% 0 \ Y F. P. A. Pamphlet No. 24 Series of 1923-24 The Case Against Heroin 1. Heroin is unnecessary in the practice of medicine. 2. Heroin destroys all sense of moral re- sponsibility. 3. Heroin is the drug of the criminal. 4. Heroin recruits its army from youth. 5. Heroin can be eliminated only by international action. Prepared by the COMMITTEE ON TRAFFIC IN OPIUM of the Foreign Policy Association — • NATIONAL HEADQUARTERS NINE EAST FORTY-FIFTH STREET NEW YORK Resolution Passed by the Fifth Session of the League of Na- tions Advisory Committee on Traffic in Opium, 1 at Geneva, May- June, 1923. “In view of the existing medical evidence tending to show the possibility of completely doing away with the use of heroin in medical and surgical practice, the Advisory Committee on Traffic in Opium recommends the Council : (a) To request each Government to appoint a committee of enquiry with a view to ascertaining the possibility of completely abolishing the manu- facture of heroin and its use; and ( b ) In the event of the committees of enquiry deciding that the manufacture of heroin cannot be be done away with entirely, to enquire into the pos- sibility of its use being limited to certain types of cases, or any particular type of case. The Chairman thought that the Committee should ask each Government for its opinion on this question. The proposal could be drafted in the form of a recommendation to the Council. Governments could be invited to make an enquiry in their own countries and send the result to the Secretariat. The Chairman’s proposal was adopted.” 1 The American delegation consisted of Stephen G. Porter, Chairman of the Com- mittee of Foreign Affairs of the House; Bishop Charles Brent, President of the Com- mission that drafted the Opium Convention of 1912 at The Hague; Dr. Rupert Blue, former Surgeon-General of the Public Health Service, Washington, D. C. The Case Against Heroin Heroin Can Be Eliminated Only By International Action dERICA leads the civilized world in one unenviable record — crime. In 1922, seventeen murders were committed in London and 260 in JL jL.New York City in the same period. 1 The suppression of heroin, which is peculiarly the drug of the criminal, is therefore a matter of vital interest to the United States. Only through international cooperation, however, can heroin be effec- tively suppressed. Smuggling over the border is only too simple a matter. Unless its manufacture is everywhere abolished, therefore, it will be im- possible to rid ourselves of this menace. The channel for this necessary international action has recently been supplied by the Council of the League of Nations, which has adopted the resolution printed on the opposite page calling on all governments to in- quire into ways and means of completely abolishing the manufacture and use of the drug. This request is now before our Department of State. In the following pages will be found evidence from eminent author- ities to the effect that 1. The average age of heroin victims may be fixed at from twenty-five to twenty-seven years. 2. In New York City, 98 per cent of the criminal drug addicts use heroin. 3. Criminologists the world over agree that most of the violent crimes may be laid at the doors of heroin addicts. 4. Heroin is declared by medical authorities to be unnecessary in the practice of medicine. What more satisfactory response, then, could be given to the request of the Council of the League than to enact a law abolishing the manu- facture of this highly dangerous and unnecessary drug? There are only four great drug manufacturing countries — Germany, Switzerland, England and America. If the United States takes the lead in abolishing heroin, it would carry enormous weight with medical opinion in the other three countries. It can take the lead, if the movement to legislate heroin out of existence has the backing not only of the medical opinion in the country, but of the various organizations who should be aroused to the paramount importance of eliminating this evil. The elimination of this one drug would so improve the narcotic situ- ation in our own country — particularly where it touches the criminal addict (our most dangerous problem) — that it would justify the most vigorous efforts on the part of the people of the United States in making illegal, in this country, any use of heroin ; and, in cooperation with the League of Nations Advisory Committee on Opium, in clearing up the international situation and so preventing the illegitimate supply, through smuggling, of this highly dangerous drug. 1 N. Y. Times , Aug. 30, 1923. 3 FACTS REGARDING INTERNATIONAL CONTROL OF HEROIN Heroin and Crime “We committed last year from this office about nine hundred drug addicts and I should say that 98 per cent are users of heroin. Very rarely do we run across a case where the addict is taking morphine or cocaine.” William McAdoo, Chief City Magistrate, New York City, New York, February 3, 1923. “I feel that in medical practice heroin is a dangerous drug, and if possible to be obtained by drug addicts, it is even more dangerous, as it combines the stimulating qualities of cocaine with the sedative effects of morphine.” D r. s Dana Hubbard, Director, U. S. Bureau Public Health Education, February 9, 1923. “Heroin cuts off the sense of responsibility, in the moral sense, much quicker than morphine. It destroys the sense of responsibility to the herd. Heroin addicts will more quickly commit crime and with no sense of regret of responsibility for it. The herd instinct is obliterated by heroin, and the herd instincts are the ones which control the moral sense, in the sense of responsibility toward others and the environment in gen- eral. Heroin obliterates responsibility the same as cocaine, and it makes much quicker the muscular reaction, and therefore is used by criminals to inflate them because they are not only more daring, but their muscular re- flexes are quicker. j) R Alexander Lambert, Attending Physician, Bellevue Hospital, New York. “Probably 75 per cent of the drug users admitted to prison take heroin. Heroin is the main problem, in my mind. Heroin produces an effect on the personality so that all respect is lost.” 1 Dr. Amos Squire, Chief Physician, Sing Sing Prison, New York. “I think criminologists the world over will tell you that the violent crimes are the ones that are committed by heroin addicts.” 1 Dr. Bundesen, Commissioner of Health, Chicago, 111. “A study of the statistics in New York County alone indicated that, whiile the evil in so far as the use of morphine, cocaine and opium was a serious one, the whole three of them put together were not nearly as ser- ious as the growth of the heroin habit. The heroin habit has grown to textremely large proportions in a way that was absolutely appalling, dis- tressful not only to the well-being of those addicted, but to the well-being of the State, because, if permitted to continue in the degree in which it has taken root, it would threaten very dire results and conditions which would call for general public activity.” 2 1 Hearing’s before the Committee on Foreign Affairs, House of Representatives, Sixty- seventh Congress Fourth Session, on the Resolutions, H. J. Res. 430 and H. J. Res. 453, Feb. 13-16, 1923. 2 Page 9, “The Drug Evil and the Drug Law,” by Cornelius F. Collins, former Judge of the Children’s Court. (Department of Health, City of New York.) 4 Heroin and Youth “At the age of sixteen even, there were no drug addicts for three months in Special Sessions. Yet, as if nature drew a line, from sev- enteen and twenty-two there were such a large number of heroin victims that the average age of victims may be fixed at twenty-two years, and that average age is made up in the period of five or six years — that is, the years between seventeen and twenty-two — thus showing that it strikes the youth particularly.” 1 “In the recent New York City Drug Clinic, out of 7,464 addicts treated from April 10, 1919, to January 16, 1920, sixty-nine per cent were under thirty, thirty-nine per cent under twenty-four.” 2 “New York City is peculiar in its form of drug addiction, for over ninety per cent of its drug users are addicted to heroin, the strongest and most powerful of habit-forming drugs, the most detrimental in its effect upon the users, and the habit which is most difficult to combat.” 3 “Most of the heroin addicts are comparatively young, a large portion of them being boys and girls under the age of twenty. This is also true of cocaine addicts, many of them, according to reports, being mere children.” 4 Heroin Unnecessary “The heroin habit is the worst of the drug evils, as it is likewise the most powerful of the habit-forming narcotics. Physicians disagree as to the necessity of its use in the practice of medicine. However, many of them who speak with knowledge and authority are in favor of the non-use. As a habit, it is the most difficult to cure and it is so totally de- moralizing to the addict that I am compelled to come to the conclusion that the public health would be more greatly benefited by its absolute prohibition.” 5 “It is the opinion of the committee, based on the results of its investi- gations, that the medical need for heroin, a derivative of morphine is negligible compared with the evil effects of the use of this alkaloid and that it can easily be replaced by one of the other alkaloids of opium with the same therapeutic results and with less danger of creating habitua- tion. Therefore, consideration should be given the subject of absolutely prohibiting the manufacture, sale, distribution, or administration of this most dangerous drug by the States and municipalities.” 6 1 Page 9, “The Drug Evil and the Drug Law,” by Cornelius P. Collins, former Judge of the Children’s Court. (Department of Health of the City of New York.) 2 Page 16, Report of the New York State Narcotic Drug Control Commission. 3 Page 6, Report of the New York State Narcotic Drug Control Commission. 4 Page 24, U. S. Treasury Report, Traffic in Narcotic Drugs. 6 Page 47, Report of the New York State Narcotic Drug Control Commission. 0 Page 29, U. S. Treasury Report, Traffic in Narcotic Drugs. 5 Heroin Disapproved by U. S. Army “This office does not approve of the administration of heroin to any member of the military personnel. Such stocks of heroin as may be on hand at posts, camps, stations or medical supply depots will be destroyed and dropped from the stock record account on certificate of the medical supply officer. Heroin is no longer issued for use of the Medical Depart- ment of the Army.” M. W. Ireland, Surgeon General, U. S. Army, December 29, 1923. Heroin Prohibited by U. S. Navy “I have the honor to inform you that further issues of heroin to the U. S. Naval Service have been prohibited.” Surgeon General, U. S. Navy, February 2, 1924. Heroin Banished from Public Health Service Hospitals To Commissioned Medical Officers, Acting Assistant Surgeons and others concerned : “In view of the fact that the great increase in the use of heroin at present constitutes a considerable menace to public health in the United States, it is desired to set an example and to signalize to the general public the danger which may accrue from its use. Heroin as a palliative in certain respiratory affections serves no purpose which cannot be ac- complished by other agents fully as effectively and without the attendant possibility of grave disaster. “You are therefore directed to discontinue dispensing heroin and its salts at relief stations of the Service and to send all the stock of these drugs now on hand to the Purveying Depot, 1414 Pennsylvania Avenue, Northwest, Washington, D. C., either by parcel post or by freight on government bill of lading.” Rupert Blue, Surgeon General, U. S. Washington, D. C., December 2, 1916. Resolution of the American Medical Association “The House of Delegates of the American Medical Association, at its 71st annual session, at New Orleans, in 1920, adopted the following resolution : ‘That heroin be eliminated from all medicinal preparations, and that it should not be administered, prescribed nor dispensed ; and that the im- portation, manufacture and sale of heroin should be prohibited in the United States’.” 1 William C. Woodward, Executive Secretary, Bureau of Legal Medicine and Legislation. 1 Page 1318, The Journal of the American Medical Association, May 8, 1920. 6 Further Facts on Heroin from Further Medical Authorities “In view of the fact that a question is being raised as to the possibility of prohibiting the manufacture of heroin, the Sub-Committee thought it might give its opinion from the medical point of view and might state that the Mixed Sub-Committee, composed of technical experts, agrees, having regard to the small therapeutic value and the harmful effects of diacetyl-morphine (heroin), to advocate the prohibition of its manu- facture. Sub-Committee on Health and Opium of the League of Nations, September, 1923. “There can be no question but that heroin is not needed in medicine and should be entirely eliminated. There is no disease to my knowledge in which heroin would be preferable to morphine or codeine.” Dr. William G. Somerville, Chairman of Section on Mental and Nervous Diseases of the Southern Medical Association, December 17, 1923. “Heroin used by a human being produces an un-moral savage. The boy or girl, man or woman, driven by heroin’s influence becomes cold- blooded, the personality is inflated to a state of paranoic egoism, and the individual is capable of committing any crime. “Heroin is not a necessity in either medicine or art. All of its use- ful qualities can be safely replaced by other alkaloids of opium. “The production of heroin should be absolutely prohibited. “The only way to successfully fight this peril is through legislation locally — forbidding its manufacture, and by international agreement, with all nations participating, not only to forbid manufacture but to prevent importation from or exportation to any land.” Dr. S. Dana Hubbard, Director, Bureau of Public Health Education, New York City Department of Health, December, 1923. “Ninety-four per cent of the criminal drug addicts arrested in New York City use heroin regularly. Placing the consumers receiving their drugs from the illicit narcotic street venders in New York City at a minimum of 10,000 (based upon arrests’ statistics), using at an average of ten grains a day per individual, we have a total of 76,000 ounces as the yearly quantity of heroin used by the narcotic addicts who procure their drugs on the streets in New York City alone, against fifty-eight ounces computed as being legitimately prescribed by the entire medical profession of the State of New York, as estimated by our census of 14,715 physicians. Eighty per cent of the physicians replying to questionnaire deemed heroin unnecessary to their practice. That is why we are trying to find a way to shut off this flow and to stamp heroin either as an out- law drug or if that be not feasible, to place a terrific tax upon it.” Dr. Carleton Simon, Special Deputy Police Commissioner in charge of Narcotic Division of Police Department, New York City. February 11, 1924. 7 The only qualifications for membership in the Foreign Policy Association are an open mind, an intelligent interest in foreign affairs, a willingness to face facts and a sympathy with the general program and aims of the Associa- tion. Annual membership $5.00 and upward College “ 2.00* *Open to under-graduates and faculty and to teachers in public and private schools. The annual dues include a year’s subscription to the weekly News Bulletin, and also entitle a member to receive all of the other publications of the Association. From one to three pamphlets are distributed each month on some phase of inter- national affairs. News Bulletin The News Bulletin of the F. P. 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