The temperance movement marches on — as does the book. This excerpt picks up where this one left off. Thanks again for the helpful comments you’ve been providing so far. The book is improved thanks to them…
In the early 1800s, the state of medical technology offered the suffering few options for pain relief. Essentially, all a doctor could do was use drugs to help a patient get high. Even the most temperate-minded were reluctant to decry an evil of such obvious necessity. But when relief that didn’t come with inebriation became available, attitudes began to change—or, more accurately, attitudes and interests that had been kept in check by the undeveloped state of medicine were finally unleashed.
Aspirin, X-ray machines, and other commonplace elements of today’s medical arsenal wouldn’t be around until the very end of the 19th century. The lack of an effective product, however, never stopped a good American businessman from trying to make a buck. Indeed, a person of that time with a headache, an infection, or any other malady had a bewildering array of supposed remedies to choose from. The commercialization of pain relief had allowed drug control to slip from the hands of the medical profession.
The once flourishing patent-medicine industry, which produced herbal and medicinal concoctions that often didn’t work, lives on in familiar descendants such as Vicks VapoRub and Geritol. The industry left a profound mark on American culture. The modern advertising industry was essentially launched by patent-medicine companies, which sold their wares without a prescription at a huge mark-up and had to compete with scores of similar producers. Thus the dawn of brand-building: Accept no substitutes! Medicinal advertising in turn fueled journalism and the rise of mass media and mass marketing. The hyperpartisan media that had previously been driven by political parties was nothing next to the commercialized journalism funded by patent-medicine firms. Major American papers were founded for the sole purpose of promoting certain patent medicines. This relationship, of course, would eventually become rather complicated, as some of the journalists created by the patent-medicine industry turned on their fraudulent benefactors. But in the meantime, there were enormous profits to be made.
When one product generally isn’t much better than another, it’s difficult for any particular company to dominate the marketplace, which accounts for the multitude of now defunct patent firms. But there’s no mystery behind those patent meds that actually were effective: They were made with alcohol, cannabis, cocaine or opium. In the unregulated capitalist jungle that grew wild then, ingredients were almost never listed, but people knew which products worked. Naturally, addictions developed—brand loyalty at its most loyal.
As the more potent patent medicines helped spread drug addiction across the country, it moved to poor and working-class communities. It also began to be associated with a criminal element. In 1909, New York City Police Commissioner Theodore Bingham sounded a warning that was becoming more common at the time: “The classes of the community most addicted to the habitual use of cocaine are the parasites who live on the earnings of prostitutes, prostitutes of the lowest order, and young degenerates who acquire the habit at an early age through their connection with prostitutes and parasites.” Five years later, New Haven Police Chief Phillip Smith told a meeting of the International Association of Chiefs of Police that “nowadays drugs have become a regular diet with harlots and their pimps, and criminally inclined persons of all kinds.”
Heroin had been assumed to be nonaddictive when introduced commercially, in 1898. But it didn’t help improve the image of the drug user after it had been around long enough for people to learn otherwise. “In many instances [heroin addicts] are members of gangs who congregate on street corners particularly at night, and make insulting remarks to people who passed,” reads a 1915 New York State Hospital psychiatric bulletin. Around the same time, New York addiction specialist Alexander Lambert called heroin a “vice of the underworld.” Taking the drug, he noted, differs from morphine use, the point of which is “to forget bodily pain and mental suffering.” Morphine users of the era typically got their drugs from a doctor and tended to be both better off and over 30 years old. Heroin users scored on the street, hung out on the corner, and tended to be teenagers or in their early 20s.
The rhetoric of American drug use was taking on an adversarial edge, one that still exists today.
Both morphine and heroin, of course, ease bodily pain and mental suffering—but it was becoming crucial whose body and mind were being eased. As more people left rural areas for the exploding cities, the general public in these new urban environments didn’t appreciate the mental suffering it had to undergo as the target of, as the psychiatrist put it, “insulting remarks” from “gangs who congregate on street corners.” In turn, addicts lined up outside of a New York City clinic were harassed and gawked at by sightseers. Inevitably, there was also a racial component to early-20th-century addiction: A turn-of-the-century study in Jacksonville, Florida, found that blacks, only few decades removed from slavery, were twice as likely as whites to be snorting cocaine—a phenomenon perhaps more significant as it relates to perception than to reality.
When users were predominantly middle- to upper-class whites and getting high was associated with medicine, there was little incentive for the government to criminalize drugs. After all, the ruling class tends to rule itself least. But as the 20th century progressed, addiction that originated with medicinal use—the most common way that rich people got hooked—declined substantially, while street use rose. Two Chicago doctors who examined more than 5,000 cases they had treated between 1904 and 1924 noticed the shift. “Fifteen or twenty years ago,” they write, “most addicts acquired the habit through the physical disease or discomfort. Today the number of new addictions through physicians’ prescriptions is small. The great majority of cases now result from association with other addicts, following their advice in taking a ‘shot’ or a ‘sniff’ for ‘what ails you’ and searching for new sensations. These are the pleasure users.”
The patent-medicine market made it difficult enough for Big Pharma to compete. The growing black market made it even harder. The further drug use got from the medical community, the less interest pharmaceutical companies had in defending it. For decades, the industry had been one of the biggest obstacles to outlawing the drugs that it had been making a fortune selling. But advances in medicine—as well as Big Pharma’s declining share of the pleasure-user market—gave it reason to rethink. Aspirin, patented in 1900 by heroin inventor Bayer, gave patients a nonaddictive analgesic and the company a new product to sell. Cocaine became less medically necessary with the invention of its synthetic versions, tropacocaine (1891), stovaine (1903), and novocaine (1904). Novocaine was perfect for the dentist’s chair, and it had no potential to cause the dreaded side effect of euphoria.
Big Pharma needed the help of the state to push the multitude of patent firms out of business. It also needed public opinion, which was turning against drug use and the people who enabled it, thanks not only to the visible consequences of the pharmacopeia utopia, but also in large part to a more unlikely source: the women’s suffrage movement.
Opium had entered the American bloodstream through laudanum and other opium-laced products available at pharmacies and recommended by doctors. When the backlash against drugs began, the opposition went straight for the pharmacist—and, to a lesser extent, the physician, who wasn’t always seen as a trustworthy professional. In 1911, Hamilton Wright, the government’s top drug official, went after both occupations in the pages of the New York Times. “A proportion of our doctors and a much larger ratio of our druggists regard their liberty to prescribe and sell as a license to advise and furnish to its victims the narcotic curse on demand,” he laments. “The contrast between European and American professional ethics in this matter is deplorable, and the dark side of the picture is America’s.”
Such mistrust was a byproduct of the growing movement for women’s rights, which was closely allied with the temperance movement. To the members of the era’s many women’s temperance leagues, druggists were little better than tavern owners—people, in essence, invested in intoxication. But the movement’s actions against pharmacies and saloons was more than an effort to clean up a few drunks. As the Women Christian Temperance Union’s version of its history makes clear, it was “a protest by women, in part, of their lack of civil rights. Women could not vote. In most states, women could not have control of their property or custody of their children in case of divorce. There were no legal protections for women and children, prosecutions for rape were rare, and the state-regulated ‘age of consent’ was as low as seven.”
The tavern, long a symbol of unruly male behavior, was also the place where rules were made. Most political meetings were held in saloons, which women were generally barred from. They didn’t much care for that arrangement, or for the public priorities that resulted. “At the end of the 19th century, Americans spent over a billion dollars on alcoholic beverages each year, compared with $900 million on meat, and less than $200 million on public education,” notes Helen E. Tyler in Where Prayer and Purpose Meet: The WCTU Story, 1874–1949. By the 1890s, the WCTU was endorsing women’s suffrage, more than half of its departments worked on nontemperance issues, and it had one of the first full-time lobbyists in Washington.