In the early 20th century, many individuals believed that drug addiction was treatable or at least tolerable. However, since most addicts were middle- and upper-class women, often addiction was simply ignored. For those who sought treatment in the early part of the century (mostly men), facilities for individuals afflicted with drug abuse dotted the nation and primarily served those who could afford to pay their fees. The treatments of that time (hot baths, purgatives, and so forth) did not work, but the point is that attitudes toward the addict were not negative. This situation changed.
By about 1920, physicians were deeply split between those who felt it acceptable and humane to treat drug addicts with maintenance doses of the drug to which individuals were addicted and those doctors who considered it immoral to sell "dope" to so-called dope fiends. Many physicians believed that there was no organic basis for addiction, and consequently, anyone addicted to drugs should be compelled to stop taking drugs altogether. Some key figures, such as Dr. Lawrence Kolb, Sr., of the United States Public Health Service, believed normal people could not become addicted to drugs and only psychopathic individuals would develop an addiction. He believed a normal person would experience no euphoria from a morphine injection, whereas a psychopath would experience such a high.
Many modern studies have shown that some individuals have a genetic predisposition toward substance abuse; however, their physiological reaction to an initial injection of opiates is, as far as is known, the same as or similar to the experience of those who have no familial predispositions toward addiction.
Reformers became distressed by opium-laced remedies in the early part of the 20th century, and in 1905, Samuel Hopkins Adams ran his "Great American Fraud" series in Collier's magazine, attacking suppliers of these nostrums. This series was influential in affecting public attitudes. In addition, after the passage in 1906 of the federal Pure Food and Drug Act, which required labeling of narcotics and alcohol on the bottle, the narcotic content of most patent medications diminished.
According to Musto, the morphine content of Mrs. Winslow's Soothing Syrup declined from 0.4 grain per ounce in 1908 to 0.16 grain in 1911, and morphine was totally removed from the product by 1915.
According to Spillane in Federal Drug Control, prior to World War I, many physicians believed in the antibody theory of addiction: that drug use somehow created antibodies in the blood of addicts, who, as a result, were helpless to end their drug addiction.
Says Spillane, "These physiological changes were [believed to be] beyond the control of the addict, and many doctors accepted that these changes required maintenance doses to be given indefinitely. Many of the leading supporters of the narcotic clinics had been schooled in versions of the antibody theory." Researchers now know that chronic drug use can result in brain changes, although these are not caused by antibodies or reactions to viruses, as far as is known.
By 1919, the theory that antibodies caused addiction was no longer in favor, and instead, addicts were believed to be mentally defective or psychopathic, with no willpower to resist addictive drugs. Law enforcement was seen as the answer to keep addicts away from the drugs they craved. Because of this punitive attitude and change in policy, most narcotic maintenance clinics were closed by 1921.
1) Musto, David F. The American Disease: Origins of Narcotic Control. 3d ed. New York: Oxford University Press, 1999.
2) Spillane, Joseph F. Cocaine: From Medical Marvel to Modern Menace in the United States, 1884-1920. Baltimore, Md.: Johns Hopkins University Press, 2000.
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