At this writing the most harmful form of opiate with which we have to deal is heroin. This preparation of morphine was first put upon the market by German chemists about fifteen years ago, the word “heroin” being nothing more than a trade name. It was first used in cough mixtures, and was widely discussed in the medical and pharmaceutical press, where it was claimed that all the harm of morphine had virtually been eliminated in this product, which, without having the depressing effect of morphine, at the same time preserved its stimulating effect. A great number of physicians themselves have acquired the habit of taking opiates in this form, believing at the outset that they were not harmful drugs.
My investigations soon showed me that heroin is three times as strong as morphine in its action, and for that reason its use sets up definite tolerance more quickly than any other form of opiate. For the same reason it shows more quickly a deleterious effect upon the human system, the mental, moral and physical deterioration of its takers being more marked than in the case of any other form of opiate.
Until the Federal Pure Food Law was passed we did not know that many of the well-known, advertised medical preparations contained quantities of various salts or alkaloids of opium. The unsuspecting users of patent medicine were making themselves confirmed drug-users unwittingly, and did not realize how necessary the habit had become to them until for one reason or another they had been deprived of their usual daily dosage.
The reader may imagine my surprise when, although a layman, I found that the physician, to whom we had looked for guidance in administering and prescribing these drugs, knew nothing about them beyond their physiological action; that their medical training both in college and in clinics had left them in virtual ignorance of the whole question. The physician freely prescribed or administered these various drugs, while laymen were able to buy over the counters of druggists prescriptions containing definite quantities of them. Unknowingly, the doctor and the druggist were creating great numbers of drug-fiends.
Physicians do not yet know over how long a period such drugs can be administered in regular daily dosage without setting up a tolerance, after which the patient cannot be deprived of the drug. If the public had been better advised on this subject, it would have been able to protect itself, and would have been more careful about what it took.
COCAINE
Outside the opium group, there is at present only one other drug that must be considered as habit-forming, and that is cocaine. The prostitution of this drug from its proper uses is absolutely inexcusable. It was first used medicinally about thirty years ago, and as an anesthetic only. Its administration upon the nose by specialists in that field of surgery soon established the fact that it not only deadened tissue, but set up a certain stimulation which for the time being made one feel abnormally strong or mentally active. This was the beginning of its common use in the shape of so-called catarrh cures. Only a small quantity—from five to ten per cent.—was used. The tissue of the nose is very susceptible to the action of drugs. When it is applied in this way, the circulation takes up the drug as quickly as if taken hypodermically. Unscrupulous chemists and physicians have unloaded upon the world a drug which is beneficial when taken medicinally, but one that has reaped a harvest of irresponsible victims, in which murder, all forms of crime, and mental and moral degeneracy have conspicuously figured, and all for financial gain.
The habit was first generally spread through the medium of catarrh-cures. Cocaine contracts and deadens the tissue with which it comes in contact, and thus, as in the case of catarrh, relieves the patient from discomfort, making him feel, indeed, as if there were no nose on his face. Its effect, however, lasts only from twenty to thirty minutes.
This is one of the reasons why the cocaine habit is so easily formed. A man taking any powerful stimulant is sure to feel a corresponding depression when the effect of that stimulant has died away, and it then becomes necessary for him to take more of the drug in order to buoy himself up and restore himself to the point of normality. It is among cocaine-users, therefore, not a yearning for any abnormally pleasurable sensation which sends them back again and again to their dosage, but merely their desire to be measurably restored to the comfort which is natural to the normal state. It must be apparent, however, that as soon as it has become necessary for any one to resort to the use of a drug in order to rise to the normal there has been a marked depreciation, physical or mental, and probably both. This explains the fact that many criminals are found to be cocaine-users. No drug so quickly brings about a mental and physical deterioration. It is virtually certain to be a short cut to one of two public institutions, the prison or the madhouse. It will send the average person to the prison first because it is an expensive drug, and the craving for it is more than likely to exhaust his financial resources and then drive him to theft. It is the most expensive of all drug habits. I have known victims who habitually used one hundred and twenty grains a day, at a cost of about seventy dollars a week. This undoubtedly explains the great number who have been made criminals by using cocaine. One who uses it thereby diminishes his earning capacity; while, on the other hand, one who must have it must have money, and much of it.
It may be that this matter of cost explains why the under-world has suddenly taken up heroin instead of cocaine. The former is much cheaper.