How bad were the social effects?
Between 1890-1910, there were more than three times as many opiate addicts, and two times as many cocaine addicts per capita as there are now. The majority of opiate users were middle class women in their 40's, representing about 3/4ths of total opiate addicts. Cocaine addiction was slightly male heavy, but close to 50/50.
Darryl S. Inaba and William E. Cohen, Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs. (Ashland, OR: CNS Productions, 2003) 400-17.
People underestimate how available hard drugs were at the turn of the 20th century. Morphine, heroin, opium, and cocaine were widely available, and CHEAP. They were all considered disreputable habits, but less so than drinking alcohol. Accurate estimates of use of hard drugs by non-addicts are lacking, but very conservatively more than half of all Americans used a hard drug at least once a year for non medical purposes.
An 1883-1885 survey of the state of Iowa, which then had a population of less than 2,000,000, found 3,000 stores in the state where opiates were on sale--- and this did not include the physicians who dispensed opiates directly.
The Consumers Union Report on Licit and Illicit Drugs: Chapter 1
To give a sense of scale, in America today there is one McDonald's per 22,174 people. In Iowa in 1885, there was one store selling opiates per 666 people. That's more than 33 times as many stores per capita.
In Iowa today, there is a liquor store or bar per 1393 people. That means that there are about half as many places to buy alcohol in any form today as there were places to buy opiates in 1885.