The U.S. Response to Addiction
The per capita consumption of narcotics in the United States was officially described in the late nineteenth century as much higher than that of any comparable Western nation, perhaps even that of China.
This may well have been the case, but reliable comparisons are often difficult to make, partly because drug use and addiction have been topics relatively neglected by historians.Concern in the United States over opiate addiction and the rise in consumption, which reached a peak in the 1890s, led to state laws that in most instances made morphine available only by a physician’s prescription, although there was no restriction on interstate commerce. Cocaine use increasingly worried the public, who associated it with the underworld and assumed that its use by blacks was a cause of unrest among them in the South. The latter association exemplifies the linkages so easily made by the public between drugs and social problems.
Some of the unusual factors associated with extensive narcotics use in the United States (i.e., late professionalization of medicine, an open drug market, and constitutional restrictions on national legislation) began to change in the late nineteenth century. A domestic movement to control dangerous drugs, especially patent medicines, led to passage of the Pure Food and Drug Act of 1906, which required accurate labeling of the narcotic contents of products sold in interstate commerce. The acquisition of the Philippine Islands in 1898 and the necessity of dealing with the opium problem there spurred the most important decision making on narcotics by the federal government. The Philippine experience not only accelerated the passage of national laws but, of broader significance, led directly to a U.S.-inspired treaty to control narcotics worldwide, as well as to the international antiaddiction effort that persists to this day.