“I Don’t Expect Many Escapes”
Tucked away near the intersection where the bustling highways of I-35W and I-20 meet in the southeastern corner of Fort Worth, Texas, sits an expansive, if initially unassuming, institution. Driving through the area that is now an uneasy mix of sprawling outlet malls, industrial buildings, and Texas prairie, you might not even notice this historic site. A quick jaunt off the highway, though, and the 1,350-acre facility looms large. Surrounded by layers of chain-link and barbed fencing covered with signs that read, “U.S. Govt. Property, No Trespassing,” the institution — now the Federal Medical Center Fort Worth — is administered by the Bureau of Prisons and closed to the public. Those driving by the facility might assume it is just another one of the nation’s many carceral sites. After all, jails, prisons, and other detention centers are ubiquitous in Texas, a state that holds the unenviable title of maintaining the largest prison system in the nation.
What to a 21st-century viewer may look like a typical carceral institution is in fact the former site of one of the longest-running and most expansive federal experiments in drug addiction treatment in the nation’s history. First opened in 1938, the grounds and buildings once housed the United States Public Health Service Hospital Fort Worth — known informally as the Fort Worth Narcotic Farm. This institution was one of only two federally funded treatment centers in the nation, and the only federal institution dedicated to treating drug users who lived west of the Mississippi River. For more than thirty years, the Fort Worth Narcotic Farm and its eastern counterpart in Lexington, Kentucky, embarked on what its architects believed would be a radical reimagining of the nation’s approach to addiction. Over the course of their time in operation, more than 60,000 patients and inmates passed through them. At a time when the country was firmly committed to crushing drug use through punitive measures, the narcotic farm model promised to provide new hope and compassion for addicts in need of care. A close look at this decades-long experiment reveals a decidedly more complicated legacy.
The opening of the narcotic farms in Lexington and Fort Worth in 1935 and 1938, respectively, grew out of heated debates over the place of narcotics and other mind-altering drugs in a society undergoing rapid change. Just as the turn of the 21st century brought a national panic over an emerging opioid crisis fueled by both prescription and “street” drugs, one hundred years earlier the country was growing concerned by what some framed as a problem of seismic proportions. During the last decades of the 19th century, Americans had begun to use opiates and other unregulated drugs to treat a wide range of medical ailments. As the number of people using these substances grew, some began to worry about their impact on society. Public discussions began to frame drug use and addiction as outgrowths of other social problems, including the rise of the patent medicine industry and big business, urbanization, immigration, and a commercialized leisure culture.
To complicate matters, though many expressed concerns about the number of Americans using these substances on a regular basis, few could agree on the nature or meaning of addiction. Doctors, researchers, jurists, lawmakers, and the public debated whether addiction should be treated as a disease, a moral failing, or a crime, and the answer often depended on how a person began using drugs. As Timothy Hickman argues, “the control of the addict population” in the first decades of the 20th century was split “between medical and penal authorities. Addicts who came to their condition at the hands of a doctor — in other words, patients — were considered to be proper subjects of medical rather than penal attention, while those who failed to acknowledge the authority of the physician — those who came to their condition at their own doing — were regarded as criminals.”
As user demographics shifted, efforts to treat addiction as a crime problem began to win out. If in the late 19th century users tended to be white, middle- and upper-class women introduced to narcotics by their doctors, by the early 20th century they were more likely to be working-class men who traversed the nation’s urban underworlds and began using opiates and cocaine for pleasure. Few Americans had sympathy for this new class of users, and their marginal status made it politically expedient to target them. Racial and ethnic stereotypes linking Chinese immigrants to opium and African Americans to cocaine helped fuel support for further punitive policies. By the early 20th century, as a wave of Progressive Era anti-vice activism swept the nation, and as “Protestant moral reformers embraced Prohibition as a means of allaying racially inflected fears of social disorder — of keeping the unwashed classes sober, self-disciplined, and on time for work,” the federal government intervened. In 1914, Congress passed the Harrison Narcotics Tax Act, the first federal law to effectively make the possession of drugs like opium, morphine, and cocaine without a prescription illegal. This expansive law had a dramatic impact on thousands of users across the nation who now found their previously legal activities punishable by federal law.
By the 1920s, the “junkie” image — which defined opiate users as criminally oriented, transient, and unredeemable — was firmly in place, and the position of drug users as criminals was secured in the minds of the American public. That the Narcotic Farms Act became law in 1929, then, initially seems like a surprising aberration in the nation’s march toward criminalization. The law called for the establishment of two institutions dedicated to treating a mix of voluntary and incarcerated addicts. The program was designed to blend psychiatric treatment, physical rehabilitation, and vocational therapy, all while segregating addicts into their own penal facilities. The “farms,” named in part because they were to be built in rural settings and use manual labor as a form of rehabilitation, were also to be divided geographically. One would be dedicated to treating users living east of the Mississippi River, and the other to those living west of that line. Proponents of the narcotic farms argued that this new model could enact the right combination of punishment and treatment, one that had been lacking since the passage of the Harrison Act. Even a cursory glance at early press coverage shows unyielding optimism that this new program would provide a modern fix to a modern problem. Their creation, the Fort Worth Star-Telegram boasted, marked a “milestone in the Government progress toward humane and scientific treatment of narcotic addicts” and was symbolic of “man’s humanity to man.” They were “proof that the humane, scientific approach is worthwhile.” The Fort Worth boosters and dignitaries who gathered for the ground-breaking ceremony for the western institution in October of 1934 were similarly thrilled to see the project come together in their community. Dr. Walter Treadway, assistant surgeon general of the Public Health Service, and Amon Carter, founder of the Fort Worth Star-Telegram and high-profile proponent of the institution, were among those invited to speak. After digging into the red Texas dirt with a gold shovel made specially for the occasion, they praised the “humanity” this great “experimentation” symbolized. If cattle and oil had put Fort Worth on the map, the narcotic farm promised to position it as a leader in health care and rehabilitation in the future.
Four years later, with the main buildings and grounds almost complete, the Fort Worth Narcotic Farm was ready to receive its first patients. The weekend before they arrived, the institution’s administration invited members of the community to tour the facility and marvel at their great achievement. When the Fort Worth Press covered the occasion, the headline set the tone from the outset: “Narcotic Hospital to Help Fiends Lead Normal Life: Not to Treat Addicts Like Prisoners.” Journalist Delbert Willis interviewed Dr. William F. Ossenfort, the man chosen to be the first chief medical officer in charge of the institution. The Public Health Service psychologist could not overemphasize the importance of the moment. He especially wanted the public to understand that although the institution would rely on “compulsory confinement,” this was no prison: “Modern movies take the place of armed guards. Iron bars give way to baseball and library reading. Solitary confinement is exchanged for individual freedom.” Their goal was “to cure the minds as well as the bodies of the dope user, who looks upon life as drab and uninteresting unless he is artificially stimulated by narcotics.” “To do this,” Ossenfort explained, “we have to set up a model community here on the farm,” one that did not rely on “lock and key.” Ossenfort saw little contradiction in the concept of freedom through confinement. He assured readers that each patient would have free run of the grounds on which they were confined and would only face penalties “if he ventures past the high fences,” at which point he would receive a five-year sentence in a penitentiary. “But I don’t expect many escapes,” Ossenfort declared. “Of course, there will be a few. It’s our intention to make the hospital so attractive that the patient will not want to go anywhere.” Instead, he expected that the “dope fiend” who “has a warped and weak personality” would be inspired to stay and make himself into a productive member of society.
Public rhetoric celebrating federal intervention into drug treatment, which emphasized its scientific, medical, and humanitarian dimensions, masked an important reality: these facilities were designed explicitly to be spaces of confinement. Though touted as hospitals, they were in fact also prisons for drug users. Indeed, the driving force behind their creation was a desire to address a growing carceral “crisis” that had emerged by the 1920s. For all the laudatory praise that portrayed them as benevolent institutions, it was the pressure on the nation’s penitentiaries and the need to find a place for a growing number of addict inmates that won them bipartisan support in Congress. Spurred on by prohibition laws meant to control unruly populations and eliminate vice, federal prisons, though less than three decades old, had become plagued by overcrowding, abysmal conditions, and inmate uprisings. This was especially true at the nation’s first federal prison, Leavenworth Penitentiary, which struggled to manage the growing number of Americans facing convictions in western states. Supporters of the new model argued that funneling addicts out of prisons and into “farms” would take the problem of addicts away from wardens, bring order back to federal penitentiaries, and place addicts in the hands of medical experts who could deal with their unique and peculiar condition. In reality, however, the narcotic farms came to embody the many ways in which federal prison structures and public health programs became intimately intertwined and interdependent during the middle decades of the 20th century.
The rise of the narcotic farm model was thus an outgrowth of two larger, interrelated developments. The first was the rise of a bipartisan commitment to developing crime control measures that expanded the power of the state. Between the 1890s and the 1930s, there was a dramatic expansion of federal bureaucracy and an accompanying administrative state. While the belief in the transformative power of the federal government was most evident in the ideologies that underpinned Progressive reforms and the New Deal, the expansion of federal authority continued throughout the decade that bridged them. As Lisa McGirr argues, the 1920s were not an aberration that sat awkwardly between those two reform eras. Rather than viewing it as “a period of retrenchment and laissez-faire” approaches to federal power, as is common in the popular imagination, we need to view that decade as intimately linked to a continuing project of state expansion. Even supposedly “individualist” presidents such as Herbert Hoover oversaw “vigorous state building” through a newfound obsession with crime control, particularly in relation to alcohol and drug regulation. That the embryonic ideas underpinning federal drug treatment crystallized into the Narcotic Farms Act in 1929, and were officially established with the opening of the narcotic farms at the height of the New Deal, suggests key linkages connecting Progressive reform impulses, the conservative politics of the 1920s, and the New Deal administrative state. Those linkages centered around the expansion of the state’s carceral control over its population, and the narcotic farms were literal and symbolic outgrowths of this development.
The establishment of the narcotic farms was also an expression of the rising power of the expert and a growing belief that social sciences could be used to shape public policy for the better. They were built during what James Gregory terms the “golden age” of American social sciences. By the 1930s, as the narcotic farm model came to fruition, sociologists, economists, and especially psychologists “spoke with more authority and their voices reached farther than in any other period before or since.” The narcotic farm model sat at the matrices of these emerging power structures: federal agencies hired experts in their fields who were given the administrative power to implement their visions on a grand scale, further justifying federal intervention into a host of social problems. The post–World War II environment deepened the commitment to “technocracy,” a philosophy that cultivated “the belief that centralized, scientific government programs could solve social problems.”
During the early Cold War years, the federal government’s investment in science expanded, and social sciences were seen as necessary to protect democracy itself. The narcotic farms were at their operational height in the postwar period and exemplified these broader intersections between federal power and expert knowledge, becoming what Claire D. Clark argues were “cathedrals to the era’s faith in experts.”
Excerpt adapted from Rehab on the Range: A History of Addiction and Incarceration in the American West, by Holly M. Karibo, Copyright © 2024 by the University of Texas Press. Published with permission from the University of Texas Press.
