LAWS, AND THEIR RELATIONS TO NARCOTIC DRUGS
The first general appreciation of the widespread existence of narcotic
drug use was brought about by the passage of anti-narcotic laws. The
United States Federal legislation which went into effect in 1914, was
what is known as the Harrison Law, still in effect and in its purpose
and drafting a wise piece of legislation. It sought to limit and
control the use of opiate drugs and cocaine by making their possession
and distribution illegal by other than those of professional and other
status designated in the law, as qualified for their intelligent
application and responsible distribution. Its administration was placed
in the Department of Internal Revenue under a provision which licensed
responsible distributors and required a yearly tax.
Taken as a whole, in its original form, administered with understanding
of addiction-disease facts, and with honest and intelligent scientific,
educational and remedial activities coincidently pursued, it should
be sufficient to control a rapidly growing menace. In its attitude
towards the medical profession it wisely limited its restrictions to
the broad statement that these drugs named must not be distributed
other than in the “course of legitimate professional practice,” wisely
making no attempt to define such “legitimate practice,” but apparently
anticipating investigative activities of the scientific professions in
the determination and dissemination of medical facts for the guidance
of honest practitioners, and of those who should interpret and enforce
the law.
Unfortunately addiction as a disease was, at that time, not a matter
of wide recognition, the public in general and the medical profession
itself still almost universally holding to the old conceptions of it
on the basis of supposed morbid indulgence and “habit.” It seems to
the author that the failure of the Harrison Law to check or limit
the illegitimate use of the drugs it describes, is not due to a
defect in the law itself, but is due to the failure of the scientific
professions to clarify the situation with a clean cut understanding
of the condition legislated against. The reaction within the medical
profession as a result of this law was unfortunate. Instead of
stimulating scientific interest and investigation into the character
of this disease, the result was that medical men in general having
little or no conception of its disease basis, regarded the narcotic
addict as a mental or correctional problem and left his consideration
and handling to the lay officials and the special institutions whose
activities had been along other lines than scientific research into
physical disease.
In the minds of most lay and of many medical workers the only
consideration was the stopping of drug use _per se_, an attitude which
to a less extent still persists. Uninformed as to the now established
facts of addiction-disease, the administrators of the law, and to a
large extent the medical profession, tended to regard supply of opiate
to an addict as the prolongation of a habit, and not as medication
indicated by the mechanism and symptomatology of a disease--and
therefore as not being legitimate medical practice. This attitude had
the effect of making the practitioner of medicine unwilling to receive
the narcotic addict as a patient.
The immediate result was the sudden deprivation of opiate to such
addiction-disease sufferers as had not had financial means or
foresight to purchase large reserves before the laws went into effect.
The history of the drastic early enforcement of the various laws,
reduplicated with more or less completeness by periodical legislative
and administrative activities, without adequate arrangement for the
relief of the narcotic-deprived addiction-disease sufferer, shows
suicides and deaths, and a rapid development of exploitation of the
needs of the addict at the hands of illicit commerce. For this illicit
commerce the laws themselves, however, are not so much to be blamed
as the influence of long-prevailing and widely-taught attitudes and
conceptions which caused scientific and other forces to fail to
recognize and meet the need for clinical handling of the situation,
and for study and investigation of the condition. Legislators and
administrators simply reflect prevailing theories.
Early theories took scant if any account of the possibilities presented
by the now rapidly-growing disease conception of addiction. The popular
conception of an addict and even the description met in standard
medical text-books was that of a “dope-fiend,” an irresponsible
panderer to a morbid “habit,” bereft of will-power, honor and decency,
a menace to himself and to society, and this conception has had
unfortunate influence in the making, interpretation, and administration
of laws. That it can be truthfully applied to some people who have
developed addiction-disease is unquestioned, but that it fails to take
into consideration a much larger number who are not irresponsible
panderers to morbid habit, nor bereft of will-power, honor and decency,
nor a menace to themselves or to society, but are honest and upright
members of society and economic assets in the community, accounts in
large part for the failure of laws and their administration to remedy
the narcotic drug situation. Measures which might be very useful in
the forcible control of those who can be justly characterized as “dope
fiends” work great harm to those who are simply sick people.
That these sick people have been commonly regarded and classed
as “dope-fiends” was due to the fact that the points of view and
special experiences of the psychologist or psychiatrist, sociologist
or penologist and the exponents of special methods of treatment
dominated the literature and teaching in which appeared practically
nothing of essential pathology, symptomatology and broad principles
of addiction-disease therapeutics and handling. The occasional voice
of the clinical student or experimental laboratory worker was almost
unheard, and the opposition accorded unorthodox views and announcements
made him a brave man who would state them, and tended to cause him to
be regarded as an academic theorist, or possessed of ulterior motives.
In such a situation the dominant theme has been the stamping out of
so-called “drug use.” The physician who under his best and honest
therapeutic judgment strove to meet the immediate indications of the
worthy and innocent addiction-disease sufferer by the administration
of opiate drug, incurred a danger of severe criticism and at times
of jeopardy to his liberties under the interpretation of his acts as
perpetuating a “habit.”
It cannot be denied that in some cases unscrupulous holders of medical
degrees have availed themselves of existing conditions in such a
way that their supplying of opiates to narcotic addicts constitutes
simply traffic in narcotic drugs and not the intelligent practice
of medicine. It should be a matter of serious consideration for
our lawmakers, administrators and judiciary, however, as to what
extent the performance of the occasional medical vampire should be
made a basis for the legal or administrative control of the honest
practitioner, and to what extent he should be enveloped by legal and
administrative restrictions, the innocent and unconscious violation
of whose technicalities may at any time be made a basis for criminal
procedure. It should be remembered that zealous administrators may not
have proper conception of the scientific facts of disease nor of the
practical problems of legitimate medical practice in addiction-disease.
The quality of the act in the determination of legitimate medical
practice is often if not as a rule more important than the mere act
itself. There has been as yet, so far as I know, no satisfactory legal
definition of legitimate medical practice. The author sees no reason
why the same rules and criteria as have developed or are formulated
for legitimate medical practice in other diseases might not be applied
to the treatment of addiction-disease. In a general way the legitimate
practice of medicine in the care of, handling of or treatment of
a disease consists of such medical attention, advice, instruction
and guidance, and clinical or therapeutic ministrations as may be
indicated by the needs of the individual case. In addiction-disease if
a physician proceeds upon the physical, clinical and other indications
exhibited in the individual case, being held responsible for reasonable
familiarity with such indications, and fulfilling to the best of
his available equipment and professional ability the general and
therapeutic requirements of each case, it is difficult for the author
to see how he can be held to be engaged in illegitimate practice.
He can of course be held responsible for reasonable familiarity
with available teaching and information on the subject treated by
him, and for average intelligence and honest application of medical
principles and practice. It seems to the author that legitimate
practice as determined in other diseases would go a long way towards
the elimination of the charlatan and shyster physician and would not
carry with it the menace and jeopardy which technical violation of
often medically impractical administrative demands may involve. If the
honest physician is left no leeway for the exercise of medical judgment
in the handling of widely differing cases of addiction-disease, or if
his exercise of honest clinical judgment is to be constantly influenced
by a necessity of worrying about its possible interpretation, in the
light of unduly stringent laws and regulations, a condition is created
in which the intelligent practice of medicine upon the sufferer from
addiction-disease becomes impossible.
A matter about which there has been a great deal of dispute is that of
the prescribing or dispensing by the practitioner of medicine of opiate
drugs to the narcotic addict in the handling of narcotic addiction,
itself. The adherents of the older theory of addiction being merely
habit or vicious indulgence, oppose as illegitimate practice the
continued supply of the opiate to an addiction patient, unless in some
cases the patient also suffers from some painful and incurable disease.
They take the attitude that, if the addict did not want to keep on
using opiate he would go somewhere and be cured, and that as long as
he can get opiate drug he will not get “cured.” The possibilities of
immediate so-called “cure” are discussed elsewhere in this volume.
Sufficient for present statement is the fact that, as demonstrated
by the testimony of the Whitney Committee Legislative Investigation
hearings, one of the most complete and valuable pieces of public
investigation work into addiction ever done, there exists at present
practically no adequate or competent machinery for the successful
so-called “cure” of the great numbers of narcotic addicts. This is
discussed elsewhere. Those who talk casually of the enforced immediate
cure of the narcotic addict would do well to investigate and realize
the lack of possibilities of its immediate attainment on any large
scale. This is a basic fact which has been too little taken into
account by those who still hold to the appetite and habit theories.
In the narcotic drug situation we are confronted by fact and not
by theory. Intelligent comprehension and unbiased investigation
are needed far more than we need premature conclusions drawn from
insufficient experience or too narrow observation along special lines.
The fundamental fact is this, as has been repeatedly stated, that
the narcotic addict, until his disease mechanism can be competently
and successfully arrested physically, needs the daily administration
of sufficient quantities of the drug of his addiction to meet the
indications of his disease. If the drug is not administered to him in
sufficient amounts to meet these disease indications, he cannot be
blamed if, in the agony of his suffering and the desperateness of his
plight, he is forced into the underworld and the illicit channels of
supply for the continuance of a physically endurable and economically
possible existence. Until the medical profession and the medical
institutions--hospital and otherwise--have in competent execution
methods of handling and treatment of the narcotic addict which are
more humane and more effective than those shown by ample testimony
to be in common use, the supply of narcotic drug to the responsible
narcotic addict to the extent of physical need, without unjustifiable
exploitation, financial or otherwise, is the duty of the medical
man. Any law which to this extent limits the supply of opiate drug
to the addict should receive the support of the medical profession.
Any law which renders it difficult or impossible for a physician to
conscientiously and rationally meet, to this extent, the indications of
narcotic drug disease, should meet from the medical profession with a
united and honest attempt at its modification.
Above all there should be fostered and promoted by the medical
profession an intelligent, unbiased investigation into the actual
facts surrounding the problem of narcotic drug addiction as a definite
disease. Such information concerning the physical and clinical facts of
this disease, as we should be in a position to give, would be eagerly
welcomed by the law-makers and the administrators and the judiciary;
and we should be in a position to co-operate with them in the making
and interpreting of narcotic drug laws. Lack of such information has
played an important part in whatever mistakes our police, legislative
and administrative bodies have made, and forced them to proceed as best
they could to meet the demand of a public menace that could no longer
be denied.
What has the law done for the addict? Like the physicians, the
legislators have done the best they could in the light of their
knowledge, experience and teaching. Some of them seem, however, to
have had their attention directed unduly to a special class of those
addicted, the addicts found among the type of person which begins
or tends to end among the criminal or vicious of the so-called
“underworld.” Legislators and administrators have realized that the
taking of narcotic drugs was rapidly spreading, and that it constituted
a public menace in the class to which their attention was directed;
and they applied the means at their disposal in the remedy of what
they saw. But again, like the physician, they tended to center their
attention upon the mere taking of narcotic drug, and they attempted
to control by legislation the possession and use of narcotic drugs
with too little appreciation of fundamental disease facts and of
general basic considerations of widespread application. They did not
seem to have appreciated the extent to which their legislation or
administration would affect the great numbers of upright, and innocent
and worthy addiction-sufferers of whom they did not know, and who did
not possess the fundamental characteristics of the class and type of
person addicted against which they legislated. They rightly directed
their attention towards the control of the sources of drug supply
and they rightly limited the ultimate legal supplying of drug to
duly licensed and responsible persons and institutions, specifically
described. The slogan of most of the special legislation has been to
place responsibility for the supply and use of narcotic drugs squarely
upon the shoulders of the medical profession. Such effort is wise,
and this is where the responsibility belongs. And this is where the
medical profession would have it placed in so far as the medical
profession supplies narcotic drugs.
The honest physician has no desire to dodge responsibility for his
handling of narcotic addicts to the best of his ability, nor should he
have any objection to a reasonable responsibility and accounting for
narcotic drugs used in that handling; especially since the taking of
narcotic drugs has in certain of its phases, developed as a serious
situation entirely outside of the medical profession, in which
situation these drugs are non-professionally supplied and used to such
an extent as to constitute a public menace. The non-medical supplying
and administering of such drugs should not, however, be controlled
in such a way as to unduly hamper their honest and legitimate use by
medical men, and to deprive the honest, worthy and innocent sufferer
from addiction-disease of their legitimate therapeutic administration.
One of the chief and most serious phases of the narcotic drug problem,
which for obvious reasons has especially called for legislation, is
the illicit and illegitimate commerce in narcotic drugs. The class
of addicts which constitutes a public menace is largely so supplied.
This fact is recognized in the recent report of the Special Committee
of Investigation Appointed by the Secretary of the Treasury, in which
is stated, “This illegitimate traffic has developed to enormous
proportions in recent years, and is a serious menace at the present
time. It is through these channels that the addict of the underworld
now secures the bulk of his supplies.”
This Report further states that “there is the so-called ‘underground’
traffic which is estimated to be equal in magnitude to that carried
on through legitimate channels. This trade is in the hands of the
so-called ‘Dope peddlers,’ who appear to have a national organization
for procuring and disposing of their supplies. For the most part it is
thought that they obtain their supplies by smuggling them from Mexico
or Canada, although smaller quantities of these drugs are obtained from
unscrupulous dealers in this country or by theft,” etc. There should
be some way to dissociate entirely, conclusively and finally in the
minds of the public the illegitimate and underworld traffic in narcotic
drugs from the efforts of the honest physician to practice rational and
scientific medicine in the help of the worthy and deserving addict.
The regulation of the narcotic drug traffic of the underworld or
“underground” is not the business of the medical profession, and the
burden of responsibility for it should not be placed upon the shoulders
of the medical profession or the consequences of it made to react upon
the head of the honest physician and innocent addiction sufferer. There
is a tremendous number of excellent and worthy and even illustrious
people in whom addiction is in no way associated with vice, or other
morbidity of mental or environmental origin, who are merely, solely
and simply sick people suffering from addiction-disease, whose problem
is the control of that disease until it can be arrested by competent
therapeutic procedure, for which they constantly seek. Misconception
of them and neglect of sufficient consideration of them is the tragic
aspect of the narcotic drug situation, and causes tremendous individual
and economic wastage. They do not in any way associate with underground
traffic unless or until driven to it by failure of legitimate sources
of opiate medication, or by the surrounding of legitimate sources with
such restrictions as make the man of standing and reputation, afflicted
with addiction-disease, fear possible publicity and economic detriment.
It is the duty of the medical organizations to see to it that these
deserving purely medical problems and worthy sick people and their
honest medical advisers shall no longer than avoidable be permitted
to remain confused in the minds of the laity and of the medical
profession itself with the problems of regulation of “underground”
traffic and the control of the “underworld” addict. It is the duty of
the medical organizations also to see to it that in the public press
and elsewhere, and especially in their own scientific journals, the
acts of the occasional individual with medical degree who prostitutes
his medical standing and the aims and ideals of his profession in the
commercial exploitation of the drug addict are not presented in such
a way as to cause by inference or otherwise, their confusion with the
honest efforts of honest medical men who are engaged to the best of
their ability in the humane and ethical help of the deserving sufferer
from addiction-disease.
It is, furthermore, the duty of the medical organizations to see to it
that whatever laws and regulations are promulgated in the control of
criminal and unworthy shall not be framed or administered in such a
way as to unnecessarily jeopardize the reputation and liberties of the
honest practitioner and to interfere with his conscientious efforts to
care for his honest and innocent addiction-disease patients to such an
extent as makes that care impossible.
Legislation or administrative regulation which limits to responsible
and authorized persons possession and distribution of narcotic drugs
and which compels from such persons reasonable accounting for such
possession and distribution, is under conditions which have long
existed but only recently been sufficiently recognized necessary and
desirable. The Harrison Law was a definite response to an obvious
need, in its obvious intent and draughting a wise and unobjectionable
legislation. It provided for responsible possession and distribution
and it enforced an accounting for the same, but did not unwisely
restrict, in its text, nor hamper the legitimate possession and
honest therapeutic employment of narcotic drugs. From the medical
organizations and educational and scientific institutions should
be available scientific study and understanding of narcotic drug
addiction-disease available for the information of conscientious
executives and administrators, who must exercise their best judgment
in the light of available and prevailing teaching. It is the duty of
the medical organizations to see to it that available and prevailing
addiction-disease information and teaching is honest, unbiased and
competent.
Those who are responsible for our laws should remember that the
possible interpretation and administration of the laws they draught are
very important considerations, and determine the real effect of the
laws often more than does the intent of the makers. Legislation which
is unduly stringent or is capable of unduly stringent administration
may have unfortunate reaction and influence upon honest effort in
the care of the deserving sick. Restricting beyond reasonable limits
the care of the honest narcotic drug addict simply tends to make
it impracticable and dangerous for the average medical man to have
anything to do with narcotic addicts, and to drive the honest and
deserving patient into the underworld, into the insane asylum or to
suicide. Until we have provided scientific and clinical study, and
have thoroughly investigated present and possible medical treatment
and handling of narcotic-drug addiction-disease, and have established
humane and effective therapeutic measures and procedures in the control
and remedy of this disease, we should not deprive the majority of
honest addicts of the only medication and means by which they can at
present remain self-supporting citizens. The handling of the problem
of the underworld and of underground supply is not going to be solved
by too restrictive regulation of the honest physician. Legislation
or regulation which makes it practically impossible for the honest
physician to care for the honest case of addiction-disease is a boon
to charlatans, and medical shysters, and the illicit underworld traffic.
It is the opinion of some that the handling and treatment of narcotic
addiction should be taken out of the hands of the practitioner of
medicine. The statement is made that the practitioner of medicine is
not competent to handle a case of this disease. It has been advised
that the treatment of narcotic addicts should be restricted to a small
number of specially designated and licensed men and institutions. How
and by whom are those special men and institutions to be selected?
In the present state of chaotic and widely diversified medical and
lay opinion as to narcotic addiction and the narcotic addict it would
be a very difficult matter to select the men or the institutions for
such absolute control. The comprehension, study and investigation
of narcotic drug addiction has entered a stage of evolution and
development in which new facts and new truths--both as to the addict
and as to the condition from which he suffers--are being recognized
and must be threshed out, correlated and coordinated with hitherto
existing opinion before too restrictive measures will be anything but
narrow-visioned, premature and harmful.
There are undoubtedly institutions, many of them not widely known,
in which is available skillful, humane, intelligent and successful
handling of this disease. From personal observation and experience
in institutional work, and from analysis and investigation of many
histories, it is my opinion that the results of institutional treatment
depend more upon the quality of its medical and nursing staff than upon
any other consideration. That the mere fact that addiction-disease is
handled in an institution is a very minor consideration in comparison
with the intelligence of that handling, is amply attested to in the
testimony of the Whitney Hearings and by the experience of many
addicts. Unquestionably, unknown and large numbers of narcotic addicts
have been relieved of their addiction in reputable sanitaria conducted
by skillful and competent medical men. Also unquestionably, large
numbers of addicts have been relieved of their addiction through the
honest efforts of practitioners of medicine, in private practice.
Unfortunately these efforts and their results have received entirely
too little recognition.
The average physician may be inexpert and not as completely educated
in the appreciation, understanding and clinical handling of narcotic
drug addiction-disease as he is in other diseases. The common-sense
remedy for this situation, however, is not to drive the addict out of
his hands, but to make him as competent in that addict’s handling as
he is in any other clinical condition. It is only a matter of time
and education before the competent practitioner of internal medicine
can be brought to a comprehension of and ability to intelligently
handle addiction-disease. It is largely a matter of securing general
appreciation of and ability to clinically recognize, and interpret
physical symptomatology, and to meet the indications of individual
disease manifestations.
The ultimate solution of the problem of handling the narcotic addict
lies largely in the education of medical men, both in institutions and
in private practice, and through them securing lay appreciation of
disease facts. Any legal or administrative restrictions which drive the
care of the honest addict out of the hands of the honest medical man
simply postpone the day when this ideal may be consummated.
Some addicts, as individuals and types, will of course always require
institutional and custodial handling. The handling of the addict who
is criminal or vicious belongs within the province of the penological
authorities, just as does the handling of any other man who is criminal
or vicious. The handling of the addict who is fundamentally degenerate,
defective or mentally weak may require the attention of the alienist
and institutional restraint, just as may the handling of any other man
who is degenerate or defective. Narcotic drug addiction-disease in the
man who is vicious or criminal or defective or degenerate should be
treated as narcotic drug addiction-disease, as any other disease is
treated in the same individual.
To our legislators and administrators and forces of penology, custody
and correction rightfully belongs the problem of looking after the
criminal and vicious addict as well as providing for the eradication of
illicit, irresponsible, and “underground” traffic in narcotic drugs.
If the illicit trafficker happens to be a physician he should have no
more consideration at the hands of the law than any other criminal and
in its action the law should have complete co-operation of the medical
profession, which should see to it also that conscientious endeavor
of its honest members is not confused in its consideration with
illicit traffic and that the acts of the doctor shall be determined
and estimated upon broad principles of medical practice and not upon
violation of incidental technicalities. Great care should be taken that
the sins of a guilty few are not visited upon the heads of a deserving
many.
Until there is available competent and adequate medical care for the
honest narcotic addict sufficient in extent to meet the needs of the
thousands of sufferers, and encouragement and protection as well as
restriction is afforded to the honest physician, the illicit traffic
will continue and grow, including in its toils many who would not
otherwise seek it. Before we have further medical restrictions, we
should have both medical and lay and official education. Over-emphasis
on any aspect resulting in premature, narrow, ill-considered and
ill-advised action only increases the complexity of the situation and
defers final remedy. For as great and complicated a problem as narcotic
drug addiction there will be found no special or specific panacea.
In conclusion I feel that a great deal more thought and attention
should be paid to the testimony of the public hearings of the New York
Legislative Investigating Committee, under the leadership of Senator
George H. Whitney, Chairman of the Committee. A vast amount of valuable
data was produced. It showed for the first time to my knowledge an
official effort to secure the true story of the narcotic addict in
all of its applications and circumstances. It is significant that the
Preliminary Report of the Whitney Committee gave official recognition
of the fact that narcotic drug addiction is a physical disease. So
important and enlightening was the above mentioned report, that it is
deemed desirable to quote from it in part as follows:
“Lack of understanding and appreciation of the disease of narcotic
drug addiction and its treatment by a large majority of the medical
profession has fostered conditions which make it impossible to
determine a rational procedure for treating and curing the addicted by
the State at this time.
“Such absence of uniformity of opinion has worked great hardship upon
the public and has laid the narcotic drug addict open to misconception,
misunderstanding and medical treatment which, in many instances, has
resulted in harm rather than good.
“Evidence offered by physicians shows that many addicts have died under
the methods of treatment existing to-day and that a large percentage of
those discharged from institutions as ‘cured’ are driven back to use
of narcotics through unbearable physical torture induced by improper
withdrawal of their drug.
“Evidence from physicians was adduced which denied that any cure
for narcotic drug addiction existed in any of the private or public
institutions of this State. Evidence from other eminent physicians was
adduced which bore testimony to the fact that the disease of narcotic
drug addiction was curable.
“The difference of medical opinion existing in medical circles
regarding this vitally important question should be made the subject
of a thorough and searching investigation as a matter of the greatest
importance to the welfare of a large number of people in the State of
New York.
“Your Committee has found that narcotic drug addiction bears no
relation in point of character and seriousness to any other known habit
induced by the use of stimulants. Narcotic drug addicts, according
to evidence adduced, should not be classed with the alcoholic or the
tobacco addict or the cocaine habitue.
“The constant use of narcotics produces a condition in the human body
that many physicians of medical authority now recognize as a definite
disease, which diseased condition absolutely requires a continued
administration of narcotics to keep the body in normal function unless
proper treatment and cure is provided.
“Withdrawal of the drug of addiction induces such fundamental physical
disorganization and unbearable pain that addicts are driven to
any extreme to obtain narcotic drugs and allay their suffering by
self-administration.
“Testimony of physicians coming in contact with the addicts and
statements of addicts themselves show that those afflicted with this
disease express every desire to secure humane and competent treatment
and cure and that most narcotic drug users are willing to undergo
physical torture and often do voluntarily undergo such torture, in an
effort to be rid of their so-called habit.
“In the present chaotic condition of medical opinion on this subject,
it is impossible for the addict to-day to either secure authentic
information on the subject of his disease and its treatment, or to
procure at the hands of the average physician competent treatment for
his malady.
“It has further been stated by competent authorities before your
Committee that drug addiction is not confined to the criminal or
defective class of humanity.
“This disease, however contracted, is prevalent among members of every
social class. Some physicians estimate that addicts of the so-called
underworld are far out-numbered by unfortunate drug users drafted from
social circles of refinement and intelligence in the State of New York,
who have become addicted to the constant use of narcotic drugs, but who
are able to hide their affliction from the public.
“The attitude of the public toward the narcotic drug addict, fostered
by the increasing prevalence of the disease in the criminal classes and
by the apparent lack of medical help, has forced such drug users to
keep their affliction a secret.
“This necessity in turn, your Committee finds, has apparently
contributed to the existence of many unsound nostrums for the cure
of narcotic drug addiction and many private institutions where this
disease is purported to be cured which exist solely for the purpose of
preying upon the addict.
“State investigation and regulation of such cures and institutions is
recommended by your Committee.
“Your Committee is inclined to criticize the medical profession for its
lack of study of the increasingly important subject of narcotic drug
addiction. The only excuse which can be offered for this unfortunate
condition lies in the fact that there has not been medical appreciation
of conditions and that legislation, both State and Federal, has forced
upon the physician a situation for which he was wholly unprepared.
“The testimony taken by your Committee shows that those charged with
the sale and distribution of narcotic drugs are in the main observing
the law, and that the legal distribution of these drugs is less than
before the enactment of existing narcotic laws, Federal and State.
“On the other hand it is apparent from this testimony that public
consumption of narcotic drugs has increased to an alarming extent. The
inevitable conclusion is that the unfortunate addict has been forced to
and does obtain his supply illegally.
“This condition arises very largely from the fact that many physicians
and pharmacists, either through misunderstanding of the law or the true
nature of the addict’s disease, have refused to prescribe or dispense
narcotic drugs to the sufferer.
“Your Committee contends that any member of the medical or
pharmaceutical professions who refuses either to prescribe or to
dispense narcotic drugs to the honest addict to alleviate the suffering
and pain occasioned by lack of narcotics is not living up to the high
standards of humanity and intelligence established by these great
professions.”