Opium Eaters and the Civil War

One of the most common medicines of the Civil War, and for thousands of years prior, were opiates such as morphine (administered via hypodermic syringe), powdered opium, and laudanum, a mix of alcohol and opium. Opium-derived medicines in the modern era are used as painkillers, however, in the Civil War era and antebellum America, opiates were used for just about every affliction and given to just about anyone regardless of age. By reading the diaries of Civil War veterans and Civil War-era medical journals, historians can see just how widely opiates were used at the time. The prevalence of opiates and their wide use became the cause of America’s real opium addiction epidemic.

            In an account published in 1876, an anonymous veteran recounted his experience with opiate addiction in the post-Civil War era. This soldier was captured after the first day of the Battle of Chickamauga and sent to the Andersonville prison camp in Georgia. While imprisoned at Andersonville he experienced a host of medical complications such as scurvy, smallpox, malnutrition, and exposure, as a vast majority of prisoners did. After Andersonville, he was moved to Charleston, South Carolina then Wilmington and Goldsboro, North Carolina. It was at Goldsboro where the Union army caught up to this soldier and brought him back north to a hospital in Annapolis, Maryland.

In Annapolis, the soldier was given opiates to treat his insomnia. He wrote, “I could see that the doctor thought the medicine would be hurtful to me if taken every night, and for that reason allowed me to have it only on alternating nights”^[1]. The opiates given to the soldier by his doctor allowed him to sleep after going multiple consecutive days without sleep. At first, while in the hospital, this soldier “noticed no injurious consequences or effects of the medicine”^[2]. This was how many soldiers of the Civil War era were first introduced to opium. Even in the modern day, many opiate addictions start in the hospital. American doctors of the 19th century never intended to be one of the causes of America’s worst opioid epidemic.

            After his time in the hospital, the soldier returned home where he, like many other veterans who were given opium, started to realize their dependency. This soldier began to see his addiction come through in his search for a good night’s sleep and to ease the pain in his stomach. He found a local doctor who began hypodermic morphine treatments. The soldier writes, “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 me to shake it off”^[3]. The doctor first prescribed the soldier a mix of morphine and Indian hemp before beginning pure morphine treatments. The soldier had built up a dependency from his time in the Annapolis hospital and his experiences with the local doctor. He wrote on his dependency, “knowing, then, that I was simply an opium eater, I purchased my own morphia at the drug-stores, and took it per mouth instead of by a hypodermic syringe”^[4].

            The years after the Civil War saw some of the worst rates of opiate addiction in the nation, especially in the American South. Opiate dependency in certain southern communities was either as bad or worse than anywhere else in the world. According to a journal article by historian Dillon Carroll, “In Atlanta, for instance, 2 out of every 1,000 people were addicted to an opioid. The worst southern city, though, was Shreveport, Louisiana, where almost 10 out of every 1,000 were addicted to opium or morphine”^[5]. The same article found that opiate consumption was much higher among white soldiers than black soldiers. The article does not explain why there was a significant difference in addiction rates between the races but does attempt to explain why the addiction rates were so high. In the South, millions of lives were adversely affected by the Civil War whether it be through property loss or through the loss of a loved one. Carroll offers the theory that some Southerners turned to opium and heroin to ease the pain of that familial loss.

            The anonymous soldier attempted many times to quit his addiction, each time he had failed and began to use again. He described “the appetite for morphia, which while I was suffering, I was able to control, grew much sharper after the tenth day… I took a small dose of morphia, thinking I might thus stay the violent cravings of the appetite”^[6]. The soldier began using opium as he believed it would cure his post-war afflictions, however, all it did was lead him to more pain and suffering due to his addiction. In an 1876 diary entry, he wrote, “my practice is now to [take] a dose of so many grains exact weight at ten o’clock A.M., and another at four and a half o’clock P.M. Regularity is absolutely enforced”^[7]. There was no effective way of treating opiate addiction in the 19th century and doctors would give opiates to addicts if requested.

            It was not until the 1890s that American doctors and the nation began to get a hold on the opioid epidemic by changing the way opiates were used. Throughout 19th century America and before, opiates were prescribed for just about anything and to anyone. Pharmacists were able to sell opiates over the counter as made evident in the diary of an opium addicted soldier. The opioid epidemic caused medical associations and colleges to change the way doctors were trained and taught about the use and prescription of opiates. The massive amounts of opiate addiction throughout the country caused states to pass legislation to restrict the sale of opiates to only those with valid prescriptions. The passage of the Harrison Narcotic Act in 1915, effectively prevented doctors from prescribing small amounts of opium to addicts, leading doctors to open early versions of methadone clinics in order to treat those suffering from addiction.

            The diary of an anonymous veteran “Opium Eater” reveals the state of post-Civil War medicinal practices as a result of opiate use during the war. An article from the Smithsonian Institute found that “The Union Army alone issued nearly 10 million opium pills to its soldiers, plus 2.8 million ounces of opium powders and tinctures.”^[8] This over-prescription of opiates led to the worst opioid epidemic in American history. As a result of this massive wave of opiate addicted Civil War veterans, the problem of addiction gained more attention. This attention led states and the federal government to pass laws to end the crisis and reduce addiction rates, especially in the American South and among its veterans. These programs aimed to end the opioid epidemic and reduce the suffering described by the anonymous “Opium Eater.” The anonymous soldier described the nature of how his addiction began, within the hospital system after suffering a great deal in Andersonville and the Confederate prison system.

Endnotes

^[1] Anon. Opium Eating: An Autobiographical Sketch. Philadelphia, PA: Claxton, Remsen & Haffelfinger, 1876. Pg 52.

^[2] Anon. Opium Eating: An Autobiographical Sketch. Philadelphia, PA: Claxton, Remsen & Haffelfinger, 1876. Pg. 53.

^[3] Anon. Opium Eating: An Autobiographical Sketch. Philadelphia, PA: Claxton, Remsen & Haffelfinger, 1876. Pg. 58.

^[4] Ibid., 58.

^[5] Carroll, Dillon. “Civil War Veterans and Opiate Addiction in the Gilded Age.” Journal of the Civil War Era, November 22, 2016.

^[6]  Anon. Opium Eating: An Autobiographical Sketch. Philadelphia, PA: Claxton, Remsen & Haffelfinger, 1876. Pg. 65-66.

^[7]  Anon. Opium Eating: An Autobiographical Sketch. Philadelphia, PA: Claxton, Remsen & Haffelfinger, 1876. Pg. 109.

^[8] Magazine, Smithsonian. “Inside the Story of America’s 19th-Century Opiate Addiction.” Smithsonian.com. Smithsonian Institution, January 4, 2018. https://www.smithsonianmag.com/history/inside-story-americas-19th-century-opiate-addiction-180967673/

About the Author

Michael Mahr is the Education Specialist at the National Museum of Civil War Medicine. He is a graduate of Gettysburg College Class of 2022 with a degree in History and double minor in Public History and Civil War Era Studies. He was the Brian C. Pohanka intern as part of the Gettysburg College Civil War Institute for the museum in the summer of 2021.