How the heroin epidemic of the 1960s and 1970s continues to impact our understanding of addiction

In the 1960s and 1970s, a heroin epidemic swept over the United States. Whilst society has progressed and become more accepting of many things – mental health among them – it is fair to say that the general attitude to addiction still has a way to come to catch up.

Whilst attitudes have improved over the years, socially, there perhaps still a tendency to see addiction in a negative light, even, some might say, to demonise addiction.

Addiction is seen by many not only as a public health issue, but as a moral one. But where did that perspective come from? Researcher Alex Mold contends that ‘drug use has long been seen as a disease,’ however, explains that it was not until the 1960s that drugs became so associated with morality. This association has ultimately led to addiction being coded as ‘a socially infectious condition.’
Whilst we’d like to think that such pejorative opinions are steadfast in the past, it would be difficult to deny that this kind of rhetoric has not impacted our understanding of addiction over time.
What was it about the heroin epidemic of the 1960s and 1970s that caused such strong views? How did those views feed into treatment, and how do they colour our contemporary understanding of addiction and shape our clinical practices in the addiction industry?

The History of Heroin: Use Before the 1960s and 1970s

Heroin is an opioid (a type of painkiller) that can be made from morphine. Morphine can be derived from the seeds of the opium poppy plant (papaver somniferum) which is native to Mexico, Columbia and some parts of Southeast and Southwest Asia.
Heroin is a rapidly acting drug. It primarily acts by increasing levels of pleasure and reducing levels of pain through acting on opioid receptor cells and the dopamine systems in the brain.
But how was the drug formed, and how did it’s use culminate into chronic heroin use and an epidemic of addiction?

Laudanum

In the Western world, opiates were frequently used in laudanum tinctures in the form of ‘’elixirs’ and ‘tonics’ throughout the nineteenth century. Laudanum tinctures and ‘poppy tea’ were used from the 1600s onwards but gained great popularity during the Victorian era, particularly among women, as a method of treating ‘female problems.’
In this era, opiates were largely used as analgesics as a method of pain relief. But at this time, there was already evidence of laudanum being used in cases of ‘nervous exhaustion’. Such preparations of opiates were prescribed by doctors or purchased from drugstores.

Morphine

In 1806, a German pharmacist named Friedrich Serturner synthesised morphine from the opium poppy. Alexander Wood, a doctor from Scotland, is associated with the creation of the hypodermic syringe in 1853.
These advancements combined to catalyse the use of injectable morphine, which was then administered as pain relief during the American Civil War.
This has led to rhetoric where The Civil War (1861 – 1865) ‘has long been blamed as the catalyst for the spread of drug addiction in America,’ solidifying the historical association of the States with excessive opiate use.

Heroin

In 1895, heroin was first synthesised by German chemist Heinric Dresser with the goal of the drug becoming ‘a sort of mega-aspirin.’ Medical trials showed that heroin could supposedly alleviate a range of different ailments, including:

• A cough

 

• ‘Catarrh’ (a build-up of mucus in the airway)

 

• Bronchitis

 

• ‘Emphysema’ (damage of lung tissue)

 

• Asthma

 

• Tuberculosis

The trials suggested heroin was able to do so without the more negative side effects associated with morphine, including sickness, issues with digestion and long-term weight loss. At this stage, Dresser ‘confidently assumed that addiction would present no problem either.’

Notably, when Dresser first synthesised heroin, the recommended dose was ‘tiny’. But, after being used on the market for some time, it became clear that heroin’s effects did not last for long, leading to increased use in both frequency and quantity.

It was during the early 1900s that the ‘Heroin Debate’ began, which started to indicate staunch concerns about the effects of the drug as a creator of ‘heroinists.’

The History of Heroin: the 1960s and 1970s

By ‘turn of the century’ there were already approximately 300,000 opiate addicts in the United States. But today, this number sits closer to around 500,000.

The prevalence of hard drug use during the latter half of the twentieth century led to what is now considered to be a long-term American ‘medico-criminal problem’, But what factors led to this epidemic taking root?

Social Context

What is considered to be ‘the second wave’ of heroin addiction began when the drug became associated with American subcultures and underground use from the 1930s onwards. It has been variously linked to different movements and specific demographics across the early twentieth century.

Marginalisation

Following the Second World War, the key demographics of heroin use began to diversify. Whilst previously heroin has been associated with ‘white working class males,’ the profile of the heroin user began to transform.

Following an increase in opium trade routes from Mexico and the large-scale migration of black and Hispanic communities into ‘segregated city neighbourhoods’ in the postwar era, heroin became more prevalent amongst different demographics.

No longer linked solely with older white men, heroin became increasingly used by younger people, as well as individuals from diverse ethnic and cultural backgrounds.

For places like New York, for example, the city became a new, bustling locale like never before. This new vision of the city led to a rise in access to drugs.

This exposure to drugs that this new visibility allowed worked in several ways; it normalised the use of heroin, but also, with the growing social culture solidifying itself around drug use, made using opiates perhaps even something to aspire to.

Heroin and the Harlem Jazz Scene

Heroin use has historical roots in the social bustle of the Harlem Jazz era. Historians have indicated that heroin was a crucial part of the musical community during the Harlem renaissance, indicating that ‘the use of narcotics was heavily accepted in the jazz community.’

In fact, the drug was even ‘rationalised’ by some Jazz musicians, creating an environment where heroin was a natural way to deal with life’s struggles as well as a crucial component of the creative process for many artists.

With the artists of the epoch openly using heroin, we can see how the use of narcotics may have been ameliorated for individuals in awe of Jazz-era stardom.

Financial Issues

After the Second World War, America found itself in serious debt. This debt was managed through an increase in taxation. For the first time in American history, income tax was expected from almost every American citizen.

While this may have helped to stabilise the economy, it has blatant repercussions for the public leading to a rise in socioeconomic issues experienced by the individual.

This itself may be linked to heroin use, as throughout history, economic depressions and financial collapses have been frequently associated with increased substance use and higher crime rates.
With two thirds of self-reporting homeless individuals linking their circumstances to substance use today, we can follow this thread between heavy drug use and economic dearth through time.

Legal Context

American legislation in the twentieth century attempted to regain some control of the nation’s drug use. The 1906 Pure Food and Drug Act marked a formal effort to prohibit the sale of ‘unlawful food and drugs’, making it legal for these products to be seized if found.

Substance use was also largely impacted by the Prohibition era, where the production and sale of alcohol was banned throughout the states. However the prohibition did not stop the consumption; it solely drove it underground.

This created an environment where substances became fully associated with secrecy and illicit access, meaning the elusive drug and alcohol trade became more visible, and therefore, perhaps, more permissible.

Effects of The Heroin Epidemic: Treating Addiction

Social commentators in the 1920s and 1930s suggested the use of ‘firing squads’ to deal with individuals addicted to narcotics. Suggesting, obscenely, that the only appropriate treatment for addiction was death.

At the front of this movement was Harry Jacob Anslinger, who led the Bureau of Narcotics in the 1920s. This was largely due to a lack of understanding of addiction and misinformation on how heroin works and what its effects can be when used consistently.
As America struggled to deal with the number of individuals developing a heroin addiction, the term ‘the heroin epidemic’ was born.

Fast-forward to 1935, and ‘narcotic farms’ were developed. These were ‘special facilities to quarantine and rehabilitate addicts’, but, in reality, worked perhaps more like institutions. One of these ‘farms’, the U.S. Public Health Service Narcotic Hospital in Lexington, Kentucky, was the hotbed of addiction research and treatment until the 1960s. But, in effectively punishing those dealing with addiction, such measures worked to isolate and demonise individuals struggling with substance use. In using these long-term structures, the freedom of an individual addicted to heroin was severely limited.

Heroin Addiction Treatment in the Twentieth Century

Fortunately, we have turned a corner from these types of treatment. The approach to addiction today is largely driven by research and close attention to the medical causes, effects and rehabilitative approaches to addiction.

With the combined efforts of chemists, psychologists and other physicians, we are in an era where the medical establishment does not consider addiction as a moral fault but rather as something to be treated. By educating ourselves on the effects of heroin, we have been able to develop ways in which to manage the difficult symptoms associated with long-term narcotics use.

In the long term, heroin has a list of dangerous side effects for chronic users. These include:

• Problems with breathing

 

• Problems with liver or kidney function

 

• Problems with the function of the lungs

 

• Problems with heart function, including infection of heart tissue

 

• Problems with stomach function, including long-term issues with digestion

 

• Risk of collapsed or damaged veins

 

• Risk of sexual dysfunction in med

 

• Risk of menstrual and reproductive complications in women

 

• Risk of developing (or exacerbating) mental health conditions

 

• Risk of developing skin conditions

 

• Risk of developing serious diseases such as HIV/AIDS

 

We have also been able to take innovative approaches to create forms of treatment that tackle addiction in a sensitive, nuanced and humane manner.
We can confidently say that UKAT’s approach to heroin addiction is informed by clinical and professional research.
Whilst there may be ongoing challenges linked to the public perception and general attitude towards heroin addiction and its treatment, our improved knowledge, implementation of prevention strategies, and specialist treatment are a gold standard of support.

 

What Does Specialist Treatment Look Like Today?

Today, treatment for heroin addiction takes place in four key stages:

• Prevention strategies

 

• Heroin detox

 

• Heroin rehab

 

• Aftercare

 

Prevention Strategies

Prevention strategies are aimed at limiting the risk of addiction developing. These can take many forms, including:

• Education on the risks of drug use

 

• Greater health and social care provision, including support for financial and housing concerns

 

• Wider-spread access to specialist addiction services and advice

 

• Programmes to support children and young people in the community

 

 

Heroin Detox

Whilst heroin was released onto the market under the belief that it is not addictive, we now understand the strength of opiate addiction.

By carefully reviewing the chemical composition of the drug and analysing the ways in which heroin impacts both the body and brain, pharmaceutical methods for detox have been developed. This means that it is possible to medically detox from heroin, using approved and regulated medications in order to control difficult withdrawal symptoms.

Heroin Rehab

Our approach to addiction is treatment, not punishment. This is why we offer a range of therapeutic interventions aimed at helping individuals work through addiction. These types of therapy can address the difficulties that may have led to addiction initially, as well as helping you to unpick the impact addiction can have on your thoughts, feelings and self-confidence.
Some of the therapies available for heroin addiction include:

• The 12-step programme

 

• Art therapy

 

• Cognitive behavioural therapy (CBT)

 

• Dialectical Behavioural Therapy (DBT)

 

• Drumming Therapy

 

• Holistic Therapy

 

• Music Therapy

 

• The Strengths model

 

Aftercare

At UKAT, we know that addiction works in cycles. That means that to tackle heroin addiction the cycle needs to be broken. Following that, however, staying sober can be a task of managing difficult life experiences and everyday stresses. For that reason we offer free aftercare to help support you after your time spent in formal rehab has ended.

Get Support for Heroin Addiction

At UKAT, We know first-hand what the impact of heroin addiction can be. But we are ready to help you move forward to a life without the weight of dependency. Contact us to discuss the treatment options available for you to begin your path towards a heroin-free life.