“Old Soldiers Disease” is an interesting concept during and after the Civil War. In his article, “Opiate Addiction as a Consequence of the Civil War,” (1978) David T. Courtwright convincingly argued that opiate addiction was a common, if unintended, consequence of Civil War medical care, settling a contemporary debate among historians about the causative link between the war and opiate addiction. This essay was the authoritative account of Civil War veterans’ opiate addictions, and was “for a number of years the most-cited work on any form of disability among Civil War veterans.”

Jonathan S. Jones, in 2020, wrote the first follow-up article on this issue. Because of online data, he was able to identified a sample of one hundred Civil War veterans who suffered from opiate addiction in their postwar lives in his research for the article, “Opium Slavery Civil War Veterans and Opiate Addiction.”

The sample included sixty-five Union veterans, thirty-one Confederate veterans, and four subjects identified anonymously by themselves or doctors as Civil War veterans. His research was seeking to understand both the experiences and outcomes of Civil War veterans’ addiction.

By the 1850’s doctors had identified that opium was highly addictive and a menace to both man and his family. Writers in newspapers, medical journals, and pamphlets were discussing its evils. It was even said that, “there is no slavery so complete as that of the opium-taker.”

The problem of this period is that opium was freely used by doctors as part of the tools of pain relief. Handbooks for medical personnel called for its use in pain reduction, to reduce vomiting, diarrhea, internal bleeding, as a topical on wounds, and in general to reduce symptoms of illiness.

The Union medical department requisitioned about 5.3 million opium pills and another 2.8 million ounces of opium preparations including laudanum (5% opium in alcohol) for pain relief.

Opium was especially used with amputees and patients with chronic pain. Dr. Silas Weir Mitchell, at Turner’s Lane Hospital in Philadelphia, used morphine injections with his neurological patients in this first specialized hospital for this type of wounded.

Later in life Dr. Mitchell recalled using over 40,000 injections in just one year at the Turner’s Lane facility. Those with “intolerable pain” were the most likely to be given enough doses to become addicted. Dr. Mitchell later blamed many of the Union Surgeons who were, “too weak, too tender, too prone to escape trouble using the easy help of some pain-lulling agent.”

Some patients did not have horrible wounds or pain from amputations. There are cases in which the soldier had been treated for chronic diarrhea during the war. They were still reaching for opium 20 years later whenever they had aches or pain.

This “self-medication” many times would lead to addiction as the patient would have to use increasing quantities to achieve the desired results.

US Custom records on imported opium indicate that addiction increased rapidly after the Civil War. Based upon the data, it rose from 0.72 per thousand population in 1842 to 4.59 in 1890.

That would indicate that there were about 313,000 addicted citizens in 1890. The demand for stimulants during the war increased both alcohol and opiate addiction. Doctors by 1876, were starting to warn the population that the effects of addiction will take generations to eradicate. Like the pension costs of the Civil War, the medical costs would only be reduced through the deaths of the soldiers from old age.

How did these men become so addicted?

Many of them either swallowed or were injected with high doses of opium, morphine, or drank laudanum. As their tolerance grew, they had to take ever increasing doses to relieve the pain, cure the diarrhea or reduce the horror that resulted in PTSD.

Usually after six to eight years of use they were consuming from 12-16 grains per day. Some soldiers admitted that they were a “slave to the opium habit.”

Quitting cold turkey resulted in frightening chills, pain, insomnia, diarrhea, hallucinations or other results that were too scary to continue. The withdrawal symptoms were not understood and the addiction was far better that waiting out these symptoms from Hades. It would take massive willpower to quit, which many of these former soldiers were unwilling to complete. The disease was better that the cure.

Many soldiers never were covered by the entitlement programs that they deserved because of addictions.

Opiate addicted veterans were restricted by the admission personnel since many of these homes looked at the applicant’s character and morality when judging the applications. Addiction was considered to indicate a “weakened character and morality.”

When these men were allowed to enter Soldier’s Homes after the war, many of them were covered with needle marks from their constant injections.

Some actually had these marks from their neck to their toes. Many of them were described as, “emaciated, feeble, and fretful.” Many did not keep their syringe or solution of the drug even clean. It would have been very obvious which men were “opium eaters” in the homes. They usually were anorexic, wasting, and had no strength. Many went from a healthy 150 pounds to 100 pounds. Losing 1/3 of their body weight resulted in serious health issues including indigestion, fatigue, irritability, and a wrecked immune system.

Pensions were another area in which there was discrimination against the veteran. The Pension Bureau in Washington City deemed opium addiction not a pension problem, since it was considered a “deviant behavior.”

It was a “non-visible” disability, unlike a missing arm, leg or eye. Those that either hid their addiction or became addicted after obtaining a pension usually got to retain their monthly income. In many cases, if the veteran died from an overdose, the widow was denied the widow’s pension since he knew that it was dangerous and took it anyway.

On the Confederate side, the question asked was,” Do you use intoxicants to any extent?”

Many times if the veterans stretched the truth, he had to have others who would “attest” to that fact upon sworn statements that his habits are, “good and free from dishonor.”

The patented medicine hawkers of the age saw the perfect opportunity by selling “cures for these poor soldiers.” The “painless Opium Antidote” is one of the examples that was available. Like all patent medicines, there were many testimonials to the success by patients. Statements like “I rapidly gained strength – so rapidly that my friends noticed, and remarked at the change,” “I feel…so much more like my old self, and restored to life, health, and manhood again.” All of these gave false hope to the veteran that he might “kick” the habit without the painful withdrawal symptoms.

Finally, there were those addicted that ended up in insane asylums as a result of this condition. Extreme “intemperance” was considered a condition of insanity. Soldiers on both sides of the Civil War were committed to these asylums for a number of reasons. Some were committed because their spouse or relative could no longer care for them. Others were committed as a result of “dementia.” Still others were committed because of violent acts against their family or friends.

We will never know the entire impact of the liberal use of opioids on both sides of the Civil War. The only thing we do know is the cost to those individuals whose cases that we have discovered in the records.

Until next time….

Your Obt. Servant,

Surgeon Trevor Steinbach

17th Corps Field Hospital