Morphine addiction

“ Addiction to drugs, whether it be opium, morphine, heroin or cocaine, is a strongly dysgenic factor. The addiction to the drug is of itself not transmissible, but the weakened constitution or degeneracy which is generally responsible for the development of the drug addiction is inheritable.
A few cases of drug addiction are external; that is, the patient may have a good healthy constitution, no hereditary taint, and still because during some [227] sickness he was given morphine a number of times he may have developed an addiction to the drug. ”

“ Until the addict can be offered rational treatment, the profession should do what it can in making the lives of addicts less unbearable by removing from the public mind some of the gross misconceptions concerning addiction, seeing to it, especially, that these unfortunates are not stigmatized as “morphine fiends” and that they are given the means of obtaining, without risk and hardship and almost prohibitive cost, the supply of their drug which, until they are cured, is to them as necessary as the air they breathe. ”

“ One of the obstacles to an appreciation of narcotic drug addiction-disease has been the casual assumption on the part of the average person, both lay and scientific, that opiate drugs act upon the addict, and that he reacts to them similarly to the actions and reactions in the non-addicted individual. Morphine action, however, as commonly observed following therapeutic administration or in experimentation upon un-addicted animals gives no conception of its manifestations in the man or woman grown tolerant to its use. ”

“ Later, mental disturbance comes on. He grows delirious, sees insects and small animals, as the delirium tremens patient does, and his suffering is very great. It is extremely difficult, and commonly impossible, to cure the morphine disease after it has been firmly established, and a deliberate acceptance of the habit is evidently a grave vice. Where a patient has become addicted to the use of the drug, through the fault of a physician, or through ignorance, the treatment from the social point of view of such a patient is commonly cruel.
Cocaine intoxication is much worse than morphinism. ”

“ Do you think—is it possible that the soothing syrups—I’ve heard they have morphine in them—had anything to do with his ruin?”
“Why, Mrs. Sharpless,” said the other, very gently, “I can only put it before you in this way. Here is one of the most subtle and enslaving of all drugs, morphine. It is fed to a child, in the plastic and formative years of life, regularly. What surer way could there be of planting the seeds of drug-habit? Suppose, for illustration, we substitute alcohol, which is far less dangerous. ”

“ Having reached this stage they cannot arouse themselves from their terrible infatuation. Gloomy and hopeless, the world and the people in it no longer interest them. A patient whom I saw some years ago, a young Spaniard, was suffering from insanity from the use of morphine. ”

“ Some physicians, by carelessly prescribing morphine for neuralgia, migraine, dysmenorrhoea, or any pain, make their patients slaves of this drug.
The degenerative effects of morphine are not so great nor so rapid as those of alcohol. It does not shorten life so much as alcohol does, nor are the children of a person addicted to the use of the drug so liable to idiocy and imbecility. The mind is enfeebled—slowly in some cases, rapidly in others. The patient will resort to almost any means to obtain the {116} drug, if he is deprived of it. ”

“ In almost every instance the accompanying ill effects will be found to be due more to the abuse of morphine than to the disease itself. Indeed, its continuance may place the patient in a condition that will preclude the possibility of recovery.
Patients with one foot apparently in the grave, when deprived of their morphine, take a decided turn for the better, and regain fair, if not perfect health. A fatal ending sometimes follows the waiting and attempting to build up the health before commencing the treatment of the habit. ”

“ It has been criminally easy for any one to acquire the drug habit. Few physicians have recognized that it is not safe for most persons to know what will ease pain. When an opiate is necessary, it should be given only on prescription, and its presence should then be thoroughly disguised. A patient goes to a physician to be cured; consequently, when his pain disappears, he naturally believes that this is due to the treatment he has received. If the physician has used morphine in a disguised form, the patient naturally believes that the cure was effected by some unknown medicine ”

“ In such circumstances the protection of a physician’s monopoly of the drug would be most welcome. But how much worse is the pressure when the well-intentioned nurse also is a drug-taker! The morphinist has an abnormal sympathy with those who have undergone or are undergoing experiences similar to his own, and there is no stronger bond than that which unites two morphine victims. As a matter of the most elementary precaution for all concerned, no nurse should under any conditions be allowed to buy habit-forming drugs. ”

“ It never cures a disease; it only stifles a symptom. It gives delicious ease; but the [Pg 48] need for its use soon recurs. Hence there is always danger that before long the patient will have to fight, not only the disease which originally caused him pain and made him call for morphine, but the morphine habit in addition. This is all familiar. But not every one realizes that the giving of money in case of poverty is as dangerous as the giving of morphine in sickness. Money like morphine satisfies an immediate need and hence is eagerly welcomed by the sufferer. ”

“ Your opium-eater does not reduce himself to a state of coma. He usually keeps well within the limits of the tolerance that has been established. The conclusion that emerges is, I think, that the drug was administered by some other person; and the most likely person seems to be Mr. Weiss."
"Isn't morphine a very unusual poison?"
"Very; and most inconvenient except in a single, fatal dose, by reason of the rapidity with which tolerance of the drug is established. But we must not forget that slow morphine poisoning might be eminently suitable in certain cases. ”

“ In the midst of us there are persons poisoning themselves to death. I refer to those addicted to the use of morphine. In England they have another class of these unfortunates, for whom the most adulterated liquors no longer suffice, and who drink ether; they are a sort of perfected inebriates, who by the scientific laws of progress succeed simple drunkards just as habitual morphine users follow the opium smokers of China. ”

“ Morphine is intrinsically far worse than opium itself, for opium has certain properties which partly counteract the effect of the morphine [Pg 216] that it contains. But morphine is not only the active principle, but the actively evil principle, of the drug.
The user of morphine always retains his faculties. He is usually capable of intelligent conversation. Unlike the alcoholic’s brain, his is not inflamed. It is impossible for the physician intelligently to discuss his symptoms with an alcoholic; with a victim of drugs, on the other hand, he can thresh out every detail of the case. ”

“ Persons under the influence of the drug have less power to resist physical and mental impressions and they easily succumb to temptations and suggestions from others. Morphine stands unequalled as a perverter of the moral sense. It creates a person whom the father of lies must recognise as kindred to himself. I know of a case where a judge charged a jury that the prisoner, a morphine addict, was mentally irresponsible for that reason. The judge knew what he was talking about. It subsequently developed that he had been a secret morphine fiend himself for years. ”

“ The legitimate use of morphine by physicians has done more than almost anything else, with the possible exception of cocaine, to relieve suffering, and there is consequently a considerable trade in the drug. ”

“ But the immediate action of morphine by no means paralyzes the mental faculties. Though when once a man becomes addicted to the drug he is [Pg 8] incapacitated to deal with himself, yet while he is under its brief influence his mind is sharpened and alert. Under the sway of opium a man does venturesome or immoderate things that he would never think of doing otherwise, simply because he has lost the sense of responsibility. ”

“ In the first place, lessening the dose is of little avail; there is as much suffering in the final deprivation of a customary quarter of a grain as of twenty grains. In the second place, it cannot be ascertained by gradual reduction whether there is any disability which makes morphine necessary, since no intelligent diagnosis can be made so long as a patient is under the influence of the smallest quantity of the drug. ”

“ For these disorders it is truly specific. It is one of the most valuable means for overcoming the bad effects of the morphine habit. In most cases in which the habitue has not used more than four grains daily the opiate may be abruptly discontinued, and even substituted, without any serious results. If a larger quantity than this amount has been taken for some time, it is better to gradually reduce the daily dose of morphine, in the usual manner, simply prescribing the [Pg 37] Avena in addition. ”

“ The nails become brittle and the skin dry, sterility shows itself in women and sexual impotence in men. While not directly causing death, morphinism so lowers the bodily powers that the patient is easily carried off by some intercurrent malady. The sudden withdrawal of the drug from a morphine habitué is followed by a train of alarming symptoms. ”

“ Beneficial and even indispensable as may be the pain-stilling and quieting operation of these drugs, it must not be forgotten that the human organization easily accustoms itself to them, so that ever more frequent application and larger doses of them are demanded, and, at last, bodily disease and mental disorder are brought on through the general poisoning they occasion. The moment when a man afflicted with neuralgia receives the morphine injection for the first time, to free himself temporarily from pain, may be decisive for his whole future life. ”

“ So they began to prescribe heroin instead of morphine, and many a morphine addict was advised to substitute heroin. All went well for a short while, until the victims found that they were enslaved by a drug that was even worse than morphine. Now, thanks chiefly to the medical profession, it is estimated that we have in our land several hundred thousand heroin addicts. Sallow of face, gaunt of figure, looking upon the world through pin-point pupils, with all of life's beauty, hope and joy gone, they are marching to premature death. ”

“ A library might be filled with books, fictional and other, glorifying alcohol and the good-fellowship and conviviality that it is supposed to promote. [Pg 246] One might search a long time for a victim of any drug habit who would speak with affection of the material which has enthralled him. No poet has ever written any song glorifying morphine. There is no drug-user in the world who would not hail with joy any opportunity that might lead to his relief. The drug-victim investigates every hint of hope with eager interest, reading, intelligently questioning, experimenting. ”

“ The most horrible instance of this is the 'soothing syrups.' These are universally loaded down with morphine. The immediate deaths which have followed an overdose of some opium-containing 'soothing syrup' are numerous enough, but the thought of the hundreds of children condemned from the cradle to a life of invalidism, to which the grave is preferable, by the formation of a morphine habit from which the delicate nervous system is never able to recuperate, is horrible. ”

“ One can but remark, that luxury, which tends to introduce itself everywhere, has already invaded the domain of morphine. The little syringe of Pravas, which permits of the injection of the poison under the skin, and the consequent avoidance of the bitter taste and the nausea which would be occasioned by eating morphine, has received ingenious and artistic modifications. ”

“ In some, before their condition was recognized, their tolerance for or dependence upon opiate had proceeded to a point where their bodies’ demand for morphine was imperative and their withdrawal suffering unendurable. In others, before body need was completely established—with their stamina and nervous resistance below par from sickness and suffering—they have been unable to forego opiate’s supportive and sedative and pain-relieving action, or to endure the nervous and other symptoms attendant upon its withdrawal after even a brief period of administration. ”

“ I ordered morphine for her on Friday, and on Saturday I doubled the dose, continuing it on Saturday and Sunday; at the inquest I know Lizzie testified before I did; on Friday I gave her one-eighth grain, on Saturday I doubled it and continued the treatment all the time up to her arrest and while she was in the station; there is no question about the effect of morphine on the mind; by changing and allaying their views and gives them hallucinations. I saw her take the medicine on Thursday ”

“ It will be seen, from the foregoing cases, that while there is no doubt that in certain individuals a morbid craving for chloral may be established by the prolonged use of the drug, it is very different, as a habit, from that produced by opium or morphine. As an offset to this stands the fact that, in those cases where a habit is formed, it causes a more complete and rapid ruin of mind and body than either opium or morphine.
Persons addicted to the habitual use of this drug are usually of the educated class, as is the case with opium. ”