THE NARCOTIC DRUG PROBLEM [Illustration] THE MACMILLAN COMPANY NEW YORK · BOSTON · CHICAGO · DALLAS ATLANTA · SAN FRANCISCO MACMILLAN & CO., LIMITED LONDON · BOMBAY · CALCUTTA MELBOURNE THE MACMILLAN CO. OF CANADA, LTD. TORONTO THE NARCOTIC DRUG PROBLEM BY ERNEST S. BISHOP, M.D., F.A.C.P. Clinical Professor of Medicine, New York Polyclinic Medical School; Member Narcotic Committee, Conference of Judges and Justices of New York State; Committee on Habit Forming Drugs, Section on Food and Drugs, American Public Health Association. Formerly Resident Physician, Alcoholic, Narcotic and Prison Service, Bellevue Hospital; Formerly Visiting Physician and President of the Medical Board, Workhouse Hospital. New York Department of Corrections; Fellow Academy of Medicine, Visiting Physician St. Joseph Tuberculosis Hospital, Consulting Physician to St. Mark’s Hospital, etc., etc. New York THE MACMILLAN COMPANY 1920 _All rights reserved_ COPYRIGHT, 1920 BY THE MACMILLAN COMPANY Set up and electrotyped. Published January, 1920. TO MY WIFE, WHO HAS SHARED MY BURDENS AND HELPED IN MY WORK, AND WHOSE INTEREST IN AND SYMPATHY WITH MY WORK HAS MADE MUCH OF IT POSSIBLE, THIS BOOK IS INSCRIBED. PREFACE This book has been prepared in response to a growing demand that the author group together under one cover some of the material collected out of a varied experience with many aspects and phases of narcotic drug addiction, and with activities in the attempted solution of its problems. Some of this experience has been previously presented in many addresses before scientific and other societies and in articles in the medical press. The author is not associated with nor interested in any hospital or institution active in the care of these cases for financial return or pecuniary benefit. He is not the exponent or mouthpiece or proponent of any special or specific “remedy” or “treatment” or method of so-called “cure.” He has no axe to grind. He is not a “specialist” in the treatment of narcotic drug addiction. He is a practitioner of diagnostic and clinical medicine, in whose professional work the care of the narcotic addict has constituted much the smaller part of his activities and studies, and that part has been largely carried on without recompense and often at his personal expense. Some years ago, through hospital affiliations and duties, the writer was brought to face this problem of opiate addiction and after a while saw in it very important and very interesting clinical problems of physical disease and physical reactions upon which he made observations and studies.