Perception and Regulation of Drug Use: The Rise and Fall of the Tide

The eventful but generally unknown history of America's drug problem provides an essential perspective on current drug policy alternatives. As DuPont and Voth [1] point out in this issue, it is useful to recall that our original antidrug laws—those enacted in the late 19th and early 20th centuries—came about only after decades of easy drug availability. It was unrestricted access to opium, morphine, cocaine, and heroin—and popular revulsion at the results—that led first to city and state laws and finally to the Harrison Narcotic Act of 1914. In the midst of that movement toward domestic regulation, the United States initiated the international control of habit-forming drugs by convening the International Opium Commission at Shanghai in 1909. Although opiates were the first target of the nations that convened in China, a more recent drug problem, that of cocaine, was also discussed and then included in the first international treaty concerning drugs, the Hague Opium Convention of 1912 [2].

Cocaine provides a paradigm of the way in which drugs rose and fell in public esteem long before the wave of drug use that began in the 1960s. Introduced in the mid-1880s, cocaine soon was touted as a unique and safe tonic with multiple medical uses. It was declared the official remedy of the United States Hay Fever Association and found its way into many tonics and soda fountain drinks. About 15 years after its introduction, however, cocaine's image had changed to that of the worst of drugs. By the 1930s, cocaine use had substantially declined [3]. In fact, it is only the skyrocketing use of cocaine and other drugs starting two to three decades ago that has reminded us how far use had fallen …