing children with opiates ." 20 In 1873 an English physician reported:
... Amongst the three millions and three-quarters [people in London] there are to be found some persons here and there who take [opium] as a luxury, though by far the greater number of those who take it in anything like quantity do so for some old neuralgia or rheumatic malady, and began under medical advice. Neither is it to be found over the agricultural or manufacturing districts, save in the most scattered and casual way. The genuine opium-eating districts are the ague and fen districts of Norfolk and Lincolnshire. There it is not casual, accidental, or rare, but popular, habitual, and common. Anyone who visits such a town as Louth or Wisbeach, and strolls about the streets on a Saturday evening, watching the country people as they do their marketing, may soon satisfy himself that the crowds in the chemists' shops come for opium; and they have a peculiar way of getting it. They go in, lay down their money, and receive the opium pills in exchange without saying a word. For instance, I was at Wisbeach one evening in August 1871; went into a chemist's shop; laid a penny on the counter. The chemist said --- "The best?" I nodded. He gave me a pill box and took up the penny; and so the purchase was completed without my having uttered a syllable. You offer money, and get opium as a matter of course. This may show how familiar the custom is....
In these districts it is taken by people of all classes, but especially by the poor and miserable, and by those who in other districts would seek comfort from gin or beer. 21
Godfrey's Cordial--- a mixture of opium, molasses for sweetening, and sassafras for flavoring--- was especially popular in England. Dr. C. Fraser Brockington reports that in mid-nineteenth--- century Coventry, ten gallons of Godfrey's Cordial enough for 12,000 doses--- was sold weekly, and was administered to 3,000 infants under two years of age.
Even greater quantities of opium mixtures were said to be sold in Nottingham.... Every surgeon in Marshland testified to the fact that "there was not a labourer's house in which the bottle of opium was not to be seen, and not a child, but who got it in some form." . . . Wholesale druggists reported the sale of immense quantities of opium; a retail druggist dispensed up to 200 pounds a year-in pills and penny sticks or as Godfrey's Cordial.... To some extent this was a practice which had been taken on during the years when malaria was indigenous in the Fens and when, a century before, the poppy had been cultivated for the London market. 22
The nonmedicinal use of opiates, while legal in both the United States and England, was not considered respectable. Indeed, as an anonymous but perceptive and well-informed American writer noted in the Catholic World for September 1881, it was as disreputable as drinking alcoholic beverages--- and much harder to detect:
The gentleman who would not be seen in a bar-room, however respectable, or who would not purchase liquor and use it at home, lest the odor might be detected upon his person, procures his supply of morphia and has it in his pocket ready for instantaneous use. It is odorless and occupies but little space. . . . He zealously guards his secret from his nearest friend--- for popular wisdom has branded as a disgrace that which he regards as a misfortune. . . 23
Opiate use was also frowned upon in some circles as immoral--- a vice akin to dancing, smoking, theater-going, gambling, or sexual promiscuity. But while deemed immoral, it is important to note that opiate use in the nineteenth century was not subject to the moral sanctions current today. Employees were not fired for addiction. Wives did not divorce their addicted husbands, or husbands their addicted wives. Children were not taken from their homes and lodged in foster homes or institutions because one or both parents were addicted. Addicts continued to participate fully in the life of the community. Addicted children and young people continued to go to school, Sunday School, and college. Thus, the nineteenth century avoided one of the most disastrous effects of current narcotics laws and attitudes--- the rise of a deviant addict subculture, cut off from respectable society and without a "road back" to respectability.
Our nineteenth-century forbears correctly perceived the major objection to the opiates. They are addicting. Though the word "addiction" was seldom used during the nineteenth century, the phenomenon was well understood. The true nature of the narcotic evil becomes visible, the Catholic World article pointed out, when someone who has been using an opiate for some time attempts to give up its use. Suddenly his eyes are opened to his folly and he realizes the startling fact that he is in the coils of a serpent as merciless as the boa-constrictor and as relentless as fate. With a firm determination to free himself he discontinues its use. Now his sufferings begin and steadily increase until they become unbearable. The tortures of Dives are his; but unlike that miser, he has only to stretch forth his hand to find oceans with which to satisfy his thirst. That human nature is not often equal to so extraordinary a self-denial affords little cause for astonishment. . . . Again and again he essays release from a bondage so humiliating, but meets with failure only, and at last submits to his fate a confirmed opium-eater. 24
The terms "addicting" and "addiction" will be further discussed later.
Our nineteenth-century forbears also perceived opiate use as a "will-weakening" vice--- for surely, they insisted, a man or woman of strong will could stop if he tried hard enough. The fact was generally known that addicts deprived of their opiates (when hospitalized for some illness unrelated to their addiction, for example) would lie or even steal to get their drug, and addicts "cured" of their addiction repeatedly relapsed. Hence there was much talk of the moral degeneration caused by the opiates.
Nevertheless, there was very little popular support for a law banning these substances. "Powerful organizations for the suppression ... of alcoholic stimulants exist throughout the land," 25 the 1881 article in the Catholic World noted, but there were no similar anti-opiate organizations.
The reason for this lack of demand for opiate prohibition was quite simple: the drugs were not viewed as a menace to society and, as we shall demonstrate in subsequent chapters, they were not in fact a menace.
Notes
A number of works are cited in this Report with great frequency. Rather than repeat the full reference each time, we have listed them in full immediately below and again when first footnoted. Thereafter they are cited in the abbreviated style indicated below.
Drug Addiction: Crime or Disease? Interim and Final Reports of the Joint Committee of the American Bar Association and the American Medical Association on Narcotic Drugs (Bloomington, Ind.: Indiana University Press, 1961). Hereinafter cited as ABA-AMA Report.
George H. Stevenson et al., "Drug Addiction in British Columbia: A Research Survey" (University of British Columbia, 1956); unpublished. Hereinafter cited as British Columbia Study.
Louis S. Goodman and Alfred Gilman, eds., The Pharmacological Basis of Therapeutics (New York: Macmillan Co.). Hereinafter cited as Goodman and Gilman, preceded by contributor's name and followed by edition number and year (3rd ed., 1965, or 4th ed., 1970).
Interim Report of the Commission of Inquiry Into the Non-Medical Use of Drugs (Ottawa: Queen's Printer for Canada, 1970). Hereinafter cited as Le Dain Commission Interim Report.
Proceedings of the First National Conference on Methadone Treatment, New York, June 1968, supported by Health Research Council, New York City; New York State Narcotic Addiction Control Commission; and National Association for the Prevention of Addiction (NAPAN); mimeographed; unpublished. Hereinafter cited as Proceedings, First Methadone Conference.
Proceedings, Second National Conference on Methadone Treatment, New York, October 1969, sponsored by National Association for the Prevention of Addiction to Narcotics (NAPAN) and co-sponsored by National Institute of Mental Health; mimeographed; unpublished. Hereinafter cited as Proceedings, Second Methadone Conference.
Proceedings, Third National Conference on Methadone Treatment, New York, November 1970, sponsored by National Association for the Prevention of Addiction to Narcotics (NAPAN) and co-sponsored by National Institute of Mental Health; U. S. Public Health Service Publication No. 2172 (Washington, D.C.: U.S. Government Printing Office, 1971). Hereinafter cited as Proceedings, Third Methadone Conference.
Charles E. Terry and Mildred Pellens, The Opium Problem (New York: Committee on Drug Addictions, Bureau of Social Hygiene, Inc., 1928). Hereinafter cited as Terry and Pellens. [A reprint edition of The Opium Problem was published in 1970 by Patterson Smith Publishing Corporation, Montclair, N.J.]
In addition, for the sake of brevity, the Journal of the American Medical Association is cited as JAMA throughout the Notes.
Footnotes
Chapter 1
1. Hubert S. Howe, "A Physician's Blueprint for the Management and Prevention of Narcotic Addiction," New York State Journal of Medicine, 55 (February 1, 1955): 341-348.
2. Charles E. Terry and Mildred Pellens, The Opium Problem (New York: Committee on Drug Addictions, Bureau of Social Hygiene, Inc., 1928), p. 18. Hereinafter cited as Terry and Pellens.
5. Charles B. Towns, "The Peril of the Drug Habit," Century Magazine, 84 (1912): 580-587.
7. Proceedings, American Pharmaceutical Association, 13 (1865): 51.
8. Perry M. Lichtenstein, "Thirteen Years' Observation on Drug Addiction at the Tombs Prison," Narcotic Education, ed. H. S. Middlemiss, Proceedings of the First World Conference on Narcotic Education, July 5-9, 1926, Philadelphia (Washington, D.C., 1926), p. 123.
9. S. Dana Hays, quoted in Annual Report of the State Board of Health, Massachusetts (1871), cited in Terry and Pellens, p. 7.
10. D. M. R. Culbrith, Materia Medica and Pharmacology, 3rd ed. (1903), cited in Terry and Pellens, p. 7.
11. Opium Poppy Control Act of 1942, Public Law No. 400, 78th Cong.
12. Quoted by Alonzo Calkins, Opium and the Opium Appetite (Philadelphia, 1871), cited in Terry and Pellens, p. 6.
13. Quoted by Calkins, Opium and the Opium Appetite.
14. Virgil G. Eaton, "How the Opium Habit Is Acquired," Popular Science Monthly, 33 (1888): 666, cited in Alfred R. Lindesmith, Opiate Addiction (Evanston, Ill.: Principia. Press, 1947), p. 105.
15. Quoted by F. E. Oliver, Annual Report of the State Board of Health, Massachusetts (1871), cited in Terry and Pellens, p. 9.
16. Annual Report, Michigan State Board of Health (1878), Table 1, cited in Terry and Pellens, p. 12.
17. W. Dodd, The Factory System Illustrated (1842), p. 149, cited in E. P. Thompson, The Making of the English Working Class, 1966 ed. (New York: Vintage Books, 1963), p. 328.
18. "Report by Dr. Henry Julian Hunter on the Excessive Mortality of Infants in Some Rural Districts of England," Public Health. Reports of the Medical Officer of the Privy Council Report 6th Report (1864), p. 459, cited in Karl Marx, Capital, ed. Friedrich Engels, trans. Samuel Moore and Edward Aveling (Moscow: Progress Publishers, 1965), 1, 399.
20. Karl Marx, Capital, I, 399.
21. Medical Times and Gazette, 2 (London: July 19, 1873): 73.
22. C. Fraser Brockington, Public Health in the Nineteenth Century (London: E. & S. Livingstone, Ltd., 1965), pp. 225, 226.
23. Anon., "The Opium Habit," in Catholic World, 33 (September, 1881): p. 828.
24. Ibid., p. 829.
25. Ibid., p. 834.
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