[We reprint Edward Marshall’s illuminating article from the New
York Times of February 22nd on the most recent serious menace
within our prisons, and outside of them. There has come throughout
the country, apparently a relatively sudden realization of the
fearful effects of the habit-forming drugs.]
Habit-forming drugs and their ravages, destructive of both the
morals and the health of the community, seem at last to have aroused
commensurate human indignation, at least in New York city.
Discussion is continual of this strangest and saddest of the problems
of our modern civilization; city officials are definitely interested,
studying and planning; a committee, including in its membership
magistrates and others of sociological force, works on an impulse
supplied by Mrs. Vanderbilt; and from a third source definite
legislation emanates to be offered in the Legislatures of this and
other States and in the National Congress.
Nothing more astonishing, nothing more appalling than the hold which
habit-forming drugs have taken on the community at large can be found
among the tragedies peculiar to modern civilization.
And all this has come suddenly. Not so many years ago the opium smoker
was the only known victim, and he was a curiosity of Chinatown; the
morphine taker was a rare, and troubled spirit, stalking solitary in
its slavery and misery; the cocaine fiend remained unknown, and the
heroin addict--latest in all this incomparably tragic company--was
undreamed of.
Now opium smoking, though still the cause of an occasional police
raid, has sunk into insignificance by comparison with morphine taking;
cocaine habitues are not uncommon sights upon the streets to those with
the depressing knowledge which identifies them; police slang has coined
a name for them--“snowbirds”; and we read in almost every issue of our
daily newspapers of new developments of the “heroin habit.”
Habit-forming drugs of one kind or another have gained so strong a
hold upon the people of this country, more especially upon the people
of American cities, that they have reached the dread proportions of a
national curse.
They play their tragic part in uncounted domestic tragedies; an annual
crop of business and professional failures numerically approaching the
sad army of alcoholic wrecks is thrust into the various bins wherein we
hide our human refuse; drugs send their yearly thousands of young men
into the prisons, of young women to the streets.
A native Southerner, of national fame, high in the councils of his
party, told me recently that habit-forming drugs, cocaine principally,
have of late so complicated the negro problem of the South as to triple
its difficulties and dangers.
These heroin and cocaine groups, lately so conspicuous, are
insignificant in numbers and in tragedy when compared by those who know
with the thousands to be found among our citizenship who, driven only
into misery, not into viciousness or crime, by drug addictions, fall
innocent victims to this most terrible of modern curses, sad sacrifices
to illness and to pain, to ignorance and to cupidity.
The victims of drug habits who have been led into them through the
mistaken methods of the doctor, who first administers the drug to ease
acute physical suffering, and by the proprietary medicine or drug
store preparation passed out as cure-alls with an indifference to or
ignorance of consequences which must remain incredible to those who
understand, is infinitely more numerous than the growing group of drug
takers led into their addictions by the tendency towards dissipation.
Drugs are even taking hold upon our youth. Within the year many
instances have been cited in the newspapers, which have uncovered
peddlers of cocaine and heroin to school children. I listened recently
to the appalling story of a seventeen-year-old Connecticut boy, brought
by his father for treatment in this city, who told how he had been the
center of a group of not less than a hundred other boys in his own town
who gained the drug through him and were completely at his mercy.
I was present recently when this father told the story, having brought
the boy to the metropolis for treatment. It was practically the
duplicate of many, and illustrates the real necessity of legislation,
which will impose upon the druggist and the medical profession a
general restriction.
“My boy,” this sorrow-racked and disappointed father said, “was
employed by a physician living near us to care for his automobile.
He paid him for his work by giving him prescriptions for heroin.
My boy quickly became a victim of the habit, and soon formed the
centre of a group of twenty or more other boy victims, who secured
from him the prescriptions by means of which they brought the drug.
“Two large manufacturing establishments in our home town were thus
infected, and at the present time not less than one hundred boys
have become slaves to the habit. They buy the drug in quantities as
large as they can pay for from the largest drug store in our city,
and are never questioned.”
Their home city is Bridgeport, Conn. I have in my possession one of the
prescriptions given to the boy by the physician, who thus paid him for
his services in attending to his motor car.
In New York State and city the situation is not better. The police
records have been full of “dope cases” for years. Morphine and heroin
are doing serious work in the demoralization of the city, and the
ravages of cocaine are as serious here as they can be among the negroes
of the South.
Miss Katharine B. Davis, now in the full swing of her duties as
Commissioner of Correction, tells me that she finds her problems
complicated all along the line by drug addictions among inmates of the
city’s prisons and jails, and the Mayor and other members of the city
government are looking into the whole subject with deep interest.
In her efforts to discover how the city’s prisoners get drugs, Miss
Davis has uncovered strange, almost uncanny methods. A prisoner’s wife
or “girl” brings him clean handkerchiefs or shirts, stiffly starched.
Left alone with them, he chews them eagerly, getting thus the morphine
which impregnates the starch.
Another prisoner greedily sucks an orange which has been brought to
him. Investigation shows that through a tiny puncture its juice has
been withdrawn, to be replaced through a hypodermic syringe, after it
has been transformed into a saturate solution of morphine.
Fountain-pens are now taboo among the prisoners. Their barrels may be
filled with drug tablets.
In a letter now in my possession, written to Charles B. Towns, the drug
expert, by Dr. Charles W. Farr, prison physician of Sing Sing, the
doctor, after announcing the successful treatment of some drug addicts,
continues:
“But the men seem to be able to get the various drugs as readily
as ever. I suppose that the usual method is to have the guards
bring it in for them. When questioned the prisoners always blame
the traffic on the honest and unpopular guards who are not really
concerned with it. I asked a convict to estimate the number of drug
takers among the prisoners. He answered:
“‘Counting the habitual users and the “joy riders,” there are
probably two hundred in this prison.’”
And while these demoralizing novelties are frequently discovered in the
underworld, the hold which habit-forming drugs are getting elsewhere,
with the worth while, is admittedly appalling. There are pharmacists
in New York city whose important trade is drug traffic; there are
physicians here, and not a few, who, while drug addicts themselves,
find their practice also among drug addicts, furnishing prescriptions
daily to habitues, collecting fees proportioned to their victims’
purses.
As these things have become generally known, so has work begun to check
the evils. Within a few days the most comprehensive legislative plan
which has so far been proposed for regulation of the traffic in all
habit-forming drugs has been launched at Albany.
It will presently be launched in the New Jersey and all other
State Legislatures. It is further planned to make this definitely
comprehensive and effective by Federal legislation, already drafted and
soon to be introduced at Washington.
Charles B. Towns, its author, also wrote the law, already on the
statute books of New York and several other States, permitting the
sale of the hypodermic syringe only upon prescription by a doctor; he
presented last year at Albany a comprehensive bill which did not pass.
His measure of this year, known in the Senate as the Boylan bill,
includes many features new to legislation of the sort, and has
already won outspoken approval from many members of the medical
profession, including Dr. Alexander Lambert of New York, and Dr.
Richard C. Cabot of Boston. Commissioner Davis has gone over it
with care, indorsing it.
“To wholly control the drug evil, which is so unfortunately
affecting New York City and the State, by any legislation entirely
local to the State,” said Mr. Towns, “is out of the question. But a
beginning must be made at home.
“For various reasons habit-forming drugs have found a stronger
foothold in this country than elsewhere in the world. Our annual
opium consumption, per capita, is far greater than that of China,
although we use it principally in the form of its derivatives,
morphine, etc., and our consumption of cocaine has grown to a
magnitude unprecedented anywhere.
“Most of the legislation drafted for the purpose of restricting the
use of habit-forming drugs has been ineffective. It is ridiculously
easy to-day to obtain morphine or any other of the inhibited
substances in New York without violation of the law, although New
York has laws which were designed to be of drastic force.
“The classification in my bill reads: ‘Opium, morphia, coca leaves,
cocaine, alpha and beta cocaine, their salts, derivatives and
preparations.’
“This classification includes automatically many substances which
it does not specifically mention, but which have recently attracted
much attention because of their common use among drug-habitues.
“Among these is heroin. But heroin is a derivative of morphine,
which is the active principle of opium, and is three times as
strong as the parent drug.
“It is not mentioned in the bill because the word ‘heroin’ is a
mere trade name, and a law prohibiting its sale under that name
would not prohibit the sale of the same substance under any one of
the new trade names which manufacturers would have no difficulty in
coining.
“I speak of this almost at once, because I have had several
inquiries as to why this drug apparently is omitted from the list
named in the bill.
“To intelligently discuss the reason for the prevalence of drug
addictions in this country would necessitate an exhaustive study of
national psychology.
“Patent medicines containing small quantities of habit-forming
drugs have wrought great havoc with us, for any medicine,
containing any quantity of any habit-forming drug, contains it in
habit-forming quantity if the dosage is regular. It is not the
quantity, but the regularity of dosage which produces drug habits.
“A lack of understanding of this fact upon the part of the medical
profession and the public has been responsible for many drug
addictions.
“The cocaine habit had its start in patent medicine, mostly
socalled catarrh cures, and will find its end in a national
degeneration if it is not checked by drastic legislation.
“Heroin was first advertised about fifteen years ago, and accepted
by the medical world as a non-habit-forming substance, having all
the useful qualities of the dangerous habit forming drugs.
“Having been thus started, and innocently promoted by physicians
and druggists, the progress of the habit, which has become a
sanitary, criminal, and social problem of real moment, can be
halted only by the passage of some law including such provisions as
those I have included in the bill now pending in Albany.
“My plan is not accidental. I went to the Orient in 1908-1909
and spent a year there, studying the opium curse as it has there
developed. Returning to this country I have since been thrown into
the closest contact with the various drug addictions, passing
several hundred cases in minute review each year. Last Summer
I toured Europe and found that drugs have gained comparatively
slight foothold there, and that no European nation has produced
restrictive legislation worthy of consideration.
“Our own internal revenue reports show us to be consuming as many
of these drugs as all of Europe put together uses.
“Of course, the fact that the drug traffic has continually
increased in this and every other State despite the presence on the
statute books of laws thought to be stringent, can mean but one
thing--that in these laws are loopholes.
“The same laws which require that these drugs must be dispensed
only upon presentation to the druggist of a physician’s
prescription fail to forbid a layman from posing as a physician in
making out prescriptions; no obligation of investigation is imposed
upon the druggist.
“The drug trade is practically without legal regulation, although
across the drug store counter are dispensed substances at least
as dangerous to individuals and public welfare as those which
are dispensed across saloon bars--and saloons are regulated very
rigidly.
“No registration of manufacturing, wholesale or retail druggists is
required by law. The importation, manufacture and distribution of
habit-forming drugs are now surrounded by fewer restrictions than
are thrown about tobacco. The proposed law provides for records
of each grain, from the time it leaves the manufacturer until it
reaches the ultimate consumer.
“Any druggist, wholesale or retail, may manufacture and market any
proprietary medicine he may desire, containing certain quantities
of these drugs, and offer it openly for sale, without the formality
of a physician’s prescription.
“The clause in the otherwise worthy and admirable National Pure
Food and Drugs act requiring that any drug store composition
containing any quantity whatsoever of any habit-forming drug must
bear upon its label an announcement of this content, was well
meant, but has worked havoc.
“Even as no physician who administers a habit-forming drug to ease
his patient’s pain should acquaint that patient with the nature
of the drug he gives, lest the patient turn again to it when
pain recurs and fasten something worse than pain upon himself,
despite the doctor’s wishes, so no medicine offered for general
sale and bearing on its label the announcement of its content of a
pain-killing, habit-forming drug should by the law be tolerated.
“Relieved by the medicine those who take it read its label
carefully, learn what has afforded the relief--it always is a mere
relief, it never is a cure--and, unacquainted with the dangers
attending substances of the sort, regularly dose themselves, either
with increased quantities of the medicine or more probably with the
straight drug.
“A drug-tainted patent medicine is absolutely certain to establish
a drug habit in any one who, for any length of time, takes it
according to directions.
“The proposed law makes such patent medicines, containing any
quantity whatever of the habit-forming drugs, illegal. Physicians
rarely if ever give prescriptions for them. The public will lose
nothing and gain much through their abolishment.
“Now let us consider the physician.
“Physicians are at present permitted to prescribe and administer
the habit-forming drugs as loosely and extravagantly as they
please, either to themselves or others, without responsibility as
to the outcome. Under the proposed law they are held responsible.
“There is real necessity for the provision which disbars from
medical practice physicians who take drugs. The drug-taking doctor
is more dangerous than the drug-taking druggist or drug clerk. All
are liable to irresponsibility at a time when it may well mean
death to others; and, furthermore, all are promoters of the drug
habit. The proposed law guards against them.
“The drug taker invariably introduces others to his drug, sometimes
openly, oftener secretly, through perverted sympathy for another’s
suffering.
“And if the drug-taking doctor should be barred from practice, so,
also, should the drug-taking nurse and the drug-taking veterinarian.
“Now how are these things to be accomplished? The State
Commissioner of Health is to prepare and furnish to all local
Health Boards or officers official prescription blanks, serially
numbered and bearing the State seal, making their imitation forgery.
“These are to be furnished to physicians on demand, and no drugs
of this class are to be dispensed, save on their presentation
properly filled out and signed; no prescription shall be refilled;
all filled prescriptions shall be filed and open to periodical
health board inspection, bearing not only dates and names of the
physicians, but the names of patients for whom the drug is ordered,
and no such prescription shall be filled more than ten days after
issuance.
“To the purchaser, for his protection, while he has the drug in his
possession, druggists must issue a certificate, giving their names
and addresses and those of the prescribing physician.
“These are the principal restrictions surrounding the prescription
blank, though there are others. And violations of these regulations
are to be regarded as misdemeanors.
“In this proposed law, also, is incorporated a provision similar
to that of the existing law restricting the sale of hypodermic
syringes to physicians’ prescriptions.
“This roughly indicates the proposed provisions covering the sale
of habit-forming drugs. They are followed by one which may seem
almost fantastic to the person unacquainted with the terrible
psychology of drug addictions.
“I shall preface any explanation of it with the announcement that
the drug habit is not a mental state, but a physical condition.
My knowledge of it, gained from observation of many hundreds of
its victims, will forever prevent me from proposing or pushing any
further restrictions of the traffic, until some provision is made
for the relief of those already enslaved.
“To deprive a drug addict of his drug without giving him definite
medical help must inevitably subject him to such suffering, such
incredible and indescribable torment, as cannot otherwise be
brought upon mankind. It may mean death; it is very likely to mean
insanity. The drug addict will steal to get his drug; indeed, he
may do murder in order to obtain it.
“Therefore this bill provides for the treatment and relief of those
who, rendered unable to procure their drug by the provisions of
the legislation, might otherwise be made the victims of a social
progression.
“Such a relief is possible and not too difficult. The treatment
by means of which it may be accomplished bears my name, but is no
monopoly. I could gain no profit from its use by the authorities
and others. It includes no medicaments not purchasable at any
well-stocked pharmacy. I have freely published broadcast every
formula connected with it, unrestricted, for the benefit of the
medical profession. It is now in use by the authorities in Sing
Sing Prison, at Bellevue Hospital, in the hospital on Blackwell’s
Island, and elsewhere. Plans are under way for its more extensive
use by the authorities.
“Very briefly I have sketched the provisions of this proposed State
legislation. It should be welcomed by the doctor, for it puts him
absolutely in control of one of his most valuable assets, the
pain-deadening drug, a control which he must share, as things at
present stand, with every corner druggist and every manufacturer
of patent medicines.
“Decent druggists will welcome the planned regulations. It will
protect them against thefts of drugs by employees, and the
drug-taking drug clerk is a dangerous and at present all too common
handicap on the employing druggist.
“A certain reputable retail druggist of my acquaintance tells me
that within a year he has discharged two clerks, one for taking
morphine, one for using cocaine. They were a threat against his
welfare. How much greater was their threat against the public
welfare?
“Neither the drug-taking doctor nor the drug-taking drug clerk
will be a possibility under the provisions of the proposed new
legislation, which demands that every grain of any of these drugs
dispensed by or in the possession of druggist or a doctor, shall be
instantly accounted for upon demand of the Health Board.
“The present situation, so terrifying that it forms a problem of
our modern civilization, has grown out of the fact that neither the
physician nor the druggist have been held really responsible.
“The druggist has been permitted to import and manufacture as
freely as he pleased, and to sell under restrictions which were
insufficient to prevent promotion of drug habits; the physician
has never been required to make accounting for prescription of or
the administration of these dangerous substances, and his medical
training, both in college and in hospital, has left him in the dark
concerning the danger point in their administration.
“This proposed New York State legislation has been drawn with
careful eye to the establishment, here in the Empire State, of a
model law for other States. General adoption of such legislation
would make proper Federal laws effective and without a perfect
understanding between the State and Federal Government as to where
responsibility of each begins and ends, no really effective action
will be possible to either.
“The first step for the Federal Government will be to require the
registration of all importers and manufacturers of habit-forming
drugs, all wholesale druggists and drug jobbers, and all retail
druggists. A similar registration is now required of all those
engaged in the tobacco trade.
“The regulation of interstate traffic in such drugs will be a
simple matter. A system of uniform order blanks furnished to the
buyer, and of uniform invoice blanks furnished to the seller on
demand, by the Government, can be so arranged that every step of
every interstate shipment can be closely followed.
“It will be necessary to require that habit-forming drugs shall be
shipped in bond; that the importer shall account for all which he
imports, the manufacturer for all which he manufactures.
“The passage of the law subjecting importations of opium prepared
for smoking to a prohibitive tax lost us millions in annual
revenue and increased the vice of smoking opium, for it forced the
preparation of raw opium for smoking in this country--an art which
theretofore had been in the exclusive possession of an ancient
Chinese company. Under this law opium prepared for smoking is
cheaper in this country than it was before its passage. Let us have
no more abortive legislation on this vital subject.
“Ninety-five per cent. of the whole nation’s drug evil could surely
be avoided by the general adoption in all the States of legislation
such as this proposed in New York State, supplemented by such
Federal legislation as I have outlined.”