[We reprint Edward Marshall’s illuminating article from the New York Times of February 22nd on the most recent serious menace within our prisons, and outside of them. There has come throughout the country, apparently a relatively sudden realization of the fearful effects of the habit-forming drugs.]

Habit-forming drugs and their ravages, destructive of both the morals and the health of the community, seem at last to have aroused commensurate human indignation, at least in New York city.

Discussion is continual of this strangest and saddest of the problems of our modern civilization; city officials are definitely interested, studying and planning; a committee, including in its membership magistrates and others of sociological force, works on an impulse supplied by Mrs. Vanderbilt; and from a third source definite legislation emanates to be offered in the Legislatures of this and other States and in the National Congress.

Nothing more astonishing, nothing more appalling than the hold which habit-forming drugs have taken on the community at large can be found among the tragedies peculiar to modern civilization.

And all this has come suddenly. Not so many years ago the opium smoker was the only known victim, and he was a curiosity of Chinatown; the morphine taker was a rare, and troubled spirit, stalking solitary in its slavery and misery; the cocaine fiend remained unknown, and the heroin addict—latest in all this incomparably tragic company—was undreamed of.

Now opium smoking, though still the cause of an occasional police raid, has sunk into insignificance by comparison with morphine taking; cocaine habitues are not uncommon sights upon the streets to those with the depressing knowledge which identifies them; police slang has coined a name for them—“snowbirds”; and we read in almost every issue of our daily newspapers of new developments of the “heroin habit.”

Habit-forming drugs of one kind or another have gained so strong a hold upon the people of this country, more especially upon the people of American cities, that they have reached the dread proportions of a national curse.

They play their tragic part in uncounted domestic tragedies; an annual crop of business and professional failures numerically approaching the sad army of alcoholic wrecks is thrust into the various bins wherein we hide our human refuse; drugs send their yearly thousands of young men into the prisons, of young women to the streets.

A native Southerner, of national fame, high in the councils of his party, told me recently that habit-forming drugs, cocaine principally, have of late so complicated the negro problem of the South as to triple its difficulties and dangers.

These heroin and cocaine groups, lately so conspicuous, are insignificant in numbers and in tragedy when compared by those who know with the thousands to be found among our citizenship who, driven only into misery, not into viciousness or crime, by drug addictions, fall innocent victims to this most terrible of modern curses, sad sacrifices to illness and to pain, to ignorance and to cupidity.

The victims of drug habits who have been led into them through the mistaken methods of the doctor, who first administers the drug to ease acute physical suffering, and by the proprietary medicine or drug store preparation passed out as cure-alls with an indifference to or ignorance of consequences which must remain incredible to those who understand, is infinitely more numerous than the growing group of drug takers led into their addictions by the tendency towards dissipation.

Drugs are even taking hold upon our youth. Within the year many instances have been cited in the newspapers, which have uncovered peddlers of cocaine and heroin to school children. I listened recently to the appalling story of a seventeen-year-old Connecticut boy, brought by his father for treatment in this city, who told how he had been the center of a group of not less than a hundred other boys in his own town who gained the drug through him and were completely at his mercy.

I was present recently when this father told the story, having brought the boy to the metropolis for treatment. It was practically the duplicate of many, and illustrates the real necessity of legislation, which will impose upon the druggist and the medical profession a general restriction.

“My boy,” this sorrow-racked and disappointed father said, “was employed by a physician living near us to care for his automobile. He paid him for his work by giving him prescriptions for heroin. My boy quickly became a victim of the habit, and soon formed the centre of a group of twenty or more other boy victims, who secured from him the prescriptions by means of which they brought the drug.

“Two large manufacturing establishments in our home town were thus infected, and at the present time not less than one hundred boys have become slaves to the habit. They buy the drug in quantities as large as they can pay for from the largest drug store in our city, and are never questioned.”

Their home city is Bridgeport, Conn. I have in my possession one of the prescriptions given to the boy by the physician, who thus paid him for his services in attending to his motor car.

In New York State and city the situation is not better. The police records have been full of “dope cases” for years. Morphine and heroin are doing serious work in the demoralization of the city, and the ravages of cocaine are as serious here as they can be among the negroes of the South.

Miss Katharine B. Davis, now in the full swing of her duties as Commissioner of Correction, tells me that she finds her problems complicated all along the line by drug addictions among inmates of the city’s prisons and jails, and the Mayor and other members of the city government are looking into the whole subject with deep interest.

In her efforts to discover how the city’s prisoners get drugs, Miss Davis has uncovered strange, almost uncanny methods. A prisoner’s wife or “girl” brings him clean handkerchiefs or shirts, stiffly starched. Left alone with them, he chews them eagerly, getting thus the morphine which impregnates the starch.

Another prisoner greedily sucks an orange which has been brought to him. Investigation shows that through a tiny puncture its juice has been withdrawn, to be replaced through a hypodermic syringe, after it has been transformed into a saturate solution of morphine.

Fountain-pens are now taboo among the prisoners. Their barrels may be filled with drug tablets.

In a letter now in my possession, written to Charles B. Towns, the drug expert, by Dr. Charles W. Farr, prison physician of Sing Sing, the doctor, after announcing the successful treatment of some drug addicts, continues:

“But the men seem to be able to get the various drugs as readily as ever. I suppose that the usual method is to have the guards bring it in for them. When questioned the prisoners always blame the traffic on the honest and unpopular guards who are not really concerned with it. I asked a convict to estimate the number of drug takers among the prisoners. He answered:

“‘Counting the habitual users and the “joy riders,” there are probably two hundred in this prison.’”

And while these demoralizing novelties are frequently discovered in the underworld, the hold which habit-forming drugs are getting elsewhere, with the worth while, is admittedly appalling. There are pharmacists in New York city whose important trade is drug traffic; there are physicians here, and not a few, who, while drug addicts themselves, find their practice also among drug addicts, furnishing prescriptions daily to habitues, collecting fees proportioned to their victims’ purses.

As these things have become generally known, so has work begun to check the evils. Within a few days the most comprehensive legislative plan which has so far been proposed for regulation of the traffic in all habit-forming drugs has been launched at Albany.

It will presently be launched in the New Jersey and all other State Legislatures. It is further planned to make this definitely comprehensive and effective by Federal legislation, already drafted and soon to be introduced at Washington.

Charles B. Towns, its author, also wrote the law, already on the statute books of New York and several other States, permitting the sale of the hypodermic syringe only upon prescription by a doctor; he presented last year at Albany a comprehensive bill which did not pass.

His measure of this year, known in the Senate as the Boylan bill, includes many features new to legislation of the sort, and has already won outspoken approval from many members of the medical profession, including Dr. Alexander Lambert of New York, and Dr. Richard C. Cabot of Boston. Commissioner Davis has gone over it with care, indorsing it.

“To wholly control the drug evil, which is so unfortunately affecting New York City and the State, by any legislation entirely local to the State,” said Mr. Towns, “is out of the question. But a beginning must be made at home.

“For various reasons habit-forming drugs have found a stronger foothold in this country than elsewhere in the world. Our annual opium consumption, per capita, is far greater than that of China, although we use it principally in the form of its derivatives, morphine, etc., and our consumption of cocaine has grown to a magnitude unprecedented anywhere.

“Most of the legislation drafted for the purpose of restricting the use of habit-forming drugs has been ineffective. It is ridiculously easy to-day to obtain morphine or any other of the inhibited substances in New York without violation of the law, although New York has laws which were designed to be of drastic force.

“The classification in my bill reads: ‘Opium, morphia, coca leaves, cocaine, alpha and beta cocaine, their salts, derivatives and preparations.’

“This classification includes automatically many substances which it does not specifically mention, but which have recently attracted much attention because of their common use among drug-habitues.

“Among these is heroin. But heroin is a derivative of morphine, which is the active principle of opium, and is three times as strong as the parent drug.

“It is not mentioned in the bill because the word ‘heroin’ is a mere trade name, and a law prohibiting its sale under that name would not prohibit the sale of the same substance under any one of the new trade names which manufacturers would have no difficulty in coining.

“I speak of this almost at once, because I have had several inquiries as to why this drug apparently is omitted from the list named in the bill.

“To intelligently discuss the reason for the prevalence of drug addictions in this country would necessitate an exhaustive study of national psychology.

“Patent medicines containing small quantities of habit-forming drugs have wrought great havoc with us, for any medicine, containing any quantity of any habit-forming drug, contains it in habit-forming quantity if the dosage is regular. It is not the quantity, but the regularity of dosage which produces drug habits.

“A lack of understanding of this fact upon the part of the medical profession and the public has been responsible for many drug addictions.

“The cocaine habit had its start in patent medicine, mostly socalled catarrh cures, and will find its end in a national degeneration if it is not checked by drastic legislation.

“Heroin was first advertised about fifteen years ago, and accepted by the medical world as a non-habit-forming substance, having all the useful qualities of the dangerous habit forming drugs.

“Having been thus started, and innocently promoted by physicians and druggists, the progress of the habit, which has become a sanitary, criminal, and social problem of real moment, can be halted only by the passage of some law including such provisions as those I have included in the bill now pending in Albany.

“My plan is not accidental. I went to the Orient in 1908-1909 and spent a year there, studying the opium curse as it has there developed. Returning to this country I have since been thrown into the closest contact with the various drug addictions, passing several hundred cases in minute review each year. Last Summer I toured Europe and found that drugs have gained comparatively slight foothold there, and that no European nation has produced restrictive legislation worthy of consideration.

“Our own internal revenue reports show us to be consuming as many of these drugs as all of Europe put together uses.

“Of course, the fact that the drug traffic has continually increased in this and every other State despite the presence on the statute books of laws thought to be stringent, can mean but one thing—that in these laws are loopholes.

“The same laws which require that these drugs must be dispensed only upon presentation to the druggist of a physician’s prescription fail to forbid a layman from posing as a physician in making out prescriptions; no obligation of investigation is imposed upon the druggist.

“The drug trade is practically without legal regulation, although across the drug store counter are dispensed substances at least as dangerous to individuals and public welfare as those which are dispensed across saloon bars—and saloons are regulated very rigidly.

“No registration of manufacturing, wholesale or retail druggists is required by law. The importation, manufacture and distribution of habit-forming drugs are now surrounded by fewer restrictions than are thrown about tobacco. The proposed law provides for records of each grain, from the time it leaves the manufacturer until it reaches the ultimate consumer.

“Any druggist, wholesale or retail, may manufacture and market any proprietary medicine he may desire, containing certain quantities of these drugs, and offer it openly for sale, without the formality of a physician’s prescription.

“The clause in the otherwise worthy and admirable National Pure Food and Drugs act requiring that any drug store composition containing any quantity whatsoever of any habit-forming drug must bear upon its label an announcement of this content, was well meant, but has worked havoc.

“Even as no physician who administers a habit-forming drug to ease his patient’s pain should acquaint that patient with the nature of the drug he gives, lest the patient turn again to it when pain recurs and fasten something worse than pain upon himself, despite the doctor’s wishes, so no medicine offered for general sale and bearing on its label the announcement of its content of a pain-killing, habit-forming drug should by the law be tolerated.

“Relieved by the medicine those who take it read its label carefully, learn what has afforded the relief—it always is a mere relief, it never is a cure—and, unacquainted with the dangers attending substances of the sort, regularly dose themselves, either with increased quantities of the medicine or more probably with the straight drug.

“A drug-tainted patent medicine is absolutely certain to establish a drug habit in any one who, for any length of time, takes it according to directions.

“The proposed law makes such patent medicines, containing any quantity whatever of the habit-forming drugs, illegal. Physicians rarely if ever give prescriptions for them. The public will lose nothing and gain much through their abolishment.

“Now let us consider the physician.

“Physicians are at present permitted to prescribe and administer the habit-forming drugs as loosely and extravagantly as they please, either to themselves or others, without responsibility as to the outcome. Under the proposed law they are held responsible.

“There is real necessity for the provision which disbars from medical practice physicians who take drugs. The drug-taking doctor is more dangerous than the drug-taking druggist or drug clerk. All are liable to irresponsibility at a time when it may well mean death to others; and, furthermore, all are promoters of the drug habit. The proposed law guards against them.

“The drug taker invariably introduces others to his drug, sometimes openly, oftener secretly, through perverted sympathy for another’s suffering.

“And if the drug-taking doctor should be barred from practice, so, also, should the drug-taking nurse and the drug-taking veterinarian.

“Now how are these things to be accomplished? The State Commissioner of Health is to prepare and furnish to all local Health Boards or officers official prescription blanks, serially numbered and bearing the State seal, making their imitation forgery.

“These are to be furnished to physicians on demand, and no drugs of this class are to be dispensed, save on their presentation properly filled out and signed; no prescription shall be refilled; all filled prescriptions shall be filed and open to periodical health board inspection, bearing not only dates and names of the physicians, but the names of patients for whom the drug is ordered, and no such prescription shall be filled more than ten days after issuance.

“To the purchaser, for his protection, while he has the drug in his possession, druggists must issue a certificate, giving their names and addresses and those of the prescribing physician.

“These are the principal restrictions surrounding the prescription blank, though there are others. And violations of these regulations are to be regarded as misdemeanors.

“In this proposed law, also, is incorporated a provision similar to that of the existing law restricting the sale of hypodermic syringes to physicians’ prescriptions.

“This roughly indicates the proposed provisions covering the sale of habit-forming drugs. They are followed by one which may seem almost fantastic to the person unacquainted with the terrible psychology of drug addictions.

“I shall preface any explanation of it with the announcement that the drug habit is not a mental state, but a physical condition. My knowledge of it, gained from observation of many hundreds of its victims, will forever prevent me from proposing or pushing any further restrictions of the traffic, until some provision is made for the relief of those already enslaved.

“To deprive a drug addict of his drug without giving him definite medical help must inevitably subject him to such suffering, such incredible and indescribable torment, as cannot otherwise be brought upon mankind. It may mean death; it is very likely to mean insanity. The drug addict will steal to get his drug; indeed, he may do murder in order to obtain it.

“Therefore this bill provides for the treatment and relief of those who, rendered unable to procure their drug by the provisions of the legislation, might otherwise be made the victims of a social progression.

“Such a relief is possible and not too difficult. The treatment by means of which it may be accomplished bears my name, but is no monopoly. I could gain no profit from its use by the authorities and others. It includes no medicaments not purchasable at any well-stocked pharmacy. I have freely published broadcast every formula connected with it, unrestricted, for the benefit of the medical profession. It is now in use by the authorities in Sing Sing Prison, at Bellevue Hospital, in the hospital on Blackwell’s Island, and elsewhere. Plans are under way for its more extensive use by the authorities.

“Very briefly I have sketched the provisions of this proposed State legislation. It should be welcomed by the doctor, for it puts him absolutely in control of one of his most valuable assets, the pain-deadening drug, a control which he must share, as things at present stand, with every corner druggist and every manufacturer of patent medicines.

“Decent druggists will welcome the planned regulations. It will protect them against thefts of drugs by employees, and the drug-taking drug clerk is a dangerous and at present all too common handicap on the employing druggist.

“A certain reputable retail druggist of my acquaintance tells me that within a year he has discharged two clerks, one for taking morphine, one for using cocaine. They were a threat against his welfare. How much greater was their threat against the public welfare?

“Neither the drug-taking doctor nor the drug-taking drug clerk will be a possibility under the provisions of the proposed new legislation, which demands that every grain of any of these drugs dispensed by or in the possession of druggist or a doctor, shall be instantly accounted for upon demand of the Health Board.

“The present situation, so terrifying that it forms a problem of our modern civilization, has grown out of the fact that neither the physician nor the druggist have been held really responsible.

“The druggist has been permitted to import and manufacture as freely as he pleased, and to sell under restrictions which were insufficient to prevent promotion of drug habits; the physician has never been required to make accounting for prescription of or the administration of these dangerous substances, and his medical training, both in college and in hospital, has left him in the dark concerning the danger point in their administration.

“This proposed New York State legislation has been drawn with careful eye to the establishment, here in the Empire State, of a model law for other States. General adoption of such legislation would make proper Federal laws effective and without a perfect understanding between the State and Federal Government as to where responsibility of each begins and ends, no really effective action will be possible to either.

“The first step for the Federal Government will be to require the registration of all importers and manufacturers of habit-forming drugs, all wholesale druggists and drug jobbers, and all retail druggists. A similar registration is now required of all those engaged in the tobacco trade.

“The regulation of interstate traffic in such drugs will be a simple matter. A system of uniform order blanks furnished to the buyer, and of uniform invoice blanks furnished to the seller on demand, by the Government, can be so arranged that every step of every interstate shipment can be closely followed.

“It will be necessary to require that habit-forming drugs shall be shipped in bond; that the importer shall account for all which he imports, the manufacturer for all which he manufactures.

“The passage of the law subjecting importations of opium prepared for smoking to a prohibitive tax lost us millions in annual revenue and increased the vice of smoking opium, for it forced the preparation of raw opium for smoking in this country—an art which theretofore had been in the exclusive possession of an ancient Chinese company. Under this law opium prepared for smoking is cheaper in this country than it was before its passage. Let us have no more abortive legislation on this vital subject.

“Ninety-five per cent. of the whole nation’s drug evil could surely be avoided by the general adoption in all the States of legislation such as this proposed in New York State, supplemented by such Federal legislation as I have outlined.”