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THE MYTHICAL ROOTS OF U.S. DRUG POLICY:

SOLDIER'S DISEASE AND ADDICTS IN THE CIVIL WAR

by Jerry Mandel*

1779 Haight St.

San Francisco, CA 94117

Special thanks to Marvin Scott for kind encouragement and superb editing.

THE MYTHICAL ROOTS OF U.S. DRUG POLICY:

SOLDIER'S DISEASE AND ADDICTION IN THE CIVIL WAR

Abstract

Soldier's Disease -- widespread addiction following massive administration of opiatesduring the Civil War -- is the earliest and most often repeated example of a drug problembefore the narcotics laws. The story exemplifies several basic themes used in support ofcontinued drug prohibition -- addiction is easy to acquire, hard to kick, and is apublicly noticed, i.e.asocial,problem. Soldier's Disease, though, is a myth. Notone case of addiction was reported in medical records or the literature of the time; underten references were made in the Nineteenth Century to addiction the cause of which was theCivil War; and no perjorative nickname for addicted veterans, like Soldier's Disease,appeared in the literature until 1 9 15, and it did not become part of the ConventionalWisdom of drug experts until almost a century after Appomattox.

THE MYTHICAL ROOTS OF U.S. DRUG POLICY:

SOLDIER'S DISEASE AND ADDICTS IN THE CIVIL WAR

myth ... 1:a usu. traditional story of ostensibly historical events that servesto unfold part of the world view of a people or explain a practice, belief, or naturalphenomena ...3 ... b:an ill-founded belief held uncritically esp. by aninterested group.

Webster's New Collegiate Dictionary, 1973

The earliest (and often the only) example of opiate addiction as a social problem whichis frequently cited by drug experts isSoldier's Disease --widespread addictionresulting from widespread opiate use in the Civil War. Most writers who report Soldier'sDisease devote no more than three sentences to it. It is the brevity, clarity,"catchiness," and conceptual implication of "Soldier's Disease" whichaccounts for the contemporary significance of such a fleeting reference. Possibly thelengthiest and most graphic description of opiate use in the Civil War, resulting inmassive addiction among veterans, was provided by Gerald Starkey, a century after thatwar:

In 1862 (sic) the Civil War broke out.... They would charge each other, literallypound chains down cannons and fire point blank at the enemy and these young men werepresented to their field surgeons with terrible shrapnel wounds ... along with terriblepain.

About all the field surgeon could do was use the two new invented tools that hadbeen presented to him in the previous five or six years I the hypodermic needle andsyringe, along with Morphine Sulfate .... They injected the young wounded veterans withhuge amounts of Morphine daily (every four hours) to kill their pain.... It was necessaryfor the surgeons to do full-quarter amputations -- literally take the arms and legs offright at the start of the body, usually to stop infectious gangrene.

In 1865 there were an estimated 400,000 young War veterans addicted to Morphine....The returning veteran could be. . identified because he had a leather thong around hisneck and a leather bag (with) Morphine Sulfate tablets, along with a syringe and a needleissued to the soldier on his discharge.... (T)his was called the "Soldier'sDisease."

(Starkey, 1971:482-84)1

The lesson to be learned from "Soldier's Disease" involves four linkedhypotheses, phrased as fact, which form a paradigm justifying today's U.S. Drug policy.This paradigm is:

Free access to opiates sooner or later breeds a massive use of opiates.

Widespread use of opiates leads to a lot of addicts.

Addiction is long-term, often enough, forever.

Addiction is a publicly manifest problem.

In sum, free availability leads to a social problem.

The historical record shows, however, that Soldier's Disease is a fancifulreconstruction of the past by writers I 00 years or more after the Civil War. There wasnot, to my knowledge, a single mention of Soldier's Disease, Army Disease, or any othersobriquet referring to addicted veterans, until a half -century after the Civil War; notone addict was noted in any writing or statistic compiled during or immediately after theCivil War; and reports of addicted veterans who began using during that War are onlyrarely mentioned throughout the rest of the 19th Century.

Soldier's Disease is a modern creation that has very little to do with the facts of19th Century drug use. Rather, it is an idea which fits, which shores up, modern drugpolicies. It is an assertion about what opiates are supposed to do, applied to a pastsituation.

In the next part -- Section I -- of this paper, the relevance of Soldier's Disease tocontemporary drug policy is addressed. Soldier's Disease is the only tale of apre-Harrison Act opiate problem which a self-respecting scholar in recent years couldpoint to as a pre-1914 social problem due to opiates. In Section 2, the modern creation ofSoldier's Disease, and its recent popularity among drug experts, is shown by noting thefirst who mention the concept and when, a generation or two later, it became accepted byscholars of all persuasions. Then the focus turns to the historical evidence which wouldtest, in order, the four steps in the above paradigm. In Section 3 the questions are:"were opiates widely used by soldiers during the Civil War?" and "wasaddiction among them widespreadduringthe war?" In Section 4 the questionsare: "was there wide-scale addiction among veteransafterthe war?" and"was this a publicly manifest problem?" What follows is the evidence foranswering these four questions: in order, " a tentative yes...... no,""no," and "no." The conclusions will expand further on how the mythicand the actual situation of Civil War opiate use relates to the current Drug policydebate.

1.The Relevance of Soldier's Disease

To Contemporary U.S. Drug Policy

The paradigm justifying U.S. opiate policy -- availability leads to use; use leads toaddiction; addiction is long-term; and addiction becomes a publicly manifest problem --conveys the idea that unavoidableSocialconsequencesof free access toopiates justify the enormous costs of contemporary U.S. drug policy. Of all the storiesabout the "bad old days" when opiates were legal, only Soldier's Diseaseprovides convincing

I. evidence" that opiate availability led to a publicly manifest problem, beyondmerely a substantial increase in the numbers of addicts. Thus, only the tale of Soldier'sDisease demonstrates Step 4 of the paradigm. The very phrase "Soldier's Disease"connotes a publicly manifest problem. Otherwise, the tales told about opiates before thelaws banning them were either too far-fetched to be repeated in modern times, or reflect asocial problem only if you believe the paradigm, (and often not even then). During andjust before 1914, the type of stories carried by the press about opiates did not indicatea social problem which might lead to a need for prohibition, and the absence of mediacoverage of the Harrison Act during the year it was passed by Congress further suggeststhe irrelevance of opiate use to a social problem.

There were, in the medical as well as the mass media of the late 19th and early 20thCenturies, occasional alarms sounded about other publicly manifest opiate problems, but noscholar in recent years believes that these were real or significant. (For example, thepress periodically reported an opium problem, particularly white women smoking opium inChinatown, with Chinese men. A racist, not an opiate problem). Even the moralisticanti-opium writers of about a century ago, with rare and often unbelievable exceptions,did not point to a publicly noticed problem.2

Today, there areimputedsocial problems, but not ademonstratedone,beyond Soldier's Disease. Historians David Musto and David Courtwright (Musto, 1972:2-4;and Courtwright, 1982:16-28) extend a tradition3 of research into the megatonnage ofopiates annually imported into the U.S. from well before the Civil War through the early20th Century. Additionally, opiates were typically a key ingredient in patent medicines,and there was a huge national campaign against them resulting in the Pure Food and DrugAct. Neither the level of imports nor the widespread use of opiates in patent medicines,in the absence of belief in a paradigm such as we noted, suggest anything beyondwidespread availability.

The medical literature of the 19th Century is filled with discussions about opiates,many written by experts who believed its use was terrible. To them, a loss of "moralwill," perhaps best exemplified by secretiveness, including husbands and wiveskeeping large scale addictions hidden from their spouses for many years,4 was a majorproblem. Addicts were deemed liars, which was only natural given the opprobrium attachedto addiction in much of U.S. society long before there were drug laws.The medicaland pharmaceutical literature also had an on-going contest, essentially, to report theoldest, most long-time, addict with the largest habit. None of the above indicates thatthe behavior of 19th or early 20th Century addicts was a publicly evident problem.

In the years just before national drug prohibition, there was barely a sign of anopiate-caused social problem, Two newspapers, to my knowledge, were indexed for 1906-1912-- the New York Times and the San Francisco Call.5 In each, there were three basic typesof stories: recent state lawswhich were forerunners of the Harrison Act in thatthey criminalized opiate use; arrests (over half being of Chinese Americans); andinternational stories. Opiates are assumed to be "evil" but the only allusion toa possible social consequence in any Times story is headlined "Says Opium Aids MusicComposers.-6 The only public problem with opiates recounted in the Call, besides whitewomen in Chinese opiate dens7 and problems which result from the local laws, is lethargyamong the troops at The Presidio. ("It destroys the vitality of the user, and wouldin time make the soldier a useless charge.") (S.F. Call, 1910b) 8

The year the nation's major opiate prohibition law was passed, the mass media, (atleast the New York Times, San Francisco Chronicle, Washington Post, and the Hearst Press),gave virtually no coverage to Congressional discussion or passage of the Harrison Act, orwhen it was signed into law or took effect. (Aldrich, 1979) Fourteen months after it wassigned, a medical journal presented the results of a one-question survey -"In youropinion what are the five most useful and important drugs in the materia medica?" --answered by teachers at leading medical schools. "Not only did it (opium) receive 102votes out of 107, but in 60 instances it was named first." (Robinson, 1916)

What the above suggests is not only that the rationales to justify opiate prohibitioncirca 1914 could not be repeated by self-respectingscholarsas rationales forcontinued prohibition today, but that hardly a rationale was offered at all. The HarrisonAct crept in on tip-toes, called a tax act, with no fanfare, no public interest or debate.When, a few years later, it became clear that this was a criminal law with considerableconsequences, there was a brief flurry of criticism and a rationale provided forcontinuing opiate prohibition, namely the vileness and criminality of "junkies"and the criminal cartels supplying them. Obviously, the consequences of the law providedthe rationale for justifying the law, but there were not that many opiate addicts and itwas not that big a social problem for the debate to continue.

"Evidence" of a social problem is needed to justify opiate prohibition onlywhen such prohibition is a significant social issue (which it was not in the yearspreceding the Harrison Act) and when criticism of drug laws crescendoes. Only then doscholars reconsider the rationales for the drug laws, and turn to the historical recordfor insights into contemporary concerns. It is only in these periods when the four partsof the paradigm, enunciated above, have to be demonstrated if contemporary drug policy isto be accepted. It is the final step -- the manifestation of a problem, in public -- whichmakes the other three socially significant. The only currently cited example of thecomplete paradigm, in the absence of opiate prohibition, is Soldier's Disease ... and it'sa myth.

2.Tracking The Develogment of The MM

A.It's Roots

The earliest portrayal of Soldier's Disease among Civil War veterans appeared as WorldWar I erupted over Europe (also the year the Harrison Act, took effect). In "TheCurse of Narcotism in America -- A Reveille," Marks, a Yale professor, intended toalert the U.S. to an enormous addiction problem among Civil War veterans that would bereplicated in another war:

Did you know that there is practically no old American family of Civil War reputationwhich has not had its addicts?.... (I)t was the "army disease" because of itsprevalence?.... (W)ith the war that hangs over us, the drug evil will spread into agiantism of even more terrible growth than the present?.... (T)here are something like4,000,000 victims of opium and cocaine in this country today?

(Marks, 1915:315)9

Marks feared the return of the "hydra-headed drug-curse" of the Civil War,but others writing during World War I about the consequences of combat upon drug use amongservicemen made no reference to the War Between the States. (Crothers, 1916; N.Y. Times,1917; Stanley, 1918; and Weber, 1918)

In the nine years after World War I, a handful of authors mentioned Civil War-relatedaddiction, though none mentioned Army Disease or any such synonym. (Bishop, 1919 and 1920;Illinois Medical journal, 192 1; World's Work, 1924; and Fell, 1924).

"Army Disease" was next noted inTheOpium Problem. Terry and Pellens' encyclopedic work of 1928, which became"regarded as the single most comprehensive work in the field" only severaldecades later.10 (Ball, 1970) For Terry and Pellens, "the Civil War gave it (chronicopium intoxication) a considerable impetus (which) seems definitely established."(Terry and Pellens, 1928: 5) Between 1928 and the late 1950's, only a handful of scholarsnoted "Army Disease" (Terry, 193 1; Woods, 193 1: Dai, 1937: Barnes, 1939; andLindesmith, 1947), and even in the early 1960's it was infrequently mentioned (Isbell,1960 and 1963; Kolb, 1960 and 1962; Clausen, 196 1; Maurer and Vogel, 1962; andSonnedecker, 1963), though prior to the drug explosion of the mid- 1960's there were fewscholars in the drug field. For the experts who the past quarter century have claimedSoldier's Disease, if they cite any reference it is typically Terry and Pellens.

B.The Contemporary Conventional Wisdom

Since 1964, Soldier's Disease, in essence, was mentioned in about 100 works by drugexperts, half of these since 1973.11 It was also mentioned in several studies byprestigious government agencies and Drug and Crime Commissions.12 Among the experts aremany renowned critics of U.S. drug policies -- including Edward Brecher, Alan Dershowitz,John Kaplan, Arnold Trebach and Norman Zinberg. In the early 1970's a few writersquestioned the factuality of Soldier's (Kramer, 1971 and 1972; Swatos, 1972; Musto, 1973;and Quinones, 1975), but shortly thereafter they were rebutted in a detailed historicalanalysis. (Courtwright, 1978 and 1982)13 Since the mid- 1970's the mention of Soldier'sDisease has diminished, maybe because the critics had an impact or because most expertsstopped probing the roots of U.S. drug policy after the early 1970's.

Soldiers Disease is, however, still mentioned by many experts ... and no one, yet, hasresponded to Courtwright.

Though briefly stated, a consistent theme involving three components is reiterated byalmost all the cited drug experts, the only variation being in the synonyms used. First,morphine in particular, and opiates in general, were administered by naive doctors"indiscriminately" (also termed " promiscuous", "imprudent","uncontrolled", "overdosage", "ignorant", etc.). Second, asa consequence of such medical naivete, addiction among soldiers was massive (also termed"prevalent", "commonplace", "thousands", wholesaleusage", "rampant", etc.). Third, so widespread was the addiction amongsoldiers and veterans that it became known as Soldier's Disease (also termed "armydisease", "soldier's illness", or "soldier's sickness."),14

The only clear disagreement is the few who estimate the number of addicted Civil Warveterans. Some claim 45,000 (Ashley, 1972 and 1978; Geis, 1973; Health PAC, 1970; andKenny, 1972); others 400,000. (H. Jones and Jones, 1977; Lingeman, 1969; Schwartz, 1980;Starkey, 197 1; Summers et. al., 1975; and Westin and Shaffer, 1972) Since no writer ineither camp provides one clue for their claim, the possibility that both estimates aroseout of the thin air circa 1970 is not ruled out.

Is today's conventional wisdom about Soldier's Disease an intellectual version of thechildren's game of Telephone where a simple message, after innumerable repetitions,becomes distorted and a new "catchy" message takes on a life of its own ... orhave recent writers captured the essence of opiate addiction in a past era? That dependson the evidence during and just after the Civil War.

3.Opiate Use and Addiction During The Civil War

A.The Need For and Use Of Opiates

During the Civil War, and at least until 1914, opiates were considered the bestmedicine for controlling dysentery and diarrhea and for containing the pain from warwounds. The Surgeon General's history of the just ended Civil War was often lavish in itspraise of opium.

"Opium --this medicine merits first place among these remedies. It wasused almost universally in all cases of severe wounds, and was particularly useful inpenetrating wounds of the chest, in quieting the nervous system and, indirectly inmoderating hemmorhage.

(US Surgeon General, 1870 :645)

But, how great was the need? How widely was it used? Given the need, and the use, ofopiates then, how many soldier addicts were there in the Civil War?

Official records from the Civil War show more incidents of severeillness forwhich opiates were the main remedy than there werewounds. More died from diseasethan were killed in battle or succumbed to wounds (For Union troops, 62%"disease," 19% "battle," and 12% "Wounds" of 360,000 deathsamong Union troops). (Duncan, 1912:397) Union medical records (for medical problems, notdeaths) show approximately 1,400,000 acute and 200,000 chronic cases of diarrhea ordysentery, 250,000 wounds, and 300,000 cases, combined, of typhoid, typhus, continuedfever, venereal disease, scurvy, delerium tremens, insanity and paralysis. (Brooks,1966:127) There were 30,000 amputations reported performed by the Union's doctors. (USSurgeon General, 1883) Among Confederate prisoners, 32% of the almost 19,000 who died incaptivity in the north succumbed to diarrhea or dysentery. (Brooks, 1966:126) InAndersonville prison from February 1864 to April 1865, of 12,541 recorded Union soldiercaptives who died, 45% did so from diarrhea or dysentery, and only 7% from wounds,gangrene or "debility." (US Surgeon General, 1879:32) There was obviously agreatneed for opiates.

Civil War physicians frequently dispensed opiates. The Secretary of War just after 1865stated the Union Army was issued 10 million opium pills, over 2,840,000 ounces of otheropiate preparations (such as laudunum or paregoric which, by weight, were well under halfopium), and almost 30,000 ounces of morphine sulphate. (Courtwright, 1978:106-7 and 1982)

B.Not One Report of Addiction In The Field

Yet for all the quantities dispensed,there was not one report from 1861-1865 ofan addicted soldier.

Could opiate addiction pass unnoticed, and have no consequences, among troops living inraw conditions and often moving from one place to another? Could so much morphine andopium preparations get used without generating a single addict?

The 30,000 ounces of morphine is most easily explained. Probably, most of it wasdustedorrubbedinto wounds or, during anesthetization,rubbedintoraw tissue. (Adams, 1952; and Brooks, 1966) In the campaign of Fredericksburg in Decemberof 1862, "hypodermic syringes were unknown, such drugs as morphine being doled out onthe point of a knife" by surgeons. (Duncan, 1985: 200) By the end of the war, thehypodermic needle was beginning to be used, in places -- "roughly 19 per cent ofUnion Army physicians were capable of administering morphine hypodermically.... and evenfewer Confederate physicians were (so) capable." (Courtwright, 1978:105) Whether thehypodermic administration of morphine during the Civil War was extremely rare as some haveclaimed (US Surgeon General, 1888:547) or as others have implied by their failure to notesuch use in medical histories of the war (Courtwright, 1978:104-105), or was frequent asone neurologist noted (Courtwright, 1978:106), there is not one case mentioned wheremorphine was injected for pleasure, or to stave off withdrawal pains.

The Civil War lasted four years, with 1,500,000 three year enlistments on the Unionside. Thus, those ten million opium pills dispensed by Union doctors average roughly twoper soldier per year (assuming the pills survived combat conditions). Prior to amputationsor other battlefield surgery, the patient routinely expected and was routinely given oneof these pills. Similarly, the 2,84 1,000 ounces of opiate preparations works out to abouta half -ounce per Union soldier per year. Though physicians argued about the benefits ofopiates for the relief of pain which accompanied "the fluxes" (diarrhea anddysentery), "the partisans of opium were very much in the majority" and usedopium for dysentery and other forms of flux including "chronic fluxes." Armyphysicians "united opium with almost every medicine employed to check the progress ofthe disease," and despite typical failure to cure returned "almost always toopium as the drug which at least alleviated, if it did not cure." Where thesufferings of the patient were very great and continuous, and where sleeplessness andrestlessness had become a medical danger, opiates were highly recommended, even by theotherwise skeptical physician. (US Surgeon General, 1879: 743-747) Again, applying basicarithmetic, and taking into account that there were many more than thereported1.6million cases of dysentery and diarrhea, it is easy to understand why there were periodicshortages of opiates. As with morphine, there is not a single report during the Civil Warof a soldier rising opium for pleasure, and the single claim of opiates used to stave offwithdrawal pains (published 16 years after the War) was the "confession" of anofficer charged with "deserting in the face of the enemy, and sentenced to beshot."15 (Nolan, 1881)

Though modern writers have accused the military doctors in the Civil War of not fullyappreciating the addictive qualities of opiates, one historian of Civil War medicinewrites that physicians in the field did not fully appreciate the benefits of opium.

Tincture of opium and paregoric were always available, but nowhere in the records doesone get the impression that they were used routinely in the management of the fluxes.

(Brooks, 1966:117)

Morphine, too, may well have been underused, to judge from a leading, albeit unusual,neurologist at the time, S. Weir Mitchell, who:

(S)colded the medical profession for its reluctance in using this mighty painkiller,pointing out that some patients' agonies were so severe the choice must lie betweenMorphine and amputation.

(Adams, 1952:138)

The naivete of military physicians regarding the negative effects of opiates, oftennoted shortly after the Civil War, had to do basically with their misunderstanding themedical effects of opiates, not the addictive properties of the drug.16 (US SurgeonGeneral, 1879:735-750)

There were no reports of addiction in situations which, a century or so later,generated numerous such references. For the Civil War, one virtually never reads of asoldier suffering withdrawal pains, or dying of an OD; or a physician in the fieldbesieged for an opiate for feeding a habit (as distinct from easing pain or controllingdiarrhea). In Wait Whitman's description of the 80,000 to 100,000 sick and wounded he sawin 600 hospital visits during three years of the Civil War, he notes that many patientscraved tobacco, sweets, or alcohol, yet he never once mentions opium. (Whitman, 1895) Thesickness form submitted by physicians to the Surgeon General from mid- 1 862 to the end ofthe war listed 152 categories of disease, including "serpent bite,""apoplexy," "insanity," "night blindness,""poisoning," "inebriation," "delirium tremens" and"chronic alcoholism", but not addiction or opiate deprivation. (US SurgeonGeneral, Pt. 1, V. 1). In the Surgeon General's history of the Civil War, "nostalgia... .army itch .... poisoning .... alcoholism .... and venereal disease," but notopiate use, are singled out for special comment. Under "nostalgia" the problemof boredom is given prominence and smoking tobacco, drinking alcohol, and gambling aresingled out for their "sedative influence," to "pass the dull hours"in lieu of satisfying the craving for excitement. (US Surgeon General, 1888: 886) In sum,there is no hard evidence of addicts during the Civil War, and it is hard to believe itwould have been missed had addiction been significant.

C. Not One Report of Addiction Immediately After The Civil War

If addiction among Civil War veterans was significant, it should have been most noticedin the immediate post-War years. There were 63,000 soldiers whose chronic diarrhea carriedon after the war, (Adams, 1889) and over 20,000 survivors of amputations reported by Uniondoctors. (US Surgeon General, 1883) When the Civil War ended, and veterans filled theprisons, New York State prison keepers at Auburn and Sing-Sing told of contraband smuggledinto prisons, such as "whiskey, tobacco... yellow covered literature.... sugar, tea,coffee, butter, pies, cakes, liquor, looking glasses, combs, brushes, etc.", yetopiates were not mentioned. (North American Review, 1867:572-74) In the Mississippi StateHospital, whose admission records of the mentally ill go back to 1855, the first narcotismcase was recorded in 1884. (Jaquith, 1965) The edition of the United States Dispensatory,(the enormous physician's desk reference of the time), which appeared just after the CivilWar devotes 27 pages to "opium" without noting the Civil War. (Wood and Bache,1868) Surely a significant minority of those 63,000 diarrhetics and 30,000 amputees wereadvised to take opiates by their physicians, and willingly took what at the time was thebest relief of their problems. Yet only two references to veterans who began using opiatesduring the Civil War were published before 1880. (Day, 1868; and Oliver, 1872) (A thirdpre-1880 case-history of an addicted veteran, cited by some as demonstrating Soldier'sDisease, started using opiates after the war). (Anon, 1876)

D.The Logic For Claiming The Existence of Many Civil War Addicts

How, then, could recent experts agree on massive addiction during the Civil War? Almostcertainly it has to do with trust in the statements of Terry and Pellens without botheringto check the original sources. The one exception -- the one historian who has checkedthose sources and maintains the validity of addiction during the Civil War -- isCourtwright, who believes that addiction must exist ... even though it is not in evidence.For morphine, Courtwright cites S. Weir Mitchell's claim that 40,000 morphine injectionswere given at one army hospital in one year. This number is far beyond any other -- infact, except for it there would be no consideration of thewidespreaduse ofmorphine other than what was rubbed and dusted into wounds. Courtwright considers theclaim "puzzling, to say the least," (and there are reasons for doubting Weir,personally),17 but he concludes if that number "is even half correct, it seemsimpossible that a substantial portion of the patients ... did not end the war asaddicts." "Impossible" as it seems, not a single addict was reported duringthe Civil War.

Courtwright also notes "the frequency and casualness with which opiates wereadministered" and states that "vast quantities of opium preparations other thanmorphine were dispensed under circumstances (such as to those with chronic diarrhea,dysentery or malaria) which could very easily lead to addiction." The only trouble is"very easily" did not occur.

Disregarding the lack of documentation on a single addict during the Civil War,Courtwright contends "that the war contributed to the spread of addiction," and"offerthe fighting, sick and wounded veterans greatly expanded the pool for iatrogenicaddiction." (Courtwright, 1982:55-56, emphasis added) Since opiates were widelyadministered in the early as well as last years of the Civil War,itis hard toimagine why addiction would only develop after the war. Nonetheless, acceptingCourtwright's contention for the moment, the test of the validity of Soldier's Diseasethus depends on analysis of post-war addiction among veterans.

4.Reports of Addicted Veterans Through the 19th Century

Were it not for Horatio Day'sThe Opium Habit, published in 1868, the modern daynotion of Soldier's Disease might never have developed. The latter of these two sentencesby Day (quoted by Terry and Pellens) is, by far, the most widely cited writing onSoldier's Disease:

The events of the last few years [Civil War] have unquestionably added greatly totheir [confirmed opium eaters'] number. Maimed and shattered survivors from a hundredbattlefields, diseased and disabled soldiers released from hostile prisons, anguished andhopeless wives and mothers made so by the slaughter of those who were dearest to them,have found, many of them, temporary relief from their sufferings in Opium.

(Day, 1868:1)

This remark, quoted by several modern writers,18 is the only reference to the Civil Warin Day's 335 page tome. Day recounts many types of persons who were addicts, but not onespecific case of a soldier or veteran.19 in context, Day's two-sentence allusion to theCivil War suggests an extremely minor problem recounted by an encyclopedic problem-seeker.

A.Courtwright's Evidence Is Skimpy

Courtwright recognizes that "army disease" was not an "epidemic,"but still concludes: "It is possible to document numerous references to addictedveterans both as a class and as individuals." (Courtwright, 1978:1 1 1) Using thesame evidence, and more, I reach opposite conclusions. Why?

InDark Paradise: Opiate Addiction In America Before 1940, Courtwright cites 118 books and articles published between the Civil War and the end of the century(Courtwright, 1982) yet in his studies of Soldier's Disease he lists nine references toaddicted veterans, and only five appeared in the 19th Century2O and were to veterans whohad used opiates during the Civil War. Adding two more which I uncovered (Earle, 1880;Nolan, 188 1), and including two other brief and vague references (Crothers, 1892 and1893), this averages one reference every 4 years between 18651899. The overwhelmingmajority of articles about opiate use written in the fifteen years following Appomatox,including several by writers who presented lists of the types of people who were addicts,do not single out the Civil War,21 nor can I find such a reference in newspapers of thetime.22

None of these nine sources demonstrates that opiate addiction by Civil War veterans wasof social significance. In addition to those previously quoted (Day and Nolan, who writesof the alibi used by a deserter), there were three references by the most prolific writersof the period, Mattison and Crothers (twice).23 Mattison's sole mention appears at the endof his career, 3 years after the War ended. (Mattison, 1898) Crothers wrote prolifically.If a "drug problem" could be unearthed, trust Crothers to lead the diggingparty.24 In the context of his encyclopedic writings, Crothers' few mentions of the CivilWar suggests its role in subsequent addiction was miniscule. (Crothers, 1892 and 1893)Further, when World War I broke out in Europe, Crothers urged combat physicians_to useopiates liberally, and fears of a subsequent addiction problem were groundless. (Crothers,1916) Two other references are of tone addicts, one -- of a long-time successful minister-- demonstrating the difficulty of detecting addiction at the time. (Russell, 1887; andKeeley, 198 1)

B."Only Your Pharmacist Knows For Sure"

The two other references suggest that for a while, in some places, there were someaddicted veterans ... reported by those who would notice addicts even if the generalpublic did not recognize them -- i.e. the apothecaries who sold opiates. Terry andPellens, reviewing an 1 878 study , noted that even physicians did not recognize theextent of addiction:

Druggists were in a much better position to know the truth .... when counter saleswere legal, and as a matter of common practice, physicians were called upon only by thoseopiate users seeking (cure).

(Terry and Pellens, 15)

A Massachusetts study of 1871 "consulted" 20-30 druggists and got mailedresponses from 125 physicians. 40 of these physicians did not know of a single case of"opium eating," and of 46 who commented on whether "the injurious use ofopium has increased of late years," 6 1 % answered it had not and another 13%answered it was diminishing. Only one physician, but at least two druggists, stated thatopiate use begun during the late war was an important cause for addiction. (Oliver, 1872)Without denying the significance of this report, these mentions of addicted veterans hadno ramifications in the drug literature at the time. It was a state publication with verylimited circulation, the few summaries or reviews of the report in the medical literatureat the time did not mention the Civil War,25 and save for Terry and Pellens' lengthyexcerpt from it in 1928 we might never have known that some pharmacists, at least,recognized that addicted veterans, as a class, were among the ranks of addicts.26

In Chicago in 1880, 50 pharmacists were surveyed about the cause of addiction of theirregular opiate using customers. The most mentioned were " rheumatism andneuralgia" (38 each); "some" respondents, (but less than four), believedaddiction was caused by sickness and pain and/or the "loss of property and positionin society" due to the recent war. (Earle, 1880) (On another government survey, ofdoctors in Michigan in 1878, the Civil War was not mentioned). (Marshall, 1966)

In toto, these surveys indicate that there was a small, temporary phenomenon ofaddicted veterans, which was not a social problem in the sense that anyone but a fewpharmacists recognized it in the quarter century after the Civil War.

C."Any" Vs. "Many"

No one doubts that all the opiates used to alleviate the pain from all the chronicdiseases and continuous pain resulting from the Civil War resulted in some soldiers usingand becoming addicted to opiates. The issue, however, is not whether there wereanyaddicted veterans but if there weremany. Courtwright's contention that"asubstantialnumber of them (veterans) eventually became addicted to opium or morphine," andthat "two events, the Civil War and the spread of hypodermic medication, triggered amassiveincrease in iatrogenic opium and especially morphine addiction," (emphasisnot in the original). (Courtwright, 1982) is unwarranted.

In arguing that the importance of Soldier's Disease should not be discounted,Courtwright stresses the importance on later 19th Century addiction of the wrenchingimpact that War had on society as a whole, such as the loss of loved ones, property,fortunes and social position. By such reasoning, any social event or condition whichoccurs in reasonable proximity before an increase in drug use can be considered a"cause." Ergo, the iron horse can be blamed for late 19th century addiction, ormovies and television for the increased drug problems of the last few decades. (In theMassachusetts study noted above, more pharmacists reported state restrictions on the useof alcohol a "cause" of recent opiate use than reported the Civil War). However,Soldier's Disease is cited in the drug literature the past few decades to imply somethingquite specific -- namely, the presence of opiates, outside of strict and knowledgeablemedical control, ipso facto causes massive publicly noted addiction, Nothing less.

5.Soldier's Disease and Drug Policy

In sum, Soldier's Disease proves to be another myth. In reality, the widespread use ofopiates during the Civil War generated so infinitesimal a problem that only two or threeapothecaries, and two or three of the most encyclopedic drug experts, even speculated onthe possibility of addicted soldiers from that War for almost half a century. Soldier'sDisease did not become the Conventional Wisdom until almost a century after that war.

Implicit in the concept of Soldier's Disease are four aspects of addiction which,together, are a paradigm used to justify current opiate laws -- easy access leads towidespread use, addiction is easy to acquire, hard to kick, and its consequences arepowerful and publicly obvious. In the popular contemporary idiom, the paradigm consists of"it's so good, don't even try it once"; "once an addict, always anaddict"; and in the image of the "junkie". (Belief in this paradigm, in theearly 1970's, led many experts, and particularly critics of U.S. military policy, to soundthe tocsin about opiate use by GIs for inevitably this would lead to a huge problem ofaddicted veterans ... which it didn't)27 Since each aspect of the paradigm is contradictedby the historical evidence, Soldier's Disease is a mythic reconstruction of the past tomake it coincide with contemporary assumptions.

How significant is the paradigm in justifying opiate laws? Each year over the past twodecades the nation has spent billions in drug law enforcement, resulting in an annualaverage of over a half million drug arrests, and has spent billions for trying thosearrestees and incarcerating scores of thousands of them. Until the mid-1980's, whencocaine replaced opiates as the most often used and most frightening "harddrug," the dangers of opiate addiction formed the core of the nation's perceived drugproblem and most of the prisoners serving drug sentences had been convicted on opiatecharges. Additionally, drugs are a major economic alternative for young poor people, aswell as a major source of police corruption. None of this -- neither the public money,arrests, incarcerations, the competitive illegal economy, and police corruption -existedregarding drugs until there were prohibitory laws.

How significant is Soldier's Disease for the paradigm which shows opiate availabilityipso facto causes a massive social problem? As noted in Section I of this paper, there isno other pre-Harrison Act example of a currently believable social problem. Though anancient and seemingly minor issue, addiction among Civil War veterans functions as alynchpin or cornerstone. Strip away Soldier's Disease, and the only problem suggested bythe paradigm are the medical consequences of addiction, which occurs in a large percentageof opiate users. The facts about addiction among the Civil War's soldiers and veteransindicates that widespread addiction, too, is a natural result of free access to drugs.

The facts about Civil War drug use indicate open availability and no recognizablenegative consequences; the facts, the past few generations, show extremely limited accessto opiates and an immense "drug problem." It is in the illegal context that themodern "opiate problem" arises, rather than in a legal context such as the CivilWar. The chemistry lesson of the Civil War is that opiates per se do not cause theproblem, the context does.

FOOTNOTES

1The imagery of the "leather thong around his neck and a leather bag"is, to my knowledge, unique to Starkey.

2 Occasionally a moralistic author of the late 19th Century cited a social problem withopiates which no-one else ever noticed, but two problems were repeated enough to warrantcomment. T.D. Crothers in several articles claimed that morphine, in particular, led tocrime. According to one scholar who studied the period, "No other writer ... assertsthe strength and ubiquity of this association .... (and) it is extremely difficult toaccept the validity of his position." (Swatos, 1972), though at least one otherexpert claimed, as an alibi in a trial for a property crime, (Kane, 1882b), that the costof opiates forced some persons with huge habits to steal. Still, before the laws all butthe extremely poor could easily afford any size habit. Crothers' unique assertions aboutopiate-caused crime can not justify a policy which generates the extraordinarydrug-related crime of today.

There were also occasional reports that addicts were lethargic and neglectful ofpersonal hygiene and business. However, the types of people on 19th Century lists ofaddicts, were typically in demanding jobs. That, said the experts at the time, was whythey sought the "stimulating" effects of opiates. The many reports of people notknowing their spouses were long term addicts suggests that the lethargy andinattentiveness to business was hardly blatant. Aside from the racist comments aboutopiate use in Chinatowns, the allegation that opiates effected the performance of a classof persons, such as impeding the performance of soldiers (S.F. Call, 19 1 Ob), was rare.

3 Terry and Pellens, in their encyclopedic classic The Opium Problem, also reportimport statistics, as does Kane, the author of the longest scholarly work in the early1880's. (Terry and Pellens, 1928:50-5 1; and Kane, 1880).

4 "It has been reported that for many years husbands and wives, to say nothing ofother members of a family, have lived in complete ignorance of the existence of thiscondition in one or the other." (Terry and Pellens: 2)

5 TheS.F. Call index is on index cards at the University of California,Berkeley library.

6 The full headline of this story is:

Says Opium Aids Music Composers

Jean Laporte Declares Many Owe Much of Their Fame to Smoking The Drug

Colleagues Support Him

Two Well Known Musicians Say a Few Pipes a Day Are No Worse Than Cigarettes - DoctorsContradict Them (N.Y. Times, 1912)

7 The obvious racism manifest in such headlines as "Crafty Chinese Are DoublyAccused" (S.F. Call, 1910a), becomes a "social problem" when white womenare involved, as suggested by the following headline:

200 Seized In 62 Drug Dens

Police and Detectives Sweep Chinatown, Battering In Doors of Opium Places

Two White Women Are Captured In Dragnet. (S.F. Call, 191lb)

The S.F. Call on occasion linked opiate use to crime or lunacy, but each time thedetails indicated the problem was a result of the law. (S.F. Call, 1910c and d, and 1911a)New York City's Commissioner of Corrections said that if addicts are deprived of opiateson arrest, "normal persons ... very frequently go insane." (N.Y. Times, 1914)

9 Estimates of the number of opiate addicts and "cocaine fiends" circa 1915varied enormously. Marks' estimated 4,000,000; a U.S. Public Health Service expertestimated a minimum of 70,000 and, elsewhere, " I 18,000.... (and) granting (a)somewhat improbable assertion ... a maximum not more than 187,000 users of opium,"(Marks, 1915; Wilbert, 1914 and 1915).

10 HadThe Opium Problem gainedearlier recognition as a classic, Soldier's Disease might have been the conventionalwisdom of drug experts before the late 1950's. The original 1928 printing of 400 copiesnot sold out for decades. A 1970 reprint sold much better.

11 Soldier's Disease citations attributable to specific authors, starting with 1973,are: Abel, 1982; Ashley, 1978; Bean, 1974; Bedworth and D'Elia, 1973; Bellis, 198 1;Blaine, Bozzetti and Ohlson, 1973; Brown, 1973; Califano, 1982; Conrad and Schneider,1980; Coombs et. al., 1976; Courtwright, 1978 and 1982; M. Cox, 1984; Cuskey, Johannes andPremkunar, 1973; Dershowitz, 1973; Ferguson, 1975; Finlator, 1973; Fuqua, 1978; Geis,1973; Goode, 1984; Hofmann and Hofmann, 1975; Jacobs and Fehr, 1987; H. Jones and Jones,1977; Kaplan, 1983; King, 1974; Kittrie, 1974; Levine, 1973; Milby, 1981; Morrell, 1973;Muuss, 1974; Pike and Goldstein, 1973; Rice, 1980; Roffman, 1973 and 1976; Rublowsky,1974; Rydell, 1980; Saper, 1974; Schwartz, 1980; Seymour and Smith, 1987; Shroeder, 1980;Smith and Seymour, 1986; Spain, 1975; Stephens and Slatin, 1974; Stimmel, 1975; Summerset. al., 1975; Trebach, 1982; Weinswig, 1973; Young et. al., 1977; and Zinberg, 1984.

12 Soldier's Disease was cited in publications by several influential governmentagencies and prestigious commissions created to address the drug issue. Starting with1973, references to Soldier's Disease can be found in: Los Angeles Sheriff's Department,1974; National Commission on Marihuana, 1973; Organized Crime Task Force, 1984;President's Commission on Organized Crime, 1986; Strategy Council, 1975; U.S. AttorneyGeneral, 1984: and U.S. Department of H.E.W., 1975.

13 Despite my many criticisms, I respect Courtwright's judiciousness and hiswillingness to grapple with the issue (which no other expert who claims Soldier's Diseasehas done), He recognizes and responds to contrary evidence, and criticizes simplisticrecitations of Soldier's Disease.

14Of the authors the past 30 years who report widespread addiction by Civil Warveterans, over a third mention Soldier's Disease, a third denote Army Disease, anoccasional author labels it Soldier's Illness or Soldier's Sickness, and the othersdescribe the phenomenon without noting a sobriquet.

15 The officer confessed at his trial that he was "suffering for want of the drug(opium) ... (and) so great was the craving that he temporarily deserted his post to ...obtain it, though knowing that his life would thereby be forfeited." (Nolan, 188 1).This smacks of tales from the 1930's of murderers caught red-handed who, desperate toavoid the electric chair, claimed marijuana "caused" their crime.

16 The failure to note opiate addiction as a significant problem was not due to theabsence of the concept of addiction during and just after the Civil War, The commissionersof the Prison Association of New York in 1866 reported that men "of a low order ofmorals ... (were) addicted to habits of profanity and intemperance." (North AmericanReview, 1867:570)

17 An article on opiates by Mitchell -- on the effects of opiates on birds -confirmshim as an eccentric scientist. (Boston MSJ, 1870) Weir found that morphia did not inducesteep "beyond a slight tendency to quietude, which we can never be sure is not due tothe habit of the wounded or sick pigeon of seeking a remote corner and remaining atrest," but "used hypodermically in excessive amounts ... act as excitants ....(and) in the duck they approach nearest to the typical strychnic spasm." Weir alsofound "great difficulty with which pigeons, especially old birds, are poisoned byopiates."

In All or part of Day's two sentences on the Civil War are quoted by five 20th Centurywriters, (Brecher et. al., 1972; Courtwright, 1978; Cuskey,

Premkunar and Sigel, 1972; Quinones, 1975; and Terry and Pellens, 1928), and closelyparaphrased without attribution by some others.

19 Calkins, Day's contemporary, refers to over 200 cases inOpium and the OpiumAppetite. but not one soldier who began opiate use between 1861-65.

20 Courtwright and Terry and Pellens cite addicted Civil War veterans who came topublic attention in the 20th Century as evidence of that war's impact on subsequentaddiction. Besides lending credence to the phenomenon they also demonstrate that suchaddiction was benign and unnoticed. The octogenarians cited in 1928 by Terry and Pellens("today in more than one old soldiers' home are cases of chronic opium addictionwhich date from this (Civil War) period") (Terry and Pellens, 69), or the 82 year oldConfederate veteran who "had been shot in the head during the Civil War" and"had been addicted 55 years" under medical supervision since then, (Waldorf,1973), reveal that the addiction of veterans was nota social problem,and not evena medical problemuntil prohibition of opiates.

21 Apart from Courtwright's citations, of the 29 books or largest articles aboutopiates, published between 1865-1879, which I have located, there is not an originalreference to soldiers addicted during the Civil War. (Brown, 1972: Calkins, 1867 and 1871;Chaille, 1876; M.D., 1878; Frost, 1870; Gibbons, 1870: Gould, 1878; Harrington, 1878;Ingals, 1877 and 1878; Layard, 1874 and 1878; Lippincott's, 1868; Ludlow, 1867; Mattison,1876 a and b, and 1878 a and b; McFarland, 1877; National Quarterly Review, 1870; Parrish,1869 and 1873; Popular Science, 1875; The Probe, 1869 a and b: Richet, 1878; R.S., 1869;and Warren, 1867). Several times as many articles were shorter pieces, and likewisemadeno mention of addiction linked to the Civil War.

22 Four lengthy newspaper articles during the 1870's, about non-Chinese opiate use, donot mention soldiers or veterans of the Civil War. (New York Daily Herald, 1877 and 1878;and New York Times, 1877 and 1878).

23 Two of the four 20th Century sources cited by Courtwright were also works byCrothers. (Crothers, 1900 and 1902).

24 Headings of 7 of the 18 chapters in Crothers' bookMorphinism and NarcomaniasFrom Other Drugs are "Chloralism .... Chioroformism .... Coffee Addiction ....Tea Inebriety .... Tobacco Inebriety .... Ether Inebriety .... (and) Addictions From OtherDrugs," these "others" including arsenic, ginger, cologne and lavender.(Crothers, 198 lb)

25 Three reviews of the 1872 Massachusetts study appeared in medical journals at thetime. None mentioned the Civil War (Amer. J of Medical Sciences, 1872; and Lancet, 1873),and one even considered the reports of opiate habituation "exaggerated .... a pieceof scandal," witness that in its subsequent annual report the Massachusetts Board ofHealth made "no allusion whatsoever to the subject (of opiates)" (Medical Times,1873).

26 Morgan provides a lengthier excerpt of the 1872 Massachusetts study than did Terryand Pellens, but omits the physician's, and two pharmacists', comments. The singlesentence relevant to the Civil War -- "The taste for opium eating among soldiersretired from the army is alluded to by a few of our correspondents" -- follows alisting of other causes of addiction, (injudicious prescribing, depressed nervous systems,overwork with deficient nutrition, a vicious mode of life, and intemperance).

27 In several fundamental respects, the opiate use of soldiers and veterans of theVietnam War is not analogous to the Civil War situation, though the fears about whatwidespread opiate use among GIs would engender once they were mustered out exactlyparallels the fears implicit in Soldier's Disease. The soldiers who used opiates in theCivil War did so to alleviate the pain from wounds, and to help cure "thefluxes," but using such drugs "to get high" or to reduce stress were theessential reasons for opiate use by Vietnam era GIs. In so far as a few veterans continuedregularly using opiates in the 1970's and 1980's, they contributed to a social problembecause, in the context of illegality, any regular opiate use tends to be a financialburden and criminal problem. The counterparts of these GIs, a century earlier, wentunnoticed. Further, the fact that so many GIs abandoned opiate use once out of Vietnam canbe argued as a demonstration of the effects of the U.S. approach of massive treatmentopportunities and massive enforcement. The handful of addicted veterans after the CivilWar would suggest that suppression is not the root cause of why regular opiate users quitbefore becoming addicted.

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1966 (eds.), Narcotic Addiction, Pp. 45-54. (Reprinted from Annual Michigan State Boardof Health, 1878, 6:63-73).

Mattison, J.B.

1876a "The Impending Danger," Medical Record, 1 1:69-7 1.

1876b "Opium Inebriety," Medical Record, 11:793-97.

1878a "Clinical Notes On Opium Habituation," Medical Record, 14:66-7.

1878b "The Responsibility of the Profession In The Production of OpiumInebriety," Medical and Surgical Reporter, 38:101-04.

1898 "Narcotic Inebriety In America," North American Review, 166:254-55,

Maurer, David and Victor Vogel

[1954] Narcotics and Narcotic Addiction, Second Edition, Springfield,

1962 Illinois, Charles C. Thomas Publisher. (P. 6)

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1877 "Opium Inebriety and the Hypodermic Syringe," Transactions of theMedical Society of the State of New York, (No Volume): 289-93.

Medical Times

1873 "Opium-Eating In Massachusetts," editorial, (Philadelphia) MedicalTimes, 3:520.

Milby, Jesse

1981 Addictive Behavior and Its Treatment, New York, Springer Publishing Co. (P. 242)

Morgan, H. Wayne

1974 Yesterday's Addicts - American Society and Drug Abuse, 1865-1920, Norman,Oklahoma, University of Oklahoma Press.

Morrell, Michael

1973 " Maintenance Of Opiate Dependent Persons In The United States: A LegalMedical History," Drug Use In America Problem In Perspective, Technical Papers of theSecond Report of the National Commission On Marijuana and Drug Abuse, Appendix Vol. IV,Treatment and Rehabilitation, Pt. 3 "Drug Dependence and the Legal System,"Washington D.C., U.S. Government Printing Office. (P. 517)

Musto, David

1973 TheAmerican Disease, New Haven, Yale University Press. (Pp. 1-2, 251)

Muuss, Rolf E.

1974 "Legal and Historical Aspects of Drug Abuse In Historical Perspective,"Adolescence, 9:495-507.

National Commission On Marihuana and Drug Abuse

1973Drug Use In America: Problem InPerspective, Washington D.C., U.S. Government Printing Office. (P. 15)

National Quarterly Review

1870 "Opium and the Opium Trade," National Quarterly Review, 20:288-310.

New York Daily Tribune

1877 "Opium and Its Consumers," July 10, 1877, (Unsigned). (P. 2)

1878 "Increase of a Dangerous Vice - The Opium Habit Morphia Syringes - CommentsOn Their Use By Prominent Physicians," December 26, 1878, (Unsigned). (P. 8)

New York Times

1877 "The Opium Habits Power - Its Extent In The United States," December 30,1877, (unsigned). (P. 8)

1878 "The Opium Habits Power - Popular Errors Corrected," January 6, 1878,(unsigned). (P. 5)

1912 "Says Opium Aids Music Composers," January 21, 1912, (unsigned). (Pt. 4,P. 12)

1914 "New Prison For Drug Users," June 30, 1914, (unsigned). (P. 7)

1917 "War Is Increasing The Drug-Consuming Habit," April 29, 19 1 7(unsigned). (Section 8, P. 5) Substantially reprinted in "The War and The DopeHabit," Literary Digest 54:1776-77. (June 9, 1917)

Nolan, D.W.

1881 "The Opium Habit," Catholic World 33:827+. (P. 83 1)

North American Review

1867 "The Reformation of Prison Discipline," (No Author), 105:55582.

O'Donnell, John and John Ball

1966 Narcotic Addiction, N.Y., Harper & Row. (P. 1)

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1872 Massachusetts State Board of Health, Third Annual Report (For 1871), Boston,Wright and Potter, State Printers, (Pp. 162-77). (Summarized in 1872, "Report of theState Board of Health of Massachusetts," American journal of the Medical Sciences,64:156-57; reprinted, in part, Pp. 43-52 in H. Wayne Morgan (ed.), Yesterday's Addicts;excerpted in Terry and Pellens'The Opiate Problem, which is partly reprinted, Pp. 41-43 inJohn Ball and Carl Chambers (eds.), The Epidemiology of Opiate Addiction in the UnitedStates.

Organized Crime Drug Enforcement Task Force

1984 Annual Report of the Organized Crime Drug Enforcement Task Force Program - March1984, Washington D.C. (P. 4)

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1869 "Opium Smoking," The Probe, 1:59-6 1.

1873 "Opium Intoxication," (Reported by T.D. Crothers), Medical and SurgicalReporter, 29:361-64.

Pike, Andrew and Eric Goldstein

1973 " History of Drug Use In The Military," Drug Use In America Problem InPerspective, Technical Papers of the Second Report of the National Commission On Marijuanaand Drug Abuse,

Appendix Vol. 1, Patterns and Consequences of Drug Use, Pt. 5 "Drug Use InSelected Populations," Washington, D.C., U.S.

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Popular Science

1875 "The Use of Narcotics," (Reprinted From Chamber's journal, England), (NoAuthor), 7:611-17.

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1986 America's Habit: Drug Abuse, Drug Trafficking, and Organized Crime, WashingtonD.C., U.S. Government Printing Office. (Pp. 190-91)

Probe

1869a "Hypodermic Use of Opium," (No Author), The Probe, 1:7-9.

1869b "Thoughts of An Opium," (No Author), The Probe, 1:87-90.

Quinones, Mark

1975 "Drug Abuse During The Civil War," International journal of theAddictions, 10:1007-20.

Rice, Jerry

1980 "A Chronicle of Federal Drug Enforcement Law," (accompanying photoessay), Drug Enforcement (US Drug Enforcement Administration), December, V. 7. (P. 4)

Richet, Charles

1878 "Opium and Its Antidote," Popular Science, 12:555-59.

Robinson, Victor

1916 "A Symposium on Drugs," Medical Review of Reviews, 22:15-26.

Roffman, Roger

1973 "Heroin and Social Welfare Policy," Social Work, 18:22-32.

1976 "Addiction Concepts and the Vietnam Experience," Urban and Social ChangeReview, 9:16-8.

Rublowsky, John

1974 The Stoned Age: A History of Drugs In America, New York, G, P. Putnam's Sons(Capricorn Books). (Pp. 129-3 1)

Russell, Ira

1887 "Opium Inebriety," Medico-Legal journal, 5:144-50.

Rydell, Wendy

1980 Drugs, North Miami, Florida, Merit Publications. (Pp. 121-22)

S., R.

1869 "Thirty Grains A Day," The Probe, 1:50-3.

San Francisco Call

1910a "Crafty Chinese Are Doubly Accused," February 4, 19 1 0, (unsigned).(P. 16)

1910b "Opium Dreams Grave Menace To Local Army," August 29,

1910, (unsigned). (Pp. I + 2)

1910C "Drug Habit City's Worst Evil," (by Charlers Fickert), December 15,1910. (P. 1)

1910d "Time For A General Crusade Against The Opium Evil," (editorial),December 16, 1910.

1911 "200 Seized In 62 Drug Dens," November 26, 191 1, (unsigned). (P. 17)

Saper, Anthony

1974 "The Making of Policy Through Myth, Fantasy and Historical Accident: TheMaking of America's Narcotics Laws,"British journal of Addiction, 69:183-193.(P. 184)

Schwartz, Linda

1980 Heroin: The Strongest Thing You Can Buy Without A Prescription, (Pamphlet),Phoenix, Arizona, Do It Now Foundation.

Seymour, Richard and David Smith

1987 Drug Free - A Unique, Positive Approach to Staying Out of Alcohol and Other Drugs,NY, Sarah Lazin Books, 1987. (P. 37)

Shroeder, Richard

1980 The Politics of Drugs, 2nd Edition, Washington D.C., Congressional Quarterly Inc.(Pp. 3 and 77)

Smith, David and George Gay

1972 "It's So Good, Don't Even Try It Once", Englewood Cliffs, New Jersey,Prentice-Hall.

Smith, David and Rick Seymour

1986 "Abuse Folio -- Opiates," High Times, (reprinted from High Times, March1984). (P. 30)

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1963 "Emergence of the Concept of Opiate Addiction," journal Mondial dePharmacie. (Reprinted Pp. 14-22 in Robert Livingston (ed.), Narcotic Drug AddictionProblems, Washington D.C., U.S. Public Health Service.

Spain, James

1975 "The United States, Turkey and the Poppy,"Middle East journal,29(3):295-307.

Stanley, L.L.

1918 "Drugs and Crime," journal of Criminal Law and Criminology, 9:341.

Starkey, Gerald

1971 "The Use and Abuse of Opiates and Amphetamines," Pp. 48 1 484 in PatrickHealy and James Manak (eds.), Drug Dependence and Abuse Resource Book, Chicago, NationalDistrict Attorney's Association.

Stephens, Richard and Gerald Slatin

1974 "The Street Addict Role: Toward The Definition of a Type," Drug Forum,3:375-89.

Stimmel, Barry

1975 Heroin Dependency - Medical, Economic and Social Aspects, N.Y., StrattonIntercontinental Medical Book Corp. (P. 4)

Strategy Council on Drug Abuse

1975 Federal Strategy For Drug Abuse-and Drug Traffic Prevention, 1975, WashingtonD.C., U.S. Government Printing Office. (P. 5)

Summers, Marcia, James Trost, E. Leif Zerkin, et. al.

1975 Our Chemical Culture - Drug Use and Misuse, Madison, Wisconsin, Stash Press.

Swatos, William H. Jr.

1972 "Opiate Addiction in the Late Nineteenth Century.- A Study of the SocialProblem, Using Medical journals of the Period," International journal of theAddictions, 7:739-53.

Terry, Charles E.

1931 "Development and Causes of Opium Addiction As A Social Problem," journalof Educational Sociology, 4:335-42.

Terry, Charles E. and Mildred Pellens

[ 1928] The Opium Problem, Montclair, New Jersey, Patterson Smith. 1970

Trebach, Arnold

1982 The Heroin Solution, new Haven, Conn., Yale University Press. (P. 38)

United States Attorney General's Office

1984 Organized Crime Drug Enforcement Task Force Program, 1983 Annual Report,Washington D.C. (P. 4)

United States Department of Health, Education and Welfare, Alcohol, Drug Abuse, andMental Health Administration

1975 Treatment of Drug Abuse: An Overview, National Clearinghouse for Drug AbuseInformation, Report Series 34, No. 1, DHEW Publication No. (ADM)75-197. Rockville, MD.

Waldorf, Dan, Martin Orlick and Craig Reinarman

1974 Morphine Maintenance - The Shreveport Clinic 1919-1923, Washington D.C., The DrugAbuse Council. (P. 20, 30-31)

Warren, Edward

1867 "A Lecture On The Sub-cutaneous Injection of Morphia," Medical andSurgical Reporter, 16:101-4.

Weber, Albert

1918 "Drugs and Crime," journal of Criminal Law and Criminology, 9:351.

Weinswig, Melvin H.

1973 Use and Misuse of Drugs Subject To Abuse, N.Y., Pegasus. (P. 19)

Westin, Av and Stephanie Shaffer

1972 Heroes and Heroin, N.Y., Pocket Books. (P. 8)

Whitman, Wait

[1895] The Wound Dresser, edited by Richard Maurice Bucke, Boston,