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When Did America Experience Its First Opioid Crisis?

America's first opioid crisis dates back to the late 19th century, following the Civil War, when morphine addiction became widespread. This era saw the rise of "soldier's disease," as veterans grappled with pain management. As we examine the roots of this crisis, consider how history informs our current battles with addiction. What lessons can we learn from the past?

Today, we know that the current opioid crisis began in the 1990s, when pharmaceutical companies convinced doctors that opioid painkillers were safe and wouldn’t cause addiction. Tragically, this led to their over-prescription and subsequent misuse by millions of Americans.

But this was not the first such opioid epidemic. More than 150 years ago, during and after the U.S. Civil War, doctors liberally prescribed opium and morphine for practically any ailment, especially to those fighting a war in which as many as 750,000 soldiers died, along with untold civilian casualties. Military doctors – some of whom were using opioids themselves – dispensed morphine injections to dull the excruciating pain of gunshot wounds and battlefield amputations. Thousands of soldiers came home with addictions, if they came home at all.

A history of opioid use:

  • Doctors were prescribing opiates liberally by the time the war started in 1861. Opium, for example, was an effective treatment for diarrhea.

  • Military doctors didn’t prescribe opiates equitably to white and African-American soldiers, so most Civil War veterans who got treated, and addicted, were white.

  • There were no regulations on narcotics during the Civil War era. Opium pills, morphine and hypodermic needles were sold over the counter at pharmacies. You could even by mail-order drugs from Sears, Roebuck & Co.

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    • The use of injectable morphine during the Civil War led to opioid addiction among veterans – and many others.
      The use of injectable morphine during the Civil War led to opioid addiction among veterans – and many others.