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1. The Criminalization of Heroin PDF Print E-mail
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Books - Heroin and Politicians
Written by David Bellis   
Saturday, 17 November 2012 00:00

The use of mind-altering drugs and drug-induced behavior is a common thread in the social fabric of humanity. For thousands of years people have taken drugs to alter mood, relax, feel better, feel different, escape and avoid pain. This has eventuated in an increasing demand for a variety of psychoactive substances. Of all the drugs, heroin may have received the most attention.


Records show that narcotics have been used for at least 8,000 years. Over the centuries admiration for the pain-relieving effects of opiates has been tempered by increased awareness of their addictiveness.

Opium (Greek: opion, poppy juice) is in the milky exudate obtained by incising the unripe seed pod of the poppy pa paver somniferum. Sumerians in what is now southern Iraq around 7000 B.C. told of its power to produce a sense of delight or satisfaction. Opium was among the most common drugs of the Assyrians and the ancient Egyptians. In Europe opium poppies were found in Hungary around 1200 B.C., and traces of their cultivation have been uncovered near ancient lake dwellings in Switzerland.

Pictorial representations of the poppy are frequently found in classical Greek culture where opium was widely used in magic, religion, medicine, and as an intoxicant. In Rome opium was considered a cure-all for various afflictions. Galen (121-201 A.D.), Rome's famous Greek physician, prescribed it for headaches, vertigo, deafness, epilepsy, apoplexy, dimness of sight, asthma, coughs, jaundice, stones, fever, leprosy, women's diseases and depression, among other illnesses. He warned, however, not to give the powerful drug to children and that frequent use leads to poisoning of the human flesh.

Around 600 A.D. Arab traders introduced opium into China, and so began a long process by which its distribution was monopolized and chronic use came to be regarded as deviant and therefore of legitimate concern to authoritative decisionmakers. Opium use became so widespread in China around 1400 that, according to legend, the last Mongol emperor asked for divine help to stem its spread. The heavenly assistance came in the form of a "red rain" (probably similar to the red tobacco virus), which destroyed the evil opium crop.


The writer Garcia da Orta described opiate addiction in India around 1560. Travel reports from Asia and other parts of the world were popular reading during the seventeenth and eighteenth centuries, and they frequently mentioned "the opium habit."

The symptoms of opium addiction were clarified only in the course of time. While medical statements on opium's habit-forming effects were still vague in the early 1700s, by 1800 there existed a more precise description of addiction stressing tolerance and physical dependence. The term addiction is not easily defined, but in all cases it manifests itself in the twin phenomena of tolerance and physical dependence. Tolerance refers to the situation wherein after repeated administration of a drug higher doses are required to elicit effects previously produced by smaller doses. Tolerance also can develop with nonaddicting drugs. Physical dependence is characterized by withdrawal symptoms upon discontinuing chronic use of addictive drugs. For the extreme alcoholic withdrawal symptoms include the tremulousness, convulsions and visual hallucinations of "delirium tremens." For the severe opiate addict there is extreme anxiety, insomnia, craving for narcotics, sweating, increased respiratory rate, fever, chills, goose flesh (hence "cold turkey"), dilated pupils, cramping, explosive diarrhea and vomiting, and almost unbearable pains.'1


With more books, newspapers, journals and reviews came more public awareness of opium addiction and its effects. Samuel Taylor Coleridge (1772-1834), hooked on opium as a teenager, published poetry written under its influence. In 1822 Thomas DeQuincey, an opium addict at nineteen, introduced the theme of opiate addiction into belletristic literature through his Confessions of an English Opium-Eater. William Blair, another teenage addict and an American admirer of De Quincey's book, wrote his own version in 1835, Confessions of an Opium Eater in America. Artistic works like Hector Berlioz's Symphonie Fantastique (1830) depicting opium dreams, perhaps in an autobiographic fashion, contributed to increasing popular awareness of the effects of opium and addiction.


Advance in drug technology led to increase experimentation with narcotics and subsequent abuse. In 1803 a young German pharmacist, Friedrich Sertiirner, isolated an opium alkaloid he called morphine after Morpheus, the Greek god of dreams, and by the mid-nineteenth century use of pure morphine rather than crude opium preparations had spread widely. The addictiveness of morphine was recognized only after the drug had become an established feature of clinical medicine. Codeine, another opiate alkaloid, was discovered in 1832 and became widely used for relief of pain, cough and diarrhea.

The first hypodermic injections of morphine were given in America in 1856. Medical journals enthusiastically endorsed its therapeutic value and, reminiscent of Galen, suggested it as a remedy for an endless variety of physical ailments. During the Civil War intravenous injection of morphine spread rapidly and addiction became so pronounced that an American narcotics "problem" was spoken of for the first time.2 Soldiers were given morphine to deaden pain from battlefield injuries and illnesses. After the war, ex-soldier addicts continued to use morphine and of ten "turned on" friends and relatives. Newspapers began to feature the evils of "soldiers' disease."


By 1870 pharmaceutical manufacturing firms included huge doses of morphine in numerous proprietary medicines sold over the counter without prescription as household remedies. Sears Roebuck and Company advertised narcotic-injecting paraphernalia. No state or federal laws regulated the sale and distribution of medicinal narcotic drugs, and pharmacists openly sold them upon customer request. Before 1900 drug manufacturers very effectively prevented federal action to require even the disclosure of opium derivatives in these commercial preparations, although anti-morphine laws spread in various states in the 1890s. Loopholes in such laws, however, permitted the uncontrollable sale of patent medicines containing narcotics.3


In 1895 it was estimated that 2 to 4 percent of the American population were morphine addicts, hooked mainly on patent medicines.4 By way of comparison, today only a tiny fraction of 1 percent of the American population is addicted to heroin. In 1874 the English chemist C. R. Wright developed a semi-synthetic derivative of morphine, diacetylmorphine, for the first time. In 1897 Professor Heinrich Dreser, Head of the Pharmacological Institute of the "Farbenfabriken vorm. Friedr. Bayer & Co., Elberfeld," began pharmaceutical testing of the substance. He immediately coined the new drug "heroin" because it performed so heroically in controlling pain—weight for weight it was three times more potent than morphine. Originally, heroin was hailed as a nonaddictive analgesic and as a wonder cure for morphine addiction, until it was discovered to be even more addictive than morphine.

By 1900 heroin was on the scene to stay, sold over the counter as a patent remedy for many different conditions. Subsequently it would become the most influential single factor in hardening public opinion against drug addictions


A startling aspect of narcotics addiction at the turn of the century was not so much its extent as the sociodemographic distribution of the known addict population. Addiction seemed most prevalent among middle- and upper-class white women.8 In 1903 a survey by the American Pharmaceutical Association of selected communities in the United States and Canada found that "the sale of opium derivatives to those of higher incomes exceeded the amount sold to lower income persons."' Perhaps because of the growing temperance movement, many of the better-off in American society, especially women, turned to morphine and heroin preparations as a substitute for alcohol. Their "problem," however, was regarded more "physiological" than criminal.


Prior to 1900 narcotics addiction was accepted by American society as behavior which, although in conflict with its norms, was still tolerable. Narcotic drugs could be obtained legally and inexpensively, and with many respectable members of society using them, addiction simply was not seen as criminal. The modern addict, forced by anti-narcotic laws to burglarize, rob, cheat and deal in heroin to support his expensive habit had not yet appeared.

Around 1900, however, a moral juxtaposition was in the making which ultimately redefined narcotics addiction as criminally deviant, intolerable behavior subject to governmental control and negative sanction. Aware of continually increasing alcoholism and heroin use, society gradually began to lower its level of tolerance. The new punitive spirit was aptly expressed by the specifically American term "dope fiend" which began to appear in newspapers around the turn of the century.8

Several explanations may account for the development of the new punitive attitude toward addicts and addiction. Addiction and deviance of all sorts were associated with the "evils" of urbanism.' The new attitude toward addicts was influenced by increased opium smoking in American cities.1° As more city types—gamblers, prostitutes and underworld characters—began smoking opium, the public came to associate its use with deviance. The new trend toward popular indignation gained momentum during the rapidly growing "Prohibition Movement," and soon lower-class addicts were distinguished from those of higher class." Whereas in 1900 the addict population was distributed fairly evenly over the social classes (with the higher classes having slightly more), by 1920 medical journals were speaking of the "overwhelming" majority coming from the "unrespectable" parts of society. An apparent reversal of attitude took place between 1900 and 1920 in the demographic and social class characterization of addicts. The sex distribution of the addict population reversed itself, too, and by 1920 most addicts were men.12

Musto suggested that the most passionate support for criminalization of narcotics was associated with fear of the drug's effect on specific minority groups in American society.'3 Heroin, especially, was feared because it seemed to undermine essential social restrictions which kept these groups under control. Thus, the use of narcotics, particularly heroin, came to be associated with groups that were already feared and despised by the white, Anglo-Saxon majority. Addicts became easier to hate.

With isolationism rampant in the early 1900s, it became easy to blame foreign nations for the American narcotics problem. This projection of blame on foreign nations for domestic evils harmonized with the ascription of drug abuse to ethnic minorites huddled in large American cities. Both the external cause and the internal locus could then be dismissed as un-American.


Some of the most important actions of government in the narcotics field involve the passage of laws—laws to punish and laws to rehabilitate, laws to restrict narcotic drugs and laws to make them available, laws to treat the symptoms and, much less often, laws to remove the presumed causes of addiction. The first major piece of federal narcotics control legislation was the Harrison Anti-Narcotic Act, unanimously passed by Congress on December 17, 1914. It marked the point at which all narcotic addicts came to be defined by society as criminal deviants, even though many of them had been respectable citizens.

The Harrison Act concluded a generation of concern and agitation against drug abuse. In 1914 the ideal of temperance hit an all-time high in American life. Influential groups agitated to prohibit both alcohol and drugs. Also at a high point were the concomitant reformist aims of facing reality and of individual commitment to rectifying social ills. The Age of Liberalism had arrived and marched under the banner of the Progressive Movement: scientific principles applied to the art of governing. The heroin scare, a new commitment to fight the international drug traffic and mounting attacks on patent medicines dramatized demands for a uniform national narcotic-control policy.

Possibly the change in society's view of narcotics addiction was partially the result of the major change in public policy. Reciprocally, attitudinal change led to passage of the Harrison Act. This legislation laid the legal foundation for the punitive approach to the narcotics problem, realized mainly through an unusually rigorous and repressive implementation aimed at discovering and then suppressing the illicit distribution of narcotics. Aggressive enforcement of the act took place with great public fanfare through much-publicized seizures, large-scale raids on physicians and pharmacists, the opening and subsequent closing of the famous narcotic-dispensing clinics, and sensational trials and Supreme Court decisions.

Enforcing the Harrison Act

The Harrison Act had three main provisions. First, anyone engaged in the production or distribution of narcotics had to register with the federal government. This requirement was designed to give officials a precise knowledge of legal traffic in narcotics. Second, all parties buying or selling narcotic drugs had to pay a tax. This put enforcement programs in the U.S. Treasury Department's Bureau of Internal Revenue. The third major provision of the Harrison Act was its subtle "sleeper": the provision that unregistered persons could purchase narcotic drugs only upon the prescription of a physician. All nonprescription narcotics became illegal.

Could doctors dispense narcotics to addicts to maintain their habits? The Harrison Act, in vague language, stipulated that physicians could prescribe narcotics to addicts only for "legitimate" medical purposes. Is prescribing a narcotic for an addict a "legitimate" medical purpose?

Supreme court decisions cut off legal supplies. When physicians became the only legal source of narcotics, thousands of law-abiding and criminal addicts appeared on doctors' doorsteps, and physicians began prescribing morphine and heroin for them. It is estimated that by 1915, a year after the Harrison Act went into effect, there were 215,000 morphine addicts in the United States.14

The question of the legality of such prescriptions under the meaning of the Harrison Act came before the U.S. Supreme Court in 1919 in the case of Webb v. United States. The case involved the conviction of a physician who wrote 4,000 morphine prescriptions for addict-patients. The Supreme Court ruled that a prescription of narcotics for an addict "not in the course of professional treatment in the attempted cure of the habit . . . but being issued for the purpose of providing the user with morphine sufficient to keep him comfortable . . ." was henceforth illega1.15

After Webb, thousands of doctors were arrested, prosecuted, fined, imprisoned and held up as examples to other physicians who would attempt to supply addicts with narcotics. Addicts suddenly found themselves cut off from all legal sources of supply and turned to illicit suppliers who immediately sprang up to service the demand. Many addicts became criminals to finance their expensive habit. The Harrison Act and its interpretation by the Supreme Court provided the final condition and context for a moral and legal redefinition of what had previously been regarded as a physiological problem. The development of the black market in illicit narcotics and crime was nurtured. The country could now connect all addicts with their newfound underworld associates and could begin to talk about a different class of people, who were not only consorting with criminals to get dope but were criminal "fiends" themselves.

The unintended consequence of enforcing the Harrison Act was to push the price of illicit narcotics even higher, resulting in more instead of fewer money crimes.16 In general, narcotic law enforcement programs in and of themselves are criminogenic—they cause as much crime as they ameliorate.17

Some have argued that the symptoms so often noted in heroin addicts are not so much related to heroin use per se but to the drug's illegality and subsequent lifestyle forced on the user through criminalization. My experience with over 15,000 street heroin addicts indicates their "diseased" state is related to difficulties in obtaining heroin, not to taking it. In fact, there is little or no valid evidence that sterile, unadulterated, properly administered heroin is any more dangerous than tobacco or alcohol. Some evidence suggests that pharmaceutically pure heroin is less toxic than, say, alcohol or tobacco. Winick found absolutely no evidence that sustained heroin or morphine use produces severe toxic effects or that either results in damage of any kind to the central nervous system.18

One is reminded of William Halsted, founder and chairman of the Department of Surgery at Johns Hopkins University School of Medicine. Famous and revered as the inventor of rubber surgical gloves, the use of silk sutures, the radical operation for breast cancer, a prototype operation for inguinal hernia and numerous other important surgical contributions, Halsted was a heavy morphine addict well into his eighties.19


In 1919 some physicians and Treasury Department officials recognized the anomalous situation Webb created for addicts. Temporarily cities throughout the country were permitted to set up legal narcotics-dispensing clinics, which numbered forty-four in only sixteen months. They were located in major cities like New York, Atlanta, New Orleans, Shreveport, Memphis, Cleveland, Kansas City, San Diego and Los Angeles. Abruptly closed down by government order in 1922 under heavy pressure from the Bureau of Internal Revenue and an outraged public, these clinics are still a focal point in the heated debate over what constitutes a "rational" addiction control policy.

The rationale for dispensing narcotics to addicts on an outpatient basis rested, as it still does, upon three simple observations. The first is that permanent abstinence is difficult for most morphine or heroin addicts. Second, experience validated the conclusion that the maintenance of a state of addiction is not necessarily lethal—physiologically or psychologically—if the narcotics are properly administered and the dosage regulated. Third, apparent after the Harrison Act between 1914 and 1919, the worst aspects of narcotic addiction appeared to be attributable to the very illegality of opiates. With the huge black market in narcotics flourishing, government officials properly reasoned that if drugs were readily available at the clinics, addicts theoretically would have no cause to deal in the black market, the illicit supply network would dry up, and addicts no longer would have to commit crimes to meet exhorbitant narcotics costs. The New Orleans clinic lasted four years and reported highly successful results in treating morphine addicts. M. W. Swords, the physician in charge, pointed out that his patients were able to live relatively normal lives as a result of the dispensary and that "narcotics peddlers in the city [of New Orleans] were forced to move away . . . as there was no profit possible."20

Shreveport, Louisiana, police were quite pleased with the clinic there. The chief of police said:

The Narcotics Clinic . . . is a model that should be copied over the entire United States. I wish to say that from a police standpoint, the City of Shreveport is greatly benefited by its being here. It has practically eliminated the bootlegger who deals in narcotics, and in this way alone has reduced the number of possible future dope users. The authorities in charge of the Police Department in Shreveport would regard it as a calamity should this Clinic be removed."

Nevertheless, abuses in the New York City Narcotic Clinic and the attendant adverse newspaper sensationalism brought about an atmosphere of near panic in the general public. The Treasury Department almost immediately set about discrediting the clinics. One of its 1920 reports asserted:

Prominent physicians and scientists who have made a study of drug addiction are practically unanimous in the opinion that such clinics accomplish no good [emphasis added] and that the cure of narcotic addiction is an impossibility unless accompanied by institutional treatment."

In the heyday of yellow journalism, New York papers sent out their best muckraking reporters, who portrayed the clinics as sinful places where addict-criminals came to satisfy their morbid pleasures by pursuing the "thrills of narcotics." An editorial in the San Francisco Examiner said that the proposal to reopen the San Francisco clinic ". . . must go into the ash can along with the man who suggested it."23 A banner headline in The Seattle Post-Intelligencer warned, the "STATE SHOULD NOT TAKE OVER SELLING OF DOPE."24

Closing the Clinics

Bending to governmental and media pressure, physicians in charge of the clinics were goaded by public opinion to publish second thoughts. S. Dana Hubbard, chief of New York City's Narcotic Clinic, with a number of distinguished colleagues, concluded that:

The public narcotic clinic [is] . . . not desirable. We have given the clinic careful and thorough as well as lengthy trial, and we honestly believe it is unwise to maintain it any longer. . . . Ambulatory treatment is farcical and useless. . . . Physicians should not be permitted, under the guise of treatment, to prescribe narcotics for such indulgence. . . . Treatment of the narcotic addict by . . . dispensing [narcotics] . . . is wrong. The giving of a narcotic drug into the possession of an addict for self-administration should be forbidden. . . . The only hope is cutting off the supply of drugs as completely as possible. Therefore, no public clinics."

On March 22, 1920, the New York City clinic was closed.
By 1923, after four years of trial, all forty-four clinics had been closed. Addicts once again turned to illegal activities to obtain their now-illicit drugs.


In 1919 soon after the Harrison Act, the Volstead Act outlawed the use of alcoholic beverages, as though in one gigantic burst of morality two of mankind's oldest foibles could be expunged by legislative fiat. Suppression of illicit alcohol and narcotics traffic became the primary concern of law enforcement agencies and reformers. Careers were made, and the seeds of bureaucratic empires were sown. Billy Sunday, the noted evangelist and leading crusader against "Demon Rum," greeted the onset of alcohol prohibition with high hopes: "The reign of tears is over. The slums will soon be only a memory. We will turn our prisons into factories and our jails into storehouses and corncribs. Men will walk upright now, women will smile and the children will laugh. Hell will be forever for rent . "26

Though it began as an idealistic gesture, Prohibition ended as a sordid fiasco. To many Americans, drinking was the preeminent vice of immigrants and corrupt city life. Nationwide prohibition itself was a product of the moral idealism of the Progressive Era and of the stresses of World War I. Criminalizing alcoholic beverages had two immediate effects. For many, liquor took on a glamor it might not otherwise have had, and illegal drinking became an exciting adventure. Putting outside the pale of the law a personal habit that millions of Americans would not give up also opened a new field of illegal enterprise to gangsters and bootleggers like Al Capone and Sam Giancana, who erected vice empires on the sale of illegal beer and liquor, which they transferred to narcotics after Prohibition was repealed in 1933.
Harry J. Anslinger joined the Treasury Department's Bureau of Prohibition in 1926 and in 1930 was promoted to assistant commissioner of prohibition. Anslinger never really believed that Prohibition could work, but he did his job zealously. In 1930, with the repeal of Prohibition in the wind, he was asked to preside over the new Federal Bureau of Narcotics (FBN), which provided a refuge for thousands of Prohibition agents who otherwise would be shortly unemployed. Anslinger swiftly laid the groundwork for an entirely new approach to narcotics enforcement—a hysterical campaign of anti-dope propaganda within the United States.27

The Moral Foundations of Prohibition

The moral foundations of prohibition policy were firmly rooted in the belief that it is morally bad to be dependent on or to be enslaved by drugs or alcohol; it is good to fight any form of dependency or weakness. It is masculine, and thus admirable, not to be drug-dependent. It is a sign of weakness, it is effete, contemptible and shameful to be dependent. Very simply, narcotics addiction was now a full-blown symbol of dependence that could arouse the same scorn as other forms of so-called passive-dependent behavior such as homosexuality, effeminacy in men, or cowardice.

1. For a good summary of drug withdrawal syndromes, see Glenn Hodding, Michael Jann, and Irving Ackerman, "Drug Withdrawal Syndromes: A Literature Review," Western Journal of Medicine 133 (November 1980): 383-391.
2. Charles E. Terry and Mildred Pellens, The Opium Problem (1928; reprint ed., Montclair, N.J.: Patterson Smith, 1970), p. 28.
3. David F. Musto, The American Disease: Origins of Narcotic Control (New Haven, Conn.: Yale University Press, 1973), pp. 3-5.
4. Marie E. Nyswander, The Drug Addict as Patient (New York: Grune and Stratton, 1956), pp. 1-13.
5. H. Wayne Morgan, ed., Yesterday's Addicts: American Society and Drug Abuse, 1865-1920 (Norman, Okla.: University of Oklahoma Press, 1974), p. 28.
6. Terry and Pellens, The Opium Problem, pp. 470-71.
7. This 1903 survey is reported in ibid., p. 468.
8. The Oxford Universal Dictionary on Historical Principles. Supplement (Oxford, England: Clarendon Press, 1933), chapter 3.
9. Charles N. Glaab and A. Theodore Brown, A History of Urban America (New York: The Macmillan Co., 1967), chapter 3.
10. Alfred R. Lindesmith, Addiction and Opiates (Chicago: Aldine Publishing Co., 1968), p. 212.
11. G. D. Swaine, "Regarding the Luminal Treatment of Morphine Addiction," American Journal of Clinical Medicine 25 (August 1918): 611; see also Terry and Pellens, The Opium Problem, p. 499.
12. J. McIver and G. E. Price, "Drug Addiction," Journal of the American Medical Association 66 (February 12, 1916): 477-91.
13. Musto, The American Disease, p. 245.
14. L. Kolb and A. G. DuMez, "The Prevalence and Trend of Drug Addiction in the United States and Factors Influencing It," Public Health Reports 39 (January 1924): 1179-204.
15. Quoted in Alfred R. Lindesmith, The Addict and the Law (Bloomington, Ind.: Indiana University Press, 1965), p. 6.
16. The criminogenic effect of the Harrison Act has been analyzed by, among others, Pearce Bailey, "The Heroin Habit," The New Republic (April 22, 1916), pp. 314-16; J. C. Densten, "Drug Addiction and the Harrison Anti-Narcotic Act," New York Medical Journal 105 (April 21, 1917): 747-48; and, more recently, by economist Thomas C. Schelling, "Economics and Criminal Enterprise," The Public Interest 7 (Spring 1967): 61-78.
17. Sanford Kadish, "The Crisis of Overcriminalization," Annals of the American Academy of Political and Social Science 37 (November 1967): 158-70.
18. Charles Winick, "Narcotics Addiction and Its Treatment," Law and Contemporary Problems 22 (Winter 1957): 9-33.
19. William Stewart Halsted's morphine addiction, which came to light only in 1969, is highlighted in Edward M. Brecher and Consumer Reports Editors, Licit and Illicit Drugs (Boston: Little, Brown and Company, 1972), p. 34; Thomas Szasz, Ceremonial Chemistry: The Ritual Persecution of Drugs, Addicts, and Pushers (Garden City, N. Y.: Anchor/Doubleday, 1974), pp. 83-84; and, most recently, see the book review by Peter 0. Olch of Owen and Sarah Wangensteen's The Rise of Surgery from Empiric Craft to Scientific Discipline appearing in Bulletin of the History of Medicine 54 (Spring 1980): 145.
20. Quoted in Guy P. Seaberg, "The Drug Abuse Problem and Some Proposals," Journal of Criminal Law, Criminology and Police Science 58 (September 1967): 366.
21. Quoted in Nathan Straus, III, ed., Addicts and Drug Abusers: Current Approaches to the Problem (New York: Twayne Publishers, 1971), pp. 20-21.
22. Annual Report of the Commissioner of Internal Revenue for the Fiscal Year 1920 (Washington, D.C.: U.S. Government Printing Office, 1921), pp. 33-34.
23. "No To Re-Opening Narcotics Clinic," San Francisco Examiner, (December 17, 1938), p. C-1.
24. "State Should Not Take Over Selling Dope," Seattle Post-Intelligencer, (February 17, 1938), p. 22.
25. New York City Health Department, The New York City Narcotic Clinic (New York: Bureau of Public Health Education, Health Department, 1920), p. 30.
26. Billy Sunday quoted in "Narcotics Prohibition," Newsweek (May 1, 1972), p. 104.
27. See Harry J. Anslinger and William F. Tomkins, The Traffic in Narcotics (New York: Funk and Wagnalls, 1953).


Our valuable member David Bellis has been with us since Tuesday, 20 November 2012.

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