America’s second opioid crisis occurred among Veterans of the Spanish-American War and World War I era, according to historical analysis of addiction treatment at the National Home for Disabled Volunteer Soldiers. The National Home, founded in 1867 to care for Union Civil War Veterans, treated Veterans substance abuse beginning in that period, with records showing 2,319 residents received treatment for opioid addiction between 1880 and 1916, and 92 deaths from morphinism or opium and morphine poisoning were reported.
Medical Approach to Addiction
The National Home treated addiction as a medical condition rather than a moral failing, with physicians filling prescriptions for treatment. One medication identified in historical records is Trional, recommended in an 1893 publication on opioid withdrawal treatment alongside mild electrical current, an early example of electrotherapy for managing withdrawal symptoms such as insomnia and chronic pain. This progressive medical approach contrasts with the moralistic views of addiction prevalent in broader society at that time.
Growth of the Crisis
The largest annual increase in case numbers occurred between 1886 and 1896, when opioid cases increased 32% each year, with five times more Veterans receiving treatment than in the prior decade. Between 1907 and 1916, overall case numbers were twice as high as the previous decade, accounting for more than 59% of all opioid cases reported at the National Homes, indicating an accelerating problem.
Contributing Factors
Several factors contributed to the crisis. Heroin, released commercially in 1898, became a popular remedy for diseases at the Homes despite being considered safer and less addictive than morphine. Opioid-based medicines were commonly found in over-the-counter products and often specifically marketed to Veterans. In 1906, the Pure Food and Drug Act required listing medicinal product ingredients, but over-the-counter opioids were just one aspect of the broader crisis. When the proportion of Veterans who served in overseas conflicts grew from less than 1% in 1901 to 21% by 1916, opioid cases at the Homes increased threefold, suggesting overseas service and exposure to opium in colonial territories contributed to increased addiction rates among this population.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://news.va.gov/143287/part-2-crisis-morphinism-national-homes/