The Opium Habit [in Iowa]

By J. M. Hull

Iowa State Board of Health, Third Biennial Report (Des Moines: George E. Roberts, 1885), 535-545.

Although my paper on the opium habit is brief, and but a small part of the sad story told, yet I am inclined to believe it contains some facts regarding this rapidly increasing evil that cannot fail to astonish even those who are well informed, and far more those who have given the subject little or no attention. Opium is to-day a greater curse than alcohol, and justly claims a larger number of helpless victims, which have not come from the ranks of reckless men and fallen women, but the majority of them are to be found among the educated and most honored and useful members of society; and as to sex, we may count out the prostitutes so much given to this vice, and still find females far ahead so far as numbers are concerned. The habit in a vast majority of cases is first formed by the unpardonable carelessness of physicians, who are often too fond of using the little syringe, or of relieving every ache and pain by the administration of an opiate. Stupid, indeed, must that patient be, who having been fifty or one hundred times relieved of neuralgia, sciatica or rheumatism, does not learn better than to pay a dollar or two for what he can buy at any drug store for a nickle; or if used hyperdermically, he procures an instrument, and continues its use until he finds himself a member of that vast army of unfortunate habitues. Too soon, and yet too late, they find their friendly drug has woven its net about them, until at the first warnings of danger they undertake to break the cords, but find them too strong for human hands. It is at this time that many escapes are made, and in most cases will be made if made at all. The most resolute, and those who are fortunate enough to discover their danger in time, may by a powerful effort of the will make good their escape; but those who fail then, to try again at another time, or under more favorable circumstances, seldom if ever succeed by their own efforts, and if cured at all, the aid must come from some one skilled in the treatment of the habit, which I am happy to say is beginning to receive some attention from the medical profession. Why it comes so late I cannot say, but the way these poor victims are fleeced by advertising quacks is pitiable, indeed. No better proof can be given of the rapid increase of this evil than the number of advertisers who claim to cure the habit. So common are they that one or more may be seen in nearly all the papers and journals of the country. Even "Lost manhood restored" does not occur as often as "Morphine habit cured without pain." Some months ago I had printed and sent to the druggists of Iowa fifteen hundred circulars, requesting information on the subject. I received one hundred and twenty-three replies, with the following information: There were 235 habitues, of which 86 were males and 129 females; of the former, 18 were physicians, 2 6 used morphine hyperdermically, all others by the mouth; 129 using morphine, 73 gum opium, 12 laudanum, 6 paregoric, 3 Dovers' powder and 4 McMunn's Elixir. The amount used hyperdermically varied from Y8 grains to 70 grains a day. The average dose of morphine when taken by the mouth, was about 3 Y2 grains, some taking as high as 30 grains each day.As to age, 2 are below twenty; 21 between twenty and thirty; 59 between thirty and forty; 35 between forty and fifty; 68 between fifty and sixty; 50 were past sixty.The age at which the habit is the most common is between fifty and sixty.While the drug is used less frequently by the hyperdermic method than by the mouth, the former method is gaining ground. The habit may be formed about as readily one way as the other.

Those who use it by the mouth as a rule make the most rapid progress, as the drug is easier taken, is free from pain, and larger than the hyperdermic dose. There are, perhaps, three thousand stores in Iowa where opium is kept for sale, and if reports had come from all it would, at the same ratio, have shown the number of habitues to have been about six thousand; but it will be remembered that my reports are mostly from the small villages; very few are from the cities, where the habit is far more common .... From reliable information which I have been able to procure from various sources, I feel safe in saying there are in this State over ten thousand people who are constantly under the influence of an opiate, and who are wholly unable by any effort of the will to break the habit, or even to abstain for seventy-two hours. These victims loathe the drug they once loved, business is gone, family broken, friends lost, moral sense blunted or destroyed, mind incapable of healthy action, body weakened, and they see no hope here or hereafter. They will lie and steal-do almost anything to obtain the drugs with which and without which they are truly in a veritable hell. The face becomes sallow and soggy, the eyes bleared and expressionless, and the final result is either death or insanity. Some persons go on using these drugs for years before the symptoms here described supervene. Some are thus affected in a few months. Having reached this stage they cannot arouse themselves from their terrible infatuation. Gloomy and hopeless, the world and the people in it no longer interest them. In some cases, more especially those of an intensely nervous organization, the prolonged abuse of opium or morphine produces a condition characterized by cerebral excitement, analogous to that of delirium potatorum. These people are, however, less violent, and the affection usually passes away in a short time without treatment.

I am strongly of the opinion that if done at all it must be done at least in part by legislation. Physicians must be taught better than to use the drug in such a manner as to cause the habit to be formed; and finally the masses must be instructed with regard to the danger of a prolonged use of opiates and especially the use of the hyperdermic syringe.