Understanding What Drugs Did People Use in the 1800s?

October 10, 2025 •

5 min read

Over 400,000 soldiers reportedly became addicted to opium or its derivatives during and after the American Civil War, underscoring the widespread and largely unregulated nature of what drugs did people use in the 1800s. This era was marked by the pervasive use of powerful, often addictive, substances for common ailments, a reality far removed from modern pharmacological standards.

Quick Summary

In the 19th century, common pharmacological treatments included highly addictive opiates, cocaine, and toxic metals due to a lack of regulation. Patent medicines, often containing these dangerous ingredients, were widely sold with exaggerated claims, while herbal remedies and newly isolated compounds coexisted in a medical landscape prone to abuse and harmful side effects.

Key Points

Opiates were pervasive: Substances like opium, morphine, and laudanum were widely available and led to mass addiction, particularly following the Civil War.
Cocaine was hailed as a cure-all: Isolated in the mid-1800s, cocaine was marketed as a miracle drug and used in tonics like Coca-Cola before its addictive nature was recognized.
Regulation was almost non-existent: The market for 'patent medicines' was completely unregulated, allowing manufacturers to make extravagant, unverified claims and hide dangerous ingredients.
Toxic treatments were common: Poisonous substances like mercury and arsenic were routinely used in medical treatments for ailments such as syphilis, often causing more harm than good.
Herbal remedies coexisted with modern drugs: While powerful compounds were becoming available, traditional remedies from plants like willow bark and foxglove remained in common use for their medicinal properties.
Legislation began to change the landscape: By the early 20th century, acts like the Pure Food and Drug Act (1906) and the Harrison Narcotics Act (1914) began regulating ingredients and requiring prescriptions.
Addiction was a severe social problem: Widespread use of opiates and cocaine created a significant addiction crisis, which was poorly understood and stigmatized at the time.

The 19th century was a turbulent period in medical history, characterized by a mix of rudimentary science, folk remedies, and a booming, unregulated market for proprietary drugs. Before the acceptance of germ theory and stricter government oversight, physicians and laypeople alike relied on substances that would be considered highly dangerous today. This era saw the isolation of potent new compounds from natural sources, the popularization of tinctures and tonics, and the proliferation of misleading 'cure-alls' that were sold without a prescription and with no ingredient transparency.

The Age of Opiates

Perhaps the most defining feature of 19th-century pharmacology was the easy availability and widespread use of opiates, derivatives of the opium poppy. Opium and its extracts were a standard part of a physician's arsenal, used to treat pain, diarrhea, and coughs.

Opium: In its raw form, opium was consumed via pills or pellets, often for pain relief and recreation. The widespread use, including by prominent figures like writer Thomas De Quincey, revealed a society with a high degree of dependence.
Morphine: Isolated from opium in 1803, morphine was a significantly more potent painkiller. Its use skyrocketed during the Civil War, where it was administered to treat battlefield injuries, leading to a massive wave of addiction among veterans. Morphine remained an unrestrained analgesic for decades.
Laudanum: An alcoholic tincture containing opium, laudanum was a ubiquitous 'cure-all' sold over the counter. It was used to treat everything from menstrual cramps and teething pain in infants to nervous disorders, headaches, and sleep issues. Its easy access and effectiveness in dulling pain made it particularly prone to misuse, especially among women.

Cocaine: The Medical 'Wonder Drug'

Toward the end of the 19th century, a new and powerful stimulant was isolated from the coca plant: cocaine. Initially, the medical community and the public embraced it with great enthusiasm, unaware of its potent addictive properties and side effects.

Early Medical Use: In 1884, Austrian ophthalmologist Carl Koller demonstrated cocaine's effectiveness as a local anesthetic for eye surgery, a breakthrough that led to its broader use in medicine. Pharmaceutical companies like Parke-Davis marketed cocaine-infused products, promoting them for a range of ailments.
Tonics and Beverages: Cocaine became a common ingredient in tonics, most famously in the original formulation of Coca-Cola, invented in 1886. These products were sold as invigorating remedies for fatigue, depression, and other problems. The widespread and casual consumption of these beverages contributed significantly to the public's exposure to the drug.

The Problem of Patent Medicines

For much of the 1800s, proprietary or 'patent' medicines flourished. This was largely due to a combination of factors, including limited access to professional medical care, distrust of doctors, and a total absence of government regulation. These were aggressively marketed products, often sold by traveling medicine shows or via mail-order, with exaggerated and fraudulent claims.

Hidden Dangers: Many patent medicines contained significant amounts of alcohol, opium, or cocaine, with no labeling to warn consumers. The addictive nature of these compounds ensured repeat business, creating a vicious cycle of dependency.
Quackery and Fraud: Products like 'Swaim's Panacea' claimed to cure a vast list of ailments, while others, like Beecham's Pills, were essentially just potent laxatives marketed as universal remedies. The lack of oversight meant manufacturers could make any claims they wanted without fear of reprisal.

Highly Toxic and Dangerous Treatments

Beyond the addictive narcotics, 19th-century medicine also employed highly toxic substances as treatments, demonstrating a lack of understanding about their long-term effects.

Mercury: Compounds containing mercury, such as calomel and blue mass, were widely used to treat conditions like syphilis, yellow fever, and constipation. Despite the toxic side effects—including organ failure, nerve damage, and tooth loss—it was considered a standard treatment for centuries. The phrase, 'A night with Venus, a lifetime with Mercury,' reflects the harsh reality of its use against venereal diseases.
Arsenic: This poisonous element also found its way into some treatments and cosmetics, reflecting the dangerous nature of the era's pharmaceutical practices.

Herbal and Plant-Based Remedies

Alongside the more dangerous substances, herbal medicine continued to play a significant role in everyday healthcare, often serving as a more accessible option than a doctor's visit.

Pain and Fever: Willow bark was recognized for its pain-relieving and fever-reducing properties, containing salicylic acid—the active compound in what would become aspirin at the end of the century.
Heart Conditions: Digitalis, derived from the foxglove plant, was used to treat heart failure and rhythm problems, though its narrow therapeutic window made it risky.
Other Herbs: Remedies for coughs, sore throats, and digestive issues included horehound, sage, and ginger.

A Comparison of 19th-Century and Modern Medicine


Feature	19th Century Medicine	Modern Medicine
Regulation	Largely unregulated; ingredient lists often absent or misleading.	Highly regulated by government bodies (e.g., FDA) with strict approval processes.
Transparency	Content of patent medicines kept secret; reliance on advertising claims.	Full ingredient transparency required on all prescription and over-the-counter products.
Opiates	Widely available over-the-counter in forms like laudanum and morphine.	Strictly controlled substances, available only by prescription for severe pain.
Cocaine	Marketed as a tonic and anesthetic, included in drinks like Coca-Cola.	Classified as a controlled substance with very limited, highly regulated medical use.
Toxic Compounds	Use of mercury, arsenic, and lead common in treatments and cosmetics.	These toxic substances are generally prohibited in medical and consumer products due to known dangers.
Scientific Basis	Often based on anecdotal evidence, flawed theories (like humoral medicine), and trial-and-error.	Rooted in germ theory, clinical trials, and evidence-based practice.

The Shift Towards Regulation

This era of dangerous, unregulated concoctions began to draw to a close with the rise of modern medicine and public safety advocacy. The acceptance of germ theory provided a more scientific understanding of disease, and social pressures mounted against the rampant fraud and addiction caused by patent medicines. Key legislation, such as the Pure Food and Drug Act of 1906, mandated that ingredients be listed on product labels, marking the first major step towards modern drug regulation in the U.S.. The Harrison Narcotics Act of 1914 further restricted the sale of opiates and cocaine, making prescriptions necessary.

Conclusion

Examining what drugs did people use in the 1800s provides a striking contrast to today's medical landscape. The period was defined by a mix of groundbreaking discoveries, such as the isolation of morphine and cocaine, alongside the widespread and reckless use of toxic and addictive substances. The reliance on unregulated patent medicines and dangerous treatments like mercury underscores the primitive nature of medicine and the serious risks people faced. The subsequent shift toward regulation and scientific evidence marked a critical turning point, paving the way for the safer, more transparent pharmacological practices we know today. However, the history of 19th-century drug use serves as a crucial reminder of the dangers of uncontrolled pharmaceuticals and the importance of stringent public health oversight. A useful resource detailing this transition can be found at the DEA Museum's historical exhibit on the opium poppy and other addictive plants.

Frequently Asked Questions

No, cocaine was not illegal in the 1800s. It was initially sold as a 'wonder drug' and used as a local anesthetic and in tonics like Coca-Cola. It wasn't until growing concerns over its addictive properties that regulation began, eventually leading to its prohibition.

Laudanum, a mixture of opium and alcohol, was used for a vast array of ailments in the 19th century. It was marketed as a 'cure-all' for pain, coughs, diarrhea, headaches, and even to quiet fussy children, making it one of the most misused opium derivatives of the era.

The American Civil War had a profound impact on drug use, particularly with opiates. Morphine was heavily administered to soldiers for pain, leading to thousands becoming addicted to the drug, a condition often referred to as 'soldier's disease'.

Patent medicines were dangerous because they were unregulated, often contained undisclosed amounts of highly addictive and toxic substances like alcohol, opium, or cocaine, and made fraudulent claims of effectiveness. Consumers were unaware of the hidden dangers, leading to widespread addiction and health problems.

Yes, mercury was used as a medicine in the 1800s, often in compounds like calomel and blue mass. It was a common, though highly toxic, treatment for diseases like syphilis and yellow fever, despite causing severe side effects like organ damage and death.

Significant drug regulation began in the early 20th century. The Pure Food and Drug Act of 1906 required ingredient labeling, and the Harrison Narcotics Act of 1914 began restricting the over-the-counter sale of opiates and cocaine, necessitating a prescription.

Yes, herbal remedies were very common in the 1800s and were used alongside or instead of other pharmaceutical treatments. Common plants like willow bark for fever, foxglove for heart conditions, and horehound for coughs were widely used for their medicinal properties.