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1 Heroin Addiction and Urban Vice Reform In 1908, James Martin, then aged 21 and working in a Coney Island music hall, joined a fellow waiter on a double date with two women his coworker had chatted up. Apparently wanting to impress his new friends, James suggested that they go at midnight to an opium den where he had entrée. None of the group had ever smoked opium before, but James had learned the complex skill of cooking up the substance for smoking while rooming with an opium smoker, and it was through this acquaintance that James was able to gain admission to the opium house. As James told it: “We smoked for two hours and I had intercourse with the girl and my testicles became swollen at that time and the pain was so severe that I kept smoking the stuff to relieve the pain. I stayed in that place for a week every night going back and forth and so I started my habit that way.”1 After this first episode of opium use, with its mixture of social and medical motivations, James Martin smoked opium regularly for the next two years: “I would stay in the house for a week at a time while I had money.” Initially, the expense was not much of a problem, because “a can of hop was only $4.00”; but “when the government made that law, it jumped up to about $50.00 a can.” “That law” was the 1909 Smoking Opium Exclusion Act, which banned importation into the United States of opium for purposes of smoking.2 Addicted to opium and facing dwindling supplies and rising prices, James switched to morphine, a more easily available drug, whose sale was still unregulated (except for the labeling requirements called for in the Pure Food and Drug Act of 1906). Then, he said, “somebody [in his social circle] came out with heroin so I was one of the first to use heroin.” From sniffing heroin, he soon changed to injecting it subcutaneously to “get a better kick out of it.” This progression from milder to more intense forms of opiate use was a common pattern for a generation of young working-class men in crowded urban neighborhoods in cities like New York and Philadelphia ⡢⡡⡢ ⡠⡣⡠ who sampled opiates and became occasional, then regular users. Both their own rising tolerance to the drug’s effects and the rising intolerance of policy makers resulted in reduced availability and rising prices. In response , users adopted more powerful forms of opiate (heroin rather than opium) and modes of delivery that intensified the power of a given dose (injecting rather than sniffing it). The psychiatrist Pearce Bailey, an astute observer of the emerging heroin scene in New York, described the pattern of switching to heroin as opium became less available and noted the former drug’s advantages: In the old days, before the police shattered the opium joints, those who had become friendly with opium from social custom carried out their ceremonial by “laying in” for smoking the pipe. But with the disappearance of these resorts, old smokers and recruits also were obliged to turn to other forms of opium-taking, and [in about 1911] they deserted for the most part all other habit-forming drugs for a new derivative of opium. This new drug, which was heroin, won an immediate and widespread popularity. It had advantages over all rivals since the days of the pipe. It was cheap, it demanded neither layout [opium-smoking paraphernalia] nor hypodermic syringe, and could be taken for a long time without disturbing the health. It stopped the craving without diminishing working capacity to a degree which would prevent the earning of money to buy the drug, and last, but not least, as it is sniffed through the nose on a “quill,” the addict could take it without much fear of being interfered with.3 James Martin had also sampled another drug in common use at parties and dance halls, cocaine: “At the time you could go in and get five cents worth in a drug store, very cheap at that time. Nobody knew what it was.” Cocaine, though, did not suit James: “It made me weak, I was afraid to go out on the street.” It made his heart beat so fast that he couldn’t speak. Above all, James found that cocaine “makes you too uncontrolled. You can control yourself if you use the other stuff”—that...

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