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American heroin black market for selling unsafe mixes. If the cause of
these deaths is the shooting of heroin while drunk on alcohol or
barbiturates, the black-market distribution system remains at least
indirectly responsible, for it is largely the high cost of black-
market heroin that makes heroin users turn to alcohol and barbiturates
on occasion - and thus, perhaps, to risk death from Syndrome X.
The two steps which must now be taken are (1) to stop sweeping these
mysterious deaths under the carpet by falsely labeling them "overdose"
and (2) to launch an intensive clinical and experimental search for what
is in fact killing these addicts.
[End]
* Thus in the _New York Times_ for December 16, 1969, a reporter was
  led to state without qualification: "About 800 addicts of all ages
  died this year from overdoses, according to Dr. Baden." [37]
Chapter 12
[footnotes, pp. 550-552]
1. Jerome H. Jaffe, in _Goodman and Gilman_, 4th ed. (1970),
   p. 286.
2. Ibid.
3. Milton Helpern and Yong-Myun Rho, "Deaths from Narcotism in New
   York City," _New York State Journal of Medicine,_ 66, (1966): 2393.
4. Ibid., Table XI, p. 2402.
5. Richard Severo in "News of the Week in Review," _New York Times_,
   February 1, 1970.
6. _New York Times_, December 30, 1970.
7. Michael M. Baden, quoted by Barbara Campbell in the _New York Times_,
   December 16, 1969; _New York Times_, December 30, 1970.
8. _New York Times_, December 30, 1970.
9. A. K. Reynolds and Lowell O. Randall, _Morphine and Allied Drugs_
   (Toronto: University of Toronto Press, 1957), p. 119.
10. Jerome H. Jaffe, in _Goodman and Gilman_, 4th ed. (1970),
    pp. 252, 268.
11. _New York Times_, June 21, 1970.
12. Reynolds and Randall, _Morphine and Allied Drugs_, pp. 176-177.
13. Jerome H. Jaffe, in _Goodman and Gilman_, 4th ed. (1970), pp. 252.
14. Robert H. Dreisbach, _Handbook of Poisoning: Diagnosis and
    Treatment_, 7th ed. (Los Altos, Cal.: Lange Medical Publications,
    1971), p. 247.
15. Reynolds and Randall, _Morphine and Allied Drugs_, p. 119.
16. William T. Salter, _A Textbook of Pharmacology_ (Philadelphia and London: 
W.B. Saunders Company, 1952), p. 77.
17. Reynolds and Randall, _Morphine and Allied Drugs_, p. 119.
18. Lawrence Kolb and A. G. Du Mez, _U.S. Public Health Reports_, 46 (1931): 
698.
19. A. B. Light and E. B. Torrance, _Archives of Internal Medicine_, 44 
(1929): 875.
20. Ibid., pp. 377-379.
21. Ibid., p. 394.
22. Ibid., p. 381.
23. Mary Jane Kreek in _Proceedings, Second Methadone Conference_,
    p. A-72.
24. Donald B. Louria, "The Major Medical Complications of Heroin
    Addiction," _Annals of Internal Medicine_, 67 (1967): 2; also,
    Helpern and Rho, "Deaths from Narcotism in New York City,"
    pp. 2405-2407.
25. Helpern and Rho, pp. 2405-2407.
26. Ibid., p. 2402.
27. Ibid., 2403.
28. Ibid.; see also Michael M. Baden, "Medical Aspects of Drug Abuse,"
    _New York Medicine_, 24 (1968): 464-466.
29. Milton Helpern in _Pharmacological and Epidemiological Aspects of
    Adolescent Drug Dependence_, Proceedings of the Society for the
    Study of Addiction, ed. C. W. M. Wilson (London: Pergamon Press,
    1968), p. 228.
30. Helpern and Rho, "Deaths from Narcotism in New York City,"
    pp. 2402-2403.
31. Michael M. Baden, "Pathological Aspects of Drug Addiction,"
    _Proceedings of the Committee on Problems of Drug Dependence_
    (Washington, D.C.: Division of Medical Sciences, National Academy
    of Science-National Research Council, 1969), p. 5792.
32. Michael M. Baden, "Medical Aspects of Drug Abuse," p. 466.
33. Ibid., p. 464.
34. Michael M. Baden, in _Proceedings, Second Methadone Conference_,
    pp. A-58, A-59.
35. Mary Jane Kreek, in _Proceedings, Second Methadone Conference_,
    p. A-72.
36. Michael M. Baden, in _Proceedings, Second Methadone Conference_,
    p. A-74.
37. Barbara Campbell, reporting in _New York Times_, December 16, 1969.
38. Milton Helpern, testifying at Hearings, House Select Committee on
    Crime, 91st Cong., 2nd Sess., June 27, 1970, p. 188.
39. Ralph W. Richter, John Pearson and Michael M. Baden, paper
    presented at 51st annual session, American College of Physicians,
    Philadelphia, 1970.
40. Milton Helpern, "Epidemic of Fatal Malaria Among Heroin Addicts in
    New York City," _American Journal of Surgery_, 26 (1943): 111.
41. Quoted by Milton Helpern in _Pharmacological and Epidemiological
    Aspects of Adolescent Drug Dependence_, p. 248.
42. Rudolph F. Muelling in _Pharmacological and Epidemiological Aspects
    of Adolescent Drug Dependence_, p. 248.
43. Robert Silber and E. P. Clerkin, "Pulmonary Edema in Acute Heroin
    Poisoning," _American Journal of Medicine_, 27 (July, 1959): 190.
44. George R. Gay et al., "Short Term Heroin Detoxification on an
    Outpatient Basis," mimeographed, unpublished, p. 9.
45. Harold Alksne, Ray E. Trussell, and Jack Elinson, _A Follow-up
    Study of Treated Adolescent Narcotics Users_ (New York: Columbia
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