The man was bleeding, wounded in a bar fight, half-conscious. Charles Schuppert, a New Orleans surgeon, was summoned to help. It was the late 1870s, and Schuppert, like thousands of American doctors of his era, turned to the most effective drug in his kit. “I gave him an injection of morphine subcutaneously of ½ grain,” Schuppert wrote in his casebook. “This acted like a charm, as he came to in a minute from the stupor he was in and rested very easily.”
Physicians like Schuppert used morphine as a new-fangled wonder drug. Injected with a hypodermic syringe, the medication relieved pain, asthma, headaches, alcoholics’ delirium tremens, gastrointestinal diseases and menstrual cramps. “Doctors were really impressed by the speedy results they got,” says David T. Courtwright, author of Dark Paradise: A History of Opiate Addiction in America. “It’s almost as if someone had handed them a magic wand.”
By 1895, morphine and opium powders, like OxyContin and other prescription opioids today, had led to an addiction epidemic that affected roughly 1 in 200 Americans. Before 1900, the typical opiate addict in America was an upper-class or middle-class white woman. Today, doctors are re-learning lessons their predecessors learned more than a lifetime ago.
Opium’s history in the United States is as old as the nation itself. During the American Revolution, the Continental and British armies used opium to treat sick and wounded soldiers. Benjamin Franklin took opium late in life to cope with severe pain from a bladder stone. A doctor gave laudanum, a tincture of opium mixed with alcohol, to Alexander Hamilton after his fatal duel with Aaron Burr.
The Civil War helped set off America’s opiate epidemic. The Union Army alone issued nearly 10 million opium pills to its soldiers, plus 2.8 million ounces of opium powders and tinctures. An unknown number of soldiers returned home addicted, or with war wounds that opium relieved. “Even if a disabled soldier survived the war without becoming addicted, there was a good chance he would later meet up with a hypodermic-wielding physician,” Courtright wrote. The hypodermic syringe, introduced to the United States in 1856 and widely used to deliver morphine by the 1870s, played an even greater role, argued Courtwright in Dark Paradise. “Though it could cure little, it could relieve anything,” he wrote. “Doctors and patients alike were tempted to overuse.”