Controlling Substances: The Evolution of the American Moral and Medical Drug Policy Regime 

By Logan Heiman, Digital Collections Manager

Senate hearings on narcotic addiction in 1969.

American drug policy as we know it today categorizes marijuana as a Schedule I substance, meaning that it is considered to place users under high risk for abuse and not accepted by the FDA or DEA as safe for use as medication with or without supervision. The FDA and DEA have rejected multiple petitions to reschedule marijuana under less restrictive categories from governmental and non-governmental entities. The Controlled Substances Act of 1970 governs federal drug policy in the United States as part of a broader effort to curtail the sale, distribution, and consumption of illegal drugs by the Nixon administration, later known as the War On Drugs. 

The “La Guardia Report,” 1944.

The status quo of American drug policy extends farther back than 1970, however. When the United States Congress passed the Marihuana Tax Act championed by Federal Bureau of Narcotics Commissioner Harry Anslinger in 1937, it was a watershed moment in the history of drug policy regulation. The legislation represented a victory for marijuana opponents who successfully convinced lawmakers of a link between cannabis usage and addiction, deviance, and criminality. New York City Mayor Fiorello La Guardia looked skeptically upon the Marihuana Tax Act and its pretext. He thus called upon the New York Academy of Medicine to prepare a report drawing from a wide variety of academic disciplines to scrutinize the drug law and the beliefs about drugs held by its proponents. In the “La Guardia Report” of 1944, the Mayor’s commission on marihuana use demonstrated that the widespread fear, even panic, around marijuana use was greatly overblown.

NYC’s Overdose Prevention Center
(Photo credit: OnPoint NYC)

In the 1950s and ’60s, the Academy continued to emphasize drug addiction as a treatable condition. During 1995 and 1996, NYAM’s Committee on Medicine in Society looked specifically at the concept of harm reduction. The Academy recommended policy changes that were, for the time, cutting edge. These included expansion of treatment programs, acceptance of methadone treatments, special efforts for those incarcerated, better training for medical professionals, and, especially, expanding needle exchange programs and decriminalizing needle distribution and possession. The Library’s Then and Now event “Drug Policy and Harm Reduction Services” brought that history up to the present time. A stellar panel mentioned NYAM’s continuing work in harm reduction, looked at the racial component of America’s drug control regime, considered the experience of those working in NYC’s new Overdose Prevention Centers, and noted that the most recent White House National Drug Control Strategy champions “harm reduction to meet people where they are.” For at least a quarter century, NYAM has supported the people-centered approach that lies at the heart of harm reduction. We wait to see where the national strategy goes next.

Side Effects May Include

By Emily Miranker, Events & Projects Manager

You’re curled up on your couch watching the latest episode of a favorite show when a commercial break comes along. An actor with amazingly white teeth goes from an unhappy to a happy face suddenly able to go about their regular life without discomfort, all thanks to Some Medication. As the ad spot wraps up, a soothing and fast-talking voice rattles off a litany of side effects: dizziness, loss of appetite, dry mouth, nausea, indigestion, insomnia, and so on.

Side effects wordcloud_FDA

Finding and Learning About Side Effects, FDA.gov.

I grew up used to the recitation of possible side effects and long lists of them stapled to prescriptions from the pharmacy. “Yeah, yeah; might get a headache…” But there is huge importance in a regular headache and a headache that presages something medically serious. Mrs. Anne St. C. of Buffalo, NY was not used to these warnings in the 1960s. Because they didn’t exist.

The inclusion of side effects, also called adverse events by the Food and Drug Administration, was an incredibly important milestone for patients and informed consumer choice. We owe these warning labels to another milestone event in public health; the oral contraceptive, the first of which was Enovid, approved for prevention of pregnancy in the United States in 1960.[1] This was a game changer for American women, and within two years 1.2 million women were taking the pill.[2]

AJOG_v83n3_Feb1-1962_Enovid_watermark

Advertisement for Enovid. American Journal of Obstetrics and Gynecology, Vol. 83 No. 3, February 1, 1962.

One of those women was Anne St. C.

Wife of a professor at a local [Buffalo, NY] university, mother of three and a user of the pill, [she] called her gynecologist and asked, “Is the pill safe? Should I be taking it?” Dr. K. snapped, “Of course, it’s all right for you to take the pill. If it weren’t, I’d never have prescribed it.” Anne did not tell the doctor the real reason why was she calling. In the preceding two weeks she had experienced several attacks of dizziness and double vision. She had also suffered from stiffness in the neck. If she had not been cowed by her doctor’s brusqueness, she might have detailed her symptoms. In that case, the doctor’s reaction might have been quite different. As it was, Anne had a stroke exactly eight days later.[3]

In that Anne survived her stroke, she was lucky. For other women, the side effects were fatal.

Two points about the world in which the oral contraceptives came to market. First, in assessing the safety of the pill, regulators focused on its “ability to prevent pregnancy because pregnancy and delivery were inherently medically risky”[4] and since the pill was effective in that objective, it met the law’s safety requirement. Second, the pill was approved before the dangers of thalidomide‑ discovered to cause birth defects in children whose mothers took it for morning sickness‑ were known and the consequent Kefauver Harris Amendment (“Drug Efficacy Amendment”) of 1962 passed.[5]

When Anne St. C. was taking the pill, doctor-patient relationships existed in the context of the 1938 Federal Food, Drug, and Cosmetic Act. That act required pharmaceutical companies to make information about drug safety available to physicians. When patients got information it was “through the filters of the prescribing physicians and the dispensing pharmacist.”[6] The balance of power rested with the medical practitioner. Come the late 1960s, the burgeoning feminist and consumer rights movements challenged the status quo of the doctor-patient relationship. The balance of power was  questioned and began to shift.

Barbara-Seaman2-300x448_ahrp

Barbara Seaman, Alliance for Human Research Protection.

Journalist Barbara Seaman, exposed the dangers of the pill in her 1969 book The Doctors’ Case Against the Pill. She wrote that “a typical package insert that is supplied with one of the most popular oral contraceptives…lists more than 50 side effects of the pill, including a number that can be fatal…Relatively few women ever see these warnings because they are written for physicians; doctors or pharmacists usually remove them from the pill packages,” advocating that it was the patient’s privilege to decide. A woman was “entitled to know the risks and give her informed consent.”[7]

Seaman’s book brought the issue to the attention of Wisconsin Senator Gaylord Nelson (organizer of the first Earth Day). In January 1970 Nelson instigated Congressional hearings on the safety of the pill and the sufficiency of information about its side effects.[8] Attending the hearings, Seaman and fellow activist Alice Wolfson (both future founders of the National Women’s Health Network) were struck by “the fact that there were no women testifying and that there are no women on panel.”[9] Wolfson’s collective, D.C. Women’s Liberation, organized women to position themselves in the hearings’ audiences and outside the Capitol to voice their twofold concerns; the dangers of the pill and the exclusionary structure of the hearings. The feminist activists’ strategic interruptions at the hearings and protests outside the Capitol captured media attention.

Policeman Approaching Young Feminists

D.C. Women’s Liberation demonstrators at the Nelson Hearings, 1970

Amid the media coverage the feminists brought, FDA Commissioner Dr. Charles Edwards announced on the final day of the hearings “that his agency planned to require a … package insert in every package of birth control pills … written by the FDA in lay language and directed to the patient.”[10] While compromise about the writing and scope of the inserts continued, the activists’ efforts laid the groundwork for the warnings that come with all prescription packages today. And today’s pills contain lower doses of hormones than the first Enovid pill.[11]

We continue this important work in increasing the public health literacy and access at the Academy with our Language Access in Chain Pharmacies project, which supports multilingual medication labels. Being able to understand firsthand how to use and any risks or side effect is immensely empowering for a patient and goes a long way to fostering trust in the healthcare system.

Special thanks to Allison Piazza for research assistance with this post.
References:
[1] Suzanne White Junod. FDA’s Approval of the First Oral Contraceptive, Enovid. Update. 1998, July-August. https://www.fda.gov/downloads/AboutFDA/WhatWeDo/History/ProductRegulation/UCM593499.pdf Accessed July 9, 2018.
[2] Alexandra Nikolchev. A brief history of the birth control pill. Need to Know on PBS. http://www.pbs.org/wnet/need-to-know/health/a-brief-history-of-the-birth-control-pill/480/ Published May 7, 2010. Accessed July 10, 2018.
[3] Barbara Seaman. The Doctors’ Case Against the Pill. New York: Peter H. Wyden, Inc., 1969: 109.
[4] Junod. https://www.fda.gov/downloads/AboutFDA/WhatWeDo/History/ProductRegulation/UCM593499.pdf Accessed July 12, 2018.
[5] Sam Peltzman. An Evaluation of Consumer Protection Legislation: The 1962 Drug Amendments. The Journal of Political Economy, Vol. 81, No. 5. 1973 Sept-Oct.
[6] Elizabeth Siegel Watkins. Expanding Consumer Information: The Origin of the Patient Package Insert. Advancing Consumer Interest, Vol. 10, 1. 1998.
[7] Seaman, 9 & 15.
[8] Nikolchev. A brief history of the birth control pill. http://www.pbs.org/wnet/need-to-know/health/a-brief-history-of-the-birth-control-pill/480/ Accessed July 10, 2018.
[9] National Women’s Health Network. https://nwhn.org/pill-hearings/ Accessed July 12, 2018.
[10] Watkins. Expanding Consumer Information. 1998.
[11] Pamela Verma Liao. Half a century of the oral contraceptive pill. Can Fam Physician, Vol. 58, No. 12. 2012 December. Accessed August 24, 2018.

 

“FEAR Narcotic Drugs!” The Passage of the Harrison Act

By Anne Garner, Curator, Center for the History of Medicine and Public Health

Ad published in American Druggist and Pharmaceutical Record, volume 36, number 6, March 25, 1900.

Ad published in American Druggist and Pharmaceutical Record, volume 36, number 6, March 25, 1900.

One hundred years ago today, Congress approved the Harrison Narcotics Tax Act. The Act’s passage critically impacted drug policy for the remainder of the century, and the habits of physicians with regard to prescribing and dispensing medicine.

By 1900, use of narcotics was at its peak for both medical and non-medical purposes. Advertisements promoting opium- and cocaine-laden drugs saturated the newspapers; morphine seemed more easily obtainable than alcohol; and widespread sale of drugs and drug paraphernalia gained the attention of medical professionals and private citizens alike.1 State regulations failed to effectively curb distribution and use.2

Physicians and pharmacists recognized they had an image problem. In 1901, the American Pharmaceutical Association formed a committee to study the country’s drug problem and recommended the ban of non-medical drug use.3 The American Medical Association seconded the APA’s pitch and strongly advocated for federal legislation.4

Hamilton Wright. In Morgan, Drugs in America. A Social History 1800-1980.

Dr. Hamilton Wright. In H. Wayne Morgan, Drugs in America. A Social History 1800-1980, p. 99.

This groundswell in support of federal action among local medical professionals also had roots overseas. In the aftermath of the Spanish-American war, the U.S. inherited control of the Philippines, and with it a serious opium problem. An American missionary, Charles Henry Brent, convened a commission in 1903 that recommended narcotics be subject to international control.5 Roosevelt seized on these findings, recognizing an opportunity to improve relations with China. In 1908 he initiated an international conference in Shanghai to talk about the narcotics problem. The President sent Brent and Hamilton Wright, U.S. Opium Commissioner, to represent the U.S.6 Wright, an outspoken, charismatic, and controversial figure, was central to the eventual passage of the Harrison Act.

Passage of a federal law would not be easy. In April of 1910, at Wright’s behest, Representative David Foster proposed a bill banning the non-medical use of opiates, cocaine, chloral hydrate, and cannabis, with harsh penalties for violations. The purchase of patent medicines containing any of these ingredients would require tax stamps and strict record-keeping. Proponents of the bill stressed the link between criminalization and drug use. Despite Wright’s best efforts, the uncompromising Foster bill garnered strong resistance from manufacturers and druggists, and died in Congress.7

A clipping from the library's Healy Collection,  which contains 19th century images, mostly clipped from Frank Leslie’s Illustrated News and Harper’s Weekly. Click to enlarge.

A clipping from the library’s Healy Collection, which contains 19th century images, mostly clipped from Frank Leslie’s Illustrated News and Harper’s Weekly. Click to enlarge.

Two more international conferences followed, at The Hague in 1911 and 1912. Soon after, Wright renewed his commitment to pass federal anti-drug legislation. A new bill proposed by Tammany representative Francis Burton Harrison, again at Wright’s urging, looked very similar to the Foster bill. But after two years of negotiations in Congress, the final legislation incorporated several key compromises. Physicians could dispense medication to patients without record-keeping. Patent medicines with legal amounts of narcotic substances could be sold by mail order or in general stores. Cannabis and chloral hydrate were omitted from regulation. With these concessions, opposition from pharmaceutical and medical professionals softened, agreement was reached, and the bill was signed into law on December 17, 1914.8

The immediate impact of the Act’s passage was confusion. The law offered only vague implementation guidelines. Was it largely a taxation measure, or was it intended to monitor and regulate professional activity? The Act’s major ambiguity related to the authority of physicians to prescribe maintenance doses of narcotics to already-addicted patients. Two 1919 Supreme Court cases clarified the issue. U.S. vs. Doremus found the Harrison Act constitutional and validated the government’s ability to regulate prescription practices for addicts. Webb et al. vs. U.S. denied physicians the power to provide maintenance doses.

The Supreme Court decisions forced addicts to locate new sources. They turned to the black market, where they paid top dollar. Petty crime increased.9 Penalties for violation of the Harrison Act were harsh. In the early years of the law, conviction numbers were relatively low—most years fewer than 500—but by 1919, the year of the Supreme Court rulings, convictions showed a marked upward trend. By 1923, convictions were approaching 5,000 per annum.10

The effect of the legislation on addicts was not viewed unsympathetically by the medical establishment, or even by law enforcement. Even the head of New York’s dope squad, Lieutenant Scherb, seemed concerned: “Many of [the addicts] are doubled up in pain at this very minute and others are running to the police and hospitals to get relief….the suffering among them is really terrible.”11 Beginning in 1919, authorities and public health officials cooperated to develop 44 addiction recovery facilities. These new facilities were short-lived, and most had closed by 1921. Unpopular with the public, many shut down because the lion’s share of patients found themselves back on the streets again.

NYAM holds a scrapbook of newspaper clippings from 1926-1927 illustrating that drug abuse was still front and center in America’s mind well after the Harrison Act’s passage.12 Most articles framed narcotic users as criminals: what was once a legal pastime was now seen as a major threat to American society. One clipping quotes Harvey Waite of the Association for the Prevention of Drug and Narcotic Addicts of Michigan: “Drug addicts are a menace to the peaceful citizens of the United States because from them come the most notorious criminals and lawbreakers.”

From the library's scrapbook of 1926-1927 newspaper clippings. Click to enlarge.

From the library’s scrapbook of 1926-1927 newspaper clippings. Click to enlarge.

The Harrison Act’s most lasting impact was in how it shifted the public conversation from a discussion about regulating a legal activity to eliminating an illegal one. The Act would form the cornerstone of all drug legislation to come, including the Controlled Substance Act of 1970.

References

1. Musto, David F. The American Disease Origins of Narcotic Control. New York: Oxford, 1999. Pp. 3-8.

2. Morgan, H. Wayne. Drugs in America. A Social History 1800-1980. Pp. 101-102.

3. Morgan, p. 102.

4. Musto, p. 56-57.

5. Courtwright, David T. Dark Paradise Opiate Addiction in America before 1940. Cambridge: Harvard, 1982.

6. Morgan, 99-100.

7. Musto, 47-48.

8. Morgan, 106-108 and Musto, 59-61.

9. Hodgson, Barbara. In the Arms of Morpheus. The Tragic History of Laudanum, Morphine, and Patent Medicines. Buffalo: Firefly, 2001. P. 128.

10. Erlin and Spillane, pp. 44-45.

11. The New York Times, April 15, 1915.

12. [Narcotics]. Clippings from newspapers from Dec. 1926-Sept. 1932. [New York?, 1926-1932]. 3 v. Email history@nyam.org to request.

Chinese Opium Dens and the “Satellite Fiends of the Joints”

By Anne Garner, Curator, Rare Books and Manuscripts

Dr. John Thackery (Clive Owen) visits an opium den. Cinemax, 2014

Dr. John Thackery (Clive Owen) visits an opium den in The Knick. Cinemax, 2014

Dr. John Thackery passes through a number of dimly-lit opium dens in the heart of New York’s Chinatown during the course of The Knick. What were these dens really like—and who frequented them?

In the mid-19th century, the Chinatowns of America were largely isolated communities, populated by immigrants brought by labor brokers to work on the Central Pacific Railroad or other jobs. Many of these workers planned to return home after several years; there was little desire to assimilate. Scholar Gunther Barth has suggested that with the safety of a familiar culture came familiar vices.1

A large number of Chinese immigrants came from Canton, a region with a rich history of opium-smoking. As the Chinese presence spread east, opium dens cropped up in the Chinatowns of every major American city.

American Opium-Smokers Interior of a New York Opium Den/ Drawn by J.W. Alexander. [New York] : Harper and Brothers, Oct. 8, 1881. Courtesy of Images from the History of Medicine (NLM).

American Opium-Smokers Interior of a New York Opium Den/ Drawn by J.W. Alexander. [New York] : Harper and Brothers, Oct. 8, 1881. Courtesy of Images from the History of Medicine (NLM).

H. H. Kane wrote in 1882 that the first white American to smoke opium did so in San Francisco’s Chinatown in 1868.2 Until then, opium smoking had been strictly confined to the areas of Chinese settlement. By 1875, the practice was widespread enough that San Francisco passed a law prohibiting opium dens. This ordinance was America’s first anti-narcotics law.

The San Francisco ordinance coincided with an increasing anxiety among whites in large urban areas that the low-paid Chinese would threaten wages and standards of living. At the time, the country was mired in a deep recession. The federal Page Act, passed the same year as the San Francisco law, similarly targeted Chinese immigrants, aiming to “end the danger of cheap Chinese labor and immoral Chinese women.”3

Beginning with Virginia City the following year, local ordinances banning opium-smoking quickly passed across the U.S. These laws were largely ineffective. Law enforcement, focused on prosecuting Chinese dens known to attract white clientele, only drove whites deeper into Chinatown, and to smoke at higher rates.4

As opium use among whites increased, community leaders began to signal a concern about the morals of white women. Philadelphia missionary Frederic Poole cautioned that white women exposed by the Chinese to opium-smoking were at risk of “a life of degradation.”5 In 1883, Reverend John Liggins wrote of the dangers of the many New York City dens found in Mott and Pearl Streets (still the heart of Chinatown today), and quoted Kane that the habit, learned from the Chinese, contributed to “the downfall of innocent girls and the debasement of married women.”6 The same year, Allen S. Williams wrote in an early book on the opium-smoking habit about New York’s Chinatown dens:

Chinamen flit noiselessly by in ghostly, fluttering garments, and startle the Caucasian intruder by the very suddenness of their unsympathetic companionship…. the Chinese opium joint…is run for the sole purpose of pandering to a vicious taste whose indulgence is injurious to society.7

On the left coast, The Wasp, a popular San Francisco paper, sent two “reporters” to that city’s Chinatown in 1881, and published their findings:

In reeking holes ‘two stories’ underground, where the light of heaven and healthy atmosphere never penetrate, we found human beings living—if it may be called living, which is at best but an existence—as contentedly as rats in a sewer, whose habitation theirs so much resembles. The opium smokers’ resorts were among the first visited…a person once there, he may well desire to make himself oblivious of such surroundings and raise himself to a temporary heaven of his own, but how white men, and even white women, can bring themselves to descend to such filthy holes, where the reeking slime courses down the walls and the air is heavy with foetid odors, is a mystery to any well-regulated mind.8

The Wasp article offers an especially disturbing example of how many Americans implicated the Chinese as a group with standards and moral habits far inferior to those of whites. As early as the 1880s, opium dens run by the French and even white American-born women could be found in New York and Philadelphia, but the imagery continued to portray them as exclusively Chinese-owned and -operated. “It’s a poor town now-a-days that has not a Chinese laundry, and nearly every one of these has its lay-out [pipe plus accessories],” wrote one white traveler in 1883.9

Fig. 2—Smoker's Outfit. In Opium-Smoking in America and China.

Fig. 2—Smoker’s Outfit. In Opium-Smoking in America and China.

The framing of opium smoking as a Chinese problem continued as the century drew to a close. Temperance advocates and moral reformers identified opium smoking with indolence and passivity, qualities out of sync with a culture that emphasized hard work and a fast-paced industrial society. These kinds of characterizations became an important way to generate public revulsion for an immigrant group perceived to threaten both economic and social stability, and to gain traction for legislative action.10

The antagonisms toward the Chinese and attendant immigration restrictions resulted in a Chinese immigrant population that decreased by 1920 to less than half of what it was in 1890.11 The last opium den in New York was raided in 1957. Decades before, many of Chinatown’s dens, largely abandoned because of the rise of opium derivatives morphine and heroin, had all but disappeared.

References

1. Courtwright, David. Dark Paradise. Opiate Addiction in America before 1940. Cambridge: Harvard, 1982. 68.

2. Kane, H.H. Opium-Smoking in America and China. New York: G.P. Putnam’s, 1882. 1.

3. Peffer, George Anthony. Forbidden Familes: Emigration Experiences of Chinese Women Under the Page Law, 1875-1882. Journal of American Ethnic History, Vol. 6 No. 1, Fall, 1986.

4. Courtwright, 79.

5. Courtwright, 78.

6. Liggins, John. The Spread of Opium-Smoking in America. New York: Funk & Wagnalls, 1883. 20.

7. Williams, Allen Samuel. The Demon of the Orient and his Satellite Fiends of the Joints. New York: [the author], [1883]. 12.

8. The Chinese in California, 1850-1925.

9. Courtwright, 73.

10. Musto, David F. The American Disease. Origins of Narcotic Control. New Haven: Yale, 1973. 294-300.

11. Courtwright, 85.

The LaGuardia Report: Exploration of a Chronic Issue in American Drug Policy

On May 1 and 2, The New York Academy of Medicine and the Drug Policy Alliance co-hosted a conference, The LaGuardia Report at 70. Featuring more than 25 speakers, including historians, policy experts, political figures, and community organizers, the conference provided a forum to understand the state of marijuana regulation and enforcement in New York and to see the current debates in the context of over a hundred years of public policy fights around drugs and drug regulation in the United States.

For the conference, we created a small exhibit featuring facsimiles of materials from the New York Academy of Medicine’s Committee on Public Health Relations archive, as well as the original 1944 report. We are pleased to share the images with you on our blog.

LettertoMayor_merged_watermark

In 1938, at the request of Mayor Fiorello LaGuardia, The New York Academy of Medicine’s Committee on Public Health Relations formed a subcommittee to study marijuana use in New York City. As you can see in this letter to Mayor LaGuardia from the Academy’s president, James Alexander Miller, M.D., the subcommittee determined a more extensive study was necessary. They recommended two approaches, a sociological study of marijuana use in the city and a clinical investigation of its physiological and psychological effects. (Click to enlarge.)

In the sociological study, six police officers acted as social investigators. They ventured into places where marijuana might be available and socialized with people in order to find out who was using marijuana and how it was being distributed. Olive J. Cregan was one of the investigators. This page from her report describes some of her interactions, including one in a speakeasy that she called “the worst dive I have ever seen.” While they learned a great deal about marijuana use in the city, one of the study’s conclusions was that “the publicity concerning the catastrophic effects of marihuana smoking in New York City is unfounded.”

In the sociological study, six police officers acted as social investigators. They ventured into places where marijuana might be available and socialized with people in order to find out who was using marijuana and how it was being distributed. Olive J. Cregan was one of the investigators. This page from her report describes some of her interactions, including one in a speakeasy that she called “the worst dive I have ever seen.” While they learned a great deal about marijuana use in the city, one of the study’s conclusions was that “the publicity concerning the catastrophic effects of marihuana smoking in New York City is unfounded.”

This report from the clinical team gives a sense of the reputation marijuana had at the time of the study, a view that the study eventually countered. There was great concern about marijuana’s potential for addiction and its role in crime. The study found little basis for its bad reputation.   (Click to enlarge.)

This report from the clinical team gives a sense of the reputation marijuana had at the time of the study, a view that the study eventually countered. There was great concern about marijuana’s potential for addiction and its role in crime. The study found little basis for its bad reputation. (Click to enlarge.)

LaGuardiaReportTP_watermark

The LaGuardia report, formally titled The Marihuana Problem in the City of New York, was published in 1944.

Marijuana Regulation: The LaGuardia Report at 70 (Item of the Month)

By Paul Theerman, Associate Director, Center for the History of Medicine and Public Health

Medical and recreational marijuana regulation is undergoing a sea change right now, the reworking of a drug regulation regime that goes back at least 75 years. Debates about the drug are not new, however; the New York Academy of Medicine found itself in the middle of the political discussion back in the 1930s and 40s and is now taking a look at this history.

For a hundred years, from the published attestation of the medical use of Cannabis by William Brooke O’Shaughnessy in 1839, medical marijuana use increased and came more and more under medical regulation.  Discussions around regulation usually sounded two concerns: first, that the material be unadulterated and eventually physician-prescribed, and second, that potential benefits could be seen to outweigh harms. For from the beginning, many demonized marijuana use; early on, some went so far as to lump it in with opiates and their abuse.

By 1930, the United States established the Federal Bureau of Narcotics, with increased central control as the goal and Harry J. Anslinger as the willing head. In 1937, over the objections of the American Medical Association, he had pushed through the Marihuana Tax Act. An indirect means of control—as the state governments had most authority to control medicine and drugs directly—it was in fact very effective in criminalizing marijuana. Imposing annual licensing fees on producers and prescribers, it also called for a transfer fee of $1.00 per ounce to registered users, such as physicians, but $100.00 per ounce to unregistered ones—the vast majority. This tax structure was laid down in an era when average American incomes were about $2,000 a year. And indeed, $2,000 was the amount of the fine that could be imposed, along with up to five years in jail, with seizure of the drug as well. The first dealer convicted under the act received a sentence of four years in Leavenworth Penitentiary!

The title page of The Marihuana Problem in the City of New York.

The title page of The Marihuana Problem in the City of New York.

New York Mayor Fiorello LaGuardia was skeptical of the reasons behind this stringent control. In 1938, he commissioned a report from the New York Academy of Medicine on marijuana use. With the study supported by the Commonwealth Fund, the Friedsam Foundation, and the New York Foundation, an expert panel of researchers considered “The Marihuana Problem in the City of New York” (as their report was ultimately titled) from the viewpoint of sociology, psychology, medicine, and pharmacology. Their work continued for six years.

The report ran 220 pages, and La Guardia’s own foreword summarized the results:

I am glad that the sociological, psychological, and medical ills commonly attributed to marihuana have been found to be exaggerated insofar as the City of New York is concerned. I hasten to point out, however, that the findings are to be interpreted only as a reassuring report of progress and not as encouragement to indulgence[!]

Anslinger was furious and denounced the report, and, as painstaking and factual as it was, it had little effect on marijuana decriminalization. Eventually, the Supreme Court found the Marihuana Tax Act of 1937 unconstitutional on grounds of self-incrimination, in a suit raised by Timothy Leary in 1969. The next year, Congress passed the Controlled Substances Act, which placed marijuana in Schedule I, the most highly controlled category, used for drugs that have no currently accepted medical use and are considered liable for abuse even under medical supervision. It remains there today.

On May 1 and 2, the New York Academy of Medicine, partnering with the Drug Policy Alliance, is mounting a day-and-a-half-long conference, “Marijuana & Drug Policy Reform in New York—the LaGuardia Report at 70.” Historians and drug policy experts will gather to consider the report and its effects, look at the “drug wars” over the last century, and survey the policy landscape of the near future. Please join us; the conference is free. View the full schedule and participant information. Register here.

Meeting for Drug and Addiction Researchers

FDA prescription drug imageAn invitation from our good friends at the Drug Policy Alliance:

Interested in innovative, critical, and creative research on addiction, drug use, criminology, and drug policy?  If so, please join us for an informal meeting of NYC-area researchers who want to share ideas and talk across disciplines about these issues.

We especially welcome researchers whose work is relevant to the drug policy reform movement.  All disciplines and levels of experience welcome!

The gathering is:

September 12th at 5:30
Drug Policy Alliance
131 W. 33rd Street, 15th Floor
New York, NY  10001

To RSVP or for more information, contact:

Julie Netherland, PhD | Deputy State Director, New York
131 West 33rd Street, 15th fl. | New York, NY 10001
Voice: 212.613.8063 | M: 347.781.5435 | Fax: 212.613.8021