rail at the narcotic clinics and "dope doctors" long after they had been suppressed; they were the floodgates that must remain closed lest the country become awash with narcotics. For three decades he managed to convince the government and the public of the correctness of his utilitarian calculation, thereby maintaining "a policy of narcotics control unlike that of almost every nation in the world."110 It was, nevertheless, a case built on bluff and intimidation. There is no objective evidence to support the idea that disallowal of maintenance saved the country from a series of mid-century narcotic epidemics.111 If the narcotic clinics had not been closed back in 1919-1920, if medical discretion and supervision had been permitted within the context of detoxification-or-maintenance programs, and if this approach had been widely emulated, then incalculable suffering, crime, and death could have been averted. Those who contemplate a purely preventative strategy for the future, who trust only in education and legal pressure, would do well to contemplate the implications of this. The combined medical-police approach, with all its contradictions and weaknesses, is by default the best policy available. The tragedy is that the country did not recognize this 40 years sooner.



Many of the interviews noted in this paper appear in edited form in David Courtwright, Herman Joseph, and Don Des Jarlais, Addicts Who Survived: An Oral History of Narcotic Use in America, 1923-1965 (Knoxville: University of Tennessee Press, 1989). Most of the material in this essay also appears in the introduction and epilogue of Addicts Who Survived.


For a review of the statistical evidence on late nineteenth-and early twentieth-century addiction, see Chap. 1 of David T. Courtwright, Dark Paradise: Opiate Addiction in America Before 1940 (Cambridge, Mass.: Harvard University Press, 1982).


Address delivered at Syracuse, New York; copy forwarded to Katharine Bement Davis, November 22, 1924, Papers of the Bureau of Social Hygiene, Series 3, Box 3, Folder 126, Rockefeller Archive Center, North Tarrytown, N.Y.


Richard J. Bonnie and Charles H. Whitebread II, The Marijuana Conviction: A History of Marijuana Prohibition in the United States (Charlottesville: University Press of Virginia, 1974), 26-27.

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