Drug Addiction and the Harrison Anti-Narcotic Act

By J. C. Densten, M.D.

New York Medical Journal, Vol. 105 (April 21, 1917), 747-48.

Laws have been suggested and passed, with a view to lessening the evil of drug addiction. So far law has failed in its purpose. There are good laws and bad laws, effective and ineffective laws. A law which fails in its ultimate purpose is ineffective and bad. A law passed for the purpose of benefiting weak humanity is commendable, altruistic, and well meaning. But a law which benefits or cures a drug addict must have as a motive more than these attributes of sentiment; it must also contain sympathy and intelligence. A law whose ultimate object is revenue does not have philanthropy, sympathy, or intelligence behind it.

The Harrison Antinarcotic Law exhibits to a superficial judgment the trinity of good intention, sympathy, and intelligence, but becomes perfidious in its execution and ultimate endeavor and fails miserably in its purpose. The addict is seldom benefited and the physician becomes the depositary for censure, criticism, and failures to cure through the law's unintelligence.

A law to be effective in curing the drug addict must be liberal, demanding, and commanding: Liberal in providing eleemosynary institutions throughout the States, each with a presiding physician and a necessary number of interns, whose sole and bounden duty it shall be to use every means, method, and contrivance, to effect a cure of the addiction; demanding in compelling every known addict to enter one of these institutes and not be released until cured or dead; and commanding in holding the respect of patient and public in the choosing of physicians and interns whose qualifications shall be sobriety, sympathy, intelligence, a dominant will, forbearance, and honesty. This law should be a Federal law and should be ratified by each State, so that it would be nationwide. Not one addict should escape its demands, for a drug addict if not cured must have the drug, go insane, or die. It becomes as necessary for him as food. It is food to the addict.

The present Federal law could be amended to meet new requirements and still stand in principle. The law as it now stands is defective and inoperative in effecting the aims and ends intended and hoped for. I venture the assertion that instead of lessening "dope fiends" it has increased them, for it has licensed unscrupulous usurers who have cohorted with the sinuous, criminal underworld to whose established stations of licensure and distribution the addicts, avoiding the physician and treatment, have become steady and profitable customers with many new converts. The pervading criminal atmosphere, the underworld channels of unscrupulous licentiates and peddlers reek of "coke" and "dope," while none but legitimate and respectable channels are watched and reported. Thousands and thousands have been licensed by the Government to barter and trade in narcotic drugs, and small fortunes have been realized in advanced prices because of the law.

It would follow from a compulsory treatment law that within a limit of three years there would not remain one drug addict in the United States. They would have all been cured or dead. The underworld would have gone out of business for want of patronage and the number of new converts would have become nil. The morals of every community would benefit by the object lessons and exposure of the addict who will have been compelled to take treatment.

The demand for any article regulates and determines its value. The great and increased demand for narcotic drugs since the passage of the Harrison Antinarcotic Law would prove a priori an increase in price or value, and since the demand regulates the supply it would follow a priori that an increased demand would increase the supply. This is the condition of affairs in the United States since the Antinarcotic Law has been in effect. It was stated by those high in political authority that the object of the Harrison Law was and is to give the drug addict a chance to be cured. The physician was licensed and expected to undertake the cure of these unfortunates, but he was and is looked upon as a person who needs watching. Inspectors are appointed to visit the drug stores and look over the prescription files, and as has often happened, some physician has been called to account for issuing too liberal a prescription, when mitigating circumstances have proved the physician well within the limit of the law. In my opinion the present law has never aided in the cure of a single addict. The unscrupulous physician was not made one whit more scrupulous because of the law, and scrupulous physicians continued their endeavors to cure as before the law, while the number of addicts increased through the congested efforts of the underworld.

A drug addict presents himself to a physician under pretense of a desire to be cured and solicits a prescription. The physician inquires as to the daily amount now used and prescribes a four or six ounce mixture, to be taken in dram doses at stated intervals, in which, a less amount per them is ordered, the purpose being to reduce gradually the amount of the drug until the patient is cured. My experience in such cases has been that the addict seldom if ever takes the dose as prescribed. He figures about how much is in the bottle and takes it to suit his needs, and will often have taken in two or three days or less the amount prescribed for a week and comes back again for a renewal. He will sometimes have two or three physicians prescribing for him at a time, and continue the rounds at stated intervals to correspond with the legitimate time to have each prescription renewed. The fact is I have yet to find one addict who ever really wanted to be cured.

So what good effect has this present law? As it stands it is good for revenue only. That is really one of the cardinal principles of every political party, and the one incentive of every politician in drafting a law.

Meanwhile, We, Us and Company are contributing our little dollar yearly to support and maintain a small army of inspectors who In ignorance of our difficulties necessities conditions environments, and privileges, seek to confirm their suspicions of us and stand ready and seemingly anxious to brand us as criminals, and the dear people, for whose benefit this law was enacted are shunning scrupulous physicians and honest treatment, having been initiated into the inner circle of the underworld supply, whence the drug addict emerges, laden with addiction commensurate with the size of his roll.