Florida senator, marco rubio in miami. Exploring the american story. Watch American History tv saturday on cspan 2 and find a schedule on your Program Guide or watch on line any time at cspan. Org history. Okay, were going to go ahead and ge. Okay, we are going to d go ahead and get started with our final session. Jonathan jones is professor at Virginia Military institute where he teaches courses on the civil war era and american medical history. I will say this is not part of his official bio but in the fall he will move into a possession at James Madison history. He will be closer and we will have opportunities to collaborate more on things. His first manuscript is forth coming with university of north carolina. The book is based on his dissertation that received civil historians 2021 and dissertation prize as well as snuys chance or distinguished ph degree graduate in 2021. His research appeared in the journal of the civil war era, washington post, other outlets, he received it from bingham university. 2021, he was the civil era scholar at penn state. So, join me in giving a warm welcome to jonathan jones. [ applause ] jones. All right. Well, thank you all. All right, thank you all for being here. Thank you professor for that introduction, can everybody here me okay . Good . Perfect. Raise it up a little. Okay, perfect there. There we go. That is much, much better, deeper sounding. Okay. Thank you again everyone for being here. Thank you to everyone who will be tuning in on cspan. Mom, we are on tv. It is exciting. [ laughter ] we will tell her it is on cnn or pbs. No, i have always been interested in the aftermath and the afterlife of the civil war. Always curious about questions like how did the war, with all of the carnage and the upheaval we have been hearing about this morping and this afternoon, how did the events effect American Society and culture and medicine. And most importantly, the individual people that survived after the conflict. These are the questions that interest me the most as a civil war scholar and teacher. These are questions that animate my Current Research project. The war is interesting, right, what comes after the war is, to me, the real story. And, opioid addiction among Civil War Veterans, the subject of my talk this afternoon, elevates my interests. And part of my book. The first Opioid Crisis that is forth coming with the press in the near future. I do not have any with me today but shoot me an email if you are interested. In the wake of the u. S. Civil war there was an epidemic of opioid addiction among veterans, and openium slavery is a medical history of this epidemic. So, i would like to open up this afternoon with a story that illustrates some of the key themes of the book. Okay. Just one sec. This is a story of a man named chapel. A confederate veteran. During the war, a captain in the 14th virginia inntry. He never got over the wounds he sustained at the battle of gettysburg as he explains in a tragic 1886 letter. The captain was shot while storming union lines with general pickets illfated Virginia Division on the hot afternoon of july 3rd, 1863. All of the offices above chapels rank had apparently been shot. It fell to him to lead his unit through clouds of smoke. A white hot led miniball stopped chapel in his tracks and prevented him from completing the charge. When it smashed into his left kneecap at full force and pancaked on impact with the bone. The wall angerly ripped through the cartilage and the soft tissue of his leg at the joint tearing a massive exit hole in the leg. So, he dropped to the tall dry grass in unspeakable pain. That is where he lay until the dust settled that afternoon when retreating survivors of the 14th virginia, chapels outlet, carried him out. He hitched a ride along with lees 17 mile long wagon train. With union troops nipping at their heels for much of the way. Every rut and rock in the road would of added to his agony and misery. Now, as we heard today. Civil war battles produce thousands and thousands of war stories just like chapels. And all too often the cases they ended in grizzly deaths from infection or blood loss, exposure. You name it. A million ways to die in the civil war. So, judging by outward appearances we might consider chapel to be one of the lucky ones. After all he somehow managed to survive long enough to actually tell his story in 1886 and the letter that we see here on the screen. But, chapel did not see it th way. He did not consid himself one of the lucky ones because, to him, survival in the long aftermath of the battle of gettysburg was a living hell. That is because 23 years after gettysburg, the unexpected consequences of chapels civil war wound still dominated the old soldiers day to day life. As he explained in that tortured 1886 letter. Quote, the doctors put me on morphine. I can not stop that. In other words, chapel had become and remained hopefully addicted to the morphine that surgeons given him in that Field Hospital to treat the pain from his wound and he kept on taking as he bounced along the route into pennsylvania and maryland and on and on. So, although the gunshot wound long sinced healed, the drugs refused to release chapel from their chains, he suffered from it. He was not alone. Tens of thousands of Civil War Veterans became addicted to opium and morphine. Historians have long known about these individuals to a certain extent scattered cases became ashes dicted to addicted. For over a century, individual veterans like chapel have made occasional appearances in mediums ranging from early 1900s social science literature, 1970s Television Shows about the civil war, a story for another day. And even congressional debates about todays ongoing Opioid Crisis as recently as a couple of years ago. Yet, addicted Civil War Veterans like chapel, are almost always relegated to the footnotes, literally, in the story of the civil war. For me this is surprising considering that the civil war era is among the best documented periods in u. S. History with sustained interest in the conflict for over 150 years. So, it go without saying that today, there are many, many Unanswered Questions about this phenomenal. For example, why did addicted veterans become addicted to opioids and how wases it . A few scattered cases . Individual cases like chapel, or was he and others like him emblematic of it afoot. How did they try to mitigate the consequences . How did, for their part, the american medical community, the doctors, the media, government officials respond to this epidemic if there was indeed, one . What is the addiction reveal about the longterm Health Consequences of the civil war . Which, unleashed so much suffering on survivors like chapel. And, so, taking up these questions for my book, i assembled a sample of 200 individual cases. The story that i just told is drawn from that sample roughly two companies of soldiers. I sourced these individual stories from 19th century medical journals, Asylum Records some, here from virginia. Medical advertisers and pensions that we have been talking about that were rich sources for the period. What i am going to do this afternoon is describe some of the sources and my Research Process as we move through the talk. But, ultimately i am going to make four key points. First, i am going to argue that the civil war did, in fact, cause an epidemic of opioid addiction among Civil War Veterans . Not merely a few oneoff cases. Second. We are going to assess the suffering that opium slavery visited on veterans and families, i am here to tell you that addiction dominated their lives to the point that few addicted men ever got over the civil war or the aftermath of the civil war battles. Third, we are going to explore some, scratch the surface of some of the ways that American Physicians and the government reacted to the veterans Opioid Crisis and finally we are going to describe how this research, i hope, will advance our understanding of the civil war to lead us to a more humanized accounting of the cost of the conflict. Lets start with the beginning, lets start at causation. What caused Civil War Veterans like chapel to become addicted to open yes, i opioids. It caused a huge number of people to get sick, to suffer from pain, to put a number on it, there were 1. 5 million casualties from the war that we know of, out of 31 million americans, to put it in our terms, almost everyone knew someone or was someone who got sick or shot or suffered some kind of a physical Health Consequence from the war. In fact, recruits had a chance of not coming back home at all. To deal with this Unprecedented Health crisis, doctors had to double down on tried and true medical therapies which in the 19th century were opioids. It is an old drug, dating back to the stone age, doctors have been giving out opium, and a drug morphine, still in use and another one that is booze mixed with opium. You can imagine the attraction of this drug. They have been giving these drugs for centuries in the lead up to the civil war. They were among the most effective and only truly effective painkillers known in the late 1860s or in the middle 1860s. Doctors in the u. S. Learned to prescribe these drugs liberally in medical school and apprenticeship. And one, i can never get over this cover. They put it like this. Quote, opium is a divine gift from heaven to illustrate that point in his medical dissertation like an exam that medical students would take at the end of their degree, he drew an angel burying an opium poppy down from heaven to earth, right . They took it literally. It is an intensely religious society. It is not a character, it is a belief that many doctors and patients had. God given them opium to ease their suffering. By 1861, the year that the civil war broke out, opium and the others, morphine, are the commonly prescribed medications in the United States. Opium was somewhere in all of the prescriptions in the United States. They were so popular because they were e till utillitarian. They were used for more than just pain. By my count, i had to actually count, in the middle 1800s they were used to treat around 150 different ailments from diarrhea to cholera to pneumonia, and my favorite, tooth aches among teething children. [ laughter ] it is a good thing this is after lunch, right . Actually, i kind of think of opium being a combination of tylenol, and pepto, combined. You might be wondering did they know about the downside of the drugs . Clearly they had a lot going for them but the risk of overdose . Addiction . Doctors did know going into the civil war that they were addictive and could kill you if you took too much. So, yes, they were aware of these downsides. This knowledge goes back to the american revolution, the founding of american medicine. I identified in the Research Project several previously unknown and undescribed cases of individuals including one in the washington family. Addicted to morphine in the writings of benjamin rush, known as the socalled father of medicine. This is something that occurs before the civil war is widely known about. It is widely deadly. Addiction and overdoses often appeared in coroners records in the antibellum era. It was 4 of the unexplained deaths in new york city. The catch, though, it is that most people who suffered from these consequences of addiction and overdose before the civil war were not men. They were, in fact, white women. Of course, you may know presumptions of chinese opium smokers in the 1800s as described in particular through the lens of american missionaries writing from china. They are pervasive in the 1800s pop culture and medical culture. But, because, both of these grew. They were so often portrayed. The addiction to opioids were not hugely culturally a problem, it seemed normal, not a big deal. It was known it was not at the forefront of cultural or medical concerns before the civil war which would create for the first time in American History a huge do hort of men who will become addicted t. Is worth mentioning that doctors, patients, Health Care Consumers had little alternative to opioids, there were few other drugs as effective as opium. It became a principal in civil war care. During the war Army Surgeons are going to rely heavily on opioids to treat pain and diarrhea. Think of the gunshots and amputations but also think as dediarrhea, diarrhea, opioids are used the union military, that kept medical records, so we know these nittygritty details, they used 2. 3 million fluid ounces of liquid opioids like morphine. And 10 million pills. In fact, the Union Government used requisition so much that they had to create it for the first time in miles an hour history governmentfunded pharmaceutical labs to mass manufacture quantities of this drug to keep up with the rapid demand, again, for the first time in u. S. History. For their part, the confederacy that has, it is enduring during the civil war an effective blockade, they tried to get it by getting poppyseeds. When it failed they attempted halfway during the civil war to coax white southern women and children left on the home front to have opium gardens and donate them to military hospitals, of course that failed and i am happy to talk more about that later on. Again, surgeons in the north and the south dueled them out liberally in way that were conducive to facilitating addiction. I will give you an example. That comes from one union hospital, turners lane in philadelphia. Philadelphia turned into essentially a giant hospital complex. At this particular hospital turners land that is where the bad cases went. Severely wounded individuals, particularly those who had nerve conditions. There, Union Surgeons began experimenting with morphine, a way to deliver it instantly. And, so, they ended up giving in one year during the civil war, 40,000 morphine injections to wounded and sick soldiers that passed through this hospital. And, in fact, it was so successful that doctors elsewhere started emulating what was done at turners lane after the war. So, in a roundabout way the civil war helped make it popular. Today, mainstay of american medicine. Now, these medicines were really, really, really, really important for civil war armies, soldiers could not have functioned or remained in the field, returning to duty without them. And, the Confederate Army handbook put it like this. Opium is the one indispensable drug on the battlefield, important to the surgeon as gunpowder. And this knowledge of a imagine illustrates it. It happens to be one of my favorite civil war ages because of the stare, intense character. These aracal civil war prescrtis. Part of my work involved counting, quantifying opioid data and finding a pattern in and outside of civil war hospitals, we can see sections where there are red underlines, those are prescriptions of various plantbased drugs including opium, under lined in red. Written in latin. It can complicate things a little bit. Doctors handwriting is bad. So, imagine reading bad doctors reading in latin and that is a taste of the research method. Predictably many soldiers are going to become addicted during the civil war through prescriptions. For example, chapel, the story i opened with today. One of the most haunting examples that i found with this phenomenal, it comes from turners lane hospital in philadelphia. That is a Union Soldier wounded in 1861. Run over by a train. Many ways to become injured during the war. That is his unfortunate fate. He spends the entire course of the war, four years, mostly bedridden and they have to amputate more and more and more of his leg to solve the pain in a span of four years. After the final surgery in 1865, the mans surgeon reported that he was good enough to be discharged accept that he had developed what the surgeon called a craving for opium. Other veterans learned to use opioids from not doctors but fellow soldiers. So, camp life, the intensity of camp life, the boardum, boredom of camp life, a finding soldiers would send letters home to their mom or father or sister asking to receive a packet of opium pills in the mail. Later on when they went back home and got sick later in life, veterans often reached for the opium bottle. A behavior they learned during the civil war because they knew the medication could be effective. Of course, all unfolding during the temperance movement. There is concern about Substance Use among americans but particularly the rank and file of civil war armies. So, they are going ballistic as they are observing this behavior. They worry about creating an epidemic in the ranks and after the war. These fears came true. Selfmedication during and after the war. One soldier, a man named george m house of the 9th alabama infill infilltry he would go and prepare to go into combat, down morphine because he found it calmed his nerve. He felt jittery and it helped him cope with the carnage he was about to be asked to endure and inflict. Fast forward several decades, 1881 i discovered his case on a patient register of a facility called the Charity Hospital in new orleans where he had checked himself in seeking some kind of help for his morphine addiction. So, again, selfmedication is a major pathway to addiction just like surgeons prescriptions. Although opioids were free flowing in civil war hospitals and camps, it is worth mentioning that white veterans are far more likely to be addicted than black veterans, black soldiers played up 10 of the union military, the army, the navy. So you would think addiction would of occurred relatively frequently among black veterans, perhaps on parwith white soldiers and veterans. I actually found this was not the case. The reason for this is that american doctors, before the civil war, are mostly white and they were trained in medical schools that are teaching a white supremacist curriculum. The ongoing belief implemented during the war is that black soldiers, black bodies could not feel pain on par with wounded white soldiers. Of course, this belief is medical racism that dates back to slavery when it was developed by southern doctors. And fafort forward through the civil war, because of this idea, black soldiers were far less likely to receive opioid painkillers from their surgeons. For example, in one case, a black Union Soldier whose foot was severed in half. He was not given morphine, specifically not given morphine because his surgeon claimed that the man was not suffering much pain. Of course, for a white soldier, this injury, the standard of care would have been morphine early and often as we saw in chapels case. The same is true of diarrhea, mortality from diarrhea and white troops it was a relatively low, we are talking about the civil war, 17. 3 . In contrast the death rate for black troops was almost 34 . Nearly double the rate of white soldiers. So, historians reading that kind of statistic, the staggering disparity was emblematic of civil war medicine. It teaches us civil war doctors were not giving out opioids for patients under their care. I am emphasizing this because it is a parallel with todays Opioid Crisis going on for 20 years at this point as we are talking in 2023. Black Americans Still today are widely under prescribed opioid painkillers, we see some of the past in the present moment. In any case, after the civil wars end in 1865, many, many veterans returned home with lifethreatening, life altering medical problems, missing limbs, half healed gunshot wounds. Starving and prisoner in of war camps. And, doctors did continue to liberally prescribe opioids to ailing veterans after the civil war. And it facilitated addiction. One doctor, george jones from cincinnati enthusiastically embraced morphine giving 2300 injections of morphine to a single pain patient over the course of just 20 months. That is unshocking but keep in mind the context is that it predates modern american pharmaceutical and drug laws. So, in the 19th century there are no legal standards for doctors to follow when prescribe opioids, no laws to prevent consumers from buying a prescription from a doctor and refilling it an unlimited amount of time for years and years and years. For the record you did not need a prescription, drugs were available overthecounter and by the mail from stores like sears where you could buy a needle kit and morphine for 1. 50. , conditions for Public Health crisis were ripe. Including here in virginia. In stanton, virginia, not far from here, pharmacists dispensed 79 doses, individual doses of opium a year in the late 70s t. Raised attention in the national media. The New York Times dispatched an investigator who labeled the great opium city of virginia, i commute to work through it so i think about that. According to the times, opium eating, another way of them saying addiction, was quote like an epidemic, it is in the atmosphere which was devastated by the war. So, in virginia and elsewhere, an addiction epidemic was among Civil War Veterans. I was caught off guard how long it lasted. Not limited to the immediate aftermath of battle or even to the 1870s. It was, in fact, a really long term Health Consequence of the civil war. For example, one confederate veteran appears in louisiana at one of the early drug rehab clinics opened up by the federal government in the early 1920s. He told doctors there he had been addicted to morphine and taking it daily since the civil war, more than five decades before. Of course, the majority of the mans life. Another veteran. He became addicted to opium at a hospital in 1864 where he was checked in for a diarrheal disease. He died in a soldiers hospital operated by the National Home for disabled volunteer soldiers of something that the doctors called chronic morphineism. He lived most of his life on the drug. To label it an epidemic, requires not just a large number of cases but people in the past to recognize a epidemic is afoot. So, in fact, during the age, addicted veterans were widely recognized, so much so they were reported on and became somewhat of a stereo type in the media and in fiction. One boston pharmacist summarized this stereo type in 1872 when he reported to the state board of health that was investigating the phenomenal that quote, veteran soldiers as a class are a diplomated to opioids. This morphine addiction, civil war Veterans Crisis left a long lasting look on culture. Not just a stamp on the lives of individuals like chapel. In fact, the First American novel about hyperrer did hyperdermic addiction, it was a Civil War Veteran not someone else. During the progressive era in 1914 when congress debated creating for the First Time Ever federal regulations on drugs like opium and other narcotics Civil War Veterans came up over and over and over again as they debated these new and far reaching laws on the floor of the house. When they referred to this as the soldiers disease. The pervasiveness of the Civil War Veteran is surprising to historians of drugs t runs counterto drug history. The use and abuse in the United States. Typically when they think of opioid addiction in the United States the people that come to mind are chinese immigrant smokers or the white woman that made up the majority of individuals as i mentioned a few months ago. It is true, there were a lot of americans that met those descriptions using opioids in. In the book i write about a woman in virginia who uses opioids, her husband leaves the army in 1865 and returns home and finds out she is addicted. He proceeds to force her into detox cold turkey. So, this creates a problem in the lives of many women. They had a prominent elevated place in postcivil war age in politics, it mattered more to politicians and doctors. There is one of the reasons i described this Opioid Crisis among Civil War Veterans as americas first Opioid Crisis. It was the first recognized Opioid Crisis. When we think about an epidemic in the eye of the beholder, people saw Civil War Veterans addiction while not seeing other folks addictions. So, that is how the addiction epidemic started with the civil war and effected Civil War Veterans, what was it like for these veterans to be addicted to these powerful really terrible drugs on a day to day basis . This is a major part of my study. Investigating the historical experience and the perception of addiction. To answer this question i followed my sample of 200 individuals through sources that were previously under available or under utilized. Rare medical records from mental asylums, pension records from the Pension Bureau and former Confederate States like virginia that in the last decade or so have taken off with historians. So many now beginning to mine the gems that live in these records. And digitalized records that represent a boom for historians. What i learn friday this process is that addiction costs veterans like chapel everything. It cost them their livelihood, selfof selfa steam. It caused them their lives. One reason, it is opiuum slavery. So, searching for a vocabulary to describe what they were experiencing and what they were seeing, 19th century americans referred to opium addiction as slavery to opium but the phrase and the lived experience of it defied cultural ideals of whiteness and it ran counter to what Civil War Veterans were to be. There are several reasons for this. First, before the war, most addicted americans had been women, so, the condition took on characteristics most associated with woman, such as dependency or in the 19th century. So, speaking of dependencies and selfcontrol, society in the age dictates men are supposed to be selfcontrolled and making decisions and carry out the decisions without any kinds of problems. Being dependent on it and having to take the drugs multiple times a day no matter what, if you want to quit or not. Is the opposite of independence. Resolving to quit. Failing to make it through the withdrawal or ordeal it was seen as a failure or self controlled. It is pain relief. Again, according to civil war era doctors, there is a hierarchy of people that experience pain in different ways and so, according to guilded age doctors only the hypersensitive bodies of white woman are thought to need long term painkillers, white men were supposed to need it at the moment of surgery but not six months later. So, for an old soldier with civil war wounds from 20 years ago, to need morphine every day or worse for someone with a lingering case of chronic diarrhea that bodies in the 1800s can not cure, this is a problem, even when the indivials were struggling with serious medical complications. Another example of the e mas cue emasculating part, impotence. It had a bigger meaning that escalated the crisis in the guilded age. And made it take on racial undertones, in the context of fears of immigration and white racial decline. In the guilded age, they are white race scientists, charles beard, for defining it, they worried that opioid addiction would prevent White American men from having children and that slowly over time with immigration this crisis might spiral out of control and lead to a nonwhite nation. When you couple the obvious implications of a white confederate veteran like chapel, enslaved to anything but let alone opioid addiction it is a crisis that threatened to off of the rails quickly. My favorite example, though, is the visual effects of a dispiks addiction and what it did to their appearance. That had weight loss and fatigue and the side effects made them look different than how men were ideally supposed to look. Guilded age men were barrel tested, strong, Teddy Roosevelt looking guys that lifted weights and had a large torso. Like the guy on your left. But it meant they defied that. Some veterans in my sample lost over 50 pounds during the course of their addiction, so they appeared skeletal like the plan that we see here on the lefthand side of the slide. A soldier lost a full third of his body weight and he appeared in september of 1891 at a hospital in indiana weighing just 100 pounds. His skin, like that of many veterans, was covered with needle marks from his head on down to his toes and his doctors were horrified by this. Again, because they believed that not only was gardener sickly looking but these needle marks indicated a lack of manly selfcontrol. Eventually the effects, the physical a effects got so bad that men were unable to work, fatigue, weight loss, unable to focus without morphine and the financial cost of the drugs added up. When this happened veterans wives typically stepped in to take over the bread winning. The dependency of addiction, they became dependent on the drug but people to take care of them. Patterson, a physician by trade, described how opioid addiction ruined him, i could not sleep until an injection of morphine was administered. My wife would get up all hours of the night. My health became so poor i was confined to my room and at last my bed. I could not eat until i used morphine let alone practice medicine. This inversion of the social order, the inversion of the body was profoundly looked down upon. It contributes to the lived consequences of addiction in veterans day to day lives after the civil war. Because addiction was stigmatized and frowned upon veterans became isolate friday their families and communities. For example, take the case of john and fanny from fredericksberg, virginia, jo, as a teenage soldier was shot in the leg in the battle of petersberg in 1864. Eventually the confederate veteran became addicted to morphine to cope with the pain. Of course, the couple kept the addiction secret. It is a stigmatized reality. And fanny worried that john, what she called johns weakness and folly would eventually get out into the papers. As it happens they were somewhat of a prominent family in fredericksberg, john promises, over and over again through the 1800s promised he will rebound. Finally in 1896, fanny returned to their house one afternoon and found him overdosed on morphine after promising a few days before, yet again, to quit. She snapped, she fled to washington, d. C. Where she declared she was going to file divorce over his inability to quit morphine. In a rare letter from her perspective or from the perspective of an addicted veterans wife. He will beg and employ me not to do this because i can bear this life no longer. Ultimately, the family, they stepped in to talk fanny down from the ledge but that raised the question, what to do with john . This addicted Civil War Veteran. Families that had the means financial low opted for what was home care, again, because they are trying to keep this addiction secret. For months, they took john out into the countryside, outside of fredericksberg to his brothers farmhouse and literally locked him in a room in the dark to detox cold turkey. They hired nurses and armed guards to keep him there and keep others from, you know, following the sounds to hear what was going on in the house. This was obviously an awful ordeal that john barely survived and it ripped a massive hole in the fabric of a family that never healed. Pensions are another great example of the cost of addiction for veterans, after the civil wars we learned the u. S. Government and Confederate States such as virginia created massive pension programs for veterans and their families. And these ultimately will set the stage for 20th century welfare policies, these are very important. But access to these entitlements were upon an applicant, standing in the community and the person who is processing their application, perception of the persons moral fiber and manliness. So, opium slaves, people addicted to opium were denied if it was discovered that they were addicted. Take for example, samuel martin, a veteran, he was denied a pension when he applied for one that someone at the Pension Bureau in washington, d. C. Literally pasted the guilded age of a sticky note on the cover of his application stating, quote, he is a morphia eater. I assume this is because if he appealed and he did and it was denied. Oftentimes they would dispatch these sort of elite pension examiners, men known as special investigators to dig into applicants who were suspected of being addicted. Their personal lives, businesses, and also to exam the body to discover the secrets, states would do this as well. This is what i suspected would happen to chapel. I opened up with this afternoon again, this is the confederate captain, shot through the knee at pickets charge. His wound and the morphine addiction left him in chronic pain and unable to work. So, chapel, who was a modestly wealthy man before the war, this stage, 20 years out of the war he became poor. His station was so badly reduced he could not afford to buy morphine, a necessity for the addicted veteran like food and water and shelter. So, as chapel explained in that may 1886 letter, quote, i cant stop taking morphine, but he continues on, i can not get it often but people give it to me. So, in those situations, in those dire circumstances, chapel applied for a confederate pension for commonwealth in the 1880s thought it might make his life more bearable and support his wife and children. His application was denied for reasons that were not stated and that chapel could not seem to wrap his head around. He wrote that letter that i drew upon and have drawn upon throughout the talk today hoping that the recipient, a former general named william r. Terry and a bigwig at there point in richmond hoping that he could interseed and help chapel get a pension, i can not see, general, why the auditor dont pay me he pleaded in the letter. If you can hoping he could help chappell procure a pension. I cannot see why the otter dont pay me, chappell pleaded in the letter. If you could do me any good, you will confer on me a great and lasting blessing. I can never want it worst that at this time. That speaks volumes of the experience and suffering that addicted veterans felt in their postwar lives. For the record the denial of benefits extended to the families of addicted veterans. During his presidency in the 1880s, Grover Cleveland vetoed dozens of pensions awarded by congress to the widows of war veterans who had overdosed to death in the 1880s. In the pitot messages, which are full of Grover Clevelands personal thoughts about the morality and the manliness, cleveland criticized veterans and for their inability to bear the pain, like a man should, without over indulging in morphine. It got personal for the president and those who cannot cure pensions. I see this kind of gatekeeping as medicine and drugs as well as a civil war historian. As an early way of a government policing drug use and abuse. Denying a man a penchant because he is deemed unworthy is, after all, a way to attach some kind of penalty to drug use even though the act itself is not yet a legal at this point in u. S. History and will not be until the 1910s. Pensions, i argue, are a precursor to United States current set of drug laws. I am happy to talk more about that in the q a. As if losing out on pensions and being forced into a closet to detox without medical assistance, and this was not bad enoughmany veterans ended up in prison or woe, a mental asylum. They were incarcerated for decades. In 1882, a virginia named henry j. Garrett, was committed to a facility in the great opium city called the Western State hospital. Her what doctors described as ill health and opium use. He died at the asylum in 1898, the turnofthecentury. He was held in a one room, effectively a jail cell, for 17 years because of his addiction. All this without the act actually being a crime. It goes without saying that these asylums are not nice places but you could be chained up, tortured and working on the prison farm, a kind of farm that helped feed the asylum patients for free. Basically, these facilities became super prisons. Like pensions, during the gilded age, the asylums also functioned as the de facto means of Police Policing addiction montessori but drama loves drug laws were enacted. What about the doctors . What did they do for the crisis . Although addiction is framed as a personal failure on the part of the veterans, veterans are going to blame the doctors. They will pivot and say, it is the prescribing physician pulpit the surgeons gave me the morphine and i cannot stop that. Physicians were a very deeply about the effects of the crisis. It undermined the reputation of the medical profession. Doctors had a lot to you lose and something had to be done but this is how the several spark major innovations american medicine but the 1880s and 1890s saw what one surgeon called a revolt against opium and the overprescribing of opioids. Prescription rates plummeted as doctors witness the addictive potential of opioids. By 1900 opium was no longer the most widely prescribed drug in the u. S. It had been supplanted by less addictive alternatives. Drugs like cocaine and heroin. [ laughter ] the irony. Developing addiction treatments was paramount for doctors, developing and monetizing these treatments. Some of the first drug rehab clinics actually emerged out of is postwar addiction crisis. For example the pennell hospital of chmond, virginia, which was chartered by the commonwealth for the reclamation of opium use in 1876 at the behest of doctors who were alarmed by what they were saying in their patients. Many of them were former confederate veterans. Scores and scores of these facilities, like the pennell hospital opened up throughout postwar decades everywhere from new york city to virginia and out to texas and california. There were none before the civil war. These are the first iteration of the modern American Drug rehab. We continue to see the effects of this isis today. Equally important, where Patent Medicine mirae res for addiction. These were prolific and big business during the gilded age. What i have discovered is that the civil war addiction crisis respond an entire sub industry or niche industry of medicine sellers dedicated to curing addiction, especially among Civil War Veterans. For the record, Patent Medicines are the snake oil, overthecounter miracle cures that traveling salomon would roll into town and sell you or you could buy them through the mail. After the civil war, a group of veterans spotted a business opportunity. They realize the veterans were desperate for a cure. The real regulations on Patent Medicines but if you could convince someone that your medicine was the cure for addiction, there was a bonanza to be had. That is exactly what occurs. Ultimately, this spiraled into a multimillion dollar business in the gilded age. Here we see some classified advertisements being marketed to Civil War Veterans in the periodical, the National Tribune it is right alongside a pension lawyer, who would value his services to help you navigate the lengthy process. To wrap it up, my hope for this research is that by telling this underreported civil war story, it will help us historians and the American Public to better understand the tragic but also be surprising ways that wars, like the civil war, affect people in the postwar period. First of all, i hope this project will call attention to the Opioid Crisis because it provides muchneeded Historical Context for todays on going on crisis. I think that this story illuminates the transformative medical legacy both for individuals but how they were ultimately shaped and reshaped the institutions of american medicine, like the Patent Medicine industry and the rehab industry as well. Finally, i think this story reminds us to take the aftermath of civil war battles seriously and not skip over them when we are retelling the story of the civil war. Until very recently, historians assume that most veterans gently moved on and that the war behind them. Opioid addiction, in my view, most of all shows the opposite. Many survivors of civil war battles never truly got over the war because they lived with its physical, social and cultural effects every day for the rest of their lives. With that, i will drop to a conclusion but i am happy to take questions. Thank you. I think we have a question in the back. We will start in the back. When you were First Talking about the introduction of hydroponic needles to supply opium, is there any kind of statistic, be it documented or just personal observations on how many patients died until they got the doses right since it was going hypodermic . That is a great question. One of the frustrating things about american medicine and that civil war and postwar decades is that there are few systematic records. There are so many mysteries about the story that we just cannot know. As an historian nothing frustrates me more than not knowing. Ive had to make my peace with not knowing the overdose rate, for example. Rather than quantitative records that say, this percentage of people using opium died with accidental overdose we do have what is called a qualitative evidence. Stories of individuals, like alpheus chappell. Effectively, what ive had to fall back on our personal accounts by veterans, like chapel but also accounts by doctors of what they were seeing in their medical practices and comparing those to similar sources from before the civil war. That is frustrating but we get impressions that opioid use was rampant among the Civil War Veterans. It is underreported phenomenon after the civil war. Great question, thank you. Thank you for taking my question. You were talking a little earlier about how pensions were denied to opioid addicts but what were the means by how the federal government came to know about the addiction . A great question and also a frustrating methodological question for historians. This is a phenomenon because the reasons we have been chatting about, people desperately try to keep it a secret. They would lock their detox relatives and closets for months to keep the newspapers from finding out. That raises the question that you are articulating but how did the Pension Bureau find out the secret people were trying to keep . That is the special investigators. That is where the special investigators came in. The reason they exist and do the job they do is to clampdown on pension fraud. There is not a whole lot of pension fraud in my view, realistically. There is the fear that the federal government is wasting money on fraudulent pension claims. I think of them like super investigators. They would come out to a better ands house. And they would physically help the better and to undress and examine the body. Often times they would discover needle punctures, like the image that i showed on the slide that we will return to print this was hard to keep secret. Often times more effectively, they would interview the acquaintances, friends and Business Partners of folks. That would be another common way to uncover the secret that the special investigators were fishing for. Keep in mind that because addition is so cigna size, the relatives, the community of these individuals were not very inclined to be sympathetic. When the Pension Bureau came asking, more often than not, they would tell the dark secret that the better and the family was trying to keep a secret. It is a tragedy. I asked in the first session , what happened to the orphan schools . I happen to know a lot of the history about stantons insane asylum. Can you go back to the original picture of that place . Absolutely. Please stay there until i am finished. Absolutely. Here is stanton, the great opium city. This is the original insane asylum, whatever you want to call it. That was the picture. We will go back. That is it. Just remember that picture. The Main Building is right in the center. The one that is probably three stories. What happened to that building, it turned into the lunatic asylum or insane. My partner ran that place for 40 years. It closed and then the state turned it into a jail. It was run as a jail. Of course, there is housing all over the place at this point. Now, go to the last picture of it. Okay. This is a total reverberation of the jail. The rooms are the size of what the jails were. And it is now a four star hotel. With luxury apartments for sale as well. However, when you go there tuesday, the bedroom is one of the jail cells and the bathroom is the other jail cell. I went up to the top and it is beautiful inside. If you can just i would never stay there. Not only were the insane people and jail people, it made me feel creepy. This is a Beautiful Hotel now but the grounds are even much more beautiful. Some of our older, older buildings carry on the history. I just wanted to share that with you. But, i think, that asylum was due to opioids. He never mentioned that. Is there a connection . A lot of these asylums are patient populations of asylums and the gilded age both in virginia and other states. It populations are skyrocketing during the 1870s and into the 90s. Early american psychiatrists and government officials appeared that generally speaking, not just because of opium and other reasons as well, that United States was experiencing an insanity crisis , as well as an opium crisis. These facilities became overcrowded fast. The conditions then deteriorated very quickly. I think that raises questions about what we do with these old facilities. In the same way that a lot of historians are asking questions about what to do with the remnants of plantations today. Should these facilities be Luxury Hotels . I dont know definitely about of food for thought. I will add that these asylums also function i mentioned they functioned as kind of prisons. They also experimented with ways to treat addiction in the facilities. A lot of the cases of veterans i write about in the book were slowly weaned off of opioids but never released. These could be places where you could get toward but that did not mean that you would be released into society. A place you did not want to end up. Thank you. We have time for one last question. I have to bring up that i can you hear it now . I am a retired anesthesiologist , who made my living giving these drugs. I was fascinated by your talk. I think you are right spot on. I think you should hopefully teach the medical students a little bit about some of these things. That is something i hope is in your future. I do want to bring up something that you know about but the audience doesnt. You take rats i have two things to say. I would like to do it in a short time. You take rats and you train them to get opioids and one side and put on the other. You know this but the audience does not. They will preferentially go to the opioids to the point they are starving and they will die and not go to the food. There is some information there that is related to the human experience. I want to mention one other thing. I just loved your presentation. Thank you. There is a book out there called empire of pain. He did not mention that. It is also good. The one about empires of pain that oxycontin is used and how they bypassed all the rules and regulations and gave money to the people who should check on this. That is a book people should be reading. Fascinating book and i will be quiet. I appreciate it. This is another way that we can see the civil wars traces in our own times. An unexpected and tragic way. Thank you, all. I believe we are out of time. I appreciate it. Thanks, jonathan. Before we officially adjourn here, one sort of logistical item two of them. Authors are available to stick around, if you have a book we need to sign, we are happy to do that. I certainly hope that you have enjoyed this day as much as i have. I think that when i conceive of a conference and i think we should talk about this at our conference. She is a very patient woman. My goal was to walk away from here today understanding the very farreaching consequences of what happened on the battlefield. I hope that you feel like i do that we have achieved that objective today. I do hope to see you all at future events, whether it is for collier in september, our fall program in november or back here in the spring of 2024. I would like to thank all of our faculty who join me today helping to bring this vision to life. Thank you, all. I would like to thank my students, kayla, mr. Brooks, matt, who is outside, and jenny truitt, they have used their time and talents. Maybe their fear of failing my class to help as conference assistance today. You will at least pass, guys. Good job. Finally, i want to thank all of you. Since i came to shenandoah as a visiting professor in 2014 and transition fulltime in 2017, this program has grown over the years. I am so happy to see people coming back and happy to see some new faces. Thank you, all, for coming and your support. I wish you all a great rest of your weekend. Until we meet again. That is it. We are adjourned. If you are enjoying American History tv. Sign up for our newsletter using the qr code on our screen to receive highlights of upcoming programs, lectures and history, american artifacts, the presidency and more. Sign up for the newsletter today and be sure to watch American History tv every weekend or anytime online at cspan. Org history. Book tv every sunday on c span2 features leading authors discovering their latest nonfiction books. Garrett graff looks at Research Done by Government Agencies d the Scientific Community into potential for alien life in his book ufo. At 10 00 p. 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