Drugs, Illicit

Drugs, Illicit. In the beginning there were no illicit drugs. From the seventeenth through the early nineteenth centuries, narcotics were simply part of medical practice, as they had been for millennia. A few patients—and doctors—exhibited symptoms of what would today be called addiction, but they were never numerous and posed no threat to the social order. The one controversial drug, alcohol, was cheap, ubiquitous, and liberally prescribed as a “stimulant.”

Concerns about opium centered on overdose and adulteration. Imported from the Middle East, opium often contained sand, fruit pulp, flour, beeswax, lead, and the like. Indeed, the first national drug law, enacted in 1848, was intended to bar adulterated foreign drugs, not drugs per se.

In the later nineteenth century, narcotic addiction took on a more visible and sinister aspect. Morphine, the principal alkaloid of opium, available commercially after 1827, came into wide use with the spread of hypodermic medication in the 1860s and 1870s. Morphine injected hypodermically was much more powerful and potentially addictive than opium taken orally. By 1900 there were perhaps as many as 220,000 medical addicts. Contrary to legend, most of these addicts were not Civil War veterans, but rather ailing women introduced to morphine by their physicians or through patent medicines, which often contained narcotics and alcohol.

They were joined by as many as ninety thousand opium smokers, mostly Chinese laborers and members of the white underworld. Habitués of the opium pipe, regarded much less sympathetically than medical addicts, were subject to restrictive local and state legislation, typically designed to outlaw public opium dens. The possibility of sexual relations between white women and Chinese men in the dens stirred fears, though in fact Chinese smokers usually kept to themselves.

Sexual anxieties also surrounded the nonmedical use of cocaine. Like morphine, cocaine began as a promising new alkaloid drug. In the mid‐1880s Parke, Davis, its leading U.S. manufacturer, promoted it for a range of illnesses, from hay fever to alcoholism. Sigmund Freud relayed these glowing American reports to a European audience in his 1884 paper, “über Coca.” Cocaine's outstanding therapeutic property, that of local anesthesia, first noted by Carl Koller, helped to revolutionize surgery and dentistry. But overdose cases soon appeared in the medical literature and, as early as 1886, warnings of addiction resulting from medical treatment.

In the 1890s, concern shifted to underworld sniffing and injection of cocaine. Alcohol, cigarettes, and opium smoking were well established among prostitutes, pimps, and gamblers, and now cocaine, reputedly a potent aphrodisiac and stimulant, joined the list. In 1900, half the prostitutes in the Fort Worth, Texas, jail were said to be cocaine addicts.

With the wholesale price fluctuating at about two dollars an ounce in the late 1890s, cocaine was affordable by ordinary laborers, including African Americans who toiled in work camps throughout the South. Although the actual extent of its use remains uncertain, a racially charged folklore linked cocaine use by African Americans to violent rampages and “increased and perverted” sexual desires.

Alarmed city councils and state legislatures passed laws restricting cocaine's purchase to those holding a prescription from a licensed physician—a provision increasingly applied to opiates as well. Had this legislation succeeded, the emerging drug subculture might have been thwarted. But economic and competitive considerations tempted physicians, particularly older and marginal practitioners, to continue to prescribe liberally. Pharmacists criticized such overprescribing but shared the blame for the problem. Retail sales were highly profitable, though “certainly the most disagreeable feature of the apothecary's business,” as one New York pharmacist lamented.

Sales to addicts were rationalized by the realization that spurned customers could simply go to another druggist—or a street dealer. Drugs diverted from legal sources were resold illegally by peddlers to those underage and without prescription. Teenage boys were avid customers for “decks” of cocaine and heroin (a semisynthetic derivative of morphine) peddled in slums and vice districts. Opium prepared for smoking was also available, though more often supplied by smugglers and illegal manufacturers who dodged the heavy customs duty. The cliché that the 1914 Harrison Narcotic Act created the black market and drug subcultures of twentieth‐century America is a political myth. Illegal sales, smuggling, and underworld use flourished decades before the Harrison Act. Drug abuse and trafficking spawned legislation, not the other way around.

The catalyst for national legislation, however, was the diplomatic situation in the Far East. American missionaries, notably Episcopal bishop Charles Henry Brent, had long deplored the British opium trade in China. In 1905 they helped secure a policy of suppressing opium smoking in the Philippines, which had become a U.S. possession. In 1906 Brent asked for President Theodore Roosevelt's help in setting up an international opium conference, which finally convened in Shanghai in February 1909. Representing the United States were Brent; Charles Tenney, a missionary and educator; and Hamilton Wright, a physician who subsequently became the chief architect of federal drug laws.

But while the U.S. government was calling for suppression of the Asian opium traffic, it continued to tolerate (and tax) opium smoking at home. To refute charges of hypocrisy, Roosevelt's secretary of state, Elihu Root, persuaded Congress to prohibit imports of smoking opium. (A later amendment also forbade its domestic manufacture.) This legislation, signed into law a week after the opening of the 1909 Shanghai conference, represented the first nationwide ban on a particular type of drug. In this sense, smoking opium was America's first “illicit drug.”

In 1910, Hamilton Wright turned his attention to a comprehensive narcotic control bill, which he wanted passed before the Hague Opium Commission, a follow‐up to the Shanghai conference, convened in 1911. Wright missed the deadline by three years, owing to prolonged negotiations and compromises with medical groups, the pharmaceutical industry, and patent‐medicine manufacturers. The 1914 Harrison Narcotic Act, named for its sponsor, Congressman Francis Harrison of New York, was a watered‐down version of what Wright sought. It required dealers in opiates and cocaine to register, pay a nominal tax, and keep accurate records of their transactions. Unregistered dealers faced prosecution. Thus narcotic distribution would be confined to legitimate medical channels and made a matter of public record.

The Harrison Act was ambiguous on a key point: whether registered doctors and pharmacists could maintain a supply of drugs for those who were addicted. In 1919 the U.S. Supreme Court, in the five‐to‐four Webb decision, ruled that they could not. This was the key precedent for the antimaintenance policy. It would have lasting implications, particularly after the Treasury Department quickly closed more than thirty experimental public clinics designed to provide a legal supply of drugs for addicts, forcing them into the black market.

In the 1920s, street drugs, mostly diverted from surplus European manufactures, were still relatively pure. However, international agreements in 1925 and 1931 made the large‐scale diversion of legally manufactured drugs more difficult. Smuggled and adulterated heroin became the mainstay of the black market, which centered on New York City, home to approximately half the nation's nonmedical narcotic addicts. In 1924 Congress effectively outlawed heroin, which, like smoking opium, was associated with vice and crime.

The Bureau of Narcotics, under the direction of Harry J. Anslinger from 1930 to 1962, was the federal agency most responsible for suppressing the illicit drug traffic. Anslinger was a hardliner who wanted traffickers behind bars and addicts in jail or in institutional treatment programs. Two large prison‐hospitals, at Lexington, Kentucky, and Fort Worth, Texas, were built in the 1930s for the latter purpose. A skilled bureaucrat and lobbyist, Anslinger increased the scope and penalties of drug laws during his long tenure. He played a key role in passage of the 1937 Marijuana Tax Act, which added a national ban to state and local legislation. This legislation was inspired by the fear that marijuana use was spreading, as indeed it was among jazz musicians, Mexican laborers, Caribbean sailors, and soldiers returning from Panama. Unknown before 1910, marijuana smoking became a subcultural ritual by the 1930s. It was a cheap high: fifteen cents a “reefer” in Harlem “tea pads.” Anslinger and other authorities condemned it for inciting wild violence. This rationale, never plausible, was later replaced by the stepping‐stone hypothesis. “Over 50 percent of young addicts started on marijuana smoking,” Anslinger testified in 1951, and “graduated to heroin when the thrill of marijuana was gone.”

Concern over the post–World War II resurgence of heroin trafficking and addiction prompted Congress to enact the 1951 Boggs Act and 1956 Narcotic Control Act, which provided progressively stiffer mandatory sentences, all the way up to the death penalty for selling heroin to minors. States followed suit. Texas made marijuana possession punishable by life imprisonment. The prison‐mindedness of drug policy provoked a reaction among those who viewed addiction as a public health problem. In 1958 a joint committee of the American Bar Association and the American Medical Association criticized the police approach and suggested the possibility of a controlled legal supply. In the 1960s, two physicians, Vincent Dole and Marie Nyswander, showed that heroin addicts could be maintained indefinitely on oral methadone, a synthetic narcotic. Their work challenged both the antimaintenance policy and the reigning explanation of addiction, popularized in the 1920s by Lawrence Kolb, a physician with the U.S. Public Health Service. Kolb and his disciples held that addicts suffered from defective, even psychopathic, personalities. But for Dole and Nyswander, addicts were more or less normal persons whose drug use triggered a permanent metabolic change. They needed narcotics the way a diabetic needed insulin. Methadone maintenance satisfied that need and kept them out of the illicit market.

Methadone maintenance was, and remains, a cost‐effective treatment for narcotic addiction. Its heyday came during the heroin epidemic of the late 1960s and early 1970s, when the country had an estimated half‐million addicts. After 1974 methadone's star faded, owing to restrictive federal regulations, local resistance to clinics, and its irrelevance to other popular countercultural drugs. Among these were marijuana, a revival of cocaine sniffing, and experimentation with lysergic acid diethylamide (LSD), a powerful hallucinogen. The causes of the drug explosion of the 1960s and 1970s were various: affluence; Vietnam; paraphernalia shops; media coverage; youthful disenchantment with mainstream culture; proselytizing gurus like poet Allen Ginsberg, novelist Ken Kesey, and one‐time Harvard psychologist Timothy Leary; growing consumption of alcohol and other “gateway” drugs; new sources of supply in Asia and Latin America; and, not least, the entry of tens of millions of baby boomers into their teens and twenties, the prime drug experimenting years.

The Richard M. Nixon administration responded with a multifaceted drug war. International enforcement efforts increased, with notable successes in Turkey and France. More funds were appropriated for research and new treatment approaches, including therapeutic communities modeled on California's Synanon Foundation. Federal antidrug spending increased from $80 million in 1969 to $730 million in 1973. Six decades of piecemeal legislation was rationalized by the 1970 Controlled Substances Act, which sorted drugs into five schedules, depending on their abuse potential and therapeutic value. Drugs commonly regarded as “illicit” fell into either Schedule I (heroin, marijuana, LSD, peyote, and other hallucinogens) or Schedule II (cocaine, methamphetamine, morphine). Schedule I drugs were forbidden to everyone, doctors included. Schedule II drugs were allowed in medicine but tightly regulated. Other therapeutically useful drugs such as barbiturates and tranquilizers were placed in Schedules III through V and subject to looser controls.

Most post‐1970 federal legislation took the form of incremental amendments to the Controlled Substances Act, as when the synthetic hallucinogen MDMA (Schedule I) or anabolic steroids (Schedule III) were added to the list. More far‐reaching amendments were enacted in 1986 and 1988, in the midst of the crack epidemic. An inexpensive, smokable form of cocaine, crack exploded in the inner cities in the mid‐1980s, culminating a sustained fifteen‐year increase in cocaine consumption. Like heroin, crack had pronounced ethnic and class overtones and was associated with prostitution, sexual degradation, and violence. The 1986 and 1988 legislation, centerpieces of the Ronald Reagan administration's drug war, substantially increased criminal and civil penalties. Crack was singled out for the heaviest punishment. Possessing five grams with intention to distribute brought a mandatory minimum sentence of five years, the same penalty prescribed for five hundred grams of powder cocaine. Federal penitentiaries became crowded with crack dealers, 95 percent of whom were black or Latino.

As in the 1950s, the vogue of imprisonment sparked a counterattack. Libertarians proposed “controlled legalization” as an alternative to the fifty‐billion‐dollar black market and a ballooning federal antidrug budget that reached fifteen billion dollars by 1997. The idea was to replace the costly and intrusive “drug war” with a regulated adult market in psychoactive drugs. Liberals and public health advocates espoused less radical harm‐reduction measures, such as needle‐exchange programs, which proliferated during the 1990s. Drug courts, a means of diverting nonviolent drug offenders into mandatory treatment, also became more common. The basic policy of the Bill Clinton administration (1993–2001) nevertheless remained that of its predecessors: drug abuse was defined, suppressed, and managed principally, if no longer exclusively, by criminal statutes and law enforcement.
See also Alcohol and Alcohol Abuse; Foreign Relations: U.S. Relations with Asia; Foreign Relations: U.S. Relations with Latin America; Medicine; Prisons and Penitentiaries; Progressive Era; Prostitution and Antiprostitution; Sexual Morality and Sex Reform; Sixties, The; Tobacco Products.

Bibliography

Charles C. Terry and and Mildred Pellens , The Opium Problem, 1928.
Richard J. Bonnie and and Charles H. Whitebread II , The Marijuana Conviction: A History of Marijuana Prohibition in the United States, 1974.
Edward M. Brecher et al. , Licit and Illicit Drugs, 1974.
David T. Courtwright , Dark Paradise: Opiate Addiction in America before 1940, 1982.
David F. Musto , The American Disease: Origins of Narcotic Control, 3d ed., 1999.
David Courtwright,, Herman Joseph,, and and Don Des Jarlais , Addicts Who Survived: An Oral History of Narcotic Use in America, 1923–1965, 1989.
John Burnham , Bad Habits: Drinking, Smoking, Taking Drugs, Gambling, Sexual Misbehavior, and Swearing in American History, 1993.
Jill Jonnes , Hep‐Cats, Narcs, and Pipe Dreams: A History of America's Romance with Illegal Drugs, 1996.
Joseph Spillane , Cocaine: From Medical Marvel to Modern Menace in the United States, 1884–1920, 2000.

David T. Courtwright