The problem of the abuse of amphetamines in Japan

Sections

1. History of the Problem of Amphetamines
2. Outline of the Amphetamines Control Law
3. Control of Amphetamines
Educational Measures
5. Medical Care
6. Present State of the Problem

Details

Author: Kiyoshi Morimoto
Pages: 8 to 12
Creation Date: 1957/01/01

The problem of the abuse of amphetamines in Japan

Kiyoshi Morimoto Director, Pharmaceutical and Supply Bureau, Ministry of Welfare, Japanese Government

1. History of the Problem of Amphetamines

Amphetamines (or awakening drugs or wake-amines) were first put on sale in Japan about 1941. The drugs were not widely used to begin with, but only administered for the treatment of some cases of mental disease. During the Second World War, amphetamines were used by the armed forces and by civilians engaged in heavy work, for the purpose of keeping awake and dispelling torpor. This use was, however, limited; and its toxic and addictive effects were negligible.

After the war, a state of social confusion prevailed which made the life of many people irregular. The constant and prolonged use of amphetamines became more popular among those who were working at night, or at irregular hours. Intoxication and addiction were increased by the habitual use of rapid-effect injections. As social order was restored, however, the control of the drugs gradually reduced the number of addicts, specially those engaged in normal occupations.

Meanwhile, the abuse of amphetamines among the criminal and depraved elements - particularly of the younger generation - reached very high proportions. Its prolonged use brought mental and physical dislocation into their lives; delinquency and crime developed to such an extent that the matter required severe measures.

Originally, the name "amphetamines" - also called wake-amines - which caused such difficulties in Japan, was the generic name for methamphetamine hydrochloride (phenyl-methyl-aminopropane hydrochloride) 1 and amphetamine sulfate (phenyl-amino-propane sulfate) 2 the former being the most widely abused. Despite the fact that amphetamines had been designated, since the beginning of their sale, as powerful drugs (to be considered as poisons under the Pharmaceutical Affairs Law of Japan), they were so greatly abused that it was finally decided to designate them as medicines that should be sold or used only on prescription or by direction of a physician. Furthermore, licensed manufacturers of amphetamines were requested to report to the Ministry of Welfare as to manufacture and sale. In this way, the ministry was able to keep a check on the manufacture of these drugs, with a view to eliminating the social evils caused by them.

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The Pharmaceutical Affairs Law, however, was not adapted to control such drugs, and to prevent the evil effects on individuals and on the public caused by their abuse. Therefore the "Amphetamines Control Law" was enacted in June 1951.

2. Outline of the Amphetamines Control Law

This law (Law No. 252 of 1951) was revised in 1954 and 1955 mainly in its penal provisions, in the light of the problems arising from the abuse of amphetamines. Amendments as regards the control of the components of these drugs were also adopted in 1955.

The following are excerpts from the main provisions of the Amphetamines Control Law:

Chapter I. - GENERAL PROVISIONS

Art. 1. This law establishes the necessary control of the import, export, possession, manufacture, transfer, receipt and use of amphetamines and their components, in order to prevent injury to health through the abuse thereof.

Art. 2. The term "amphetamines" used in this law refers to the following substances:

  1. Phenyl-amino-propane, phenyl-methyl-amino-propane and each of their salts.

  2. Any substance designated 3 by cabinet order as having the same effect as the drugs mentioned under (1).

  3. Any substance containing any other substance included under (1) or (2).

[Paragraphs 2-8 omitted.]

Chapter II. - DESIGNATION AND NOTIFICATION.

[Omitted.]

Chapter III. - PROHIBITION AND RESTRICTION

Art. 13. No one shall import and/or export amphetamines.

Art. 14. No one may possess amphetamines except: amphetamine manufacturers, directors and managers of institutions qualified to dispense amphetamines; physicians performing medical treatment in institutions qualified to dispense amphetamines; research workers in the field of amphetamines; and persons in charge of administering these drugs under the authority of the physicians performing medical treatment in the above-mentioned institutions.

  1. The provisions of the preceding paragraph shall not apply in the following cases :

    1. Assistants of amphetamines manufacturers, managers of institutions qualified to dispense amphetamines, physicians performing medical treatment in these institutions, or research workers in the field of amphetamines possessing these drugs in connexion with the discharge of their duties.

    2. Any person who is engaged in postal or transport services, possessing amphetamines in the course of discharging his duties, when the manufacturers of amphetamines send these drugs to institutions qualified to dispense them, or to research workers in the field of amphetamines.

    3. Anyone who nurses a person who receives a delivery from a physician performing medical treatment in an institution qualified to dispense amphetamines, and who possesses these drugs for the use of the patient.

    4. Anyone possessing amphetamines in connexion with actions conducted under the laws and ordinances.

3 No substances have been so designated up to January 1957.

Art. 15. No one shall manufacture amphetamines except the manufacturers of these drugs who make them for business purposes and research workers who make them for the purpose of their research with the authorization of the Ministry of Welfare.

  1. The Ministry of Welfare may determine every year the quantity to be manufactured by the manufacturers of amphetamines for each term of three months (January/March, April/June, July-September, October/December).

  2. Amphetamine manufacturers shall not manufacture such drugs in excess of the quantity, determined by the Ministry of Welfare under the provisions of the preceding paragraph.

Art. 17. Amphetamine manufacturers shall not transfer the drugs manufactured to anyone other than institutions qualified to dispense amphetamines and to research workers in the field of amphetamines.

  1. The institutions qualified to dispense amphetamines and research workers in the field of amphetamines shall not receive these drugs from anyone other than amphetamine manufacturers.

  2. Except in the cases mentioned in the two preceding paragraphs, and in the case of physicians, engaged in medical treatment in institutions qualified to dispense amphetamines, who deliver such drugs for administration thereof, no one shall transfer or receive amphetamines.

  3. The provisions of the preceding paragraph shall not apply in the case of transfer or receipt of amphetamines in connexion with the discharge of official business exercised in accordance with laws and ordinances.

Art. 19. No one shall use amphetamines except in the following cases:

  1. Use by amphetamine manufacturers.

  2. Administration by physicians performing medical treatment in institutions qualified to dispense amphetamines.

  3. Use by research workers in the field of amphetamines for research work.

  4. Administration by the person who has received the drug for administration from a physician performing medical treatment in institutions qualified to dispense amphetamines or from a research worker.

  5. Use of the drug in connexion with actions done according to laws and ordinances.

Art. 20. Physicians performing medical treatment, in institutions qualified to dispense amphetamines, shall not administer or deliver for administration, amphetamines which are not under the care of the manager of such an institution in which that physician is performing medical treatment.

  1. The aforementioned physicians shall not administer or deliver amphetamines for administration, except for the purposes of medical treatment of another person.

  2. Such physicians shall not administer, or deliver for administration, amphetamines to an addict to such drugs, for the satisfaction of his addiction or for treatment thereof.

  3. When a physician delivers amphetamines for administration as in paragraph 1, a record of the name, address and age of the patient, as well as the method of administration and conditions thereof, signed by the physician concerned, shall be kept.

  4. Research workers in the field of amphetamines shall not administer them or deliver them for administration to another person for his research work.

  5. In the case of a research worker delivering amphetamines for administration, sub-paragraph 4 shall apply.

Chapter IV. - PROVISIONS REGARDING TREATMENT

Chapter V. - RECORDS AND REPORTS OF TRANSACTIONS

Chapter VI. - SUPERVISION

Chapter VII. - MISCELLANEOUS

[Omitted.]

Chapter VIII. - PENAL PROVISIONS

Art. 41. Any person committing any of the following offences shall be liable to penal servitude not exceeding five years, or to a fine not exceeding 100,000 yen:

  1. Violation of the provisions of article 13 (Prohibition of Import and Export).

  2. Violation of the provisions of article 14, paragraph 1 (Prohibition of Possession).

  3. Violation of the provisions of article 15, paragraph 1 (Prohibition of Manufacture).

  4. Violation of the provisions of article 17, paragraphs 1-3 (Restriction and Prohibition of Transfer and Receipt).

  5. Violation of the provisions of article 19 (Prohibition of Use).

  1. Both imprisonment and fine laid down in paragraph 1 may be imposed according to circumstances.

  2. The attempt in respect of offences under paragraph 1, sub-paragraphs ( a) and ( c) to ( e) shall be punished.

Art. 41-2. Anyone who violates the provisions of the preceding Article for the purpose of profit shall be liable to penal servitude not exceeding seven years, or according to circumstances, joint imposition of penal servitude not exceeding seven years and a fine not exceeding 500,000 yen.

Art. 41-3. Anyone who repeatedly violates the provisions of the preceding two articles shall be liable to penal servitude for not less than one year but not more than ten years, or, according to circumstances, to joint imposition of penal servitude of not less than one year but not more than ten years, and a fine not exceeding 500,000 yen.

[Other penal provisions omitted.]

Since the illicit manufacture of amphetamines is technically easy, the control of their components is indispensable for that of the drug itself. Accordingly, when the control law was amended in 1955, ephedrine, methylephedrine (not including preparations), phenyl-acetic acid and phenylacetone, etc.,were put under control; the manufacture, sale, purchase, possession and use of these components are prohibited unless authorized for medical and scientific purposes.

3. Control of Amphetamines

As stated above, after the enactment of the Amphetamines Control Law, the licit use of amphetamines is to be handled only through the channels shown in Table 1, and no sales agents of the drugs are authorized to operate. Since the law was passed, no illicit sales or use of the authorized amphetamine drugs have been found. However, the number of drug addicts has not decreased. This is partly due to the fact that amphetamines can be secretly manufactured, comparatively easily, from ephedrine, etc. Crimes committed as a result of abuse of these drugs became, after 1953, numerous enough to cause alarm (see Table 2).

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TABLE 2

Number of cases and persons apprehended for offences in connexion with amphetamines

Year

Number of cases

Number of persons apprehended

1951 18,711 17,528
1952 21,727 18,521
1953 37,263 38,514
1954 53,211 55,664
1955 30,672 32,143
1956 (Jan. - Sept.)
4,567 4,754

Source:National Police Bureau.

The number of persons apprehended does not necessarily reflect a true picture of the whole situation. The numbers have considerably decreased since 1955, the general public evidently having become aware of the harmful effects of amphetamines, as a result of a series of campaigns against their abuse. Control measures were thus effectively carried out. On the other hand, crimes have become more malicious and more difficult to detect. The penalties imposed are similar to those for narcotics offences, as shown in Table 3. Under these circumstances, the decrease in the number of persons apprehended for violations in connexion with amphetamines does not warrant optimism.

TABLE 3

Number of indictments for violation of the Amphetamines Control Law

Year

Number of cases

Number of indictments

Number of persons sentenced for more than two years

1954 69,060 28,938 89
1955 43,467 19,515 228

Source: Criminal Bureau, Ministry of Justice.

Educational Measures

The Government has also been making extensive efforts in the field of educational activities, public relations, medical care, etc., which it considers an indispensable and integral part of the over-all policy to cope with the problem.

In January 1955, the Government established the "General Headquarters for the Promotion of Policy against Amphetamines ", headed by the Minister of Welfare, both as the central organization of the government policy and as a consulting and liaison organization. Besides, thirty-six local headquarters, similar to the general headquarters, were established in forty-six prefectures of Japan. These organizations have laid particular emphasis on public relations and educational activities. They show pictures, slides, drawings and posters, furnish pamphlets and leaflets, give lectures, and organize round-table conferences, and carry out other activities in a very comprehensive way. Particularly for younger people, they conduct practical campaigns through schools, social education, organizations for social welfare (consultation offices on children, welfare offices, child welfare committees, etc.), corrective institutions, and protection organizations. Enterprises and factories where amphetamines are likely to be abused, such as workshops with nightshifts and night clubs, are also the object of educational campaigns.

The following lists the publicity material prepared by the general headquarters during 1956:

Pictures (2 kinds)
100
Slide pictures (3 kinds)
2,500
Pamphlets (2 kinds)
225,000
Leaflets
470,000
Posters (6 kinds)
385,000
Portable drawings on boards
2,500

The expenditure amounted to about 16 million yen in 1955, about 8 million in 1956, and will amount to about 2? million yen in 1957.

5. Medical Care

The use of amphetamines tends to be habitual and causes mental disorders in most cases. A considerable number of addicts have become mentally ill, and show such symptoms as cannot easily be differentiated from those of schizophrenia. These addicts have often committed crimes and other acts of violence, either due to the effect of the drug, or in order to procure it. As they not only injured their own health, but also caused many social problems, the Government has undertaken to provide medical care for them. Since they show similar symptoms to those of insanity, they are treated in mental hospitals. Accordingly, the necessary amendments to the Mental Hygiene Law were passed in June 1954.

The number of beds made available in accordance with these amendments is as follows:

1954 250
1955 2,100
1956 1,400

The medical treatment of the addict to amphetamines gives satisfactory results when it is started in good time. Recently, however, there has been an increase in the number of addicts - who present symptoms of addiction of a more serious nature - being treated by psychiatrists.

6. Present State of the Problem

Although a considerable amount of research is being carried out on individual addicts (mainly in asylums), many aspects of the problem still remain unclear. It is almost impossible to investigate and analyse statistically what the situation is in the underworld. However, with a view to ascertaining the state of affairs, the Ministry of Welfare, in co-operation with local authorities, has made surveys of addicts (three have been made since 1954) by means of anonymous census cards. The following tables show the results:

TABLE A

Past and present users of amphetamines

Date of inquiry

May 1954

May 1955

Nov 1956

Total number of those who filled in the form
127,142 42,185 69,452
Past users of the drug
9,108 3,375 5,083
Percentage of total
7.2
8. 0
7.3
Present users of the drug
2,241 569 287
Percentage of total
1.8
1.4
0.4

Note:The number of present users is not included in that of past users. The same applies to the following table.

TABLE B

Users of amphetamines by age

(Percentages)

 

1954

1955

1956

Age

Past users

Present users

Past users

Present users

Past users

Present users

Under 15
0.7 0.5 0.0 0.0 0.0 0.7
15-16
2.5 1.9 1.4 1.6 0.9 0.4
17 4.4 4.4 2.8 1.8 1.3 2.4
18 6.5 5.7 6.2 4.1 3.5 5.6
19 8.5 8.3 7.4 7.8 5.2 9.7
20
..
..
9.5 7.8 7.2 10.9
21
..
..
10.0 9.4 8.2 8.2
22
..
..
11.1 10.9 11.3 14.6
20-22
28.2 27.7 30.7 28 26.7 33.7
23-24
18.5 19.4 17.1 15.0 18.1 14.6
25-29
21.1 21.4 22.4 22.8 27.7 17.2
Over 30
9.2 10.7 13.0 18.8 16.6 15.7

TABLE C

Percentage of past users of amphetamines according to motive

Motive

1954

1955

1956

Study
7.7 6.4 8.9
Night work
14.2 14.7 14.4
Recommendation by friend
29.1 27.2 25.6
Curiosity
27.9 32.0 30.8
Pleasure
12.6 12.7 11.4
Despair
3.4 4.5 6.1
Other reasons
5.1 2.5 2.8

TABLE D

Percentage of present users of amphetamines according to motive

Motive

1955

1956

Study
1.1 3.0
Night work
24.8 17.1
Recommendation by friend
27.6 22.6
Curiosity
25.6 26.1
Pleasure
14.3 21.4
Despair
4.9 9.4
Other reasons
1.7 0.4

TABLE E

Reasons given by addicts for continued use of amphetamines

(Percentages)

Reason

1954

1955

1956

Addiction
58.6 60.2 38.4
Work
12.8 8.0 14.2
Study
3.7 0.6 1.4
Compulsion
0.4 1.5 4.3
Temptation
16.1 22.3 32.2
Others
8.4 7.4 9.5

TABLE F

Percentages of average numbers of ampoules of amphetamines used daily

1. Past Users of Amphetamines

(Percentages)

Numbers of ampoules

1954

1955

1956

1-4
27.5 29.4 30.2
5-9
20.2 20.2 17.5
10-19
17.7 18.7 15.0
20-29
11.4 11.8 9.6
30-49
8.4 7.4 9.5
50-99
7.0 4.6 7.7
Over 100
3.2 2.1 4.7
Indefinite
4.6 5.8 5.8

2. Present Users of Amphetamines

(Percentages)

Number of ampoules

1954

1955

1956

1-4
22.5 15.5 17.3
5-9
26.3 26.7 14.2
10-19
29.0 31.7 21.8
20-29
9.8 10.6 18.2
30-49
5.7 2.1 12.5
50-99
1.7 2.7 4.9
Over 100
0.7 0.8 4.9
Indefinite
4.3 9.9 6.2

These figures may not reflect the existing state of affairs with scientific accuracy. Nevertheless, we may safely say that the number of addicts- estimated to be about 500,000-550,000 in 1955-has greatly decreased. We cannot, of course, be too optimistic, but it is believed that the 1957 campaign will bring the problem still closer to a solution.