Birth of a Cocaine Factoid

Jacob Sullum | March 9, 2009

Scattered around the Web, mostly at sites dealing with drug addiction (here and here, for example), is a "Cocaine Timeline" that includes this 1912 milestone: "U.S. government reports 5,000 cocaine-related fatalities in one year." The number seems awfully high, given that the Drug Abuse Warning Network (DAWN) counted about 4,000 "drug misuse deaths" involving cocaine in 2004, when the U.S. population was about 294 million, three times what it was in 1912.

Although the DAWN data, based on reports from medical examiners in 31 metropolitan areas, do not cover the entire country, they include almost all of the big cities, and they tend to overstate the number of deaths caused by cocaine in each area. As a recent DAWN publication puts it, "It is important...to remember that not every reported substance is, by itself, necessarily a cause of the death or even a contributor to the death." A 2008 article in the journal Forensic Science International reinforces skepticism about deaths tagged as "cocaine-related," concluding that it is "very difficult to attribute a death to cocaine," that "isolated blood cocaine levels are not enough to assess lethality," and that "we can affirm that cocaine can be responsible for the cause of death only when there is a reasonably complete understanding of the circumstances or facts surrounding the death." Leaving such concerns aside, even if the actual number of cocaine-related deaths in 2004 was double the DAWN total, it would still be smaller as a share of the population than 5,000 deaths in 1912.

Such a disparity, of course, would be consistent with the view that the legal availability of cocaine, which was banned (except for medical use) by the Harrison Narcotics Act of 1914, led to widespread abuse and addiction, greater (in relative terms) than what we see today. But it turns out that the figure for cocaine-related deaths circa 1912 is fictitious. Surprisingly, the cocaine timeline was produced by Erowid, a site that is known for calm, rational advice about intoxicants, as opposed to anti-drug hyperbole. The original version of Erowid's timeline cited Steven Karch's A Brief History of Cocaine as the source for the estimate of cocaine-related deaths. In the 2006 edition of that book, Karch writes:

According to a U.S. government report, the total number of deaths from heroin and cocaine in the United States constitutes a smaller proportion of the total population now than it did in 1912, when the number exceeded 5000.

Karch then confusingly compares "the total number of deaths from heroin and cocaine" in 1912 to the number of "cocaine-related deaths" today. Given this juxtaposition, it's not hard to see how readers might conflate the two categories. But where did Karch get the first number? Although he does not identify which "U.S. government report" he has in mind, Gabriel Nahas' 1989 book Cocaine: The Great White Plague seems to provide the answer:

According to a 1912 official publication by M.J. Wilbert and M.G. Motter of the United States Treasury Department, cases of fatal poisoning, excluding those due to alcohol, numbered 5,000 in one year and the majority were related to opium or cocaine.

Note that we have gone from "cocaine-related deaths" to "deaths from heroin and cocaine" to "cases of fatal poisoning." Nahas cites Martin I. Wilbert and Murray G. Motter's Digest of Laws and Regulations in Force in the United States Relating to the Possession, Use, Sale, and Manufacture of Poisons and Habit-Forming Drugs, a report issued by the U.S. Public Health Service. A table on page 17 of that report provides mortality figures, based on Census Bureau data, for deaths by poisoning in the years 1900 through 1910. The highest total, including suicides but leaving out alcohol (2,578 deaths), "inhalation of poisonous gases" (1,837), lead (86), and "other occupational poisonings" (five), is for 1909, when it was 4,503. If you round that up, you get 5,000, which presumably is how Nahas arrived at his number. But the conclusion that most of these deaths "were related to opium or cocaine" appears to be Nahas'; the table does not say anything about either drug.

Since DAWN data indicate that cocaine is very rarely used for suicide, it's not clear that the 2,462 suicides by poison in 1909 should be included; leaving them out reduces the total number of fatal poisonings to 2,041. Of those, 1,779 (87 percent) were described as "acute poisonings," a category in which cocaine probably played a small role as well. The Forensic Science International report notes that "cocaine-related deaths occur for the major part after prolonged drug use." Fatal overdoses are more likely to involve opiates (often in combination with other depressants). And then we have to consider the role of every other poison (aside from alcohol, lead, and gases). It seems safe to say, based on the very report that Karch and Nahas cite, that the true annual number of cocaine-related deaths in the years leading up to the Harrison Narcotics Act was much smaller than 5,000. It might have been closer to 500.

After I emailed the folks at Erowid about this factoid, they corrected their timeline. But the number is still floating out there in many different places, including the website of the U.N.'s International Narcotics Control Board. No doubt drug warriors will continue to cite it as evidence of prohibition's success. But the persistence of this fake fact should not be seen as an indictment of accuracy in the Internet age. The original misinterpretations of the poisoning data, after all, appeared in books, and I never would have tracked down the error without an emailed tip from a psychopharmacology researcher in Norway and the help of Google, Google Books, and Amazon. Finding the 1912 report did require visits to brick-and-mortar libraries in other cities, which my colleagues Jesse Walker and Jeff Winkler were kind enough to help me with.

Comments

</|3.9.09 @ 10:59AM|#

Cocaine improves pistol marksmanship in Negroes according to early 20th Century scientific authorities.Perhaps that is where the cocaine related deaths come from.

Warty|3.9.09 @ 11:19AM|#

Negro cocaine fiends!

BakedPenguin|3.9.09 @ 11:31AM|#

That was some good journalism. All that piece needed was some ToughQuestions and UploadedVideo...

</|3.9.09 @ 11:39AM|#

You have to trust America's Newspaper of Record.

Hambone|3.9.09 @ 11:46AM|#

"Cocaine improves pistol marksmanship in Negroes according to early 20th Century scientific authorities.

Not in my neighborhood.

</|3.9.09 @ 11:55AM|#

Knowing that he must kill this man or be killed himself, the Chief drew his revolver, placed the muzzle over the negro's heart, and fired-"Intending to kill him right quick," as the officer tells it but the shot did not even stagger the man. And a second shot that pierced the arm and entered the chest had as little effect in stopping his charge or checking his attack.

Meanwhile, the chief, out of the corner of his eye, saw infuriated negroes rushing toward the cabin from all directions. He had only three cartridges remaining in his gun, and he might need these in a minute to stop the mob. So he saved his ammunition and "finished the man with his club."

The following day, the Chief exchanged his revolver for one of heavier calibre. Yet, the one with which he shot the negro was a heavy, army model, using a cartridge that Lieutenant Townsend Whelen who is an authority on such matters, recently declared was large enough to "kill any game in America." And many other officers in the South; who appreciate the increased vitality of the cocaine-crazed negroes, have made a similar exchange for guns of greater shocking power for the express purpose of combating the "fiend" when he runs amok.

The list of dangerous effects produced by cocaine just described-hallucinations and delusions, increased courage, homicidal tendencies, resistance to shock is certainly long; enough. But there is still another, and a most important one. This is a temporary steadying of the nervous and muscular system, so as to increase, rather than interfere with, good marksmanship.

Makes Better Marksmen

Many of the wholesale killings in the South may be cited as indicating that accuracy in shooting is not interfered with--is, indeed, probably improved-by cocaine. For a large proportion of such shootings have been the result of drug taking. But I believe the record of the "cocaine nigger" near Asheville who dropped five men dead in their tracks using only one cartridge for each, offers evidence that is sufficiently convincing. I doubt if this shooting record has been equaled in recent years: certainly not by a man under the influence of any other form of intoxicant. For the bad marksmanship of the drunken man is proverbial; while the deadly accuracy of the cocaine user has become axiomatic in Southern police circles.

Warty|3.9.09 @ 12:08PM|#

Meanwhile, the chief, out of the corner of his eye, saw infuriated negroes rushing toward the cabin from all directions.

Cocaine turns negroes into zombies? Good thing it was banned.

BakedPenguin|3.9.09 @ 12:13PM|#

My earlier comment really, really missed. I was trying to laud the piece while taking a shot at Lonewacker. Instead, it came of as an insult.

Preview is my friend.

|3.9.09 @ 12:14PM|#

Cocaine turns negroes into zombies? Good thing it was banned.

Fast zombies, apparently.

And cocaine turns white people into assholes, so I guess there must be some genetic-based difference to the effects.

|3.9.09 @ 12:43PM|#

Zombie assholes, pooping and moaning and with no head to shoot them thru...

|3.9.09 @ 12:44PM|#

73% of all statistics are made up.

|3.9.09 @ 12:57PM|#

For the bad marksmanship of the drunken man is proverbial; while the deadly accuracy of the cocaine user has become axiomatic in Southern police circles.

Isn't this an argument for the police to use cocaine when on duty? Those that aren't already, that is.

|3.9.09 @ 1:06PM|#

So deaths attributable to cocaine have decreased since 1912? Fantastic! The War on Drugs is WORKING!

JD|3.9.09 @ 3:12PM|#

Actually, I could kind of believe that drug-related deaths might have been dropping. It takes time for a culture to get used to new intoxicants. A while back I read "Craze", a book on the history of gin in England, which mentioned that when gin was new to England, people tended to serve, order, and drink it like the drinks they were used to...by the pint. Over time, culture adapted, and nobody now (barring fraternity initiates) drinks a pint of gin.

BakedPenguin|3.9.09 @ 4:09PM|#

JD, most of the initial delivery methods for cocaine were highly diluted. For example, a Sherlock Holmes story has him using a "7 1/2% solution".

Opiates were probably much deadlier, as the quantity of morphine can vary greatly from one poppy to another. Drinking tinctures - paragoric and laudanum - was a crapshoot.

Once morphine was isolated, it became much safer, as morphine is far less toxic than codeine. Even though codeine makes up a much smaller part of opium than morphine, it is usually the killer in opium overdoses.

Anonymous|3.9.09 @ 7:29PM|#

JD, most of the initial delivery methods for cocaine were highly diluted.

BP,

Diluted????

Have you ever mainlined a %7.5 solution of pure cocaine? I don't have a Merck manual handy but I wouldn't call that very diluted.Roughly .075 grams in 1cc if my calculations are correct.
Repeated at short intervals of 30 minutes or so.....