The silent epidemic : women and opiate addiction in America, 1847-1914, 2025

From the eighteenth century to the early-twentieth century, upper and middle-class American women were disproportionately likely to develop an opiate addiction. In an effort to understand the gendered legacy of addiction, this thesis examines women’s opiate addiction between the founding of the American Medical Association in 1847 and the passage of the Harrison Narcotics Tax Act in 1914. The formation of the American Medical Association represented a movement towards medical professionalism that fostered an overprescription of addictive opiate-based medicines to women. Women’s addiction was tolerated under a veil of silent acceptance until the late-nineteenth century when public focus shifted toward non-white and impoverished opiate users. The Harrison Narcotics Tax Act was passed to restrict non-white and impoverished opiate users, but it also had catastrophic effects for female addicts. The Harrison Act cut medical opiate addicts (the majority of whom were female) off from their supply and forced them to battle addiction in the shadows of society. By centering the experience of women throughout this transitional period, this thesis highlights how medical advancements, racial anxieties, and early drug policies converged to silence the persisting epidemic of female opiate addicts.

Keywords: women, gender, addiction, habituation, habitué, opiates, American Medical Association, Civil War, patent medicines, Chinese Immigration, opium-smoking, Orientalism, Harrison Narcotics Tax Act.