“As Gunpowder to the Ordnance”: The United States’ First Opioid Crisis

By Lauren Letizia ’23

“…none of the bounties of Providence when abused, are capable of producing greater evil to the human family [than opium].”

Moses Clarke White (Yale medical student), 1854

“Opium… bound me up with cords that God only knows how often I tried to break, and as many times failed.”

Albert W. Henley (Confederate Army surgeon), 1879

The United States’ opioid epidemic has cracked and destroyed communities across the nation, particularly in the Appalachian and Northeast regions. In 2019 alone, 70,630 people died from drug overdoses, while 1.6 million Americans were diagnosed with an opioid abuse disorder.[1] These numbers are unprecedented and have forced the federal government to declare a public health emergency. However, America’s battle against opioids and opioid addiction began 157 years ago with the conclusion of the Civil War.

The Civil War killed 750,000 young men and maimed approximately one million more. Soldiers returned home from the blood-soaked fields of Fredericksburg, Gettysburg, Vicksburg, and Richmond, carrying both physical and emotional wounds. During the antebellum era and the war itself, opium, a substance derived from poppy seeds, was distributed to soldiers suffering from bullet wounds, amputations, or chronic diarrheal illnesses. Many women also relied on opium to help relieve cramping and, like Mary Todd Lincoln and famed South Carolina diarist Mary Chesnut, to combat anxiety, depression, or “general nervousness.”[2] It was often administered in a powder or pill form that was consumed orally by the patient.[3] However, as the opium-based drug, morphine became more common and hypodermic syringes were made available, physicians and army doctors began to administer the drug intravenously. This was the quickest and most reliable way to relieve the phantom pain of an amputated limb, the pounding of a bullet wound, or severe diarrhea or coughing.

For Civil War doctors, opium and other opiates were a miracle treatment. A Confederate medical handbook stated that “opium is the one indispensable drug on the battlefield—important to the surgeon, as gunpowder to the ordnance.”[4] After the war, an estimated 400,000 soldiers were addicted to opium.[5]

In the North, after the declaration of war in 1861, the US Army began to requisition enormous quantities of opium: Approximately 5.3 million pills and 2.8 million ounces of “opiate preparations.” Surgeons were encouraged to prescribe opium to soldiers for most illnesses and pain. In 1864, though the Confederate Army struggled to obtain medical supplies, physicians of the 2nd NC Military hospital included opium in 40% of their prescriptions.[6] Doctors and scientists were aware of drug dependency and addiction, at least in the most basic sense. It was understood that the more a patient is given a drug, the more resistant their body will become. However, opium was the best treatment solution for ghastly wounds and camp maladies. Because of the exorbitantly high rates of opiate prescriptions, post-war America had to grapple with a new, internal war. Some historians estimate that hundreds of thousands of Americans, both civilians and veterans alike, were addicted to opium by the 1890s.[7]

Union doctors administering opium to a wounded soldier

            In 1876, an anonymous Union veteran published an autobiography of his opium addiction called Opium Eating: An Autobiographical Sketch. The soldier volunteered for the army in 1861 at the age of sixteen. He enlisted as a drummer because of this age, but his eagerness to fight caught the attention of an officer, who asked him to accompany the regiment to Stone’s River. The soldier later fought at Chickamauga on September 19, 1863, where he was captured with 5,000 other soldiers. After a three-week detainment in Richmond with little food, the soldier and his comrades were sent to the notorious Andersonville Prison in Georgia, where the prisoners were starved, abused, and executed. “ANDERSONVILLE! Dread word! Dread name for cruelty, and patriots’ graves, I stand paralyzed before thy horrid gates,”[8] the soldier recalled. The soldier was eventually transferred from Andersonville in September 1864 to Florence Prison in Charleston, South Carolina due to the military threat posed by General Sherman’s infamous “March to the Sea.”. In early 1865, he and his surviving prisoners were sent to Wilmington, North Carolina as part of a prisoner exchange with the Union Army. The soldier was free.

Andersonville Prison Survivor

            “On getting home,” he wrote, “and taking inventory of myself, I found that I was but a skeleton.”[9] Sores broke out over his body, and he had difficulty consuming food. His most potent problem, however, was insomnia. He asked a doctor to prescribe him a sleeping draught, most likely laced with opium, to help him sleep. The doctor was reluctant, but eventually capitulated. “I felt that the sleep would, even with taking it, much more than counterbalance all evil effects that would likely arise from the medicine, and I determined to procure it if possible,” the soldier wrote.[10] The soldier was able to avoid addiction at this time, but he was soon wracked by stomach pains and excruciating migraines. With trepidation, he consulted his town’s physician, who insisted on treatment via hypodermic injection. The soldier said he did not want morphine, to which the physician claimed the medication was opiate-free. His health slowly improving, the soldier returned to the physician only to discover that he was being secretly dosed with a morphine mixture via injections. He recalled, “The doctor soon found he had an elephant on his hands,—saw that I was in the habit; became tired of my regular calls for hypodermical injections, and endeavored to shake me off. After giving him fully to understand his culpability in the matter, we parted.”[11] Now officially an addict, the soldier began to purchase his opiates from a drugstore. The soldier’s account of the desperate hold that the drug now contained over his body is heart-wrenching:

“I discovered that the power to fight and overcome great obstacles in this life, and which had always served me in my struggles theretofore, and which I relied upon then, was the very first thing destroyed by the enemy, namely, the will. Here I was, then, an opium eater. The outward effects and injurious properties of the drug soon made themselves manifest: what was I to do? Quit it, some may say; but no one well posted upon the opium habit would use those words, so hard and feelingless. A reply like this, I think, would betray more wisdom and humanity: “Your case is wellnigh hopeless; I can give you no encouragement whatever; do your utmost to release yourself from the unhappy predicament in which you have been placed; and may God help you, for I fear you will need other help beside your own.”[12]

“When bachelor dens cast over waking hours a loneliness so deep,” c. 1904. Courtesy of the Library of Congress.

The unknown “opium eater” continues his sketch by documenting the psychological battle he waged against his addiction. He details the cycle of pain, craving, relief, and shame that define the addict’s existence. In the 19th century, opium addicts, particularly men, were believed to be unmanly, weak-willed, and cowardly. They had few avenues for recovery or support. Often, if a person wanted to quit opium, they would have to endure unsafe withdrawal or “cold turkey” recovery, leading to more health issues or even death. The United States soldiers, who had survived so much death and bloodshed, were now engaged in an all-encompassing internal fight to heal their minds and bodies. Their struggle reveals that the American population has never been truly free from drug abuse and addiction. From the aftermath of the Civil War to the crack-cocaine epidemic of the late 1980s to the current Opioid Crisis, the United States continues to battle against the dark and dismal road of addictive drugs. Only time will tell if politicians and experts learn from the 157-year-old crisis that started the deadly pursuit.

[1] U.S Department of Health and Human Services, “What is the U.S. Opioid Epidemic?” About the Epidemic, https://www.hhs.gov/opioids/about-the-epidemic/index.html.

[2] R. Gregory Lande, “American Civil War Medical Practice, the Post Bellum Opium Crisis, and Modern Comparisons,” in Sage Journals (August 2, 2020). https://journals.sagepub.com/doi/full/10.1177/0957154X20946304

[3] Michael Ruane, “America’s first opioid crisis grew out of the carnage of the Civil War,” The Washington Post, December 1, 2021. https://www.washingtonpost.com/history/2021/12/01/opioid-crisis-civil-war-addiction/

[4] Jonathan S. Jones, “Opium Slavery: Civil War Veterans and Opiate Addiction.” Journal of Civil War Era 10, no.2 (2020): 190.

[5] Wendy McElroy, “U.S. Government Guilty of Creating Heroin Addicts,” The Daily Bell, October 16, 2014. https://www.thedailybell.com/all-articles/editorials/wendy-mcelroy-us-government-guilty-of-creating-heroin-addicts/.

[6] Jones, “Opium Slavery,” 191.

[7] Ruane, “America’s first opioid crisis,” https://www.washingtonpost.com/history/2021/12/01/opioid-crisis-civil-war-addiction/.

[8] Anonymous, Opium Eating: An Autobiographical Sketch By an Habituate,” (Philadelphia: Claxton, Remsen & Haffelfinger, 1876), 19.

[9] Anonymous, Opium Eating, 51.

[10] Anonymous, Opium Eating, 52.

[11] Anonymous, Opium Eating, 58.

[12] Anonymous, Opium Eating, 60.

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