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not to incorporate opium and its preparations in any prescription, and when its use is indicated it might be dispensed by the physician without the knowledge of the patient as to the nature of the remedy. But perhaps the easiest way to solve the question would be to follow the lead of the New York legislature which, in June, 1887, enacted a law that no pharmacist, druggist, apothecary, or other person shall refill more than once prescriptions containing opium or morphine, or preparations of either, in which the dose of opium shall exceed one-fourth grain or morphine one-twentieth grain, except with the verbal or written order of a physician.

The Committee submitted drafts of two bills for consideration which it was believed would go far towards preventing the spread of the opium habit, and also expressed the opinion that, with regard to the sale of proprietary and secret medicines containing poisonous drugs, the contents should be clearly expressed on the label and the word "poison" added as required in the sale of poisons under existing acts. No action was taken for several years upon these recommendations, which were clearly in the interest of public health and morals. In the meantime the cocaine habit also assumed alarming proportions, so that Major Sylvester, Chief of the Police, in his annual report for 1904, p. 27, called attention to the fact that examination of the poison register of one dealer's place alone disclosed 40 sales in one day. The goods having been put in properly labeled envelopes, there was no violation of the law. In his report for 1905, p. 36, he pointed out that parties have been apprehended for peddling the drug from door to door and that some most worthy and capable people have wrecked their own lives and made that of others miserable. In each of his reports he urged appropriate legislative action. A new pharmacy law was finally enacted and approved May 7th, 1906, which placed greater restrictions upon the sale of poisons in general and the habit-forming drugs, such as opium, morphine, cocaine, chloral in particular, and also made the filling of prescriptions containing such drugs in certain doses, except upon the written order of the signer of the original prescription, unlawful.

The Chief of Police in his report for 1906, on p. 23, says: "The cocaine habit and sale is the most difficult to cope with and the law should be so complete as to prohibit other than licensed druggists, physicians, dentists or veterinarians having it in his or her possession except on a physician's prescription, and then the package to bear the name of the physician and the patient for whom prescribed." In the report for 1907 he states "that the sale of cocaine has been largely reduced, but there are many who dispense the drug under cover."

Dr. Paul B. Johnson, in his investigation of 175 prisoners in the Washington Workhouse, found that 15 had intimate knowledge of the use of cocaine. "Cocaine was described always as used by sniffing the powder into the nostrils, either from the package, or from the palm of the hand, or from the fingers like snuff, or most often by dipping a short quill into the powder and placing the other end to the nostril. It was stated as easily purchased in drug stores or in the rear of bar rooms." Dr. Lyman F. Kebler, Chief of the Division of Drugs of the Bureau of Chemistry, U. S. Department of Agriculture, in a recent paper on the "dope question," refers to the cocaine habitué as socially inclined, offering a friend a "sniff." In fact, whole circles assemble to enjoy a cocaine spree, where the dope, commonly known as "coke," is passed from one to another to take an allotted sniff. In speaking of the effects, Dr. Kebler states that "cocaine in some cases transforms otherwise safe and tractable citizens into dangerous characters, and in most instances wrecks the individual and all depending on him as well as jeopardizes the lives of many."

Major Sylvester, in a letter dated December 6th, 1908, writes as follows: "Investigation shows that there were about a half dozen druggists making a specialty of the sale of cocaine and other drugs, and a dozen or more selling such to a few customers; the other druggists in the District would not make such sales except to persons whom they had reason to believe would use the same for legitimate purposes, and some of them would not handle it at all.

"Upon the passage of the present pharmacy law, such sales were stopped by druggists, except a limited number who continue the sale to customers upon whom they could rely not to betray them, and who were actuated by sympathy rather than other motives; three or four others continued the sale, only to be apprehended and fined.

"The member of the force detailed as Inspector of Pharmacy has had occasion to bring to Court three physicians for writing prescriptions for morphine and cocaine, all of which were aggravated cases, and he has given notice to others not to indulge in the practice.

"The Department, in this work, has had the cordial co-operation of physicians generally, and finds that in their opinion the drug habit, especially morphine, is due largely to the injudicious prescribing of drugs, and it has evidenced an inclination on the part of physicians to curtail the use of them.

"In the course of his investigation the Inspector found that morphine fiends, with two exceptions, had become addicted to the use of the drug through sickness or injury; one of those excepted stated he formed the

habit through no other cause than that of the lowest depravity, while the other stated he became addicted to its use through having it prescribed by a physician after getting over a long spree.

"I am informed that there are one or two physicians who have a few patients whom they feel in duty bound to supply with the drug.

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"It is believed that if the law could be made stringent enough to put the sale of morphine beyond the reach of such persons, after they had been treated under confinement, they would make useful citizens.

"The morphine, laudanum, and kindred drug users, according to the observation of the Inspector of this department, have been greatly reduced in number through the efforts of the medical profession.

"The habit of opium smoking has never become serious in this city; it was slightly increased with the passage of the pharmacy law, as the drug is easier to get from Chinamen, who are hard to detect. It is confined principally to degraded persons, both white and black, who are beyond reformation. Arrests are made by the police and penalties imposed upon the Chinese engaged in the traffic. I think if the penalties inflicted were a little more severe the effect would be more ample.

"The Inspector states that in the course of his investigations he has learned of no foreign white people who are addicted to the drug habit. He finds that the cocaine habit is by far the greatest menace to society because the victims are generally vicious. The use of this drug superinduces jealousy and predisposes to commit criminal acts. In districts where druggists formerly dispensed cocaine, disorder has decreased so noticeably that it is commented upon by the neighbors and the police officers on the beats; it has also had the effect that a large percentage of persons using cocaine will not make an effort to get it when it is accompanied by the risk of arrest.

"The present source of supply is mainly through druggists who are not now in the business, and clerks who are employed at drug stores, who, it is believed, deliver it to persons to peddle when they can find anyone who will purchase. Others procure it from the near-by suburban towns, localities without this jurisdiction.

"It is quite a difficult matter to convict these people, as possession of the drug is not held to be sufficient evidence. In Virginia possession is held to be evidence of intent to sell, and is punishable by not less than one nor more than five years in jail. Under the present law there is no distinction between a clerk and a proprietor; if a person is registered he can purchase any amount. No person other than a druggist should have the privilege of handling cocaine.

"It is believed that there are about a dozen persons who peddle cocaine from time to time, and those who use it are numbered approximately by the Inspector's report at about one hundred. The number of persons who use morphine cannot be approximated, as they are distributed throughout all classes of society. Many who use the drug are not known as such habitués outside of their own homes. There have been number of peddlers or writers of bogus prescriptions arrested and fined from fifty to two hundred dollars, or sent to jail. My information is that the sale of cocaine is about one-tenth of what it was before the present law went into effect." * * *

MEDICINAL PREPARATIONS WHICH CONTAIN HABIT-FORMING DRUGS. Dr. Kebler says: "There are upon the market many medicinal preparations which contain, as ingredients, habit-forming drugs. Such drugs are: alcohol, opium and its derivatives, notably morphine, codeine and heroin; cocaine, chloral, cannabis indica, acetanilid, etc."

The presence of most of the habit-forming drugs, under the provisions of the Pure Food and Drugs Act, must now be declared upon the label of drug products, and the public is thus made aware to some extent of the nature of preparations containing these agents. The drug products which contain opium and its derivatives most frequently are the painkillers, cough and consumption cures, and soothing sirups.

Below is given a list of some of the medicinal preparations which contain habit-forming drugs other than alcohol:

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DANGER OF SOFT DRINKS CONTAINING HABIT-FORMING DRUGS.

In this connection attention is directed to the danger of soft drinks containing caffeine, extract of kola nut and extract of coca leaf, the active principle of the two latter being cocaine. According to Dr. Kebler, see Appendix, there are now nearly one hundred different medicated soft drinks on the market.

These beverages are extensively advertised, some, in fact, as headache remedies and nerve tonics, and sold at nearly every soda-water fountain or as carbonated goods in all parts of the country without the slightest warning to the public of the harmful ingredients contained therein. We restrict the use of coffee and tea in children and delicate nervous individuals, and yet these same persons frequent the soda fountains, regale themselves with soft drinks, quite unconscious of their contents, experience the stimulating and refreshing effects and soon fall victims to the habit, so that even "Coca Cola fiends" have come into prominence. We have seen how the opium habit may be acquired by the use of the various proprietary or secret preparations (pain killers), usually employed as domestic remedies, and so the cocaine habit may be developed by the use of these much-lauded soft drinks.

It is a significant fact that Mr. Vanzant, the special police officer charged with the execution of the Pharmacy Law, with the exception of the Chinese opium fiends, has never encountered other foreigners who are addicted to the drug habit. This may be accounted for by the fact that nowhere is the habit of self-medication with secret or proprietary medicines for each and every ailment so widespread as in this country. No wonder that insanity and diseases of the nervous system are on the increase, and that the physical, moral and mental wrecks of the alcohol and drug habit continue to swell the number of dependents in hospitals, insane asylums and other public institutions.

From a careful analysis of the evidence it is apparent that the sale of habit-forming drugs is still carried on through the instrumentality of (1) unscrupulous local dealers, (2) depraved and unscrupulous local physicians and (3) through dealers, physicians, agents and peddlers located in other jurisdictions.

The writer has reached the conclusion that Major Sylvester's proposed amendment to the present law will not prove effective unless a law is enacted permitting the revocation of a license to physicians, dentists and veterinarians whenever in the judgment of the Court such persons are abusing the privilege of prescribing these drugs. A law should likewise be enacted regulating the transportation of habit-forming and poisonous

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