[1][2] "An Act To provide for the registration of, with collectors of internal revenue, and to impose a special tax on all persons who produce, import, manufacture, compound, deal in, dispense, sell, distribute, or give away opium or coca leaves, their salts, derivatives, or preparations, and for other purposes."

In Webb v. United States, the act was interpreted to prohibit prescribing maintenance doses for narcotics unless it was intended to cure the patient's addiction.

[3] The Harrison anti-narcotic legislation consisted of three U.S. House bills imposing restrictions on the availability and consumption of the psychoactive drug opium.

[9] Demand gradually declined thereafter in response to mounting public concern, local and state regulations, and the Pure Food and Drug Act of 1906, which required labeling of patent medicines that contained opiates, cocaine, alcohol, cannabis and other intoxicants.

[17] There were many hysterical news reports in the early 20th-century about cocaine-fueled rampages using hyperbole like "cocaine-crazed negro" and others exaggerating the addictiveness of cocaine saying it quickly reduced users to "another entry in Satan's ledger".

[20][21] In 1900, the Journal of the American Medical Association published an editorial stating, "Negroes in the South are reported as being addicted to a new form of vice – that of 'cocaine sniffing' or the 'coke habit.'"

[22][24] According to historian David F. Musto public opinion about cocaine turned negative as newspapers and even Good Housekeeping scapegoated the drug to explain rising crime in the South:[25] Thus the problem of cocaine proceeded from an association with Negroes in about 1900, when a massive repression and disenfranchisement were under way in the South, to a convenient explanation for crime waves, and eventually Northerners used it as an argument against Southern fear of infringement of states's rights.Despite the extreme racialization of the issue that took place in the buildup to the act's passage, contemporary research in Northern cities found relatively few cocaine users compared with alcoholics and opium addicts overall and no significant concentration among blacks.

[28] Wright testified at the hearing about the dangers alleging that drugs made blacks uncontrollable, gave them superhuman powers and caused them to rebel against white authority.

[30] He also stated that "one of the most unfortunate phases of smoking opium in this country is the large number of women who have become involved and were living as common-law wives or cohabitating with Chinese in the Chinatowns of our various cities".

[25][29][32] Writing in 1953 Rufus G. King explained that the Harrison Act was "intended partly to carry out a treaty obligation, but mainly to aid the states in combating a local police problem which had gotten somewhat out of hand.

[34] The Congressional Record showcases that the House was unsure whether the Commerce Clause actually permitted the federal government to restrict what types of goods could be exported, but the chamber adopted an expansive view based on dicta from the 1904 antitrust case Northern Securities Co. v. United States.

[35] Representative Thomas U. Sisson of Mississippi objected to restricting the market for narcotics as encroaching on state police power in violation of the Tenth Amendment.

Surprisingly, Sisson and Harrison were in agreement that the bill would allow physicians to continue prescribing narcotics as part of medical treatment for those with substance use disorder, yet the act's enforcement by the Commissioner of Internal Revenue frequently prosecuted such patients.

He says the public hysteria surrounding contemporaneous press reports about violent "dope fiends" probably distorted the Congressional intent and turned addicts into criminals.

[citation needed] Secretary of the Treasury William Gibbs McAdoo appointed Representative Henry T. Rainey to lead a special committee to investigate the law's effects.

[39] In June 1919, this Rainey Committee found that criminal organizations were smuggling drugs into the country across all four of the United States' coastal and land borders.

[35] The act's applicability in prosecuting doctors who prescribe narcotics to addicts was successfully challenged in Linder v. United States in 1925, as Associate Justice James Clark McReynolds ruled that the federal government has no power to regulate medical practice.