Heroin Has Never Discriminated

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America's heroin addiction is dominating public discourse and headlines today, yet it's not the first time we've fallen down the long, dark hole of dependency thanks to this powerful drug. The history of heroin in the US is a lot more complicated—and weird—than most people realize.

It's an ironic outcome for a man-made substance that was concocted in a 19th-century lab specifically to be a potent cure-all for the evils of… guess what? Addiction.

Not just any addiction, mind you. Heroin was engineered to address the massive opium and morphine epidemic that swept across the country in the early to mid-1800s. Hard as it may be to believe, those cowboys riding across the plains in the days of Billy the Kid and Butch Cassidy were just as likely to be found in a hazy backroom opium den as pounding a whiskey at the saloon bar.

Yes, the Wild West was high on opium, an ancient (and in some cultures homeopathic) product derived from the poppy plant. The earliest references to it being cultivated date back roughly to 3,400 BC, in lower Mesopotamia (southeast Asia). The "Hul Gil," or joy plant, was a staple among the ancient Sumerians, who shared their happiness with the Assyrians, who in turned passed it on to the Egyptians, and before long it was a pipeline product along the Silk Road, shuttled profitably from the Mediterranean to Asia.

Once firmly ensconced in China, the poppy plant set off the Opium Wars of the 1800s with the British Empire—but in America, it created a war of a whole different kind—really, our first unofficial War on Drugs. Brought over to the west mainly by Chinese immigrants who toiled on US railroads, the natural opioid transported its users into a relaxed dream state—but also left them with a crippling physical addiction that seemingly had no end.

Much like the addiction crisis hitting the US today, America's earliest epidemic had its roots in the medical establishment. Heedless to the after-effects of opium use, doctors had seized upon its sedative-like properties to develop it into a concentrated product they were sure would be a great boon to mankind: morphine.

With morphine as readily available as candy—and also touted as a treatment option for America's other scourge, alcoholism—its abuse skyrocketed among the general population, women and children included. The epidemic raged not just in the big port cities and urban areas but also across far-flung homesteads. It reached such a pitch that when another German doctor stepped forward and declared he'd come up a cure, American doctors couldn't wait to embrace this new miracle product.

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Dubbed "heroin" for its sure-to-be heroic role in ending the opioid plague, the wonder drug was rapidly exported and shipped to the US in the 1880s, where it was marketed as a safe and non-addictive substitute for morphine.

"Heroin was everywhere, in health tonics and elixirs, it was used to treat women, especially white upper-class women for 'hysteria,' that nice catch all phrase that could cover anything from mental illness to boredom. Doctors were prescribing it and we wound up with whole populations that were addicted," says Samuel Roberts, associate professor of history and sociomedical sciences at Columbia University.

At the same time the upper classes were getting heroin and morphine via the medical establishment as a treatment for various ills, those standing a bit lower on the socioeconomic ladder got their drugs through more direct means. Those who could afford it bought the small IV kits sold by early medical firms to help people shoot up at home. Others found illicit ways to get their hit.

"What we might call today the 'subculture,' the poorer working class people which might include prostitutes, criminals, and many of what back then were considered ethnic whites—immigrants from Poland or Italy or other parts of Europe—they wanted to get that drug too," says David Herzberg, associate professor at Buffalo University who studies the history of the pharmaceutical industry and its role in addiction. "They wanted to feel good just as much as the upper classes, and so you saw heroin become part of the subculture and part of the nightlife in many places. But that drug use was perceived differently from the consumption of the upper classes," Stretching from roughly 1880 through 1920, America passed through an intense and overwhelming addiction to heroin—one that left no strata of society untouched, but created a variety of public reactions that were largely influenced by class.

By 1920, through a series of legislative actions, Congress had outlawed heroin and reduced morphine to a controlled substance. Doctors, now more mindful of the addictive properties of both, used morphine sparingly.

But the final result was a two-tiered country of addicts: Those with the means and the social status could get the drugs they needed through doctors. But the poor, well… seemingly overnight, they were cut off, Herzberg says.

"It left a lot of people without any treatment or access, while the wealthier ones could find ways to access some kind of drug that would help them," he says.

Two phrases about addiction that remain in our collective lexicon today stem from that era: "kicking the habit" grew out of the familiar sight of detoxing addicts twitching and spasming, literally kicking their legs as they went through withdrawals. Likewise, the term "junkies" came from this initial dry period when the heroin spigot abruptly shut off. Addicts took to combing city streets and trash heaps looking for scrap metal and other bits of junk they could sell for cash to buy in-demand drug.

Naturally, the shortage of heroin didn't last long. Organized crime stepped in to fill the void, and its repercussions would influence the public health discourse—negatively, as it turned out—for the next several decades.

The crime lords who began servicing the subculture drug trade focused on large port cities—especially New York, which was one of the busiest US harbors in the country but also had the added benefit of a crime infrastructure. There were plenty of players—including in some cases the police—who all had a role in funneling the shipments from New York into specific neighborhoods around the city and into other major metropolises.

"That scene in The Godfather, where the five families meet and they make a decision to only sell drugs in black neighborhoods? That's pretty much how it was," says Herzberg.

Herzberg says that the Mafia's deliberate business choice—deal mainly to black and Latinx neighborhoods—helped create the narrative of the inner-city junkie, a drug fiend who would steal and cheat to support their nasty habit. In other words, a criminal.

At the same time, upper class families—mainly whites—dosed themselves liberally with all kinds of prescriptions in the '50s, '60s and '70s, mainly barbiturates of the kind referenced in the Rolling Stones song "Mother's Little Helper."

Heroin also resurfaced as a cool new counterculture drug in hippie communities—until it started claiming too many victims, like Janis Joplin, for one. But at the same time, police were cracking down on the drug trade in new and frighteningly intense ways. A lead-up to the War on Drugs was underway—especially as black drug kingpins began to crack the Mafia business model and stake out their own territory in places like Harlem and the Bronx.

Before long, New York had passed the punitive Rockefeller Drug Laws—which criminalized even the smallest possessions of illegal drugs, including marijuana—and sent scores of low-level users to prison for extended sentences.

"It became the norm, with the official War on Drugs, to see police that were essentially militarized—really, using military-grade equipment—charging through the streets and into homes to combat addiction," Roberts says. "That was not part of the landscape in the earlier waves of addiction in the US—it would have been unheard of."

Roberts believes the War on Drugs was misguided from the beginning—and is still doing damage today, mostly in communities of color. "We never should have declared a war on drugs. The real problem is, we have no public health policy that's effective," he notes. Drugs, including heroin, go in and out of style, and right now the US is in the grip of a heroin and opioid epidemic, but it's actually no worse than what we've gone through in prior cycles, he says. It's just more visible at the moment because of which groups are being affected.

Kassandra Frederique, director of the Drug Policy Alliance's New York office, sees an eerie repeat of the epidemic that greeted 20th century America. Then, as now, there's a class and race divide in how the country is responding to its current addiction problem, she says.

"Now we hear talk of 'accidental addicts,' the predominantly white population that got hooked on opioids through pain pills prescribed for a legitimate medical reason. When they can't get their hands on any more pills, they're forced to turn to heroin—it's 'accidental," Frederique says. "So what, does that mean all the other addicts did it on purpose? When white communities fall into addiction, it's not their fault. When black and brown communities do, society makes a moral judgment, and they get punished."

The silver lining in America's current crisis is that it's opened up more talk about the perils of addiction and generated a more compassionate response—at least for the middle-class white families who have shared their stories of loved ones lost to heroin.

As Frederique says, "That compassion should have been there all along, but now that it's finally present, let's include all the people who need help in that response."

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