Podcast Summary

Podcast: New Books Network

Host: Rachel Pagonis
Guest: Elizabeth Kelly Gray
Book: Habit Forming: Drug Addiction in America, 1776-1914 (Oxford UP, 2023)
Date: January 18, 2026

Overview

This episode delves into Elizabeth Kelly Gray’s new book, Habit Forming: Drug Addiction in America, 1776-1914, exploring the history of drug addiction in the United States from the country’s founding to the passage of the Harrison Narcotics Tax Act. Host Rachel Pagonis and Gray discuss how Americans understood, treated, and legislated drug addiction; the shifting social perceptions; the role of gender, class, race, and international context; and the long-term effects of early 20th century drug policy.

Main Discussion Points & Insights

Gray’s Path to the History of Addiction

• Origin in Foreign Relations (03:07):
  Gray started in US foreign relations history, studying the First Opium War. While exploring Americans' reactions, she realized understanding America’s own relationship to opium was key—and largely unexamined for the early period.

  "I realized really, not many people had looked at drug addiction as an American problem in this early time." (03:35, Gray)

Americans and the Opium War

• Moral Outrage vs. Complicity (04:37):
  Americans perceived the British as morally in the wrong in the Opium War, supporting the Chinese. However, Americans in China often sided with British merchants.

Defining the Timeline—1776-1914

• Why End in 1914? (05:54):
  Gray notes that before 1914, there were few, if any, national regulations on addictive drugs; parents could send children to buy morphine at drugstores. The Harrison Narcotics Tax Act marks a sea change in drug access and the beginning of national control, as well as the start of associating addiction with crime.

  "There really were no national laws... that limited access to addictive drugs. Even up until the early 20th century, parents could send their 12 year old to the drugstore to buy morphine and the child could come home with it." (06:19, Gray)

Drugs Used in 1776-1914 America

• Opiates as the Primary Focus (08:59):

  • Laudanum (opium + alcohol, common household medicine), morphine (especially after hypodermic syringe invention), and later heroin (semi-synthetic).

  • Cannabis/Hashish: Not widely used, but available (e.g., hashish candy) and sometimes marketed as medicinal, particularly for convulsions or “nervous diseases.”

  • Cocaine: Gained popularity in later 19th century—marketed as an anesthetic and included in products like “catarrh cures.”

  • Alcohol was excluded from Gray's focus as it's been more widely covered elsewhere.

    "The most common forms were laudanum... Morphine injections become a popular method... Heroin is… advanced as having medical value." (09:28, Gray)

    "Newspapers in the late 1860s, the ads for hashish candy were just all over the place." (12:21, Gray)

What Did “Addiction” Mean?

• Language Shaped Attitudes (13:25):
  Gray notes that the term “addiction” wasn’t commonly used; “habituation” and “habitué” were standard, framing drug use as a mere habit—something breakable by willpower. Only later did society begin to comprehend the depth and physiological roots of addiction.

  "Referring to it as a habit connoted that it was something that a person could end… by summoning willpower." (14:17, Gray)

• Personal Accounts Debunk the “Habit” Myth (16:29):
  Stories from users and families show that even with strong will or seclusion, breaking the “habit” was extraordinarily difficult.

  "[A woman] jumped out the window to try to find... a supply of it." (17:17, Gray)

When Did Addiction Become a Public Concern?

• Post-Civil War Surge in Discussion (17:46):
  Though opiate use grew from the mid-19th century (as proven by ballooning imports), addiction only became a public issue in the late 1860s, spearheaded by accounts like Horace Day’s The Opium Habit (1868).

  "Before 1867... it's just glimpses. In 1868... a steady stream of other works... noting that this is a huge problem." (19:05, Gray)

Gender, Class, and Addiction

• Why Affluent White Women? (21:53):

  • Doctors, particularly after morphine injections became common, were primary drivers of addiction—over 90% of cases, per a 19th-century physician.

  • White middle-class women accessed doctors more due to proximity and norms discouraging men from seeking care.

  • “Female complaints” and chronic pain contributed to a higher prescribing rate for women.

  • Gray draws parallels to the modern opioid crisis, where prescription origins and perceptions of class/race influence public and policy responses.

    "90% of the cases of addiction originated with a doctor's visit..." (22:26, Gray)

    "David Courtright said that people's attitude towards addiction depends on their perception of who is addicted." (26:29, Gray)

Home Remedies and Bad Medicines

• Quackery and the Medicine Cabinet (27:54):

  • Over-the-counter remedies, often containing opiates or morphine, were heavily marketed with no ingredients disclosed before 1906's Pure Food and Drug Act.

  • “Morphine cures” sometimes contained morphine, perpetuating addiction.

  • Public perception of the “invalid woman”—bedridden with bottles—may align with real cases of chronic opiate use.

    "Until passage of the Pure Food and Drug act in 1906, no manufacturers had to tell what was in them." (28:24, Gray)

Treatment & Cure Attempts

• Wealth & Access Influenced Recovery (30:28):
  • Wealthier women might afford sanatoria; less affluent women attempted dubious mail-order “cures.”
  • Some cases resolved if the underlying medical issue was addressed.
  • Decline in new addiction cases as doctors became wary of morphine use by the mid-1890s.

Cannabis and Cultural Perceptions

• Imported Views, Blurred Realities (33:12):

  • Americans’ view of cannabis came largely from “exotic” foreign travel accounts (e.g., Ludlow’s The Hashish Eater).
  • Cannabis often symbolized a critique of the American work ethic/capitalism—"drug use being associated... with critiques of mainstream society." (36:47, Gray)

• Psychoactive Drugs as Creativity Enhancers? (37:55):

  • Opium, while used for pain/sleep, was also reported (like de Quincey’s Confessions of an English Opium-Eater) to induce euphoria, vivid dreams, and inspire “imaginative” individuals.

International Context & Colonialism

• Learning from Abroad, Shaping Policy (39:54):

  • Travelogues from Persia, Turkey, Africa, and Asia shaped American medical and public understanding of addiction, often with medical knowledge relying on centuries-old foreign descriptions.

  • Drug use abroad linked to critiques of “lack of productivity”; this justified colonialism in the eyes of Westerners. Drug use thus became a sign of inferiority and a rationale for colonial intervention.

    "It’s seen being used in other countries as a sign... that these other societies were, were just not as active... used as a justification for colonialism." (43:47, Gray)

• The Double Standard on Alcohol (46:18):

  • Despite widespread, even binge, drinking in 19th-century America (triple today’s consumption), alcohol was seen as nutritious rather than a dangerous drug.

    "For a while... beer was not considered an alcoholic beverage... Water was something that would be more for animals." (46:56, Gray)

Harrison Narcotics Tax Act (1914): The Watershed

• What Changed? (48:49):

  • Required prescriptions for opiates/cocaine.

  • Supreme Court soon ruled prescriptions must be for “ever diminishing amounts”; maintenance for addiction explicitly forbidden.

  • Class and race disparities: poorer “bums” couldn’t access prescriptions, leading to the rise of the illicit market.

    “You end up with a huge illicit market... and drug association being associated with crime where... they would seem almost inextricable at this point.” (52:02, Gray)

• **The public had sympathy for earlier, “respectable” addict profiles (white, female, middle-aged); by 1914, the focus shifted to less sympathetic groups (young, male, heroin users), reducing opposition to restrictive policies.

Long-term Impact & Legacies

• Addiction & Crime: Linked by Law (53:36):

  • The equation of addiction with criminality, which feels “inextricable” today, began post-1914.

  • The US remains resistant to “harm reduction” compared to other nations; “restorative drug use” (maintenance dosing) is still a point of debate.

    "Drug addiction and crime do not need to be inextricably linked. I think that's part of what this shows." (54:02, Gray)

• Modern Parallels and the Opioid Epidemic (55:05):

  • Modern crisis mirrors the 19th century: initial medicalization, pharma company deception, prescriptions skyrocketing, public and familial suffering.
  • Who is seen as an addict continues to shape policy and compassion.

Notable Quotes & Memorable Moments

• On linguistic change and its meaning:

  “Referring to it as a habit connoted that it was something that a person could end… by summoning willpower.” (14:17, Gray)

• On addiction as experienced, not just named:

  "[A woman] jumped out the window to try to find... a supply of it." (17:17, Gray)

• On race, class, and policy:

  "People's attitude towards addiction depends on their perception of who is addicted." (26:29, Gray, citing David Courtright)

• On public obliviousness about regulations:

  "I don't think that in general people are familiar with the Harrison narcotic. I think it's... among the most important... that Americans in general haven't heard of." (48:49, Gray)

Key Timestamps

| Time | Topic/Segment | |---------|-----------------------------------------------| | 03:07 | Gray’s path to studying drug addiction history| | 04:37 | Americans’ response to the Opium War | | 05:54 | Why the book ends in 1914 | | 08:59 | Drugs used by Americans (opiates, cannabis) | | 13:25 | Language: habituation vs. addiction | | 17:46 | When addiction became a public issue | | 21:53 | Gender/class – white women as prominent addicts| | 27:54 | What was in medicine cabinets and quack cures| | 33:12 | Cannabis/hashish and imported perceptions | | 39:54 | International context & colonial views | | 48:49 | Immediate and long-term effects of Harrison Act| | 53:36 | Still living with Harrison-era legacies | | 55:05 | Parallels with the opioid crisis |

Closing

Elizabeth Kelly Gray is now working on a broad, novelistic history of antebellum Baltimore—her hometown—seeking to capture the city’s complexity and historical themes during a formative era.

Book Featured:
Habit Forming: Drug Addiction in America, 1776-1914 by Elizabeth Kelly Gray (Oxford University Press, 2023)

Host: Rachel Pagonis
Guest: Elizabeth Kelly Gray

This episode is highly recommended for anyone curious about the medical, legal, and cultural history of addiction and drug policy in the United States.