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It’s hard to imagine these days, but there was a time in America when opiates were largely unregulated and widely used by the general population without fear of addiction.

Throughout the 19th century, elixirs and tonics containing opium were found on drugstore shelves across the nation, and they were particularly popular among women who suffered from “female problems.” In the 1850s, Chinese railroad laborers popularized the pastime of smoking opium, and by 1900, opium dens were found all over the country.

Meanwhile, since its synthesis in 1803, the medical community had long been using morphine, which was heralded for its safety and long-lasting effects, to treat a wide range of ailments. During the Civil War, injectable morphine was widely used as a pain reliever, and as a result, scores of soldiers developed an addiction to it.

Heroin Hits the Market

When heroin was synthesized in 1895 and subsequently marketed by the Bayer Company, it was considered a potential cure for morphine addiction, and to that end, the St. James Society mailed free samples of heroin to people who were addicted to morphine. Not surprisingly, the unforeseen result was a growing heroin addiction problem. In 1910, Bellevue Hospital in New York admitted the first person to seek treatment for a heroin addiction, according to History Today, and in 1915, that number rose to 425 people.

The Harrison Narcotics Act Takes a Stand Against Heroin

Although heroin wasn’t associated with crime in the early part of the 20th century, and alcohol was far more demonized than heroin, the Harrison Narcotics Act was passed in 1914. The act essentially levied an impossibly hefty tax on opiates not prescribed by a doctor. Anyone caught with non-prescription opiates was charged with a tax violation.

In 1919, the legal interpretation of the Harrison Act made it illegal for physicians to prescribe certain opiates for the purpose of treating other opiate addictions. Shortly thereafter, heroin hit the black market, and drug dealers began selling it on the street.

Heroin Addiction Becomes a Major Public Concern

By the early 1920s, heroin was blamed for a number of murders in New York City, and people who abused it became a major concern for the public and the authorities. According to the United Nations Office on Drugs and Crime, the Special Deputy Police Commissioner wrote in February of 1924 that 76,000 ounces of heroin was used by addicts each year, while only 58 ounces were prescribed by physicians. In June of that year, all crude opium imports and the domestic manufacture of heroin were categorically outlawed by Congress.

The Controlled Substances Act and the Narcotic Addict Treatment Act

Despite these measures, there was no stopping the flow of heroin into the U.S. It became a popular drug of choice for the hipsters of the Harlem jazz scene in the 1930s and 1940s, and then for the beatniks in the 1950s. The Controlled Substances Act was passed by the Nixon Administration in 1970, and heroin became a Schedule I drug, establishing it as a highly addictive substance entirely without medical value.

In 1971, Congressman Robert Steele (R-CT) estimated that 10 to 15 percent of Vietnam servicemen were addicted to heroin, and in 1974, in response to the growing heroin abuse epidemic, the Narcotic Addict Treatment Act amended the Controlled Substance Act to allow the establishment of Federally licensed methadone detoxification and maintenance programs.

The Current Situation

In the 1980s, street heroin became purer, and more people began smoking and snorting it. Its use increased significantly in the 1990s, and it continues to increase today.

Heroin abuse and addiction more than doubled between 2002 and 2012, when the National Survey on Drug Use and Health reported that 669,000 Americans had used heroin in the past year. While the number of teenagers between the ages of 12 and 17 who abuse heroin has been steadily declining since 2005, the number of young adults between 18 and 25 who abuse it has been steadily increasing. Among that age group, admissions to treatment for heroin addiction increased from 11 percent of all admissions in 2008 to 26 percent in 2012.

Treating a Heroin Addiction

Modern treatment for heroin addiction starts with detox, which is medically supervised and involves administering medications to reduce the severity of withdrawal symptoms and shorten the duration of detox. Methadone, buprenorphine and naltrexone are commonly used for long-term maintenance to reduce cravings and slowly wean patients off of opiates.

Behavioral therapies are equally important in treating a heroin addiction. By addressing the complex issues behind the abuse and addiction and learning to identify and change self-destructive thoughts and behaviors, those in recovery from a heroin addiction strive to make meaningful and healthy lifestyle changes to restore their health and improve their quality of life as well as learn to enjoy living without heroin.

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Heroin Addiction: A History of the Hardest Drug
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