May 26, 1924, Baca f ie 9 a, Surgeon General, Us te servioe, Sir: (acne Acting Director) | ie reference to the article entitled "the Peril of Nercotics « A Warning" by Righeve P. Hobson, President of the International Narcotic Educational Association, which mas referred by you to me for comuent, ‘T have the honor to report as follows: ; : : | 00 facts this article eunveins are 80 bound. up with and obscured by ‘ and mislesding inflammatory state= ments that only a person thoroughly versed. in al phases of narcotic addiction could discover them in he Much space d@ given to a discussion of the. prevalence of drug addiction anh ite alarming inerease in the United States. It is inti- | ‘mated that we have at leset 1,700,000 addicts, and the nue ber is increasing every day, and it is positively asserted thet the munber 4s mown to be more than a million, In . the face of this a very eareful survey of the sttuation by | the Public Health sof¥ie* uring the past 16 months shows eonclusively that the extreme Limit of probabilities is ; 150,000 OGL ahe, and the probable number is placed at 110,000. | it is also shown that not only the incidénee, but the actual Pig mumiber of drug addicts in the United States has been dew ‘ereasing since 1910 in the face of e greatly increasing population. : | : | The article states ‘that the amount of opium produced and consumed in the world probably exceeds three thousand tone and the average addict uses 10 grains of morphine daily. When these figures are analyzed we find that three thousand ‘tone of opium converted into morphine and used exclusively a for addiction at the rate of 10 grains por day, would supply less than 1,440,000 addicts, In this calculation we heave | assumed that opium contains’ los morphine and that thie is inereased 25% on conversion inte the sulphate. The facts are that most of this opiun does not contain 10% of morphine. _ Published statistics show that the opium and entirely consumed in the countries of the Far East amounted in 1922 to 1,415,752 pounds, &@ little more than 700 tonsa. ‘This, if used entirely for addiction at the, rate of 10 grains of more phine sulphate daily, would supply. only about 340 ,000 addicts “and 1t 48 to be borne in ieind that this opium 1s produced for distribution among about 800,000} 000. | | -It is stated that America now Leads the world in the in its entirety the ¥06,000. tons she ts) eredited with producing, as well es considerable quantities raised elsewhere. If _ statements emanating from interested } : people can be credited as "reliable, tons of morphine are being enmggled into China. This would reduce still’ farther the supply available for the sight hundred atlas eer above referred to, and rational inference \s 3. | | ‘would be that the other large countried could not be seriously addicted, yet Mr. Hobson attempts to show that the entire world — 4s menaced by the narcotic evil. | | ' Host of the paper is as unreliable as the. sections dealing with prevalence and spread of addiction are shown to be, but such a striking statistical refutation as has been given canes be made of all the absurdities it contains. We need not come nent. upon the statements that five tons of opium are probably | gufficient for the medicinal needs of me world, thas four young people can be made addicts with «a grain or heroin and that nearly 2000 addicts can be created within a week from one ounce of heroin. . All of thia ia known to be nonsense by any physi eian | who has given the subject ten mimates of thought end stuly, Much ie made of an inereastof crime due to dope, chiefly —__ heroin, and fraguents or statistics are furnished to prove it; coy for instance, | the Narcotic Division is quoted es reporting 65% more criminal cases in 1922 then in 1921,end Mr. Crim as saying that 40% of persons sent to certain Federal prisons are addicts. These statements are true, but the inference drawn from them that they show an alarming increase of addiction and crime is erroneous. fhe reason Federal prisons are now crowded with addicts is not - because addiction has increased or because these addicts are ‘eny worse than they use to be, but because a lew passed in | 1915 made it e prison offence for en unlicensed person to have “ parcoties in his possession. This lew is being enforced with increasing severity and suceess each years During 1983 more than 4000 convictions, representing 93% of cases that came to oe trial for whelating the narcotic laws, were secured and sentences 4 _were imposed aggregating more than 4000 thousand years. This speaks volumes for the efficiency of the Narcotic Division and it is one explanation of why there are nore persone today than there were some years ago, put it does not show that the persons convicted are basically more criminal than they were before the law creating this new crime was enacted. Neither heroin, or any other preparation of opium, ever incited any one to commit a violent crime. The effect of these drugs is sxnctiy opposite. When taken in large doses they \pro- duce lethargy and inadtiviéy) the normal man works less and the criminal is less likely to commit a violent crime when under %)°'™ their influence. They do produce a certain enount ot datertoras tion because the decreased working efficiency, which results, and the high cost of drugs brings about financial embarassment and dependence in some cases. In addition to this the addicts associates are usually low and he has to sneak around dodging | the police. The whole train of circumstances produces or accelerates the delinquency common to a sneak thief sort of individual. There is no protoplasmic change, such as is brought about by excessive indulgence 4n aléohel and normal people are apparently very little harmed by opium. Many of the wotat criminals ae addicts, but they are addicts because of the nine: psychopathic na otal that causes them to be criminals. The studies I have made clearly ahow. thise : Heroin, which is held up as a drug that is about to sap the vitality of the world, is no more harmful than morphine and neither of these drugs causes a degeneration of the brain or other part of the nervous system and recovery is complete iim use is discontinued. Heroin te now used by-sddtets on the Eastern sea board of the United States from Washington northward because they are unable to get morphine, the reason for this being that the smaller bulk of heroin makes 1% more easily concealed. ‘Therefore, both the peddler and the addiet : are less likely to be arrested if he handles heroin wether than | The criminal heroin addicts in the Hast are no worse than ¢riminal morphine addicts in the West and South. | There are some physicians who believe that heroin is more haraful then morphine, but their opinion has been warped by e few of the heroin addicts in New York and other large cities of the East. They have >not made personality and psychiatric studies of heroin and morphine eddicts. When this is done it 4g shown that there ig no difference between the two, and also cured cases of one do not differ from cured cases of the other. | Precticaliy ask of the cooaine ,us0d by persons who are alse addicted to some form of morphine. The amount of cocaine _ used then does not increase the total number of addicta. This drug produces stimulation, but in large doses it does not cause the comaission of crime. ‘There is,on the contrary, a state of Lear and anxiety prought about and @ person under ite influence is hiding from his enemies, especially the police. No aggressive, violent crime, ugh as the robbery of a bank, would ever be — "Committed by an addict who was overcharged with cocaine. This dpag, unlike opium, does bring on acute insanity when used in... ‘Large quantities, but the article does not sey 80. | The statenent thet opium produces an antitoxin whieh causes the symptoms of withdrawal has been abundantly disproved at the - 6 | Hygienic Laboratory and by work at other places, and the idea that opium produces ite effect by. penetrating the fatty sheaths | | 8 the upper brain apparently originated through misunderstanding — of a discarded theory that opium enters into a combination with and ‘Ghasolves fate, in this way demiding the norvess Heroind addicts do not have a mania for producing other one | addicts. The peydhopathic characters who become addicts today no doubt help to corrupt their psychopathic associates, but the addict who hea any stability at ell desires to get rid. of his. addiction. Be also likes to heve his friends cured. i have © treated heroin addicts who have left the hospital and persuaded others to come) in for treatment, and some of them have contimed to send in oades even after they themselves had relapsed. mre Beneon is alarmed because excessive indulgenee in opium destroys the reproductive powers» Unfortunately, this. as not. trues Opium doce ‘decrease gex desire and power in all cases ‘and when teken in Large quentitica there is complete cessation of sex functions tor the time being. Fortunately, the psycho~ path, because or mip extrene ‘uncontrollable impulses is the individuel who im es | excessively and consequently Loses — | sex funetions. mochuse of this, numerous insane porsons, criminals and epileptios, whom he might being into the world ape never born. it is to be regretted that the psychopath re~ gains his sex power lumediately after being cured. I have seen — & man addicted for forty years who, nevertheless, raised a oe family of ven ehildred, and I have seen childredn of other ‘Lifetime addicts who were healthy, normal and happy, but their : parents were norms) and took only fron 2 to 16 greins of morphine \ ar \ Gatize | ‘tore ts no sush thing as luring girls and boys inte “ a5 = addictions The addicts being created today are a type mostly psychopathic, who deliberately seek associates of a certain cherecter and who are anxious to try any experiment whieh promises an ynusual sensation, yet this article warns boys and giris to accept nothing away from home to eat or drink, even from @ supposed friend, end girls ere warned to have their face powdera anslyzod regularly for hneroin. The inference from all ~ this veing. that every one is ‘surrounded by heroin addicts in SS the guise of friends whose enter motive 18 to addict us in order ‘that we may join then in their villfsnous campaign to meke help- Less addtote and orivinals of all the world, and if we may judge : by the temwe-of ‘the evticle, a few doses of heroin taken un- ; - Imowingly in this way is supposed to be sufficient to bring about this transformations All of thie te so absurd thet many physiciam 3 “would probably take the attitude that 1t could make no difference af the paper is published because no one would be likely to be- Lieve it, but the mere feet that it was composed by « ‘sincere, = 3 intelligent person shows thet many, persons would take it serious=— | lye ‘Therefore, if the ‘article is pieced in every home ant school with the indorsenent of Congress, es is proposed, an une c oe state of fear will be aroused in thousands of p rsons. s The arousing of fears like this is contrary to the principles: of mental hygiene’ and ean result in nothing but harme _ The paper will cause addicts to be still farther handicapped in | their contact with sooiety with the result that moral de | tion wild inereage and opportunities for' ‘eno treatment, ee “trier dooreane. The spresding of misinformation end on arousal '§ of harmful fear is not the only evil to be foared from the wholesale broadcasting of this article. Thousands of psycho~ “pathie characters in tho United States have never heard of | heroin or drug addiction. It is a weakness of such characters thet an impulse to action is sufficient justification for the act, they are susceptible and have urmisual oravings and desires, they do not have the inhibitions that restvain normal people — from committing antisocial acts and they apparently do not see ‘the necessity of conforming to social customs. Many of then will be impelled to seck for and try this newly advertised senantion end vice and some who live in or near lerge cities will persist until they find tt with the result that new addicts will be created “AMON people who are most harned by addictions One : hundred and ten thousand drug addicts are sufficient for the . United States. z estimate that it is et least 90,000 more than there ie any good reason for being and it would be unfortunate to have the work being carried on to reduce this evil set back or handd capped by an assault like this. fhe International Narcotic Educattone Association waa’ ‘formed in California and I understand that the headquartere are - st@B2 located in that State. - I have been told that the presi- dent receives 2 salery ef $20,000 per years The Association te gaid to have conducted an educational campaign in California: oy along the lines indiceted in this article. ‘he President of | the Association was denounced recently by Commissioner Enright of New York for publicly asserting thet there were 27,000 school chiléredn sddi cted in ‘one borough of the city. | : Respectfully, es | _ Reapeettedly forwarded: | | cS . Dyer | . Lawrence Kolb / wer Fe Surgeon. :