Some topics covered in this historical review are alcohol use and the prohibition movement, Progressive era reforms (1898-1917), regulation of the health professions, heroin maintenance programs, and the medical and psychological response to addiction (1962-1970). Legislation considered includes the Smoking Opium Act (1901), The Harrison Act (1914), and the Narcotic Drugs Import and Export Act. The evolution of the Federal drug law enforcement bureaucracy is also traced. The review concludes that narcotics abuse in the United States has been a political problem, and the legal response has resulted from political pressures rather than from medical or scientific principles. The potential difficulty of such an approach is that a political response may deal only with public perceptions and fear of drug abuse rather than with drug abuse itself. The issue is how to relieve public concern about drug abuse without adversely affecting the real problem of drug abuse, scientific research, and therapy. Those formulating national strategy against narcotics abuse must try to put drug abuse into a realistic social and medical perspective and make it part of a unified effort to address threats to public health. 57 references.