Popular Science Monthly/Volume 33/September 1888/How the Opium-Habit Is Acquired
|HOW THE OPIUM-HABIT IS ACQUIRED.|
I AM not one of the persons who raise a great cry about the evils of the "opium-habit." I have no doubt that the continued use of narcotics, whether they be tobacco or opium, is injurious to the nervous system; but I also firmly believe that the recuperative powers of the body are such that they can largely overcome any harmful results coming from the regular use of these substances. For instance, I know a stone-cutter who resides at Cape Elizabeth, Me., who for the past twenty years has used twenty cents' worth of black "navy plug" tobacco every day. He is a large, vigorous man, weighing over two hundred pounds. His appetite is good; he sleeps well, and, save for a little heart disturbance caused by overstimulation, he is perfectly healthy, and is likely to live until he is fourscore. He is now fifty-one years of age, and he assures me he has used tobacco since he was fourteen, and never had a fit of "swearing off" in his life. A peculiar and, I should say, a rather troublesome habit of his, is to go to bed every night with a big "quid" of hard "plug" tobacco between his molars. As this is always gone in the morning, and the pillow shows no traces of the weed, he thinks he chews it and swallows it in his sleep, though he never knows anything about the process.
There is a widow who keeps a lodging-house in Oak Street, Boston, Mass., who takes three drachms of morphia sulphate every day, in three one-drachm doses, morning, noon, and night. When it is remembered that an eighth of a grain is the usual dose for an adult, while two grains are sufficient to kill a man, the amount she takes seems startling. I asked her why she did not try and substitute tobacco, or bromide, or chloral hydrate for morphine, and she said they made her sick, so she could not use them. This woman is sixty years old, very pale and emaciated. Her appetite is poor. She attends to her duties faithfully, however, and is able, with the help of a girl, to carry on a large lodging-house.
I might give scores of instances similar to the above, but these will do for my purpose. I believe that the person who takes liquor or tobacco or opium, in regular quantities at stated intervals, is able to withstand their effect after getting fixed in the habit, and that it is the irregular, spasmodic use of these articles which brings delirium and death. It is the man who goes on a "spree," and then quits for a time, who has the weak stomach and aching head. His neighbor, who takes his regular toddy and has his usual smoke, feels no inconvenience.
For the past year or more I have studied the growth of the opium-habit in Boston. It is increasing rapidly. Not only are there more Chinese "joints" and respectable resorts kept by Americans than there were a year ago, but the number of individuals who "hit the pipe" at home and in their offices is growing very fast. A whole opium "lay-out," including pipe, fork, lamp, and spoon, can now be had for less than five dollars. This affords a chance for those who have acquired the habit to follow their desires in private, without having to reveal their secret to any one. How largely this is practiced I do not know, but, judging from the tell-tale pallor of the faces I see, I feel sure the habit is claiming more slaves every day.
In order to approximate to the amount of opium in its various forms which is used in Boston, I have made a thorough scrutiny of the physicians' recipes left at the drug-stores to be filled. As is well known, all recipes given by physicians are numbered, dated, and kept on file at the drug-stores, so that they may be referred to at any time. To these I went in search of information.
I was surprised to learn how extensively opium and its alkaloids—particularly sulphate of morphia—are used by physicians. I found them prescribed for every ailment which flesh is heir to. They are used for headache, sore eyes, toothache, sore throat. laryngitis, diphtheria, bronchitis, congestion, pneumonia, consumption, gastritis, liver-complaint, stone in the gall-duct, carditis, aneurism, hypertrophy, peritonitis, calculus, kidney trouble, rheumatism, neuralgia, and all general or special maladies of the body. It is the great panacea and cure-all.
During my leisure time I have looked up more than 10,000 recipes. It has been my practice to go to the files, open the book, or take up a spindle at random, and take 300 recipes just as they come. The first store I visited I found 43 recipes which contained morphine out of the 300 examined. Close by, a smaller store, patronized by poorer people, had 36. Up in the aristocratic quarters, where the customers call in carriages, I found 49 morphine recipes in looking over 300. At the North End, among the poor Italian laborers, the lowest proportion of 32 in 300 was discovered. Without detailing all the places visited, I will summarize by saying that, in 10,200 recipes taken in 34 drug-stores, I found 1,481 recipes which prescribed some preparation of opium, or an average of fourteen and one half per cent of the whole.
This was surprising enough; but my investigations did not end here. Of the prescriptions furnished by physicians I found that forty-two per cent were filled the second time, and of those refilled twenty-three per cent contained opium in some form. Again, twenty-eight per cent of all prescriptions are filled a third time; and of these, sixty-one per cent were for opiates; while of the twenty per cent taken for the fourth filling, seventy-eight per cent were for the narcotic drug, proving, beyond a doubt, that it was the opiate qualities of the medicine that afforded relief and caused the renewal.
From conversation with the druggists, I learned that the proprietary or "patent" medicines which have the largest sales were those containing opiates. One apothecary told me of an old lady who formerly came to him as often as four times a week and purchased a fifty-cent bottle of "cough-balsam." She informed him that it "quieted her nerves" and afforded rest when everything else had failed. After she had made her regular visits for over a year, he told her one day that he had sold out of the medicine required, and suggested a substitute, which was a preparation containing about the same amount of morphine. On trial, the woman found the new mixture answered every purpose of the old. The druggist then told her she had acquired the morphine-habit, and from that time on she was a constant morphine-user.
It was hard to learn just what proportion of those who began by taking medicines containing opiates became addicted to the habit. I should say, from what I learned, that the number was fully twenty-five per cent—perhaps more. The proportion of those who, having taken up the habit in earnest, left it off later on, was very small—not over ten per cent. When a person once becomes an opium-slave, the habit usually holds through life.
I was told many stories about the injurious effects of morphine and opium upon the morals of those who use it. One peculiarity of a majority is that, whenever a confirmed user of the narcotic obtains credit at the drug-store, he at once stops trading at that place and goes elsewhere. All the druggists know this habit very well, and take pains to guard against it. Whenever a customer asks for credit for a bottle of morphine, the druggist informs him that the store never trusts any one; but if he has no money with him the druggist will gladly give him enough to last a day or two. In this way the druggist keeps his customer, whereas he would have lost his trade if the present had not been made at the time credit was refused.
Of course, I heard much about the irresistible desire which confirmed slaves to the habit have for their delight. There is nothing too degrading for them to do in order to obtain the narcotic. Many druggists firmly believe that a majority of the seemingly motiveless crimes which are perpetrated by reputable people are due to this habit. In pursuit of opium the slaves will resort to every trick and art which human ingenuity can invent. There is a prisoner now confined in the Concord (Mass.) Reformatory who has his opium smuggled in to him in the shape of English walnuts donated by a friend. The friend buys the opium and, opening the walnut-shells, extracts the meat, and fills up the spaces with the gum. Then he sticks the shells together with glue and sends them to the prison.
At present our clergymen, physicians, and reformers are asking for more stringent laws against the sale of these narcotics. The law compelling every person who purchases opium or other poisons to "register," giving his name and place of residence to the druggist, has been in force in Massachusetts for several years, and all this time the sales have increased. No registration law can control the traffic.
The parties who are responsible for the increase of the habit are the physicians who give the prescriptions. In these days of great mental strain, when men take their business home with them and think of it from waking to sleeping, the nerves are the first to feel the effects of overwork. Opium effects immediate relief, and the doctors, knowing this, and wishing to stand well with their patients, prescribe it more and more. Their design is to effect a cure. The result is to convert their patients into opium slaves. The doctors are to blame for so large a consumption of opium, and they are the men who need reforming.
Two means of preventing the spread of the habit suggest themselves to every thoughtful person: 1. Pass a law that no prescriptions containing opium or its preparations can be filled more than once at the druggist's without having the physician renew it. The extra cost of calling on a doctor when the medicine ran out would deter many poor people from acquiring the habit. Such a law would also make the doctors more guarded in prescribing opiates for trivial ailments. With the law in force, and the druggists guarded by strict registration laws, we could soon trace the responsibility to its proper source, and then, if these safeguards were not enough, physicians could be fined for administering opiates save in exceptional cases.
2. The great preventive to the habit is to keep the body in such a state that it will not require sedatives or stimulants. The young men and women in our cities have too big heads, too small necks, and too flabby muscles. They should forsake medicine, and patronize the gymnasium. Let them develop their muscles and rest their nerves, and the family doctor, who means well, but who can not resist the tendency of the age, can take a protracted vacation. Unless something of the kind is done soon, the residents of our American cities will be all opium-slaves.