Opium usage had begun to decline by 1914 after rising dramatically in the post Civil War Era, peaking at around one-half million pounds per year in 1896. Demand gradually declined thereafter in response to mounting public concern, local and state regulations, and the Pure Food and Drugs Act of 1906, which required labeling of patent medicines that contained opiates, cocaine, alcohol, cannabis and other intoxicants. As of 1911, an estimated one U.S. citizen in 400 (0.25%) was addicted to some form of opium. The opium addicts were mostly women who were prescribed and dispensed legal opiates by physicians and pharmacist for "female problems" (probably pain at menstruation) or white men and Chinese at the Opium dens. Between two-thirds and three-quarters of these addicts were women. By 1914, forty-six states had regulations on cocaine and twenty-nine states had laws against opium, morphine, and heroin.