Report of the Interdepartmental Committee on Narcotics to the President of the United States

Abstract

An interdepartmental Committee representing the Departments of State, Treasury, Defence, Justice and Health, Education & Welfare of the Government of the United States of America was appointed by the President of the United States on 27 November 1954. The terms of reference of the Committee were to make a comprehensive up to date survey on the extent of narcotic addiction, in order to define more clearly the scope of the problems and to promote effective co-operation among federal states and local agencies. Determination of what the states and local agencies had accomplished and what they were equipped to do in the field of law enforcement and in the rehabilitation of the victims was to be included. The Committee's report was designed to expedite systematic review and improvement of the narcotics programmes, local, national and international. The report was transmitted to the President on 1 February 1956.

Details

Pages: 4 to 10
Creation Date: 1956/01/01

Report of the Interdepartmental Committee on Narcotics to the President of the United States

An interdepartmental Committee representing the Departments of State, Treasury, Defence, Justice and Health, Education & Welfare of the Government of the United States of America was appointed by the President of the United States on 27 November 1954. The terms of reference of the Committee were to make a comprehensive up to date survey on the extent of narcotic addiction, in order to define more clearly the scope of the problems and to promote effective co-operation among federal states and local agencies. Determination of what the states and local agencies had accomplished and what they were equipped to do in the field of law enforcement and in the rehabilitation of the victims was to be included. The Committee's report was designed to expedite systematic review and improvement of the narcotics programmes, local, national and international. The report was transmitted to the President on 1 February 1956.

The Committee's report stated that its method had been that of pooling the information and the experience gained by the agencies of the federal government most directly concerned and by other pubic and private authorities and investigators familiar with the problem in its manifold phases. From its study and review of the available material, it had endeavoured to arrive at an evaluation of the existing situation and to make recommendations looking towards a plan for integrated federal, state, and community action most likely to result in its improvement, within both the near and the more distant future.

The Committee believed that no important, informed point of view with respect to the character and dimensions of the problem, or method proposed for its alleviation, had been overlooked. The subject was one to which many, in private and public life, had given earnest thought. Numerous differing opinions had been advanced and complete unanimity never found on any single aspect of the problem except the chemical analyses of the drugs themselves.

A survey by the Bureau of Narcotics, covering the calendar years 1953 and 1954 on addicts reported by the various enforcement authorities and, to a limited extent, by the co-operating hospitals and medical services listed a total of 24,043 addicts reported during that period. Approximately 13% were under the age of 21; of this group, 3,145 (87.6%) were found to be 18 or over. This figure was significant as indicating that unofficial reports of a problem of serious dimensions among young people of school age had been exaggerations; the number in that age bracket, among the total of 24,043, was under 400. Additional names were reported during 1955, bringing the total number of addicts known to authorities to approximately 32,000. Preliminary analysis of these most recently reported cases indicated a still smaller proportion of those under the age of 21.

The Department of Defence had secured statistical data indicating a rate of addiction of less than three per 100,000 military personnel, or less than one-tenth the estimated rate for the civil population in the United States. A problem of some proportions was found to have existed in the Far East.

A majority of these addicts were found to have been involved with narcotics prior to their entry into service. The rate of addiction found among military personnel in the Far East was in general similar to that estimated for the civilian population, for comparable age groups in the United States.

A Bureau of Narcotics analysis of arrests for violations of the various narcotics laws during 1954 showed 1,430 by federal, and 18,059 by local authorities. This indicated a drop of 17% from 1953, during which 1,774 federal and 21,853 local arrests were made. A special tabulation of cases involving persons under the age of 21 showed 58 federal and 2,078 local arrests in 1954, against 134 federal and 2,598 local arrests in 1953. It is encouraging to note that the greater decline --21.8%--was among the younger group.

In addition to formal studies and reports, the Committee had the benefit of numerous consultations with experts within the Departments concerned, and with others possessing substantial experience with the problems of addiction. This was of great value in the interpretation of the extensive literature on the subject.

The Committee was aware of the extremely informative testimony elicited by the Committees of both the Senate and House of Representatives, which had been currently conducting hearings on matters pertaining to narcotic drugs, had had the benefit of generous co-operation by their chairman, members, and staffs, and also the opportunity of reviewing the valuable preliminary report of 9 January 1956 on this subject of the Sub-committee on Improvements in the Federal Criminal Code of the Senate Judiciary Committee. Representatives had participated in a panel discussion on the subject conducted by the American Bar Association, and attended meetings of the Committee on Drug Addiction and Narcotics of the National Academy of Sciences and the National Research Council.

The studies conducted by state and municipal authorities, and by numerous private and civic groups, had been reviewed. The Committee had been in correspondence with the State and city agencies concerned with problems of prevention and treatment of drug addiction, and enforcement of the narcotics laws. It had been aided in this by the officers and Washington representatives of the Council of State Governments and the Conference of Mayors of the United States. Among the special studies undertaken on behalf of the Committee was the "Report on Drug Addiction" prepared by a committee of the New York Academy of Medicine. Advantage was taken of the opportunity to visit the Riverside Hospital in New York City, and to observe the special programme conducted there for the treatment and rehabilitation of juvenile addicts.

The Committee was impressed by the consistent support given to the federal authorities in charge of control of narcotic drugs by physicians and pharmacists, and by the manufacturers, importers and distributors in the drug field. Associations representing these groups had co-operated in assuring compliance with all regulatory measures, and made notable contributions to the effectiveness of the programme.

Drug controls in the United States

The Committee drew attention to the fact that general properties of narcotic drugs had been known for many centuries, the world over, and that as their use had become widespread and new drugs had been discovered, the danger to society had grown together with their usefulness.

Within the United States, narcotic drugs were used with considerable freedom throughout the nineteenth and early twentieth centuries. Addicton was relatively common, though not frequently recognized until after the Civil War, when its prevalence among veterans whose first acquaintance with narcotics had been in military service gave it for a time the name of " the soldiers' illness ". Narcotics were important ingredients in a number of proprietary medicines widely sold to the public, and were also prescribed by physicians far more freely than in contemporary practice.

Owing to these circumstances an unknown though certainly large number of persons became unwitting addicts; they continued the use of the drugs in one or more of the many forms then available. Many of these people must have had only slight understanding of the real nature of their involvement with and dependence upon the drugs.

There appeared meanwhile a considerable, number of addicts who had resorted to narcotics for purely sensual gratification, and who obtained their supplies through unregulated purchase, without need for prescriptions. The resulting medical and social problems led to efforts, as long as eighty years ago, to estimate the number of persons affected and the quantities of drugs consumed. These early estimates were based upon sample reports from physicians and pharmacists, usually confined to relatively small areas or segments of the national population. The extrapolation of such locally established rates to the whole population produced widely differing total estimates, ranging upwards to the millions. Careful scrutiny of such early estimates and the methods by which they were reached suggested that they were of value chiefly as indications that a problem of considerable importance was already recognized.

The first truly national estimate of any statistical validity was made by Dr. Lawrence Kolb of the Public Health Service in 1923, at which time he found indications supporting the figure of 100,000.

By that date, however, narcotic drugs had already come under federal controls, and their manufacture, importation and distribution were subject to regulation. Certain of the states had already adopted restrictive and regulatory controls, and the problem had been modified to a considerable extent where effective local measures were enforced. The basic statute establishing federal controls was the Harrison Narcotic Law, enacted in 1914, and incorporated with its amendments in the Internal Revenue Code. The Narcotic Drugs Import and Export Act of 26 May 1922 further extended direct federal interest in and control over these drugs.

Enforcement of these laws was a responsibility of the Treasury Department. The Bureau of Narcotics, established in 1930, was charged with the duty of regulating, supervising, and controlling the trade in narcotic drugs, and served as the special administration which the United States became obligated to create for this purpose under Article 15 of the Narcotics Limitation Convention of 1931.

The duties of this Bureau included regulatory supervision over all stages of importation and manufacture of narcotics, and the registration of physicians, pharmacists and others concerned with their use. It was responsible also for the apprehension of those found to be violators of the narcotics laws, including those involved in the illicit traffic. The prevention of smuggling, an important consideration since the United States does not produce the materials for the natural narcotic drugs, was a responsibility of the Bureau of Customs. These two Treasury agencies worked in close co-ordination, and each maintained a small number of agents abroad for the purpose of preventing illegal shipments to the United Stales and co-operating with the enforcement agencies of other governments.

The Public Health Service, which was also at that date a Treasury agency, pioneered systematic studies of the nature and extent of addiction in the early twenties. Dr. Kolb, mentioned above, and Dr. Walter L. Treadway undertook a series of special studies, widely recognized as important contributions towards the development of effective measures for the treatment and rehabilitation of addicted persons. In 1928 the federal government authorized the establishment of the special Public Health Service hospital at Lexington, Kentucky, and later a similar institution at Fort Worth, for the purpose of treating narcotic addicts. An important purpose was to provide special treatment for federal prisoners known to be addicts, but provision was made also for patients admitted on a voluntary basis.

This Public Health Service activity continued within the Department of Health, Education and Welfare. Its hospitals, unique in their special programmes and facilities for the care of narcotic addicts, were also centres of the first importance in the research studies into the properties of the drugs and their effects. The extremely productive projects which their staffs undertook were carried on in association with the National Research Council, and drew upon the resources of the World Health Organization and principal medical teaching institutions throughout the world.

Drug addiction--character of the problem

The Committee found useful for the purpose of its study the definition of drug addiction drafted by the Expert Committee on Drugs Liable to Produce Addiction of the World Health Organization. *

In a recent statement summarizing the experience of the Public Health Service with the problem of addiction, over a period of thirty years, Surgeon General Leonard A. Scheele had reported :

"There are two groups of addicts. First are those who, after receiving repeated doses of narcotic drugs during a long and painful illness, become physically dependent upon the drug, and, therefore, addicted. In a majority of instances, people who become physically dependent in this way will lose their dependence simply by gradual withdrawal. A few do go on to become true addicts in the sense that they continue to be psychologically as well as physically dependent after efforts at withdrawal.

* See World Health Organization Technical Report Series No. 21.

"The second and by far the larger group represents those in whom drug addiction is a manifestation of some abnormality of character or attitude. These addicts often say that they became addicted after having been introduced to the drug by their companions. For these people, the drug fills an emotional need, giving them a feeling of security, of being able to meet the realities and frustrations of life with more equanimity than they could otherwise muster. They usually suffer from any one of the types of character or personality disorders and have mental and emotional inadequacies that we classify as psychoneurotic, psychopathic, or more rarely, psychotic. These characteristics are not limited to narcotic addicts, they are found also in the chronic alcoholic and the barbiturate addict. In all of these addictions, the underlying emotional problem is likely to be similar. In fact, some narcotic addicts are first alcoholics, and turn to narcotic drugs as a secondary addiction."

The Surgeon General has made the following qualifications of the above quotation: "It should be borne in mind that the mental illness from which addicts suffer is rarely of the kind that can be classified as insanity. Their illness is similar to that suffered by many delinquents in the population who do not use narcotic drugs."

According to the Committee, analysis of the data concerning addicts tended to support the following generalizations as applicable at the present time:

  1. The addict was likely to be a person of any social, economic, or intellectual status. The chances were 4 out of 5 that he was a male-almost exactly a complete reversal of the situation existing prior to the passage of the Harrison Act in 1914, when female addicts represented much the larger number. More than half were under the age of 30, 13% under the age of 21; of this latter group, however, nearly all were persons approaching their majorities.

  2. Heroin was the drug of choice for the large majority of addicts. It was the drug most often encountered in the illicit traffic; it was easily adulterated; addicts reported that it produced a greater effect than other drugs. Since manufacture or importation of heroin was prohibited within the United States, it was available only through smuggling and subsequent illicit traffic within this country; it was apparent that heroin addiction required some form of contact with underworld sources. It was to be noted that heroin was now outlawed by all governments except Albania, Bahrein, Belgium, France, Hungary, Italy and Paraguay.

  3. Since the costs of illicit drugs had been maintained at high levels, it was estimated that the addict dependent upon the illicit traffic had to spend from 50 to 75 dollars per week. Regular procurement of such an amount, considerably beyond the legitimate means of the average individual, accounts in part for the striking record of profit-motivated crime or other anti-social activity commonly associated with drug addiction. Available data indicated:

  1. Established patterns of delinquency prior to and following addiction to the drugs;

  2. The fact that a large majority of addicts, identified as such through other than law enforcement activities, were found to have become known to the police;

  3. A high degree of similarity between the settings and circumstances in which both addiction and delinquency were prevalent.

  1. Despite the difficulty of arriving at anything like a complete understanding of the phenomenon of addiction, and the conservatism of those most competent to form opinions in advancing them, it seemed clear to the Committee that addicts of whatever description shared a characteristic and abnormal concern over the need for relief from pain, discomfort or anxiety, and that they were prone to look for aid in dulling their perceptions. In each case, the addict seemed to feel the need for relief from some oppressive circumstance, whether this related to physical pain, recognition of personal or social inadequacy, or more complex considerations. The effect of the drugs had been likened to the function of a crutch, which enabled an addict to get along in his given situation. Many addicts described the effects of drugs in positive terms of euphoria, but this apparently did not commonly continue beyond the early stages of addiction except for those who had become habituated to intravenous injections. For most, the drugs seemed to offer an escape which was a line of retreat, not an advance. Studies made in New York and Chicago indicated that in many instances the first use of drugs resulted from examples set by addicts enjoying local prestige, as in juvenile gangs; from a desire on the part of the individual to gain acceptance by his peers; or occasional thrill seekers who used drugs only as a phase in their pattern of delinquency, without developing into confirmed addicts. The manner of its spread was felt to justify use of the term "contagion ", particularly in the cases of the younger addicts.

Many and varied estimates had been made as to the number of persons in the United States addicted to narcotic drugs. The Committee regarded the current estimate of the Bureau of Narcotics, based upon the analysis of the figures tabulated later in this report, as the most accurate available. This estimate, indicating a current addict census of 60,000, was based upon the records of its own agents, and co-operating state and municipal authorities.* The validity of the method by which it has been arrived at was supported in part by the Chicago and New York studies, which indicated that a majority of the younger addicts, however identified as such, were known to the police. Addiction might have existed for a period of months before the individual attracted police or other official attention, but upwards of ninety per cent of such cases came within police knowledge within a relatively short period. Such duplication was found in checking the names secured in an exceptionally thorough and confidential census of addicts in metropolitan neighbourhoods.

It had been noted further that persons who had arrived at larger estimates base their conclusions chiefly on contact with or observation of various categories of addicts which were included in the overall addict census maintained by the Bureau of Narcotics.

The Committee felt that the existence of one addict was one addict too many. But the estimate of sixty thousand narcotic addicts, which the Committee regarded as the most reasonably accurate figure, was not as high as had been expected. The Committee was heartened to find that the numbers of juvenile addicts was smaller than had been thought even though, once again, the Committee realized that the addiction of any person, young or old, was clearly a matter of concern.

It was noteworthy that the rate of addiction found among military personnel was at the virtually negligible level of 3 per 100,000. The thoroughness with which that special survey had been conducted by the Department of Defence, coupled with the obvious difficulty of concealing narcotic addiction within the circumstances of military life, made such a finding especially encouraging. Only in the Far East, where drugs were relatively plentiful and cheap, and civil enforcement measures largely ineffective, had a significant level of addiction been discovered. In such an environment, clearly favourable to experimentation with and use of the drugs, the rate was found only to be close to that among males of military age within the civil population at home. That addiction had not been found to be more prevalent in this critical area reflected credit upon commanders and service personnel generally, for their adoption of and responsiveness to effective preventive measures.

* According to the Bureau of Narcotics, 80% of these addicts are negroes.

The enforcement programme

It appeared to the Committee that with growing public interest in the narcotics problem had come an intensification of the enforcement efforts by local authorities. There were indications, meanwhile, that the volume of the illicit traffic was declining. During 1954 there were a total of 19,489 arrests under the narcotics laws as compared with 23,627 in 1953. The arrests of persons under 21 years of age dropped from 2,732 to 2,136. These figures suggested an encouraging reversal of the trend observed during the years immediately following World War II which, like the corresponding period after World War I, had shown increases in the numbers of reported offences.

State and municipal authorities had improved their agencies for coping with the local problem, by increase of the numbers of enforcement personnel assigned to narcotics squads, and provision of special training in this field. The Bureau of Narcotics had continued to receive a high measure of co-operation and support from the local agencies, facilitating concentration of the efforts of its own personnel on the major offenders, particularly in interstate traffic. The Bureau of Customs had continued its apprehension of smugglers of the drugs, and had recently strengthened its force of Customs agents on the Mexican border, in order to meet the changing channels of traffic from abroad.

Notable success had followed the various international efforts at controlling the production of the raw materials from which the narcotic drugs were manufactured, and in restricting their conversion and distribution to the requirements for medical and scientific use. The Narcotics Commission of the United Nations, and the World Health Organization, had been fruitfully active in this field. The United States had a continuing interest in encouraging efforts towards world-wide, co-operative controls of narcotic drugs, since illicit traffic was supplied through smuggling from abroad. While synthetic drugs were not as yet a factor in international traffic they clearly offered a threat for the future of control measures.

About 90 nations were parties to one or more of the international narcotics treaties. The United States Government had usually assumed the initiative in the adoption of these treaties.

Four organs at present exerted international narcotic control : The Commission on Narcotic Drugs, which was the general supervisory and policymaking body, reviewed annually the situation in all countries, considered necessary improvements in the control system, prepared new measures therefor, and appealed to public opinion. The Permanent Central Opium Board and the Drug Supervisory Body were specialized supervisory bodies which worked closely together on statistical returns and estimates of governments and watched over international trade. The Expert Committee on Drugs Liable to Produce Addiction of the World Health Organization was concerned mainly with medical aspects of drug addiction, and decided which new drugs, particularly the synthetic drugs, should be brought under international control. The Division of Narcotic Drugs, part of the United Nations Secretariat, worked on implementation of existing treaties, planned new measures, and conducted scientific research.

The proposed Single Convention, under consideration for approximately five years, was intended to simplify and replace all existing narcotic treaties, and extend control to poppy straw, coca leaves, and cannabis, as well as to synthetic narcotics.

The assignment of a small number of narcotics agents to duty in southern Europe and the Middle East had resulted in striking accomplishment in the way of assistance to the internal police activities of co-operating governments, and had aided materially in reducing the sources of supply of raw opium and processed drugs intended for the illicit market.

Evidence from seizures of drugs in the illicit traffic indicated that the risks of the clandestine trade had kept costs at a high level. Coupled with this had been a progressively greater adulteration of the drugs (sugar or milk being the common adulterant for heroin) associated with the greater scarcity of the basic drugs. Quantities seized in average individual cases, or by totals over comparable periods of time, had declined markedly in recent years; although, as in two recent instances, substantial amounts had occasionnally been encountered. There were continuing indications that the illicit drug traffic, though still supposedly profitable, had been recognized by the underworld as increasingly hazardous.

The Committee noted however that officers enforcing the narcotic laws felt strongly that their activities had been severely curtailed by a series of adverse court decisions in the last two decades. Their views were summarized as follows:

These decisions had upset investigative processes which had had the sanction of the courts for many years. Some of these processes were : evidential use of post-arrest admissions and confessions; authority to arrest without warrant; authority to search for and seize contraband before and after a valid arrest. Officers had been compelled to desist from close pursuit and to abstain from seizing plain evidence of crime before them in favour of obtaining arrest or seizure processes from a magistrate, where there had been any indication that the circumstances would permit of that course. The right of defendants to claim a third party's interest against search and seizure on a third party's premises had been asserted. The decisions had practically abolished the conception of a consent to search by the accused. Great latitude had been given suspected persons in asserting their rights against self-incrimination.

While restrictions imposed by these court decisions applied equally to all federal law enforcement efforts, there was belief on the part of many able law enforcement people that they penalized with particular force operations against the illict narcotic traffic. This was a well organized, professionalized "racket ", with a high degree of recidivism among violators. These professionals were very well informed as to the limitations placed on the operation of law enforcement officers and could be expected to conduct their business so as to take full advantage of every new development. Furthermore, the contraband merchandise was small in volume and high in price; a fortune in narcotic drugs could be concealed under the clothing. It could be transported to a place of safety on a few moments' notice.

Even the shortest delay incident to obtaining a warrant from a magistrate under the most favourable circumstances had been fatal to many narcotic cases. Much of the business was in neighbourhoods where alarms are quickly spread; much of the activity of narcotic criminals was at night and at weekends, or at other times when a magistrate could not be reached without delay.

The deleterious results of this line of judicial action had come to light occasionally in borderline cases which were thrown out of court. What had not appeared so clearly was the frustration and the lack of effectiveness and efficiency imposed on the law enforcement agencies, as the areas of immunity and sanctuary of the criminal expanded.

That these disabilities were real there was no question. When the multiplicity of areas was considered it was obvious that the cumulative result was the equivalent of a severe loss of manpower. In 1950, in an attempt to offset some of these handicaps, the Bureau of Narcotics shifted enforcement emphasis to the purchase of drugs from violators-a method which was slow, costly and inefficient by previous standards, but designed to avoid judicially imposed disabilities.

In more recent years there had been a tendency to take what might more appropriately be federal cases into the state courts, because of fear that technical considerations would prevent their full development in the federal courts. It was believed that the problem noted here should be considered by Congress and by the judiciary.

Treatment and rehabilitation

The Committee's report stated that patients were now withdrawn from physical dependance on the drugs without difficulty, as was routinely done at the Public Health Service hospitals; but treatment had usually to be carried out in a controlled and drug-free environment because of the patient's psychological or emotional dependence. Institutional care thus seemed to be an essential for all except those patients possessing unusually high motivation.

Rehabilitation towards resuming a useful place in society was commenced at once, and constituted an important part of the individual's reorientation, under psychiatric supervision. The patient was guided towards a better understanding of his own problem, and an effort was made to help him prepare for the give-and-take of normal life in a modem community. For many, supervised experience in good work habits, and the development of some basic skills, were important. Ideally, the patient should leave the institution with considerably heightened confidence in his own ability to solve many of the basic and recurring problems of ordinary life, without the aid of drugs.

Inevitably, the transition from institutional to free community life was a difficult one. The released former addict was likely to find himself cut off from helpful guidance and opportunity at the moment when he felt the need for them most keenly. Communities, even families, showed a marked scepticism, sometimes hostility, towards the former addict. Too often he could find quick acceptance only in his former haunts, and among those associated with his earlier addiction. His attitude was too surely and quickly that of seeking what appeared to be the only available and familiar line of retreat, a return to the drugs.

It seemed apparent, therefore, that post-hospital follow-up was essential to hopeful and lasting treatment of the addict. The recently released narcotic patient could benefit from many community services where these were available to him. They were likely to prove more effective where he could be guided in the light of the information gained from the close and continued observation of his special problems, gained during his hospitalization. Conversely, the progress already made in devising improved methods of institutional treatment would be further advanced if they could be planned in the knowledge that certain facilities within the individual patient's community would be available to him after release. The interchange and co-operation which could follow, between centralized institutions and home communities, would throw additional light on the least understood aspect of the addiction problem-those measures most likely to aid in its prevention.

Federal, state and local responsibilities

The Committee found that although the federal government had recognized its great responsibility with respect to the control of abuse of narcotic drugs, it was believed that in the aggregate, the major responsibility must inevitably rest with the states and the local communities. In recognition of this, commendable attempts had been made during recent years to adopt measures designed not only to bring the drugs under more effective controls at the local levels, but also to make greater provision for treatment and rehabilitation within the communities directly affected. The federal government must clearly retain responsibility for the control of importation; and should have the power to licence manufacture of synthetic narcotic drugs, fix quotas within medical needs, and control distribution. It should also continue its vigorous enforcement activities with respect to the international and interstate traffic, and the breaking up of the major distributive networks. Beyond this, it had provided for and should continue the important work of research into the properties of the drugs, and those courses of treatment found to be most effective in contributing to the rehabilitation of addicts, through its hospital programmes at Lexington and Fort Worth.

With increasing, though yet far from complete under-standing of the problem of addiction, had come the realization of its importance to the local community, not only as the principal victim of the abuse of the drugs, but also as the environment in which corrective measures on behalf of the addict, his family, and society could be most hopefully undertaken. With recognition of the importance and broader implications of the subject, attention had been properly directed towards preventive as well as curative action.

It was apparent that, despite the highly important contribution to a solution of the problem made by the federal neuropsychiatric hospitals, they would be limited by the virtually insurmountable problems of effective follow-up, and reintegration of the individual patient into the life of his community after hospitalization, without the essential elements of community organization.

The Committee believed therefore that it was of the utmost importance to encourage the states and at least the major municipalities to undertake an extension of their hospital and community welfare programmes to include treatment and social guidance for the narcotic addict.

Equally necessary, and perhaps even more difficult to provide, was the co-ordination of activities designed to help the individual overcome the handicap of his addiction experience, in resuming his place as a self-reliant and productive member of society. Experience had shown that without such support, a large proportion of former addicts were likely to return to the use of drugs. To the extent that alternatives were not open to him, he was apt to return to the same environment, associations and personal dilemma - perhaps - in even more aggravated form which had originally brought him to recourse to drugs.

Recommendations

  1. The Committee recommended that the federal government should encourage continuing studies of the narcotics problem within the states and municipalities. Such Studies, related to the special circumstances found to exist within the communities concerned, should be productive of sound and practical planning for a reduction of the problem. The federal agencies already active in this field could provide valuable guidance and information for the assistance of state and city authorities.

  2. Assistance to the states and municipalities by the federal agencies should include provision of courses of instruction for both public health and enforcement officers, to be conducted in Washington, and also by visits of small teams of qualified experts to appropriate centres. Some federal support for such activities would be required, but it was believed that their cost would be moderate.

  3. In each state, and in each city where a narcotic drug problem existed, at least one senior law enforcement official should be specifically charged with duties pertaining to this problem. An important function of such a designated official would be to undertake co-ordination of enforcement activities in this field, including exchange of reports and information with the Bureau of Narcotics and enforcement agencies of other states and municipalities.

  4. There should be available within each state, and the larger municipalities where justified by the number of known addicts, adequate provision for the withdrawal of addicts from the drugs, and appropriate programmes for their effective treatment and rehabilitation. In many instances such projects could be undertaken as extensions of existing hospital programme. In the planning of such facilities, the Committee felt that the assured maintenance of drug-free environments was essential to hopeful therapy, and that maximum use should be made of associated community resources and services in the social and economic readjustments undertaken on behalf of former addicts, following releases from institutional care. The suggestion had been advanced that the hospital facilities and services which were required might be established on a regional basis, by groups of two or more states acting in concert.

  5. States should give consideration to the desirability of establishing or alternatively more frequently utilizing present procedures for the legal commitment of addicts to institutions where they might be treated and rehabilitated, either within or without the boundaries of the states concerned.

  6. If certain of the states wished to provide for commitment to the federal hospitals, pending the availability of comparable facilities under state auspices, legislation authorizing this for a limited period, in the future, and on a reimbursable basis, should be considered for enactment. In view of the differing circumstances in which such commitments might be made, it was considered desirable to reserve to the Surgeon General, Public Health Service, determination as to the suitability of patients for admission, and their length of stay. In determining suitability of patients for admission the Surgeon General should be authorized to take into account the mechanisms and programmes for follow-up and aftercare within the state after the patient was discharged from the hospital.

  7. The Public Health Service Act, Public Law 410 of the 78th Congress, should be amended to permit the Surgeon General of the Public Health Service to disclose information on voluntary patients under the usual regulations governing disclosure of material in the medical records, where, in his opinion, physicians and recognized health and welfare agencies would be enabled to act in the interest of the patients in further treatment of their addiction.

  8. The progress towards full and effective international controls over the production and distribution of the narcotic drugs was felt by the Committee to have been highly encouraging. It recommended that the United States Government continue its policy of close co-operative effort through the agency of the United Nations, and with other international groups and individual nations concerned with the problem.

  9. Frequent note had been made of proposals for including special information concerning narcotic drugs in texts and curricula for the schools. The Committee had formed the conclusion that unless carried out with extreme care, such programmes might have the undesirable effect of attracting attention to and arousing curiousity over experimentation with the drugs. It was felt that further study by educational authorities, in concert with those engaged in the regional inquiries recommended above, was likely to result in programmes best suited to local problems and conditions. The same cautions were urged on those sponsoring motion picture, television, and radio treatment of the subject. The Committee proposed to seek further advice and counsel on this matter, in realization of its extreme importance in assuring a healthful understanding of and popular attitude towards drugs.

  10. The Committee had given extended consideration to the matter of fixing penalties of appropriate severity for violators of the narcotics laws. It had been impressed with the importance of assuring not only deterrents to this category of crimes, but also of facilitating social as well as medical rehabilitation of those offenders who were users of the drugs. It had considered the special problems of three groups of persons involved in the illicit traffic in narcotic drugs.

    1. Violators of the narcotics laws whose involvement was of an exclusively criminal character, and who were not themselves addicts or habitual users of the drugs. It had been noted that, of the three groups, this group included the highest proportion of major criminals, with respect to other forms of crime as well as the narcotics offences committed by them.

    2. Peddlers who were themselves addicted. This group was composed largely of persons with records of delinquency or criminality preceding as well as following their addiction. Criminal activity of persons in this category was usually, but not exclusively, restricted to relatively petty crime. Even their involvement in the drug traffic was commonly found in the lowest retail brackets. They were however much the more numerous, their aggregate contribution to the traffic was very large, and their control presented peculiarly difficult problems of enforcement and rehabilitation. This resulted from the fact that their use of drugs was associated with some degree of incapacity for normal emotional and social adjustments, resistance to corrective and rehabilitative efforts, and the impetus of a habit supportable only at an expense beyond the legitimate earning capacity of the average citizen.

    3. Addicted persons with either no records of criminal activity, or records of delinquency not involving viola tions of the narcotics laws other than obtaining and possessing the drugs for their own use. Anti-social activity among this group was commonly found to be of a petty character, but was, in combination with such legitimate activities as occupied the addict, sufficiently productive to support the high costs of addiction. This was the least homogeneous of the three groups; its members ranged from unemployables with serious psychiatric problems, to highly skilled professional people. It was the class from which a majority of peddlers were recruited, and it provided the essential market of consumers for the illicit traffic. It included also the most hopeful subjects of the curative and rehabilitative programmes, many of whom underwent voluntary treatment in the public and private hospitals.

    The Committee found itself in immediate agreement with respect to the first and the third of these groups. For the commercial type of trafficker, motivated solely by hope of gain from his handling of the drugs, it was agreed that penalties of a severe type were indicated. With respect to the third group, not involved in importation, manufacture, or sale of drugs, it was felt that the problem was principally one of appropriate treatment and rehabilitation, with subsequent guidance by interested social agencies within the individual's community. However, note was made of the fact that in certain instances tangible evidence involving known major traffickers depended solely upon possession of drugs. It was felt therefore that any scale of penalties applicable to convictions based merely on proof of possession should be broad enough in range to cover both the relatively innocuous and the serious offenders.

    With respect to the second group, those involved in both trafficking and personal use of the drugs, the question had been raised as to whether the levels of punishment most likely to serve as effective deterrents might not obstruct the reform and ultimate rehabilitation of the individuals concerned. While recognizing the probable validity of such arguments, the Committee believed that first consideration must be given to the protection of society from the trafficker.

    It was to be hoped that the extension of treatment and rehabilitative services into communities importantly affected, as recommended elsewhere in this report, would not only aid in reducing the problem of addiction, but also compensate in some degree for the effects of long prison terms on convicted addict drug peddlers. The Committee noted the fact that the addict-trafficker had in the past shown a high rate of recidivism, both as addict and as peddler. Where he retained or returned to psychological dependence on the drug, he was often less responsive to the deterrents of future punishment than the more hardened, ordinary criminal. It was to be hoped that, as states and local communities accumulated experience with enforcement and treatment programmes, valuable and much-needed data on the peculiarly difficult problem of the addict in crime would be produced. Such information should receive close and continued study at all levels of government.

    The Committee arrived at the conclusion that there was need for a continuation of the policy of punishment of a severe character as a deterrent to narcotic law violations. It therefore recommended an increase of maximum sentences for first as well as subsequent offences. With respect to the mandatory minimum features of such penalties, and prohibition of suspended sentences or probation, the Committee fully recognized objections in principle. It felt, however, that, in order to define the gravity of this class of crime and the assured penalty to follow, these features of the law must be regarded as essential elements of the desired deterrents, although some difference of opinion still existed regarding their application to first offences of certain types.

    The Department of Health, Education and Welfare, because of its long experience with and responsibility for the treatment of addicts, further recommended for consideration a legislative step designed to provide for greater opportunity for the rehabilitation of certain addict-violators, particularly in groups (b) and (c), whose criminal activity was secondary to their addiction. Under this proposal, wider latitude was to be given to the courts by authorizing them, in the case of such addict-violators, to commit the convicted offender for a period of hospital treatment, followed by an extended period of conditional release under close supervision by specially trained personnel. This procedure was to be limited to those with the best prospects for rehabilitation, and was to be applicable only under optimal conditions of post-hospital supervision. A few cases could be selected immediately for this procedure, to be supervised in the few communities where adequate personnel and services for effective supervision and rehabilitation were available. The plan could be gradually extended to additional communities as effective local rehabilitation programmes were developed.

  11. The Committee was impressed by the record of enforcement activities carried out by the Bureau of Narcotics, and especially by the results of its recent efforts at cutting off the foreign sources of supply of the illicit traffic. It recommended that consideration be given to an increase in the agent force of that Bureau, with appropriately increased administrative and operational support.

  12. The development of synthetic drugs with properties similar to the narcotics, not dependent upon foreign sources of supply, had created a need for effective controls over their manufacture and distribution. It was recommended that consideration be given to legislation which would empower the Bureau of Narcotics to licence the manufacturers of such drugs, fix quotas to keep total quantities produced within the medical needs, and regulate their distribution.

  13. It was recommended that the problems noted by enforcement officers and prosecutors, arising from court decisions limiting the procurement and presentation of evidence in narcotics cases, be given thorough and careful consideration from the standpoint of the optimum in law enforcement, in balance with and giving complete effect to the rights of individuals. The Committee believed that the judiciary and appropriate committees of Congress and of the various state legislatures should be made aware of these problems, in order to determine to what extent legislative action was desirable.

  14. The Committee noted striking similarities between the individual and social problems raised by the abuse of narcotic drugs, and such substances as marihuana, barbiturates, amphetamines, and others which affected emotional behaviour. It had been observed that the circumstances and attitudes underlying excessive habitual use of such depressants and stimulants frequently paralleled or preceded those associated with the narcotics. It was recommended that a similar study of the extent and effects of the improper use of such drugs be undertaken, with a view to determining the appropriate scope of federal state and local regulatory controls.