The second national campaign against narcotics ran, with ups and downs in what newspapers like to call public hysteria, for roughly 15 years, that is, from 1905 to 1920.
In that time Congress passed three major pieces of antinarcotics legislation—the Pure Food and Drug Act of 1906, the 1909 act "to Prohibit Importation and Use of Opium," and the Harrison Act of 1914— and then, along with a number of court decisions broadening the scope of the legislation and police powers to enforce it, fixed the national policy of prohibition on narcotics down to the present day.
The background for this was a concoction of myths which, in this instance, is the sociological term for lies and deceptions which took many sincere people in, a background that performed much the same covering role as did antiopium propaganda for the Chinese exclusion movement a quarter of a century before, except that this time the target was enlarged to take in blacks and working-class whites of immigrant origins. The underlying pattern of economic crisis and class conflict was repeated; only the political dynamics were different. An irreversible force (the medical profession) met a corruptible object (the legal profession).'
What the Pure Food and Drug Act did was not ban narcotic drugs but only require that when medicines contained them, that fact and the quantity would be clearly labeled on the package. Actually the popular agitation that culminated in the 1906 act was concerned only incidentally with the consumption of drugs. In the event, the measures dealing with the opiate and cocaine contents of patent medicines were inserted into the bill at the last moment. Its Congressional sponsors and the man who drafted it, Dr. Harvey Wiley of the Bureau of Chemistry in the Federal Department of Agriculture, favored the measures but did not consider them as important or as likely to pass as the food adulteration provisions, which were the heart of the legislation.2
The bill drew support from a variety of forces. One of them, which was to have a roundabout, but telling, effect on the narcotics story by the time of the Harrison Act, was the medical profession. For most of the nineteenth century doctors had been practicing their medicine without much popularity or prestige and in competition with pharmacists, druggists—in fact, anyone with the imagination or capital to risk in offering his services or products for the cure of ailments and disease. By 1900 two developments had begun to transform the once laissez-faire free enterprise in cures. One was medical theory after Louis Pasteur had refocused attention in diagnosis and pathology on the parts of the body rather than the body as a single entity. This, in turn, spurred specialization and division of labor within the medical profession, while at the same time the number of medical graduates began to multiply fast.3
Meanwhile, the patent medicine industry had grown to such size in output, dollar sales, and the capital needed to sustain operations that it was no longer easy for the lone entrepreneur to make good. The newspaper and advertising industries had generated much of their revenues over the years from the marketing of patent medicines, but by late in the,century competition had become so intense that the cost of mass advertising campaigns had reached the point where the large capital investments necessary to launch a new product began to limit the entry of newcomers to the field. In short, only the large companies could survive, and economic concentration was already well advanced before the 1906 act which accelerated it.
The increasingly self-assertive medical profession contested the provisions of the legislation with the drug manufacturers, whose economic power had become more and more centralized. What was at stake was control of the market in medical services. So long as anyone could offer medical treatment by marketing a patented formula of his own invention, the doctors' accreditation and the legitimacy this was intended to carry were subject to indiscriminate competition in the marketplace. Pharmacists and druggists, who also claimed a special position on similar grounds, could earn nothing for the scarcity. The price of their skill was thus squeezed, in addition to their being between the doctors as prescribing agents and a welter of drug and medicine suppliers, whose repute depended on marketing and advertising campaigns and not on the efficacy of their products.
The economics of this system made everyone a charlatan. The 1906 legislation did not change much, not even the quality of medical goods and services; it simply reduced the ability of some groups to supply the goods and services and divided the market up between those who were left—organized doctors and a diminishing number of drug companies, with a system of licensed retailers in the middle. Nor did the 1906 act, as is often claimed, stop the abuses of the patent medicine industry; it merely helped rationalize its economic structure and legitimize the output, the effect of which was higher prices and greater profits in the pharmaceutical business.
Opium, heroin, morphine, and cocaine were at the time the principal analgesic drugs in use. The fight to control them, which the American Medical Association had begun in 1905, reflected the profession's determination to take over greater control of drug production and supply than was granted it in the provisions of the 1906 act.
Hamilton Wright, a medical scientist specializing in tropical diseases, was the principal representative of the prohibitionists in the profession; practically speaking, both the 1909 and 1914 acts were his doing.
Since 1908 Wright had been deputized by the State Department to represent the United States in negotiations with the Chinese for controlling their own opium problem and at a number of conferences the United States sought to convene to regulate the international traffic in opium. The Report on the International Opium Commission, was written by him following meetings of the Shanghai Opium Commission in 1909. Before the commission had even adjourned its proceedings, Congress passed an act to tighten controls over imported opium, which prohibited the entry of the drug in a form intended for nonmedicinal use and limited the entry of approved shipments to 12 designated ports.4
Initially the State Department's concern with opium stemmed from a desire to block the importation of Chinese supplies of the drug into the Philippines which, at the time, were under American colonial administration. The report by a committee of the Philippine Commission, issued in 1906, stimulated the government to act on the problem of foreign traffic, and Wright was responsible for linking this aspect of policy with draft legislation he proposed for dealing with domestic consumption in the United States. He told the House Ways and Means Committee in 1910:
The opium problem in the United States as it now stands needs to be confined by a triangle. One side of that triangle has been laid down by the act of last February. The importation of opium prepared for smoking and of other forms of opium except for medicinal purposes is prohibited by that act. If the proposed act about to be submitted, or some other act of Congress to control the manufacture and interstate traffic in the drug passes and is approved, the second side of the triangle will have been laid down. The third side may be made from an internal-revenue act that will prohibitively tax the manufacture of smoking opium within the United State s.5
It took four more years for Wright's triangular policy to be implemented, but when it finally was, in the form subsequently known by the name of the bill's sponsor in committee as the Harrison Narcotic Act, Wright had extended the provisions to include all of what he called habit-forming drugs, including the opium derivatives morphine and heroin and the pharmacologically unrelated cocaine. Trade, prescription, or consumption of these drugs were not prohibited under the new law, not at first, for it was designed as a revenue measure and provided only for registration of the channels through which the drugs passed at each stage of trade, from importation of the raw material to final consumption, and the levying of registration charges and tax on each of the groups involved, from manufacturers to medical practitioners and retail druggists. Regulations later issued by the Treasury transformed the act into the blanket prohibition that Wright had originally intended, including the prohibition against doctors prescribing the drugs to maintain existing habits.
Wright himself believed that two things were basic to the case for narcotics prohibition. The first was that the use of opium in one form or another, either by smoking prepared gum opium or by injecting morphine or heroin, was widespread in American society. He made a special point of social class. Smoking opium, he wrote in 1910, "had steadily spread to a large part of our outlaw [sic] population and even into the higher ranks of society" (my emphasis). Even worse was the so-called cocaine habit, "the most threatening of the drug habits that has ever appeared in this country," which "apart from the outlaw population, threatens to creep into the higher social ranks of the country."6
To some extent Wright put the blame for this on irresponsible dispensing practices by medical practitioners, along with a "certain amount of ignorance as to the danger in the use of opiates."7 That being the case, he reasoned, the medical profession would be responsible—in effect, wholly responsible—for rescuing the country from the danger by curing those with drug habits involuntarily or otherwise acquired. This was the second fundamental tenet of his belief—that addiction to opiates or cocaine was a disease of a recognizably pathological character and that it could be cured by medical treatment.
Such a belief depended on evidence of the way in which the drugs affected the body, and a great deal of then fresh clinical research appeared to provide it, along with recipes for a variety of treatments.8 One of them had been developed for use in a private New York sanitarium by Charles Towns who had also applied it, with reputedly great success, in the Philippines and China. Wright was so impressed that he attached it to his report to the State Department at the conclusion of the Shanghai meeting. It was also taken up by Alexander Lambert, a Cornell professor and associate of Wright's, and, crucially, the medical advisor and friend of President Theodore Roosevelt. Because of their powerful network of government contacts, official assignments within the government, their spokesmen role for the American Medical Association on the drug issue, and close association together, Wright and Lambert deserve to be regarded as the founding fathers of American drug policy.
The immediate effect of the Harrison Act was, in one sense, the realization of the medical profession's long-standing aim: to gain control of drug production and supply. Musto describes the result as "almost a monopoly for physicians in the supply of opiates to addicts." What happened was that the act licensed the doctors to prescribe the drugs, but it did not limit the purposes for which the prescribing could be done. The result was that doctors took to the trade as the old patent medicine salesmen had done before 1906, offering drug supplies at a premium price in the name of progressive withdrawal or just plain habit maintenance.
Wright and Lambert had conceived of medical control of the drug trade—but not in these terms. They supported total prohibition, even of maintenance doses, because they -thought they knew what led people to consume the drugs, what caused their addiction, and what would without fail cure them of it. Total narcotics prohibition, as it came into force in 1919, produced sharp dissent and opposition among practitioners dealing with drug users, but it reflected Wright's and Lambert's position exactly. Lambert was elected president of the AMA in 1919, and his position on drugs was the official AMA one.
This has frequently been characterized as a retreat by the profession from what is loosely called the "medical approach," as distinct from the "police approach" to drug users. In fact, the two were never alternatives in the original Wright proposals but from the very beginning complemented each other. For Wright from the beginning and later Lambert consistently distinguished among drug users between the "outlaw population" and the "higher social ranks." The first part of their case for narcotics prohibition was that addiction was spreading from one to the other, increasing the size of the former with recruits from the latter. The second part of their case said quite simply that those who would be cured could be cured—if drugs were completely prohibited. For example, Lambert, who tested the Towns cure at Bellevue Hospital in New York, never believed that curability extended to the criminal element. The punitiveness that is generally associated with the "police approach" was the policy he espoused for that element or type of addict. What this amounted to was a distinction of social class, expressed in terms of the drug involved, or the "personality differences" between groups of drug users.
It is usually a just differentiation, Lambert told the AMA narcotics committee in 1921, "that the heroin addict is of an inferior personality compared with the morphinist . . . morphine is the drug of the stronger personality . . . . The social and public health problems of the narcotic drug question are practically confined to the addicts of heroin and cocaine, and their hospitalization and after-care. The problems of the morphine addicts belong more to general medicine and are more easily solved and show no tendency to become a social menace."10 The working-class addict, as I indicated earlier, was either a "correctional case," "mental defective," or "social misfit." Prison was the recommended mode of treatment.
It seems so natural now—to some, reasonable—that the nonmedical use of these drugs should be prohibited totally and that the prohibition should be backed by the threat of prison. At first, though, Wright, Lambert, and their associates in the federal government and the AMA found it difficult to convince those responsible for enforcing the ban and applying the sanctions that, as a general rule, an individual didn't have the freedom to consume whatever drugs he chose or that in the particular case presented to the court, the individuals charged were guilty of any crime other than the exercise of this freedom of choice.
An Oregon district court, for example, ruling on the conviction of a Chinese for selling opium, acknowledged at the height of the first opium crusade that the target of the prohibition was not the drug per se but the particular and characteristic user: "Smoking opium is not our vice, and therefore it may be that this legislation proceeds more from a desire to vex and annoy the 'Heathen Chinese' in this respect, than to protect the people from the evil habit." The conviction was sustained on the grounds that "the motives of legislators cannot be the subject of judicial investigation for the purpose of affecting the validity of their acts."
To uncover what these motives were for each major episode of narcotics prohibition and to identify the real targets among drug users marked for prison—this is how I will approach the history of the policies and laws, but lawyers took no such approach in the early resistance to prohibition. Essentially it was fought out in the courts on the constitutional issue. How far could the police powers of the state be extended over individual behavior such as opium use or tobacco and alcohol use which involved similar and parallel legal struggles and in which supposed basic personal rights were involved?
The fight to stave off state and police control of the alcohol trade was already virtually lost by the time of the first antiopium legislation, but mere possession of alcohol, for consumption rather than sale, was successfully defended by lawyers and sustained by judges until at least 1915.12 During the same period, possession of narcotics—in virtually every case, possession of opium by a Chinese—failed to make or win such a defense. Instead, courts in Oregon, Washington, and California decided that it was up to the state legislatures to decide what public harm there was in use of a drug. When it was argued that this was much worse than alcohol consumption, the courts accepted the distinction. In the case of Yun Quong, who was convicted in California in 1911 for possession of opium, the lower court said bluntly:
Liquor is used daily in this and other countries as a beverage, moderately and without harm, by countless thousands . . . whereas it appears there is no such thing as moderation in the use of opium. Once the habit is formed the desire for it is insatiable, and its use is invariably disastrous.
In letting the decision stand, the state supreme court held that the evils of opium might well be worse, but that it was sufficient that legislators were not acting unreasonably merely to think so.
The validity of legislation which would be necessary or proper under a given state of facts does not depend upon the actual existence of the supposed facts. It is enough if the law-making body may rationally believe such facts to be established. If the belief that the use of opium, once begun, almost inevitably leads to excess may be entertained by reasonable men—and we do not doubt that it may—such belief affords a sufficient justification for applying to opium restrictions which might be unduly burdensome in the case of other substances, as, for example, intoxicating liquors, the use of which may fairly be regarded as less dangerous to their users or to the public.13
After World War I had begun in Europe and as the United States edged toward intervention, the hyperpatriotism, the widespread paranoia about German-speaking Americans and the rumored fifth column of spies, and the determination of the Wilson Administration to dragoon a substantially unwilling population into war and either subvert or destroy the opposition—all were circumstances making the time poor for the Bill of Rights and for constitutional guarantees of personal liberties. Legal resistance to the prohibition of alcohol collapsed, and the Volstead Act instituted the decade and a half known as Prohibition by outlawing the possession of liquor. This was upheld by the United States Supreme Court in 1919. At the same time a succession of Treasury Department regulations enlarged the prohibition on narcotics, and again the Supreme Court held that this was permissible under the Harrison Act and supported the original Wright-Lambert policy that simple maintenance of a drug habit interfered with the cure and therefore must be banned."
What was subject to police power, as now construed by the courts, was whatever legislators or the vast, if manipulable, public thought to be harmful to public welfare, whatever that might be. Gone was the earlier limitation that the harm be demonstrably and directly injurious to society; gone, too, was any requirement that the damage to welfare be proved. In their places was the force of public opinion, right or wrong, which, as a practical rule, amounted to the force of medical opinion, again right or wrong. But, as indicated, research findings could be used to support either side of the prohibition issue, so that there was no way clear to decide between sides—not, at least, on scientific grounds. What became public opinion then, or What this was generally understood to be, and what became public policy cannot be explained on their scientific merits, simply because the merits were evenly divided. If there was a connection between opinion and policy, it had to be a political one, of people and opinion mobilized for particular policy objectives. The story of each episode is the account of how this was done and what the objectives were.
A commentary on the evolution of police power indicated just how far, by 1914, legal policy on the issue had departed from the guarantees in the Bill of Rights:
As each litigation arose, the judges could follow no rule but the rule of common sense, and the Police Power, translated into plain English, presently came to signify whatever, at the moment, the judges happened to think reasonable. Consequently, they began guessing at the drift of public opinion, as it percolated to them through the medium of their education and prejudices.15
In this way it happened, then, that the machinery was set up, principally by leaders of the medical profession but with lawyers in the supporting role, to mobilize whatever community resources were available to attack or punish the social groups or forms of behavior that these politically commanding elites considered dangerous or threatening. The next step in the story is to illustrate which groups were newly singled out during this period and to show that the conventional rationales for narcotics policy at the time, in particular those provided by Hamilton Wright, were almost certainly untrue and known to be untrue by a number of people who advocated them. ,
The point I am making is that several latent forces and interests (in the political-economic sense of the term) were acting on the policy-making process throughout the period. The fact that one of the results was the foundation of a narcotics policy in the United States does not necessarily mean that the individuals and groups which laid them down did so in response to a manifest need for narcotics control per se. If we ask what was the evidence of a drug problem during the period 1905-20, we will find, as we did in analyzing the first episode, a visible gap between what the problem really was, what its dimensions were supposed to be in public opinion and whose interests were served, and what was accomplished by the adoption of the policy when it came.
There are three distinct drug "problems" in the historical record. One was a sharp and noticeable increase in the number of adolescent drug users between 1910 and 1915. The evidence for this is found in court, hospital, and prison records. A judge of the Court of Special Sessions, in New York, reported that in 1916, 18.9 percent of drug cases presented to him were under 21 years old and that between 1916 and 1921 this was the peak year for that age group.15 W. A. Bloedorn, who analyzed drug addiction admissions to New York's Bellevue Hospital from 1905 to 1916, found that most of the cases were concentrated between the ages of 21 and 23:
When we take into consideration the fact that most addicts have been constant users of the drug for at least a year and in many cases for several years before admission to the hospital, we see that a large percentage began the use of drugs while they were still minors.17
There is no way to be sure how general, or how unusual, this phenomenon was. Bloedorn's evidence indicates that among users of morphine, opium, and cocaine at Bellevue, the average and modal ages were significantly more than those among the heroin users, that the annual admissions rates for the former drug groups peaked in 1913 at the latest, and that there was a sharp and continuous rise in the admissions rate for heroin users from 1913 to 1916, the last year studied. This suggests that something unusual may have been happening and that the rise in heroin use and the fall in the age of the users were parallel, related phenomena.
Kane was one of the publicists during the first episode (see Chapter 2) who claimed that the young, especially young women, were particularly susceptible to the opium habit,18 but Bloedorn's evidence belies this.18 For opium addiction he found two age peaks at the 24-26 and 36-40 age groups (a total of 74 cases), for morphine a flat and even distribution between the ages of 24 and 40 (1,393 cases), and for cocaine, a single peak at 27-30 years (53 cases)."
Rosenblutt, who was the superintendent of a New York State reformatory in 1914, has stated that he had more "youthful dope users" at that time than in any period since, including the period of the second adolescent "epidemic" between 1949 and 1951.21 Without being specific about the age of the users, Perry M. Lichtenstein examined a thousand cases of addiction among New York City prison inmates and reported a substantial rise in the proportion of addicted inmates from 1909, together with the fact that "the greatest increase has been within the last year (1913-14). "22 "The number of young people addicted is enormous. I have come in contact with individuals sixteen and eighteen years of age, whose history was that they had taken a habit-forming drug for at least two years. This includes girls as well as boys."22 Dr. Ernest Bishop, who was in charge of drug addicts at the city workhouse on Blackwell's Island, testified before the New York State Joint Legislative Committee in 1916: "I remember when victims sent to us were men, some of them aged, but now they are chiefly young men and boys."24
The second drug problem that can be identified between 1905 and 1920 is the prevalence of drug use, primarily heroin and cocaine, in the armed services during World War I. This is probably a consequence of the first problem, insofar as the same young men who were exposed to drugs between 1910 and 1913 were likely to enlist or be drafted for service during the war.25
Leaky and an anonymous reviewer of his study of heroin users reported the existence of the habit among naval enlisted men in 1915-16. Concerning the social background of such men, the reviewer noted that they had a "history of having been in reformatories for petty crimes; others are members of gangs. Others live with prostitutes. . . . They give a history of a bad record at school and afterward were unsuccessful [i.e. , unemployed]. "28
Kolb and DuMez cited Army statistics for the entire period of wartime mobilization, those men rejected for service because of mental diseases—a total of 72,323. Of these, only 3,284 were identified as drug addicts. In addition, they quote the testimony of Colonel Pearce Bailey, the chief of neurology and psychiatry in the medical corps, who told them that "there was very little traffic in drugs in the camps in this country and in France, as practically no cases of any addiction were reported among the soldiers."27 After allowing for some underestimation on the part of Army examiners ("the error . . . must have been small"), 29 Kolb and DuMez concluded that "the Army findings are the most important in indicating that the youth of the country are not addicted in great number."29
In fact—and this pattern was repeated in official military briefings on the matter during World War II, in Korea, and in Vietnam—the Army was deliberately misleading in its use of statistics, and the conclusions Kolb and DuMez drew were unfounded. The place to look for reliable statistics, such as they were, on drug use among enlisted men during the war was in court-martial and discipline records. Although they represent only the number of drug users who were caught, the total proportion of soldiers likely to have used drugs was significant.
King, whose findings were based on a study of over 2,500 prisoners in the Army Disciplinary Barracks between 1914 and 1915, estimated that at least 4 percent of the military prison population were drug users, and no less than 1 percent of the total enlisted population were the same:
It is my opinion that the use of drugs (chiefly cocaine and heroin) during the period under consideration has been greater than has been believed. . . . It seems that the majority of users coming under our observation began its use after enlistement. A smaller proportion before enlistment. Regarding this point, often no very definite evidence is obtainable."30
Extrapolating these percentages to the total number of enlisted men who served during the war suggests approximately 35,000 drug users, a number large enough to have made a drug problem visible to the military authorities.31 Since King, whose study was the most detailed on the subject, also argued that drug use was contagious, the potential threat to military discipline was magnified several times over. In circumstances where drug use was particularly concentrated, the threat extended to the efficiency and reliability of entire units.32
The important point here is that these two problems were almost exclusively working-class in character. King presented background material on eight cases, none of which appears to have had more than eight years' schooling and most of them a history of paternal alcoholism typical of working-class families. Bloedorn identified drug use as particularly a problem of "the large centers of population":
There can be no doubt that overcrowding, congestion, insanitary surroundings, and a lack of facilities for healthful recreation are predisposing factors in drug addiction . . . with this sort of environment the drug habit is considered to be highly contagious, particularly among minors.33
According to Lichtenstein (whose sample was of prison inmates), "the greater number are of the gangster type and consequently are mental and moral degenerates."34 It is reasonable to guess that both this "type" and the delinquents referred to by Leaky were of working-class origin.
I have not considered either race or ethnicity of the drug users identified so far. There is not much doubt about identifying the military users as white, but the adolescent population is more difficult to identify. It was almost certainly not Chinese. In New York, according to Lichtenstein, the three most common groups, by ethnic origin (heroin users only), were American, Italian and "Hebrew-American" (Jews born in the United States to immigrant parents).35 Among the 159 arrestees whose names were reported by the New York Times in the first 24 months after enactment of the city's antinarcotic legislation, the Towns-Boylan Act, Jews were especially prominent. They appear to have dominated the street trade in drugs in Brooklyn where Samuel Greenberg, known as the "King of Cokies," was arrested for possession of cocaine in July 1914.36 Italians or combinations of Italians and Jews ran sales networks in lower Manhattan (the Bowery and the Lower East Side) and in the Tenderloin (6th and 7th Avenues, 30th to 39th Streets), which, according to the Times, was "supposed to be the center of the drug traffic."37
What is missing here is any sign of drug users from the "higher social ranks," to use Wright's phrase; yet scarcely a contemporary survey of American drug use has not accepted his characterization that the drugs were evenly distributed throughout the society, at least until the Harrison Act.38 After Wright and until 1928, the most authoritative source was The Opium Problem by Terry and Pellens, in which they collected survey and questionnaire results from a series of reports going back to the mid-nineteenth century. These consistently suggested that narcotic addiction has generally been the result of overmedication by anxious patients and irresponsible doctors or accidental in cases where the addict was unaware of the identity of drugs he or she consumed. Terry and Peliens also claim that the typical addict was more likely to be female than male, white than black, and middle rather than working class.
Many of the surveys quoted excluded working-class residential areas from investigation altogether. The surveys of Michigan (1878) and Iowa (1885), for example, omitted the major cities in those states from consideration. "With the usual vicious elements of city life eliminated," according to Hull," and with "underworld influences such as prostitution, gambling, etc., largely . . . eliminated," Marshall reported,'" it should not be surprising that a distorted profile of drug abuse emerged. Questionnaire returns were particularly low-48 percent for Marshall and 9 percent for Hull. Conclusions about the social class of addicts were derived from highly selective sources of information. "We are confident," wrote the reporter for the American Pharmaceutical Association's survey of 1903, "that the use of narcotics is increasing. . . . While the increase is most evident with the lower classes, the statistics of institutes devoted to the cure of habitués show that their patients are principally drawn from those in the higher walks of life. "41
What the early reporters failed to distinguish was the unusual from the routine pattern of drug use. It shocked them to discover pockets of heavy opiate consumption among the village ladies of the Midwest or in medical suites of the big cities. It was equally shocking, equally visible, because it was well publicized, but it was equally unrepresentative in the aggregate, when heroin use today is discovered among middle-class students in well-to-do communities. There is little doubt that it can happen now (see Chapter 5) or that it was happening, as Terry and Peliens regarded it, at the beginning of this century. But it is nevertheless likely that, when counted into the overall prevalence of opiate and cocaine consumption, this pattern was just as exceptional before the Harrison Act as after it. When viewed closely, the rationale for the act and the total prohibition that resulted from it—at least so far as Wright can be believed in stating what that was—had next to nothing to do with the purported morphinism of doctors or the opiate addiction induced among middle-class consumers of patent medicines. Claims to this effect were part of the campaign to manipulate public opinion concerning the dangers of the drugs, while the true target of the prohibition was much the same as it was in the first opium crusade.
Drug use among blacks in the period was a special and distinctive problem. Because of the heated opinions it generated, let us consider it in detail.
Wright expressed the popular view in 1910:
It has been stated on very high authority that the use of co- caine by the negroes of the South is one of the most elusive and troublesome questions which confront the enforcement of the law in most of the Southern states . . . the drug is commonly sold in whiskey dives, and it seems certain that a large quantity of the liquor sold in these illicit places is laced with cocaine. The combination of low-grade spirits and cocaine makes a maddening compound.42
Lichtenstein also reported that cocaine was the preferred drug among bid& prison inmates in New York in 1914.43 Two years later the physician attached to the Harlem Prison claimed that there were 15,000 "boy addicts" in Harlem alone."
The most common belief was that "cocaine is often the direct incentive to the crime of rape by the negroes of the South and other sections of the country."43 It would also make "criminals more efficient as criminals. Beyond this point it brings on the state of fear or paranoia, during which the (cocaine) addict might murder a supposed pursuer."46 The chief of police in Washington, D.C. wrote in 1908 that "the cocaine habit is by far the greatest menace to society because the victims are generally vicious. The use of this drug superinduces jealousy and predisposes to commit criminal acts."47 Finally, the drug "transforms otherwise safe and tractable citizens into dangerous characters, and in most instances wrecks the individual and all dependent on him, as well as jeopardizes the lives of many."48
The connection between cocaine and rape is crucial in this context, for allegations of black sexual assaults on white women were frequent throughout the South and in the northern cities in the later war years. On August 1, 1914 the New York Times reported that "a young man, who has not been identified, went insane from cocaine poisoning in Battery Park last evening and ran about like a madman. He seized several women who were taking the air on the benches and soon the park resounded with their screams."43 During the "Red Summer of 1919" such charges precipitated lynchings of blacks all over the South, as well as major race riots in Millen, Georgia, Longview, Texas, and Washington, D.C.50
Apart from press allegations and the ex cathedra pronouncements quoted above, what evidence was there of the link between blacks and cocaine? Actually, very little.
E.M. Green, who examined admissions to the Georgia State Sanitarium from 1909 to 1914 (a total of 2,119 blacks, "by far the larger part coming from the rural districts and from small communities"), found only three cases of narcotic addiction among black patients, in contrast to 142 "drug psychoses" among whites. Of the three, cocaine was used by itself once and once in combination with morphine and alcohol. The third case involved the opiate, laudanum.51 Green emphasized that his findings ran contrary to public opinion:
In view of the frequent statements made by the daily press and the generally accepted opinion regarding the use of liquor and drugs by the negro race, it may be of interest to review the table showing the forms of psychoses found in 2,119 negroes admitted. By this table it will be seen that alcoholic psychoses are found three times as often in the white as in the negro. . . . As is the case with alcohol the cost of cocaine precludes its habitual use, for cocaine unfits an individual for work, and when work ceases money with which to purchase the drug fails, so that the habit does not become established. It may be that in communities in which the negro is more prosperous, drug psychoses are oftener found. . . 52
Although blacks in the northern cities were hardly prosperous, they enjoyed higher wage rates than southern blacks. Two studies of Washington's institutionalized population—one of 175 workhouse inmates and another of patients treated in the Washington hospitals from 1900 to 1908—indicated that the number of cocaine users at the time was very small compared with the size of the alcoholic or even the opium addict population, and no particular concentration of blacks was observed.53
Of course, there may be a large error of estimation in relying on institutional figures, if it is supposed that blacks would be less likely than whites to seek or receive treatment for cocaine addiction at sanitaria or hospitals. But it does appear that the picture shown in institutional counts such as these matches that given by such observers as the police.
Bloedorn, for example, provides evidence from admissions statistics of Bellevue Hospital that cocaine use in New York peaked in 1907 and dropped quite sharply between 1908 and 1909, remaining at a low level through 1916 (no breakdown by race provided). An almost identical pattern was reported by the chief of Washington's police, who described the cocaine problem as reaching "alarming proportions" around 1906-1907, but that following the passage of the Food and Drug Act, it diminished substantially: "my information is that the sale of cocaine is about one-tenth of what it was before the present law went into effect."" Again, no notice was taken of racial characteristics, but the implication to be drawn from the Homes Commission reports is that few officials regarded the use of cocaine as either an especially black problem or, after 1909, as serious as the problem of heroin use (which began to intensify in the subsequent 12 months).
Why, then, did Wright, who had read these reports, insist that "the misuse of cocaine is . . . the most threatening of the drug habits that has ever appeared in this country" and that the principal carriers of the threat were black?55 What could have caused blacks to use cocaine in lare enough proportions to create the impression that they, in particular, were addicted to the drug?
Cocaine was first marketed widely in America in patent medicines. Tucker's Asthma Cure, Agnew 's Powder, and Anglo-American Catarrh Powder were cocaine-based preparations, and the names indicate what they were for. It might be argued that one of the reasons for thinking the use of narcotics was greater among working-class people was that the incidence of tuberculosis and bronchial diseases such as asthma, pneumonia, and influenza conditions like catarrh were higher for them than for the middle class. There is no information that makes it possible to compare the illness and mortality rates of blacks and whites within the working class in this period. It is possible, however, to show that a general comparison of the races makes it clear that blacks were much more likely to suffer from these diseases than were whites.
In Washington, for instance, a large discrepancy between the mortality rates of whites and blacks occurred for pneumonia (ratio of white deaths to black, 1:3.3). Other diseases for which this or higher ratios obtained included tuberculosis of the lungs (1:3), "abdominal tuberculosis" (1:4.1), "pulmonary hemorrhage" (1:6.1), infant diarrhea and gastroenteritis (1:3), malaria (1:4), and typhoid (1:1.8). The only medical conditions for which the white rate exceeded that of the black in Washington had to do with drinking, alcoholism, delirium tremens, and cirrhosis of the liver.58 This means that in conditions of relative poverty, when doctors and hospital treatment were either physically or financially inaccessible, blacks can be expected to have sought relief in the only thing readily available to them—the patent medicine. How they spent their money should show this, although there are some problems with the evidence. W.E.B. DuBois collected a variety of family budgets from black families in Philadelphia in 1896, Atlanta (1900 and 1909), and two small towns in Ohio and Virginia (1903 and 1897). In some cases the outlay for medicine was indicated, but in most it was lumped together with the doctor's bill or labeled "sickness." Most of the itemized budgets reflect the occupation and living conditions of laborers or farmhands. For them the proportion of income spent on medical needs ranged from 3.8 to 5.6 percent.57 It is impossible to say, however, how representative the individuals picked by DuBois were of both the urban and the rural blacks of the time.
These percentages may be compared with the figure for 143 families, Polish and Lithuanian, who lived and worked in the Chicago stockyards district in 1909-10; 1.6 percent of their total expenditures went for medicine and doctor's services.58 This is low by comparison, and especially so in light of the fact that the working-class disease, tuberculosis, was worse then in the stockyards ward than in all but two others in Chicago, causing a third of all deaths, and that infant mortality was also so high that one child in three did not live beyond two years.58 In this instance the susceptibility to illness was about as high for whites as for blacks, but blacks appear to have spent more money for relief.
The President's Homes Commission sponsored a similar survey of family budgets in Washington during 1908, which resulted in a breakdown of expenses according to the income group to which the families belonged. Since it is clear from other evidence in the report that black families were disproportionately concentrated in the class with income of $500 or less, the results demonstrated what has been anticipated so far; that blacks, being more likely than whites to suffer sickness, spent a larger portion of their income than whites on patent medicines.56 What is surprising about the report is that families with the least income spent more of it than those with the most on such medicines. This, then, was the first likely source of cocaine for blacks.
Another source which may have made its use evident and distinctive enough to encourage formation of a racial stereotype was in soft drinks with a cocaine base. The Coca in the original Coca-Cola, produced in Atlanta at the turn of the century, stood for the coca leaf, the plant from which cocaine is extracted. In a report on soft drinks issued by the federal government in 1908, over 40 brands of soft drinks were identified as containing the drug."61
Drinks of this kind were first introduced in the South during the 1880s. Their appeal spread throughout the country, although the greatest demand remained in the South. They were widely advertised as remedies for headache and as general tonics. Since they were considerably cheaper than either liquor or cocaine, they may have been especially popular among blacks who could not afford the others. This being so, and assuming that the drinks were potent enough to stimulate a habit for them, it is conceivable that the link between blacks and cocaine may have been established here.
Nowadays it is hard to imagine Coca-Cola leading anyone to commit rape. Nevertheless, government officials used to talk about "the prevalence of the so-called 'coca cola fiend' . . . becoming a matter of great importance and concern."82 In the thinking of the South at the time, if the fiends were black, it seemed quite conceivable that they would attempt to force their sex on white women. But documentation is hard to find; it may not even exist. Government analysts of the soft drinks never identified their contents beyond the generic label, extract of coca leaf; its potency was never measured chemically nor tested in expetiments on the human side effects. In other words, there is only the word of a single pharmacologist that notable side effects might have existed, and for all his professional zeal in the anticocaine crusade, there is nothing but words to show for the alleged drug problem.
It is possible that another factor may have been at work stimulating cocaine use in the South—the prohibition of liquor. Between 1880 and 1910 prohibition had spread from state to state, most rapidly and extensively in the South, and there were press reports that one of its effects was to increase the use of drugs as a substitute for liquor." On the other hand, it is known that consumption of alcohol by blacks was far less than that of whites, so that prohibition was less meaningful to them. Even at the price Wright quotes for cocaine in 1910 (25e per grain)," few blacks working as sharecroppers or as unskilled laborers could have afforded it regularly and still have eaten and paid the rent.
The fact is that Wright, the chief authority for the claim of a black cocaine problem, was reporting unsubstantiated gossip, and knowingly misrepresented the evidence before him. The best evidence available indicates that, whether it was among blacks or whites, cocaine use peaked in 1907 and went sharply down thereafter. The import figures Wright quotes bear this out: in 1907, 1.5 million pounds of coca leaves entered the country, but the next year the amount was less than half that.65
During World War I, circumstances combined to increase the supply of cocaine, notwithstanding the restrictions introduced on imports in 1909 and on the sale and possession of the drug by the Harrison Act. Hostilities increased the demand in Europe for cocaine as a surgical anesthetic while at the same time cutting the Europeans off from their source of supply, which was in Central and South America. Until 1914 most raw materials for processing the drug were shipped in and out of London or Amsterdam, but once Atlantic shipping became the target of submarines the primary entrepôt became New York.
In 1915 C.E. Vanderkleed, a representative of a Philadelphia drug concern, told a New York Times reporter in Berlin that the war was good for the American drug business if it would take advantage of the scarcity in Europe and the disruption of established trade and production patterns. It "affords the U.S. the chance to become the drug and chemical center of the world."66 What happened was close to the prediction, as coca leaves were diverted to New York, which, in turn, created the opportunity to divert cocaine from legitimate to illegitimate trade.
This would explain the allegation by Dr. Royal Copeland, New York's Health Commissioner, that in January 1919 more cocaine was sold in the city than in all of 1918 and that in February the demand was even greater.67 However, this is the only evidence from the press or elsewhere that the use of the drug had risen since 1907. Moreover, Copeland did not say or imply that the users were predominantly black.
Throughout 1919 the papers became curiously silent on the race of cocaine users, curious because stories of black sexual assaults were legion, and racial tension was frequently whipped up by the press to the point where it actually precipitated racial violence in a number of places." Although lynch mobs murdered 78 blacks in 1919, many of them accused of rape,69 and although three of the major city riots also involved claims of sexual assault by a black man on a white woman, cocaine was rarely mentioned as a contributing cause. Instead, the blame was laid on socialist and radical agitators, members of International Workers of the World, the Bolsheviks—even, in one well known case, on Harvard graduates."
We learn something important about the mythology of drugs from this. Just as it was pure invention that Bolshevik agitators had led blacks to riot in 1919, so it was an invention that cocaine was "a potent incentive in driving humbler negroes all over the country to abnormal crimes."71 Both functioned as myths to explain how it could happen that otherwise docile, passive (humble is Wright's word for inferior) black people would react against the impoverished condition in which they were confined.
In these years this condition, along with that of the entire working class, fluctuated, each paralleled by evidence or claims of a new drug problem. Unemployment rose sharply between 1907 and 1908 (the peak of the first cocaine problem), between 1913 and 1914 (the beginning of the heroin problem), and again between 1919 and 1921 (when cocaine and the opiates were reputedly involved once more)."
The war itself stimulated the reconstruction of the northern labor force by inducing the large-scale emigration of blacks out of the rural South to man the labor-scarce urban economy. As this economy changed with postwar demobilization from a condition of labor scarcity to labor surplus, the tension between working-class whites and blacks rose as the necessity to compete for jobs and declining wages was forced on them." Rape, crime, and drug addiction were elements of the hostile stereotype that emerged in this conflict; their relation to true conditions was immaterial. Actually, this, the first generation of blacks to become urbanized and leave the farms for the work in Chicago, -Washington, and New York, did not respond to the new conditions by widespread drug use or involvement in illegal enterprise. That came in later generations. It had already been established in public opinion by the ideology of narcotics that they had—some 35 years earlier. The assault on white women, like the Bolsheviks' attack on patriotism or the crazed antics of the cocaine fiend, were all elements of a common ideology designed to justify and legitimize the repression with which black claims for equality were met. As I have said, the conflict over social justice is what the story of narcotics in America is about.