Books interview with Lucy Inglis: “Opium has held mankind’s hand since the beginning”

Where does the story of opium begin?

Opium has held mankind’s hand since the beginning. Active cultivation of the opium poppy began around 5,000 years ago, in the Neolithic period, somewhere on the Anatolian coast of the Black Sea. Our relationship with it really does go back that far.

What different forms have opiates taken over time?

To make opium, you harvest the milk of the opium poppy and form the raw gum into a ball – it usually looks a bit like a hockey puck. Over time people have sought to create increasingly powerful substances from the opium poppy. While in China or Iran people traditionally smoked opium in a levelled way – a certain amount of times per day and then no more – in the west, there has always been a desperate appetite for anything stronger.

In 1804, morphine was first extracted from opium poppies, and from that, diamorphine, or heroin, was first synthesised in 1874. By the 1890s, heroin was being mass-marketed and sold over the counter as a non-addictive alternative to morphine.

Now, of course, you can synthesise opioids that are far more powerful than ordinary heroin. These new synthetic forms of opiate – like fentanyl and carfentanil – can be incredibly dangerous. The devastating opioid epidemic we are currently witnessing in America is the latest reflection of that age-old desire for something stronger.

How has opium been used medically?

Medicinal use of opium goes all the way back to the ancient world. It’s a medical panacea in many ways – it stops diarrhoea, sleeplessness and coughing, and is very successful at killing off pain.

By the 19th century, opiates had become a common ingredient in medicinal cure-alls, and it’s easy to see their appeal. If you were in the middle of nowhere on the American frontier with a sick or crying child and the closest doctor was a day’s journey away, opiate-laden medicines like Mrs Winslow’s Soothing Syrup would have been very seductive. People weren’t aware of the dangers, but the recipes for these patented medicinal products could be terrifying. One dose of a cough syrup called Syrup Toluheras contained 20mg of heroin, along with cannabis, chloroform and alcohol. And you could have had any number of these syrups, pills and cure-alls in the kitchen cupboard.

It’s no surprise that overdosing of children with morphine-based products became a real problem in the 19th century. Surveys show that this was a particular problem in the factory towns of Lancashire, where women had to work incredibly long hours in the mills and relied on opiates to soothe their children to sleep.

Were there concerns about the widespread use of opiates?

When you speak about opiates now, the first thing that springs to mind is street heroin. But historically, opium was accepted as a part of life in a way that it isn’t anymore. People saw it as a natural crop and, for a very long time, it was the painkiller of choice.

Heroin was sold over the counter as a non-addictive alternative to morphine

There was no real concept of addiction until the 18th century, and when concerns about opiate addiction did arise, they generally targeted women. Although Victorian London’s opium dens were frequented by both men and women, concerns focused on the possibility of young women frequenting the dens after an evening at the theatre. Similarly, when morphinism became a craze in 1870s America, the media fixated on women getting high alone at home. Even today, if you look at the publicity surrounding drug deaths, it’s always those of young girls that generate the coverage. Dozens of young men die from drugs every week, but we very rarely hear about them.

Are there any instances where opium changed the course of history?

It’s changed history in many different ways. Often that change has been incremental, but there have definitely been some moments where it has been dramatic.

One example would be the foundation of Hong Kong. Today it’s one of the world’s greatest financial centres but historically, Hong Kong was a city built on opium. The original British trading hub for the drug in China was Canton, but increasing Chinese resistance made the situation there very precarious. However, Chinese demand for opium was so strong that British corporations were desperate to find a way to keep trading there. So, in the mid-19th century they simply moved down the Pearl river estuary to Hong Kong island, which they essentially transformed into an opium trading colony. Of the 12 companies that originally moved to the island, 10 traded in opium. They were so successful that Hong Kong kept expanding, and within 15 years or so, the city had exploded.

Anglo-Chinese disputes over opium trading led to the Opium Wars. Why were they so significant?

The two Opium Wars (of 1839–42 and 1856–60) mark the birth of modern China as we know it, but also a period of what the Chinese see as deep disgrace at the hands of the British. The reality is that Britain was making huge amounts of money from the opium, tea and bullion trades in China, and if the only way to hold on to those profits was to inflict addiction on the Chinese nation, then the British were happy to do it. No one emerges from the Opium Wars coated in glory, but they undoubtedly changed the course of east-west relations.

How successful was early government regulation?

Very shortly after heroin hit the market in 1898, governments knew that it was going to create chaos. They saw immediately that pharmaceutical companies were making an absolute fortune out of heroin-based products and that huge amounts of people were becoming addicted.

But when America’s Harrison Act – regulating and taxing the production, import and sale of opiates – was passed in 1914, the timing couldn’t have been worse. It was the era of the First World War and soldiers were living knee deep in water and suffering dreadful injuries from artillery fire. There was suddenly an immediate demand for a vast supply of opiates. However, due to the new act, the price of these kind of banned pharmaceuticals skyrocketed just at the time that US soldiers needed them most.

Laws were passed by the UK government soon after, such as the 1920 Dangerous Drugs Act, which issued controls over substances including opium, morphine and heroin. By 1945, opiate production was more or less controlled everywhere, under the influence of the League of Nations.

Did these government crackdowns fuel organised crime?

As hard as it is to hear, heroin has a global consumer base that is very reliable, and organised crime will feed off anything it can. Although opiates were banned, street demand for them remained high, meaning that the criminal trade in heroin boomed. This benefited organised crime networks from Shanghai’s Green Gang to the Corsican Mafia and New York’s Cosa Nostra. Opium became an enormously profitable business – we’re talking about insane amounts of money. In the 1990s, one warlord in Afghanistan made $1m a week from opium at a time when most of the country’s opium farmers were earning less than a dollar a day. Money has always been at the heart of the opium trade.

What role have opiates played in war?

Ever since the later 19th century, wars have been fought in ways that they couldn’t have been fought without opiates. People simply couldn’t have stayed on their legs. A good example of this is the Soviet-Finnish winter war of 1939–40. All Finnish soldiers were dosed with heroin pills, and I would argue that was part of the reason why they were able to hold out so long against the Soviets despite bitter winter conditions.

Another conflict that shaped the history of opiates was the American Civil War, which heralded artillery warfare on a scale no one had ever seen before. The injuries inflicted were so horrendous that opiates were handed out like sweets. One federal surgeon recounted powdered morphine being “doled out with a pocket knife”, and another dispensed it from horseback during battle – he had soldiers lick it out of his hand. It’s believed that up to 100,000 veterans demobbed from the Civil War were suffering from what became known as ‘the army disease’, morphine addiction. Amazingly, some of these civil war vets were still turning up for morphine prescriptions in the early 20th century. The idea of opiate-addicted veterans created by the civil war became so deeply ingrained in the US psyche that I would argue that even Nixon’s ‘war on drugs’ – more than 100 years later – can be seen as a hangover from it.

After studying their history, what do you think the future holds for opiates?

Humanity’s war with opiates is still being fought across the globe. The internet makes it easier than ever to get hold of these drugs, and the opioid crisis is clearly still raging in the US. Meanwhile in Kabul, an estimated 25 per cent of all young men are addicted to heroin.

The big problem with opiates is the tantalising lack of existential fear that they offer – they block not only pain but also the fear of pain, and that is at the heart of why people become addicts. I think that is the ultimate reason that we still are yoked to opiates, and why we will not escape their grip anytime soon.

BOOK: Milk of Paradise: A History of Opium by Lucy Inglis (Pan Macmillan, 464 pages, £25)

IN CONTEXT

Humans have been using opium to cure pain and induce pleasure for thousands of years. A narcotic extracted from the seedpods of poppies, opium was found in ancient societies such as Mesopotamia and Greece, and was one of the first products traded between east and west. The global opium trade went on to generate immense profits and even triggered war in the 19th century. Over time, increasingly powerful opiates have been created from opium, including laudanum, morphine and heroin. More recently, potent synthetic opioids have been blamed for a rise in opiate addiction in the US.