Heroin and the International Conferences on Narcotics of 1925 and 1931
Pages: 55 to 58
Creation Date: 1953/01/01
Article 14 of the International Opium Convention signed at The Hague on 23 January 1912 provides that:
"The Contracting Powers shall apply the laws and regulations respecting the manufacture, import, sale, or export of morphine, cocaine, and their respective salts:
"(c) To heroin, its salts and preparations containing more than 0.1 per cent of heroin;"
In accordance with this provision, preparations containing 0.1 per cent or less of heroin might be bought and sold without any restrictions and supplied by chemists without a doctor's prescription.
At the very beginning of the Second Opium Conference, which met at Geneva on 17 November 1923, the United States Delegation put forward a draft Convention for consideration by the Conference. Among other suggestions, the following provision was included in the draft:
"The Contracting Parties shall enact effective laws or regulations prohibiting the manufacture and distribution of heroin."
The Conference had also before it the suggestions made by the Advisory Committee on the Traffic in Opium and other Dangerous Drugs of the League of Nations, which did not propose any changes in Article 14(c) of the Hague Convention.
The Advisory Committee, however, in its report to the Council of the League of Nations relating to the Committee's Fifth session stated that:
"With regard to heroin, the Advisory Committee, on the suggestion of the Portuguese representative, decided to recommend to the Council a resolution to the effect that Governments should be asked to transmit their views as to the possibility of the total suppression of the manufacture of heroin or, alternatively, the limitation of its manufacture to the minimum quantities recognized as necessary either for special cases or for prescriptions by specialists. The Portuguese representative supported his proposal by referring to certain authoritative opinions expressed in the medical world, which tended to show that the total suppression of the manufacture of heroin would not deprive the medical world of a necessary drug."
The Conference first discussed the problem at its Thirteenth Plenary Meeting on 8 December 1924. Doctor Rupert Blue, one of the representatives of the United States at the Conference explained the reasons which impelled the Government of the United States to make its suggestion. Dr. Blue stated that although for several years the importation into the United States of heroin and other narcotic drugs had been prohibited by law, it was not until June 1923 that the United States Congress enacted legislation providing that no crude opium might be imported into the United States for the manufacture of heroin. Since no crude opium is produced in the United States, the Act effectively prohibited, so far as the United States was concerned, the manufacture and distribution of heroin. Dr. Blue then summarized briefly the hearings before the Committee on Ways and Means of the House of Representatives which preceded the adoption of this legislation.
Dr. Blue ended his speech by saying that the suppression of the manufacture in the United States was, however, of little value unless the other manufacturing nations were prepared to take similar action, because the heroin abusively used in the United States was for the most part manufactured outside the United States and entered that country through illicit channels. While the Government of the United States had every desire to protect its people from the baneful influences of heroin, it was not for this reason alone that the United States Delegation was appealing to the other manufacturing countries represented at the Conference to suppress the manufacture and distribution of this most pernicious of all drugs. Drug addiction knows no barrier or limitation and what was the problem of the United States to-day will be the problem of other countries to-morrow and Dr. Blue invited the other countries to join the United States in a common cause against a common enemy.
At the proposal of Mr. de Myttenaere, delegate of Belgium, the Conference decided to refer the question of heroin to the Sub-Committee F of the Conference, composed of experts of the medical and pharmaceutical profession.
1. A 13 1923 XI [O.C. 144 (1)] League of Nations publication.
2. See article entitled, "The United States bars the manufacture of heroin" in the present issue of the Bulletin.
The Sub-Committee F on 28 January 1924 adopted a report in which it expressed itself as follows concerning the question of heroin.
"The Sub-Committee decided unanimously, with the abstention of the United States of America, that it was not competent to suppress this alkaloid. Only on the recommendation of a medical enquiry throughout the whole world could its entire suppression be decided upon. Nevertheless, impressed by the terrible ravages of the heroin habit, especially in the United States of America, the Sub-Committee, in contrast to the stipulations of the previous article as regards morphine and cocaine, adopted the suppression of the percentage, which means in practice, that it is impossible to sell to the public any preparation containing even the smallest quantity of heroin without a medical prescription.
"For this reason, some of the delegates found it necessary to observe that they were not empowered to accept this modification and that, although they associated themselves personally with the high motives which inspired the change, they made a reservation regarding the Government's acceptance of this suppression of the tolerance extended to other narcotic alkaloids.
"At the same time, many of the delegates considered that it would be well to proceed, first, to the reduction, and then, no doubt, to the removal of heroin from therapeutics throughout the world.
"With regard to the wording of the paragraph, the German delegate justly observed that the word 'heroin' could not stand by itself in the text of the Convention, since it was the property of the commercial firm and had not come into public use; it was therefore desirable to refer to this product by its chemical name of diacetylmorphine,putting in brackets the names (diamorphine, heroin) by which it is still known in commerce."
The United States member of Sub-Committee F, who, as indicated above abstained from giving his approval to the report, presented on this matter a minority report which read as follows:
"It is recommended that an article providing for the suppression of the manufacture of heroin be included in the Convention (see Article 9 A of the suggestions of the United States).
"The United States delegation has noted with interest the recommendations submitted by the Sub-Committee regarding the limitation of the use of heroin and would respectfully urge the Conference to take advantage of the present opportunity to place a ban upon this noxious drug in the manner indicated in Document O.D.C./C.R./13 .In further support of the proposal to suppress the manufacture of heroin, reference may be made to the report of the Health Section of the League of Nations:
3. This document contained the minutes of the Thirteenth Meeting of the Conference the gist of which has been given above.
"Diacetyl-morphine (heroin) is a very dangerous drug, still more toxic than morphine and still more dangerous as regards the forming of the drug habit. Since the pharmacologists and clinical practitioners admit that heroin can be dispensed with in therapeutics, the Mixed Sub-Committee recommends the possibility of entirely forbidding its manufacture should be considered."
"The foregoing statement not only constitutes a strong endorsement of the views entertained by the delegation of the United States regarding the suppression of the manufacture of heroin but would also seem to afford the answer to the statement that sufficient evidence has not been obtained to warrant the suppression of the manufacture of the drug at the present time."
The report of Sub-Committee F was discussed at the Thirtieth Plenary Meeting of the Conference on 12 February 1924, six days after the United States had withdrawn from the Conference. Professor Perrot, Delegate of France, stated that there was no reason why the Conference should deal more severely with heroin than with morphine and cocaine or why the Conference should draw up draconian measures for the complete suppression of heroin, which is a very active product of preparations which do not give rise to toxicomania. On behalf of the French Delegation, Professor Perrot requested, therefore, that heroin should continue to be dealt with as in the Hague Convention.
In the discussion which followed, Mr. de Myttenaere from Belgium and Dr. Carriere from Switzerland, the former a member and the latter the chairman of the Sub-Committee, vigorously defended its report and requested the Conference to reject the French proposal. In the absence of the United States Delegation no formal request was made for the complete suppression of heroin, but the Delegates of Poland, Dr. Chodzko, of Brazil, Dr. Pernambuco and Dr. Gotuzzo, and of Canada Dr. Riddell, pointed out that, although they were in favour of the suppression, they accepted the Sub-Committee's report as a practical measure since it appeared that the majority of the members of the Conference would not agree to it.
The Egyptian Delegate, however, expressed the view that the Health Committee of the League of Nations should be asked to carry out the necessary enquiries among international scientific institutions with a view to making it possible to suppress heroin entirely, if the enquiries proved conclusive in this respect. He proposed to insert in the Convention a clause to the effect that complete suppression would be admitted on the recommendation of the Office international d'bygiene publique and the Health Committee of the League of Nations. The Chairman of the Conference ruled that the Egyptian proposal should be referred to the Drafting Committee for insertion in the Final Act. The ruling of the Chairman was accepted by the Conference but the matter did not develop further and no provision was included in the Final Act.
Doctor Belances, Delegate of the Dominican Republic proposed a solution which he thought was half way between the Sub-Committee's proposal and the amendment of the French Delegation namely: that the Conference should not forbid the manufacture of heroin but should reduce the quantity proposed by the French Delegation. The Delegate of France immediately accepted a reduction by 50 per cent, i.e., to have the percentage fixed at half of the percentage stipulated in the Hague Convention i.e., at 0.05. A neutral position was taken by Sir Malcolm Delevingne who thought that not sufficient evidence has been produced before the Conference in favour of any solutions proposed. He stressed the difficulty of governments to require any change in national legislation unless strong reasons were put before Parliament.
The matter then came to the vote. Six delegations voted in favour of maintaining the provision of the Hague Convention as amended by the proposal of the Delegate of the Dominican Republic. The Conference decided then, by 21 votes, to adopt the conclusions of the report of Sub-Committee F.
No special provision regarding heroin was included in the draft prepared by the Advisory Committee on Traffic in Opium and Other Dangerous Drugs for the Conference for the limitation of the manufacture of Narcotic Drugs which met at Geneva on 27 May 1931. But very early in the general debate, on 29 May, the Austrian Delegation proposed the total suppression of heroin
The Austrian Government was of opinion that the total suppression of the manufacture of diacetylmorphine would be the most effective step in the campaign against the abuse of narcotic drugs. Heroin was the most poisonous of all the derivatives of morphine;consequently, owing to its small bulk, it was most suitable for the illicit traffic. Further, it was the only derivative of morphine which could be taken as snuff. It was therefore easier and more convenient to use than morphine. The fact that the consumption of heroin was small in many of the countries where general civilization and health organizations were most highly developed, and that its use had been prohibited in the United States of America since 1925 showed that this narcotic drug could be dispensed with, without depriving patients of medical treatment,and that heroin could be replaced by other less dangerous derivatives of morphine.
At the tenth plenary meeting, on 3 June, the Austrian Delegation proposed to include in the Convention the following provision: "The manufacture of diacetylmorphine is forbidden," and asked that this proposal should be referred to the Technical Committee of the Conference.The Polish delegate, Dr. Chodzko, warmly supported the Austrian proposal, but pointed out that it was a very radical suggestion and that, therefore, it might encounter resistance and finally be defeated, because certain countries thought it absolutely essential to have a certain quantity of heroin available for certain special cases. If any country was ready to run the risk of employing heroin, that was its own affair, but all possibility of exposing other countries should be avoided, He, therefore, proposed that heroin should in no case be exported.
The British Delegate opposed both the Austrian and the Polish proposals and asked for an immediate vote. Dr. Vasconcellos from Portugal requested the Austrian Delegation to withdraw its amendment. Other delegations, however, warmly supported the Austrian proposal as did Dr. Wu Lieu-Toh from China and Mr.Figueredo-Lora from Costa-Rica. Mr. Cavazzoni from Italy, stressing the humanitarian aspect of the problem gave his preference to the Austrian proposal but was in favour of referring both proposals to the Technical Committee. Colonel Sharman, Delegate of Canada, said that if the Austrian proposal were referred to the Technical Committee, the latter's report would be of great value in enabling the Canadian Delegation to bring to the attention of its Government and medical profession the considered opinion of so authoritative a body of experts, and thus materially co-ordinate the views held in Canada on the subject. He was not, however, in the position to commit at the present time his Government to the abolition of heroin. The Conference finally agreed to refer both proposals to the Technical Committee.
The Technical Committee at its second meeting on 8 June in its turn referred the problem to its Committee of experts composed of highly qualified specialists: Professor W. E. Dixon (British), Professor Erich von Knaffl-Lenz (Austrian), Professor M. Tiffeneau (French) and Dr. P. Wolff (German). Dr. Small from the United States was added to the body.
The Committee of experts had to answer a series of questions put to it by the Technical Committee and its findings could be summarized in the following way:
Heroin is more powerful than morphine and its dose is smaller. Unlike morphine, it may be readily taken as snuff. In the East it is occasionally smoked.Also, in view of the smallness of its dose, trafficking is easier. Heroin euphoria is much more pronounced than that of morphine, and constipation does not occur in the addict.
Heroin is at least equal to morphine in its effect in the relief of pain. The experts, however, expressed the belief that the properties of heroin which render it popular with some physicians can in most, if not all, cases be efficiently replaced by other morphine drugs.
The experts further stated that in their opinion the dangerous nature of heroin from the social point of view overshadowed its therapeutic importance. They admitted however that the opinion of the medical profession on the therapeutical value of heroin varied, not only in different countries, but even in the same country. Their final conclusion was that in view of the evidence which they possessed and especially the fact that all the beneficial actions of heroin could, in their opinion, be obtained by other less dangerous drugs, heroin could be entirely dispensed with.
4. For Professor Erich von Knaffl-Lenz's personal recollections on the work of the 1931 Conference, see Bulletin on Narcotic Drugs, Vol. IV, No. 4.
The findings of the experts came for discussion at the seventh meeting of the Technical Committee on 17 June, Dr. P. Wolff and Dr. Dixon defending eloquently and highly competently the conclusions of the experts. The Committee after a lengthy debate during which the thesis advanced during the general debate were repeated with slight variations divided evenly when it came to a vote: 9 members of the Committee voted for the Austrian proposal, 9 against and 7 members were absent. According to the League of Nations procedure the Austrian proposal was considered as rejected.
The Conference considered then at its Eighteenth Plenary Meeting a draft article based on the Polish proposal which with some amendments became article 10 of the 1931 Convention.
At its Thirty-Fifth Meeting on 12 July, the Conference approved Resolution VI which took place in the Final Act of the Conference and which reads as follows:
Recognising the highly dangerous character of diacetylmorphine as a drug of addiction and the possibility in most, if not all, cases of replacing it by other drugs of a less dangerous character:
Recommends that each Government should examine in conjunction with the medical profession the possibility of abolishing or restricting its use, and should communicate the results of such examination to the Secretary-General of the League of Nations.
5. See article entitled, "Article 10 of the 1931 Convention."