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by

H. J. ANSLINGER

And

WILLIAM F. TOMPKINS

United States Attorney for the District of New Jersey Former Chairman, Legislative Commission to Study Narcotics, General Assembly of New Jersey

II

THE ANATOMY OF NARCOTIC DRUGS

THE DESCRIPTION AND DISCUSSION THAT IS PRESENTED IN THIS CHAPTER will provide the reader with a survey of the narcotic drugs and, it is believed, with a better understanding of the problems to be discussed in later chapters. While not exhaustive in detail, sufficient information is given to establish clearly the various characteristics of the drugs that contribute to what is in this book called the traffic in narcotics.

OPIUM AND ITS DERIVATIVES

The use of opium in medicine and surgery is indispensable. The famous English physician of the seventeenth century, Sydenham, once wrote, "Among the remedies which it has pleased Almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium." There can be no doubt that opium is a blessing when properly utilized; but, as has been indicated earlier, a vast illicit use for it has unfortunately been prevalent through the centuries and probably will always continue.

The term opium is defined by the United States Pharmacopoeia as the "air-dried milky exudation obtained by incising the unripe capsules of Papaver somniferum Linné, or its variety album De Candolle (Fam. Papaveracea)." Opium is obtained from the Poppy plant, which is an annual herb, and in commerce must be cultivated. The plant is probably indigenous to Asia Minor; it is now most widely grown in China, India, Turkey, Macedonia, Yugoslavia, Bulgaria, and Iran.

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By the middle of the sixteenth century, the use of opium was both accepted and fairly well understood by the physicians and pharmacists of Western Europe. Paracelsus first used the term laudanum in 1537, and in the eighteenth century Le Mort made the first preparation of paregoric. In 1805, a German pharmacist named Sertürner first isolated morphine from opium. This was the beginning of modem alkaloidal medicine. In 1832 Robiquet isolated codeine, and sixteen years later Merck discovered papaverine.

The alkaloids, comprising about 25 percent by weight of opium, represent its pharmacologically active constituents, and the most important of these are morphine, codeine, and papaverine. Other natural alkaloids of lesser import are thebaine (1835), narcotine (1803), and narceine (1832). Additionally, there are many derivatives of morphine, among which are heroin, dionin, codeine, dilaudid, and dicodid.

There are two preparations of opium which are therapeutically employed today, laudanum and paregoric. These compounds, however, have been used with decreasing frequency since the isolation of morphine, and today the customary use of paregoric is with children and in the treatment of diarrhea.

There follows a brief description of the principal opium derivatives.

MORPHINE

The most commonly used and best known of the alkaloids is morphine, the principal medical function of which is the relief of pain. Its greatest drawback is the danger of addiction. It is usually prescribed in the form of its salts and the two most familiar of these are morphine sulfate and morphine hydrochloride. Morphine may be given orally or by subcutaneous injection, and under emergent conditions it is given intravenously. Dosage, of course, depends upon the patient, the nature of the illness, and varying other factors of diagnosis.

The therapeutic uses of morphine may be summarized as follows: *

*Pharmacologic Principles of Medical Practice, by John C. Krantz, Jr. and C. Jelleff Carr.

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HEROIN

Heroin (diacetylmorphine), which is about five times as potent as morphine, can produce a most vicious addiction. Because of this potency, together with the concomitant strong euphoric effects, this drug is always in great demand by addicts, and, accordingly, it has become the foundation of the illicit traffic. In view of the fact that its value from a therapeutic standpoint is no greater than that of morphine and since its toxicity is higher and objections to its use greatly outweigh its advantages, the United States prohibits the importation, manufacture, or sale of heroin. Some fifty nations now prohibit the manufacture of heroin.

DILAUDID

Dilaudid (dihydromorphinone hydrochloride), used mainly as a substitute for morphine, is also more potent than morphine. It has a much greater analgesic effect, but of shorter duration, than morphine. Both tolerance and addiction to dilaudid occur.

DIONIN

Dionin (ethylmorphine hydrochloride) generally has the same pharmacological qualities as codeine. Formerly used as a cough remedy, its use is presently mainly employed in treatment involving the eyes.

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CODEINE

Codeine, widely used and frequently prescribed in the phosphate or the sulphate form, is a derivative of morphine, and tolerance and addiction to it can occur as well. While it is employed in several ways, its primary use is in the treatment of cough. it is much less potent than morphine and, for that reason together with the fact that it generally fails to produce euphoria, is rarely used by drug addicts.

PAPAVERINE

Papaverine hydrochloride is the salt of an alkaloid contained in opium and as such is embraced within the scope of the Federal narcotic laws and regulations. It is unlike morphine both pharmacologically and chemically, and has only a mild analgesic effect.

COCAINE

Cocaine is obtained from the leaves of the Erythroxylon coca Lamarck, and also from other species of Erythroxylon, a shrub indigenous to Peru and Bolivia. Peru provides the bulk of coca leaves for the commercial trade. But the, species are grown successfully elsewhere in tropical regions. Their leaves can be harvested from two to four times annually depending on climatic and other growing conditions.

There are four principal uses of coca leaves: (1) in medicine; (2) for the manufacture of cocaine; (3) for the manufacture of non-narcotic flavoring extracts; (4) for chewing.

The Incas of ancient Peru believed that coca-leaf chewing both. diminished hunger and lessened fatigue, and thereby enhanced their endurance and they considered it of paramount importance in connection with high-altitude labor, particularly in the Andes mountain regions.

Coca-leaf chewing, or coqueo as it is called, is habitual in several South American countries, notably in Peru and Bolivia, but it is also prevalent in Colombia, northern Argentina, and Brazil. While many local factors probably are involved, coca-leaf chewing

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has been considered in some areas a practical necessity in overcoming the effects of climate, altitude, and nutrition. Recent studies, however, indicate that neither climate nor altitude has been a determining factor since the practice occurs in varying climates and in widely differing altitudes. Coca-leaf chewing, by inhibiting the sensation of hunger, maintains a constant state of malnutrition, ultimately undermining the health and stamina of the user. The conclusion, therefore, is clear that in its effects it is injurious and not beneficient.

The discovery of cocaine is usually credited to Nieman, who reported it in 1859. It has been claimed, however, that the real credit belongs to Gardeke, who produced it under the name of erythroxyline in 1855. Subsequent to its introduction, toward the close of the nineteenth century its growth as a local anesthesia drug in medical practice increased tremendously. However, as its use spread, it became evident that it was not only very toxic but also habit-forming.

Cocaine may be classed in the stimulant or excitant group of drugs as far as its effects on the nervous system are concerned. It is patent therefore, that its very nature makes it a most dangerous drug, particularly so when the user has a maladjusted personality. The drug causes mental deterioration; and, physically, nausea, digestive disorders, sleeplessness, loss of appetite, emaciation, and tremors result from its continued use.

In medicine, cocaine is used principally as a local anesthetic. It produces desensitization of the sensory nerve endings and because of this is often employed as a nasal, oral, or ocular anesthetic before treatment or surgery. Due to its dangerous characteristics, however, it has been replaced in medicine by preparations, such as procaine and Novocaine. Because of its toxicity, it is rarely used hypodermically, inasmuch as less toxic compounds are readily available for the purpose of injection.

Addicts prefer to sniff the drug, absorbing it through the mucous membranes of the nose. The cocaine powder used in this way is commonly known as snow, and its continued sniffing can cause the nasal septum to become perforated.

Cocaine is very scarce on the illicit market because the international

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movement of coca leaves is strictly controlled. Peru, it might be mentioned, has closed all cocaine factories.

MARIHUANA

Delving back through the centuries, we find references to the hemp plant as early as three thousand years ago in China-about 1200 B.C.--- hence its description as a drug of the New and Old World is apt. It is probable that central or southern Asia was its original habitat. Today it is found growing either wild or under cultivation in wide areas of India, the Shan States of Burma, Turkey, Syria, Lebanon, Greece, Brazil, Mexico, the United States, and in Africa. In Western European countries only small quantities are grown.

Because of its wide-spread distribution, it might be helpful to identify some of the names by which it is known throughout the world. The name marihuana, of Mexican-Indian origin, has become the general term in North and South America. In the United States the word reefer has through popular usage come to mean a marihuana cigarette. In England, which is experiencing an increase in its illegal use, it is popularly known as Indian hemp. Then there is the hashish of the Middle East, which is sometimes used in the United States. In Morocco and Algeria it is called kif; in Tunisia, takrouri; in South Africa, dagga; in India, bhang, charas, and manzoul. It is the maconha and djamba of Brazil, and the esrar and manzoul of Turkey.

What is this substance and whence does it come?

Marihuana, to use its popular name, belongs to the genus Cannabis, of which there is only a single species, Cannabis sativa L. Varieties, grown in different sections are botanically described as Cannabis indica (Indian hemp), Cannabis mexicana, and so forth. Since the bulk of the resin is contained in the flowering tops, the term marihuana has been relatively limited to those portions of the plant, while hashish refers to a special form of recovered resin of the plant. Commercially the plant, aside from its drug-producing properties, is used in the production of textiles, cord, and twine; depending on climate and soil, plants in

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different areas will have a greater or lesser commercial value due to the relative softness or hardness of the fibers.

Numerous products are made from the hemp plant that are used by drug addicts. Bhang is obtained from the leaves, the whole substance of which is reduced to a powder. The powdered leaves are frequently mixed with spices, honey, or water. It is eaten or drunk as well as smoked. Ganja consists of the flowering tops of the plant and is prepared by crushing it into a sticky mass. it is for the most part smoked in pipes or as cigarettes, but on occasion is eaten. From the resin extracted from the tops is secured the charas of India and central Asia; the chira, chiras of Egypt, Syria, and Greece; the hashish of Egypt, India, and Syria. The raw resin extracted from the tops is either kneaded into sticks or reduced to powder.

In discussing its use, one fact should be emphasized at once. Whereas the opiates can be a blessing when properly used, marihuana has no therapeutic value, and its use is therefore always an abuse and a vice. This important fact should never be forgotten, and pharmacopoeias throughout the world have generally expunged it.

At present the consumption of hemp is allowed by law in only three countries, namely, India, Tunisia, and Morocco. The oral consumption of bhang has always been permitted in India and the smoking of ganja is still permitted in many Indian states, but all states have now decided to restrict progressively the consumption of Indian hemp. Only Indian hemp mixed with tobacco is permitted to be used in Morocco. Hemp in the form of takrouri is legally consumed in Tunisia.

Hemp is either smoked or taken orally depending upon the individual, the place, or local customs. By absorbing it through the digestive tract, some experts feel that the effect is stronger. However, smoking is undoubtedly the most prevalent method of use in the Americas and in England. Cigarettes are prepared from the tops and leaves of the plant, and they are typically about the size of an American king-size cigarette, but somewhat thinner and more loosely packed. A cheaper grade is also prepared from the leaves and other parts of the hemp plant which, since the

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resin content is less, results in a product less effective for the smoker.

Marihuana is grown illegally in some States of the United States. While the Mexican variety, some of which is smuggled over the Texas border, is preferred by some smokers, there is always a ready market for all types. It is cheap compared to the price of heroin and cocaine since the price of a cigarette on the illicit market averages from fifty cents to one dollar.

The user of marihuana, unlike the heroin addict, seems to prefer to pursue his vice in groups or, in the vernacular, at tea parties. He (and here it might be interjected that men far outnumber women in this vice) has been well termed by one authority as a "gregarious addict." Like all narcotic addicts, any reasonable conception of hygiene on the part of the smoker is sorely lacking. At gatherings a cigarette is passed from lip to lip. Cupping the hands to prevent the loss of the fumes, the greatest amount of smoke possible is deeply inhaled and retained for a maximum length of time. At times several consecutive short puffs are taken, and on occasion the smoke is swallowed. And so it goes until eventually the cigarette is entirely consumed.

As a result of this habit, the inveterate smoker will have the same tell-tale stains of any heavy smoker of ordinary cigarettesthe yellow or dark brown stains accompanied by a hardening of the skin of those portions of the fingers which have held the cigarette.

EFFECT ON THE INDIVIDUAL

What are the physiological and psychological effects of the use of marihuana? What does it do to the individual? First of all, marihuana does not create physical dependence as do the opiates. Habituation occurs in the average case, but experts have observed the development of a special tolerance in instances of prolonged and excessive use. Collaterally, the danger of progression to the use of and addiction to the opiates always lurks in the background for the user of marihuana. A further distinction between the opiates and marihuana has been touched on before but bears repeating. While opium can be a blessing or a curse, depending on its use, marihuana is only and always a scourge

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which undermines its victims and degrades them mentally, morally, and physically.

Medical experts agree on the complete unpredictability of the effect of marihuana on different individuals. A small dose taken by one subject may bring about intense intoxication, raving fits, criminal assaults. Another subject can consume large amounts without experiencing any reaction except stupefaction. It is this unpredictable effect which makes of marihuana one of the most dangerous drugs known. Moreover, every individual will react in a different degree to the same dosage of this narcotic, depending on his physiological and emotional constitution.

Certain physical effects appear to be present in the majority of cases of marihuana intoxication. The first reactions appear, an hour or so after consumption, in the form of muscular trembling, increased heartbeat, acceleration of pulse. This is accompanied by a ringing in the ears, an intense feeling of heat in the head, dizziness, and sensations of cold in the hands and feet. Constrictions in the chest, dilation of the pupil of the eye, and muscular contraction follow. The physical reactions increase in intensity until either vomiting or complete stupefaction occurs. Initially the individual is excited, restless, and boisterous, over-garrulous and uninhibited. Next comes a period of dissociation of ideas and exaggeration of emotions. judgment and concentration are impaired; the subject shows a marked inability to judge both time and space; perceptions are distorted; in short, mental confusion occurs, accompanied by hallucinations. Marihuana sharpens the sensibilities, and in this stage the addict is prone to suggestion, violent or otherwise. The intense overexcitement of the nerves and emotions leads to uncontrollable irritability and violent and irresponsible acts due to irresistible impulses of suggestive origin. The last stage might include hallucinations, varied and often terrifying. Restless sleep, accompanied by bizarre phantasmagoria, then overcomes the victim.

In the earliest stages of intoxication the will power is destroyed and inhibitions and restraints are released; the moral barricades are broken down and often debauchery and sexuality results. Where mental instability is inherent, the behavior is generally violent. An egotist will enjoy delusions of grandeur, the timid

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individual will suffer anxiety, and the aggressive one often will resort to acts of violence and crime. Dormant tendencies are released and while the subject may know what is happening, he has become powerless to prevent it. Constant use produces incapacity for work and a disorientation of purpose. The drug has a corroding effect on the body and on the mind, weakening the entire physical system and often leading to insanity after prolonged use.

BY WAY OF ILLUSTRATION

The following are summaries of a few of the many cases recorded in the files of the U. S. Bureau of Narcotics which illustrate the homicidal tendencies and the generally debasing effects arising from the use of marihuana:

Oklahoma City, Okla. 1943. While under the influence of marihuana, twenty-seven-year-old Carl J. M., hotel bellboy, shot and killed elderly J. S. S., guard in the Federal Building at Oklahoma City, Oklahoma. He was convicted for the crime and sentenced to serve 10 years. Another bellboy, who was arrested in the case, confessed that he and M. had smoked marihuana in a hotel room before the crime was committed. M. then left the hotel and walked to the Federal Building. On the street he met three sailors, one of whom he bit on the neck. He struck a small boy whom he met on the sidewalk. M. then went to the Federal Building and took charge of an Army Recruiting Office. When Mr. S. . . . , the building guard, was called to remove M., a fight ensued. M. seized a gun from the guard and shot and killed him instantly. M. then placed the gun on a chair and walked down the hall singing. He engaged in another fight, but was finally subdued and placed in jail. Two days later M. was still unable to think or talk coherently. He talked about trying to get on the top of an automobile where he could reach a telephone wire and swing himself to the top of the hotel and from there he could get to heaven. Later, at a hearing, M. stated that he had smoked marihuana several times; that he did not remember leaving the hotel, nor the fights nor the shooting of Mr. S.... ; he did not remember his arraignment and stated the first he knew about the matter was after he came out of the stupor when someone told him he had shot and killed a guard at the Federal Building. M.'s employers stated he had always been quiet and sober, and had never caused trouble of any kind.

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The effects he experienced are characteristic, particularly with regard to the distortion of space and lack of restraint or memory by individuals of their own actions while under the influence of marihuana.

Clarksburg, W.Va. 1937. Lewis H., twenty-six years of age, arrested for rape of nine-year-old girl while under the influence of marihuana.

Del Rio,. Texas. 1940. One Eleutero G. while allegedly under the influence of marihuana, shot to death two women and then committed suicide by literally slicing himself to bits about the abdomen, heart, and throat, in a manner which indicated that he was bereft of all reasoning. Law enforcement officers believed that G. was under the