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The First Rendition of the Opioid Crisis

Humans have used the poppy plant for thousands of years. We won’t be covering the full history of opioids here, so let’s fast forward to 1800.

Sometime between 1803 and 1805, a German chemist named Friedrich Sertürner isolated morphine from the other alkaloids that are present in Papaver somniferum, the opium poppy’s scientific name. 

Some four decades after the singling out of morphine was carried out, the world’s first hypodermic needle came to be, which was formed in 1844 by an Irish doctor named Francis Rynd. 

About two decades later, the American Civil War began. 

War Is Absolutely No Fun — Morphine Sure Does Help a Lot, Though

Opioids, although not everybody likes them, provide a strong feeling of euphoria to users. Many people self-medicate with opioids like morphine to reduce anxiety, depression, and similar symptoms. Opioids are often commonly used as a way to dull pain during surgeries and other painful medical procedures. 

War is tough. Although I’ve never been a soldier, thank goodness, I can imagine that marching on, and on, and on, and on to no end gets tiring, exhausting, and nothing short of old. Morphine also helped soldiers go for longer periods, believe it or not. 

Although morphine isn’t a wonder drug, it was ideal to improve the performance of soldiers — put simply, it helped them go longer, stronger, and harder. 

Physicians Weren’t Able to Access Treasure Troves of Treatments and Procedures

Back around the time of the American Civil War, which lasted from 1861 to 1865, physicians weren’t good at a lot of things. They were not able to administer anesthesia to people to operate on them without patients feeling such pain or being conscious, making surgery easier and more successful for both parties. 

Antiseptics, at the time of the Civil War, had been used for at least 2,000 years, if not longer. However, the capabilities of the physicians on both sides of this battle were quite limited when it came to the use of antiseptics. Despite physicians doing the best they possibly could to repair wounded soldiers and keep them alive, major wounds often ended up getting infected, causing deaths not too long after such infections took hold. 

Both sides wanted to win, obviously, and physicians had to do something to beef up their own sides’ chances of winning. They eventually decided on widely using morphine, which was produced in laboratories by this time instead of just being isolated from poppy plants’ organic material, in combination with hypodermic needles to get more utility out of morphine that was available. 

If hypodermic needle supplies ran out or were otherwise unavailable, soldiers were given opium tablets that ultimately resulted in the same feeling as morphine. 

What Happened After the War?

Though they knew addiction would result from pumping soldiers full of these drugs, physicians and other decision-makers would have rather kept their soldiers in a better physical and mental state through the administration of morphine and opium throughout the four-year war instead of making them tough it out. Physicians were willing to take on the end result of a much, much greater prevalence of morphine addiction and dependency

Depending on where you reference this information, you may find that the Civil War ended up with a total of 400,000 or more soldiers walking away from the battlefield with an addiction to and dependency on opioids. 

One interesting — and upsetting — thing is that, upon the release of soldiers from their respective sides of the conflict, they were given morphine, hypodermic needles, and opium tablets, and absolutely nothing else to compensate them for their service. At this time, unfortunately, there was no such thing as Veterans Affairs. 

Soldiers were entitled to pensions once they retired from the governments they fought for. However, letting other members of society learn about one’s morphine addiction could have resulted in them being cut off from their upcoming pension plan payouts. As such, we can’t really say exactly how many soldiers left the American Civil War addicted to and dependent on opioids

From the end of the American Civil War to about 1900, the vast majority of soldiers who fought in this war had already perished. 

Just Because Soldiers Died Doesn’t Mean That Morphine Addiction Died Out

After the Civil War, the world of domestic medicine was not regulated well. As such, it proved easy for businesses to sell what are known as patent medicines, or those that are available over-the-counter rather than only via prescription, protected by trademarks or other intellectual property legal protections, and typically not labeled with complete lists of ingredients so as to make it difficult for competitors to copy what certain brands were selling. 

Thanks to the widespread lack of regulation, it was easy for people to purchase them just like they’d buy anything else. 

One reason why patent medications were in such high demand is that they were advertised for all sorts of health problems, ranging from coughing to serious, soon-to-be fatal diseases. Even people who weren’t so keen on developing addictions to morphine and other opioids bought these patent medicines to hopefully improve their health outcomes. 

These people often ended up getting addicted. 

People who simply weren’t aware of opioids and how bad they could be also got addicted en masse. 

Lastly, individuals who were aware from the jump that they were just trying to get high ended up developing addictions themselves, too. 

And Along Comes a Replacement to Morphine

You’re familiar with the idea of opioids being marketed as non-addictive and unable to be abused — which is what Purdue Pharma started doing in 1996 with the release of OxyContin — right? 

No matter how you package an opioid, it’s still going to leave people at a chance of developing an addiction, a dependency, or both. Despite this simple concept, it seems as if the Food and Drug Administration, pharmacists, physicians, politicians, and countless others were lied to by Purdue and its cohorts in the pharmaceutical industry. 

OxyContin wasn’t the first opioid marketed as being entirely new and in a class of its own — that title belongs to Heroin. 

In the 1870s, a chemist named Charles Romley Alder Wright of England came up with a series of chemical reactions that resulted in the output of diacetylmorphine, a play on the basic morphine molecule that was both stronger and thought to be more enjoyable as a recreational drug than its older counterpart. 

Bayer Pharmaceuticals, the same Bayer Pharmaceuticals that is still doing business today and best known for its famous brand of aspirin, came out with diacetylmorphine across the United States in 1898 sold under the brand name of Heroin. 

Small glass vial of heroin, branded Friedr, Bayer & Co., or what's now known as Bayer.
Bayer’s brand-name Heroin
MPV_51 / WIKIMEDIA COMMONS

Heroin was marketed to all shapes, sizes, ages, and conditions of people, ranging from taking care of children’s lagging coughs to being a solid way to relax in the evenings — and, of course, the relief of chronic pain symptoms as a form of pain management before the field even become a subspecialty researched by academicians and practiced by thousands of practitioners across the United States. 

Guess What Happened?

If you can’t guess what ended up happening in the years following the release of Heroin by Bayer Pharmaceuticals… well, I guess you’re about to find out. 

Heroin ended up being addictive, as consumers would later find out. It turns out to be just as addictive as morphine, as well as liable to form physical dependencies just as strong as morphine, opium, or codeine, the big three known opioids that were out on the market prior to the release of Heroin. 

People reported the classic signs of using substances that were addictive, such as having to use more and more heroin to end up feeling the same effects in what’s known as tolerance

It Didn’t Take Long for This Drug to Become Outlawed

The same year Heroin came out — that was after the Spanish-American War ended — many people spoke out against Heroin and other opioids. 

In 1909, some one decade later, people from around the world came together for the International Opium Commission in Shanghai, China. Two years later, in 1911, the second such get-together was held, where the first policy for making opioids illegal and regulating them was formulated. 

Smear campaigns from the likes of Hamilton Wright, an outspoken racist who was appointed to the role of Opium Commissioner, spoke publicly to the American people and claimed that the United States did more drugs than any other country despite not knowing if that was true or not. Wright then said that cocaine caused rape carried out by Black people living in the Southeastern United States. Journalists followed suit in adopting the idea that drugs were inherently bad and should be outlawed, running such stories and studies to further spread these ideas. 

In 1914, out of the 48 states that were officially part of the union, a total of 46 of them had agreed to outlaw heroin, morphine, opium, or other opioids. 

Shortly after this point, the federal government signed the Harrison Narcotics Tax Act, which read as a bill that taxed people for the purchase and sale of drugs, though what it actually did was prevent people from buying opioids or cocaine from any vendor other than a legitimate, certified pharmacy. However, physicians were able to prescribe these medications at this time.

Bridging the Gap Between This Point and the Start of What Would Become the Opioid Crisis

Due to the feelings that Americans held widely at this time, opioids — as well as cocaine, which is not an opioid — were not turned to very often in medical practice, only ending up being used for extreme cases of pain. Over the next few decades, opioids were still not often prescribed. 

Eventually, as mentioned in “The Modern Opioid Epidemic in My Words,” another article of mine, the 1980s would roll around and people’s attitudes toward opioids for treating health issues began to shift. 

By Daniel Garrett

I'm a self-employed writer, long-term drug user, and resident of rural Tennessee. Find me on Twitter at @DanielGarrettHR or email me at danpgarr@ut.utm.edu.

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