Drug Addiction, Crime or Disease?

Interim and Final Reports of the Joint Committee of the American Bar Association and the American Medical Association on Narcotic Drugs.

APPENDIX B

An Appraisal of International, British and Selected European Narcotic Drug Laws, Regulations and Policies

ITALY

Italian officials know of only a few hundred addicts, approximately fifty of whom are sent each year to public mental health institutions. It is estimated that in the life of the Italian narcotic drug laws, which have been in force for fifty years, approximately one hundred medical practitioners have been subjected to prosecution.

A recently enacted law34 is considerably more severe, however, and the Ministry of Health is now policing the medical profession rigorously. Supervision is provided through a provincial health officer in each of the ninety two provinces, but when an offense is suspected, the matter is promptly turned over to the police and the Justice Department for processing as a criminal case. A Central Narcotics Bureau has been established, and personnel is assigned to it from the national and local police arms. The new law prescribes mandatory minimum sentences in a comparatively harsh penalty structure.35 Pharmacists are rigidly controlled because of a strict limitation on the number of licenses (15,000 in the country), resulting in keen competition for the right to operate a pharmacy. Any deviation from the regulations as to the keeping of prescriptions and records, when discovered in the course of inspection by the regional health officer or the police, may result in loss of the pharmacy license.

Because of this strict hold on pharmacies, the pharmacist is used as an observer-informant, and if his suspicions are aroused he is expected to communicate promptly with provincial officers. Doctors are also under a direct obligation under the new law to denounce any known addict to the police,36 and their rights to prescribe are limited to bona fide medical purposes which do not include prescriptions for addicts.

Although addicts may be incarcerated directly in a mental health institution by the police, to be held at the discretion of the hospital staff until it is determined whether they can be rehabilitated,37 in practice the police often hold addicts in jail and put them through "cold turkey" withdrawal. The authorities also not infrequently succeed in prosecuting addicts on the basis of their presumed intent to sell illegally, from the fact of possession of large amounts of drugs.

There is a provision by which, after incarceration in a mental hospital and observation by a special medical commission, an addict may be determined to be incurable, in which event the medical commission may recommend that he be permitted a stabilizing regime. In practice, however, this provision is used only for addicts with medical complications.

The largest problem, in the official view, is the transit traffic in narcotic drugs being imported in raw form, and processed for trans-shipment to the United States black market. The special narcotic squads of metropolitan police departments are mostly concerned with this type of smuggling and clandestine manufacturing activity. There is also a considerable amount of forgery of prescriptions, theft of drug stocks, and similar crimes, indicating an unsatisfied demand for drugs.