The narcotic drug problem

by Ernest S. Bishop

The ultimate solution of the problem of handling the narcotic addict lies largely in the education of medical men, both in institutions and in private practice, and through them securing lay appreciation of disease facts. Any legal or administrative restrictions which drive the care of the honest addict out of the hands of the honest medical man simply postpone the day when this ideal may be consummated.

Some addicts, as individuals and types, will of course always require institutional and custodial handling. The handling of the addict who is criminal or vicious belongs within the province of the penological authorities, just as does the handling of any other man who is criminal or vicious. The handling of the addict who is fundamentally degenerate, defective or mentally weak may require the attention of the alienist and institutional restraint, just as may the handling of any other man who is degenerate or defective. Narcotic drug addiction-disease in the man who is vicious or criminal or defective or degenerate should be treated as narcotic drug addiction-disease, as any other disease is treated in the same individual.

To our legislators and administrators and forces of penology, custody and correction rightfully belongs the problem of looking after the criminal and vicious addict as well as providing for the eradication of illicit, irresponsible, and “underground” traffic in narcotic drugs. If the illicit trafficker happens to be a physician he should have no more consideration at the hands of the law than any other criminal and in its action the law should have complete co-operation of the medical profession, which should see to it also that conscientious endeavor of its honest members is not confused in its consideration with illicit traffic and that the acts of the doctor shall be determined and estimated upon broad principles of medical practice and not upon violation of incidental technicalities. Great care should be taken that the sins of a guilty few are not visited upon the heads of a deserving many.

Until there is available competent and adequate medical care for the honest narcotic addict sufficient in extent to meet the needs of the thousands of sufferers, and encouragement and protection as well as restriction is afforded to the honest physician, the illicit traffic will continue and grow, including in its toils many who would not otherwise seek it. Before we have further medical restrictions, we should have both medical and lay and official education. Over-emphasis on any aspect resulting in premature, narrow, ill-considered and ill-advised action only increases the complexity of the situation and defers final remedy. For as great and complicated a problem as narcotic drug addiction there will be found no special or specific panacea.

In conclusion I feel that a great deal more thought and attention should be paid to the testimony of the public hearings of the New York Legislative Investigating Committee, under the leadership of Senator George H. Whitney, Chairman of the Committee. A vast amount of valuable data was produced. It showed for the first time to my knowledge an official effort to secure the true story of the narcotic addict in all of its applications and circumstances. It is significant that the Preliminary Report of the Whitney Committee gave official recognition of the fact that narcotic drug addiction is a physical disease. So important and enlightening was the above mentioned report, that it is deemed desirable to quote from it in part as follows:

“Lack of understanding and appreciation of the disease of narcotic drug addiction and its treatment by a large majority of the medical profession has fostered conditions which make it impossible to determine a rational procedure for treating and curing the addicted by the State at this time.

“Such absence of uniformity of opinion has worked great hardship upon the public and has laid the narcotic drug addict open to misconception, misunderstanding and medical treatment which, in many instances, has resulted in harm rather than good.

“Evidence offered by physicians shows that many addicts have died under the methods of treatment existing to-day and that a large percentage of those discharged from institutions as ‘cured’ are driven back to use of narcotics through unbearable physical torture induced by improper withdrawal of their drug.

“Evidence from physicians was adduced which denied that any cure for narcotic drug addiction existed in any of the private or public institutions of this State. Evidence from other eminent physicians was adduced which bore testimony to the fact that the disease of narcotic drug addiction was curable.

“The difference of medical opinion existing in medical circles regarding this vitally important question should be made the subject of a thorough and searching investigation as a matter of the greatest importance to the welfare of a large number of people in the State of New York.