Before 1800, opium was available in America in its crude form as an ingredient of multidrug prescriptions, or in such extracts as laudanum, containing alcohol, or “black drop,” containing no alcohol. Valued for its calming and soporific effects, opium was also a specific against symptoms of gastrointestinal illnesses such as cholera, food poisoning, and parasites. Its relatively mild psychological effect when taken by mouth or as part of a more complex prescription was enhanced by frequent use, and the drug was supplied freely by physicians. In addition, self-dosing with patent medicines and the ministrations of quacks contributed to narcotic intake. The medical profession’s need for something that worked in a world of mysterious mortal diseases and infections cannot be overlooked as a major stimulus for the growth of the opium market. A drug that calmed was especially appealing since physicians could at least treat the patient’s anxiety. Technological advances in organic chemistry during the early nineteenth century led to plentiful supplies of potent habit-forming drugs. Alkaloids in crude opium were separated and crystallized to isolate active principles that give opium its physiological and psychic effects. Analysis Read more [...]

Lay reformers took a vigorous and uncomplicated stand on narcotics. In general, two problems enflamed them: corporate disregard of public welfare and individual immorality. This dichotomy is artificial but it helps to identify the objects of the reformers’ zeal and it made a difference in the kinds of laws proposed. Reformers like Samuel Hopkins Adams, whose “Great American Fraud” series in Collier’s in 1905-07 revealed the danger of patent medicines, were of course concerned over the damage done to unsuspecting victims of such medicines. Adams directed his attack against pharmaceutical manufacturers whose expensive and inaccurate advertising promotions sold harmful nostrums to the public. In keeping with his exposes of crooked politicians and corporations, Adams argued that regulatory laws should be aimed at the suppliers.27 For other reformers, though, the addict evoked fears; their agitation resulted in legislation directed more at the user, who might be sent to jail for possession, than at the manufacturer who produced barrels of morphine and heroin. The Southerners fear of the Negro and the Westerner’s fear of the Chinese predominated in this approach to the drug problem. The origin of concern thus affected the Read more [...]

The pharmacists who were eager to proclaim themselves professionals, as opposed to mere retailers of prepared medicines and sundries, became members of the American Pharmaceutical Association (APhA). Retail druggists were divided over patent medicines, some making profits from the preparations, others embarrassed by such trade. Nevertheless, many druggists stocked proprietaries in self-defense. The American Pharmaceutical Association frowned on narcotic use for other than medical purposes, and the association’s leaders fought proprietary medicines, as did the AMA, on both moral and self-interest grounds: they were dangerous, self-medication had inherent risks, and legitimate trade was taken from the pharmacists who prepared their own products.35 In September 1901, the American Pharmaceutical Association convened in St. Louis. The Section on Legislation and Education heard lawyer-pharmacist James H. Beal report that the model state pharmacy law which had been adopted at the previous convention was gaining popularity, and that a number of states had already enacted some of its provisions. Nevertheless, the desire of physicians to register as pharmacists without examinations continued. Beal also spoke of a new issue Read more [...]

1906 The pharmacists’ early formulation of a national policy led to endorsement of state laws that would restrict to pharmacists and physicians the supply of habit-forming drugs. A second and slightly revised model law was adopted by the NWDA, NARD, APhA, and the PAA in December 1905, formally extending the drug trades’ support of the 1903 APhA model. In May 1906 Congress adopted for the District of Columbia a pharmacy act which druggists, particularly the American Pharmaceutical Association, considered exemplary.48 It followed closely the language of the model state pharmacy law promulgated by Beal in 1900 and included two sections adopting most of the association’s model narcotic law of 1903.49 As a general pharmacy law, the Act protected registered pharmacists from those without a license, as well as from the sale of drugs by hawkers and door-to-door peddlers. As usual, physicians were exempt from the law with regard to their own patients, for whom they could compound and dispense medicines. Changes from the model narcotic statute reflected compromises reached in most attempts to restrict dangerous but popular medications. Minimal amounts of morphine, opium, cocaine, and chloral hydrate exempted in patent Read more [...]

The word alcoholic and its companion word, alcoholism, were coined in 1848 by Magnus Huss, a Swedish scientist. Prior to that time, the condition was referred to as chronic or continual drunkenness, and the person who suffered from the condition was known as a drunkard. In his landmark 1960 book The Disease Concept of Alcoholism, Dr. E. M. Jellinek, who did more than anyone else to make the medical establishment recognize alcoholism as a disease, provided a simple definition for this kind of destructive drinking: “Alcoholism is any use of alcoholic beverages that causes any damage to the individual or society or both.” Jellinek made his explanation of this disease so simple and broad that everyone could understand it and accept it. In the decades since Jellinek defined alcoholism, medical experts have refined his original concept. Alcoholism is now considered an addiction, one that is potentially as destructive to the individual as an addiction to illegal drugs such as cocaine or heroin. The medical field has also created new terminology for heavy drinkers that can be used in place of alcoholic. Generally, anyone who drinks too much on a consistent basis can be considered a problem drinker. Medical experts also differentiate Read more [...]

Unlike other addictive drugs such as marijuana, cocaine, and heroin, alcohol is legal to use and can be easily purchased by adults in the United States almost anywhere and at any time. People routinely buy a six-pack of beer along with a gallon of milk at their corner grocery store or even when they stop at a gas station. Dr. Gail Gleason Milgram calls alcohol “the drug of choice for most Americans.” Yet America is also the nation that early in the twentieth century believed alcohol was such a menace to the well-being of its citizens that it banned the manufacture and sale of this drug during what was known as Prohibition. This unique effort in social engineering began in 1919, but Prohibition had no sooner gone into effect than tens of millions of Americans began rebelling against it. Their decision to keep drinking beer, wine, and liquor even though it was illegal doomed America’s attempt to eradicate alcohol, and Prohibition ended in 1933. Although Prohibition has been dead for decades, remnants remain of the national fear that once existed regarding the harm that unlimited access to alcohol can cause people. The spirit of Prohibition still lives today in laws that restrict the sale of beer, wine, and liquor Read more [...]

Although most neurologists and pharmacologists report few lasting adverse physical effects from hallucinogen use, one concern among those who formulate the government’s drug policies is whether hallucinogens might be addictive. Of the scientific studies that have focused on this aspect of hallucinogens, none has concluded that they are addictive. This means that their prolonged use does not create a physiological craving or dependency based on changes in a user’s body chemistry. In addition, unlike drugs known to be addictive, there do not appear to be any physiological withdrawal symptoms or cravings when use of hallucinogens is terminated. Furthermore, unlike users of addictive drugs, users of hallucinogens typically do not have the urge to take their drugs many times a day. In fact, hallucinogenic experiences tend to be exhausting, and users report needing time to rest and recover following a trip. The use of hallucinogens more often than once a week is extremely rare; the majority of regular users report using them once a month or a few sporadic times in the course of a year. One of the reasons given for this low frequency of use is the long duration of a hallucinogen trip, which often lasts many hours. The Read more [...]

Being nonaddictive does not mean hallucinogens are risk-free, however. Although the probability of death from the effects of a hallucinogen itself is low in comparison to narcotics such as heroin, health-care professionals warn that using hallucinogens can still have serious health consequences. There are no known deaths among humans because of brain, heart, or pulmonary failure that can be directly attributed to an overdose of any hallucinogen (although laboratory animals administered high doses of LSD have died from respiratory arrest). However, even though studies indicate that low doses of hallucinogens produce no long-lasting effects, high doses of hallucinogens have been known to cause severe psychotic breakdowns requiring long periods of psychiatric treatment. The danger of hallucinogens lies not in their toxicity but, rather, in the unpredictability of their psychological effects. For example, users have been known to wander down streets without knowing who they are or where they have been, or have walked in freezing weather without proper clothing, unaware that they were suffering from frostbite. Episodes of fatal consequences of hallucinogen use, mostly attributed to LSD, have been recorded. Pedestrians Read more [...]

The past fifty years have witnessed considerable debate among policy makers over the legal status of hallucinogens, although that debate has yet to reach a clear resolution. Five decades of illicit hallucinogen use by millions of Americans, coupled with legitimate scientific research, have prompted many people to challenge government claims that hallucinogens represent a serious health risk to individuals and to the nation in general. At the heart of this disagreement are the standards that since 1970 have been used to classify certain drugs as illicit while others are listed as legal. The DEA and Drug Classifications In 1970, Congress authorized the Food and Drug Administration (FDA) to study all drugs, both licit and illicit, to determine which are potentially dangerous and should be strictly regulated as controlled substances. The Controlled Substances Act, Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, is the legal foundation of the government’s fight against the abuse of drugs and other substances. This law is a consolidation of numerous laws regulating the manufacture and distribution of narcotics, stimulants, depressants, hallucinogens, anabolic steroids, and certain chemicals Read more [...]

The reasons given by the DEA for grouping hallucinogens in Schedule I along with the so-called hard addictive drugs are rooted in assumptions about drug use, drug users, and their perceived dangers to American society. In fact, much of American drug policy has been driven by a series of specific models, or sets of assumptions, about how illicit drugs operate, affect users, and impact American society. Over the past century, four models have evolved, and each one has had an impact on how the nation handles drug offenders. The first model, called the punitive model, dominated drug policy during the first half of the twentieth century. At its core is the assumption that illicit drugs cause addictive and destructive behavior, which ultimately leads to antisocial and criminal behavior. Those who adhere to this model believe that illicit drugs should remain illegal and that illicit drug users should be punished with incarceration and fines. During the 1940s and ’50s, following psychiatric studies of illicit drug users, a second model called the disease model developed. This model holds that taking illicit drugs leads to uncontrollable addiction, which, like many other diseases, is not the fault of the addict. The disease Read more [...]