This investigation led me into some very interesting discoveries. I found that old, confirmed subjects of the drug habit were sent to such institutions. Where they were taking large daily doses of opiates the institutions were able to reduce these people, when there was no underlying physical disability, within a few weeks or a few months, according to the temperament of the patient, to a very small daily dosage, often as low as one half or one eighth of a grain a day. When they had reached this dosage it was often found absolutely impossible to limit them further. In some cases where the patient was confined and finally deprived of the drug entirely I found that when he had reached this minimum dosage he would suffer just as much physical discomfort in the end as if he had been suddenly deprived of a very much larger quantity of the drug taken daily. This led up to the further interesting fact that even where patients were finally deprived of the drug and lived through the horrible suffering inevitably accompanying the deprivation, although they outlived the tremendous depression and lassitude which followed, and for long periods of weeks and months after that time had the best of care and attention until they showed marked improvement in their physical condition, nevertheless, with too few exceptions, they never lost the desire for the drug. Always the need of some stimulant returned, and on the slightest excuse or opportunity they were taking their drug again. My investigation finally proved to me that deprivation did not remove the cause of the drug habit, because it did not remove the physical craving for the drug. No matter how long a period the deprivation had been, the needed physical and mental change had never taken place.
EFFICACY OF THE AUTHOR’S TREATMENT
During the first two years of my work, after finding in various ways patients from the under-world to use as subjects for demonstration, I was finally able to treat any case of drug habit which came to me unless it was complicated by underlying physical disability. After a period of from three to four days these patients would not feel the slightest craving or desire for any form of opiate, whether their addiction had been cocaine, alcoholic stimulants, or tobacco.
When the efficacy of this treatment was assured, it began to attract the attention of some of the best-known medical men in the country—men who were interested in this line of study. They followed carefully the medical administration of the new treatment of these cases.
It was only a matter of time before the value of the work was thoroughly established and became a medical fact. After hundreds of definite clinical histories had been recorded, the formula was publicly announced, first, at the International Opium Conference at Shanghai in 1909, and a month later to the medical world. Since the complete information concerning my work has been given to the medical profession, and after all these years of study and investigation and medical comment, I have never yet had from any physician an entirely satisfactory explanation as to why or how we were able successfully to unpoison these cases in this short period. At present this treatment is, so far as I know, the only one known to medical science that will bring about this definite physiological change.
The intelligent beginning of help in these cases is to unpoison the patient, put him physically on his feet, where he does not want drugs or drink, and where he does not feel the slightest desire or craving for them, and has no dread of ever drifting into these habits again. When you have brought about this definite physical change, you are invariably able to get a definite mental change. You cannot hope to get the mental change until you have first cleared the system of poison, for in this state the patient is in a most responsive condition to deal with. If physical building up, change of environment, change of surroundings in any way whatever are necessary, they can then be taken up intelligently.
LEGISLATIVE EFFORTS
The knowledge I gained from dealing medically with those afflicted with habits and addictions led me to take up personally the movement to bring about definite legislation with a view to subordinating as much as possible the traffic and consumption of drugs to legitimate medical needs; and to put an end to the criminal negligence by which such drugs have been permitted to be imported, manufactured, and distributed.
In contact with the afflicted of this class, I discovered the laxity with which drugs were dealt in, and began in 1912 to try and bring about some restrictive legislation with regard to the evil before the New York legislature. I had first found that in the medical use of the drug the principal evil had sprung from the knowledge of what would ease pain, and that the principal means used for this purpose was the hypodermic syringe. At that time there was no restriction placed upon the sale of this instrument; it could be bought in any drug store just as easily as a package of chewing-gum. The department stores that carried drug supplies advertised hypodermic outfits as low as twenty-five cents. A physician’s instrument permitted to be manufactured and sold in this way! Through the bill which was introduced in the New York legislature in 1912, for the first time in the history of the medical world it became possible to purchase this instrument only on a physician’s prescription.
In 1913 I was the author of a drastic law regulating the sale of habit-forming drugs in New York State, but because of severe pressure brought by physicians and druggists, I was unable to put it through. In 1914 I tried again, and after a hard fight I was able to have enacted a bill, which was introduced by Senator John J. Boylan, and which bears his name. For the first time there was put upon the statute-books of a State real restrictive drug legislation. Other States are taking up this matter, and, as the intention was, the New York bill has been the means of establishing a legislative precedent.