December 19, 2012 - The more things change, they more they remain the same. Most people associate the start of Prohibition when the Volstead Act banned alcohol in 1920, but it actually started five years earlier when the Harrison Narcotic Act authorized the Federal government to dictate what we could put into our bodies for the first time. This bill set the stage for all future prohibitions and started a domino effect on our freedoms that continues today.
Before the Harrison Narcotic Act, doctors were able to prescribe opiates to treat their patients' drug dependency, a system that worked well for both the patient and the community. Our 100-year experiment with Prohibition has only caused more problems than it has solved, and despite spending billions of dollars every year to stop drug use, efforts have failed miserably to reduce either supply or demand.
Opium: The Tie That Binds
The Long Depression (1873-1879) was the start of widespread discrimination toward Chinese immigrants in this country. Our national xenophobia climaxed with the passage of the Chinese Exclusion Act of 1882 that banned Asians from immigrating into this country for many years. By 1905, Chinese merchants retaliated by staging a voluntary embargo against American merchants and the State Department was called upon to soothe the situation. Opium provided a common denominator that could unite the two countries.
The Chinese Exclusion Act
Sensing an opportunity to break Britain's near monopoly on Chinese ports, America exploited the bad feelings China held toward the Crown by sponsoring the Shanghai Opium Convention. One of our country's primary reasons for banning opium was to curry favor with China in the hope that they would reopen their ports to American interests.
The Shanghai Convention
The U.S. convened a 13-nation league to discuss the growing concerns over the opium trade. The conference was held in Shanghai in 1909, headed by Episcopal Bishop Charles Henry Brent, an early advocate for banning opium. Brent first became aware of the opium problem when the Church assigned him to head their ministry work in the Philippines after America took control of the territory following the Spanish-American War. Before the US takeover, the Philippines regulated opium under a state-controlled monopoly that supplied addicts and medical patients alike.
Although the terms of the Shanghai Convention were non-binding as none of the members had the authority to sign a treaty, it created an "understanding" that member nations would voluntarily try to curb the manufacture and distribution on opium.
The US was represented by Dr. Hamilton Wright who pushed to strictly limit opium for "legitimate use" only, but this standard was resisted by colonial powers (Britain). The final resolution read, "The use of opium in any form otherwise than medical purposes is held by almost every participating country to be a matter for prohibition or for careful regulation; and that each country in the administration of its system or regulation purports to be aiming, as opportunity offers, at progressively increasing stringency." [emphasis in original text]
The underlying agenda for America was to put the onus of reducing supply on the producer nations since neither poppy nor coca were grown in this country. It also laid the groundwork for Brent and Dr. Wright to pressure Congress to pass stringent drug laws to match those of our allies.
The Hague Convention, 1912
Round two in the Prohibition fight began on January 23, 1912 at the International Opium Convention attended by representatives from China, France, Germany, Italy, Japan, the Netherlands, Persia (Iran), Portugal, Russia, Siam (Thailand), the UK (including overseas territories), and the United States.
Britain insisted on including manufactured drugs in the Treaty to deflect attention away from its massive raw opium trade and to break the stranglehold Germany had on the market for synthetic drugs. Heinrich Dreser, a Bayer Pharmacist, had only synthesized heroin for commercial distribution a decade earlier as a cough suppressant, but it had claimed a huge market share in a relatively short time. Tuberculosis and pneumonia were the leading causes of death at the time and heroin was widely viewed as a miracle drug. It was also marketed as a cure for opium and morphine addiction. A move to include hashish as a banned substance was rejected after India objected to its inclusion on religious grounds.
By 1914, the Convention had only been ratified by five countries before it was put on the back-burner by the outbreak of WWI. It only gained universal acceptance when it was incorporated into the Treaty of Versailles as a condition of peace at the conclusion of the war.
The Harrison Narcotic Act
The Hague Convention provided the push for a drug ban in this country. Proponents argued that a federal law was necessary for the U.S. to fulfill its obligations under the Treaty. The U.S. Supreme Court rejected that notion two years later in 1916, but by then the Harrison Narcotics Act was the law of the land and would remain a pillar of U.S. drug policy for the next 100 years.
Getting a Federal drug prohibition bill through Congress would prove to be a long and difficult fight. Not only were the medical professions hostile toward the idea, there was a little matter called States Rights standing in the way. (The US Constitution grants the right to regulate the practice of medicine to the States.) To protect their Jim Crow laws, Southern states resisted any move by the federal government to infringe on their autonomy in any manner whatsoever. (The birth of the "slippery slope" theory?)
Ironically, racism played a key role in winning the eventual approval of the Southern states for the drug ban. Cocaine was added to the list of "narcotics" that were included in the ban, even though it is a stimulant rather than a narcotic. Playing on Southern fears, Dr. Wright alleged before the Congressional hearing on the Harrison Act that cocaine "made blacks uncontrollable, gave them superhuman powers and caused them to rebel against white authority."
Dr. Christopher Koch of the State Pharmacy Board of Pennsylvania testified, "Most of the attacks upon the white women of the South are the direct result of a cocaine-crazed Negro brain."
Police records do not support these wild claims. Records indicate that drug addiction was dominated by the white population- especially in the South where poor blacks could not afford to buy patent medicines on a daily basis. All of these incendiary allegations stemmed from Northern drug opponents designed to inflame the fears of Southern lawmakers.
Secretary of State William Jennings Bryan was one of the chief proponents of abstinence in this country and a strong supporter of the Harrison Narcotic Act. Bryan was a man of deep religious convictions and favored abstinence of all mood-altering substances. (He is best remembered as the lawyer who defended the state of Tennessee in the famous Scopes Monkey Trial, arguing against the Theory of Evolution.)
As the State Department's representative, Dr. Hamilton Wright was tasked with soothing the way between competing professional interests by the bill's sponsor, US Representative Francis Burton Harrison. Harrison wasn't concerned about the form or philosophy of the bill as much as he was over the political fallout.
The Birth of the National Drug Trade Association
Sensing some form of drug legislation in their future, representatives of pharmacists, druggists, manufacturers, and chemists met with Wright individually on numerous occasions over the next two years trying to reach an acceptable compromise. To strengthen their position, the various trade groups met in Denver in 1912 and agreed to hold the National Drug Trade Conference in Washington, DC early in January the following year.
Trying to find consensus amongst the competing interests of the medical professions was truly an exercise in herding cats. Pharmacists didn't want doctors to be able to fill prescriptions, nor were they supportive of manufacturers of patent medicines having a different set of regulations than drugstore pharmacists. Patent medicine manufacturers argued for their right to sell their nostrums by mail. Doctors wanted the ability to dispense medicine directly to their patients. Somehow these groups had to find common ground.
The one thing on which they did all agree was that they opposed the bill as it was written. Wright and Representative Harrison agreed to meet the trade association at the Hotel Willard to listen to their objections after the group rejected Wright's invitation to meet at the State Department.
Wright was not a man prone to compromise. He believed that the ultimate goal should be the elimination of all narcotics except for extreme medical need. The first draft of the bill contained no provision for exempting even small amounts of narcotics in patent medicines.
Wright didn't take kindly to the association's suggestions and he stormed out, declaring "that all meetings would be held at State in the future." His angry reaction united the group's opposition, and for a while, the bill appeared to be DOA. Being a true politician, Representative Harrison told Wright that he had to find an acceptable resolution with the trade group before he would move the bill forward.
Enter the AMA
Although the American Medical Association was established in 1847, it was still in its infancy stage in 1913. Their total membership only numbered 36,000 and most of those physician's were located on the East coast. The AMA quickly realized that to achieve their professional goals, they would have to get involved in the political scene.
At this stage in their development, the AMA was still open to government regulations and were strong supporters of the Pure Food and Drug Act; but by 1920, they had completely reversed their position. Unfortunately, the Harrison Narcotic Act came about during the AMA's transitional period from welcoming government intervention to their total opposition of any regulation that would limit the prerogatives of the independent practitioner. The fallout from the Harrison Narcotic Act played a large part in their changing attitude.
A joint committee of the State and Treasury Departments worked with the IRS to draft a bill that would meet with the approval of the various medical trade groups. One by one, the trade groups signed off on the bill and the Harrison Narcotic Act was finally introduced to Congress where it was approved sixteen days later.
The bill stalled in the Senate and several major compromises were made before it became law. One line that was inserted in the bill purportedly to give doctor's protection from prosecution actually contained a poison pill stating that opium and its derivatives could only be administered "in the course of his (a doctor's) professional practice."
Prosecutors interpreted that one line to exclude the maintenance of a drug habit since addiction was not considered a medical condition. Many physicians were arrested and jailed under this provision, and those who escaped conviction had their careers ruined by the publicity. Treasury Decision 2200, issued in 1915, explicitly stated "physician's must prescribe narcotics in decreasing doses or face arrest."
The medical profession quickly learned that to supply addicts with opiates or cocaine was a risky business. Consequently, a law that was intended to ensure the orderly marketing of narcotics was converted into a law that prohibited a physician from prescribing drugs to addicts.
The Fallout Begins Immediately
Within six weeks of the passage of the Harrison Act, an editorial in the New York Medical Journal stated, "As was expected...the immediate effects of the Harrison anti-narcotic law were seen in the flocking of drug habitues to hospitals and sanitariums. Sporadic acts of violence were reported too, due usually to desperate efforts by addicts to obtain drugs, but occasionally due to a delirious state induced by sudden withdrawal."
Twenty major cities reported an influx of addicts from rural areas desperate to obtain drugs. Some states and many cities responded by establishing drug clinics where, as long a patient registered as a drug addict, they could receive a free or low-cost maintenance dose of morphine. The first clinic was created shortly after the Harrison Act became law (1914); by 1921 there were 44 clinics spread throughout the country not including countless sanatoriums where the rich could go to detox.
The Treasury Department began to close the maintenance clinics and started prosecuting doctors who prescribed or dispensed opiates to their patients after the Supreme Court upheld the constitutionality of the Harrison Act. The government argued that easily obtained maintenance drugs undercut efforts to convince addicts from seeking a cure. The last drug maintenance clinic was closed in Knoxville, Tennessee in 1925.
Addicts were left to fend for themselves. With no legitimate avenue to obtain their drugs, they were forced to buy them on the emerging black market at greatly inflated prices. The term "junkie" was a term for addicts who would search the gutters and back alleys looking for junk they could convert into cash to support their habits.
Crime rates soared as legitimate sources for opiates disappeared. New York City reported 260 murders in 1922 and many of those were directly tied to heroin addicts. Reports like these led Congress to ban all domestic manufacture of heroin by 1924, but the action only resulted in an increased supplied. Two years after the ban, US Narcotic Inspector S.L. Rakusin declared that heroin seemed "more plentiful than it ever was before."
Many women turned to prostitution to support their habits. Men and women both resorted to petty and sometimes violent crimes ranging from shop lifting to home invasions. And, worst of all, Prohibition opened the door to violent gangs that still plague the world today.
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