I was 19 and I'd been in the country about four months when somebody handed me a cigarette that wasn't tobacco. It cost almost nothing. It was strong, and for the first time since I landed, the days stopped counting themselves. I'd been carrying a number around in my head, the days I had left, and I put it down.
When I didn't have it, I got sick. I sweated through the cot. My legs wouldn't stay still. I knew the word for what I was, and I used it on myself. It didn't change anything about the next morning.
Then they told us we'd be tested before any of us flew home.
Before 1969, the drug that was everywhere for American soldiers in Vietnam was marijuana. There were some amphetamines around too, a few of them handed out by the military itself. Then heroin started showing up. A little at first, and by 1970 and 1971, a lot.
It was cheap and it was very pure. Pure enough that you didn't need a needle. Most users crumbled it into a cigarette, mixed in with tobacco or marijuana, and smoked it. Only about one in ten of the men who used opiates injected.
For almost all of them, this was new. About 11 percent had tried any opiate before they shipped out, and for most of those it meant codeine cough syrup. Only about 2 percent of the men who used heroin in Vietnam had ever used it before. A tour lasted twelve months.
The men who used tended to be younger and on their first enlistment, and they got in more trouble with discipline. One of the strongest predictors of who would use in Vietnam was simple: whether he'd used drugs before he went in.
The report that started the panic
In April 1971, two congressmen, Morgan Murphy of Illinois and Robert Steele of Connecticut, went on a three-week trip to look at the world heroin trade, with a stop in Vietnam. Their report, The World Heroin Problem, estimated that 10 to 15 percent of American troops there were addicted. In some units, it said, the number might be as high as 25 percent, and most of the men got hooked within their first 30 days in the country.
The New York Times put the story on its front page. People started asking what would happen when tens of thousands of addicted soldiers came home, and the fear that came up most was crime.
The number itself was shaky. Murphy later backed away from his own estimate. The historian Jeremy Kuzmarov argues the whole thing was overblown, that the roughly 5 percent of men who later failed urine tests is a better measure of real abuse, and that the panic gave Americans an explanation for a war they were losing.
The larger study that came later, the one this post is really about, counted anyone who was dependent at any point during his tour and got about one in five. So you could get 5, 15 or 20 percent, depending on who was counting, over what stretch of time, and what they decided to call addiction.
Golden Flow
On June 1, 1971, at a news conference in the East Room, Richard Nixon said: "It is not simply a problem of Vietnam veterans; it is a national problem." On June 17 he called drug abuse "public enemy number one" and asked for an all-out offensive against it. He set up the Special Action Office for Drug Abuse Prevention and put a psychiatrist named Jerome Jaffe in charge. Jaffe later said he was "recruited by ambush."
The plan was blunt. Every soldier leaving Vietnam would have his urine tested. A positive result meant treatment, not a court-martial. The order went out on June 17, and testing started within days at the big departure points: Long Binh, Cam Ranh Bay and Da Nang. It got a nickname right away: Operation Golden Flow.
About a thousand soldiers were leaving Vietnam every day. By late September 1971, 4,788 of the 92,096 men tested, a little over 5 percent, had come up positive for opiates. A man who tested positive didn't get on the plane. He stayed in Vietnam to detox until he was clean, and according to Jaffe, word of that got around fast.
943 men
Jaffe wanted to know what happened to these men once they got home. He asked Lee Robins of Washington University in St. Louis to find out.
Between May and September 1972, her team went looking for 943 enlisted men who had flown home from Vietnam in September 1971. There were two groups. 470 were picked at random to stand in for Army enlisted men in general. 495 were men whose urine had tested positive on the way out. Some men were in both groups, which is why the total is 943 and not 965. They were interviewed eight to twelve months after they got back and gave urine samples. About 900 were found and interviewed.
In the general group, almost half had tried heroin or opium in Vietnam, and about one in five had become dependent. Back home, about 10 percent of that group used any opiate at all. Fewer than 1 percent showed signs of dependence.
The positive-test group was the hard case. Three quarters of them said they'd felt addicted in Vietnam. Back home, about a third used an opiate at some point, and 7 percent showed signs of dependence.
Robins kept following some of the men for three years. Of the ones who had been addicted in Vietnam, 12 percent were addicted again at some point in those three years. At the time, what people expected came from addicts who had been treated in hospitals, and more than 90 percent of those relapsed within a year.
Why they stopped
A lot of people didn't believe it at first. So Robins asked the men directly why they hadn't gone back to heroin.
It wasn't because they couldn't get it. Most of them said heroin was easy to find where they lived. The reasons they gave were more personal. They were afraid of getting addicted again, afraid of what it would do to their health, and afraid of getting arrested, and their families and friends didn't approve. When the researchers asked which drug had done the most harm in Vietnam, 90 percent named heroin, whether they'd used it or not.
The men who kept using after they came home were mostly the ones who'd used drugs before the war and used heavily in Vietnam.
Robins took a lesson from this about research itself. Almost everything anyone knew about recovering from heroin came from addicts who had ended up in hospitals or treatment programs. The people who quit on their own never showed up in anyone's data, because nobody was watching them.
What it doesn't show
It's easy to take this study too far, and people have.
It doesn't show that heroin isn't addictive. About one in five of these men became dependent in a place where almost anyone could get it. It doesn't show they stopped using drugs either. Many of them switched from heroin to amphetamines or barbiturates. Alcohol is its own story, and Robins studied it separately in the same men.
It covers one group: Army enlisted men who left Vietnam in one particular month, followed for months and then for a few years. It says nothing about men who left earlier or later, or who didn't make it home. And the reasons for quitting come mostly from what the men said about themselves.
Later reviews of Robins' work point out that her findings got pulled into very different arguments over the years, by people who wanted them to prove very different things.
The pattern
What the numbers show is a pattern across hundreds of men. The drug was easy to get, and every one of them had a date on the calendar when he'd go home. A lot of them became dependent. Most of those didn't stay that way once they got there.
The soldier at the top of this post never existed. The pattern did.