SEEKING means to convey a true picture of the distortions supported for so long in the United States by overbearing federal narcotic authorities, it occurs to me that besides detailing a few chronicles like Dr. Ratigan's, I might stress the point another way: in only a few pages here, before telling about Congressman John Coffee, I can note all the significant critics of Narcotics Bureau policy from the beginnings of the reign of terror, at the close of World War I, until the American Bar Association and American Medical Association made their joint challenge at the end of the 1950's.
One of the first of these was Dr. Ernest S. Bishop, a highly respected senior member of the profession in New York, and an acclaimed authority on drug addiction. From the outset he objected to the oppressive way in which Treasury agents had set about enforcing the Harrison Act, remonstrating that Congress had never intended a prohibition measure, and that associating addiction with crime would tend both to create a black market and to lead adventure-seekers to take up drugs.
Dr. Bishop was indicted in January 1920 for a technical infraction of the Harrison Act. An indictment is merely a formal accusation of the commission of a crime, authorized by a twenty-four-member grand jury on a one-sided presentation by prosecuting officials—if the government wants to indict someone, grand jurors almost never resist. But ordinarily ( and in deference to some clear constitutional precepts), an indicted person is arraigned promptly, and if he pleads not guilty he is soon thereafter brought to trial. In Dr. Bishop's case the authorities simply left the indictment hanging as a threat, to discredit and silence him, for more than three years, until the matter had become a national scandal. By the time he succeeded in having it quashed, Dr. Bishop was growing old, was ill, and was never able to resume the fight.
When the clinic programs of the early 1920's came under federal attack, as has already been described, no one really arose to battle vigorously in their defense, and indeed their two most prominent New York sponsors—Dr. Royal S. Copeland ( who later served nearly three terms in the U.S. Senate) and Dr. S. Dana Hubbard—eventually did about-faces and meekly joined the chorus of abuse being heaped on "ambulatory" treatment.
The last holdout was Dr. Willis P. Butler, parish physician in Shreveport, Louisiana. After general medical practitioners of the Shreveport area had been driven out of the picture byfederal indictments returned against four of them, and after clinics in New Orleans, Alexandria, and elsewhere in the state had been shut down at the insistence of Treasury agents who brought pressure through the Louisiana State Board of Health, Dr. Butler carried on alone, supported only by the city council ( quaintly named Police Jury) of Shreveport. His clinic, which also flouted accepted standards of the day by taking venereal cases, continued treating addicts until early in 1923, when he was curtly summoned to the office of the U.S. Attorney and there told by federal narcotic agents that they had been sent specially to close his clinic "because it was the only one left in the United States."
This show of authority—in the inflamed atmosphere of 1923— so intimidated Dr. Butler that he agreed to terminate his work, sadly recording thereafter that of the hundred-odd incurable cases he was obliged to abandon, a number promptly landed in city jails or the state penitentiary, some died, and most, forced to patronize drug peddlers, quickly "reached a condition of wretched poverty."
If one were to name a single grand old man on the American drug scene it would assuredly be Dr. Lawrence Kolb, whose career and personal experiences embrace the whole epoch. It was Dr. Kolb, then a young physician in the U.S. Public Health Service, who with A. G. DuMez made the classic 1924 study which, as noted earlier, brought the estimated addict population of the nation down to a reasonable figure ( 110,000) and helped somewhat to damp the hysteria of preceding years. He also organized and headed the first staff at the U.S. Public Health Service Hospital, then called the U.S. Narcotic Farm, at Lexington, Kentucky.
But Dr. Kolb, like other eminent public servants whom we shall meet later, never faced the fury of an onslaught by the Narcotics Bureau because he was held sternly in check in his official positions in lifelong federal employment. It was only after he retired from the Service, with the rank of Assistant Surgeon General and so many professional honors that he was unassailable, that Dr. Kolb was able to speak out, in stinging articles such as his 1956 Saturday Evening Post feature entitled "Let's Stop This Narcotics Hysteria" and in his valedictory book, which appeared in 1962.
The protesting voice raised in 1922 by doctor-lawyer-congressman Lester Volk has already been quoted here; he—like Coffee a dozen years later—found his remonstrances wholly futile, ignored alike by his colleagues on Capitol Hill and by the executive establishment at the other end of Pennsylvania Avenue.
In the early thirties a prominent Los Angeles physician, E. H. Williams, who had a national reputation as a writer, lecturer, and authority in the drug field, and two associates were prevailed upon to take over treatment of a small group of addicts who had been receiving help from Los Angeles City public-health authorities. All three doctors were promptly indicted, tried, and convicted on the testimony of a government addict-informer who had been surreptitiously included among the city patients. On appeal, the conviction of one of Dr. Williams' co-defendants was reveised ( with a scalding rebuke from the court for the tactics employed by the Narcotics Bureau), but in his own case the record was left standing because of a technical default on the part of his attorneys.
Subsequently Dr. Williams tried to establish a nonprofit organization, the World Narcotics Research Foundation, to encourage studies aimed at dissipating some of the ignorance and confusion surrounding the problem. Bureau agents countered this effort by contacting persons potentially interested in the Foundation and warning them that the venture was "in for trouble with Uncle Sam" and that it was a "criminal organization." Why criminal? Because of Dr. Williams' Bureau-engineered conviction, still remaining on the books solely because of a technical lapse.
Also in the mid-thirties, a retired businessman in Seattle, Everett G. Hoffman, doubtless aware of Dr. Ratigan's contemporaneous activities, took on the Narcotics Bureau with speeches and articles specifically challenging the bland official assertions that there were only some 300 addicts in the Seattle area and that the addiction situation was well in hand. Hoffman insisted that the number was more like 3,000, and charged collusion among enforcement agencies to distort the facts. Warnings began to reach him that if he did not desist he was likely to be framed by the federal men. He proceeded with his campaign until February 1938, when he was subpoenaed to appear before a federal grand jury. He was interrogated in such a way that it became clear an attempt was being made to establish a criminal charge against him. Grand jury proceedings are protected by secrecy, and Mr. Hoffman never disclosed the details of what happened, but the experience was enough to quiet him; he caused the Bureau no more serious embarrassment.
And a final good name on the roster: at this writing one combatant of long standing remains very much in the fight, Dr. Alfred R. Lindesmith, whose doctorate is in sociology and whose unassailable base has long been increasingly important faculty posts at Indiana University. Lindesmith first occupied himself with the drug scene in the early thirties, bringing to his studies a Phi Beta Kappa background, a mixture of fine scholarship and articulateness, and a no-nonsense determination to observe carefully and talk about what he saw. Lindesmith's own books, Opiate Addiction (1947) and The Addict and the Law (1965), are landmark statements, while thanks to his good offices the Indiana University Press was for many years the main—and sometimes the only—publishing outlet for outspoken critics of official Narcotics Bureau dogma.
The first attack on Lindesmith came in 1939, shortly after his initial appearances in professional journals as a dissenter. A bureau agent went to members of the Indiana University Board of Trustees, and then to the president of the University, with a somber warning that Lindesmith was connected with a "criminal organization." Although he was then only a very junior faculty member, his president—in the happy atmosphere of those days where academic freedom was taken for granted—smartly dispatched the government man to face the young professor himself, whereupon it quickly came to light that the allegedly criminal organization was none other than the World Narcotics Research Foundation then being organized by Dr. E. H. Williams, whose own story we have just told, and that Lindesmith's "criminal association" consisted of exchanges of correspondence with the eminent Dr. Williams.
The following year, when Lindesmith published an article entitled "Dope Fiend Mythology," the Bureau responded with a twenty-seven-page answer, purportedly authored by a San Francisco judge but transparently scrabbled together from prior Bureau pronouncements. The latter work, entitled "Lindesmith's Mythology," was subsequently reproduced in great quantities by the Treasury Department at U.S. taxpayers' expense and handed out for years to discredit Lindesmith and as an authoritative statement of Bureau policy.
This second assault on the professor stirred unfavorable comment from observers whose connection with the press and public life could not be blinked. So he received another official visit, this time from a higher-ranking Bureau spokesman ( who will appear in person a few chapters hence) dispatched from Washington. Lindesmith was informed, by way of grudging apology, that the mission of the Narcotics Bureau was to make certain that only "right information" reached the public, and thus the Bureau was obliged to respond when anyone disseminated "one-sided" views.
And that is the full list, bringing us to the Honorable John M. Coffee, a member of Congress from the state of Washington who served five terms in the House, arriving as a freshman in 1937 at the time the Ratigan fight was reaching its climax in his home state. He deserves special attention in this narrative for four reasons: he came on the scene at the moment when someone should have picked up Dr. Ratigan's failing cause; he was serving, with increasing importance, precisely where the Bureau should have been called to account—in the Congress of the United States; what he undertook to do was so right, and his statements so faultlessly reasoned and presented, that no one has made a better case before or since; and his efforts, through the entire ten years of his incumbency, failed, incredibly, to pick up a single supporter.
Coffee was an able lawyer who had moved into politics through local offices in the city of Tacoma. He was a Democrat, so he belonged to the party which had firm control of both houses of Congress most of the time, but he got short shrift even from his own leadership.
His vehicle was a House Joint Resolution, first introduced in April 1938, calling for a review and evaluation of the narcotic-drug situation by the U.S. Public Health Service. Had this ever passed it would have turned medical authorities like Dr. Kolb loose to examine the policies of the Bureau, appraise their effects, and speak out freely with congressional protection. Had the resolution ever so much as reached the hearing stage, it might have provided a forum for both private and official critics of the Bureau to raise questions about its activities. But though reintroduced by Coffee in subsequent congresses, the measure never found a single parallel sponsor in the Senate and never survived being bottled up, year after year, in its reference committee.
Coffee's first line of attack, addressed to a nation just pulling out of the Great Depression, was economic. Quoting the American Association on Drug Addiction, an ad hoc organization which had sprung up in the Pacific Northwest to support Ratigan, he estimated that the annual cost of addiction to American taxpayers was $2,735,000,000, or approximately $80 per family. Said Coffee:
It is claimed that this is a needless burden imposed on the people, not by conditions inherent in the problem of drug addiction, -and not by the operation of law, but by the mistaken interpretations of law made by the Federal Narcotics Bureau. If this claim is justified, the Narcotics Bureau stands as the costliest Bureau or governmental department in the world, and the Commissioner of Narcotics ranks as far and away the costliest man in the world.
Brushing aside attempted bans on importation ( with the observation that preventing the smuggling of products of such small bulk must always encounter "obvious extreme difficulties"), Coffee then leveled his attack on the federal law:
In examining the Harrison Special Tax Act we are confronted with the anomaly of a law designed (as its name implies) to place a tax on certain drugs, and raise revenue thereby, resulting in reducing enormously the legitimate importation of the drugs in question, while developing a smuggling industry not before in existence. That, however, is only the beginning. Through operation of the law, as interpreted, there was developed also, as counterpart to the smuggling racket, the racket of dope peddling; in a word, the whole gigantic structure of the illicit-drug racket, with direct annual turn-over of upward of a billion dollars.
Incidental effects were the persecution of perhaps a million victims of the diseased condition known as drug addiction, the great majority of whom had been law-abiding, self-respecting, self-supporting citizens, but who now became human derelicts and were thrust by thousands into jails and prisons simply because they could not legally secure the medicine upon which depended their integrity of mind and body.
Good lawyer that he was ( and, happily, at this writing, is), Congressman Coffee stressed the full importance of the Supreme Court decisions, culminating in the Linder case, already described. The issue could not be framed better than this:
The Narcotics Bureau ignores these decisions and assumes authority to prevent physicians from even the attempt to cure narcotic addicts unless the patients are under forced confinement. The addicts number, by the very lowest estimate, at least 100,000. The institutions that will receive them as patients are almost non-existent. It follows that the prohibitory mandate of the Narcotics Bureau effectively denies treatment to the vast majority of narcotic addicts. It is believed that this is the first instance in all history of the denial of medical treatment to a class of citizens of whatever status or capacity. The fact that the Supreme Court has declared that narcotic addicts are diseased and proper subject for medical treatment makes the action of the Narcotics Bureau peculiarly paradoxical.
Further on the matter of involuntary treatment in incarceration, Coffee carried the argument as follows:
Addiction, once developed, is a very chronic condition. It is admitted by the authorities, including the narcotics commissioner, that very few "cures" result from incarceration for a 1-year period. It has been suggested that a 5-year segregation is the least that can be expected to restore the average addicts. The idea of incarcerating even a hundred thousand, let alone a million, unfortunates for a term of five years is rather startling—especially considering that they are sick people, for the most part of average respectability and moral status, not markedly handicapped by their infirmity.
The alternative he urged was simply to allow the Harrison Act to operate "as was designed," and to bring victims of drug addiction under medical supervision so they could be supplied with whatever medicine they might need, at slight cost, through legitimate channels:
Morphine which the peddler sells for a dollar a grain would be supplied, of pure quality, for 2 or 3 cents a grain. The peddler, unable to meet such a price, would go out of business—the illicit narcotic drug industry, the billion-dollar racket, would automatically cease to exist. . . . Almost as certain is it that the army of narcotics derelicts would be reduced to the vanishing point. Courts would cease to be crowded with delinquents who owe their downfall to the necessity of meeting the dope peddlers' exhorbitant demands. Jails would be emptied; Federal prisons would lose a quarter or a third of their population.
The Congressman concluded with a challenging question:
Why should persons in authority wish to keep the dope peddler in business and the illicit drug racket in possession of its billion-dollar income? It will be obvious, I think, that this is the really significant question at issue. . . . If we, the representatives of the people, are to continue to let our narcotics authorities conduct themselves in a manner tantamount to upholding and in effect supporting the billion-dollar drug racket, we should at least be able to explain to our constituents why we do so.
But as has already been noted, not a single colleague so much as acknowledged Coffee's efforts. None of the committees which should have been concerned ever called a hearing. And Narcotics Commissioner Anslinger, having the congressional situational so well in hand, made only oblique attacks on Coffee in Geneva, through the League of Nations. In 1939 when the Opium Information Committee passed a resolution calling for a worldwide review of legal and economic aspects of drug addiction, Anslinger took the opportunity to attack all such studies and to excoriate their proponents on the ground that drug addiction is a criminal condition, not an affliction, and that the addict must accordingly be treated as a criminal regardless of economic or social consequences, which should not be taken into consideration. Coffee responded:
The Commissioner holds persistently to his view in opposition to all recognized medical authorities and to the opinions of humanitarians in general. He has repeatedly characterized the narcotic addict as a major criminal of America. In support of this strange claim, the Commissioner advances a curious argument. He cites fingerprint records which show more recidivists among narcotic-law violators than among any other types of criminal. This, in his view, establishes the narcotic addict as the major criminal of the country.
If you accept this reasoning, the same table reveals vagrancy as the second major crime, with prostitution, drunkenness, and suspicion bracketed in the same category. . . . The valid interpretation of the table is not that the narcotic-law violator is a major criminal, in any proper sense of the word—the contrary being the fact accepted by all competent criminologists—but that addicts are arrested again and again for purchasing the drug that their infirmity makes essential to their well-being; and that dope peddlers violate the statutes with every sale.
In 1940 Coffee also challenged Anslinger on his official estimates of the addict population:
Reference should be made to another pronouncement of the Narcotics Bureau that is equally misleading and even more ridiculous. This is the assertion that the number of drug addicts in this country has been reduced to an astonishing degree in the past 15 years or so. This appraisal might be dismissed with the statement that no one else who is entitled to an opinion on the subject pretends to have any accurate knowledge as to how many addicts there were 15 years ago or how many there are now. Perhaps it is worthwhile, however, to examine the Commissioner's claims in brief detail, because he appears to regard the alleged reduction in the number of addicts as giving strong support to the methods of operation of his Bureau, which we have criticized—and which we continue to criticize.
Coffee addressed an inquiry to Dr. Lawrence Kolb, then Assistant Surgeon General, who we have already identified. Dr. Kolb responded by a letter written in February 1940 to which the Congressman referred as follows:
In this letter, Dr. Kolb quotes the estimate of the Bureau of Narcotics that there are 1.53 addicts per ten thousand of the population (or about 20,000 addicts in all), and adds that, whereas no survey available is absolutely reliable, "from the information we do have, I am inclined to believe that we still have at least 100,000 to the various opium preparations and cocaine." That would be at least five times the number estimated by the Narcotics Bureau. . . .
It is obvious that the Bureau's claim . . . has no standing in the eyes of the physician who, because of his long familiarity with the subject and his recent experience in charge of the Federal Narcotics Hospital at Lexington, Ky., may be regarded as the foremost authority in this particular field. . . . Suffice it that this flagrant misrepresentation is of a piece with other pronouncements —as to criminality of addicts, cures of addicts, and so forth—that have come from the Bureau.
Finally, Congressman Coffee attacked the Bureau position that addicts could only be benefited by incarceration. He pointed out that prisoner-patients reported to be "cured" upon their discharge were merely not taking drugs when released, "somewhat as a duck kept in a dry pen is not swimming." And this is a typical Coffee peroration:
Let me repeat that this legislative body has no direct concern with the question of curability of disease to which we have just adverted. What does concern us, however, is the fact that the United States Government in establishing the hospital at Lexington, and a second one at Ft. Worth, Texas, as authorized by action of the Congress, recognizes narcotic addiction as a disease, subject to medical treatment. It is perhaps immaterial, but not without interest, that the Supreme Court has explicitly voiced the same view; whereas the Commissioner of Narcotics holds stubbornly to the view that the addict is not a sick man, but a criminal, and by his ruling makes it impossible for the medical profession outside institutions to offer treatment or aid to victims of this officially recognized malady. . . .
Questions of the number of addicts, the criminality of addicts, the curability of addicts, are matters for the statistician, the Department of Justice, the medical profession. But the matter of flouting Federal law—the supplanting of statutes enacted by the Congress with rulings of a minor Bureau of the Treasury Department—is something of vital concern. That the edicts of one man should take precedence over congressional enactments and clear decisions of the Supreme Court is an anomaly worthy of attention.
But does this anomaly obtain? I answer, unqualifiedly, yes. That is the actual situation which has obtained throughout the ten years of the existence of the Bureau of Narcotics. One man, the Commissioner in charge of that Bureau, has persistently interpreted the Harrison Special Tax Act, the statute governing the distribution of narcotic drugs, in a way clearly at variance with the terms of the Act itself, and in defiance of the interpretation of the Supreme Court of the United States.
But that is all there was. To have been so forcefully and articulately right was not enough. Congressman Coffee's ten-year campaign against the Bureau received little attention from the general press, no support on Capitol Hill, and no acknowledgment in other quarters. He was defeated for re-election in 1946, and it was another full decade before anyone else on Capitol Hill cast so much as a quizzical eye upon the Anslinger empire.