The History of Injecting, Part One: Scar Tissue

Injecting drugs was once perfectly acceptable among society's elite.

Injecting drugs is often seen as a moral failing, even among people who snort or smoke drugs. The moment needles are mentioned, you can see the reflexive recoil in a non-injector’s eyes. That recoil is less about the act itself than what it represents. In the collective mind, injecting is tied to crime, poverty, ne’er-do-wells, “junkies.” It’s a mix of class prejudice, fear of disease, and moral panic.

Snorting coke is considered indulgent, glamorous; injecting ice (meth) or heroin is desperate, dirty, failed. Yet beneath the scorn lies hard-won knowledge: skills forged in bedrooms, kitchens, cars, and public toilets. Track marks and scars show the mess of trial and error, of circumstance and access. Out of that comes understanding. Most people don’t know which vein has the strongest flow, or how to feel the pulse of an artery. The injector knows these things.

The irony is that the people called “junkies” often know much more about harm reduction than occasional drug users. Which is why nitazines in cocaine or ketamine are so dangerous: the executive doing bumps in the club toilet isn’t carrying naloxone.

But injecting wasn’t always seen as dirty.

In 1853, two men, Alexander Wood in Britain and Charles-Gabriel Pravaz in France, each fashioned their own version of the hypodermic. Wood had a plunger, Pravaz had a screw. A decade earlier, an Irishman, Francis Rynd, had already jabbed morphine under the skin with a clumsy needle. But it was Wood’s plunger that won out - easy, repeatable, efficient. A tool meant for healing that would carry drugs straight into the bloodstream, and straight into the mess of history.

At first, it was seen as progress. Doctors prescribed morphine, heroin, and cocaine by injection for a range of “maladies” from pain and coughs to “nervous disorders.” Many middle- and upper-class patients self-injected at home with no real stigma attached. The hypodermic was marketed as modern, efficient, genteel. An elegant solution for the frailties of civilized life. A symbol of progress, as much an everyday instrument as a thermometer or stethoscope.

19th century hypodermic syringe

At the time, many drugs that are now illegal were available to all, and it wasn’t long before people worked out that injecting them made the effects more powerful. The first signs of dependency soon followed.

Doctors themselves were among the first to be injected with morphine, often experimenting on their own bodies with the new drug, and many quickly developed dependence. Middle-class housewives followed, prescribed morphine injections for menstrual pain, “hysteria,” anxiety, and insomnia; the first doses were given in the surgery, but women were soon sent home with syringes of their own, their reliance hidden behind respectability. Soldiers, too, had the mark of the needle: during the American Civil War thousands were injected with morphine for pain and dysentery, and many returned home dependent, a pattern so common it later became known as “the soldier’s disease,” though historians debate how widespread the phrase really was. Sigmund Freud injected cocaine, promoting it as a cure-all wonder drug and gave it by syringe to his friend Ernst von Fleischl-Marxow in an attempt to cure his morphine habit. Instead, his friend got hooked on both drugs.

I think he guilt of that tragedy, along with professional backlash, weighed heavily on Freud, but he never issued a retraction. The furthest he went was to to say, “I had been the first to recommend the use of cocaine, in 1885, and this recommendation has brought serious reproaches down on me.”

He continued to use cocaine himself for years and sometimes defended its medical value. Whatever regret he felt seems more about the stains on his name and the wreckage in his circle than any deep reckoning with the drug itself. It wasn’t regret from the heart. It’s a reminder that medicine advances through trial, error, unintended consequences, and sometimes, innocent casualties.

“I had been the first to recommend the use of cocaine, in 1885, and this recommendation has brought serious reproaches down on me.” Sigmund Freud.

Freud

By 1890, non-medical use was common enough for Arthur Conan Doyle to write about it in The Sign of Four. Sherlock Holmes injects a “seven-per-cent solution” of cocaine when he’s bored between cases. The scene isn’t treated as shocking or shameful. Dr Watson disapproves, but he is never sanctimonious - he’s worried, but he’s tolerant. Conan Doyle’s plain description shows how normal injecting had become among the gentry of the era.

Holmes and Watson

“But consider!” I said earnestly. “Count the cost! Your brain may, as you say, be roused and excited, but it is a pathological and morbid process, which involves increased tissue-change, and may at last leave a permanent weakness. You know, too, what a black reaction comes upon you. Surely the game is hardly worth the candle. Why should you, for a mere passing pleasure, risk the loss of those great powers with which you have been endowed?”

Holmes brushes him off, saying:

“My mind,” he said, “rebels at stagnation. Give me problems, give me work… but I abhor the dull routine of existence. I crave for mental exaltation. That is why I have chosen my own particular profession, or rather created it, for I am the only one in the world.”

By the late 1890s, doctors and moralists were seeing patterns of dependency, which they called “morphinism” and “cocainism,” and medical journals were warning of the risks. Doctors started framing the very same technology that was once cutting-edge as a dangerous enabler of vice. Across the Atlantic, those same fears took on a distinctly American character. In the United States, anxieties about drugs fused with older currents of nativism and racial panic. Protestant reformers who had used alcohol as a weapon against Irish, Italian, and German immigrants turned the same tactics onto “narcotics.” Chinese immigrants became the focus of West Coast opium panics, while in the American South newspapers spread lurid warnings about “cocaine-crazed negroes.” Drug scares were never just about drugs, they were entangled with race, class, and power. They’re used as weapons to enact laws that keep the poor and minorities in their place.

This is where the needle’s turns. What started as an emblem of science and refinement was becoming a marker of danger, indulgence, and moral weakness - scar tissue. In part two, we’ll look at how governments seized on those fears, turning a medical tool into a criminal one, and laying the foundations for the “junkie” stereotype that still haunts us today.