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addiction, because it doesn't have that loss of motor control from taking morphine or heroin.
Chairman KEFAUVER. Marihuana is a stimulant?
Dr. KOLB. Marihuana is as bad as alcohol, no worse, no better. Chairman KEFAUVER. Cocaine is a stimulant?
Dr. KOLB. Cocaine is a stimulant which, from the standpoint of health, is worse than any of these drugs, but cocaine isn't quite as bad from the standpoint of crime as marihuana would be, or alcohol would be, because the man who gets cocaine gets extremely anxious, and he develops a paranoid type of psychosis, and he stops. in that psychosis, he could commit a crime.
Mr. MITLER. He sometimes thinks people are coming through the keyhole, and detectives are coming after him.
Dr. KOLB. I have seen cocaine addicts-we don't see many nowI saw one who, after walking around the city, saw a policeman walking behind him, and he attacked a laundry bag, attacked it with a bar, thinking it was a man.
Cocaine is really a destructive drug taken excessively, and it fortunately isn't today.
Marihuana is a dangerous drug, but it isn't anywhere near as dangerous as it is put up to be.
For instance, there are 200 million, estimated 200 million, marihuana addicts in the world. I don't know whether that is right. I rather think it is large now. There are about 5,000 in the United States.
Now, illustrating the hysteria in the United States about addiction, how we advertised our plight, marihuana has gotten to be known in Europe as an American vice because of our good advertising policy of a distressful situation we are in from addiction. Of course, it would be a terrible thing if we should get 68 million people in the United States smoking marihuana; then it would be an accentuation of crime. But there is no danger of that, even if you turn it loose, because it is not a destructive thing and it has no social usages like alcohol does; and even if we didn't have any laws, I doubt if we would ever get more than 50,000.
Did you want to ask a question?
Mr. MITLER. I just wanted to ask you what your recommendations were for an improved treatment program.
Dr. KOLB. I would like to finish answering the question that, Senator Kefauver asked.
Mr. MITLER. Surely. I am sorry.
Dr. KOLB. That is about the medical opinion about this opium and heroin.
Now, in 1898, a great English psychiatrist and physician wrote a book on narcotics, and he coined a phrase there which is true and which is followed all over Europe, that is, "Opium soothes; alcohol maddens." It just expresses the difference between those two things, and they go after the alcoholic in Europe much more than they do after the addict, because they know that the opium and morphine addict is not harming anybody.
They do, however, attempt to cure these addicts. Now, morphine and heroin and opium addiction is a terrible thing because of this physical dependence that people get; not because of the harm that it
gives to a person who has taken 5 or 10 grains a day, but that person has got to have his dose 4 or 5 times a day or he gets sick. It makes a slave of a person; and practically every addict I ever saw, except some of the very psychopathic, wanted to get cured, and they make an attempt to get cured over and over again, and they flunk on it just as the alcoholics do when they are of the psychopathic type of people.
So the world agitation against the opium drugs is very well based. It is based, not on the fact that these drugs are making people commit crimes, but on the fact that these people become slaves, and on the fact also that if you do get up to 30 or 40 grains of morphine or heroin a day, I personally think that it is physically harmful, because I did a lot of experiments with monkeys on-more with morphine than heroin, and found when I got to giving them up to what in a man would be the equivalent to 60 grains a day, that they very definitely suffered in health.
And while we are talking about withdrawal symptoms, one of these monkeys when I suddenly took the drug away from him, just died in the withdrawal period.
Did you want to ask me a question?
Chairman KEFAUVER. Then as I understand it, you feel as to heroin and morphine, that while in large amounts they may be harmful to the person, the chief crimes that come from them are that you become tolerant and addicted, and you must have your dose, and you go out and steal or do anything else in order to get the money?
Dr. KOLB. That is right.
Chairman KEFAUVER. In order to carry on this nefarious habit.
Dr. KOLB. That accounts for at least 95 percent of the crimes that the drug addicts commit. The other 5 percent are violations, and from the fact of the nature of these people beforehand, that they were criminals anyhow, and the drug addiction
Chairman KEFAUVER. Of course, is it not well known that a morphine or heroin addict's appetite for food diminishes, he does not take nourishment, and he does not eat normally?
Dr. KOLB. No; that is not well known. When you get tolerant to drugs, the tolerance implies that your physical functions are acting normally; and if a morphine or heroin addict taking 5 to 10 grains a day is given all the food he needs, he will eat it and he won't be emaciated, and I defy anybody in the world to pick out an addict just to look at him, a nourished addict, who is getting his dose.
Now, you can go around to jails and prisons when they first come in, and station houses when they brought a lot of people in, and pick one out and say, "That fellow is an addict," because he will be emaciated because he starved to death and spent all his money for morphine or heroin, and also because he has not been able to get enough of the morphine or heroin in between. He has been sick in between, say, 1 day sick because he hasn't got it, and the next day too much. And he gets to vomiting and has diarrhea, and he doesn't eat. That is what brings about emaciation.
Cocaine is the thing, if you take it in large doses, you will get emaciated from it, sort of an anesthetic effect on the stomach, and it is a terrible drug.
Chairman KEFAUVER. Well, morphine and heroin are given to people to quiet them, are they not, in hospitals?
Dr. KOLB. They are.
Chairman KEFAUVER. And you say that putting them to sleep and the effect when it has been given in hospitals, does not adversely interfere with their normal
Dr. KOLB. Well, the one dose will. The one dose-if some of us here should take, say, a half a grain of injection of morphine now, we probably would be sick, we might be vomiting. But if you kept on giving it to us for 2 months, we would have to have that thing just to keep from being sick; that is the difference.
But the first dose of morphine is liable to make a person sick, and often does; and in that time it will have cut down the appetite, cut down digestion, too, and will make you constipated, and all that type of thing.
But when you get tolerant to that type of thing, that is what builds up a person-you can build up a quarter of a grain a day, and in the course of 2 months, you can build them up in 2 months to taking 10 grains a day, where you will absoluely be in need of it, and he absolutely has to take it, and he will be sick if he doesn't take it.
And that is what makes the opiate drugs such dreaded drugs. I am talking about alcohol. I would rather be a drug addict, that is, if it weren't for our severe laws, rather than be an alcoholic, if I was sure I could stay out of crime with drugs and could stay out of the gutter.
Now, these 412 million alcoholics we have in the United States are not all in the gutter; some of them are functioning all right, and some of them are just killing themselves. And they didn't get so they have got to have that alcohol in order to keep from being sick. They built up an emotional attitude for it, but there is a different type of emotional withdrawal from alcohol. You can build up a withdrawal, brilliantly proved down at Lexington, by giving large amounts of alcohol to people, in 6 weeks they have had just as bad withdrawal symptoms as morphine and heroin, but that was amounts of alcohol that very few people take.
A fellow who takes 4 or 5 or 6 drinks a day isn't going to get any withdrawal symptoms. He can stop, and might be functioning perfectly normally. That is the difference between these drugs. And the terror that people have of becoming addicts, physical addicts, is what has caused all of the agitation throughout the world to stop the addiction.
Now, these tranquilizing drugs that are now being given to so many of the insane people and to the neurotic people are physically, every one of them is physically, more harmful than morphine or heroin. They cause dysphasias, they cause stomach and liver disorders and death.
Chairman KEFAUVER. What kind of drugs are they?
Dr. KOLB. The so-called tranquilizing drugs that you hear so much about in the newspapers, that are curing all the mental patients. Of course, it is not curing them, but it is quieting them down, and it may be curing some of them; I don't know.
But the morphine and heroin are much better tranquilizers, but of course they wouldn't be used because, if you used them right along, those people would become slaves to it and users. But those drugs are doing much more physical harm.
Chairman KEFAUVER. What is the makeup of the tranquilizing drugs?
Dr. KOLB. I couldn't give you the chemical formula. One of them is called chlorpromazine; one is reserpine-it comes from an old Chinese plant, I believe; and another one is called Milltown; and there is one called frenquil. And they are being given by the tons now to nervous people. In fact, the medical profession is getting disturbed about it, because every doctor has become a psychiatrist. If anybody has become anywhere nervous, they give him tranquilizing drugs.
I attended a meeting here in Washington 2 months ago that was called just because they were disturbed about this thing, and it came out there that 30 percent of all the prescriptions issued by physicians in the United States are issued for these tranquilizing drugs.
Of course, this is not a thing that any police need to get in on. The doctors will solve this eventually in their own way, and will use these things as they should be used.
But I merely brought up the effect of the tranquilizing drugs. They say it is the same thing that morphine and heroin do.
The Public Health Service has been trying for years to find an opium drug, a drug that would act like morphine, that wouldn't have the physical addicting properties of morphine. I don't think-I don't know whether they are ever going to succeed in it or not, but if they do, it would be the greatest boon to mankind, because these opium drugs are tranquilizers; they cure a lot of things.
There was one time in the world when morphine was practically given for everything, or opium, because it is a soothing, pain-relieving thing, but always we had this thing, that physical addiction. And in legislating we should remember this one thing: The only reason we need to stop, we need to regulate, the opium drugs at all, morphine and heroin, is the physical addiction. It is not crime producing; it is nor character deteriorating.
We got off on the wrong foot in this country in contrast to what they did in England, and made it a criminal problem, and this is how it came about:
They began arresting doctors for violating this law, Mr. King told you about that, and sent them to the penitentiary, often for giving drugs to cure patients and to save their lives.
I have seen a drug addict, a woman, who wanted to come to Lexington. The doctor had been scared off. She died. She was a fine mother of children. It was because of this one thing.
Now, this hasn't happened once, it has happened dozens of times. I have seen a woman commit suicide who in England would have been given her drugs. She was a nurse. I advised her to go to Lexington; she couldn't go. The police went after her. She committed suicide. In England she would have been doing a good day's work, and would not have been disturbing anybody.
Now, the idea that the addicts try to create addicts is another fallacy that has gotten into this business. My own experience has been that the addicts advise their friends to stay away from this drug and to get cured.
The reason why I bring this up is that they state that every addictand I have heard it stated from a reasonable source every addict creates four addicts. That has been given, not by a doctor, but by a law-enforcement official of high standing.
Well, I figured out what this would come to. I knew it was absurd from my own experience, but I got a statistician to work out what would happen. Well, if every addict, starting with our 60,000 in the United States, made 4 other addicts, and assuming no deaths, in 30 months there would be 187,500,000 addicts in the United States.
So now there is an illustration of the absurd things that are said about drug addiction, and which gets the public so stirred up that they will support any sort of ridiculous legislation that is proposed.
We heard, I believe yesterday you said something about the California report. I don't know what it is, but I think I have seen the report, the report to the Attorney General, and it has some good points in it.
But it has one thing in it of extreme absurdity which I would like to point out to you.
Chairman KEFAUVER. Let's let the record show at this point that the doctor is talking about the report brought out in testimony of Mr. Neeb, which is called the report of the Citizens Advisory Committee to the Attorney General.
Dr. KOLB. Well, I haven't read that report for some time, but I thought yesterday that was it. But in that report, this statement is made about the illegal market: One pound of heroin sells in the illegal market-let's see, I put it down here; I looked it up again this morning for $768,000 to $1,228,000, and people grab that.
Those kind of foolish statements are being made in newspapers right along.
Well, figuring that out, it means that a 6-grain-a-day heroin addict would have to spend $900, from $600 to $900, which is, of course, to anybody who ought to know, an absolute absurdity.
But these statements are made repeatedly in newspapers about this $1 million, $2 million, $3 million seizure, and if I read them all, it makes me a little bit mad because it is so absurd, and find out that just this thing is what would happen.
Of course, the heroin and morphine addicts do pay a lot. They pay up to $10, maybe some $15, a day, and they haven't got it; that is why they commit a crime.
Chairman KEFAUVER. Well, but are you taking into consideration the fact that when they talk about these large payments, that when you translate it down to the individual dose, that the pure heroin or morphine is cut many times before it finally reaches the consumer.
Dr. KOLB. That is right. It is cut more times; and even that $1,800,000-$200,000 there, if a man got the equivalent of the 6-graina-day habit, that is what he would have to pay.
Now, the 6-grain-a-day I found out in 1924 was the average addiction-day habit at that time. And it was a reasonably moderate habit. They would have-I also discovered in my studies at the time, if the average addict had his way about it, he would be taking 15 grains a day, but I have seen people-I saw 1 woman who had been on morphine for 65 years, and she was taking 3 grains a day— I think she was in Tennessee, Bristol, Tenn., or Virginia. And she was perfectly healthy, the mother of six children, and nobody was after her.
In the present day they would have gotten after her, and she probably would have died from withdrawal or would have been intensely miserable from the thing; or, if they had gotten her soon enough, she