Restrictions
In most European nations, the central government controlled the practice of medicine and the availability of dangerous drugs through legislation. In addition, by the mid-nineteenth century, European physicians and pharmacists had organized themselves on a national level.
By contrast, in the United States the federal government relegated to the individual states control over the health professions, and the professions themselves were poorly organized nationally. No laws controlled the sale of, contents of, or claims for “patent medicines,” and there were few local laws restricting the availability of opium, morphine, and, later, cocaine. The result was a thriving and open market in these substances until late in the century, when some states began to enact laws preventing the acquisition of opiates and cocaine except with a physician’s prescription. The U.S. Constitution grants the regulation of commerce among the states to the federal government, so no state law could affect the sale of drugs or products across state lines. The consequence was a higher per capita consumption of opium and opiates in the United States than in other Western nations and even, a government official claimed in 1910, more than the legendary consumption of opium in China.
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