Referred to as “the Army disease” in the late 19^th century, addiction to opium derivatives including morphine allegedly involved as many as 400,000 Civil War combatants.  As this estimate derives mostly from Federal disability pension records and the rolls of early veterans’ associations such as the Grand Army of the Republic, it is bound to have excluded survivors of the Confederacy. 

Reviewing literature in the history of medicine surrounding the induction of addiction during wartime, several conflicting opinions arise regarding the origins of morphinism among the war’s survivors.  Authors have included Mark Quinones, David T. Courtwright, and David Musto.  Conciliation is provided by William L White, [http://www.williamwhitepapers.com/pr/dlm_uploads/Opium-Morphine-and-the-Civil-War.pdf] who suggests that regardless of the prevalence of morphine use during the war, addiction certainly reached a peak in the veterans’ population. This is replicated by our own experience in the past century.  The interface between PTSD and substance use disorders is well recognized, if not yet fully understood.  Authors and clinicians such as Anthony Dekker have been relentless in their pursuit of strategies for managing these overlapping diatheses in the active-duty and veteran populations [open-source: http://amops.org/wp-content/uploads/2015/04/PTSD-and-TBI-by-Anthony-Dekker-DO.pdf ].

As a new Presidential administration seeks to anneal the divide within our country, please acknowledge our colleagues and the population they serve, a population that seeks to guard us from external dangers:   all at hazard of death or injury, injuries immediate or delayed, and injuries both corporeal and psychological.

 Editor-in-Chief: Dr. William Haning, MD, DFAPA, DFASAM