Opioid crisis deadliest, but it is far from the first

NEW YORK» While declaring the opioid crisis a national public health emergency Thursday, President Donald Trump said: “Nobody has seen anything like what’s going on now.”

He was right, and he was wrong.

Yes, this is the most widespread and deadly drug crisis in the nation’s history. But there has been a long string of other such epidemics, each sharing chilling similarities with today’s unfolding tragedy.

The good news, though, is that drug epidemics do fade considerably — usually because reduced supply and demand eventually diminish the number of new addictions, experts say. And that history offers some hope for the future.

THE 1800s: BETTER — AND MORE DANGEROUS — MEDICINES

Most U.S. drug epidemics over the past two centuries were sparked by pharmaceutical companies and physicians pushing products that gradually proved to be addictive and dangerous. In the 1800s the drug was often opium, usually sold as a liquid in products like laudanum, and given to patients for pain or trouble sleeping. Mary Todd Lincoln, President Abraham Lincoln’s wife, took it for headaches and became addicted.

The drug was also used to get high. “Opium fiends” smoked it in opium dens like those in San Francisco’s Chinatown.

The young nation’s drug problem grew because of morphine, a painkiller derived from opium through a chemical process that was perfected by E. Merck & Company of Germany. It made battlefield injuries more bearable for Civil War soldiers, but so many veterans got hooked that morphine addiction was sometimes called “the army disease.”

It would get worse. Cocaine and heroin were soon developed — in part to help morphine addiction.

Merck introduced cocaine, which became a prime ingredient in a variety of over-the-counter tonics for sinus problems and other ailments. Because of its energizing effects, beverage makers put it in their wines and sodas and laborers in the South sniffed it to get through grueling work shifts.

Bayer, another German pharmaceutical company, began marketing heroin in the 1890s. It often came in pill form, without prescription, and was used to treat the flu and respiratory ailments. But it came to be sniffed — and later injected — by those looking for a more intense high or a substitute for other drugs, whether it was morphine in 1905 or opioid pain pills such as Vicodin in 2015.

THE EARLY 1900s: FROM CURE TO CURSE

In the early 1900s cocaine shifted from a consumer fad into reviled epidemic, as physicians began documenting addiction problems and police chiefs linked recreational cocaine use to prostitution and violent crime. It led to the first national effort to contain a drug epidemic: In 1914, Congress passed the Harrison Act, which said cocaine and heroin could be sold only as a prescription medicine, not in over-the-counter remedies or in consumer products.

Historians believe a growing stigma attached to cocaine use was the main reason the epidemic declined, but they say enforcement of the Harrison Act — and its impact on prices — also was important.

Drugs were still abused in the later years in pockets of society — cocaine use was rampant in Hollywood in the 1920s, for example. But economics and politics helped prevent large-scale epidemics for a time. The Great Depression meant few had the disposable income for an illicit drug habit, and World War II decimated the supply of drugs from overseas.

MID-20TH CENTURY: THE FIRST WAR ON DRUGS

Alcohol and cigarettes were — and remain — the nation’s primary addictions. Both kill far more people than drugs. But since the middle of the century, there’s been wave after wave of other drug abuse outbreaks.

Amphetamines, developed in the 1930s, took off in the 1950s. Marketed by drug companies and promoted by doctors, they were used for weight loss, anxiety and depression. Methamphetamine, developed by the Burroughs Wellcome drug company, was often prescribed as a diet pill and abused by those attracted by the surge of energy it produced.

Greater regulation of the drugs in 1970, along with the stigma attached to speed freaks, caused the drugs to recede as others became more widely used.

In the 1960s and 1970s, heroin use surged, prompted in part by Vietnam War soldiers who were exposed to it while fighting overseas. This wave victimized poor inner-city neighborhoods most.

LATE 20TH CENTURY: COCAINE ON HIGH

Heroin use faded in the late 1970s, but cocaine was on its way back, first in powder form and then becoming an epidemic of crack in the 1980s when a supply glut prompted dealers to sell hardened cocaine rocks that sold for $5 to $10 on the street.

Many young thrill-seekers, wary of heroin and needles, thought crack was less dangerous because it was smoked like marijuana.

The crack epidemic died out in the 1990s, tailing off at roughly the same time both in cities that aggressively arrested people and cities that didn’t. Experts said the police crackdown contributed, but more important was society’s growing repulsion to the drugs.