Drug abuse and criminality
THE RELATIONSHIP BETWEEN CRIMINALITY AND DRUG ABUSE
1. Crimes committed under the influence of drugs: direct relationship
2. Crimes committed to procure drugs: indirect relationship
3. The criminal milieu and drug abusers
4. The reaction of society
I. The present situation
II. The reasons
III. Policies and programmes for dealing with the crime/drug problem
THE ECONOMICS OF TRANSNATIONAL DRUG-RELATED CRIME
IV. Drug-related offences and the criminal justice system
A. THE CRIMINAL LAW
B. LAW ENFORCEMENT
C. THE COURTS
Pages: 35 to 46
Creation Date: 1972/01/01
Note prepared by the Secretary-General for the first session of the Committee on Crime Prevention and Control held at New York from 8-16 May 1972
The Committee on Crime Prevention and Control was established by the Economic and Social Council in its resolution 1584 (L) " in order to provide the variety of professional expertise needed on social defence questions spread over a wider geographical area. " The Council decided that it should report to the Commission for Social Development and, as appropriate on particular aspects, to the Commission on Human Rights and the Commission on Narcotic Drugs.
The problem of drug abuse has long been a concern of the United Nations, particularly through its Commission on Narcotic Drugs and the International Narcotics Control Board, which have sought to develop appropriate international instruments of control and to promote national efforts in this direction. The medical aspects of the problem have been dealt with by the World Health Organization whose expert committees have considered its epidemiological, pharmacological and therapeutic aspects. 1 Certain intergovernmental organizations, such as e.g. the Council of Europe and the League of Arab States, and quasi-intergovernmental organizations, such as INTERPOL, have dealt with wider or more specific facets of this problem. A number of international non-governmental organizations in consultative status with the Economic and Social Council are also active in this field (e.g. the International Council on Alcohol and Addictions and the World Federation for Mental Health).
* Document E/AC.57/4.
** Part II of this article will be published in No. 1 of volume XXV.
In recent years, at both the national and international levels, there has been an upsurge of concern in the face of an escalating problem, new patterns of drug abuse and a world-wide trade which seems to involve most countries as producers, consumers, processors or market centres.
This concern has been paralleled by the growing preoccupation with increasing rates and new forms of crime. The relationship between these phenomena and the scope for possible action are considered in greater detail below. It might be noted here, however, that efforts to date on both fronts have been inadequate to deal with even a fraction of this combined problem which manifestly lowers human potential and, on occasion, threatens to offset the technological and economic gains of society. Although these problems have become particularly acute in some of the most developed countries, they are also affecting an increasing number of the developing nations.
It has been suggested that the drug crime phenomenon might be a symptom of a more fundamental malaise, reflecting an underlying dysfunction of society in an age of very rapid change. Certainly, increased conflict, particularly in the urban industrial areas, and the erosion of traditional values and institutional support in areas of population concentration seem to create a moral and emotional vacuum always likely to be filled in synthetic and harmful ways. The increasing involvement of countries, groups and individuals at different levels of education and affluence tends to suggest that non-material considerations are as significant as other factors and that the problems must be approached on different levels simultaneously.
1. These are very rough distinctions with considerable overlap; in practice, the Commission on Narcotic Drugs has also been concerned with aspects of treatment of drug abusers and the World Health Organization with those of pharmaceutical production controls (the fact that a substantial part of the supply of illicit drugs comes from licit production further underlines the inter-relatedness of the problems involved and of the action required).
It is evident that priorities have to be established. The General Assembly, in its resolutions 2843 (XXVI) and 2859 (XXVI), recognized the urgency of both the crime and the drug-abuse problems and the need for a concerted attack upon them involving all elements of the United Nations system. It also established certain immediate priorities: in its resolution 2859(XXVI), it is concerned with the most vulnerable segment, youth, in relation to dependence-producing drugs. Both the Economic and Social Council and the Commission for Social Development have stressed the importance of a unified approach to problems of national development and a more balanced international Strategy for the Second United Nations Development Decade. By approving the broader mandate of the Committee on Crime Prevention and Control, these bodies also recognized the essential interdependence of the various aspects of crime legislation, drug abuse, human rights etc. and sought expertise and effective action even when this might mean cutting across the established administrative and procedural boundaries.
In March 1971, the United Nations Fund for Drug Abuse Control was established (see General Assembly resolution 2719 (XXV) and Economic and Social Council resolution 1559(XLIX)) to permit the mobilization of joint international efforts and implementation of a short-term and long-term policy and concerted programme of action dealing with all problems related to drug abuse control. The Commission on Narcotic Drugs has already approved a plan for concerted action against drug abuse 2 which does not, however, deal with crime. This Committee, therefore, which is considering an international strategy in the field of crime prevention and control must incorporate action against drug abuse as it relates to crime.
The guidance of members of the Committee will be sought in areas of common concern to the several functional bodies of the United Nations and on the strategies for the kinds of joint action to which priority should be given. Special attention must of course be given to the implementation of the decisions of the policy-making bodies of the United Nations, such as the General Assembly resolution referred to in paragraph 5 above, and the priorities and requirements set by the Commission on Narcotic Drugs.
2. See Official Records of the Economic and Social Council, Resumed Forty-ninth Session, Supplement No. 12, para. 43 and chap. V.
The terms " criminality " and " drug abuse " are evidently not homogeneous entities; they subsume a whole range of phenomena with differing origins, dynamics and consequences. Furthermore, both categories of phenomena represent society's definitions and subjective evaluations and reactions rather than absolute reality. The simple classification given below must therefore be considered to be merely schematic and far from exhaustive.
There is nothing crime-provoking per se in opium and its alkaloids (morphine, heroin etc.); these drugs have a depressive effect with passive behaviour as a result. The consumption of hallucinogens (LSD, STP etc.) or of cannabis leads to asocial rather than criminal behaviour. A Brazilian study 3 concluded that the criminal activities of a sample of marijuana-using offenders could not be attributed to their drug use. An Indian study 4 has also found no proved correlation between cannabis and crime. A Nigerian study 5 suggests that those who are prone to use of hashish are also prone to criminality because of their primary social and psychological characteristics.
There is evidence, however, of a direct relationship between amphetamine abuse and aggressive behaviour, violence and crime. The relationship between high dose (excessive) intravenous amphetamine abuse and criminal acts has been scientifically documented by Swedish and American authors. The Swedish Committee on Drug Abuse, in its report submitted in 1969 to the symposium arranged by the Swedish Committee on International Health Relations, 6 and the Select Committee on Crime to the United States Congress (Washington, 1971), in its Fourth Report, are unanimous in this respect. Phen-metrazine, methamphetamine, amphetamine and methyl-phenidate are most commonly the central nervous stimulants which are administered intravenously by drug abusers. The therapeutic doses of these compounds are between 5 and 25 mg, but drug abusers inject from 500 to 1,000 mg of them. In many cases the false energy the need for activity and the pathological self-confidence induced by the drug lead to aggressive behaviour and all forms of violence. Some criminals say that they intentionally take an injection to get enough courage and self-assuredness to commit a crime. In states of acute paranoid psychosis (which develops as a consequence of prolonged heavy use of amphetamines) panic-filled addicts can commit dangerous acts of different types. In an opinion expressed at the symposium, " in many cases the influence of the drug on the paranoid psychoses has been an important and sometimes quite dominating factor in the genesis of crime...". 7 Cocaine appears to have a similar, though shorter-lasting effect as the amphetamines, although the mechanism may differ.
3. See O. Moraes Andrade, " The criminogenic action of cannabis (marijuana) and narcotics ", Bulletin on Narcotics, vol. XVI No. 4 (1964), pp. 23-25.
4. See C. Chopra, " Man and marijuana ", International Journal of the Addictions, New York, vol. IV, No. 2 (June 1969), pp. 219-233.
5. See T. Asuni, " Socio-psychiatric problems of cannabis in Nigeria ", Bulletin on Narcotics, vol. XVI, No. 2 (1964), pp. 17-28.
6. In " Abuse of central stimulants " edited by F.Sjoqvist an M. Tottie, (Stockholm, 1968).
Some widely accepted substances are the most noxious. It has been said that alcohol is the most dangerous drug; yet, in most countries it is available relatively freely and its provision and consumption are not legally proscribed or viewed with the moral reprobation attached to the use and dispensation of drugs less generally-used socially. The numbers of alcoholics in some countries are estimated in the millions and the relationship of the abuse of alcohol to crimes of different kinds (e.g. crimes of violence, unskilled property crimes and traffic offences) has received considerable attention, 8 but generated only very limited solutions.
An aspect that has received due consideration only on rare occasions relates to offences committed out of " negligence " while under the influence of drugs. In modern technocratic society, the manipulation of machines and mechanical systems has assumed particular importance. Even soft drugs tend to disturb co-ordination and interfere with sustained attention and they often lead to acts of criminal negligence. The need to give this problem greater attention has been underlined at recent meetings by participants from both East and West. 9
Drug abuse leads to drug dependence, and the addict's craving has a much greater influence on the link between drug addiction and criminality than the pharmacological properties of narcotic drugs. This drug-craving, the physical " need " of a drug, is an important factor: the addict is ready to do anything to procure his drug.
8. It was estimated in the United States of America that 50 % of its prisons were populated in 1968 by individuals who had committed crimes while under the influence of alcohol (Stanley Einstein, " The addiction dilemma: Gaps in knowledge, information-dissemination, service and training ", International Journal of the Addiction, New York, vol. 4, No. 1 (March 1969), p. 33).
9. Intervention made by Manuel Lopez-Rey, for example, at the International Congress on " The limits of penal sanctions ", Brussels (Universite libre de Bruxelles), 16-18 March 1972.
As a rule, drugs must be bought or obtained illicitly. This activity leads to contacts with the criminal milieu and to committing criminal acts:
In some countries the frequency of burglaries in pharmacies is quite proportional to the increase in drug-abuse cases;
Addicts frequently commit crimes (theft, burglary, forgery) to obtain money to cover the expenses of drug abuse. A good example of this activity and its impact on society is the description presented in the report of a Special Study Mission by United States Congressmen as follows:
Based on the estimates that there are at least 250,000 heroin addicts in the United States, it would take between 4 and 5 tons of heroin to support the addict population.
The estimates of the cost of the heroin that the average addict requires daily varies, however, from $30 to $100 per day.
The estimated amount of money spent by heroin addicts in the United States is $7.5 million per day. This figure is based on the fact that there are 250,000 addicts with an average habit (minimum) of $30 daily. For this year (1971) the estimated figure would be approximately $2,737,500,000.
To support the habit, reliable authorities estimate that the addict would have to steal goods with at least 4 or 5 times the cost of his habit per year. If 75 per cent of those addicted resorted to crime, using the above figures, then the cost of crime committed to sustain the habit would be in excess of 8,000,000,000 dollars per year at a minimum. 10
In this light, the comments of the Congressmen that " narcotics have been cited as a primary cause of the enormous increase in crimes committed over the past few years " is understandable. 11 But more detailed and exhaustive statistical data are still needed on the relationship of drug abuse to different kinds of criminal activity.
10. The World Heroin Problem (Washington, D.C., 1971). Some reservations have been expressed regarding the meaningfulness of such figures (see e.g. Max Singer, " The validity of mythical numbers ", Public Interest, New York, No. 23 (Spring 1971)). It is undeniable, however, that drug-related offences exact an enormous material cost and a still greater social cost.
11. According to a recent United States report, criminal justice experts ascribe 34 to 50 per cent of the hold-ups, burglaries, and thefts committed in the nation's 34 major urban Centres to heroin addicts, and some criminal court judges have found that 75 per cent of all the cases they try involve defendants with a history of heroin use. It States: " To a large extent, the problem of urban crime is the problem of heroin addiction. This close correlation between crime and heroin can be directly linked to the failure of this nation's addiction control policy to contain heroin habits and prevent their spread to others " (American Bar Association Special Committee on Crime Prevention and Control, New Perspectives on Urban Crime (Washington, D.C., 1972), p. 8).
An investigation in the Netherlands, covering the period 1 April-1 October 1970, found that the misuse of drugs was hot confined to those detained for the infringement of the Opium Act, and that those detained for all kinds of other offences constituted more than half of the drug-using prison population, arid that they used more drugs on the average (council of Europe, " Draft report on the penal aspects of drug misuse ". (Strasbourg, 1971), p. 139).
Addicts buying their drug supply illicitly are inevitably in regular contact with criminals (illicit traffic in narcotics is one of the best examples of organized crime). Through this contact, drug abusers themselves often become drug peddlers (" pushers ") and the line between trafficker and addict tends to disappear.
Drug abuse is often a manifestation of social maladjustment, as is delinquent behaviour, and some countries report the parallel increase of drug abuse and delinquency in the same groups or social strata. For example, it was found that in Sweden the majority of intravenous amphetamine abusers were members of juvenile delinquent gangs. In the United States of America, the majority of the young heroin addicts in " black ghettos " had a criminal record preceding their heroin addiction. While there is no evidence that some drugs are a cause of crime in the sense that they inevitably lead to criminality, among addicts with a delinquent life style drug use seems to be part and parcel of other activities, crime included. In so far as the use of certain drugs leads to effects which incapacitate users socially, or perpetuates membership in an asocial or antisocial group, that use also poses serious problems for the community at large. 12
In society's reaction to drug abuse there is the danger of action being too one-sided against all drug abusers without differentiation. Distinction should be made between drug traffickers who have merited the heaviest penalties for their profit-motivated crimes and the abusers who, in many cases, are victims of the former's activity. Many addicts have become " pushers " in order to get drugs for themselves. It has been acknowledged by the World Health Organization that drug dependence is an illness; drug-dependent persons, consequently, have to be treated; they need medical and social help rather than heavy penalties. Furthermore, there exists a great number of " experimenters " who take drugs occasionally, or use drugs regularly without becoming really addicted to a drug. Penalties and rehabilitative measures need to be used with great discrimination. Attempts to deal with this as purely a crime problem are likely to fail; as have attempts to deal with it as purely a medical problem. Rehabilitative measures have no high success rates and even the substitute of methadone is subject to abuse. Vice and adversity as well as sickness and victimization are in the drug syndrome.
12. For consideration of this aspect, see Richard Blum, " Drugs and violence ", Crimes of Violence, Staff report submitted to the National Commission on the Causes and Prevention of Violence (Washington, D.C., U.S. Government Printing Office, 1969), pp. 1490-1493.
The recent increases in drug abuse, particularly among the young, have been causing growing alarm in a number of countries; in one of the most developed, it has been termed the number one national problem. 13 Although much of the concern is in the industrialized countries of the West, it has spread and is spreading elsewhere, including countries where until recently it was practically unknown. 14 Indigenous population groups in different parts of the world have, of course, used certain drugs for years, often as a way of dulling hunger and discomfort bred of want and adding " energy ". But more recently, partly as a result of expanded tourism and improved communications, but also as a product of more organized traffic, there have been indications of the spread of drug abuse in its newer forms to the developing regions. This is revealed in the press, 15 in existing legal regulations, 16 and in new measures such as those against the admission of persons associated with drug abuse. 17 It would be useful to explore this facet more systematically, particularly as concerns the transnational aspects of drug offending. Some of these aspects, such as the problems arising from the imprisonment of young persons convicted for drug offences in foreign countries, require attention and probably international solutions.
Drug abuse is serious for any country. Its consequences for developing areas, however, with only limited resources and populations striving to improve their standard of living, can hardly be overstated.
One of the striking things about recent forms of drug abuse has been its extension to all strata of society, to the affluent, to progressively younger age groups 18and across sex lines, 19 to users of different origins, personality structure and motivation. 20 Though a certain life style is associated with the " drug culture ", its characteristics are not easily defined.
13. President of the United States on 20 March 1972 ( The New York Times, 21 March 1972, p. 1).
14. See e.g. T. Borkowski and F. Chrobok, " Czy nowy problem-marihuana? " [A new problem-marijuana?] Zagadnienia Kriminalistyki, Warsaw, No. 5 (1970), pp. 96-106.
15. See e.g. " Drug addiction our latest bane ", Manila Times, 10 July 1971, p. 5.
16. See e.g. Jacqueline da Costa " Penal policy and underdevelopment in French Africa ", African Penal Systems, Alan Milnar, ed. (London, Routledge and Kegan Paul, 1969), pp. 380-386.
17. The Vice-President of Kenya recently announced that " hippies " would be banned (as has been done e.g. in Nepal) and " itinerant tourists " as well as some foreign volunteer workers have been accused of introducing drugs to Kenyan children. Drug use is said to be particularly severe in the schools of Nairobi and the police have been instructed to crack down on teachers who would encourage " this antisocial behaviour ". This has elicited popular support, but some dissenters have noted the local availability of bhang (marijuana) and the use of hashish by the coastal population, asking " Who... is corrupting whom? " (Associated Press dispatch, 14 March 1972).
18. While the largest percentage of users seems to come from the 16- to 25-year age group in some countries the lower limit has dropped further. Preferences for certain drugs have also been found among particular age groups (Council of Europe, " Draft report on penal aspects of drug misuse " (Strasbourg 1971), p. 141). A nation-wide study conducted in one country (USA) revealed the highest rate of drug use to be not on college campuses-as had been expected-but among unemployed youths and in military camps. (Lloyd Johnston, " Drugs and American youth " (University of Michigan, Institute for Social Research, Survey Research Center), to be published.)
There is also great variability in the narcotic substances and drugs misused and linked with illicit behaviour. The range of such substances has widened in the sixties and seventies, although there is often a main focus of special concern. In general, however, the pattern has grown progressively more intricate, more serious, and more widespread. Vogues of drug use succeed each other or coexist; substitution and progression become more frequent; the multiple use of drugs is another special manifestation of their widening reach. 21 Again there seems to be a parallel with the expansion of criminal activity, where the lines between licit and illicit are not easily drawn and the boundary separating offender and non-offender is faint, and with the multiplication of types of deviant and illegitimate behaviour fostered by the proliferation of possibilities that modern life affords.
The multiplicity of factors operating in current forms of crime-related drug abuse underlines the inap-propriateness of simplistic explanations and " solutions " predicated on them. It has been emphasized that the drug wave should not be viewed as a homogeneous phenomenon, but that it has different aspects and that responses to drugs result as much from the set and setting as from the drug itself. The deprived and under-privileged, from among whom many delinquents in the past have come, live in socio-cultural climates favourable to the abuse of drugs such as heroin, which provides escape from or at least insulation against harsh reality, and the problems attendant on its use including crime do not result from the pharmacological action of the drug but correlate rather with the social context in which it is used. Drugs are also used to compensate for parental and emotional deprivation. Further-more, the increased use of medicines, sometimes indiscriminately, for various purposes has reinforced the credo of " better living through chemistry ", of which this drug abuse may be an expression. The tempo of change, increased mobility, the erosion and pluralism of values, the loosening of traditional ties, urban anonymity etc., have all contributed to the pervasive insecurity and anxiety. The pressures of an increasingly competitive existence and the jarring impact of certain technological advances help to increase discomfort and further reduce the level of frustration tolerance. Alienated youth, often coming from middle-class back-grounds, are impatient with outmoded mores and have lost faith in the norms and values of an older generation and, under the pressure of peer groups, they turn to mind-expanding drugs to experiment, to challenge existing taboos or simply to gain new experiences. 22
19. While most drug abusers are men, the proportion of women, as in crime, also seems to be increasing.
20. It has been noted that the experienced addict prefers the high-yield low-risk offences because apprehension and incarceration make withdrawal a certainty. Thus he concentrates on such crimes as burglary, shop-lifting and pandering for which apprehension rates are low and the monetary return is adequate to feed a habit. Younger addicts and those facing imminent withdrawal are more likely to commit violent crimes, such as armed robbery and purse-snatching. Only the very young and very inexperienced addicts seem to engage in assaults, murders and rapes unrelated to stealing money or property. (American Bar Association Special Committee on Crime Prevention and Control, New Perspectives on Urban Crime (Washington, D.C., 1972), p. 49).
21. In one metropolis it is observed with alarm " the addiction problem is a social disaster. There is every indication that the addict population is growing and that drug addiction is penetrating previously unaffected geographic areas and social classes " (New York City, Criminal Justice Co-ordinating Council, 1971 Plan, p. 38).
It must be emphasized that most of the work done so far on the extent and motivation of drug abuse has been in those countries with the greatest drug problems. There are other areas of the world where these back-grounds to drug abuse may not apply. The situation is perhaps very different in countries with uniform value systems or in those developing areas where traditionally the less addictive drugs have been in fairly wide and sometimes largely tolerated use. However, even in the remoter parts of the world the reasons for use are changing as mass communications spread the " drug culture ". 23
The gamut runs from the occasional to ingrained patterns. Some have claimed that it is the chance availability of drugs that brings about exploration leading to conditioning and eventually addiction, but others have pointed out that involuntary contact with drugs is far less important than the atmosphere in which it takes places and that the overwhelming majority of drug dependants have not become so involuntarily, but have been searching for drugs. The General Assembly, in its resolution 2859 (XXVI), stressed the social nature of the problem, which requires an understanding of the deeper forces at play, and of its relationship to other phenomena and problems. 24
22. For a discussion of some facets of youthful drug abuse see e.g. Renato Breda, "Riflessioni sul problema delle 'droghe'", Quaderni di Criminologia Clinica, Rome, vol. 13, No. 4 (October-December 1971), pp. 410-451; C. Somerhausen " La drogue et les jeunes: aspects socio-culturels ", Revue internationale de l'enfant, Geneva, vol. 35, No. l0 (June 1971), pp. 3-17, and Hugo Solms " La drogue et les jeunes ", ibid., vol. 32, No. 1 (1968), pp. 33-41.
For a comprehensive bibliography of the different aspects of drug abuse, see Italy, Ministero di Grazia e Giustizia, " La droga: aspetti sociologici e criminologici: bibliografia 1950-1970 ". Rome, Quaderni dell'Ufficio Studi e Richerche della Direzione Generale per gli Istituti di Prevenzione e di Pena, 1971, p. 288.
23. See e.g. Ahmed Khalifa, lecture on some social aspects of drug abuse, Fourth United Nations Congress on the Prevention of Crime and the Treatment of Offenders (United Nations publication, Sales No.: E.71.IV.8), part three, section III.
Again, it is easy to overstress the pathological features of modern society. However, it must not be forgotten that the vast majority of the people subjected to all these pressures, influences and temptations do not have recourse to drugs.
Most of the characteristics of the modern mobile, restless and frustrating society described above, as related to drug abuse, are also closely associated with increasing rates of crime. Whether or not a crime is committed may depend upon whether there is a " flight or fight " reaction to the stress of a given situation (although it might be more appropriate to speak of a " flight cum fight " reaction in some cases of drug-related crime).
As in criminality, the issue of " normalcy " arises with respect to addicts and others involved in drug abuse. The existence of an underlying pathology has often been suggested, with the indication that many drug-dependent individuals may have certain personality disturbances which are akin to psychopathic disorders. This might provide a common denominator for a substantial portion of offenders, particularly those recidivists who are thought to have a psychopathic personality structure. The hypothesis has also been advanced that while drug abuse may be a symptom of psychological or social disturbances, when addiction supervenes it is no longer a symptom but, in fact, a morbid condition of its own, and that its development will not be affected by the removal of the initiating factors. According to this view, addiction has the strength and character of a natural drive: it may be considered as an artificially- induced drive developed through chemical stimulation of the pleasure centre. The fact that addiction occurs spontaneously in insects and can easily be induced in other animals is cited in support of this contention. 25 Although conditioning does seem to operate in addiction and other forms of drug abuse, this kind of biological explanation underplays the multiplicity of factors-including the operation of social and psychological pressures-in the genesis and persistence of addiction and addictive life styles. The assumption that the drug habit is responsible for other criminal acts, while true in many cases where the attempt to procure the means for obtaining additional drugs involves theft, robbery and other offences, has been subjected to doubt by evidence of previous criminal records in a large proportion of drug abusers. In a study recently carried out in the Netherlands, it was found that 31 per cent of the respondents had been committed earlier in their lives to juvenile institutions. (Council of Europe, " Draft report on penal aspects of drug misuse ", p. 140.) However, the fact that there were previous criminal histories should not be taken as suggesting that a criminal proclivity inclines to drug abuse. Quite independent pressures of a personal, family and environmental nature may be responsible for both the crime and the drug habit.
24. The fact that drug abuse today is a socio-cultural problem, rather than just a legal or medical one requiring appropriate social action, has been emphasized by a number of experts. See ibid; Breda, op. cit., and Sergio Garcia Ramirez, " Delitos en materia de estupefacientes ", Criminalia, Mexico, D.F., vol. 37, No. 6 (June 1971), pp. 301-326.
25. Nils Bejerot, Karolinska Institut, Stockholm, " A theory of addiction as an artificially induced drive ", American Journal of Psychiatry, Washington, D.C., vol. 128, No. 7 (January 1972), pp. 842-846.
But these explanations, however plausible, are still subject to continued debate in both medical and penal circles, as indeed are the treatment methods based upon them. Typological and other studies are obviously required to provide the needed empirical data. In recent experimental methadone maintenance studies, for instance, no consistent pathology has been found that could serve as a therapeutic guide. 26
Most countries facing massive problems of addiction and related crime have found that reliance only on the deterrence power of the criminal law and/or the threat of criminal proceedings have had limited value. Some of the countries with the strictest laws and severest penalties for the mere possession of drugs have a burgeoning addiction/crime problem. Incarceration and civil committal remove the addict from the scene only temporarily and-owing to the failure of most " treatment " programmes and the high relapse rates-return him, often repeatedly, to the same setting with the same external and internal pressures, dependent on the same mechanisms and behaviour patterns to obtain relief. 27 The hope that stiffer penalties for trafficking in narcotics will serve as a deterrent is also unlikely to be borne out since large-scale traffickers are very likely to escape prosecution. More viable strategies are obviously needed that would take into account the dynamic forces operating at different levels.
26. " No psychiatric diagnosis can be shown to apply to all heroin addicts or even to a majority of them. Thus, while addicts tend to be depressive, they are not so depressive as neurotic non-addicts. While some addicts are schizophrenic, 80 to 90 per cent are not. Some are psychotic, but the great majority are not. In short, no satisfactory explanation of the psychological roots of addiction has been found, much less developed to the point where it is operationally useful for treatment purposes. " See United States National Institute of Mental Health, Proceedings of the second and third national conferences on methadone treatment, 1969, 1970; and James V. DeLong " Treatment and rehabilitation ", Staff Paper 3, Dealing with Drug Abuse: The Drug Abuse Survey Project, prepared for the Ford Foundation by Patricia M. Wald, Peter B. Hutt and others (London, New York, Praeger, 1972), p. 224.
27. Even if the exact nature of addiction and the possible metabolic changes accompanying it are still not clearly understood, the compulsive effect of the craving for the addictive drug has been generally acknowledged as is the fact that it obliterates rational powers of control assumed to operate in the deterrence principle.
The major goals of prevention and treatment, including rehabilitation, largely overlap, of course, even if couched in somewhat different terms. The goals of prevention have been stated as the following: ensuring that dependence-producing drugs are not available from illicit sources; reducing the interest in such drugs and demand for them; minimizing discomfort, antisocial activity and economic loss deriving from drug-taking; reducing the possibility of exposure to dependence-producing drugs without the provision of information concerning their effect and possible complications. There are corresponding goals for treatment. 28
As the WHO Expert Committee on Drug Dependence has recommended, the immediate, intermediate and long-range goals for prevention, as for treatment, need to be clearly formulated, along with the aetiological assumptions (as far as this is possible) on which each aspect of these programmes is based. In order to avoid loss of confidence and retardation of programmes, such factors as the availability of the necessary infrastructure, personnel and technical assistance required to provide them also must be ascertained. The prevention and control of drug abuse must be an integral part of social defence planning, which implies that it should be the concern of national planners at the highest level not only for the present but also for the future generation, for too little attention has been given to prevention in the past. Consideration of the whole issue of the crime/drug problem again underlines the need for the careful preparation of planners so that they are familiar with it and can relate the various investments in the prevention of crime and ensure balanced social and economic planning.
Some immediate steps can be taken without undue difficulty-for example, as part of wider educational, civic, public health training programmes 29-by utilizing and influencing public opinion 30 and by enlisting public co-operation in programmes for prevention and control. An attempt must also be made to determine whether preventive education does indeed reach the target population at risk, 31 and whether it does in fact meet its postulated objectives-for example, where teachers and counsellors report to law enforcement authorities, obviously the rapport needed to ensure programme effectiveness cannot always be maintained. 32 Other preventive options also need to receive proper attention, such as, for example, the utilization of community health centres and specialized or multipurpose family and child welfare services, with a prophylactic focus and directed at groups in special need (for example, children of addicts who have heretofore received little attention), as well as the encouragement of youth development activities designed to involve young people in community service and other meaningful pursuits to provide healthier satisfaction of needs and promote a feeling of belonging to the larger group as a way of offsetting possible negative peer pressures.
28. For a more extensive discussion of these, see WHO Expert Committee on Drug Dependence (1970), Eighteenth Report, World Health Organization Technical Report Series No. 460 (Geneva, 1970), 15 pp.
29. Perhaps as a continuous process of education about drugs in general (legal and illegal), acquaintance with the law and the criminal justice system.
30. Special care must be exercised in this connexion not to arouse undue curiosity and unwittingly encourage experimentation, particularly through the media. These and special public campaigns should, rather, seek to disseminate more accurate information, dispelling widely held myths concerning aspects of drug misuse, helping to make it unfashionable to try drugs and to promote more scientific attitudes towards addiction (as has been done through official propaganda, e.g. in Sweden).
31. One problem with school-based education on which some countries have concentrated, for instance, is that a large portion of serious young drug-users have already rejected school. There is also need for programmes initiated sufficiently early in view of the lowering age of drug-users and for parent education.
A preventive strategy, if it is to be at all effective, must use a variety of methods in a comprehensive approach. Such a policy would take due account of the whole spectrum of needs, permitting rational choices between different options on the basis of the best available knowledge, testing and evaluating the different kinds of approach as part of a continuing process.
The guidance of the Committee is invited regarding ways in which such strategy could best be achieved, its priorities, its means of implementation and its specific forms of co-operation with the Division of Narcotic Drugs of the United Nations office at Geveva, the World Health Organization and other agencies and organizations concerned, as well as, of course, with Governments.
Among the most ambitious preventive efforts are those designed to curtail and presumably, eventually, to eliminate the illicit narcotics supply. Efforts in this direction include recent agreements intended to strengthen international machinery for uncovering the illicit production and sale of narcotics, 33 as well as United Nations-assisted pilot schemes designed to promote crop substitution (e.g. in Thailand). If they are to succeed, projects of the latter kind must take local attitudes, cultural traditions and social patterns fully into account, giving due regard to fundamental human rights as well as providing appropriate technologies and marketing opportunities so as to offer viable alternatives to the cultivation of opium poppy. Where possible, they should be integrated with wider programmes of agrarian reform and rural development. In some cases-as in the " golden triangle " in Asia (Burma, Laos and Thailand) -a regional or subregional approach seems to be called for. The expertise of United Nations regional, land reform and community development advisers can be most useful and the co-operation of the respective section of the Social Development Division of the Department of Economic and Social Affairs in this connexion needs to be enlisted. The problem may well be complicated by local resistance and that is why strictly legalistic measures which impose prohibitions from above have been largely ineffective. Opium-poppy cultivation in the " golden triangle ", which accounts for 60 per cent of world opium production, is engaged in largely by tribes who do not respond to governmental edicts. It has been utilized mostly for home consumption, but could provide a vast and profitable reservoir for traffickers cut off from their usual sources of supply.
32. Innovative ways of overcoming this problem have been suggested. See e.g. Donald B. Louria, " The drug ombudsman: a new role for schools ", Drug Forum, New York, vol. 1, No. 1 (October 1971), pp. 37-40.
33. Such as the Protocol amending the 1961 Single Convention on Narcotic Drugs intended to give a more specific mandate to the International Narcotics Control Board, signed at Geneva on 25 March 1972 by a number of countries (to enter into force upon ratification by 40 countries); but not by others who considered that the amendments proposed might lead to undue interference in national affairs-an illustration of the difficulties inherent in attempts to impose this type of control.
Recently, the Government of the United States of America offered compensation, e.g. to Turkey, for the loss of revenue from opium production and enlisted the co-operation of the Government of Turkey and other Governments in stemming the flow of illicit narcotics traffic. Bilateral arrangements of this kind are helpful, but they are not sufficient, nor are the commendable attempts of individual countries to curtail or even suppress their own production-as the example of Iran has shown. They do not prevent the increase of supply from other sources or the substitution of other drugs for those difficult to obtain. Nor do they deal with possible existing stocks. The Director of the United States Bureau of Narcotics and Dangerous Drugs recently pointed out that years of neglect of the problem and token co-operation by most countries has enabled traffickers actually to build up a sufficient backlog, e.g. of heroin, to fill the void created by large seizures by law enforcement agencies, and the International Narcotics Control Board noted in its 1971 report that the illicit supply had expanded to meet the increased demand for misused dependence-producing drugs (E/5103, para. 5). Measures to curtail the supply must be combined with measures to deal with the demands. Similarly, national action and bilateral agreements need to be part of a more comprehensive international drive to deal with this trade in human dependency.
Unilateral policies which concentrate on one part of the issue to the neglect of others could, in fact, exacerbate the problem. For example, stricter law enforcement, shrinking the supply of a narcotic such as heroin, may not only further raise its price and the level of criminal activity required to meet it; as has been found in Sweden, for instance, it may also encourage substitution of other drugs. In some countries using methadone maintenance, for example, a black market in methadone has sprung up, and stricter controls over methadone distribution are now being introduced. In Japan a concerted campaign against trafficking in heroin and for treating addicts compulsorily has decreased the number of addicts, but increased the number of frauds or thefts of medicinal narcotic drugs from medical practitioners. 34 Complete elimination of certain illegal drugs may make addicts more amenable to treatment, although it is unlikely that it can be achieved. However, new policies bringing more hard-core addicts into treatment neccesitate " pushers " seeking out new, less reliable clientele, becoming thus more visible and more vulnerable to arrest.
The link between the narcotics traffic and organized crime has been widely recognized and forms part of every economic discussion of the drug problem. As middlemen, the organized crime rings have prospered. Measures against transnational operations of this kind evidently require international countermeasures, and such bodies as the International Narcotics Control Board and INTERPOL have exercised commendable initiative in this respect. But more pervasive and far-reaching strategies are still required to deal with a problem that seems almost intractable. Using improved technologies, maximizing mobility 35 and profiting often from official venality and corruption, 36 the main operators have usually successfully defied detection. 37 Even where stiffer penalties for the distribution of narcotics have been enforced, those caught are usually at the bottom level and can easily be replaced. It has also been suggested that the patterns here have also changed and that crime syndicates in certain countries have moved out of the narcotics trade because of the high risks and into lesser risk areas (e.g. gambling and prostitution), but that they have been replaced by a large number of smaller gangs and operators who are even more elusive. Differences between national regulations (e.g. concerning amphetamines) facilitate traffic in drugs still largely diverted from licit supplies. The emergence of fresh patterns and new types of " trader " in drugs-migrant workers, students, " hippies ", " diplomats ", military personnel etc. -requires new approaches and more concerted international efforts which cannot, perhaps, any longer be limited to the slow process of ratification and aplplication of international instruments though these are undoubtedly essential. For instance, in spite of its acceptance in principle, the Convention on Psychotropic Substances has to date been ratified by only one country and acceded to by two.* A network of international agreements and arrangements must be developed that will permit prompt and effective action.
34. See Japan, Ministry of Health and Welfare, " A brief account of narcotics abuse and countermeasures in Japan " (Tokyo, 1970), p. 3.
35. Laboratories for the processing of narcotics are now said to be often located in vans which can move from place to place and even cross frontiers.
36. The International Narcotics Control Board in its 1971 report made special mention of the danger that countermeasures against illicit supply and traffic in drugs might be seriously undermined by corruption (E/5103, para. 7).
37. Although the seizure reports furnished by Governments may show occasional decreases in quantities of drugs seized in illicit trade, recent surveys by the Commission on Narcotic Drugs indicate that on the whole illicit traffic remains extensive and well-organized.
It is necessary to extend international co-operation and improve the machinery for direct, informal, rapid action to ensure that traffickers do not profit from the transnational nature of their activities-that is, that they do not escape prosecution on jurisdictional grounds or arrest on grounds of territorial exemption. Counter-measures against the international narcotics traffic must also become international not only at the legislation level but also at the implementation level.
The need for an array of new tactics is also dictated by certain concomitants of international drug traffic that seem to be escalating. A recent study of professional criminals who are drug dealers revealed that the lucrative market for illicit drugs has become more competitive in recent years and that increasing violence on an inter-national scale is occurring among syndicates. This increase in organized violence in international drug traffic is also said to be associated with the theft and smuggling of weapons employed in warfare among criminals. 38
There have been other approaches to the crime/ drug problem based upon tolerance of certain market conditions 39 or the controlled supply of heroin to registered addicts. One country has combined military control of growing areas with police supervision of traffic and large-scale free and open treatment for those needing it. It is frequently argued that tolerance of a certain level of addiction and open trading reduces criminal activities based on black market conditions. The difficulty arises from the precise lines to be drawn between legal and illegal conduct.
Some systematic efforts have in fact been made to gauge the theoretical effect of different policy options on the narcotics market and the rate of crime. 40 The analysts have noted that the development of an effective policy which combines both efforts to suppress supply and attempts to inhibit demand for certain narcotics must necessarily involve a close scrutiny of the total economics and social system and the benefits and costs of various options. They have suggested that cost-benefit analyses can illuminate the probable reduction in the social costs of addiction to be derived from one policy as compared with another. 41 The most important conclusion, probably, is that no policy can be really effective which addresses itself to only part of the problem. The Committee can perform a valuable function in suggesting the kinds of policies that it considers most useful and to which, in its view, the most serious consideration should be given in future work in this field.
* Note by the Editor: At the time this number goes to press Bulgaria, Chile, Egypt, Panama, Paraguay, Saudi Arabia and Venezuela are Parties to the Convention.
38. Richard Blum, op. cit., pp. 1507-1509.
39. In one country (the Netherlands) daily broadcasts give information on the current prices of cannabis, amphetamines and LSD on the black market with a view to protecting potential buyers against exploitation.
40. See e.g. John F. Holahan and Paul A. Henningsen, " The economics of heroin ", Staff Paper 4, Dealing with Drug Abuse: The Drug Abuse Survey Project, prepared for the Ford Foundation by Patricia M. Wald, Peter B. Hutt and others (London, New York, Praeger, 1972), pp. 255-299; and Mark More, " Policy concerning drug abuse in New York State ", The Economics of Heroin Distribution, vol. III (Croton-on-Hudson, Hudson Institute, 1969).
Penal policies and the criminal justice system are being re-examined in some countries because of the growing realization that they have not fulfilled their essential purposes and in fact have often exacerbated the problems they were designed to solve. This is true as concerns drug abuse and related offences, as has been recognized by the special commissions of inquiry, 42 legislative reforms 43 and administrative directives adopted in a number of countries. At both the national and international levels there is an admitted urgency to cope more effectively with a problem that has caused intense personal suffering and exacted an exorbitant social cost. The dysfunctionality of the criminal justice system and of its various elements has significantly contributed to it. Inadequate in themselves, often working at cross purposes, they have lacked a basic coherence and rational guiding policy that would relate them to each other, to other programmes and services, and to a comprehensive over-all policy with well thought-out and realistic objectives. And yet, a viable, well-functioning criminal justice system operating under such a policy could be instrumental in dealing with this and other serious social problems.
Legal controls on drugs relate to their production, distribution and availability. Practically all countries have laws against illicit trafficking in potentially dangerous drugs; most consider their mere possession a criminal offence. Related offences, such as the so-called " street crimes " committed to finance the drug habit, fall under the respective provisions of the penal law, which has not usually recognized their compulsive nature as a form of diminished responsibility. Extensive reliance on penal law to perform tasks for which it is ill-suited has often served to exacerbate existing problems and to impede further the efficient functioning of criminal justice systems. In both developed and developing countries, the law has often failed to differentiate adequately between different types of drugs and different categories of misusers (e.g. addicts v. traffickers), 44 crowding court calendars and limited facilities, although there has been a decided movement, particularly in recent years, to provide for such differentiation.
41. A framework for the quantification of the elements involved and assessment of the costs and benefits of alternative options has been made e.g. in Robert Lind and Jean Lind, " The identification and measurement of drug control objectives ", unpublished paper, International Research Consortium on Drug Legislation and Programmes, Stanford University, 1972 (mimeographed).
42. In Canada, for example. Interim Report of the Commission of Inquiry [the Dain Commission] into the Non-medical Use of Drugs, (Ottawa, Queen's Printer, 1970).
43. In recognition of this fact e.g. the United States Comprehensive Drug Abuse Prevention and Control Act of 1970 abolished most of the harsh minimum mandatory sentences for narcotics possession established under legislation adopted in the 1950s (coupled with intensified law enforcement), providing for greater flexibility in sentencing although still adhering to a primarily punitive approach.
The Council of Europe, in a recent resolution, underlined that the primary roles of the penal law should be to regulate the handling of drugs by manufacturers, producers, distributors and the professions and to define and make punishable activities likely to foster drug misuse in a significant way, and recommended that the law provide for a sufficiently flexible scale of penalities, sanctions and measures to meet the need for suitable action in respect of the different kinds of anti-social behaviour connected with drugs. It has been increasingly recognized that the complex problem of drug abuse requires equally complex and flexible solutions rather than recourse to extremes; that neither an indiscriminate and highly punitive grouping together of quite different types of behaviour with different social implications nor a wholly permissive approach can provide a solution.
The concept of " dangerousness " has also been suggested, e.g. by the Conference of the European Ministers of Justice, as a basis of dispositions relating to the misuse of drugs. This term, of course, has several meanings: danger to life, genetic danger, danger of psychic and social deterioration, or danger of harming other persons or society as a whole; moreover, the degree of danger in individual cases must be related to the kind of drug, the type of user, the type and scale of consumption and the context of the use.
In certain countries, including the developing ones, young drug addicts constitute a sizable proportion of the idle, whose condition is exacerbated by chronic malnutrition and who are a drain on the economy and a potential source of increasing crime. Some Governments have attempted to cope with the problem by repressive legislation against forced idleness and against drug abuse, which is not adequate since it does not strike at the root of the problem or offer suitable rehabilitative measures.
44. In Gabon where there is a National Narcotics Bureau and narcotics offences are punished with imprisonment of up to two years and fines up to 1,000,000 francs, there is no distinction between the use of drugs and traffic in them, and an attempt is punished with the same severity as a consummated narcotics offence. A useful feature of the country's legislation, however, and one with relevance for international co-operation is the fact that prescribed penalties may be imposed even though several acts constituting the offence are committed in different countries.
Even these few considerations emphasize the importance of adjusting the legislative framework of drug-abuse controls to differing circumstances and requirements and to changing medical and social views. Efforts in this direction, such as recent modifications of legislation and proposals relating to cannabis, should help to reduce the frequent overreach and irrelevance of the criminal law which has been counterproductive and to decriminalize those kinds of behaviour not proved to be harmful so that the criminal law and the criminal justice system can be utilized to cope more effectively with activities presenting a real public threat. Failure to do this in the past has helped to breed disrespect for the law and to overburden the criminal justice apparatus with cases it has been ill-equipped to handle.
In some countries-in Denmark, for example-administrative rather than legislative measures aim to control and prevent drug abuse. To be really useful, legislative and administrative dispositions must incorporate provisions for suitable treatment. This must all be done in the context of a broader, meaningful social defence policy related to national socio-economic policy and development planning as a whole. In the Single Convention on Narcotic Drugs, 1961 45 and the Convention on Psychotropic Substances, 1971 (E/ CONF.58/6 and Corr.1) the United Nations has provided the basis for appropriate national legislation against the illegal abuse of psycho-active drugs. It would be useful to supplement these Conventions-to render them more effective, through the development of legislative and administrative prototypes incorporating provisions for suitable treatment (to be formulated in co-operation with WHO) -and other elements of an enlightened social defence and public health policy designed, inter alia, to minimize the social and personal costs of drug abuse, which could be adapted to differing national systems and local circumstances. The development of such legislative and administrative models as a comprehensive framework for the treatment and prevention of drug abuse, giving sufficient discretion to the courts and authorities to permit them to deal flexibly with drug offenders, would help to foster a more meaningful approach at the country level. As noted earlier, there is also room for expanded and diversified international provisions promoting social defence strategies against organized crime and its transnational activities. The advice of the Committee concerning the scope and nature of such action should prove most useful to the Commission on Narcotic Drugs and to the United Nations as a whole in devising and carrying out a concerted strategy in this respect.
45. Single Convention on Narcotic Drugs, 1961 (United Nations publication, Sales No.: 62.XI.1).
The police have a crucial role to play in strategies for the prevention and control of drug abuse and related crime, since at some point most drug abusers come into contact with them. Police action need not-and, in fact, should not-be primarily repressive, although one of the primary functions of the police is evidently to try to identify the sources of supply of illicit drugs. Allegations of police corruption in some countries and the tactics employed by traffickers would seem to indicate that this role has at times been selectively discharged, concentrating on the more visible users and small-time "pushers" rather than the large-scale operators. As previously mentioned, the latter tend to operate across national frontiers, underlining the need for the co-operation of law enforcement bodies in the different countries (as promoted, e.g., by INTERPOL), using new tools and methods ingeniously and on a global scale. Such co-operation needs to be broadly based and to include other services concerned, such as customs authorities.
Effective law enforcement must incorporate both prevention and control and must promote the objectives of a comprehensive social defence policy. In its preventive task, the police, particularly through specially-trained drug squads, can fulfil a useful role in identifying addicts and actual or potential offenders and steering them into channels and to services able to provide needed help. 46 This again underlines the pervasive need for co-ordination among all the bodies and services concerned, including the social, health, educational, and social defence services in a coherent framework which would permit effective, flexible co-operation in coping with drug abuse and other serious problems affecting different communities.
The tendency of many criminal justice systems to overcriminalize and the extension of police activity have placed an inordinate burden on the courts in some countries. The result has been crowded court calendars, long detention periods, and sentencing practices which are not only unrelated to the needs of the defendants, but are handicapped by the lack of adequate treatment facilities even when the sentencing is careful and appropriate. Courts overburdened in this way may be obliged to have recourse to summary practices to dispose of cases quickly-practices which may engender a disrespect for the law. The problem, particularly in the developing countries, is largely one of limited resources and trained personnel; but it is even more severe in some of the most developed countries. Clearly, then, the only or main reasons for the shortcomings is not the lack of means, but, rather, the lack of clear and realistic objectives and of policies and practices designed to achieve them.
46. More effective procedures in this respect might also help countries to gauge more accurately the size of their drug abuse problems; although this function would ideally be discharged by social welfare personnel, developing countries particularly have a dearth of them, and the police members with the proper training can be used for this purpose-particularly in the light of the increasing emphasis placed almost everywhere on the social role of the police.
Some innovative approaches to the disposition of drug-abuse cases have recently been introduced in certain countries beset with an inundating problem. For example, to relieve court congestion and provide a more suitable approach to the needs of this particular group, special narcotics courts have been established in certain major cities on an experimental basis-in the United States of America, for example.
A twofold and actually contradictory trend currently exists in many countries: the wider use of both criminal and civil procedures for an increasing variety of behaviour, and the attempt to transfer responsibility for certain less harmful conduct to other authorities. Sometimes there is a mixture of the two, or the same basic purpose is achieved by different means and regardless of the nomenclature. In some countries penal sanctions may be replaced by curative measures for persons willing to accept them (for example, the French Public Health Code, as amended in 1970, which provides for penalties including imprisonment for the personal use of drugs, allows these traditional sanctions to be replaced by the court and charges not to be brought against persons submitting to a disintoxication cure; in fact, the waiver of proceedings is compulsory in certain cases); in one jurisdiction (Hong Kong) the criminal record is effaced when a drug-dependent person agrees to, and satisfactorily completes, a fixed period of institutional care and rehabilitation.
On the other hand, in States where the "legality" principle still prevails and public prosecutors are legally bound to take action on all offences coming to their notice, legislative reforms might be necessary to allow public prosecutors a greater measure of discretion. Judges must also be afforded wide discretion to decide which is the most appropriate sanction or measure to be taken, on the basis of full information concerning the offender's personality, background and circumstances, Such individualized treatment is possible, of course, only if the facilities for it exist and if there is proper co-operation between the courts and the services concerned-which all too often, is lacking.
Diversion from the criminal justice system, whether as part of an express policy or as individual exceptions to the rule, has taken place mainly in recognition of the fact that the regular criminal process is not appropriate in all cases. Past experience with other attempts at diversion, e.g. procedures for juveniles through juvenile court and civil committal for mentally ill offenders, has made it clear that "humanitarian intentions do not guarantee either more humane treatment of the individual or more successful rehabilitation ". 47 Despite these criticisms, there has been considerable interest in broadening the use of civil procedures and committal as an " enlightened " alternative for, among others narcotic addicts and alcoholics. This alternative has, of course, the obvious advantage of achieving for certain categories of offences a kind of decriminalization and of avoiding the labelling and stigma which strengthen criminal identification. Properly utilized, it offers considerable potential.
The experience with civil processing and compulsory committal has, however, been far from satisfactory. All too often, it has meant only the substitution of an unsatisfactory alternative. A good deal of controversy has surrounded civil committal, focusing on both its legality and its social value. Criticism has centred on the apparent failure adequately to safeguard due process (partially because of difficulties of definition), the emphasis on custody which appears to have taken precedence and often replaced any genuine attempt at treatment, which was supposed to justify the committal, and the injustice of longer committal under civil as compared with criminal procedure. 48 Compulsory civil committal has thus frequently differed little from penal incarceration, deterrence and removal of the offender from society being the primary motivation despite professed treatment goals. It has been claimed that in some cases civil " treatment " has been more punitive than criminal " punishment ". The latter may, in fact, be more genuinely treatment-oriented. 49 It is therefore important that the formal framework does not obscure fulfilment of the basic requirements of treatment, which can be met in different contexts, depending upon the particular system and the nature of the case.
47. Eleanor Harlow, " Review: diversion from the criminal justice system ", Crime and Delinquency Literature, New York, vol. 2, No. 2 (April 1970).
48. The United States President's Commission on Law Enforcement and Administration of Justice, while accepting involuntary civil committal as offering sufficient promise to warrant a fair test, warned that such programmes must not become the civil equivalent of imprisonment, that the best possible treatment should be provided and that the length of confinement should not exceed that which is " reasonably necessary ". But the estimate of the latter-like the indeterminate sentence-depends on subjective criteria.
49. This has led Rome to claim that the civil nature of what they call " quasi-criminal proceedings " is a legal fiction. See e.g. Sol Rubin, Psychiatry and Criminal Law: Illusions, Fictions and Myths (Dobbs Ferry, N.Y., Oceana, 1965), pp. 139-170; and Harlow, op. cit.
In a number of countries, addict-offenders may be offered some form of treatment instead of traditional sanctions such as imprisonment as a condition of probation, a suspended sentence, or waiver of criminal proceedings. The usefulness of such a disposition would appear to hinge primarily on the extent to which it provides meaningful treatment opportunities. Further-more, it is essential in all cases that the organs of control co-operate with the medical and social services, thus supporting the community's efforts to provide care and hope for drug abusers, rather than dragging them deeper into criminal activity.
The relapse and recidivism rate of addicts is notoriously high and the success of most treatment approaches limited. But certain methods that have been showing promise point towards more hopeful prospects if addicts can accept and be maintained in treatment; measures such as probation may provide the necessary framework guidance and supervision for approaches of this kind. The question of compulsion and of the necessary respect for human rights is dealt with below (see part II), but perhaps a measure of compulsion may not be inappropriate for drug-dependent patients if it serves treatment objectives and promotes recovery. Indeed, the adage that treatment must be sought by the individual concerned is not always practicable in the case of the addict who is often poorly motivated.
The complexity of this question has been recognized by the WHO Expert Committee and other scientific bodies, including the Commission on Narcotic Drugs itself, which called for work that would promote further knowledge in this respect. These bodies also recommended the setting-up of well-staffed pilot projects with built-in evaluation schemes to test the efficacy of treatment programmes carried out in different contexts, including the penal setting.
(To be continued in No. 1 of vol. XXV.)