Drug use

“ DRUG abuses have become so grave that at last the medical profession is compelled to correct them. The public should learn clearly our mutual positions in the proper and improper use of drugs, which are chemical substances found useful or necessary to combat the effects of disease. ”

“ The horror of pain is not so great as the horror of the drug habit.
Another very serious reason for extreme caution on the part of the medical profession in regard to the use of habit-forming drugs is that the effect of such drugs upon a patient must almost certainly make accurate diagnosis of his case difficult or even impossible. A patient whose consciousness of pain is dulled or eliminated by the use of drugs cannot accurately describe to a physician the most important symptoms of his ailment. ”

“ The routine and unintelligent use of the products of these groups of drugs in the treatment of narcotic addiction—under the mistaken impression that they somehow or other have direct curative action upon the disease condition—has been the cause of a considerable mortality and an easily understood opposition among intelligent addicts. ”

“ If, as they say, the use of the drug means the increase of the dose, where will it stop, and at what precise point of frenzy and delusion will a healthy grown-up man be ready to rush headlong upon a cutlet or make a dash for death or glory at a ham-sandwich? ”

“ The enactment of the 1938 Federal Food, Drug, and Cosmetic Act illustrates the expansion of the definition of drug. One of the changes contemplated in S. 2800, an early version of the Act, [7] defined 'drug' to include
' (1) all substances and preparations recognized in the United States Pharmacopoeia, Homoeopathic Pharmacopoeia of the United States, or National Formulary or supplements thereto; and (2) all substances, preparations, and devices intended for use in the cure, mitigation, treatment, or prevention of disease in man or other animals ”

“ Until the medical profession and the medical institutions—hospital and otherwise—have in competent execution methods of handling and treatment of the narcotic addict which are more humane and more effective than those shown by ample testimony to be in common use, the supply of narcotic drug to the responsible narcotic addict to the extent of physical need, without unjustifiable exploitation, financial or otherwise, is the duty of the medical man. ”

“ The physician or surgeon should realize that the use of a narcotic drug by a patient under his care is of very little immediate importance compared with the satisfactory recovery of his patient from the condition for which he is treating him. ”

“ Drugs which hide such signals from us are a more than doubtful benefit. If it were possible for us to suppose that a fraction of a grain of cocaine could afford to exhausted nerve centres, and muscles, the nutriment which they require for their restoration, and at the same time eliminate the poisonous waste products, then it would be reasonable to prescribe the drug for use by all who are overworked, and perhaps suffering from the malnutrition consequent upon, 'nervous dyspepsia,' as well as mere want of rest. ”

“ Although the mid-1960's saw the most concentrated use of drugs in the American culture recorded in our history, it was not until the present decade that writers began to deal with spiritual and psychological explorations of drug experience as a way of continuing that Romantic visionary quest through the interior flights of chemically-stimulated fantasy. ”

“ This new knowledge is being used by parents, community volunteers, local officials, teachers, health care professionals, and young people themselves. These are the individuals who are closest to current potential drug users, and they can have the greatest influence in preventing the abuse of drugs. ”

“ With the return of health, vitality, and normal nutrition and elimination, his body requires still less drug and he voluntarily and without mental struggle and nervous strain reduces the amount of drug used. ”

“ Laws have been enacted which require on the labels a declaration of the contents of the preparation, both as to the kind of drug used and the amount, and the choice of accepting or refusing such mixtures is left to the individual. But the great mass of people are ignorant of the harmful nature of drugs in general, and hence do not even read the self-accusing label, or if they do glance at it, fail to comprehend the dangerous nature of the drugs specified there. ”

“ His acquired tolerance for the drug has brought about so great a physical change that deprivation or even reduction of dosage is intolerable. Hundreds of cases where physicians had experimented with the drug with these disastrous results have been brought to my attention.
No one shows less foresight, less appreciation of the danger of tampering with drugs, than the physician himself. I am constantly amazed by the fact that any doctor will take even the slightest risk of becoming a drug-user. That many voluntarily incur the peril passes my understanding. ”

“ Save for the occasional use of cocaine, he had no vices, and he only turned to the drug as a protest against the monotony of existence when cases were scanty and the papers uninteresting. ”

“ 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. ”

“ On the other hand, the [Pg 141] majority of illnesses that do not get well without drugs will not get well at all. I have mentioned before the figures which seem approximately true in relation to the cure of disease by drugs. Drugs will cure about six or eight diseases out of about one hundred and fifty diseases known to science. Anybody who fails to give a drug for one of those six or eight diseases is criminally negligent. We should press that drug upon the patient. I do not want anybody to think that I do not believe in drugs. ”

“ Without hesitation, and without blame, for with him the custom has probably been unconsciously built up, the druggist reaches to his shelf and dispenses preparations in which the utmost peril lurks—preparations containing ingredients which should be sold only on the prescription of a physician. Under the present law, as I think it exists in every State, druggists cannot prescribe, but they can advise customers to purchase advertised preparations and those which they themselves compound.
Only a very powerful drug can stop a headache as quickly and completely as Americans have come to demand. ”

“ If anything has been demonstrated conclusively concerning narcotics it is that the methods of the past, legal, administrative, and medical, have not solved the narcotic drug problem, nor controlled the narcotic drug situation, nor been successful in the handling of the narcotic drug addict. ”

“ These drugs, in addition to being harmful, affect the person using them in such a manner that he soon feels the need for the drug. Thus the drug habit is formed,—a condition which has wrecked thousands of lives. ”

“ He is worried and becoming exhausted. It becomes apparent that by continued maintenance of narcotic administration below the amount of physical body-drug-need the very factors are created which have been described as increasing body-drug-need. ”

“ Is it not rather the recognition by the living substance of the lifeless one? The whole theory of drug action is easily explainable on this hypothesis. Drugs—inert substances—do not act upon the living organism, but are acted upon, with a view to their expulsion from the living domain. ”

“ Perhaps there is nothing more characteristic of the march of intellect of the present day, or more indicative of a healthy tone of mind, than the suspicion with which the public in general, and many physicians in particular, are beginning to regard the use of drugs as curative agents—that chiefest engine of the allopathic physician for the relief of suffering humanity. ”

“ Habitual users of drugs or drink are literally human derelicts. The symptoms of their true condition are submerged, and to clear them of [Pg 210] their concealed weaknesses it is necessary to lift them like a barnacle-ridden hulk into the dry-dock for investigation and repair.
I regard as a preferred risk among the victims of the drug habits those who have acquired it through the administration of a narcotic by physicians in time of pain or illness. ”

“ The nature of such drugs as alcohol, opium and cocaine is to benumb sensation, so that pain is stilled, and the pain, or functional disturbance forgotten for the time, because the nerves are drugged into insensibility. The person feels better while under the influence of the drug, so thinks it is benefiting him.
2. There are people who imagine they have diseases which they do not have; since trained physicians occasionally err in diagnosis, it is not strange if the laity should do likewise. Such persons are always ready to aver that a certain medicine "cured" them. ”

“ The remedy is plain, and the necessity for immediate activity is obvious. Education—scientific medical and lay, administrative and public health education is the lacking element or factor in the solution of the many sided narcotic drug problem. Appreciation of addiction-disease and what it may mean in the individual should be as widespread and as comprehensive as possible and at the earliest possible moment. ”

“ They all believe in the principle of "curing one disease by producing another." In other words, their practice is, to induce a drug disease to cure a primary one, for this is exactly what is done when drugs are administered, in pathological conditions as we shall prove later on by testimony from authorities on medical practice. ”

“ There should be some way to dissociate entirely, conclusively and finally in the minds of the public the illegitimate and underworld traffic in narcotic drugs from the efforts of the honest physician to practice rational and scientific medicine in the help of the worthy and deserving addict. ”

“ It is not inconceivable that any inhibiting poison or toxin is capable of producing its own addiction-mechanism, and it has seemed to me that my own clinical familiarity with the action and reaction of narcotic, inhibiting, or addiction-forming drugs and of addiction-mechanism upon circulation, glandular and intestinal and other function has been of no little assistance in the interpretation, control and remedy of other chronic intoxications. ”

“ The author sees no reason why the same rules and criteria as have developed or are formulated for legitimate medical practice in other diseases might not be applied to the treatment of addiction-disease. In a general way the legitimate practice of medicine in the care of, handling of or treatment of a disease consists of such medical attention, advice, instruction and guidance, and clinical or therapeutic ministrations as may be indicated by the needs of the individual case. ”

“ Consider the quantity of proprietary medicines taken in this country, some of them harmless, some of them good in some cases, some of them injurious, but generally taken without advice and in absolute ignorance of the nature of the disease or the specific action of the remedy. The drug-shops are full of them, especially in country towns; and in the far West and on the Pacific coast I have been astonished at the quantity and variety displayed. They are found in almost every house ”

“ Save in New York State, the druggist’s shelves are crowded with jars and bottles holding dangerous compounds which he may dispense at will, his drawers are crowded with neat pasteboard boxes containing powders which are potent of great peril. The public will have made a long step toward real safety when [Pg 64] it realizes that any drug which brings immediate relief from pain or which will artificially produce sleep is an exceedingly dangerous thing. ”

“ It is indeed high time that the medical profession raised, with one accord, its voice in solemn protest against the use of all nerve-obtunding and felicity producing drugs, which are all, without exception, toxic agents, working mischief and only mischief in the human body."—Dr. ”

“ It is evident therefore, that upon the intelligent and competent estimation, measure and control of physical narcotic drug balance and inhibition of function depend the reaction, well being and therapeutic progress of the man who has narcotic drug addiction-disease. These factors also markedly influence the action of all medication, including the drug of addiction, upon the body of the opiate addict. ”

“ Consequently, the fewer number of times in a day a dose of narcotic drug is administered, the greater amount of competent metabolism is present—the more adequate is the patient’s elimination and nutrition—the smaller amount of opiate or its product lies stored in inhibited and atonic cells, and the smaller amount of antidotal substance is manufactured for the protection of the body, and to some extent, the smaller amount of opiate is required. ”

“ Many of these workers have considered the possibility that their results may have been influenced by suggestion, or of bias towards results which were to be expected theoretically, and some have show that effects similar to those following the adminstration of a drug may be the consequence of the administration of a wholly inactive substance which is supposed by the subject to be the drug in question. ”

“ Physicians have come to the realization that drugs are as a two-edged sword—under proper conditions, striking against the disease; otherwise, against the patient’s health. The first condition for their proper use is adequate knowledge of their composition and purity; of their actions and malefactions; their field and limitations. Slowly and painstakingly—sometimes painfully—this scientific knowledge has been gathered, is still being gathered, by chemists and pharmacists, pharmacologists and clinicians, with increasing thoroughness, care and discrimination. ”