Friday, February 15, 2013

Dr. Charles E. Terry on the Aftermath of the Harrison Narcotic Act



"At this stage the truth of my opening sentence is apparent, for while I recognized the medical and public health angles of the problem, I still felt that rigid laws offered great promise. I felt with others that national law which would control interstate traffic in these drugs would solve the greatest part of the difficulties confronting us. It must be home in mind that at this period only a few states had restrictive laws that were not openly broken on every side and for the most part the formality of a physician's prescription was rarely observed by druggists in dispensing any of the addiction or habit forming drugs'. Effectual restrictive legislation had never been tried and it was perhaps not unnatural to suppose that with the well-known sources of supply curbed, the use of these drugs would be very materially if not entirely prevented. It is obvious, however, that we had counted without the peddler. We had not realized that the moment restrictive legislation made these drugs difficult to secure legitimately the drugs would also be made profitable to illicit traffickers.

"I had had practically no experience with this fraternity for a reason which I now understand well, namely because we furnished in the health office free prescriptions for those unable to pay for them, nor did we try to dictate to them the quantities they should take or for that Matter humiliate or persecute them in any other way. As a consequence the peddler could not make a living in our town, though he had begun to flourish in Massachusetts and New York.


"Feeling as I did about the need for further restrictive legislation, I looked forward to the Passage of the Harrison Act, and during the months immediately preceding its beginning operation in May 1915 we tried to prepare our indigent cases for the drug deprivation which we believed was in store for them. They were urged to reduce their daily amount to the lowest possible limit, and they earnestly cooperated, and looked forward as did we to the time when they would be cured. Meanwhile, a fund was raised by private subscription and hospital and nursing facilities provided for about 20 beds. These beds were filled and refilled until between 65 and 75 patients had been treated. This is one of the experiences in my attempts to work out this problem which I do not like to recall. A local physician kindly volunteered to treat these cases. Although not practicing I visited them daily, and the nursing attention they received was of the highest order. The method of treatment employed was that known as the Towns treatment [rapid withdrawal plus administration of a belladonna mixture]. We felt, as do most when contemplating drug addiction treatment, that a certain amount of suffering was necessary, but I was not prepared for the extreme suffering which I witnessed in these cases, nor was I prepared for one death which occurred in an apparently healthy woman. With the exception of 2 or 3, all of these cases relapsed within a very short time after their discharge as cured, and I realized more than ever that here was indeed a medical problem and I began to harbor my first doubts as to the wisdom of blind restrictive legislation. And by this I mean legislation based upon habit and vice theories of drug addiction and upon the assumption that satisfactory methods of treatment are generally available.

"That my experience was not unique was determined by the committee on habit forming drugs of the American Public Health Association, through a questionnaire submitted to the medical schools of the country.
It would seem unnecessary to state that the narcotic drug addict must be supplied with his drug in doses physically necessary until such time as he may receive treatment which will leave him in at least as good condition as that in which it found him. That to supply this drug is not only necessary, but is vital, that to deny it is to cause a physical and possibly a moral wreck, while to heap contumely upon narcotic drug addicts as a whole is to drive them to the underworld for their supply, It never must be lost sight of that among the sufferers from this disease are numbered many of the highest intellectual types of men and women in the business and professional worlds, and that individuals of this type May not contemplate the indignities which many administrators seek to heap upon them, through their ignorance of the true nature of this condition and their apparent misconception of the character of its victims."

-Dr. Charles E. Terry, who had been working with addicts in Jacksonville, Florida, from 1911 until the Harrison Act went into effect in 1915

Quoted from "the Addict and the Law" by Alfred Lindesmith [Bold added -Ed]

Afterword:
I am compiling a list of fatalities resulting from opiate detoxification for a future post. This is one of the earliest records I have been able to uncover that refutes the notion that nobody dies from opiate withdrawal. While the evidence in this particular case isn't overwhelming, as the patient may have died as a result of the belladonna mixture, there are other cases in which people have died from going "cold turkey" (usually while incarcerated). If anyone has evidence of other cases of people dying from an opiate (opioid) withdrawal please send me an email or leave a link in the comments.

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