CHAPTER VIII. Laws, and Their Relations to Narcotic Drugs

LAWS, AND THEIR RELATIONS TO NARCOTIC DRUGS

The first general appreciation of the widespread existence of narcotic drug use was brought about by the passage of anti-narcotic laws. The United States Federal legislation which went into effect in 1914, was what is known as the Harrison Law, still in effect and in its purpose and drafting a wise piece of legislation. It sought to limit and control the use of opiate drugs and cocaine by making their possession and distribution illegal by other than those of professional and other status designated in the law, as qualified for their intelligent application and responsible distribution. Its administration was placed in the Department of Internal Revenue under a provision which licensed responsible distributors and required a yearly tax.

Taken as a whole, in its original form, administered with understanding of addiction-disease facts, and with honest and intelligent scientific, educational and remedial activities coincidently pursued, it should be sufficient to control a rapidly growing menace. In its attitude towards the medical profession it wisely limited its restrictions to the broad statement that these drugs named must not be distributed other than in the “course of legitimate professional practice,” wisely making no attempt to define such “legitimate practice,” but apparently anticipating investigative activities of the scientific professions in the determination and dissemination of medical facts for the guidance of honest practitioners, and of those who should interpret and enforce the law.

Unfortunately addiction as a disease was, at that time, not a matter of wide recognition, the public in general and the medical profession itself still almost universally holding to the old conceptions of it on the basis of supposed morbid indulgence and “habit.” It seems to the author that the failure of the Harrison Law to check or limit the illegitimate use of the drugs it describes, is not due to a defect in the law itself, but is due to the failure of the scientific professions to clarify the situation with a clean cut understanding of the condition legislated against. The reaction within the medical profession as a result of this law was unfortunate. Instead of stimulating scientific interest and investigation into the character of this disease, the result was that medical men in general having little or no conception of its disease basis, regarded the narcotic addict as a mental or correctional problem and left his consideration and handling to the lay officials and the special institutions whose activities had been along other lines than scientific research into physical disease.

In the minds of most lay and of many medical workers the only consideration was the stopping of drug use per se, an attitude which to a less extent still persists. Uninformed as to the now established facts of addiction-disease, the administrators of the law, and to a large extent the medical profession, tended to regard supply of opiate to an addict as the prolongation of a habit, and not as medication indicated by the mechanism and symptomatology of a disease--and therefore as not being legitimate medical practice. This attitude had the effect of making the practitioner of medicine unwilling to receive the narcotic addict as a patient.

The immediate result was the sudden deprivation of opiate to such addiction-disease sufferers as had not had financial means or foresight to purchase large reserves before the laws went into effect. The history of the drastic early enforcement of the various laws, reduplicated with more or less completeness by periodical legislative and administrative activities, without adequate arrangement for the relief of the narcotic-deprived addiction-disease sufferer, shows suicides and deaths, and a rapid development of exploitation of the needs of the addict at the hands of illicit commerce. For this illicit commerce the laws themselves, however, are not so much to be blamed as the influence of long-prevailing and widely-taught attitudes and conceptions which caused scientific and other forces to fail to recognize and meet the need for clinical handling of the situation, and for study and investigation of the condition. Legislators and administrators simply reflect prevailing theories.

Early theories took scant if any account of the possibilities presented by the now rapidly-growing disease conception of addiction. The popular conception of an addict and even the description met in standard medical text-books was that of a “dope-fiend,” an irresponsible panderer to a morbid “habit,” bereft of will-power, honor and decency, a menace to himself and to society, and this conception has had unfortunate influence in the making, interpretation, and administration of laws. That it can be truthfully applied to some people who have developed addiction-disease is unquestioned, but that it fails to take into consideration a much larger number who are not irresponsible panderers to morbid habit, nor bereft of will-power, honor and decency, nor a menace to themselves or to society, but are honest and upright members of society and economic assets in the community, accounts in large part for the failure of laws and their administration to remedy the narcotic drug situation. Measures which might be very useful in the forcible control of those who can be justly characterized as “dope fiends” work great harm to those who are simply sick people.

That these sick people have been commonly regarded and classed as “dope-fiends” was due to the fact that the points of view and special experiences of the psychologist or psychiatrist, sociologist or penologist and the exponents of special methods of treatment dominated the literature and teaching in which appeared practically nothing of essential pathology, symptomatology and broad principles of addiction-disease therapeutics and handling. The occasional voice of the clinical student or experimental laboratory worker was almost unheard, and the opposition accorded unorthodox views and announcements made him a brave man who would state them, and tended to cause him to be regarded as an academic theorist, or possessed of ulterior motives.

In such a situation the dominant theme has been the stamping out of so-called “drug use.” The physician who under his best and honest therapeutic judgment strove to meet the immediate indications of the worthy and innocent addiction-disease sufferer by the administration of opiate drug, incurred a danger of severe criticism and at times of jeopardy to his liberties under the interpretation of his acts as perpetuating a “habit.”

It cannot be denied that in some cases unscrupulous holders of medical degrees have availed themselves of existing conditions in such a way that their supplying of opiates to narcotic addicts constitutes simply traffic in narcotic drugs and not the intelligent practice of medicine. It should be a matter of serious consideration for our lawmakers, administrators and judiciary, however, as to what extent the performance of the occasional medical vampire should be made a basis for the legal or administrative control of the honest practitioner, and to what extent he should be enveloped by legal and administrative restrictions, the innocent and unconscious violation of whose technicalities may at any time be made a basis for criminal procedure. It should be remembered that zealous administrators may not have proper conception of the scientific facts of disease nor of the practical problems of legitimate medical practice in addiction-disease. The quality of the act in the determination of legitimate medical practice is often if not as a rule more important than the mere act itself. There has been as yet, so far as I know, no satisfactory legal definition of legitimate medical practice. The author sees no reason why the same rules and criteria as have developed or are formulated for legitimate medical practice in other diseases might not be applied to the treatment of addiction-disease. In a general way the legitimate practice of medicine in the care of, handling of or treatment of a disease consists of such medical attention, advice, instruction and guidance, and clinical or therapeutic ministrations as may be indicated by the needs of the individual case. In addiction-disease if a physician proceeds upon the physical, clinical and other indications exhibited in the individual case, being held responsible for reasonable familiarity with such indications, and fulfilling to the best of his available equipment and professional ability the general and therapeutic requirements of each case, it is difficult for the author to see how he can be held to be engaged in illegitimate practice. He can of course be held responsible for reasonable familiarity with available teaching and information on the subject treated by him, and for average intelligence and honest application of medical principles and practice. It seems to the author that legitimate practice as determined in other diseases would go a long way towards the elimination of the charlatan and shyster physician and would not carry with it the menace and jeopardy which technical violation of often medically impractical administrative demands may involve. If the honest physician is left no leeway for the exercise of medical judgment in the handling of widely differing cases of addiction-disease, or if his exercise of honest clinical judgment is to be constantly influenced by a necessity of worrying about its possible interpretation, in the light of unduly stringent laws and regulations, a condition is created in which the intelligent practice of medicine upon the sufferer from addiction-disease becomes impossible.

A matter about which there has been a great deal of dispute is that of the prescribing or dispensing by the practitioner of medicine of opiate drugs to the narcotic addict in the handling of narcotic addiction, itself. The adherents of the older theory of addiction being merely habit or vicious indulgence, oppose as illegitimate practice the continued supply of the opiate to an addiction patient, unless in some cases the patient also suffers from some painful and incurable disease.

They take the attitude that, if the addict did not want to keep on using opiate he would go somewhere and be cured, and that as long as he can get opiate drug he will not get “cured.” The possibilities of immediate so-called “cure” are discussed elsewhere in this volume. Sufficient for present statement is the fact that, as demonstrated by the testimony of the Whitney Committee Legislative Investigation hearings, one of the most complete and valuable pieces of public investigation work into addiction ever done, there exists at present practically no adequate or competent machinery for the successful so-called “cure” of the great numbers of narcotic addicts. This is discussed elsewhere. Those who talk casually of the enforced immediate cure of the narcotic addict would do well to investigate and realize the lack of possibilities of its immediate attainment on any large scale. This is a basic fact which has been too little taken into account by those who still hold to the appetite and habit theories.

In the narcotic drug situation we are confronted by fact and not by theory. Intelligent comprehension and unbiased investigation are needed far more than we need premature conclusions drawn from insufficient experience or too narrow observation along special lines. The fundamental fact is this, as has been repeatedly stated, that the narcotic addict, until his disease mechanism can be competently and successfully arrested physically, needs the daily administration of sufficient quantities of the drug of his addiction to meet the indications of his disease. If the drug is not administered to him in sufficient amounts to meet these disease indications, he cannot be blamed if, in the agony of his suffering and the desperateness of his plight, he is forced into the underworld and the illicit channels of supply for the continuance of a physically endurable and economically possible existence. Until the medical profession and the medical institutions--hospital and otherwise--have in competent execution methods of handling and treatment of the narcotic addict which are more humane and more effective than those shown by ample testimony to be in common use, the supply of narcotic drug to the responsible narcotic addict to the extent of physical need, without unjustifiable exploitation, financial or otherwise, is the duty of the medical man. Any law which to this extent limits the supply of opiate drug to the addict should receive the support of the medical profession. Any law which renders it difficult or impossible for a physician to conscientiously and rationally meet, to this extent, the indications of narcotic drug disease, should meet from the medical profession with a united and honest attempt at its modification.

Above all there should be fostered and promoted by the medical profession an intelligent, unbiased investigation into the actual facts surrounding the problem of narcotic drug addiction as a definite disease. Such information concerning the physical and clinical facts of this disease, as we should be in a position to give, would be eagerly welcomed by the law-makers and the administrators and the judiciary; and we should be in a position to co-operate with them in the making and interpreting of narcotic drug laws. Lack of such information has played an important part in whatever mistakes our police, legislative and administrative bodies have made, and forced them to proceed as best they could to meet the demand of a public menace that could no longer be denied.

What has the law done for the addict? Like the physicians, the legislators have done the best they could in the light of their knowledge, experience and teaching. Some of them seem, however, to have had their attention directed unduly to a special class of those addicted, the addicts found among the type of person which begins or tends to end among the criminal or vicious of the so-called “underworld.” Legislators and administrators have realized that the taking of narcotic drugs was rapidly spreading, and that it constituted a public menace in the class to which their attention was directed; and they applied the means at their disposal in the remedy of what they saw. But again, like the physician, they tended to center their attention upon the mere taking of narcotic drug, and they attempted to control by legislation the possession and use of narcotic drugs with too little appreciation of fundamental disease facts and of general basic considerations of widespread application. They did not seem to have appreciated the extent to which their legislation or administration would affect the great numbers of upright, and innocent and worthy addiction-sufferers of whom they did not know, and who did not possess the fundamental characteristics of the class and type of person addicted against which they legislated. They rightly directed their attention towards the control of the sources of drug supply and they rightly limited the ultimate legal supplying of drug to duly licensed and responsible persons and institutions, specifically described. The slogan of most of the special legislation has been to place responsibility for the supply and use of narcotic drugs squarely upon the shoulders of the medical profession. Such effort is wise, and this is where the responsibility belongs. And this is where the medical profession would have it placed in so far as the medical profession supplies narcotic drugs.

The honest physician has no desire to dodge responsibility for his handling of narcotic addicts to the best of his ability, nor should he have any objection to a reasonable responsibility and accounting for narcotic drugs used in that handling; especially since the taking of narcotic drugs has in certain of its phases, developed as a serious situation entirely outside of the medical profession, in which situation these drugs are non-professionally supplied and used to such an extent as to constitute a public menace. The non-medical supplying and administering of such drugs should not, however, be controlled in such a way as to unduly hamper their honest and legitimate use by medical men, and to deprive the honest, worthy and innocent sufferer from addiction-disease of their legitimate therapeutic administration.

One of the chief and most serious phases of the narcotic drug problem, which for obvious reasons has especially called for legislation, is the illicit and illegitimate commerce in narcotic drugs. The class of addicts which constitutes a public menace is largely so supplied. This fact is recognized in the recent report of the Special Committee of Investigation Appointed by the Secretary of the Treasury, in which is stated, “This illegitimate traffic has developed to enormous proportions in recent years, and is a serious menace at the present time. It is through these channels that the addict of the underworld now secures the bulk of his supplies.”

This Report further states that “there is the so-called ‘underground’ traffic which is estimated to be equal in magnitude to that carried on through legitimate channels. This trade is in the hands of the so-called ‘Dope peddlers,’ who appear to have a national organization for procuring and disposing of their supplies. For the most part it is thought that they obtain their supplies by smuggling them from Mexico or Canada, although smaller quantities of these drugs are obtained from unscrupulous dealers in this country or by theft,” etc. There should be some way to dissociate entirely, conclusively and finally in the minds of the public the illegitimate and underworld traffic in narcotic drugs from the efforts of the honest physician to practice rational and scientific medicine in the help of the worthy and deserving addict. The regulation of the narcotic drug traffic of the underworld or “underground” is not the business of the medical profession, and the burden of responsibility for it should not be placed upon the shoulders of the medical profession or the consequences of it made to react upon the head of the honest physician and innocent addiction sufferer. There is a tremendous number of excellent and worthy and even illustrious people in whom addiction is in no way associated with vice, or other morbidity of mental or environmental origin, who are merely, solely and simply sick people suffering from addiction-disease, whose problem is the control of that disease until it can be arrested by competent therapeutic procedure, for which they constantly seek. Misconception of them and neglect of sufficient consideration of them is the tragic aspect of the narcotic drug situation, and causes tremendous individual and economic wastage. They do not in any way associate with underground traffic unless or until driven to it by failure of legitimate sources of opiate medication, or by the surrounding of legitimate sources with such restrictions as make the man of standing and reputation, afflicted with addiction-disease, fear possible publicity and economic detriment.

It is the duty of the medical organizations to see to it that these deserving purely medical problems and worthy sick people and their honest medical advisers shall no longer than avoidable be permitted to remain confused in the minds of the laity and of the medical profession itself with the problems of regulation of “underground” traffic and the control of the “underworld” addict. It is the duty of the medical organizations also to see to it that in the public press and elsewhere, and especially in their own scientific journals, the acts of the occasional individual with medical degree who prostitutes his medical standing and the aims and ideals of his profession in the commercial exploitation of the drug addict are not presented in such a way as to cause by inference or otherwise, their confusion with the honest efforts of honest medical men who are engaged to the best of their ability in the humane and ethical help of the deserving sufferer from addiction-disease.

It is, furthermore, the duty of the medical organizations to see to it that whatever laws and regulations are promulgated in the control of criminal and unworthy shall not be framed or administered in such a way as to unnecessarily jeopardize the reputation and liberties of the honest practitioner and to interfere with his conscientious efforts to care for his honest and innocent addiction-disease patients to such an extent as makes that care impossible.

Legislation or administrative regulation which limits to responsible and authorized persons possession and distribution of narcotic drugs and which compels from such persons reasonable accounting for such possession and distribution, is under conditions which have long existed but only recently been sufficiently recognized necessary and desirable. The Harrison Law was a definite response to an obvious need, in its obvious intent and draughting a wise and unobjectionable legislation. It provided for responsible possession and distribution and it enforced an accounting for the same, but did not unwisely restrict, in its text, nor hamper the legitimate possession and honest therapeutic employment of narcotic drugs. From the medical organizations and educational and scientific institutions should be available scientific study and understanding of narcotic drug addiction-disease available for the information of conscientious executives and administrators, who must exercise their best judgment in the light of available and prevailing teaching. It is the duty of the medical organizations to see to it that available and prevailing addiction-disease information and teaching is honest, unbiased and competent.

Those who are responsible for our laws should remember that the possible interpretation and administration of the laws they draught are very important considerations, and determine the real effect of the laws often more than does the intent of the makers. Legislation which is unduly stringent or is capable of unduly stringent administration may have unfortunate reaction and influence upon honest effort in the care of the deserving sick. Restricting beyond reasonable limits the care of the honest narcotic drug addict simply tends to make it impracticable and dangerous for the average medical man to have anything to do with narcotic addicts, and to drive the honest and deserving patient into the underworld, into the insane asylum or to suicide. Until we have provided scientific and clinical study, and have thoroughly investigated present and possible medical treatment and handling of narcotic-drug addiction-disease, and have established humane and effective therapeutic measures and procedures in the control and remedy of this disease, we should not deprive the majority of honest addicts of the only medication and means by which they can at present remain self-supporting citizens. The handling of the problem of the underworld and of underground supply is not going to be solved by too restrictive regulation of the honest physician. Legislation or regulation which makes it practically impossible for the honest physician to care for the honest case of addiction-disease is a boon to charlatans, and medical shysters, and the illicit underworld traffic.

It is the opinion of some that the handling and treatment of narcotic addiction should be taken out of the hands of the practitioner of medicine. The statement is made that the practitioner of medicine is not competent to handle a case of this disease. It has been advised that the treatment of narcotic addicts should be restricted to a small number of specially designated and licensed men and institutions. How and by whom are those special men and institutions to be selected? In the present state of chaotic and widely diversified medical and lay opinion as to narcotic addiction and the narcotic addict it would be a very difficult matter to select the men or the institutions for such absolute control. The comprehension, study and investigation of narcotic drug addiction has entered a stage of evolution and development in which new facts and new truths--both as to the addict and as to the condition from which he suffers--are being recognized and must be threshed out, correlated and coordinated with hitherto existing opinion before too restrictive measures will be anything but narrow-visioned, premature and harmful.

There are undoubtedly institutions, many of them not widely known, in which is available skillful, humane, intelligent and successful handling of this disease. From personal observation and experience in institutional work, and from analysis and investigation of many histories, it is my opinion that the results of institutional treatment depend more upon the quality of its medical and nursing staff than upon any other consideration. That the mere fact that addiction-disease is handled in an institution is a very minor consideration in comparison with the intelligence of that handling, is amply attested to in the testimony of the Whitney Hearings and by the experience of many addicts. Unquestionably, unknown and large numbers of narcotic addicts have been relieved of their addiction in reputable sanitaria conducted by skillful and competent medical men. Also unquestionably, large numbers of addicts have been relieved of their addiction through the honest efforts of practitioners of medicine, in private practice. Unfortunately these efforts and their results have received entirely too little recognition.

The average physician may be inexpert and not as completely educated in the appreciation, understanding and clinical handling of narcotic drug addiction-disease as he is in other diseases. The common-sense remedy for this situation, however, is not to drive the addict out of his hands, but to make him as competent in that addict’s handling as he is in any other clinical condition. It is only a matter of time and education before the competent practitioner of internal medicine can be brought to a comprehension of and ability to intelligently handle addiction-disease. It is largely a matter of securing general appreciation of and ability to clinically recognize, and interpret physical symptomatology, and to meet the indications of individual disease manifestations.

The ultimate solution of the problem of handling the narcotic addict lies largely in the education of medical men, both in institutions and in private practice, and through them securing lay appreciation of disease facts. Any legal or administrative restrictions which drive the care of the honest addict out of the hands of the honest medical man simply postpone the day when this ideal may be consummated.

Some addicts, as individuals and types, will of course always require institutional and custodial handling. The handling of the addict who is criminal or vicious belongs within the province of the penological authorities, just as does the handling of any other man who is criminal or vicious. The handling of the addict who is fundamentally degenerate, defective or mentally weak may require the attention of the alienist and institutional restraint, just as may the handling of any other man who is degenerate or defective. Narcotic drug addiction-disease in the man who is vicious or criminal or defective or degenerate should be treated as narcotic drug addiction-disease, as any other disease is treated in the same individual.

To our legislators and administrators and forces of penology, custody and correction rightfully belongs the problem of looking after the criminal and vicious addict as well as providing for the eradication of illicit, irresponsible, and “underground” traffic in narcotic drugs. If the illicit trafficker happens to be a physician he should have no more consideration at the hands of the law than any other criminal and in its action the law should have complete co-operation of the medical profession, which should see to it also that conscientious endeavor of its honest members is not confused in its consideration with illicit traffic and that the acts of the doctor shall be determined and estimated upon broad principles of medical practice and not upon violation of incidental technicalities. Great care should be taken that the sins of a guilty few are not visited upon the heads of a deserving many.

Until there is available competent and adequate medical care for the honest narcotic addict sufficient in extent to meet the needs of the thousands of sufferers, and encouragement and protection as well as restriction is afforded to the honest physician, the illicit traffic will continue and grow, including in its toils many who would not otherwise seek it. Before we have further medical restrictions, we should have both medical and lay and official education. Over-emphasis on any aspect resulting in premature, narrow, ill-considered and ill-advised action only increases the complexity of the situation and defers final remedy. For as great and complicated a problem as narcotic drug addiction there will be found no special or specific panacea.

In conclusion I feel that a great deal more thought and attention should be paid to the testimony of the public hearings of the New York Legislative Investigating Committee, under the leadership of Senator George H. Whitney, Chairman of the Committee. A vast amount of valuable data was produced. It showed for the first time to my knowledge an official effort to secure the true story of the narcotic addict in all of its applications and circumstances. It is significant that the Preliminary Report of the Whitney Committee gave official recognition of the fact that narcotic drug addiction is a physical disease. So important and enlightening was the above mentioned report, that it is deemed desirable to quote from it in part as follows:

“Lack of understanding and appreciation of the disease of narcotic drug addiction and its treatment by a large majority of the medical profession has fostered conditions which make it impossible to determine a rational procedure for treating and curing the addicted by the State at this time.

“Such absence of uniformity of opinion has worked great hardship upon the public and has laid the narcotic drug addict open to misconception, misunderstanding and medical treatment which, in many instances, has resulted in harm rather than good.

“Evidence offered by physicians shows that many addicts have died under the methods of treatment existing to-day and that a large percentage of those discharged from institutions as ‘cured’ are driven back to use of narcotics through unbearable physical torture induced by improper withdrawal of their drug.

“Evidence from physicians was adduced which denied that any cure for narcotic drug addiction existed in any of the private or public institutions of this State. Evidence from other eminent physicians was adduced which bore testimony to the fact that the disease of narcotic drug addiction was curable.

“The difference of medical opinion existing in medical circles regarding this vitally important question should be made the subject of a thorough and searching investigation as a matter of the greatest importance to the welfare of a large number of people in the State of New York.

“Your Committee has found that narcotic drug addiction bears no relation in point of character and seriousness to any other known habit induced by the use of stimulants. Narcotic drug addicts, according to evidence adduced, should not be classed with the alcoholic or the tobacco addict or the cocaine habitue.

“The constant use of narcotics produces a condition in the human body that many physicians of medical authority now recognize as a definite disease, which diseased condition absolutely requires a continued administration of narcotics to keep the body in normal function unless proper treatment and cure is provided.

“Withdrawal of the drug of addiction induces such fundamental physical disorganization and unbearable pain that addicts are driven to any extreme to obtain narcotic drugs and allay their suffering by self-administration.

“Testimony of physicians coming in contact with the addicts and statements of addicts themselves show that those afflicted with this disease express every desire to secure humane and competent treatment and cure and that most narcotic drug users are willing to undergo physical torture and often do voluntarily undergo such torture, in an effort to be rid of their so-called habit.

“In the present chaotic condition of medical opinion on this subject, it is impossible for the addict to-day to either secure authentic information on the subject of his disease and its treatment, or to procure at the hands of the average physician competent treatment for his malady.

“It has further been stated by competent authorities before your Committee that drug addiction is not confined to the criminal or defective class of humanity.

“This disease, however contracted, is prevalent among members of every social class. Some physicians estimate that addicts of the so-called underworld are far out-numbered by unfortunate drug users drafted from social circles of refinement and intelligence in the State of New York, who have become addicted to the constant use of narcotic drugs, but who are able to hide their affliction from the public.

“The attitude of the public toward the narcotic drug addict, fostered by the increasing prevalence of the disease in the criminal classes and by the apparent lack of medical help, has forced such drug users to keep their affliction a secret.

“This necessity in turn, your Committee finds, has apparently contributed to the existence of many unsound nostrums for the cure of narcotic drug addiction and many private institutions where this disease is purported to be cured which exist solely for the purpose of preying upon the addict.

“State investigation and regulation of such cures and institutions is recommended by your Committee.

“Your Committee is inclined to criticize the medical profession for its lack of study of the increasingly important subject of narcotic drug addiction. The only excuse which can be offered for this unfortunate condition lies in the fact that there has not been medical appreciation of conditions and that legislation, both State and Federal, has forced upon the physician a situation for which he was wholly unprepared.

“The testimony taken by your Committee shows that those charged with the sale and distribution of narcotic drugs are in the main observing the law, and that the legal distribution of these drugs is less than before the enactment of existing narcotic laws, Federal and State.

“On the other hand it is apparent from this testimony that public consumption of narcotic drugs has increased to an alarming extent. The inevitable conclusion is that the unfortunate addict has been forced to and does obtain his supply illegally.

“This condition arises very largely from the fact that many physicians and pharmacists, either through misunderstanding of the law or the true nature of the addict’s disease, have refused to prescribe or dispense narcotic drugs to the sufferer.

“Your Committee contends that any member of the medical or pharmaceutical professions who refuses either to prescribe or to dispense narcotic drugs to the honest addict to alleviate the suffering and pain occasioned by lack of narcotics is not living up to the high standards of humanity and intelligence established by these great professions.”