In a time when the use of many drugs is illegal in the United States and the public is inundated with information on such drug use, it is probably surprising that this set of circumstances is a historically recent phenomenon. Throughout most of the history of the United States, the manufacture, possession, and use of most drugs now considered addictive were legal, and very little was known about these drugs, their use or abuse.
Other than ALCOHOL (through the TEMPERANCE MOVEMENT), the drug that first captured the attention of policymakers and medical and public-health sciences was OPIUM. An interest in the addiction to opiates in the United States can be found as far back as 1877, when Dr. Marshall conducted a study of the number of opiate addicts in Michigan. However, this and the handful of similar efforts at epidemiological research conducted through 1920 were plagued with methodological problems. Generally these studies were conducted by sending short questionnaires to physicians or pharmacists who, at that time, legally supplied people with OPIUM and opium-based products. These physicians or druggists were simply asked to report the number of opium addicts they saw in their communities. All these studies were done in only one city, county, or stateith one exception. The exception was a study done by the U.S. Department of the Treasury, in an attempt to provide direct estimates of the number of opium-addicted people in the nation. Unfortunately, none of these studies would come close to meeting the requirements of sampling or of measures taken that would be required today.
A very important step forward in the study of drug addiction or dependency in general, and opiate addiction in particular, took place in a now classic study done for the Committee on Drug Addictions of the Bureau of Social Hygiene, in cooperation with the U.S. Public Health Service, by Charles E. Terry and Mildred Pellens from 1923 to 1924 (Terry & Pellens, 1924, 1927, 1928). This study was groundbreaking in several ways. First, rather than sending questionnaires to physicians and pharmacists, only about 30 percent of whom had responded in any of the previous studies, Terry and Pellens used field study techniquesheir staff went to the sites of data collection. Second, rather than relying on self-reports, Terry and Pellens took advantage of official records that physicians, dentists, veterinarians, institutions, and laboratories were required to keep for all opium distribution, as mandated by the HARRISON NARCOTIC ACT of 1914. Third, and perhaps most important, Terry and Pellens conducted their study in six sites across the United States: Sioux City, Iowa; Montgomery, Alabama; Tacoma, Washington; Gary, Indiana; Elmira, New York; and El Paso, Texas. Although no known precedent existed for such a research strategy, they selected these six cities on the basis of racial characteristics, occupations, geographic region, and other social demographic factors, so that in aggregate these six sites could represent the United States as a whole.
As a consequence of these efforts, Terry and Pellens not only attempted to collect data more accurately but also produced the first study of the EPIDEMIOLOGY of drug addiction or dependence that tried to take into account social and demographic factors that, now as then, affect the number and distribution of people who are addicted to or dependent upon chemical substances. Their book, The Opium Problem, which contains chapters on the history of the problem, theories of its etiology, and contemporary treatments, is considered a classic in the field.
(SEE ALSO: Epidemiology of Drug Abuse; High School Senior Survey; National Household Survey on Drug Abuse; Treatment)
TERRY, C. E., & PELLENS, M. (1928). The opium problem. New York: Bureau of Social Hygiene.
TERRY, C. E., & PELLENS, M. (1927). A further study and report on the use of narcotics under the provisions of federal law in six communities in the United States of America, for the period July 1st, 1923 to June 30th, 1924. New York: Bureau of Social Hygiene.
TERRY, C. E., & PELLENS, M. (1924). Preliminary report on studies of the use of narcotics under the provisions of federal law in six communities in the United States of America, for the period July 1st, 1923 to June 30th, 1924. New York: Bureau of Social Hygiene.
ERIC O. JOHNSON
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