3. Advances in Pain Management Set the Stage for an Epidemic of Addiction
America’s Civil War was one of the first major “modern” wars. It was a conflict in which rapid advances in weapons and their lethality outpaced advances in battlefield tactics. As such, there was an imbalance between ever deadlier weapons on the one hand, and outdated tactics that had not yet caught up with new battlefield realities. The result was high casualties and horrific injuries that confronted the armies’ physicians with unprecedented challenges. The standard of medical care was abysmally low by modern standards, and had not advanced much beyond that of the Napoleonic era, half a century earlier.
One exception to the era’s generally low standards of medical care was the field of pain management. Civil War physicians might not have known about antiseptic practices to prevent infections. However, thanks to the recent invention of the hypodermic needle, coupled with the discovery of morphine decades earlier, they could at least do something to ease the pain of wounded soldiers. When hypodermic needles and morphine were not available, opium pills were in plentiful supply – at least in Union hospitals.
2. Hundreds of Thousands of Civil War Veterans Became Addicted to Morphine
Civil War soldiers – the ones in blue, at least – were often dosed with massive amounts of morphine or opium to deaden the pain of amputations, other surgeries, and various ailments. Many wartime accounts highlight that liberality in dispensing drugs. For example, one Union doctor diagnosed wounded soldiers from horseback, and if any needed morphine, he would pour a dose on his hand, and have the soldier lick it. On the Confederate side, one Rebel doctor was known for giving patients plugs of opium, depending on whether or not they were constipated.
The potential for addiction was known, but the risk was deemed acceptable: it was considered a lesser evil that could be dealt with later. “Later” came when the soldiers were discharged from the hospitals. It is estimated that over 400,000 Civil War became morphine addicts because of their wartime experiences. If that figure is prorated to America’s 2021 population, it would be the equivalent of an American war whose aftermath left about 4,200,000 veterans with a drug addiction. The term “Soldiers Disease” was coined to describe that addiction. Many addicts were readily identifiable by a small bag dangling from a leather thong around their neck, containing morphine tablets and a hypodermic needle.
Cowboys in Arizona in the 1880s. Arizona State University
Unsettled frontiers attract a disproportionate number of single young men, eager for adventure and new horizons. They are often rowdy, rambunctious, restless, and absent the social restraints typically imposed by families and neighbors in more established communities, frequently lawless. Many of them were Civil War veterans, still young in years although aged beyond measure by what they had witnessed and experienced. PTSD amongst their numbers accounts for at least some of what made the Wild West so wild and crazy. Indeed, some of the wilder and most famous of the West’s outlaws, such as Jesse James and his brother Frank, were molded in their early years by their wartime experience as combatants.
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Where Did We Find This Stuff? Some Sources and Further Reading