“Your Committee is inclined to criticize the medical profession for its lack of study of the increasingly important subject of narcotic drug addiction. The only excuse which can be offered for this unfortunate condition lies in the fact that there has not been medical appreciation of conditions and that legislation, both State and Federal, has forced upon the physician a situation for which he was wholly unprepared.
“The testimony taken by your Committee shows that those charged with the sale and distribution of narcotic drugs are in the main observing the law, and that the legal distribution of these drugs is less than before the enactment of existing narcotic laws, Federal and State.
“On the other hand it is apparent from this testimony that public consumption of narcotic drugs has increased to an alarming extent. The inevitable conclusion is that the unfortunate addict has been forced to and does obtain his supply illegally.
“This condition arises very largely from the fact that many physicians and pharmacists, either through misunderstanding of the law or the true nature of the addict’s disease, have refused to prescribe or dispense narcotic drugs to the sufferer.
“Your Committee contends that any member of the medical or pharmaceutical professions who refuses either to prescribe or to dispense narcotic drugs to the honest addict to alleviate the suffering and pain occasioned by lack of narcotics is not living up to the high standards of humanity and intelligence established by these great professions.”
CHAPTER IX
SOME COMMENTS UPON THE LEGITIMATE USE OF NARCOTICS IN PEACE AND WAR
Before commenting upon the legitimate use of narcotics, it is desirable to emphasize again that the term “narcotics” as used in this volume refers particularly to the preparations and derivatives of opium, because as the term “narcotics” has come to be used it is synonymous in the minds of many with “habit-forming drugs,” a phrase often loosely used and grouping under its title a number of drugs of widely dissimilar action and properties.
Although many of these drugs have narcotic properties, their action upon the human body is in many respects totally unlike the action of the opiates themselves. Also the condition resulting from their prolonged and continuous administration is an entirely different condition clinically and physiologically from that manifested in the case of opiate addiction-disease. The problems associated with the use of alcohol, cocaine, chloral, cannabis, the various coal tars, etc., differ from each other and all of them are, in their basic medical principles, of an entirely different character from the problems associated with the use of opiates. As has been previously stated, it has not yet been demonstrated that any of them form the basis for an addiction-disease mechanism such as clinical study and laboratory experiment seem to demonstrate in opiate addiction-disease.
In considering legitimate as well as illegitimate use of opiates, therefore, it is important not to confuse them with the drugs above mentioned and to be sure that in the mind of the reader there shall not exist any lingering impression that attributes popularly supposed to be associated with so-called “habit-forming drugs” are of necessity displayed in the opiate group.
The habitual use of cocaine for example, may be regarded as an indulgence of appetite and the obtaining of sensation and artificial stimulation and not as based upon the demands of a specific physical addiction-disease mechanism. The therapeutics of its discontinuance are entirely different. Habitual indulgence in cocaine tends to result in mental and moral deterioration. In the addict of the so-called “underworld” it is the coincident use of cocaine with its manifestations of mental, moral and physical deterioration that has led to the wide and erroneous attributing of characteristics of this class of cocaine habituates to the average opiate addict. The habitual use of cocaine is an entirely different matter from the continued administration of opiate in the case of an opiate addict, and its manifestations should be completely dissociated from the clinical picture and problem of opiate addiction-disease.