The use of drugs in the 19th century was, in retrospect, almost shockingly common. According to Levinthal, an estimated 25 percent of the population in the United States in the 19th century relied upon either morphine or opium, and these and other drugs were widely available to the general public. They were often included in popular nostrums purchased at the local apothecary (pharmacy) with no prescription. Yet to individuals in the 21st century, the idea that opium and its products (as well as cocaine) were freely available to men, women, and children and even administered to infants in the past is difficult to understand or grasp.

Barbara Hodgson offers some perspective in her book In the Arms of Morpheus: The Tragic History of Laudanum, Morphine, and Patent Medicines:

Before the twentieth century, those who were ill had little choice but to turn to a substance such as opium. At least three conditions paved the way for this situation. First, opium was a vital means of coping with cholera, dysentery and tuberculosis, diseases borne of horrific living conditions such as those of the Industrial Revolution, because it reduced the physical manifestations of the disease--for example, diarrhea and coughing. Second, many diseases were incurable; opium eased the pain brought on by these ailments. And last, because opium was effective, available and cheap, those who distrusted or couldn't afford medical help diagnosed and treated their ailments themselves.

Opium was used by physicians to treat severe pain, menstrual problems, dysentery, arthritis, diabetes, pneumonia, sexually transmitted diseases, and many other ailments. It was actually effective in treating dysentery because opiates tend to cause constipation. Opiates were and still are effective at treating pain; however, they have no antibiotic or antiviral action, nor do they treat diabetes, and thus they were and are not efficacious in treating bacterial or viral diseases. However, the drug did make many sick people feel better.

Opium was available in powdered and gum forms, although most people consumed opium in some type of solution. Many people drank their opium in laudanum (a mixture of opium and other ingredients), and many of these solutions included up to 90 proof alcohol.

After the Civil War, sales of patent drugs escalated. Most of the drugs were not actually patented, but some were trademarked. However, these remedies together were referred to as patent medications. There were no controls over these medications; they were freely obtainable and obtained. Most consumers had no idea of what was included in their favorite remedies.

Says the author John Parascandola in his article on patent medications in Caduceus, "After the Civil War, patent medicine quackery really entered its golden age. Thousands of products flooded the market. As the cost of getting into business was relatively small and no great knowledge was required, many would-be entrepreneurs entered the field." In many cases, these drugs were worthless to trusting consumers, and in some cases, individuals became addicted to narcotic-laced remedies.

Medicine makers advertised their concoctions in calendars, almanacs, coloring books, and cookbooks, and in many other ways. Some sellers offered medicine shows, where they marketed their drugs in public and combined the sales pitch with a puppet show, magic show, or animal act.

Mail order drugs were also readily available to the population. According to Stephen R. Kandall, the author of Substance and Shadow: Women and Addiction in the United States, many Americans relied on patent medicines purchased through Sears Roebuck and similar mail-order catalogues. Some concoctions had names that may amuse the public today, such as Pink Pills for Pale People and Mrs. Winslow's Soothing Syrup.

Some of the popular patent medications that were sold by mail or in apothecaries and were specifically targeted to infants and children contained narcotics; for example, Mrs. Winslow's Soothing Syrup contained morphine (as well as sugar syrup, anise, caraway, fennel, and alcohol) and was given to infants for teething pain or other common problems of infancy.

Cough syrups commonly included narcotics; for example, according to Parascandola in his article in Caduceus, Dr. Bull's Cough Syrup comprised morphine sulfate dissolved in syrup.

In the 19th century, experts estimate that women used opium at a rate at least three times greater than that of men. In part, this was because the drug was commonly recommended or administered to them by physicians as a cure-all solution for numerous complaints. In addition, alcohol use among women was greatly frowned upon, while the use of opium and laudanum was widely accepted. Women were also heavy consumers of popular nostrums laced with opium and morphine. Most addicted women had no trouble obtaining their "medicine" whenever they needed it.

Opium and morphine were prescribed for menstrual difficulties, headaches, and many other common ailments suffered by females. As a result, some women became addicted to drugs. Says Kandall in Substance and Shadow: Women and Addiction in the United States, "Addiction to opiates touched all social levels--society women identifying with the artistic or intellectual set, rural and working-class women coping with long hours and loneliness, and prostitutes in city streets and opium dens. It is hardly surprising that such a large proportion of America's opiate addicts were women."

References:

1)         Hodgson, Barbara. In the Arms of Morpheus: The Tragic History of Laudanum, Morphine, and Patent Medicines. Buffalo, N.Y.: Firefly Books, 2001.

2)         Kandall, Stephen R. Substance and Shadow: Women and Addiction in the United States, Cambridge, Mass.: Harvard University Press, 1996.

3)         Levinthal, Charles F. "The History of Drug Use and Drug Legislation." In Drugs, Society, and Criminal Justice. Boston: Allyn & Bacon, 2006.

4)         Parascandola, John. "Patent Medicines in Nineteenth-Century America," Caduceus: A Museum Quarterly for the Health Sciences 1, no. 1 (Spring 1985): 1-41.

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