A review of drug abuse and counter measures in Japan since World War II

Sections

I. Introduction
II. The Latent Period up to 1945
III. The Stimulant Drug Period, 1946-1954
(In percentages)
IV. Narcotics, especially heroin, 1955-1962
(In percentages)
Subjects who used narcotics most frequently, and type of narcotics used
V. Other drugs
VI. Conclusion
MISCELLANY

Details

Author: Masamutsu NAGAHAMA
Pages: 19 to 24
Creation Date: 1968/01/01

A review of drug abuse and counter measures in Japan since World War II

Masamutsu NAGAHAMA Chief, 2nd Narcotics Section, Pharmaceutical & Supply Bureau, Ministry of Health & WeIJ3re, Japanese Government

I. Introduction

In recent years the abuse of dependence-producing drugs seems to have spread among the younger generation in many countries throughout the world, bringing with it serious social problems.

Twice since the end of 1945, when the Second World War ended, Japan has had to face a critical situation caused by the mental and physical ill effects of dependence-producing drugs on her people. The abuse of stimulant drugs (known as "awakening" drugs in Japan) arose in young people in 1946 and continued to 1954, while drugs of the narcotic type, mainly heroin, were a serious problem from 1955-1962.

Nowadays in Japan, we rarely come across drug addicts even among delinquents. The abuse of stimulant drugs has also dropped sharply.

Thus the nation's efforts against drug addiction have been successful, but Japan remains on its guard against the danger recurring.

The history of dependence-producing drugs in Japan can be divided into four phases:

First period:
up to 1945
When there was no serious problem;
Second period:
1946-1954
Marked by abuse of stimulant drugs;
Third period:
1955-1962
Marked by abuse of heroin;
Fourth period:
from 1963
Narcotic Addiction Eradication Period

II. The Latent Period up to 1945

Before 1945, there was hardly any drug addiction. There was some opium smoking amongst the Chinese, and there were some cases of cocaine sniffing, in all about 400 cases of addiction.

III. The Stimulant Drug Period, 1946-1954

In the confusion caused by the Second World War, the population became an easy prey to the considerable quantities of drugs (amphetamines and narcotics) released on the market by ex-army personnel. This led to a great increase in the number of drug addicts, and most cases of narcotics offences occurred in the busiest streets and at military bases.

The amphetamines abused were mainly phenyl-amino-propane and phenyl-methyl-amino-propane and of these, the latter became a major social problem. (These drugs came on to the Japanese market about 1940, for the treatment of mental diseases.) During the war these drugs were used in order to increase efficiency in the services and in factories. We did not envisage that these would be the cause of a serious social problem after the war.

The abuse of stimulant drugs began in a small way just after the war, amongst writers, entertainers etc. It then spread among the younger generation, and soon became a grave social evil, leading to crime and disorder; the number of addicts and of the cases of mental disorder due to drug abuse increased alarmingly.

If we had not taken a firm line in addiction control the situation would have got out of hand.

Control of stimulant drugs

Measures to control the use of stimulant drugs have been in force since 1948, when the abuse of these drugs first became apparent. They were designated as "powerful drugs" and their control was incorporated in the Pharmaceutical Affairs Law. However, as the abuse of these drugs could not be entirely restricted by these measures, the manufacture of stimulant drugs in powder or tablet form was tightly controlled and only their manufacture in injection form was permitted. As injections, however, have a more immediate and lively effect, addicts used these mainly. As the vice of stimulant drug-taking became more rampant through the use of injections, the Government vetoed the manufacture of any such drugs in 1949.

These control measures were quite inadequate to stem the tide of this fast spreading evil, so in 1951 the Diet established the Amphetamines Control Law. This law was prepared in accordance with the Narcotics Control Law, because stimulant drugs have the same effect of inducing dependence in spite of their medical usefulness. The objectives of the law are as follows:

  1. To restrict the use of stimulant drugs to medical and scientific purposes only;

  2. To list the persons and enterprises such as manufacturers, research workers etc. who would be entitled to possess and manufacture amphetamines;

  3. To prohibit the possession of amphetamines which was not envisaged in the existing control system;

  4. To issue transfer and receipt forms for amphetamines to be handed over to Metropolitan, Hokkaido and Prefectural Governors on delivery, to prevent diversion.

With these measures we began to control the abuse of stimulants throughout Japan, after six years of disappointing results under the Pharmaceutical Affairs Law.

The light punishment for violation of the drugs act did nothing to lessen the incidence of drug addiction or prevent the appearance of illicit manufacture; and as the abuse of stimulant drug-taking became even more serious and widespread, the Amphetamines Control Law was partly revised in 1954 to increase the penalties for violations. The Mental Health Law was amended to include treatment of addicts, as well as of the mentally-deranged.

The new legislation was brought in to fight the ever-growing menace of stimulant drug-taking, but black markets were already established, and cases of illicit manufacture were occurring all over the country. We therefore had to institute measures to control intermediates and precursors for the manufacture of stimulant drugs.

The control law was amended to this effect in 1955, and in addition to the basic drugs the precursors for the manufacture of stimulants were also controlled. Penalties for offences were increased, with the following results:

Year

Number of offences

Number of persons arrested

1951 18,311 17,528
1952 21,727 18,521
1953 38,263 38,514
1954 53,211 55,664
1955 30,672 32,145
1956 5,014 5,233
1957 779 803
1958 268 271

Meanwhile public opinion against drug addiction and illicit trafficking hardened, and as from 1953 the arrest of illicit manufactures and traffickers was intensified.

In 1955 the General Headquarters for the Promotion of Policy against Amphetamines was established and a nation-wide drive against these drugs was launched. Gradually surveys showed an improvement in the situation, justifying the methods used.

General Headquarters for the Campaign against Amphetamines

The principal objectives of this organization were:

  1. To put an end to the abuse of amphetamines;

  2. To strengthen the control system;

  3. To provide treatment for persons dependent on amphetamines;

  4. To inform the public as to the dangers of drug addiction;

  5. To be a clearing house of information on methods for the treatment of addicts;

  6. To foster awareness of the need to improve economic and social conditions, as an indirect attack on the problem of drug abuse.

This organization worked in co-operation with other bodies with an interest in the problem, and anti-drug centres were established in all prefectures. The organization aimed particulary at making social workers and teachers at all levels alive to youth. This campaign also covered prisons, factories, clubs etc.

Crime and drug abuse (of amphetamines)

The following table shows the number of persons arrested for crimes directly or indirectly stemming from the use of stimulant drugs.

 

1955

1956

1957

Murder
29 3 0
Robbery
82 1 0
Arson
5 1 0
Sex offences
20 0 0
Causing hurt
704 52 2
Menace
456 30 2
Assault
318 20 1
Fraud
270 34 4
Larceny
2,520 244 23
Other offences
462 29 5
Total
4,866 414 37

Summary of the situation and the counter-measures taken

Stimulant drug addicts were, at an estimate, over 1,000,000 in number when these drugs were being most widely used; the majority of these addicts belonged to the younger age groups and were as mentally unbalanced as any mentally deranged person. For this reason it was decided in 1951 that they should be treated in mental hospitals in accordance with the Mental Hygiene Law.

A series of practical measures were taken. We appointed certain persons to look after addicts, and gave them full responsibility for the medical care and welfare of their patients. A system was set up whereby any known addict was to be reported to the medical authorities, or to the Metropolitan, Hokkaido or Prefectural Governors. The public was also asked to report an addict to the police, public procurator, or to chiefs of correctional institutions. Addicts were hospitalized in mental hospitals if beds were available. The Metropolitan, Hokkaido and Prefectural Governors were authorized to commit to hospital any addict considered dangerous to himself or others. In the case of lack of accommodation in the hospitals addicts were confined to their homes, or to any other suitable establishment. With the permission of the appropriate authorities officials and persons related to the patient would visit their homes to help and advise them.

Since the establishment of this system, the treatment of addicts in mental hospitals was expanded, but it was found that there was a shortage of beds. We therefore obtained a larger allocation from the national budget, and the number of beds was increased as follows:

 

Beds

1954 263
1955 2,100
1956 1,400

The number of persons dependent on stimulants undergoing hospitalization was:

 

Patients

1954 4,000
1955 1,200
1956 300
1957 200

As the figures indicate, the number of persons needing treatment declined steadily and today applications are negligible.

A survey of approximately 11,000 stimulant drug addicts were carried out by the Anti-Stimulant Drug Headquarters with the following results:

(In percentages)

Sex

Male
71.5
Female
28.5
Total
100.0

Age

Up to 15
0.7
15-19
22.9
20-29
66.6
30+
9.8
Total
100.0

Cause of abuse

Cause of abuse
 
Curiosity
27.8
Temptation or imitation
29.2
To work without sleep
22.9
To seek pleasure
12.6
Self-abandonment
3.3
Others
4.2
Total
100.0

IV. Narcotics, especially heroin, 1955-1962

After the war, arrests for drug abuse numbered 1,000 cases a year. In the succeeding years the number of addicts increased, particularly in the poorer quarters of the large cities and around the military bases. Organizations for illicit drug trafficking also became active.

At the same time that measures to control stimulant drug-taking were becoming effective, leading to a decrease in the number of users, there was a marked increase in the incidence of narcotic drug-taking, especially heroin. As a result, the Japanese people had to contend with the now more widely used narcotic drugs, rather than the stimulant, and after the war heroin was prohibited even for medicinal use. It was a difficult and very serious problem aggravated by smuggling. Heroin and morphine brought into Japan from South East Asia, were obtainable by addicts through gangs Of international smugglers who made enormous profits out of their sale. ·

About 1960 (15 years after the war) narcotics crime increased to about 2,000 cases a year. Another 2,000 addicts were discovered and it was found that this evil was spreading into all sections of society.

A drive to stem this trend was undertaken by the Press, radio, television etc. in the hope of putting a sinister picture before the public and obtaining their co-operation in overcoming addiction.

In Yokohama, in July 1962, as the supplies of drugs were stopped, addicts suffering from abstinence syndromes prowled the streets, seeking peddlers, and .the problem of drug addiction became a major social problem. The Government was thus forced to take strong counter-measures. This resulted in .the formation of the Anti-Narcotic Drugs Headquarters, comprising representatives of appropriate ministries and control organizations.

The main features of the counter-measures were as follows:

  1. To enlighten the public on a nation-wide scale as to the dangers of drug addiction;

  2. To check stringently crimes against the narcotics law and to eradicate sources of supply;

  3. To establish a medical treatment system for narcotics addicts, and to rehabilitate them;

  4. To intensify the guidance and supervision of narcotics officials, to strengthen the administration of narcotics, and to prevent illegal use.

The Narcotics Control Law was basically amended to make provision for these measures.

Control of narcotics

Unlike stimulant-drugs, narcotics have been controlled for many years. It is said that the opium poppy was introduced to Japan from India about 500 years ago, and cultivation was started later. Opium has been used in Japan for medicinal purposes since 1722 when the inspection of crude drugs was established, and the name "WA-AHEN" (Japanese Opium) appeared. We have no records of opium smoking in those days, but we know that the succeeding governments strictly controlled opium. In 1742 the death penalty was introduced for opium peddling and, in 1857, cultivation and possession of opium was prohibited, bearing in mind the Opium War in China (Qing-Country) in 1840. After the Meiji Restoration of 1868, we continued to control opium and our country participated in the International Opium Convention, signed at The Hague in 1912 and in the International opium Convention signed at Geneva in 1925 the Government promulgated the Narcotics Control Regulations. In the light of these treaties the Conventions and regulations played the main role in the control of narcotics until 1945.

After the war there was a remarkable change in the narcotics situation.

The occupation authorities issued several orders relating to narcotics. In 1946, based on these orders, the Narcotics Control Regulations were revised. In 1947, the Cannabis Control Regulations were also applied, according to the orders on cannabis issued by the occupation authorities, and the Cannabis Control Law was put into effect in 1948. At that time 1,000 to 1,500 narcotics offences occurred each year.

Narcotics control officers were appointed in 1946. Police Officers, customs and maritime police officers cooperated in fighting the narcotics evil. The narcotics control officers, with their expert knowledge, came under the Ministry of Health and Welfare. They were divided into 8 sections (8 district narcotics control officers, and 3 branch officers throughout the country).

The Director of the Pharmaceutical and Supply Bureau had charge of the co-ordination of the enforcement agencies. He took action as necessary, as the control authority set up by the Convention of 1936 for the Suppression of the Illicit Traffic in Dangerous Drugs. The Narcotics Control Law was later amended several times.

Despite this, narcotics crimes and the number of addicts increased and became worse year by year, as indicated in the following table:

Year

Cases

Persons detected

Persons involved in heroin cases

Percentage of heroin users

1955 1,280 1,753 954 54.3
1956 1,060 1,575 1,070 67.9
1957 1,013 1,365 1,033 75.6
1958 1,616 2,073 1,855 89.4
1959 1,394 1,714 1,462 85.4
1960 1,667 1,987 1,795 90.3
1961 2,027 2,442 2,265 92.7
1962 1,773 2,176 1,797 82.5

As can be seen from the table, heroin cases showed a great increase in number.

In 1961, syndicates of illegal dealers in narcotics were most active and the number of heroin cases again showed an alarming increase. In 1962, in order to check this serious state of affairs the Government amended the Narcotics Control Law. Its main provisions were:

  1. To increase the punishment of offenders

 

Maximum penalty

Maximum fine

Before amendment
7 years 500,000 yen
After amendment
life imprisonment
5,000,000 yen
  1. To establish a system of compulsory hospitalization for narcotics addicts.

Before the amendment, addicts were treated in mental hospitals according to the Mental Health Law. Under the new Law, those addicts who were dangerous to themselves or to others were to be hospitalized. In fact only a few patients were treated under this Law; therefore the hospitalization scheme was incorporated into the Narcotics Control Law, and a group of 207 counsellors for the rehabilitation of addicts was appointed and placed in the nine districts which had the highest incidence of addiction.

  1. To restrict the issue of licences to narcotics users for medicinal purposes only.

In 1963 the number of narcotics control officers and the budget for narcotics control investigation were greatly increased, and the number of arrests was the highest on record.

The groups of gangsters engaged in smuggling were sought out and broken up and consequently the number of cases, especially of heroin addiction, dropped sharply:

Year

Number of cases

Number of persons arrested

Number of persons arrested for heroin offences

Percentage

1963 2,136 2,571 1,883 73.2
1964 707 792 375 47.3
1965 1,035 1,090 296 27.2
1966 899 974 33 3.4

Heroin addiction had by then almost disappeared but a strict watch was still kept on smuggling activities, especially in seaports and other ports.

It is estimated that in 1961, at the peak of the drug addiction crime period there were about 40,000 drug addicts and about 60,000 habitual users of drugs which were not dependence-producing.

About 1,000 addicts per year were hospitalized before 1962, and a greater number of potential addicts were given addiction treatment. Of these patients, 80% used heroin. Patients were kept in hospital for 30 to 40 days and were discharged as soon as the physical and mental crises were over and the pains of abstinence had disappeared

A review of drug abuse and counter measures in Japan since World War II 23

In 1963, the Narcotics Control Law was amended and compulsory hospitalization was established. About 900 mental hospitals throughout Japan were designated as addict treatment centres under the Ministry of Health and Welfare Ordinance. However, because of the specific treatment necessary for addict patients, it was found necessary to establish mental institutions specializing in this treatment, and nine of these institutions, with a total of 650 beds, were organized to provide such facilities. The number of addicts hospitalized in these institutions in 1963 decreased to 25% of all those admitted to hospital in 1962, and this was probably due to the offenders going underground because of fear of the heavier penalties introduced and, of course, the threat of compulsory treatment.

In consequence of tighter control, the number of addicts treated recently in hospital amounts to about 100 per year. Heroin addiction seems to have decreased remarkably. The treatment period in hospital has been increased to 70-80 days, in the hope of obtaining a complete cure.

Following the introduction of the report system in the Narcotics Control Law amendment, the number of addicts has only been about 500 persons a year since 1964.

Under the report system about 10,000 ex-addicts were registered by the Ministry of Health and Welfare and in our opinion a great number of addicts were rehabilitated, so that the present number of addicts is very small.

The following table shows the motives and causes of drug addiction.

(In percentages)

Motive or cause

1962

1966

Curiosity
46.7 1.0
Temptation or imitation
5.5
-
Avoidance of pain and anxiety
23.9 5.6
Treatment of disease
17.0 87.9
Switching from stimulant drugs
1.7
-
Others
5.2 5.5
Total
100.0 100.0

We would like to mention here the contribution of the counsellors for narcotic addicts. The counsellor system was started in 1963, when the Narcotics Control Law was amended. They are appointed by the Metropolitan, Hokkaido and Prefectural Governors and are chosen for their integrity and dedication to this service. As long ago as 1951 certain citizens living in the delinquent quarters of the towns rebelled against drug-taking and all its evils and tried to eradicate it. They tried to enlighten, guide and assist addicts and obtained good results. Now there are 207 counsellors in the delinquent areas.

The survey of narcotics addicts under the Japan-U.S. joint specific research

Since the Japan-U.S. Joint Agreement was concluded between the late Premier Hayato Ikeda of Japan, and the late President of the United States of America, John F. Kennedy, in 1961, joint research work has been fostered in the fields of science, culture and economy. The joint research problem of abuse of narcotics and other drugs has also been undertaken in the medical field since April 1966.

There are two groups: the medical and the pharmacological. The former group has dealt with the theme of the socio-psycho-medical survey of drug abuse.

In 1966 a Japanese clinical group made a detailed investigation and statistical study of the living conditions of a group of 1,934 narcotics addicts, and ex-addicts known to the Ministry of Health and Welfare. As already mentioned, after the amendment of the Narcotics Control Law of 1963, there was a marked improvement in the narcotics situation. This was borne out in the following analysis of the group.

(Sex)

 

No. of addicts

Percentage

Male
1,461 75.5
Female
473 24.5
Total
1,934 100.0

(Nationality)

 

No. of addicts

Percentage

Japanese
1,812 93.7
Korean
94
4..9
Chinese
28 1.4
Total
1,934 100.0

(Age)

 

No. of addicts

Percentage

20-29
171 8.8
30-39
832 43.0
40-49
499 25.8
50-59
283 14.7
60 147 7.6
Unknown
2 0.1
Total
1,934 100.0

(Drugs used)

 

No. of addicts

Percentage

Heroin
1,038 53.6
Opium
1 0.1
Marihuana
1 0.1
Morphine
370 19.1
Opium alkaloid mixture
230 11.9
Codeine
5 0.3
Cocaine
2 0.1
Synthetic narcotics
25 1.3
Unknown
174 9.0
Others
88 4.5
Total
1,934 100.0

The following figures illustrate how the amendment of the Narcotics Control Law in 1963 influenced the situation with regard to narcotics abuse.

Subjects who used narcotics most frequently, and type of narcotics used

 

Subject

Percentage

Pre-amendment *
1,660 87.0
Post-amendment **
264 12.5
Unknown
10 0.5
Total
1,934 100.0

(Type of narcotics - subject and percentage)

 

Heroin

Other narcotics

Unknown

Total

Pre-amendment *
996 594 70 1.660
 
(60.0%)
(35.70%)
(4.3%)
(100%)
Post-amendment **
38 209 7 264
 
(14.4%)
(79.0%)
(6.6%)
(100%)
Unknown
4 5 1 10
 
(4.0%)
(50.0%)
(10.0%)
(100%)
Total
1,038 808 88 1,934
 
(53.7%)
(41.6%)
(4.7%)
(100%)

* The term of "pre-amendment"means those who used narcotics frequently before the amendment.

** The term "post-amendment" means those who used narcotics most frequently after the amendment.

As to the age-grouping of pre-law amendment patients, there were 751 (46 %) in the 30-year-old group, and 399 (24 %) in the 40-year-old group. Most of the heroin addicts were found among the younger generation having become addicted in the last 5-10 years. As regards the post-amendment situation, the 40-year-old group had the maximum number of addicts (99 persons-37.5 %) and in the 30-year-old group, 76 persons (28.7 %). These figures show that while heroin addicts among the younger generation decreased, medicinal narcotics addicts increased.

The relapse rate in Japan is very low, being 36.4% in the pre-amendment and 14% in the post-amendment eras.

As to the motives for withdrawal, such measures as compulsory hospitalization and fear of penal servitude acted as a deterrent and we had 29.0 % pre-amendment patients, compared with 56.1% post-amendment patients.

From these figures it can be seen that hospitalization and treatment under the Narcotics Control Law is extremely effective in the treatment of addiction.

However, there are still medicinal drug addicts and persons engaged in illicit medical practices to be found and we are determined to master this problem.

V. Other drugs

Cannabis

Cannabis is controlled by the Cannabis Control Law of 1948. Cases of cannabis crime in Japan are generally of foreign origin and the situation is being closely watched. There has been an increase in cannabis offences lately and in the number of arrests of foreign sailors and soldiers on leave from the Vietnamese war fronts who import cannabis into Japan.

Sleeping drugs and tranquillizers

Cases of abuse of sleeping drugs and tranquillizers have been observed amongst juvenile delinquents. Under the Pharmaceutical Affairs Law, the Minister for Health and Welfare has designated sleeping drugs as habit-forming drugs, and has prohibited the sale of these drugs to minors. Tranquillizers have been designated as "potent drugs" and a doctor's prescription has been made compulsory for their purchase. This has reduced sales.

LSD

We cannot find any abuse of LSD but in view of the unfortunate results of its use in some European countries and in the United States of America a strict watch is being kept.

VI. Conclusion

In conclusion, we think we can state that the drugs problem is under control thanks to the strong line taken to eradicate addiction, loyally supported by public opinion, good treatment arrangements in rehabilitation centres and a great improvement in the standard of living of the Japanese people.

MISCELLANY

CHRONIC LSD EFFECT

As more individuals have taken LSD in higher doses, there has emerged the chronic LSD effect. Those suffering from this condition take from 200 to 750 microgrammes per day, frequently and regularly. In the opinion of Dr. W. W. Burgess (University of California), this group of users is untreatable because they are so subjectively convinced that theirs is a better way of living. ( Journal of Amer.Coll.Hlth ,Ass., 16, 123, 1967.)