Dopesick - Beth Macy Page 0,8

that “addiction can scarce be possible.”

By 1899, Bayer was cranking out a ton of heroin a year and selling it in twenty-three countries. In the United States, cough drops and even baby-soothing syrups were laced with heroin, ballyhooed at a time when typical opioid consumers were by now not only war veterans but also middle-aged barbers and teachers, shopkeepers and housewives. Many were mostly functioning, doctor-approved users, able to hide their habits—as long as their supply remained steady, and as long as they didn’t overdo.

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At the dawn of the twentieth century, the pendulum began to swing the other way as a few prominent doctors started to call out their overprescribing peers. Addressing the New York Academy of Medicine in 1895, a Brooklyn doctor warned colleagues that leaving morphine and syringes behind with patients, with instructions to use whenever they felt pain, was “almost criminal,” given that some were becoming hooked after only three or four doses. “Many cases of the morphine habit could have been avoided had the family physician not given the drug in the first place,” he said. By 1900, more than 250,000 Americans were addicted to opium-derived painkillers.

And yet heroin’s earliest years were mostly full of praise, as medical journals heralded Bayer’s new cough suppressant, considering it distinctly superior to and apart from morphine, some promoting it as a morphine-replacement drug. Though a few researchers warned about possible addiction—“the toxic properties of the drug are not thoroughly known,” one noted in 1900—for eight years you could buy heroin at any American drugstore or by mail order.

In 1906, the American Medical Association finally sounded a sterner alarm: “The habit is readily formed and leads to the most deplorable results.” Heroin-related admissions to hospitals in New York and Philadelphia were rising by the 1910s and 1920s, and it was dawning on officials that addiction was skyrocketing among both the injured and recreational users (then called “vicious,” meaning their use rose from the world of vice). Soldier’s disease, in the words of New York City’s commissioner of health, had now become “the American Disease.”

The Harrison Narcotics Act of 1914 severely restricted the sale and possession of heroin and other narcotic drugs, and by 1924 the manufacture of heroin was outlawed, twenty-six years after Bayer’s pill came to market. By the thirties, typical heroin users were working-class, and many of them were children of immigrants, along with a growing number of jazz musicians and other creative types, all now reliant on criminal drug networks to feed their vicious habit—and keep their dopesickness at bay. The addicted were now termed “junkies,” inner-city users who supported their habit by collecting and selling scrap metal. The “respectable” upper- and middle-class opium and morphine addicts having died out, the remaining addicted were reclassified as criminals, not patients.

Gone and buried were the doctor-addicted opioid users once common, especially in small towns—think of Harper Lee’s morphine-addicted eccentric, Mrs. Dubose, from To Kill a Mockingbird, or the morphine-addicted mother who inspired Eugene O’Neill’s Long Day’s Journey into Night. Think of the “Des Moines woman [who] gave her husband morphine to cure him of chewing tobacco,” as one newspaper chortled. “It cured him, but she is doing her own spring planting.”

Think of the time in 1914, decades before the term “neonatal abstinence syndrome” was coined (to describe the withdrawal of a baby born drug-dependent), when a Washington official wrote that it was “almost unbelievable that anyone for the sake of a few dollars would concoct for infant use a pernicious mixture containing…morphine, codeine, opium, cannabis indica, and heroin, which are widely advertised and which are accompanied by the assertion that they ‘contain nothing injurious to the youngest babe.’”

Below the story, on the same newspaper page, appeared an ad for an opium “sanitorium,” a sprawling Victorian home in Richmond in which Dr. H. L. Devine promised that he could cure opium addiction in ten days to three weeks.

But the yellowed newspaper warnings would become moot, like so many historical footnotes—destined to repeat themselves as soon as they receded from living memory.

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Despite all the technical, medical, and political sophistication developed over the past century, despite the regulatory initiatives and the so-called War on Drugs, few people batted an eye in the late 1990s as a new wave of opioid addiction crept onto the prescription pads of America’s doctors, then morphed into an all-out epidemic of OxyContin’s chemical cousin: Heinrich Dreser’s drug.

No one saw the train wreck coming—not the epidemiologists, not the criminologists, not even the scholars who for decades had dissected