HISTORY OF DRUG USE AND DRUG USERS IN THE UNITED STATES by Elaine Casey From Facts About Drug Abuse - Participant Manual - The National Drug Abuse Center for Training Resource and Development 656 Quince Orchard Road Room 607 Gaithersburg, Maryland, 20760 Publication No. 79-FADA-041P Printed: November, 1978 American opinion has always included some opposition to the non-medical use of any drug, including alcohol and tobacco. From colonial times through the Civil War, abstentionist outcries against alcohol and tobacco sporadically provoked prohibitory legislation. One 18th century pamphleteer advised against the use of any drink "which is liable to steal away a man's senses and render him foolish, irascible, uncontrollable and dangerous." Similarly, one nineteenth century observer attributed delirium tremens, perverted sexuality, impotency, insanity and cancer to the smoking and chewing of tobacco. Despite such warnings, alcohol and tobacco use took deep root in American society. De Tocqueville noted what hard drinkers the Americans were, and Dickens was compelled to report that "in all the public places of America, this filthy custom [tobacco chewing] is recognized." Nevertheless, the strain in our culture opposed to all non-medical drug use persisted (National Commission on Marihuana and Drug Abuse, 1972). INTRODUCTION All manner of substances have been used by Americans throughout our history. Colonial residents and their predecessors relied on derivatives of natural substances to cure ailments, increase sexual potency, relieve pain--and to provide pure old fashioned pleasure. Until the late 1800s, abstentionists and prohibitionists had a relatively easy task in identifying their targets for attack: Tobacco users were conspicuous in their enjoyment. Alcoholic beverage drinkers could be found in every saloon, and alcohol was served openly in homes and at social gatherings. Even opium dens of the west coast were well known, and opium could be purchased readily, free from state or federal government controls. Early prohibitionists may be the envy of the "anti-drug" movements of the twentieth century. Until the Controlled Substance Act was passed by Congress in 1970, anti-substance legislation was hard put to keep pace with (or even to categorize) the endless variety of natural substances and preparations, multisubstance compounds, synthetic derivatives and "improvements" upon the natural that were adopted by different subcultures in the search for a new high or an intensified religious experience. Physician-prescribed medications, once used for legitimate treatment, came into use as alternatives to "illicit" substances. Children inhaled glue and aerosols. Students, housewives, and truck drivers found a new way of life through consumption of prescribed and black-market sedatives and amphetamines. Even LSD was no longer just "acid." LSD-25 was joined by DMT, psyilocybin mushrooms, nutmeg, morning glory seeds, peyote, mescaline, animal tranquilizers (PCP), and sundry combination capsules and tablets, as descendents of the Haight-Ashbury counterculture looked for new hallucinogens not yet outlawed by state and federal legislatures. In short, the variety of twentieth century substances with potent for abuse confounded every abolitionist/prohibitionist effort. And the crazy-quilt patterns of new legislation reflected that confusion. The resourcefulness of those determined to get high was remarkable. When one hallucinogen was outlawed, another took its place. With law enforcement agencies concentrating on dealers of marihuana and hashish, and putting more energy into locating users and sources of heroin, the "weekend" alcohol drinker soon had an opportunity to try smoking marihuana, found that he liked it, and often substituted it for alcohol at social occasions. Younger Americans came to have increasingly easier access to "black market" marihuana, cocaine, prescription drugs, and animal tranquilizers. EARLY SUBSTANCE HABITS For Americans, the past 15-year period is not the first experience with a resourceful multi-drug culture. Our European forebears, fifteenth, sixteenth, and seventeenth century explorers, traders, and conquerors, were open to the pleasures and products of the new worlds. The European explorers from Columbus on found other [in addition to alcohol] mind-affecting drugs, and brought them with them. Tobacco was discovered on Columbus' first voyage. Cocaine was found in large areas of South America. Caffeine and LSD-like drugs were found scattered all over the world ... the Europeans not only adopted nicotine and caffeine but spread them everywhere. They also imported opium. In a remarkably short space of time, western Europe was converted from an alcohol-only culture to a multi-drug culture (Brecher, 1972). Tobacco was first introduced to Europeans by American Indians. Sailors tried and adopted the practice, both smoking the leaf and chewing it, and brought tobacco home to England. But where a habit could be found, a prohibitionist was not far behind. In 1575, the Catholic Church in Mexico passed a regulation forbidding smoking in church. In 1642 and 1650, Papal edicts against the use of tobacco were issued. The European states, Constantinople, Japan, and Russia all had anti-tobacco laws, but the practice continued against all opposition. Russia's Czar Michael Feodorovitch, first of the Romanoffs, in 1634 pronounced a penalty that tends toward overkill: "'Offenders are usually sentenced to slitting of the nostrils, the bastinado, or the knout,"' a visitor to Moscow reported. However, the visitor noted, tobacco was a premium commodity in Moscow, and smokers would pay any price for the precious leaf (Brecher 1972) Among other new habits the early explorers introduced into European culture were the many ways to enjoy caffeine: coffee from Arabia and Turkey; tea from China; the West African Kola nut, later used as a source of caffeine in cola drinks in nine teenth and twentieth century United States; drinks from the bean of Mexico's cocoa tree; Brazil's ilex plant, from which mate is brewed; and cassina, early used in a caffeine beverage by Indians living in the (now) Virginia to Florida region, and as far west along the Gulf coast as the Rio Grande. European settlers in America soon adopted the cassina plant to their own uses, preparing a tea they called "Black Drink," "Black Drought," or "dahoon," and later letting the leaves ferment to produce a brew containing both caffeine and alcohol (Brecher, 1972). Spanish conquerors of Mexico found peyote in ritual use by the Incas who also had the habit of chewing leaves from the Erythroxylon coca plant. The practice of coca leaf use was encouraged by Spanish rulers as a means of controlling the Indian natives; but the Europeans had strong doubts about the habit, and refrained from using it themselves. They did, however, try to curtail use of peyote and other indigenous herbal hallucinogens by the Aztecs, who had kept substance use as part of their religious practices since pre-Columbian times. Indian tribal use of peyote continued in spite of Spanish opposition, and the practice is still found in some areas today. Cannabis sativa, too, was available in the early days of the new world. This plant was not indigenous to the Americas, but brought to the area by the Spaniards, with cannabis first appearing in Chile, where the Spanish introduced it in 1545 (Brecher, 1972). The plant became a staple crop for colonial farmers, who reportedly grew it for its fiber. Along with tobacco, hemp became a major export crop for pre-Revolutionary American farmers. The Jamestown settlers [brought] the plant [cannabis] to Virqinia in 1611 and cultivated it for its fiber. Marihuana was introduced into New England in 1629. From then until after the Civil War, the marihuana plant was a major crop in North America, and played an important role in both colonial and national economic policy...George Washington was growing hemp lin 1765_7 at mount Vernon... presumably for its fiber, though it has been argued that Washington was also concerned to increase the medicinal or intoxicating potency of his marihuana plants (Brecher, 1972). In 1775, hemp culture was introduced into Kentucky and large hemp plantations flourished in Mississippi, Georgia, California, South Carolina, and Nebraska until well into the 1800s. For the majority, however, alcohol and tobacco were the popular American substances of habit until the Civil War era. For the minor "caffeine vice," residents in Confederate states returned to beverages made from cassina. Civil War blockades on southern ports curtailed imports of tea and coffee, so cassina drinks, abandoned since the "Black Drought" days of early settlers, became popular for the duration of the war.* OPIATES: THE NEW NINETEENTH CENTURY HABIT One of the first "exotic," non-indigenous substances to become a part of the nineteenth century culture was opium. Immigrant Chinese laborers building the trans-continental railroad migrated across the United States, bringing their opiumsmoking habit with them to the west. In the early to mid-1800s the practice was open and opium and its preparations were easily obtainable, subject to no controls or regulations. Also, the use of opium became fashionable among some of the Litepati in Europe, and their various letters and books extolle its virtues. Thomas DeQuincey's Confessions of an Opium Eatl-ep, published in 1822, received wide notice, giving heretofore naive readers some second-hand taste of the pleasures of the drug. ... I do not readily believe that any man, having once tasted the divine luxuries of opium, will afterwards descend to the gross and mortal enjoyments of alcohol. I take it for granted "That those eat now who never ate before, and those who always ate now eat the more."... What I contemplated in these Confessions was to emblazon the power of opium--not over bodily disease and pain, but over the grander and more shadowy world of dreams. *Similarly, when coffee prices rose substantially during and after World War I, Congress and the United States Department of Agriculture persuaded Americans to adopt temporarily cassina teas and soft drinks as a substitute caffeine source. ...A man who is inebriated, or tending to inebriation, is, and feels that he is, in a condition which calls up into supremacy the merely human, too often the brutal part of his nature; but the opium-eater... feels that the diviner part of his nature is paramount--that is, the moral affections are in a state of cloudless serenity, and high over all the great light of majestic intellect (DeQuincey, 1822). But DeQuincey's subsequent Miseries of Opium, detailing his own agonies of addiction, was generally ignored, as were the scattered medical warnings against habitual use of the substance. Opium and Medical Practices Use of opium was predominantly medicinal at this time, although in 1832 a physician wrote this summary of the drug's effects: "There is scarcely a disease in which opium may not, during some of its states, be brought to bear by the judicious physician with advantage." [But he cautioned against its indiscriminate use when other drugs are available:] "when it is thus used, it seldom fails to lay the foundation for a long train of morbid symptoms, which sooner or later terminate in all wretchedness, which disease is capable of inflicting. Yet, this drug is in use every day, particularly among the better circles of society, and the softer sex" (Levine, 1974). There was at this time a vigorous patent medicine industry growing in the United States, with widespread advertising of preparations containing large quantities of opium. These "medicines" claimed to cure just about anything from "nerves" to marital problems, but what they amounted to were a source of opium, uncut and available to anyone with the nominal price of a bottle of the elixir. Morphine: The Universal Cure Morphine was first separated from opium by European chemists in the early 1800s, and was found soon after in the United States, where it began to take the place of opium in patent medicines. Physicians believed the new opium derivative to be non-addicting, and hoped that it could actually cure opium addiction in patients. Doctors prescribed the new opiate often. Prevalent medical opinion held that the addiction process occurred in the individual's stomach, and that ingestion of an opiate was responsible for addiction. The hypodermic needle and syringe were introduced in 1850--greeted as a boon by physicians who hoped to use morphine injections to kill pain and believed that the injection process itself would eliminate the addiction problem (Levine, 1974). Morphine was used commonly as a pain killer during the Civil War. So large a number of soldiers became addicted as a result of the opiate given them for battle injuries that the post-war morphine addiction prevalent among veterans came to be known as "Soldier's Disease." Late in the 1800s, morphine was prescribed commonly as a sub- stitute for "alcohol addiction"; the practice continued until late in the 1930s. Dr. J. R. Black, in a paper entitled "Advantages of Substituting the Morphia Habit for the Incurably Alcoholic," published in the Cincinnati Lancet-Clinic in 1889, had the following praise for morphine in the alcoholic treatment regimen: [Morphine] "is less inimical to healthy life than alcohol... [It] calms in place of exciting the baser passions, and hence is less productive of acts of violence and crime; in short-the use of morphine in place of alcohol is but a choice of evils, and by far the lesser-On the score of economy the morphine habit is by far the better. The regular whisky drinker can be made content in his craving for stimulation, at least for quite a long time, on two or three grains of morphine a day, divided into appropriate portions, and given at regular intervals. If purchased by the drach at fifty cents this will last him twenty days" (Brecher, 1972). Women: The Opiate Addicts Throughout the late 1800s, the opiates (morphine and opium) continued to be distributed widely in patent medicines. There was also a widespread physicians' practice of prescribing opiates for menstrual and menopausal disorders. Too, there was extravagant advertising of the opiate patent medicines as able to relieve "female troubles." Women, it seemed, had become the prevalent class of opiate users. Prescription and patent medicines containing the substances were advertised and accepted without question. Also, this was a convenient, gentile drug for a dependent lady who would never be seen drinking in public. "The extent to which alcohol-drinking by women was frowned upon may also [in addition to opiate medicines] have contributed to the excess of women among opiate users. Husbands drank alcohol in the saloon; wives took opium at home" (Brecher, 1972). EARLY COCAINE USE Medical practice also helped contribute to a new class of cocaine users. In 1844, the alkaloid cocaine was first isolated in pure form from coca leaves. However, this discovery received little attention until 1883, when Dr. Theodor Aschenbrandt, a German army physician, issued a supply of pure cocaine to Bavarian soldiers during maneuvers. Dr. Aschenbrandt later reported positive results, including beneficial effects on the soldiers' ability to endure fatigue during battle-like conditions (Brecher, 1972). An Addicted Physician At about the same time in the United States, Dr. William Halsted (1852-1922), prominent surgeon and later one of the founders of the Johns Hopkins School of Medicine, discovered that cocaine injected near a nerve produces a local anesthesia in the area served by that nerve. The discoverer of the first local anesthetic continued to experiment with cocaine, and soon found himself dependent on cocaine use. His subsequent efforts to rid himself of the dependence led Dr. Halsted to "cure" his cocaine habit by switching to morphine injections. At one time, his habit was reported to be a quantity of 180 milligrams daily. Eventually, he reduced this to a maintenance dose of 90 milligrams, which continued for most of his life (Brecher, 1972). Freud and Cocaine In 1884, Sigmund Freud is reported to have experimented on himself with 50 milligrams of cocaine. He prescribed cocaine to relieve the pain of a chronically ill friend who was at that time addicted to morphine, and wrote glowing reports of the drug's success, even to the point of sending cocaine to his fiance to "make her more lively '.' In the July,1884, issue of the medical journal Centralblatt fur die gesammte Therapie, Freud published an essay praising cocaine as a "magical drug," and continued to use it periodically to relieve depression in himself (Brecher, 1972). In 1885, a German named Erlenmeyer published the first attacks on cocaine as a possibly addicting drug, and two years later Freud himself discontinued use and prescription of the drug, partially due to cocaine's harmful effects on the friend for whom he had originally prescribed it for pain (Brecher, 1972). Coca-Cola In 1885, John Styth Pemberton of Atlanta, Georgia, who had manufactured previously such patent medicines as Triplex Liver Pills and Globe of Flower Cough Syrup, introduced "French Wine Coca--Ideal Nerve and Tonic Stumulant." The product relied heavily on extract of coca leaves. The next year, Pemberton introduced a syrup called "Coca-Cola." The "Cola" in the name indicated the presence of an extract of the kola nut--an African product that contains about two percent caffeine. That year, Pemberton is said to have sold 25 gallons of the syrup. At various times it was advertised as "a remarkable therapeutic agent" and as a "sovereign remedy" for a long list of ailments, including melancholy and (curiously) insomnia (Brecher, 1972). (In 1906 a federal pure food and drug law was enacted, and Pemberton's successors, who were still making Coca-Cola, switched from using unadulterated coca leaves to decocainized leaves. The product still included caffeine, as it does today.) MARIHUANA AND HASHISH During the mid-1800s, cannabis sativa, whose use dates back to the second millenium B.C. in China, was considered a legitimate (and wholly licit) medication. From 1850 until 1942, the United States Pharmacopeia, which lists most widely-accepted drugs, recognized marihuana as a legitimate medicine, under the name "Extractum Cannabis." Too, the United States Dispensory in 1851 reported the use of hemp extract: "The complaints in which it has been specially recommended are neuralgia, gout, rheumatism, tetanus, hydrophobia, epidemic cholera, convulsions, chorea, hemorrhage" (Brecher, 1972). Limited non-medical use of cannabis, however, was reported in an 1869 issue of the Scientific American: "The drug hashish, the cannabis indica of the U.S. Pharmacopeia, the resinous product of hemp, grown in the East Indies and other parts of Asia, is used in those countries to a large extent for its intoxicating properties and is doubtless used in this country for the same purpose to a limited extent" (Brecher, 1972). Non-Medical Cannabis Use Use of cannabis products for recreation grew gradually. The December 2, 1876, issue of the Illustrated Police News featured a drawing of five exotically-attired young ladies supposedly indulging their "hasheesh" habit in a room where hookahs were conspicuous. The News captioned the drawing: "'Secret Dissipation of New York Belles: Interior of a Hasheesh Hell on Fifth Avenue"' (Brecher, 1972). Popular magazines and newspapers began to feature stories about the newly-discovered hashish users and their lurid habitats. The November, 1883, issue of Harper's New Monthly Magazine featured an article by an anonymous explorer of the "hasheesh dens": "There is a large community of hashish smokers in this city [New York], who are daily forced to indulge their morbid appetites, and I can take you to a house up-town where hemp is used in every conceivable form, and where the lights, sounds, odors, and surroundings are all arranged so as to intensify and enhance the effects ... [The hashish smokers] are about evenly divided between Americans and foreigners; indeed, the place is kept by a Greek, who has invested a great deal of money in it. All the visitors, both male and female, are of the better classes, and absolute secrecy is the rule. The house has been opened about two years, I believe, and the number of regular habitues is daily on the increase... Smokers from different cities, Boston, Philadelphia, Chicago, and especially New Orleans, tell me that each city has its hemp retreat, but none so elegant as this" (Brecher, 1972). A number of physicians reported ingesting hashish during this era--some for "experimental" purposes, others admitting frank curiosity, and occasionally supplying fluid extract of cannabis to their friends. Hashish candy, too, was available in post-Civil War sweet shops. Dr. George Wheelock Grover, in his book Shadows Lifted or Sunshine Restored in the Horizon of Human Lives: A Treatise on the Morphine, opium, Cocaine, Chloral and Hashish Habits, admitted purchasing a box of the candy in Baltimore. Determined to test the product on himself, Dr. Grover took "'a full dose ... (then the drug) manifested its peculiar witchery with scarcely prelude or warning"' (Brecher, 1972). At the time, he was dining with several friends, and felt compelled to tell them of the peculiar sense of well being which had come over him: 'It is undoubtedly here a day of jubilation or of something in the way of celebration. You perceive that the tables are set with golden plate, that the waiters all seem to be dressed in velvet costumes, and that hundreds of canary birds are singing in gilded cages. It must be a celebration of a good deal of magnitude, as the many bands of martial and orchestral music seem all to be playing at once" (Brecher, 1972). Cannabis, it seems, possessed considerably more useful properties than those first attributed to it in the early Pharmaco ,peia listing. However, the contemporary prohibitionist movement was focusing its attention on the opium problem, and left cannabis products and their users to themselves for the next several decades. EARLY ANTI-SUBSTANCE LEGISLATION In 1872, California passed the first anti-opium law. This held that "'the administration of laudunum, an opium preparation, or any other narcotic to any person with the intent thereby to facilitate the commission of a felony"' now constituted a felony (Levine, 1974). However, this first awkward attempt failed to control unlawful use of opium in the state. In 1881, the California legislature passed a law making it a misdemeanor to maintain a place where opium was sold, given away, or smoked. The bill applied only to commercial places, presumably the opium dens frequented by immigrant Chinese laborers and their fellow habitues. Smoking opium alone, or with friends in a private residence, was not covered by the legislation. The practice continued. In the same year, California became the first state to establish a separate bureau to enforce narcotic laws, and one of the first states to treat addicts. Connecticut, in 1874, became the first state to have a law whereby the "narcotic addict" was declared incompetent to attend to his personal affairs. The law required that he be committed to a state insane asylum for "medical care and treatment" until he was "cured" of his "addiction" (Levine, 1974). The Opium Prohibitions During the last quarter of the nineteenth century, the western states continued to pass legislation restricting use of opium. Nevada's 1877 law was the first actually to prohibit opium smoking; this made it illegal to sell or dispense opium without a physician's prescription, and prohibited the maintenance of any place used for smoking or otherwise "illegally using" opium. Other western states soon had similar laws, with most legislation directed at outlawing opium smoking, rather than curtailing use of other substances. Controlling Opiate and Cocaine Distribution In 1887, the Territory of Oregon passed the first comprehensive anti-substance law, providing: That licenses would be issued to physicians and pharmacists for sale of narcotics; that no person could sell, give away, or possess opium, "smoking opium," morphine, cocaine, or chloral hydrate, except by prescription of a licensed physician (Levine, 1974). Similar laws were adopted by other states, but with no uniformity as to which drugs were controlled, which controls were actually enforced, and the type of penalties to which offenders would be subject. In 1905, Connecticut passed a law whereby cocaine could be sold and possessed only with a physician's prescription; this remained in force until 1913, when the law was amended to include opium, morphine, and heroin. In general, early laws restricted or prohibited possession of opium derivatives and cocaine without considering whether the substances could have significant medical use. Laws were concerned with the manner in which drugs were to be sold, not with setting standards for determining their legitimate use by physicians. In their limited knowledge, doctors continued to prescribe opium derivatives for a variety of ailments. Many over-the-counter preparations containing quantities of morphine, heroin, and opium were still available to anyone complaining of an illness those opiates were believed able to cure. Peyote During the 1870s, American Indians had begun ritual use of peyote, as had the Aztecs before them. For the Comanches, Cheyennes, Arapahoes, and other tribes, the peyote cult was entirely religious, requiring total abstinence from alcohol-which, after being introduced to Indians by white settlers and soldiers, had become a substance of considerable abuse. White land speculators, desiring Indian tribal lands, united with Christian missionaries in seeking to have peyote outlawed (Brecher, 1972). In 1899, Oklahoma became the first state to outlaw peyote. The legislation was repealed in 1908, following the pattern of it's legal/it's illicit again peyote laws enacted by legislatures in several western states. In 1929, New Mexico outlawed peyote, but the law was rarely enforce As recently as 1959, that law was amended to permit ritual peyote use. A major factor in maintaining the legal status of peyote has been the Native American Church of North America, an organization that claims some 250,000 Indian members from tribes throughout the United States and Canada. In addition to successfully opposing Congressional action against peyote and securing the repeal of state laws, the Native American Church has succeeded in several states in having such laws declared unconstitutional as a violation of freedom of religion (Brecher, 1972). As ritual peyote use continued, mail-order companies were established to meet the demand, as with patent medicines.* In spite of erratic legislative attempts at control, an indigenous American herbal hallucinogen was gradually moving from tribal rituals into the culture at large. *Dried mescal buttons could be purchased, legally, for as little as $8.00 for 100 buttons, until as recently as the 1950s; and mail-order companies advertised freely in college newspapers and other publications during the late 1950s and early 1960s (Brecher, 1972). Heroin: The Last Legal Opiate Heroin, the newest opium derivative, was first produced commercially by Germany's Bayer Company in 1898. "It was widely advertised as being at least ten times as potent a painkiller as morphine with none of the addicting properties .... one claim was made that the use of heroin could and would cure opium and morphine addiction" (Levine, 1974). General opinion held that heroin was the ultimate cure for morphine and opium addiction, and physicians made use of heroin in treating varied ailments. It was not until 1925 that import of opium for the manufacture of heroin finally was banned in this country. The 1900s: Summary Throughout the nineteenth century, the United States continued as a multi-substance society. Frequent users of opium-derivative medications continued their habits. Cannabis smokers enjoyed their diversion with little harassment. And while other subcultures were finding other substances to use, opposition groups tried to keep pace. THE FIRST FEDERAL LEGISLATION While the medical community was prescribing heroin to cure fever and morphine/opium addiction alike, prohibitionists were finally succeeding in their battle against opium. The federal Pure Food and Drug Act was passed in 1906. Irrespective-of opposition by manufacturers of patent medicines, the Act required that medicines containing opiates, among other substances, must be so labeled. After the Act was passed, the manufacturers of Coca-Cola switched from using unprocessed coca leaves to decocainized leaves, but caffeine remained in the beverage.* *Currently, Maywood Chemical Company is the only United States firm licensed to import coca leaves; the majority of those are subjected to a decocainizing process before shipment to the CocaCola Bottling Company. Cocaine extracted by Maywood is sold to licensed chemical and pharmaceutical companies for manufacture of medical products. Subsequent amendments to the 1906 Pure Food and Drug Act required that the quantity of each drug contained be stated on medicine labels, and that drugs meet official standards of purity. Subsequent public service campaigns urging people not to use patent medicines containing opiates "...no doubt helped curb the making of new addicts. Indeed, there is evidence of a modest decline in opiate addiction from the peak in the 1890s until 1914" (Brecher, 1972). THE HARRISON NARCOTIC ACT The federal Harrison Narcotic Act was passed in 1914. Official title of the Harrison bill had been "An Act to provide for the registration of, with collectors of internal revenuer and to impose a special tax upon all persons who produce, import, manufacture, compound, deal in, dispense, sell, distribute, or give away opium or coca Leaves,* their salts, derivatives or preparations, and for other purposes." The law specifically provided that manufacturers, importers, pharmacists, and physicians prescribing narcotics should be licensed to do so, at a moderate fee. The patent-medicine manufacturers were exempted even from the licensing and tax provisions, provided that they limited themselves to "preparations and remedies which do not contain more than two grains of opium, or more than one-fourth of a grain of morphine, or more than one-eighth of a grain of heroin... in one avoirdupois ounce." Far from appearing to be a prohibition law, the Harrison Narcotic Act on its face was merely a law for the orderly marketing of opium, morphine, heroin, and other drugs--in small quantities on a physician's prescription. Indeed, the right of a physician to prescribe was spelled out in apparently unambiguous terms: "Nothing contained in this section shall apply ... to the dispensing or distribution of any of the aforesaid drugs to a patient by a physician, dentist, or veterinary surgeon registered under this Act in the course of his professional practice only." Registered physicians were required only to keep records of drugs dispensed or prescribed. It is unlikely that a single legislator realized in 1914 that the law Congress was passing would later be deemed a prohibition law. ...After passage of the law, this clause ["in the course of his professional practice only"] was interpreted by law-enforcement officers to mean that a doctor could not prescribe opiates to an addict to maintain his addiction. Since addiction was not a disease, the argument went, an addict was not a patient, and opiates dispensed to or prescribed for him by a physician were therefore not being supplied "in the course of his professional practice." Thus a law apparently intended to ensure the orderly marketing of narcotics was converted into a law prohibiting the supplying of narcotics to addicts, even on a physician's prescription. Many physicians were arrested under this interpretation, and some were convicted and imprisoned. Even those who escaped conviction had their careers ruined by the publicity. The medical profession quickly learned that to supply opiates to addicts was to court disaster (Brecher, 1972). For all purposes, opium and cocaine could no longer be gotten legally, in quantity, by the user on the street. As licit sources became more controlled, new illicit channels opened to supply users. Use of "narcotics" (the true opium derivatives, and also cocaine, mistakenly labeled a narcotic by Congress in the 1914 act) continued at relatively the same level as prior to the Act's passage. By fixing severe limits on the amount of opiate a patent medicine could contain, and by otherwise prohibiting the traffic in opiates except for medicinal purposes, the [Harrison Act] abolished the legitimate traffic. When the Supreme count ruled in the early 1920s that prescriptions for addictions were not legitimately medical practice, the interpretation meant simply that addiction thereby became a federal crime ... The court thus lowered narcotics use into the underworld, forcing addicts to migrate to the urban centers of illicit supply. It also forced formerly decent and responsible citizens who had acquired an unfortunate habit to become aggressive and violent criminals. It made addicts conform to the image of nonscience; as they robbed or cheated or prostituted themselves to support the illicit price, they did indeed become debauched, corrupt, and depraved. In 1923, as many as 75 percent of the women in federal penitentiaries were Harrison Act prisoners (Clark, 1976). In 1918, just three years after the Harrison Act went into effect, a study by a Congressional committee (which members included Dr. A. G. Du Mez, Secretary of the United States Public Health Service) released these findings: o Opium and other narcotic drugs [including cocaine] ... were being used by about a million people.  The "underground" traffic in narcotic drugs was about equal to the legitimate medical traffic.  The "dope peddlers" appeared to have established a national organization, smuggling the drugs in through seaports or across the Canadian or Mexican borders ...  The wrongful use of narcotic drugs had increased since passage of the Harrison Act. Twenty cities, including New York and San Francisco, had reported such increases (Brecher, 1972). As a result of those findings, Congress responded with measures to strengthen the Harrison Act. In 1924, a law was enacted prohibiting importation of heroin for any purpose, including medical use. Still, the nation was finding that ridding itself of heroin would require considerably more than legislation. "The 1924 ban on heroin did not deter the conversion of morphine addicts to heroin. On the contrary, heroin ousted morphine almost completely from the black market after the law was passed" (Brecher, 1972). PROHIBITION(S) IN THE EARLY TWENTIETH CENTURY The opiates and cocaine were not the only targets of the early twentieth century prohibitionists. Alcohol and tobacco, traditionally respectable American habits, were beginning to feel the abolitionists'attacks. Tobacco Until the first decade of the twentieth century, tobacco use was usually confined to smoking in pipes and cigars, chewing, and inhaling snuff. Cigarettes as we know them today began to appear in the late nineteenth century, gaining wide popularity some twenty years later. The new cigarettes were made of a mild, Virginia tobacco; they were smaller, paper-wrapped,and generally more attractive to more people, especially women. People tried them, liked them, adopted the habit. This new fondness, aided by public outcries against the foul cuspidor, helped confirm Americans in the tobacco-smoking habit. The explosive increase in cigarette smoking after 1910 can...be attributed in part to the public-health campaigns of that era against the chewing of tobacco and its inevitable accompaniment, the cuspidor. The sputum of tobacco chewers, according to repeated public-health warnings, spreads tuberculosis and perhaps other diseases. Most of those who gave up tobacco chewing no doubt turned instead to cigarette smoking. The ashtray replaced the cuspidor, and lung cancer replaced tuberculosis as the major lung disease (Brecher, 1972). Anti-cigarette leagues flourished. Patterning their efforts on the anti-saloon leagues then lobbying throughout the country, tobacco prohibitionists had some measure of success. By 1921, the year after alcohol prohibition, 14 states had laws prohibitin cigarettes, and 92 anti-cigarette bills were under consioeration in 28 more state legislatures (Brecher, 1972). But people continued to smoke, and the last statewide cigarette prohibition law was repealed in 1927. Only laws concerned with cigarette sales to minors were retained. Not only did most states prohibit sale of cigarettes to minors, they also set penalties sometimes so severe as to make the whole tobacco prohibition approach a source of ridicule for the decades of the future. A Florida law made it illegal for anyone under the age of twenty-one to smoke cigarettes. It was also illegal in Florida to provide anyone under 21 with a cigarette, a cigarette wrapper, or a substitute; a twenty-year-old caught in possession of a cigarette could be hauled into court and compelled to testify concerning its source... In Maine an offer to sell cigarettes to a minor was punishable...Xn Massachusetts snuff and cigars were forbidden to young people under sixteen; the ban against cigarettes continued until eighteen...In Pennsylvania, a minor who refused to divulge the source of cigarettes or cigarette paper could be fined, imprisoned, or certified to the juvenile court; refusal to serve as an informer against his cigarette supplier also made a child a criminal in South Carolina. These laws led, of course, to ridicule and contempt on the part of law-defying young people (Brecher, 1972). Alcohol The second decade of the twentieth century marked the culmination of alcohol prohibitionist efforts. During the previous two centuries, abstentionists had been gathering supporters, and by 1900, they were a force to be reckoned with. The Woments Christian Temperance Union, anti-saloon leagues, and allied anti-alcohol crusaders convinced America that her downfall lay in continued use of alcohol. The Eighteenth or "Prohibition" Amendment passed both houses of Congress in December 1917, and was ratified by three-fourths of the 48 state legislatures 13 months later. From 1920 until 1933, the manufacture, sale, and consumption of alcohol was prohibited in the United States. As with tobacco, the opiates, and cocaine, legislation failed to create a general climate of abstention. And where there was a populace of willing consumers, supply was still able to keep pace with demand. Alcohol remained available during Prohibition. People still got drunk, still became alcoholics, still suffered delirium tremens. Drunken drivers remained a frequent menace on the highways... The courts, jails, hospitals, and mental hospitals were still filled with drunks... Instead of consuming alcoholic beverages manufactured under the safeguards of state and federal standards ... people now drank "rotgut," some of it adulterated, some of it contaminated. The use of methyl alcohol, a poison, because ethyl alcohol was unavailable or too costly, led to blindness and death; "ginger jake,11 an adulterant found in bootleg beverages, produced paralysis and death. The disreputable saloon was replaced by the even less savory speakeasy. There was a shift from relatively mild light wines and beers to hard liquors--less bulky and therefore less hazardous to manufacture, transport, and sell on the black market. Young people--and especially respectable young women, who rarely got drunk in public before 1920--now staggered out of speakeasies and reeled down the streets. There were legal closing hours for saloons; the speakeasies stayed open night and day. organized crime syndicates took control of alcohol distribution, establishing power bases that (it is alleged) still survive. Marihuana, a drug previously little used in the United States, was first popularized during the period of alcohol Prohibition ... and ether was also imbibed (Brecher, 1972). In spite of vigorous federal efforts to enforce the Eighteenth Amendment, the alcohol prohibition concept proved unenforceable. Americans and their European forebears had been drinking for centuries and were not ready to stop. The Twentieth Amendment repealing prohibition passed Congress in February 1933. It was ratified by the requisite number of states in less than ten months. The Twenty-first Amendment returned to individual states the power to retain statewide alcohol prohibition, and made it a federal offense to ship alcoholic beverages into a dry state. But the states, too, had learned how impossible it was to keep citizens from drinking. One by one, each repealed its local anti-alcohol legislation, with Mississippi the last state to surrender--in 1966. Prohibitionists had little difficulty in finding a new substance to oppose. America had returned alcohol to stores and taverns. So be it. If Americans chose to destroy their bodies and pickle their livers by consuming alcohol--let them. But a new evil had begun to gain popularity during the alcohol prohibition era, and the country had to be protected from this newest path to degradation. Marihuana During the years of alcohol prohibition, marihuana use had gained in popularity. [In New York City] marihuana "tea pads" were established about 1920. They resembled opium dens or speakeasies except that prices were very low; a man could get high for a quarter on marihuana smoked in the pad, or for even less if he bought the marihuana at the door and took it away to smoke. Most of the marihuana, it was said, was harvested from supplies growing wild on Staten Island or in New Jersey and other nearby states; marihuana and hashish imported from North Africa were more potent and cost more. These tea pads were tolerated by the city, much as alcohol speakeasies were tolerated. By the 1930s there were said to be 500 of them in New York City alone (Brecher, 1972). In 1926, two New Orleans newspapers, the item and morning Tribune, published a series of "exposes" of the marihuana menace. The papers reported that sailors from Cuba and the South American countries were importing large quantities of cannabis into New Orleans, and that marihuana smoking had become widespread, even among children "'The Waif's Home, at this time was reputedly full of children, both white and colored, who had been brought in under the influence of the drug. Marihuana cigarettes could be bought almost as readily as sandwiches"' Brecher, 1972. In 1927, Louisiana passed a law providing for a $500 fine or six months' imprisonment for sale or possession of marihuana. Numerous arrests and a subsequent curbing of imports resulted but, as with alcohol, use continued. Resourceful Louisiana residents stopped buying retail and started growing their own. The first large growing crop in the city [New Orleans] was found in 1930 and its value estimated at $35,000 to $50,000 ... One 1936 about 1,200 pounds of bulk weed were seized along with considerable quantities of cigarettes. On one farm, 5 1/2 tons were destroyed and other farms yielded cultivated areas of about 10 acres ... one resident of the city was found growing 100 large plants in his backyard" (Brecher, 1972). As with alcohol prohibition, the determination of users to continue use of a substance subverted the efforts of law enforcement officials to put a stop to the practice. However, marihuana prohibitionists continued their campaign. In 1929, Colorado passed anti-marihuana legislation, likely aimed at curtailing the habits of Mexican laborers who, being imported to work in the state's beet sugar fields, brought cannabis supplies north with them (Brecher, 1972). The federal government soon adopted an anti-marihuana posture. On January 1, 1932, the Treasury Department's newly-formed Federal Bureau of Narcotics took over enforcement of federal anti-opiate and anti-cocaine laws. The fact that the Bureau had no actual legal jurisdiction over marihuana failed to deter Commissioner Harry J. Anslinger from lobbying to include cannabis in future federal legislation. Shortly after Commissioner Anslinger's appointment, the National Conference of Commissioners on Uniform Drug Laws submitted a draft of a "Uniform Anti-Narcotics Act" which the Conference suggested for adoption by individual state legislatures. In actuality, the text of the model law did not mention inclusion of a ban on marihuana, but did offer states an optional supplementary provision restricting traffic in "Indian hemp" (Brecher, 1972). By 1937, the District of Columbia and 46 states had adopted some form of legislation against marihuana. In most of those states, marihuana was subject to the same rigorous penalties applicable to morphine, heroin, and cocaine, and was often erroneously designated a narcotic" (Brecher, 1972). Encouraged by the zeal of Anslinger and his colleagues, newspapers and magazines gave marihuana scare stories front page coverage. One horror tale appearing in the July 1937 issue of American Magazine (and co-authored by Commissioner Anslinger and Courtney Ryley Cooper) described this atrocity: "An entire family was murdered by a youthful [marihuana] addict in Florida. When officers arrived at the home they found the youth staggering about in a human slaughterhouse. With an ax he had killed his father, mother, two brothers, and a sister. He seemed to be in a daze ... He had no recollection of having committed the multiple crime. The officers knew him ordinarily as a sane, rather quiet young man; now he was pitifully crazed. They sought the reason. The boy said he had been in the habit of smoking something with youthful friends called 'muggles,' a childish name for marihuana" (Brecher, 1972). Commissioner Anslinger was not satisfied. Reacting in large part to his vigorous lobbying efforts, Treasury Department officials submitted to Congress a proposal which was eventually passed as the Marihuana Tax Act of 1937. The Act did not actually ban marihuana but, like the Harrison Narcotic Act of 1914, did recognize the potential medical uses of the substance, while imposing a tax on those involved in distribution. members of the medical community, including physicians, dentists, veterinarians, were required to pay a licensing fee of $1.00 per year, which granted them the right to prescribe cannabis to patients. Druggists dispensing the substance would pay a $15.00 annual licensing fee, with marihuana growers taxed at $25.00 per year, and importers, manufacturers, and compounders required to pay $50.00 annually to continue in business. Only nonmedical and untaxed sale or possession of the substance was made illicit. At this time, the only patent medicine use for cannabis was in preparations of corn plasters or corn removers. In general, manufacturers elected not to register under the tax, and stopped including the substance in their formulae. SCARE TACTICS AND TIGHTER LAWS At the same time the Marihuana Tax Law was passed, Congress also approved a schedule of increased penalties for second, third, and subsequent offenses against existing "narcotic" laws. Penalties to previous offenders for selling, importing, or exporting narcotics were a maximum of 20 years in prison or $10,000 in fines (Levine, 1974). In 1939, the federal government again tightened restrictions via a vehicle seizure law, which provided for confiscation of any vehicles used to transport illicit drugs in violation of federal laws. Marihuana Narcotic prohibition was on the rise and cannabis was included with the opiates and cocaine in anti-substance legislation. Since 1937, restrictive legislation on marihuana has increased in quantity and severity. Most state marihuana laws specified that marihuana penalties should be the same as heroin penalties. Thus, as heroin penalties were escalated through the decades, marihuana penalties rose automatically. Nineteen states, moreover, made no distinction between mere possession of one marihuana cigarette and the sale of large quantities of heroin. Under both federal law and the laws of many states ... the giving or furnishing of a narcotic drug or of marihuana was included in the definition of "sale" (Brecher, 1972). State legislatures did not take lightly the threat of multiple ax murders by crazed marihuana smokers. Evils of the opiates had been publicized widely. Physicians and laymen alike warned the public of the curse of "addiction." Marihuana was less well known than the opiates, but that didn't mean it was less deadly. The states were taking no chances. As recently as 1970, these state penalties were in force: In Georgia, sale of marihuana to a minor was punishable by life imprisonment, even if it was a first offense... A second such offense was punishable by death... · In Illinois, the penalty for a first-sale offense was not less than ten years and as much as life. A mandatory life sentence was in effect for a second-sale offense. These penalties remained in effect after a 1968 amendment to the law reduced the penalties for possession of-small amounts. In Louisiana, anyone over twenty-one years of age possessin marihuana was subject to a mandatory minimum sentence of five years at hard labor for a first offense ... An adult selling marihuana to another adult was subject to a minimum mandatory sentence of ten years at hard labor and a maximum sentence of thirty years at hard labor and could draw a death sentence. No suspended sentence or probation was permitted for any sale offenses or for second-possession offenses. · In Massachusetts, it was a felony punishable by not more than five years in prison to be in a place where marihuana was kept or deposited, or to be in the company of anyone known to be in illegal possession of marihuana. · In Missouri, the judge could hand down a life sentence for a second-possession offense or a first-sale offense ...If the buyer were a minor, a death sentence was possible for a first-sale offense... · In Utah a life sentence was possible for a first marihuana sale offense or for a second possession-with-intent-tosell offense (Brecher, 1972). The federal government, too, was determined to protect citizens from recreational use of the hemp plant. In 1951, fixed mandatory minimum sentences were established for all marihuana (now classified with the "narcotics") offenses. In 1956, mandatory federal penalty minimums were raised: At least two years for first-term possession; five years for secondoffense possession (with no parole, probation, suspended sentence possible); five years, minimum, for first offense sale; and ten years for second sale offense. Under this law, penalties were identical with respect to marihuana and opiates. Controlling the Opiates The 1956 Narcotic Control Act was not restricted to marihuana controls. It also augmented previous regulations regarding the opiates. In 1942, a federal opium poppy control act had required a license for anyone growing opium poppies within the United States, and a 1944 synthetic opiates law had included isonipecaine (Demerol(D) under previous classifications and definitions of narcotic drugs. In 1946, legislation controlling other synthetic drugs went into effect. This defined a new comprehensive class of drugs, the to opiates," which has since been expanded to deal with a number of synthetic substances, including methadone, under narcotic control laws. For purposes of this particular act, "opiates" were defined as "any drugs found by the Secretary of the Treasury, after due notice and opportunity for public hearings, to have an addiction-forming or addiction-sustaining liability similar to morphine or cocaine." In addition to the mandatory minimum marihuana/narcotic penalties discussed previously, the 1956 Narcotic Control Act also placed travel restrictions on "narcotic addicts." Anyone convicted of violating a state or federal law related to marihuana or narcotics, for which the penalty was more than one year's imprisonment, could neither leave from nor enter the United States unless he registered with U.S. Customs. The act also provided for surrender of all existing heroin to the federal government (actual import of opium for heroin manufacturing had been banned in 1924), irrespective of whether that he-roin had been manufactured prior to 1924. With the 1956 Narcotic Control Act in force, prohibitionists should have been able to rest. But again Americans were finding new drugs to use and to domesticate. While the abolitionists had been warring against opium derivatives, alcohol, marihuana, and synthetic opiates, other members of the culture were adopting new, licit substances to take the place of those that were being made illicit. BARBITURATES AND AMPHETAMINES Gradually, barbiturates and amphetamines became a part of American life. During the nineteenth century, opiates had been used frequently for their sedative benefits. However, these were soon found to be addictive and physicians often prescribed bromide salts as an alternative. Bromides, however, never gained great popularity, largely due to the risk of chronic bromide poisoning. Until the first years of the twentieth century, physicians continued to prescribe alcohol (against all threats from temperance unions) as the most common sedative (Brecher, 1972). Barbiturates In 1903 ' barbital, a derivative of barbituric acid, came into medical use as a tranquilizer and sedative. Trade name for the product was Veronal(R Nine years later, LuminalO (phenobarbital) came on the market. Apparently, a great many Americans had trouble sleeping. Demand for the new sedatives increased with alarming speed, and the laboratories were hard pressed to make supply meet demand. More than 2,500 other barbiturates were subsequently synthesized, and some 50 of them were accepted for medical use--as sedatives, as sleeping pills, and for other purposes. Long-acting barbiturates were developed for daytime sedation; short-acting barbiturates followed for prompt sedation and for inducing sleep without delay ... the end of the 1930s an estimated bMion grains [of barbiturates] were being taken each year in the United States alone (Brecher, 1972). As with substances before them, the barbiturates were subject to increasing non-medical "abuse." In 1942, a magazine called Hygeia (later re-named Today's Health), published by the American Medical Association, ran the first article warning against use of barbiturates except by people under a physician's care. ' That article, titled "1,250,000,000 Doses a Year," was followed by a 1945 Hygeia feature called "Waco Was a Barbiturate Hotspot." Collier's followed with it's April,1949.,article, "Thrill Pills Can Ruin You." The scare was on. Barbiturates, once represented as medicallysafe sedative/tranquilizers, had become "thrill pills." Sleeping pills had a new image. They were a new high, a new drunk--and the scare was on. Agents of the United States Food and Drug Administration worked to cut down available supplies of non-prescription barbiturates. States passed laws. Citizens were arrested. Headlines ensued. And a black market developed. Warnings and scare tactics had literally created the "thrill pill" reputation and the American public was firmly convinced it could become more than calm by taking barbiturates. One medical result of the barbiturate panic was a trend toward prescrilainq non-bar_biturate datives and sleeping pills (i.e., DoridenqO, Placidyl(@, NoludaA in increasing quantities. Too, the "minor tranquilizers" came to be used with greater frequency. The first of these was meprobamate (marketed as Miltown(S)) and followed by chlordiazepoxide (Librium and diazepam (Valiulrg@The "minor tranquilizers," particularly, have since gained a reputation as substances of common use and physicians prescribe them for everything from pre-vacation jitters to post-auto accident muscle spasms. Amphetamines Amphetamines were first synthesized in 1887, but little use for them was found until 1927, when laboratory experiments discovered their usefulness in raising blood pressure and stimulating the central nervous system. During the later part of the 1930s, amphetamines were used to treat both narcolepsy and, curiously, hyperactive children. During World War II, army physicians issued amphetamines to American, British, German, and Japanese armed forces for alleviation of battle fatigue (as cocaine had earlier been used for Bavarian soldiers). Following the war, physicians routinely prescribed amphetamines for depression. During the Korean War era, the earliest intravenous use of amphetamines by United States servicemen was reported. Some soldiers stationed in Korea and Japan during the early 1950s had the habit of mixing heroin with amphetamine and injecting the combination (Brecher, 1972). (This was a variation of the traditional "speedball," which combined heroin and cocaine.) A number of returning service men brought the custom back to the United States. During the late 1950s, some San Francisco area physicians prescribed amphetamine injections as treatment for heroin addiction, often using Methedrine@. Availability increased. As recently as 1960, it was reportedly common practice in the San Francisco area for injectable amphetamines to be sold without prescription, or via forged prescriptions. Such practices eventually became known, and the resultant scandals during 1962 and 1963 caused the bulk of injectable amphetamines to be withdrawn from pharmacy shelves. With injectable amphetamines available legally only to hospitals, the inevitable black market suppliers appeared. "Speed" went underground and illicit laboratories specializing in the amphetamine business were reported in the San Francisco area as early as 1962 (Brecher, 1972). THE 1960s: HALLUCINOGENS Amphetamines were not the only chemicals being channeled from the laboratory to the streets. LSD-25 In 1938, Drs. Albert Hofmann and W. A. Stoll of Sandoz Laboratories in Basel, Switzerland, discovered the ergot derivative d-lysergic acid diethylamide. Since this was the twenty-fifth lysergic compound the scientists had discovered, they called the substance LSD-25. When initial testing on animals showed no interesting properties of the drug, the substance was put away for the next five years. In 1943, Dr. Hofmann took the first acid trip. On April 16, 1943, Dr. Albert Hofmann ... was working in his lab at Sandoz... was working with the derivatives of ergot, a fungus that grows on grains. Sandoz had successfully marketed ergot derivative for use in obstetrics and in treating migraine headaches. Midway through Friday afternoon Hofmann decided to go home. He felt restless and dizzy. At home, "I lay down and immediately fell into a peculiar state similar to a drunkenness, characterized by an exaggerated imagination. With my eyes closed, fantastic pictures of extraordinary plasticity and intensive color seemed to surge towards me. After about two hours this condition disappeared."... Hofmann went back to the lab the next week and took what he thought was a very small amount of his new chemical. He began taking notes: "mild dizziness ... inability to concentrate ... uncontrollable laughter." Because of the war there were no cars, so Hofmann got on his bicycle to ride the four miles home, probably the last time anybody has tried to ride a bicycle four miles on LSD. "My field vision swayed before me and was distorted like the reflections in an amusement park mirror. The faces of those around me appeared as grostesque, colored masks; marked motoric unrest.' He also had "a clear recognition of my condition, in which state I shouted half insanely or babbled incoherent words. Sounds were transposed into visual sensations so that from each tone or noise a comparable colored picture was evoked, changing in form and color kaleidoscopically." That was the second acid trip. Sandoz sent the new drug off to the University of lurich, and Hofmann's associate, W. A. Stoll, wrote up the results of the testing. LSD was not toxic and was not addicting, but an extremely small dosage had profound results. Most drugs are measured in milligrams, or thousandths of a gram; LSD was measured in micrograms, or millionths of a gram. Five grains, an aspirin-sized tablet, could produce effects in 3,000 people. The United States Army began to stockpile LSD. Therapists around the world began to use it with patients. it allowed, they said, repressed memories to come forth, and the material that came up could be better understood because it took the form of visual symbols. Yet, with all the imagery, the patient kept a state of awareness, and retained his insights after the experience. Originally, LSD was called a hallucinogen, that is, an agent that causes hallucination. But the LSD ingester was not quite like, for example, an alcoholic with delirium tremens, who sees snakes and green elephants. The alcoholic thinks the snakes and green elephants are real; the LSD subject "does not ordinarily accept them as real. He remains aware that what he is experiencing is a drug-induced phenomenon." So LSD was not a hallucinogen. Dr. Humphrey Osmond, one of the first psychiatrists to use the drug, called it psychedelic, mind-manifesting or mind-expanding... and he hoped LSD would be an aid to curing schizophrenia in his Saskatchewan hospital (Smith, 1975). Research During the next two decades, LSD-25 was tested as a possible cure or treatment aide for a variety of medical conditions. The Maryland Psychiatric Research Center, among other facilities, had success in using the drug for treating chronic alcoholics. The Cook County Hospital in Chicago and Sinai Hospital in Baltimore reported good results when using LSD to treat pain in terminal cancer patients (Smith, 1975). In 1950, Drs. Anthony K. Busch and Warren C. Johnson published the first report on the use of LSD in psychotherapy treatment. The doctors, after using the drug on 21 hospitalized psychotic patients, offered the conclusion that LSD-25 was a promising means of dealing with chronically-withdrawn patients, and that it might serve as a method for shortening the duration of psychotherapy treatment in general. In Poland, Dr. M. Rostafinski used the drug to treat a small group of epileptic patients. In the United States, Dr. Charles Savage reported a particular lack of success in using LSD to treat 15 patients suffering from depression. In 1954, a German physician named Federking proposed that LSD was more effective than mescaline in treating neurotic patients "refractory to psychotherapy" (Brecher, 1972). International research continued. Hallucinogens: One Author's Trip In The Doors of Perception and Heaven and Hell, published in the early 1950s, Aldous Huxley described some of his experiences with hallucinogens. Following is his account of one day's diversion with mescaline. Most takers of mescaline experience only the heavenly part of schizophrenia. The drug brinqs hell and purgatory only to those who have had a recent case of jaundice, or who suffer from periodical depressions or a chronic anxiety...But the reasonably healthy person knows in advance that-mescaline is completely innocuous, that its effects will pass off after eight or ten hours, leaving no hangover and consequently no craving for a renewal of the dose... We walked out into the street. A large pale blue automobile was standing at the curb. At the sight of it, I was suddenly overcome by enormous merriment. What complacency, what an absurd self-satisfaction beamed from those bulging surfaces of glossiest enamel! Man had created the thing in his own image--or rather in the image of his favorite character in fiction. laughed till the tears ran down my cheeks. We reentered the house. A meal had been prepared. Somebody, who was not yet identical with myself, fell to with ravenous appetite. From a considerable distance and without much interest, I looked on. When the meal had been eaten, we got into the car and went for a drive. The effects of the mescaline were already on the decline: but the flowers in the gardens still trembled on the brink of being supernatural, the pepper trees and carobs along the side streets still manifestly belonged to some sacred grove...And then, abruptly, we were at an intersection, waiting to cross Sunset Boulevard. Before us the cars were rolling by in a steady stream--thousands of them, all bright and shiny like an advertiser's dream and each more ludicrous than the last. Once again I was convulsed with laughter... The Red Sea of traffic parted... An hour later-we were back at home, and I had returned to that reassuring but profoundly unsatisfactory state known as "being in one's right mind" (1954). Legislation: Hallucinogens Prior to 1962, almost all the LSD-25 and psilocybin available in the United States and Canada was produced by Switzerland's Sandoz Laboratories. The chemicals could be purchased, legally, by physicians, psychiatrists, psychologists, and other mental-health professionals who could certify legitimate use for the substances, The only major restriction was a United States Food and Drug Administration label on each LSD container: "Caution: New drug--limited by federal law to investigational use." During 1962 and the years immediately following, the Food and Drug Administration issued more stringent regulations pertaining to investigational new drugs (IND), including LSD-25. In consequence, many states passed legislation outlawing LSD and a new federal law further restricting use of investigational drugs, including LSD, went into effect. Sandoz virtually curtailed production of LSD-25. However, the formula for making LSD could be gotten from the U.S. Patent Office for fifty cents, and precursor chemicals were still relatively easy to acquire. Underground laboratories began production. Far from limiting seriously the availability of LSD, the new federal regulations only served to give the drug wider publicity. Both supply of and demand for "acid" were higher than ever before. The Sixties took over, the psychedelics became a subcult, the partisans said it brought Utopia, the antagonists said it brought the plague; LSD became a terror symbol, which made it attractive to children who... knew that the Establishment and the law and their parents were all lying. "The anti-LSD publicity, the scare campaigns, and the laws," said Consumer Reports, "helped to convert what had been (for twenty years) a relatively unknown and innocuous drug into a quite damaging one." ... The laws were passed, the police were alerted, raids began, the generation gap widened, and the epidemic spread (Smith, 1975). LSD and Soci2lz Two men who helped spread the epidemic and widen the cultural gap were Drs. Timothy Leary and Richard Alpert, instructors at Harvard University's Center for Research in Human Personality. During the summer of 1960, Leary had tried the Mexican psilocybin mushroom--and liked what he found. He and Alpert began experimental work with LSD and synthetic psilocybin--which, by the way, was first synthesized by Sandoz's Dr. Hofmann, some 15 years after his psychedelic bicycle ride. In the fall of 1960, Leary and Alpert purchased some psilocybin from Sandoz for an experiment they planned with prisoners at the Massachusetts Correctional Institute in nearby Concord. Initial results were promising: Prisoners who had taken a psilocybin trip prior to release from Concord were found less likely to be returned for parole violation than those who had not had an Alpert/Leary trip (Brecher, 1972). Drs. Leary and Alpert continued to take recreational/experimental acid trips themselves. Being teachers by profession and generous men by nature, they spread the word of LSD to anyone who would listen: There was a revolution about to start. The mind would at last be freed from the bondage of proletarian concerns. "'You are never the same after you've had that one flash glimpse down the cellular time tunnel,' [Leary] said. 'Turn on"' (Smith, 1975). Leary turned on. So did Alpert, their graduate students, and a conspicuous percentage of those living on the Harvard campus. In 1962, the FDA, Massachusetts law enforcement officials, and the Harvard board of trustees caught up with Leary. Harvard's Crimson warned students against using LSD. National media spread the alarm. While FDA and state officials were investigating Leary, the professor took advantage of this new celebrity stature to campaign nationally for LSD. At the request of the university, Leary and Alpert left Harvard in spring 1963. But this was just the beginning for the two professors. Rather than sneaking off to find tenure at some small university in the midwest, they did what they could to become cult heroes. It was their cult. Their acid. They had taken the first trips, the first risks. They were the first dropouts. They made the rules. Leary and Alpert preached "set and setting." Everything in taking LSD, in having a fruitful-freakout-free LSD experience, depended on set and setting. You should take it in some serene and attractive setting, a house or apartment decorated with objects of the honest sort, Turkoman tapestries, Greek goatskin rugs, Cost Plus blue jugs, soft light--not Japanese paper globe light, however, but untasselated Chinese textile shades--in short, an Uptown Bohemian country retreat of the $60,000-a-year sort, ideally ... The "set" was the set of your mind. You should prepare for the experience by meditating upon the state of your being and deciding what you hope to discover and achieve on this voyage into the self. You should also have a guide who has taken LSD himself and is familiar with the various stages of the experience and whom you know and trust (Wolfe, 1968). Their mystique grew. Followers arrived. Professors became gurus and America found itself possessed of a subculture that would change its music, life styles, attitudes toward marriage, beliefs in salvation, conception of divinity, the content of its university courses and cookbooks, and the substances it used for recreation and enjoyment. Post expulsion...[Alpert and Leary] landed in a fiftyfive-room mansion in Millbrook, New York, owned by a Mellon Heir, Billy Hitchcock, with the local cops peering through the bushes. The local cops were led by G. Gordon Liddy, later known as a Watergate burglar... ... [Eventually] G. Gordon Liddy went to prison for burglarizing the Watergate ... Leary went to prison for possessing a fingernail's worth of marihuana... and Richard Alpert went to India and became Baba Ram Dass, the very symbol of the seeker (Smith, 1975). In retreating to Millbrook, Leary and Alpert had hoped to minimize their difficulties with the law. But, they still had to contend with opposition groups. Did they bring it on themselves by publicizing the pleasures of psychedelic-heightened consciousness? If LSD-25 had stayed in the laboratory and the parlors of a few university scholars, would it still be legal, available, and pure? Academic questions--and Alpert and Leary were no longer academicians. They were gurus and the substance of their cult, d-lysergic acid diethylamide, was the newest target of American prohibitionists. LSD: Prohibition In 1965, federal drug abuse control regulations were passed. Based on its power to regulate interstate commerce, Congress now regulated the sale and use of depressant, stimulant, and hallucinogenic drugs. The Drug Abuse Control Amendments required the registration of every person who engaged in the manufacture, preparation, compounding, wholesaling, jobbing, and distribution of depressants or stimulants. Penalties were provided for anyone who sold, gave away, or otherwise distributed any substance in violation of the law, but no stipulation was made regarding someone who possessed depressant or stimulant drugs for use by members of his own household.* *1968 amendments to the legislation granted more strict penalties for any convicted of selling or distribution. For the first time, the 1968 amendments also provided for penalties (not more than one year in prison, a fine of not more than $1,000, or both, for a first conviction) for anyone found guilty of illegally possessing a depressant or stimulant drug. Not to be caught napping, most state legislatures responded to the early-to-mid 1960s attacks on LSD with prohibitive legislation of their own. In 1965, New York state passed a law providing for a maximum of two years in prison for anyone convicted of possessing, selling, giving away, or otherwise distributing LSD or "LSD-like drugs." Subsequent panic by New York citizenry caused penalties to be increased to a maximum of 20 years in 1966. In 1966, California passed the Grunsky bill, which prohibited possession, sale, manufacture, or importation of LSD and dimethyltryptamine (DMT) into the state. One notable result of the California legislation was to raise the average price of an acid trip from $3 to $10 (Brecher, 1972). Publicity surrounding the legislation didn't hurt LSD's popularity, either. Prior to 1962, the Food and Drug Administration had labeled LSD an "investigational new drug." By 1966, it was almost as well known as aspirin. For twenty years, from 1943 to 1963, the dissolving boundaries and unleashed memories and flowing feelings produced by the interaction of Dr. Hofmann's chemicals and minds brought no talk of revolution. The subjects and the therapists both had short hair, and society paid them no attention ... The Freudians found Freudian symbols. The Jungians found Jungian archetypes and the collective unconscious, the Rankians found separation anxiety, the Sullivanians found oral dynamism... Then came: Free Speech, birth control pills, long hair, brotherly love, Flower Children, predators on the Flower Children, cops, narcotics, speed, laws, judges, politicians campaigning, busts, riots, Vietnam, war resisters, the Mafia, Richard Nixon, Woodstock. Confrontation. Psychedelics were no longer experimental substances used by researchers to peel back the layers of the mind, they were a social issue--and a divisive one at that. LSD ADDICTS STARE AT SUN, the newspapers report; no point in detailing the hoax, newspapers print what they believe sells. Someone at the Saturday Evening Post must have known that picture was thalidomide babies, not "LSD babies," but they gave it the LSD caption; more proof that the Establishment lies, said the counter-culture. Were there some chromosome breaks in the lab experiments? Why was that front-page, said the counter-culture, when the same breaks for caffeine and aspirin go unreported? Could it be because coffee and tea and aspirin are major advertisers? (Smith, 1975). SUMMER, 1967 Came the summer of 1967. The students who heard Leary and Alpert's promises of universal love, freed consciousness, enlightenment, inner peace, general good times, and LSD all got together in San Francisco for the summer. The media loved it. They called it the Summer of Love, called the LSD takers Flower Children. Communal living, "free" love, gentle, stoned people passing out flowers in the parks. Marihuana, LSD, and brotherly love were there for the taking. musicians, journalists, poets, cultural an-IL-.hropoligists, and earnest undergraduates came to Haight-Ashbury to study the phenomenon. For a very short while, it was phenomenal. All the revelations that Alpert and Leary promised were there. Right Now there are two ways it can go in HaightAshbury. One is the Buddhist direction, the Leary thing. There are good heads like Michael Bowen and Gary Goldhill who want to start the League for Spiritual Discovery here and pull the whole movement together in-to one church and give it a focus and even legal respectability. And they have given up much for this dream. Goldhill is a beautiful head! He is an Englishman who was writing this experimental stuff for TV in England and the BBC sent him to the U.S...and he took a vacation in Mexico and ran into some American heads in San Miguel de Allende who said, Man, you got to come back here when the rainy season start and take some magic mushrooms, and damned if they didn't send him a telegram in Guadalajara or wherever--RAINS CAME MUSHROOMS UP--and he returned out of curiosity and took the mushrooms, just as Leary had, and discovered the Management and gave up all, all the TV BBC game and dedicated himself to The Life-for, as Leary has said, a home should be a place of purity that the Gautama Buddha himself could walk into from 485 B.C. and feel at home. For some day grass must grow again in the streets, in pastoral purity, for life is shit, a duress of bad karmas, endless fight against catastrophe, which is to be warded off finally only by utter purification of the soul, utter passivity in which one becomes nothing ... but a vessel of the All.-the All-one ... ... as against the Yesey direction, whict@ has became the prevailing life style of Haight-Ashbury...beyond catastrop;Le....like, picking up on anything that works and moves, every hot wire, every tube, ray, volt, decibel, beam, floodlight and combustion of American flag-flying neon Day-Glo America and winding it up to some mystical extreme carrying to the western-most edge of experience-(Wolfe, 1968). Owsley (August Owsley Stanley III, sound man for the Grateful Dead rock group) was home-brewing the very finest LSD and everybody's trip was beautiful. The Haight-Ashbury heads held the first big "be-in," the Love Festival on October 7, on the occasion of the California law against LSD going into effect. Thousands of heads piled in, in high costume, ringing bells, chanting, dancing ecstatically, blowing their minds one way and another and making their favorite satiric gesture to the cops, handing them flowers, burying the bastids in tender fruity petals of love... the thina was fantastic, a freaking mind-blower, thousands of high-loving heads out there messing up the minds of the cops and everybody else in a fiesta of love and euphoria (Wolfe, 19G8). Orange Sunshine, a combinsation of lysergic acid and ergotamine tartrate, was reportedly Owsley's best product. To the buyer on the street, just the word "Sunshine" was enough to ensure quality in LSD. Soon, due to federal restrictions and penalties, chemically-pure LSD-25 was no longer available. Owsley and his chemists kept trying to improve their product, but Sandoz they were not. Searching for the ultimate 'acid," they mixed Orange Sunshine with strychnine, amphetamines, other chemicals. They called them Clear-Lite, Window Pane, Purple Pie, Yellow Smash, but with no FDA to control production, "acid" wasn't only LSD-25 any longer. The flower children were uncritical consumers. They believed in trust, and they often trusted people who shouldn't have been. "Mescaline" was rarely pure--or even partially--mescaline. "Psilocybin" was sometimes the dried magic mushroom, sometimes its synthetic equivalent, sometimes canned grocery store mushrooms soaked in phencyclidine (PCPJ, an animal tranquilizer producing a chemical reaction close to alcohol intoxication. Amphetamines weren't pure. Most every substance was cut with strychnine or arsenic--or even rat poison or baby powder. Even the cannabis was often treated with something to make it "better" than nature intended. When the children took the strychnine, or the arsenic, or the atropine, or the Methedrine, or even LSD--sometimes there really was a college chemist just cooking for his friends--they sometimes had adverse reactions, whereupon their friends dumped them into the emergency room of a hospital, an environment that can produce a bad trip in people who are stone cold sober and just passing through (Smith, 1975). LEGACY OF THE SUMMER Before long the summer of love was corrupted. Police started raiding the children's homes and carting them off to jail on charges varying from illegal possession of drugs to cohabitation. Chemicals bought on the street were increasingly unreliable. "Speed freaks" and "junkies" moved in, bringing their amphetamines and heroin with them. The flower people moved to the country-, the heroin and amphetamine users stayed. Amphetamines "Speed kills," the LSD users warned. Maybe it didn't often (technically) kill those who used it, but speed did help end the fragile climate of brotherhood (Haight-Ashbury) in the counter-culture. As early as 1965, the underground press had tried to warn cannabis and LSD users away from amphetamines. Poet Allen Ginsberg said it best, in his December, 1965, interview in the Los Angeles Free Press: "Let's issue a general declaration to all the underground community, contra speedamos ex cathedra. Speed is antisocial, paranoid making, it's a drag, bad for your body, bad for your mind, generally speaking, in the long run uncreative and it's a plague on the whole dope industry. All the nice gentle dope fiends are getting screwed up by the real horror monster Frankenstein speed freaks who are going around stealing and bad mouthing everybody' (B7Lecher, 1972). The 1970 Interim Report of Canada's (Le Dain) Commission of Inquiry into the Non-Medical Use of Drugs analyzed the phenomenon of amphetamine use in the counter culture: "Som 'speed' users who inject almost suicidal doses of methamphetamine into their veins without any regard for their safety and health, may actually be trying to test the truth of the youth slogan 'Speed Kills.' The role of the doomed person who is at once a martyr sacrificing himself, a hero braving the confrontation with certain destruction and a gambler playing dice with death, is a role which seems to have a strong seductive pull for some young people who are morbidly hungry for compassion, admiration and excitement. For these individuals the slogan 'Speed Kills,' may, paradoxically, carry more attractive than deterrent power--and thus may not serve the purpose for which it is being promoted" (Brecher, 1972). The federal government increased efforts to curb increasing black market amphetamine traffic. Underground speed labs were busted, as illegal stills had been during alcohol prohibition. Speed became harder to come by. Legal stimulants were controlled closely. Prices went up. Black market merchants began importing increased amounts of cocaine to meet the stimulant demand. HEROIN AND THE MIDDLE CLASS The descendents of Haight-Ashbury turned increasingly to heroin. Use was no longer centered mainly in the non-white ghettos; the heroin habit was finding a place in the lives of children from white, middle income homes. In an article in the Spring, 1971, issue of the Journal of Psychedelic Drugs, three medical staff members of the Haight-Ashbury Medical Clinic traced the changing patterns of heroin use: Within the last two years L`1969 to 1971,7 there has evolved a new style of heroin addict consisting largely of alienated white youth suffering from disillusionment, disaffiliation, frustration, and despair... 1970 is becoming recognized as the "year of the middle class junkie,' a reflection of the changing socioeconomic background of today's heroin extraction. They have begun using heroin (the perfect tranquilizer) only within the last few years and are now beginning to seek medical help in rapidly increasing numbers. The "middle class Junkie" is ... composed of two rather distinct types: the "New Junkie" (who began using heroin after January, 1967) and the "Transition Junkie" (who began using heroin between January, 1964 and January, 1967). The TJ is characterized by a similar family and social background to the "New Junkie" and differs mainly in the effects of the social atmosphere of the drug subculture that existed when he came onto the scene. He passed through a period of optimism and hope, and reflects this in the drugs he used heavily prior to heroin (the psychedelics and amphetamines). He is a self-medicator and a drug experimenter; he has "tried all drugs." The newer addict entered the drug subculture at a time of beginning frustration and despair, and therefore, engaged in less experimentation before "settling" on heroin. He is more aware of the dangers of the "street drugs" (havinq seen some of the effects on the Transition Junkie's contemporaries). and less of a self-treater than his Transition Junkie counterpart. These two groups together lNJ and TJ ./ make up the "middle class junkies" and are distinguished from the older ghetto-bred addicts ... by many factors other than background, family status, percentage of females, and race. They are also separated by therapeutic response, with the older addict being a more "faithful" patient and less likely... to get "clean" than his newer counterparts (Sheppard e t a l. , 19 72) . The Haight-Ashbury Free Medical Clinic study on which the above report was based uses January, 1964, as the approximate time when heroin use began to spread from non-white ghetto areas into segments of America's white, middle class community. As Sheppard, Gay, and Smith stipulate in the article, the San Francisco area has proven to be a place where drug use trends begin some six to 18 months before they are evident in the rest of the country. An Addicted Author: Heroin vs. Hallucinogens When I speak of drug addiction I do not refer to keif, marijuana, or any preparation of hashish, mescaline, Bannisteria Caapi, LSD6, Sacred Mushrooms or other drug of the hallucinogen group ... There is no evidence that the use of any hallucinogen results in physical dependence. The action of these drugs is physiologically opposite to the action of junk. A lamentable confusion between t two classes of drugs has arisen owing to the zeal of the US and other narcotic departments ... ... All the hallucinogen drugs are considered sacred by those who use them--there are peyote cults and Bannisteria cults, hashish cults and mushroom cults-"The Sacred Mushrooms of Mexico enable a man to see God"--but no one ever suggested that Junk is sacred. There are no opium cults. opium is profane ... Junk is the ideal product... the ultimate merchandise. No sales talk necessary. The client will crawl through a sewer and beg to buy... The junk merchant does not sell his product to the consumer, he sells the consumer to his product. He degrades and simplifies the client... I awoke from The Sickness at the age of forty-five, calm and sane, and in reasonably good health except for a weakened liver and the look of borrowed flesh common to all who survive The Sickness...Most survivors do not remember the delirium in detail. I @Lpparently took detailed notes on sickness and delirium. I have no precise memory of writing the notes which have now been published under the title Naked Lunch... ... I lived in one room in the native quarter of Tangier. I had not taken a bath in a year nor changed my clothes or removed them except to stick a needle every day in the fibrous grey wooden flesh of terminal addiction. I never cleaned or dusted the room. Empty ampule boxes and garbage piled to the ceiling. Light and water long since turned off for nonpayment. I did absolutely nothing. I could look at the end of my shoe for eight hours. I was only roused to action when the hourglass of junk ran out...And suddenly my habit began to jump and jump. Forty, sixty grains a day. And still it was not enough. And I could not pay (Burroughs, 1960). Federal Response to Heroin Use By 1966 it was apparent that heroin use by whites was increasing. That same year, the federal government passed the Narcotic Addiction Rehabilitation Act, which provided treatment and rehabilitation for both convicted and volunteer heroin addicts. The Act specified conditions for short-term, in-patient care in medical facilities, and for long-term, continued out-patient care in the community. The United States Surgeon General was mandated to assist states and municipalities in developing treatment programs and facilities for addicted "narcotic" users. As defined in the law, "treatment" was to include "'confinement and treatment in an institution, and supervised after-care in the community... designed to protect the public and benefit the addict by correcting his anti-social tendencies and ending his dependence on addictive drugs and his susceptibility to addiction"' (Levine, 1974). In 1968 the Department of Justice's Bureau of Narcotics and Dangerous Drugs was created. The Bureau, charged with enforcing federal laws having the goal of suppressing illicit drug traffic, replaced the two agencies previously concerned with drug-rrelated activities: the Treasury's Federal Bureau of Narcotics and HEW's Bureau of Drug Abuse Control. Irrespective of federal control efforts, heroin use continued to increase. Young people had heard too many scare tactics and warnings they knew were false: "Marihuana is habit forming," "LSD causes insanity, leads to deformed babies." People were familiar with different drugs--had tried them, used them occasionally (or frequently), believed that government and medical indictments against the substances came from ignorance, fear, hostility toward the youth culture. Heroin was just another drug, something they could try, and could stop using whenever they became bored with it. HEROIN: THE VIETNAM WAR Vietnam brought many white young people who would otherwise never have seen an opium poppy into contact with heroin. Young whites and blacks, just graduated from high school or university, were drafted and sent to fight a guerrilla war in a small Asian country they had never studied in geography class. Heroin, marihuana, amphetamines, and barbiturates were available. Since cannabis and opium poppies were common agricultural crops in southeastern Asia, marihuana and heroin were particularly inexpensive. The combination of war, substance availability, boredom, the sense of futility in fighting a war nobody seemed to be winning, and a general scepticism about anti-heroin warnings from the government that "got us into this mess in the first place" all combined to turn a number of American soldiers on to heroin. Like their Korean War predecessors, many United States military men in Vietnam had some variety of heroin habit. Some brought the habit with them to Vietnam; others learned not long after they arrived. The Military's Response Military officials turned their heads, discharged some soldiers for use of marihuana, and ignored the heroin problem as long, as they could. Shortly after the United States began military support to South Vietnam, high incidence of drug abuse, particularly of marihuana and dangerous drugs such as the amphetamines and barbiturates occurred among the military stationed there. The Department of Defense appointed several Task Forces to inquire into... the problem... Early reports from one of the Task Forces stated that there was a relatively low rate of drug abuse in the services ... The report concluded that there was virtually no drug addiction in the military... In contrast... in 1969 the military conducted about 36,000 investigations of drug abuse and in 1970, about twice that many (Levine, 1974). Addicted Soldiers One survey by two army physicians conducted on GI's returning from Vietnam showed that more than 16 percent admitted using heroin during their final thirty days in Vietnam. But about 6 percent of those GI's interviewed admitted using heroin before going to Vietnam. A congressional Committee, in early 1971, found that a significant portion of the drug users were inducted into the services because of inadequate pre-induction screening. During early 1971, as a result of an amnesty program, the Pentagon reported that nearly sixteen thousand servicemen voluntarily identified themselves as heroin users and sought treatment. The majority of those servicemen who sought treatment (14,736) were from the Army. The remainder (977) included servicemen from the Navy, Marines, and Air Force. There is no estimate of how many servicemen qualified for treatment but did not identify themselves as heroin users. ... Whatever estimated figure one chooses to accept, there were anywhere from 25,000 to 50,000 American troops in Vietnam who were heroin users by mid-1971, and this estimate does not include addicted servicemen who had previously served in Vietnam and returned to civilian life. Perhaps the most alarming statistics show that the death toll from heroin overdose 21rose,7 in Vietnam despite the reduction in the number of men stationed there. In 1970, the quarterly average reported was 26 deaths from heroin overdose; in the first quarter of 1971, the figure rose to 35 deaths (Levine, 1974). In early 1971, the Veterans Administration set up a treatment program for discharged heroin addicts. By June, 32 clinics treating 6,000 people were in operation. Treatment was primarily by methadone maintenance. Also in June, 1971, President Nixon appointed Dr. Jerome H. Jaffe to head the new White House Special Action Office of Drug Abuse Prevention, which was to have overall responsibility for major federal drug abuse prevention, education, treatment, rehabilitation, training, and research programs. The only area that Dr. Jaffe's office did not oversee was the Federal Bureau of Narcotics and Dangerous Drugs, under the control of the State Department and the Department of Defense. COMPREHENSIVE FEDERAL LEGISLATION In 1970, the federal government passed the Controlled Substances Act; it provided, for the first time, a comprehensive, integrated set of regulations governing substance use and control. Briefly, these are the main areas covered by the act: e Five separate substance schedules are set down, according to the "potential for abuse" and current accepted medical use attributed to each substance group. - Schedule I: heroin; marihuana*; LSD; THC; hallucinogens. *Like earlier legislation, the 1970 Act includes marihuana with heroin as substances whose users receive the most severe category of penalties. - Schedule II: Opium; morphine Dilaudide; Demerol; Methadone; cocaine; liquid amphetamine. - Schedule III: amphetamines; Nallineq shortacting barbiturates; and DoridenR, Noludalo, RitalenP, paregoric. - Schedule IV: minor tranquilizers; long-acting barbiturates. - Schedule V: substances that can be sold over the counter, without prescriptions--primarily cough syrups, such as terpin hydrate with codeine.  Separate penalty scales are provided for violations within each substance schedule.  The act differentiates between "addict," "user," and "trafficker" when setting penalties.  The jurisdictions for controlling drugs as they pass from manufacturer to distributer to consumer are specified.  Provision is made for including any new substances or drugs under the five schedules of the existing act.  The act calls for increased research regarding prevention of drug abuse, and for continued research on treatment and rehabilitation methods. Also in 1970, the National Conference of Commissioners approved a Uniform Controlled Substances Act. Provisions outlined in the Act were to be adopted separately by each state. Like the federal Controlled Substances Act of 1970, this was an attempt to create a codified system of drug control, classifying all narcotics," the "dangerous drugs," and marihuana into five separate penalty scales. Particular penalties were left to the determination of individual states. TRANSITIONS: 1970 TO 1977 Drug use in recent years has meant neither the social stigmas nor the revolutionary political convictions that were partners of the drug culture in the 1960s. One of the most significant patterns to emerge during the 1970s is that there are no longer set stereotypes of drug users and drug use patterns. Ghetto junkies aren't the only heroin addicts. Student radicals aren't the only people smoking marihuana and trying cocaine. Long-distance truckers are not the exclusive users of amphetamines. At one time in the twentieth century, the statement "minorities are the heroin addicts" might have been largely true. Use of opiates once implied images of alien, ghetto-based "misfits." Vietnam challenged the preconceptions. The country saw a significant percentage of its white, middle-class young people return from the Vietnam War with the heroin habit. For the first time, the ghetto junkie stereotype wasn't adequate to describe the problem. Use of other substances--marihuana, LSD, cocaine, mescaline, peyote, amphetamines--during the 1960s implied the user's belief in social revolution and his search for the cosmic knowledge Leary had promised. When Vietnam, Kent State, the marches on the Pentagon were over, the student radicals and the seekers began to disappear. They became professionals, parents, members of the community. To some extent, most still used some of the drugs they had been turned on to during the decade before. Younger students kept their elders' patterns of drug use--but without the implicit social/revolutionary convictions that had been an integral part of what media liked to call "the youth drug culture." Again, the old stereotypes wouldn't work. The Polydrug Phenomenon Use of a particular substance can no longer be attributed to a single subculture. The pharmacological and street names of drugs, their effects and side effects, have received good press; society as a whole is more knowledgeable than it was. Sometimes, the knowledge has resulted in a greater tolerance toward use of a substance, such as with marihuana. Sometimes, the information has helped create a more knowledgeable drug user-someone who uses, even mixes, many kinds of drugs openly without the fear of societal and legal reprisals he once would have had. The New York Times, in a March 25, 1973, article titled "Mixing of Mind-Altering Drugs Rises as Spread of Heroin Addiction Slows," attempted to analyze what has been called "polydrug use": "Allowing for variations of region, age and class, cocaine, methadone and alcohol, and a variety of barbiturates and other 'downersl--most notably a sedative-hypnotic known as methaqualone--appear to be increasingly popular street drugs. "And, while it is difficult to gauge the extent of the phenomenon, a considerable number of people appear to be casually using and abusing several drugs in often dangerous combinations--methaqualone and alcohol, or methadone and alcohol... Vvin San Franci a narcotics police officer notes: Three years ago, it was common to have five or six young people collapse in school every day from an overdose of barbiturates. We don't get that any more; the kids are becoming more sophisticated about drugs.' "As for heroin, a Chicago drug counselor observes: 'Word has gone out to the black community that smack is part of their oppression, and they are sticking to grass and psychedelics and pills, uppers and downers, for their highs.' "Polydrug abuse, as the drug-mixing phenomenon is known, appears to be characteristic of both school-age dabblers and old-time junkies, who are finding it almost impossible to 'cop' (buy) good-quality heroin" (Markham, 1975). Same Drugs, Different Campus In the September, 1977, issue of Esquire magazine, a 1975 Yale University graduate talks about drug use when he was on campus. It was, he says, a time of many drugs and few politics. The trappings of rebellion hung loosely on us, like older siblings' clothes. We espoused hand-me-down politics and tripped on hand-me-down LSD... We saw the drop outs of older classes crawling off to communes or hanging about the college... They were exhausted--refugees from themselves--politicall