PART II Opiate Addiction as a Social Problem

CHAPTER 11 THE EFFECTS OF WORLD WAR II

Every major war in which the United States has engaged, beginning with the Civil War, has had considerable effect upon the narcotics problem. World War 11 was not an exception. TheCivil War, by popularizing the use of the hypodermic needle in medical practice, and through the none too careful use of opiates for wounded soldiers and for those suffering from such diseases as dysentery, caused an increase in the number of addicts in the United States. The Spanish American War also bad a perceptible effect of the same kind but on a lesser scale. World War I again substantially increased the number of addicts, though by this time opiates were being handled with greater prudence and the number of new addicts created by army medication was probably proportionately less than in earlier conflicts. The recent war has had two major effects. In the first place, by disrupting the channels of illegal distribution, it created a drastic shortage of drugs on the internal illicit market and thus reduced the spread of the habit in the civilian population, In the second place, the use of opiates with the army probably increased - the number of addicts in the armed forces and also added to the number of those who may be called potential addicts.

Effects on the Illicit Traffic

The war in Europe disrupted American connections with European sources of illegal drugs, but this was made tip for by an increased flow from the Far East. Government supervision of shipping and of foreign travel handicapped the smuggler generally. From the point of view of the local addict, however, the situation became serious only after the beginning of the Pacific war, which cut off supplies from the Orient, particularly from Japan and from territories controlled by Japan. A drastic internal shortage then developed rapidly. Smuggling declined to a record low, illicit prices skyrocketed, and quality deteriorated sharply. Heroin of 1 or 2 per cent purity became common and was sold for as much as from $30 to $5o an ounce. Addicts experienced great difficulty in maintaining their habits and resorted to desperate stratagems and inferior substitutes. A considerable increase in pressure to divert larger quantities of drugs from legitimate to illegitimate channels was noticed. In some cities drugstores began to do a booming business in paregoric, which contains small quantities of opium. This entire picture is clearly portrayed in the annual reports of the Bureau of Narcotics during the war years. The bureau seized the opportunity presented by this situation to tighten its controls, and as a result the illicit traffic was reduced to a record low.

The fact that the Axis controlled a number of the major sources of opium caused that drug to become a strategic item for the Allies. There was, of course, a greatly increased demand for opiates because of the war, and supplies were short, not only on the illicit market but generally. The shortage on the illicit market is indicated by the fact that seizures in the internal trade declined 5o per cent, and that addicts and peddlers increasingly resorted to burglary, robbery, and forgery to obtain supplies.(1)

The sharp rise in illicit prices and correspondingly increased profits apparently encouraged new producers of opium to enter the field to supply American users. The opium poppy can be cultivated in many parts of the world, and it would have been overoptimistic to suppose that new sources of supply would not have appeared to replace the old. During the war years Iran, India, and Mexico became the chief sources for illicit drugs that appeared on the American market. After the German submarine threat in the Atlantic had been brought under control, smugglers were able to reestablish connections with India and Iran and to step up importations from those countries to make up for supplies previously obtained from European countries and from Japan. Although Mexico prohibits the cultivation of the poppy, an increasing tendency is noted in the annual reports of the Bureau of Narcotics for opium of Mexican origin to find its way to American addicts. The Bureau of Narcotics reported in 1944 that there. was evidence that the acreage devoted to the clandestine cultivation of the poppy in Mexico was being increased. If the war situation had continued it is probable that a new equilibrium of supply and demand would eventually have been established, and that an increased volume of production in the countries named, and possibly in some other Central American countries, would have lowered illicit prices and improved the quality. The Mexican border and Southern and Atlantic ports became the focus of the smuggling problem during the war.

It is still too early to know what the effects of the termination of the war will be, but the Narcotics Bureau is probably correct in assuming that they will be favorable to an expansion of the illegal business. Having discovered the commercial possibilities of opium production, Central American producers will stay in the business and increase their output unless energetic countermeasures are taken. As trade channels to Europe, China, and Japan are reestablished, supplies from these pre-war sources will again appear to compete with Iranian, Indian, and Mexican opium. It is to be expected that prices will drop, supplies will become more plentiful, dilution will diminish, and the enforcement problems of the Narcotics Bureau will be increased .(2)

Indications that smuggling between China and the United States is already being resumed are available. A United Press dispatch from Shanghai on May 6, 1946, describes countermeasures being taken by Counter Intelligence to prevent the smuggling of drugs out of China.(3) It is pointed out that the profits on a small package of drugs may be 3,000 per cent between China and the United States. Because of the small bulk of opiates the traffic is extremely difficult to control. Many of the persons who transport packages of narcotics are unaware of the fact, since they are paid simply to transport it without being told of its contents. Although American authorities in Japan and China are said to be taking energetic measures to prevent smuggling of narcotics to this country, it must be kept in mind that the vast poppy-producing areas on the continent of Asia are not under American control, and that the detection of illicit shipments of drugs, particularly on merchant ships, is exceedingly difficult if not impossible. The fact that narcotics may be transported on other than American ships to Mexican, Canadian, or other neighboring countries makes the situation doubly difficult.

Chaotic conditions in many parts of the world and flourishing black markets will favor the traffic in drugs. Persons with criminal inclinations or experience who have learned of the profits in the black market may very well turn to the drug traffic, which is probably the most lucrative of all. Current shortages of drugs for medical purposes in Europe may be expected to stimulate the manufacture of morphine. Unsettled conditions will make regulation difficult.

In the Far East, in that part of the continent of Asia occupied by Japan, the number of addicts increased during the war, and the cultivation of the opium poppy was stimulated. The production of opium has become, even more than before, an integral part of the economic structure of many communities. It has become a means of livelihood for many people and an important source of revenue. The millions of addicts in the Far East constitute a huge market and create a powerful demand for opium. As in the past, it is probable that this demand will call forth a large supply, some of which will undoubtedly go to the United States.. Unsettled political conditions make it appear highly improbable that any effective means of dealing with the postwar narcotics problem in China will be found very soon. The existence of this situation in China will make our own problem that much more difficult.(4)

Effects of World War II on Prevalence of Addiction

As has been indicated, the high cost of drugs and their scarcity made it difficult for American users to maintain their habits during the war. Many of them, perhaps most of them, did manage, however, by one means or another to continue their habits Usually they were compelled to reduce their daily dosage, and sometimes they may have been compelled to abstain, but the ingenuity and persistence of addicts in maintaining their supplies have always amazed those who know them.

The use of inferior substitutes for heroin and morphine was one of the ways in which the attempt to continue the habit was facilitated. Paregoric is such a substitute and can be purchased in small amounts without a prescription. Larger quantities may be obtained by going to several pharmacies, signing a different name at each. It contains a little less than two grains of opium per fluid ounce. American addicts have long been familiar with distillation techniques by means of which some of the nonessential ingredients can be eliminated so that the concentrated residue may be used hypodermically. Sometimes they also drink it straight. I once observed an addict drink an entire water glass of pure paregoric and follow it with a chaser of water. It is relatively easy to purchase paregoric because of its low opium content, and it was, therefore, inevitable that addicts resorted increasingly to it during the stringency of the war years.

The difficulty of obtaining morphine and heroin probably reduced the rate of appearance of new addicts in the American underworld, since available supplies were inadequate even for the old users. It is therefore probable that there was an overall decrease in the number of addicts in this country, although no good statistical evidence is available to prove that this was true. In prewar days, the large quantities of drugs continuously flowing through underworld channels of distribution accounted for a large proportion of the new cases that were constantly appearing. Persons who came in contact with these drugs, or with the peddlers and addicts who handle them, were exposed to addiction. It was relatively simple for the neophyte to obtain heroin or morphine for experimental purposes. The drug was relatively abundant and relatively cheap. The main necessity was to have the proper connection with the underworld. On the other hand, during the war the potential addict or the dabbler found himself crowded out by the fierce competition of old users for an inadequate supply. Some new addicts unquestionably appeared, but their numbers were considerably reduced.

The decline of addiction in the civilian population has, however, no doubt been cancelled, at least in part, by an increase among the members of the armed forces. Opiates were extensively used for the relief of pain and, of necessity, were often in the hands of persons with little or no medical training and with little conception of the danger they represent. Under combat conditions in particular it is impossible to administer morphine with the care that is normally exercised in peacetime medical practice. It is reasonable to suppose that some of the wounded and ill of the armed forces became addicts; (5) and that others were exposed to addiction by experiencing the effects of the drug and might be classed as potential addicts. As demobilization proceeds, ex servicemen of the types described are beginning to be noticed among those who are arrested for violation of the narcotic laws. It is to be hoped that public sympathy for wounded veterans who acquired their addiction in Army and Navy experience will lead to an examination and overhauling of the assumptions that underlie present enforcement practices. It should be noted that after World War I nothing of this sort occurred. The veteran who became addicted by having been gassed, for example, was treated just like an addicted pimp or shoplifter.

There is, of course, no way of knowing in advance the precise nature of our eventual postwar narcotics problem. It is certain however, that the problem will become more acute and that addicts will appear to be more numerous than was the case during the war. It is possible that the postwar problem will be even more severe than the prewar problem. Unfortunately, available statistics in the United States are not sufficiently reliable, because of the sub rosa character of addiction, to give a dependable index of the number of addicts or of trends.

Some persons will no doubt reason that since war is a time of worry and anxiety, it is to be expected that individuals seeking escape or relief from their worries and fears will resort to drugs more frequently than in time of peace. Though this argument is superficially plausible, it does not take into account the fact that opiates are simply Dot accessible to most people. Liquor is, and the argument is perhaps applicable to alcoholism. In the case of drugs, however, the dominant statistical determinant of the incidence of addiction is not personal inclination but availability of

Addiction is common in the medical profession for that reason. Addiction declined among civilians in the United States because drugs were exceedingly scarce and difficult to obtain; it probably increased in the armed forces because drugs there were abundant, free, and easy of access. Addiction spreads rapidly in China because the extensive cultivation of the poppy and the large numbers of addicts there make the drug easily obtainable.

1. Statement by Elmer Irey reported in the New York Times, July 31, 1941, P. 3, col. 2. See also The Chicago Tribune, Sept. 13, 1941, on the increased demand for paregoric.

2. See Gerald Pie], "Narcotics; War Has Brought Illicit Traffic to All-Time Low but U.S. Treasury Fears Rising Postwar Addiction," Life (July, 1943), 15: 83-94.

3. Indianapolis Star, May 6, 1946, P. 4, MI. 7.

4. See Frederick T. Merrill, Japan and the Opium Menace, joint publication of the International Secretariat, Institute of Pacific Relations, and the Foreign Policy Association (New York, 1942), for an excellent discussion of the opium problem in China under Japanese occupation.

5. One of the first of these cases to come to public attention was that of the late Barney Ross, who volunteered to federal authorities for the cure of a drug habit allegedly contracted at Guadalcanal (Associated Press dispatch, September 12, 1946). See alsoNew York Times, Jan. 11, 1947, P. 15, cOl. 2.