18. Over-Prescribing Opium During the American Civil War
The United States Civil War was the country’s bloodiest. About 10 percent of all Northern males, and 30 percent of all Southern males, perished in the conflict. Modern estimates put the war’s fatalities at between 785,000 to 1 million deaths – the latter figure representing 3.2% of America’s then-population. If extrapolated to 2020 population estimates, it would be the equivalent of about 10,600,000 deaths.
It was one of the first major “modern” wars, and one in which advances in weaponry outpaced advances in battlefield tactics. The result was high casualties and horrific injuries that confronted the armies’ physicians with unprecedented challenges. The standard of medical care and state of medical knowledge were abysmally low by modern standards. So it is perhaps unsurprising that Civil War-era doctors did not fully appreciate drug addiction and its risks: they prescribed morphine and other opium derivatives like candy. The result was a massive post-war addiction, little reported but as devastating as any modern drug addiction epidemic.
