Drugs—A Long and Varied History - Availability Of Drugs

In late nineteenth century America it was possible to buy, in a store or by mail order, many medicines (or alleged medicines) containing morphine, cocaine, and even heroin. Until 1903 the soft drink Coca-Cola contained cocaine. The cocaine was later removed and more caffeine (already present in the old drink from the kola nut) was added. Pharmacies sold cocaine in pure form, as well as many drugs made from opium, such as morphine and heroin.

Beginning in 1898 heroin became widely available when the Bayer Company marketed it as a powerful cough suppressant. According to the U.S. Government Office of Technology Assessment ("Technologies for Understanding and Preventing Substance Abuse and Addiction: Appendix A, Drug Control Policy in the United States—Historical Perspectives," http://www.drugtext.org/library/reports/ota/appa.htm), physician prescriptions of these drugs increased from 1% of all prescriptions in 1874 to 20-25% in 1902. These drugs were not only available but also widely used, with little concern for negative health consequences.

Cocaine, heroin, and other drugs were taken off the market for a number of reasons. A growing awareness of the dangers of drug use and food contamination led to the passage of such laws as the Pure Food and Drug Act of 1906 (PL 59-384). Among other things, the act required the removal of false claims from patent medicines. Medical labels also had to state the amount of any narcotic ingredient the medicine contained and whether that medicine was habit-forming. A growing temperance movement, the development of safe, alternative painkillers (such as aspirin), and more alternative medical treatments contributed to the passage of laws limiting drug use, although these laws did not completely outlaw the drugs.

In addition to health-related worries, by the mid- to late 1800s drug use had come to be associated with "undesirables." The term usually included poor Americans, often African-Americans and immigrants, especially from southern Europe and Asia, who were arriving in ever greater numbers in the United States.

In the United States especially, narcotic use was thought to be confined to the poor and disadvantaged, while evidence of use among the wealthier classes was overlooked. When drug users were thought to live only in the slums, drug use was considered solely a criminal problem; but when it was finally recognized in middle-class neighborhoods, it came to be seen as a mental health problem.

By the turn of the century, the use of narcotics was considered an international problem. In 1909 the International Opium Commission met to discuss drugs. This meeting led to the signing of a treaty two years later in the Netherlands, requiring all signatories to pass laws limiting the use of narcotics for medicinal purposes. After nearly three years of debate, Congress in 1914 passed the Harrison Narcotic Act (PL 63-223), which called for the strict control of opium and coca.