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Mr. Chairman, thank you for your invitation to testify today

about the history of the drug problem in the United States. This is a broad subject extending more than a century into our past,

but I will try to extract thos6 features most relevant to the

current debate over the legalization of drugs such as cocaine. I

discuss these matters in much greator detail in my book The

American Di Sgas (expanded edition, 1987, Oxford University


The first point to be made is that narcotics were legal in

the United States last century. There were several reasons for

this. Strict construction of the Constitution left police powers

like curbing careless physicians or prohibiting dispensing of


DF Musto, MD


Testimony 29 Sept. 1988

certain drugs - to the States. Furthermore, although US

consumption of opium and its active ingredient morphine grew

continuously during the 19th century, levels and consequences did not alarm the public until the use of the hypodermic syringe

exploded after the 18608. We reached a level of opium and opiate

consumption in the mid-1890s which 18 arguably the highest per

capita level in our history. Some steps at the state level, in

some states, were taken by 1900 to limit access to morphine, but

the effectiveness was nodest if not invisible. Drugs were

available from mail-order houses and a wide choice of hypodermic kits could be purchased from the Sears, Roebuck Catalog and


A fear of the effects of morphine and opium appears to have begun a reduction in per capita consumption after the 1890s. We

entered what has been called the progressive Era, a time in many ways like our own today, Americans became increasingly concerned about the environment and what we took into our bodies. The

conservation movement, battles for clean air and streams, pure

food and drugs, and a curbing of industrial disregard for the

waste products of factories energized Americans. Many of the basic laws in these fields wero enacted around the turn of the

century. Included in this concern was the effect of narcotics on

the individual, family and community.



DF Musto, MD


Testimony 29 Sept. 1988

But it was not just morphine or, after 1898, heroin that worried Americans. A new drug, a powerful stimulant, had arrived in the 18808: cocaine. At first cocaine was considered harmless. Experts in the drug and medical areas assured Americans that

cocaine not only safely energized the weary and cheered the

melancholy, but that there was no such thing as cocaine

addiction. Sometimes the praise was slightly tempered by the

advice that cocaine should be taken "in moderation," at other

times this bow toward common sense was lacking.

Cocaine rapidly spread through American society. At first it was rather expensive, but in about ten years or so the price of cocaine had dropped enough that it was available to almost

everyone. It became a standard remedy for sinusitis and hay


It had been in Coca-Cola from the beginning until about

1900 when cocaine's reputation began plummeting.

Its damage,

especially among young people, was most visible in the cities. In Chicago, Jane Addame was appalled by the effect of cocaine on children she and her co-workers were trying to help. One example

she gave: "He had been in our kindergarten as a handsome merry

child, in our clubs as a vivacious boy, and then gradually there

was an eclipse of all that was animated and joyous and promising,

and when I last saw him in his coffin (at the age of seventeen), it was impossible to connect that haggard shriveled body with

what I had known before."

Jane Addams succeeded in getting a

stronger state law in Illinois in 1907, eighty-one years ago.

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Chicago's poor neighborhoods did not differ much from the worst inner-city areas of today. One observer called Chicago "first in violence, deepest in dirti loud, lawless, unlovely,

111-smelling, new..." Cocaine was everywhere, from soda pop to

sniffing powders. But Me Addams, who would later become the first

American woman to receive the Nobel Peace Prize, did not abandon

these difficult neighborhoods to cocaine. She was spurred to action by the effect of cocaine on the minds and bodies of young

people. And eventually, after years of struggle, she and the

neighborhoods won. As a result of the anti-cocaine attitude

expressed in several state laws, such as the Al Smith anti

cocaine law of New York in 1913, and then at the national level

the Harrison Anti-narcotic Act of 1914, the attack on cocaine

eventually succeeded, although more slowly than an impatient

America wished. Cocaine's availability in the 1930s was far less

than in 1910 and by the 1940s and 1950s, cocaine had become a

memory for the vast majority of Americans.

In the time from 1885 to about 1905, twenty years, cocaine

had moved from a harmless tonic to a drug which was seen

dangerous to take even once. This 18 a fundamental shift in

popular attitudes that underlay the decline in demand. Such a

changed perception of a drug from being a help to a hindrance

occurred in the United States in other cycles of drug use.

SEP 25 88 16:44


DF Musto, MD


Testimony 29 Sept. 1988

In fact, the United States has a long history of slowly alternating attitudes toward drugs. If we include alcohol, these cycles of tolerance and intolerance toward drugs extend back to the earliest days of our nation. What can I say briefly about these cycles? That a drug is initially seen as being a tonic, a stimulant to the body, and helpful in attaining insight or relaxation. The claim. for drugs are positive and their use, if

someone knows nothing more than the claims, seems reasonable. The

road from this initial positive attitude to refusing to try

drugs, is a long one. We find any reason to reject the

dangerousness of drugs and overlook or explain away the bad effects. Because the use of drugs is in general an individual

decision, a lot of minds must change in order to reduce demand.

This move toward seeing drugs as harmful to achieving

productive goals in life affects all the institutions of society.

Schools, the police, courts, churches, and other institutions

cooperate and reinforce one another in the rejection of drugs. In

the first stage of drug use these institutions may not have taken

the problem very seriously or not even have seen drug use as a

problem. Gradually, the pressure of these institutions makes drug uso less muy, less desirable and less approved. Peer pressure can be as much against drugs as for them. Slowly, drug use


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