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The New York Times April 29,1917
WAR IS INCREASING THE
Hospitals Develop Craving, Says
Charles B. Towns, Who
Urges Federal Action,
No human intensity can compare with that of the drug user for his drug. Unrelieved, he will let nothing stand between him and it; neither hunger, nakedness, starvation, arson, theft, nor murder will keep him from the substance he craves. This is the opinion of Charles B. Towns of New York City, of whom Dr. Richard C. Cabot of Boston does not hesitate to say that he "knows, more about the alleviation and cure of drug addictions than any doctor I have ever seen." The man who first indorsed Mr. Towns and urged Dr. Cabot, to study his specific treatment for the drug-taker, was Dr. Alexander Lambert of Bellevue Hospital, Professor of Clinical Medicine at the Cornell University Medical College.
And it is also the opinion of Mr. Towns that the war in Europe has resulted in a tremendous and unnecessary increase in the use of habit-forming drugs, and that the great need in our country at the moment is that Congress empower the President to appoint a committee of able men to investigate this whole matter in all its phases and make such appropriation as may be required to protect our soldiers from the insidious evil that is doing its work abroad.
Mr. Towns is going to Washington in a few days with this object in view. He hopes to bring forcefully to the attention of President Wilson certain facts concerning the growth of the drug habit among the troops in Europe, together with the necessity that this country take up this whole subject by commission, because it is so far-reaching, involves so much detail, and affects so many and such varied interests that it would be impossible at this time to introduce in Congress legislation that would meet the case as it should be met.
"I presume you have read in the papers," said Mr. Towns, "the account of the arrest of some illicit traffickers in habit-forming drugs in which an enormous quantity--- $500,000 worth, it is reported--- of such drugs was found and it was also stated that this organization had representatives in foreign countries and was carrying on a wholesale business in such drugs. This is of great interest and confirms my position, namely, that unless this problem is taken up internationally it will be impossible to reach such things, because, the present Federal and State laws on the subject are wholly inadequate."
Before any legislation is proposed, Mr. Towns believes the subject should be investigated by the Federal Government and that its findings should be made public and studied as a preliminary to the enactment of any law or amendment to the present law.
"With the united wisdom of Congress applied to the matter,'' he said a few days ago, "there can be no doubt that such an investigation as I have in mind would lay the foundation for Federal legislation that would once and for all solve this monstrous problem. Such action of Congress would mean not only a solution of this subject as far as the Federal Government is concerned; it would mean also a solution for the States. And it would, mind you, establish a legislative, medical, and sociological precedent that would give this country for the first time the primacy it ought to have in asking other countries to join with us once and for all in terminating this evil--- an evil which has now become not merely a series of isolated national problems, but a united world problem.
"I have recently had a patient in this hospital who had been going through two kinds of battle in France. He won the Victoria Cross. But he also acquired the drug habit. The army hospital made a drug taker out of him. It has probably done the same for half a million other brave men.
"Before enlisting in the present war he in South Africa, was awarded a South African Service Medal, and was honorably discharged. He went to France in August, 1914, and was in his first engagement on Aug. 25, 26, 27, and 28 when he was 'gassed.'
"He told me that the physical condition produced by gas was similar to pneumonia in several respects. One being a contraction of the chest which makes it impossible for the patient to lie down. The patients, himself included, were carried into the hospital, set up against a wall, and immediately placed under the influence of morphine. He said it had been found that morphine was the only thing that would relieve a sufferer from the effects of gas.
"As soon as the patients were able to help themselves and to use a hypodermic a mixture of this morphine solution was put on a table within their reach, and they were allowed to use it as often as they felt inclined.
"Now, this soldier was not aware that he was becoming a morphine addict, but in those three months he became one. The treatment followed in his case was the usual one, and, so far as his observations went, each of the gas victims who entered the hospital for treatment left it a confirmed drug user.
"He returned to the front and took part in the Hill 60 engagement, where his battalion was wiped out---the Eleventh Battalion of the Black Watch. He stood for an hour and a quarter at roll call, and was the only man who answered to his name. But he was wounded and went again to the hospital. He told them that he was up against the morphine habit, and they gave him what morphine he needed while there.
"He left that hospital and joined the Royal Engineers. was again wounded, again went to the hospital for three weeks in March, 1915, and again was supplied with the drug during that time. Then he was sent to the Somme front, where itwas trench fighting. But he was still able to get the drug in any quantity from civilians. As he put it to me: 'Thousands and thousands of dollars' worth of drugs are being sold by the women who are following the army.
"It is the firm conviction of this man that all those who have been through the war from the first and have been 'gassed' are takers of the drug.
"On July 27, 1915, his officers had ordered the blowing up of a trench. My friend started with a crew of eleven men to cross 275 feet of tunnel toward the enemy, when, after reaching half the distance, shells from the Austrian guns fell short and blew the tunnelers to pieces. Where had been a tunnel was now only a hole.
"My friend picked himself up and found that his leg was sprained and his back hurt. There was one fellow whose leg was blown off. My friend carried him over to their trenches so looked back and saw another companion trying to get up. So he carried him in. He carried back the whole eleven, and dropped when the job was finished.
"When he knew anything again he was back in the hospital--- the same hospital at which he had remained previously for nearly three months.
"He informs me that the hospital records show that while he was in them morphine was administered to him regularly. This will appear on the charts, but not the quantity. He has seen morphine administered to twenty men at one time from the same hypodermic; in fact, the nurses never refused morphine to any one who asked for it.
"After he arrived in this country he went to Boston and the British Consul there arranged for him to go to Bermuda with the nurse. He stayed there about two weeks, but his cough got no better and he came back. He then went into the Maine woods, where he tried to rid himself of the drug habit, but found he could not. The open air did cure his cough, and he returned to Boston determined to conquer his addiction to drugs. A physician prescribed for him for four weeks, and he was taking as much morphine at the end of that time as he had been at the beginning.
"This man told me that he was very discouraged, and had made up his mind to shoot himself. He talked the matter over with his wife, and they came to New York and saw me. He had only $71 left when he reached New York. I gave him the best room in the house, feeling that I owed it to the boys over there in Europe to do something. He is cured.
"Now the basic way for the United States or any other country to deal with this question." Mr. Towns asserted, "to go at once and directly to the very root of the whole business, would be to restrict all use of opium to its crude form and to its forms as laudanum and paregoric. This would cut off all pecuniary interest in it, save for supplying it for legitimate medical needs in the crude form, and in its least harmful forms of laudanum and paregoric. Opium is produced only in a few countries--- practically none in our own country--- and it is only the manufacture of its alkaloids that requires such large outlay of capital in laboratory equipment.
"Where an opiate is indicated there are very few instances in which the required results could not be had from the administration of the crude product. Crude opium is the least harmful form of opium that can be taken for it contains all of the alkaloids and may be taken either by the mouth or in suppositories. If the traffic in and sale of this drug was reduced to traffic and sale of crude opium it would not inconvenience the medical profession in its legitimate use of the drug in any way whatsoever find it would Immediately stop this large illicit traffic that has grown out of the habit-forming drug situation.
"No possible good will come out of attempting merely to forbid the importation, manufacture or sale of heroin. The chemists are very clever and they would give us in another day some preparation of opium under some other trade name. And if it was not an actual preparation of opium they would claim that it was a synthetic one. The only way to meet such a habit-forming drug condition is, I repeat, to restrict the manufacture, sale, prescribing and administering of opiates to the crude opium, to laudanum, and to paregoric, and then to hold the physician to a strict accounting of all of these he personally prescribes or administers. There are no physical conditions in which heroin or any other narcotic is indicated but what could be met by these. We can dispense even with morphine and all of the opium alkaloids.
"I can go back to the time in the South when there was an old rosewood medicine chest with a ball of opium and a vial of paregoric, and these easily met every possible need where opiates were considered necessary to alleviate pain. The medical profession would not be inconvenienced in the slightest degree by such a restriction, and it would at once eliminate every unfavorable hazard that has grown out of the use of habit-forming drugs for medical purposes.
"Stopping importation is a farce, unless at the same time there is a rigid Governmental control in those countries that produce or import the drug. The only obstacle to an international understanding is that the producing countries know very well that Government regulation would materially lessen the sale of the drug. Within the borders of our own country such a system would simplify rather than complicate present conditions. We have today along our frontier find in our parts inspectors trying to stop the illicit traffic in opium, and the money thus spent by our Government would be more than sufficient to handle and distribute all of the drug that is needed for legitimate purposes.
"Any druggist could of course continue to buy all that he wished, but he would have to account for what he bought. The drug would serve only its legitimate purpose, because the druggist could sell it only on prescription. This would at once eliminate the gravest feature of the case, the indiscriminate sale of proprietary and patent medicines containing small quantities of opium. The physician would thus have to shoulder the entire responsibility for the use of any habit-forming drug.
"I must hammer this point once more: With the Government as the first distributor and the physician as the last, the whole condition of affairs would assume a brighter aspect, for it would be a simple matter to get from the physician a proper accounting for what he had dispensed. Thus the new crop of users would be small, and less than 10 per cent. of the opium at present brought into this country would be sufficient to meet every legitimate need."