3.  What kinds of people used opiates?

Several characteristics of opiate use under nineteenth-century conditions of low cost and ready legal availability will strike contemporary readers as strange.

First, most users of narcotics in those days were women. An 1878 survey of 1,313 opiate users in Michigan, for example, found that 803 of them (61.2 percent) were females. An 1880 Chicago study similarly reported: "Among the 235 habitual opium eaters, 169 were found to be females, a proportion of about 3 to 1." An Iowa survey in 1885 showed 63.8 percent females.

The use of opiates by prostitutes did not fully account for this excess of women in the user population. Thus the Chicago report noted: "Of the 169 females, about one-third belong to that class known as prostitutes. Deducting these, we still have among those taking the different kinds of opiates, 2 females to 1 male."

The widespread medical custom of prescribing opiates for menstrual and menopausal discomforts, and the many proprietary opiates advertised for "female troubles," no doubt contributed to this excess of female opiate users. A 1914 Tennessee survey, which found that two-thirds of the users were women, noted also that two-thirds of the women were between twenty-five and fifty-five. "The first twenty years of this period," the survey report commented, "is about the age when the stresses of life begin to make themselves felt with women, and includes the beginning of the menopause period. [Nineteenth-century women, on the average, reached menopause somewhat earlier than twentieth-century women do.] It appears reasonable, therefore, to ascribe to this part of female life, no small portion of the addiction among women."

The extent to which alcohol-drinking by women was frowned upon may also have contributed to the excess of women among opiate users. Husbands drank alcohol in the saloon; wives took opium at home.

After passage of the Harrison Narcotic Act in 1914, the sex ratio in addiction altered drastically. By 1918 a "Special Committee on Investigation" appointed by the Secretary of the Treasury could report that "drug addiction is about equally prevalent in both sexes. Thereafter the sex ratio continued to change. Estimates during the 1960s indicated that males outnumbered females among known addicts by five to one or more.

A second remarkable fact about the nineteenth-century use of opiates in the United States was the age of the users. The 1880 Chicago survey showed an average age for males of 41.4 years and for females of 39.4 years. In the small towns of Iowa in 1885, the average age of 235 users was 46.5 years. The 1914 Tennessee survey showed an average age of 50. Today, in contrast, nearly half of all addicts known to the Federal Bureau of Narcotics and Dangerous Drugs are 30 or younger, and only 13.6 percent are over 40. The age at which they started taking narcotic's is, of course, much earlier--- usually in the teens or early twenties. Thus one aftermath of the twentieth-century narcotic laws has been a shift in the brunt of the addiction problem from menopausal females to adolescent males.

A third interesting fact was the socioeconomic status of nineteenth century narcotics users. The Massachusetts State Board of Health reported in 1889 on 612 answers to the question: "What classes of people use opium in your community?" (Here, as in much of the nineteenth-century literature, "opium" included morphine and other opiates.) Replies from 446 druggists and 166 physicians are shown in Table 1.

The 1881 Catholic World article, cited above, said much the same thing more eloquently:

Opium-eating, unlike the use of alcoholic stimulants, is an aristocratic vice and prevails more extensively among the wealthy and educated classes than among those of inferior social position; but no class is exempt from its blighting influence. The merchant, lawyer, and physician are to be found among the host who sacrifice the choicest treasures of life at the shrine of Opium. The slaves of Alcohol may be clothed in rags, but vassals of the monarch who sits enthroned on the poppy are generally found dressed in purple and fine linen.

The 1885 Iowa survey similarly noted that the majority of opiate users are to be found among the educated and most honored and useful members of society."

Finally, there is no evidence of any disproportionate use of opiates among black people during the nineteenth century; indeed, there are few references to their use of opiates at all. Surveys made in 1913 in Jacksonville, Florida, and throughout the state of Tennessee in 1914, turned up a much lower proportion of opiate users among blacks than among whites. The high proportion of black people among known opiate addicts during the 1950s and 1960s is a quite recent development * visible chiefly since World War II. It appears to be closely related to a shift in the channels of heroin distribution (see below) and not to any predilection of black people for opiates. Since the late 1960s heroin use has increased again among youthful middle-class whites; this increase will be discussed in Chapter 20.

* Among 68,864 opiate addicts known to the Bureau of Narcotics and Dangerous Drugs as of December 31, 1970, 48.4 percent were said to be black." The great majority of addicts, however, were not known to the bureau. The high proportion of black people among known addicts may result at least in part from the greater likelihood that a black addict will get arrested or otherwise come to the attention of the bureau.

The enormous shift in the characteristics of narcotic addicts after 1914, the further shift in the late 1960s, and evidence of similar changes from time to time, and from place to place in the kinds of people who use other drugs, to be reviewed in subsequent chapters, should warn against placing excessive reliance on studies equating particular personality characteristics with a tendency to use a particular drug. There is an enormous literature of such studies-purporting to show, for example, that opiate addicts are excessively close to their mothers, or display masochistic tendencies, or that marijuana smokers are psychopathic or introverted. The most such a study can prove, however, is that at a particular time, in a particular place, under a particular set of laws and popular attitudes, morphine or heroin or some other drug tends to attract users of a particular stripe. By the time such a study is completed, the typology of drug use may well have shifted.

Footnotes
Chapter 3