These figures do not include arrests for shoplifting and other small thieveries.

A chief of police in a western city, in commenting on narcotics and crime stated: "I fully realize that any gain in the illegal use of narcotics has a direct relation to the increase in crime, and, conversely, where narcotic traffic is suppressed, crimes become less frequent. I have, therefore, increased the number of officers assigned to our narcotic squad in order that we might more effectively combat this evil."

In a report (1936) by the Narcotic Educational Association of Michigan, Tue., covering ten years' work in the operation of a farm for the cure of drug addiction, an analysis of 83 cases handled at the institution divulged the information that only 9 of the addicts had been gainfully employed; 2 were maintained by relatives; and 72 had been engaged in various types of crime as a means of livelihood.

In 1924, a special committee of physicians prepared a report on the ambulatory treatment for drug addiction, which was adopted by the American Medical Association and printed in its journal, reading in part as follows:

Your committee desires to place on record its firm conviction that any method of treatment for narcotic drug addiction, whether private, institutional, official or governmental, which permits the addicted person to dose himself with the habit-forming narcotic drugs, placed in his hands for self-administration, begets deception, extends the abuse of habit-forming narcotic drugs, and causes an increase in crime. Therefore, your committee recommends that the American Medical Association urge both Federal and State governments to exert their full powers and authority to put an end to all manner of such so-called ambulatory methods of treatment of narcotic drug addiction, whether prescribed by the private physician or by the so-called narcotic clinics or dispensary.

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The following is quoted from statements regarding "The Criminal Addict" made by an expert on narcotics, judge William T. McCarthy, U. S. District Court, Boston, Massachusetts:

The Harrison Narcotic Act and the Narcotic Import and Export Act are very efficacious laws. They are a part of the golden treasury of laws that help to preserve our social order and we should resist with all the power at our command any attempt to interfere with their proper administration.

Both logical reasoning and demonstrable facts place the great group of narcotic addicts in the category of criminals first and addicts later. The crook and the hoodlum, the prostitute and the shoplifter are most frequently and freely exposed; therefore, their ranks logically contain a large percentage of recruits to drug addiction.... With few exceptions the use of narcotics is not the efficient cause of the presence of the addict in the underworld; he is usually thoroughly conversant with a dubious environment long before he becomes addicted. . . . In attempting to dispel the conception that the opiate addict is a dope fiend who is stimulated to crimes of violence, too much emphasis is placed on the soothing effects of opiates. . . . The drug that allows a patient to contemplate the surgeon's scalpel with equanimity also gives the irresponsible criminal a false sense of security and serves as an obvious explanation in . many instances for the commission of very serious crimes....

The statement, "The long criminal records which drug addicts sometimes accumulate must be studied carefully," implies that these records arise from addiction. I agree that the records of these people should be carefully examined, but such records usually disclose a first arrest for something other than narcotics. While it is not conclusive, it gives rise to the presumption that the man was a criminal first and an addict afterward. Even where the first arrest is for narcotics, careful examination often discloses criminal or borderline activities before the narcotic agent happened to apprehend him. . . .

Dr. J. Bouquet, the French expert, in his remarks included in the papers of the 24th Meeting of the Opium Advisory Committee at Geneva, Switzerland, referring to a North African situation, makes these trenchant comments: "Nothing, I think, can be expected from methods which liken a toxicomaniac to a sick person and not to an offender. Such methods are only applicable to the class of drug sufferers who, as the result of necessary temporary medical treatment, have become accustomed to morphine or heroin.... But it must not be forgotten that this class constitutes a very small group of toxicomaniacs.

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The majority have no desire to become cured; it consists only of depraved people who are not only useless to the community but dangerous to the public welfare because they have only one desire, that is to find a means to satisfy their vice however ignoble the means to be employed to that end may be. In my opinion, such people should be considered not as sick people worthy of pity but as delinquents who must be prevented from causing harm and who must be treated with the greatest severity."

In a report dated July 25, 1943, on "The Present Drug Addiction Situation in Tunisia" Dr. Bouquet states, "It is argued that 'the majority of the drug addicts are vicious criminals and that they deserve to be imprisoned rather than placed in hospitals."'

Several years ago, the Canadian Government conducted a study on narcotic criminality. It showed that 93 percent of those convicted of narcotic offenses during the period under review had committed at least 1 crime prior to the first narcotic offense, and some had committed as many as 27 other crimes prior to the first narcotic offense. Two hundred persons convicted had committed a total of 2122 crimes, of which only 465 were narcotic crimes.

It was the conclusion of Canadian authorities that over 95 percent of all drug addicts are criminal addicts; and that in nearly all of these cases the addict was a criminal before becoming addicted; addiction was caused by criminal association.

The General Secretary of the Department of Public Health, Mexico, D. F., Mexico, reporting on observations made with respect to 150 drug addicts in the Federal Penitentiary, stated that "in almost all of the cases the prisoners give as the reason for their addiction having been influenced by vicious friends."

The most casual inquiry would disclose that there are among the population of Federal and State penitentiaries in the United States a large number of non-addicted drug peddlers. In those ranks one will find a substantial proportion of big-shot racketeers ranging from the arrest and conviction of persons such as Louis (Lepke) Buchalter, head of the notorious gang, Murder, Inc.*

* in that capacity, it was alleged that he had ordered the deaths of anywhere from sixty to eighty men, and had manipulated simultaneously some 250 criminal ventures, with at least 300 straw bosses and a staff of irresponsible triggermen, strongarms and industrial saboteurs. Buchalter was eventually convicted of first-degree murder and executed in 1944.

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(not only an interstate but actually an intercountry and intercontinent organization which obtained its narcotic supplies in China and distributed them from New York throughout the country); the Newman (Neiditch) brothers of New York City (who were important enough to have at one time corralled the entire illicit drug supply being exported from France to the United States), and extending back in the past to the capture and imprisonment of figures like the Ezra brothers and "Black Tony" Parmagini. (In 1930, Antone Parmagini, alias "Black Tony," who had been "king" of the racketeers on the Pacific Coast, was convicted of narcotic law violations and sentenced to serve seventeen years in the penitentiary and fined $17,000. William Levin, a confederate, was given a similar sentence and fined the same amount in 1930, when he and Parmagini were considered the largest drug smugglers on the Pacific Coast. It was then estimated that their drug smuggling had netted $50,000,000 annually.)

There is ample evidence that few of the non-addicted big shots in the narcotic traffic finally escaped the law.

December 17, 1952.

SPEAKERS: H. J. Anslinger, U. S. Commissioner of Narcotics; K. W. Chapman, M.D., Medical Officer in Charge, U. S. Public Health Service Hospital, Lexington, Kentucky.

If our definitions were simple with relation to drug addiction and addiction-forming drugs, we would indeed be fortunate. I am going to let Dr. Chapman handle that part of the subject be

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cause we have been in much controversy in international committees over the definition of addiction.

In order to get a good understanding of the problem we are faced with today, I want to give you a run-down of addiction in various parts of the world as related to this country; it all ties together.

In England, the British Government reports annually only 350 drug addicts known to the authorities-mostly doctors and nurses. When we ask them about the statistics on seizures of opium and hashish, they say: Negroes, Indians, and Chinese are involved. In this country, we don't distinguish; we take the situation as a whole. England, during the past year, has had a surge of hashish addiction among young people. A year ago they were looking at the United States with an "it can't happen here" attitude. Suddenly hashish addiction hit the young people. Ordinarily hashish is only something for the Egyptian, the Indian. Now the British press is filled with accounts of cases of addiction of young people.

Two years ago the French said they had no problem of addiction; perhaps a little cocaine was being used. Recently we helped the French Sureté uncover three heroin factories in France. The French admitted that probably 400 kilos of heroin were manufactured clandestinely in France last year. Incidentally, the trade in heroin has been prohibited by some fifty nations.

The nation I thought would hold out to the last against controls was Switzerland, but they have now prohibited the manufacture and consumption of heroin.

There has been a big surge of addiction in Germany since World War 11. Prior to that, the Nazi regime bore down heavily on the addict, and had the situation pretty well in band. There are signs of a great spread of addiction again. We have tried to set up an organization in West Germany to combat the narcotic traffic.

There is some cocaine addiction in Italy, and some in Czechoslovakia.

The representatives of the USSR tell us that there is no addiction in the Soviet Union. I have reminded the Russians of the eight tons of smoking opium seized along the Siberian border. That indicates addiction.

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Some of the worst addiction spots are in the Near and Middle East. In Istanbul, Turkey, addiction is far higher than it is anywhere in the United States. There is uncontrolled production of opium, and no control of distribution. Almost every shop in the opium growing centers sells opium. There are many clandestine heroin laboratories operating.

Egypt has suffered most from addiction; it is a victim country. There is no production there, only consumption. General Naguib recently decreed that an addict would serve fifteen years at hard labor; a peddler would be executed. The result of this decree is, of course, as yet unknown.

Iran once had a government opium-smoking monopoly. They have introduced in their Parliament a law providing the death penalty for anyone caught, smoking opium.

India has made rapid strides in controlling addiction, despite the fact that many addicts there have a quasi-medical need to eat opium. The All-India Congress has decided that by 1958 all such consumption must cease.

During World War 11, we succeeded in having the British, French, Portuguese, and Dutch abandon across-the-counter selling of smoking opium in their possessions. As a result of that action the situation has greatly improved but there is still some illicit traffic.

Only one government in the whole world legalizes the sale of opium for smoking-Thailand. The opium comes from Yunnan and Burma, and is sold in government shops.

In Communist China there is a great deal of opium smoking, and a great deal of heroin used. We get some of these drugs on our Atlantic and Pacific Coasts.

Japan, strangely enough, is overrun with heroin addicts and peddlers--- a situation very different from what it was before the recent war. Our agents, in cooperation with the Japanese Government, have uncovered the activities of a great many Communists engaged in smuggling.

North Korea has the largest opium production of any country in the Russian orbit.

There is relatively little addiction in South America, some use of marihuana in Brazil. Peru and Bolivia produce coca leaves

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from which cocaine is derived. Indians there have been chewing coca leaves for many years. A commission sent there from the United Nations to study the situation found that the practice was largely a result of malnutrition.

There is much addiction to cannabis (marihuana) in Mexico. Mexico has a large illicit production of marihuana.

By 1948 we could scarcely find one cocaine seizure in all those that we made in this country. Suddenly the country was flooded with cocaine. It was found to be coming from Peru. The government there had allowed seventeen factories to operate, producing cocaine. There is only one factory in this country and we manufacture for 155 million people. Your Commissioner went to the Peruvian Ambassador and succeeded in having the President of Peru close all the factories. In six months there was a phenomenal change in the prevalence of cocaine addiction--- it had almost disappeared again.

Most of the heroin smuggled into this country comes from old stocks in Italy. Italy didn't live up to her treaty obligations very well. She estimated for manufacture ten times more heroin than was needed or used. Finally we got an agreement from her suspending the further production of heroin.

Much of our heroin comes from Turkey and some from China.

Heroin is the most popular drug with addicts in this country today. As bought by addicts, the drug is from 5 to 8 percent pure. After the smuggler "cuts" it, the wholesaler and retailers all "cut" it. Users pay $3,000 an ounce for heroin here; it costs $100 an ounce in Turkey.

In the New England States there is relatively little addiction. The big addiction centers are large cities: New York, Philadelphia, Washington, Baltimore (last year they took effective action there), Chicago, Cleveland, Detroit, Los Angeles.

We have been able to get especially good cooperation in New

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Jersey. New Jersey leads the States in efforts to combat addiction. They approached the problem in a very intelligent way. The

Legislature established a commission of very able men who came up with a set of recommendations, all but one of which were adopted, (The one not adopted was a plan for establishing a farm for the treatment of addicts in southern New Jersey, in an old CCC Camp). They established narcotic squads in the State Police and in local police forces in the cities where they had a problem. We matched them man for man.

It's a curious thing about the State of Pennsylvania. There is rather heavy addiction in southern Philadelphia, then none until YOU get to Pittsburgh. Washington has a very substantial problem. In Baltimore, a year ago, they were finding fifteen-year-old boys dead in the gutter from an overdose of heroin. The government was going to place some beds in state hospitals for addicts. Maryland adopted a very stiff penalty law for peddlers, and judges in Baltimore really gave sentences to peddlers: two, five and ten years for first, second, and third offenses. There the situation has been cleaned up by enforcement measures.

In St. Louis, Missouri, one Federal judge said, "Bring me your big peddlers." They invariably got eighteen years for peddling, and this practically wiped out the narcotic traffic in St. Louis.

Michigan has taken the problem seriously. In Detroit there was a very bad situation a couple years ago. Seventy-eight teenagers were brought before the Grand jury. They were not school children, but were of school age. Michigan passed a law providing

that first offenders-peddlers-get twenty years to life imprisonment. This had a very sobering effect on peddlers in Detroit. A peddler is an innate gambler: he will gamble on being caught,

on how much of a sentence he will get, and so on.

in Chicago, some citizen groups established an advisory council in an attempt to solve their narcotic problem. They advised the family and the victim, before and after cure. They have furnished us useful information.

I almost omitted Texas. We can make more cases in Texas than in any other State in the country. Precisely why, we do not understand. One thinks of wide open spaces and healthful outdoor living in connection with Texas. But there is oil and money,

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and where you have these, you will have pimps and Prostitutes.

Los Angeles has a police squad of twenty-eight men for narcotic investigations. The feeling was that every addict would steal $30 worth of merchandise a day to maintain his addiction; his drugs would cost about $10 a day. If there are police to bring in the peddler and addict, the crime rate would be substantially reduced. A good narcotic agent is worth three detectives.

We have a bad addiction problem in Washington, D.C. If you go across the bridge into Alexandria or Arlington, you don't find addiction. Virginia has a very stiff penalty law. Once in a while we have a few cases in Norfolk or Richmond.

Throughout the South, little addiction is found until you come to New Orleans.

On the State level in this country, we have the Uniform State Narcotic Acts. The one in the District of Columbia is not very strong. On the international level, we should thank God for the United Nations, if only for what they have done on international narcotic control. International treaties lessened the manufacture of morphine from 100 tons a year to 40 tons a year, the manufacture of heroin from 5 tons to 1-1/2 tons, cocaine about the same.

Nearly all the traffic in drugs today, with the exception of diversion from Italy, is underground. Some years ago it thrived

above ground; there was no control. Today, almost every nation observes protocols limiting manufacture and distribution. Every nation must make an estimate of its medical needs. Those estimates are added, and that amount is manufactured throughout the world. Every country is put on its honor to manufacture only for legitimate needs. Furthermore, exporting drugs involves the use of import and export certificates of various governments. All governments have adhered to the Hague Convention requiring that all persons handling narcotic drugs must be licensed. We are working now on a protocol to limit the production of opium. It has already been drawn up and will be considered in May 1953. So far as synthetic drugs are concerned, all nations are bound by protocol to produce only for medical needs. If it weren't for that protocol, this country would be flooded with synthetic drugs.

The Michigan Medical Society in 1878 made a survey in which they found that one out of 400 was sniffing cocaine, smoking or

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eating opium, or using morphine. I know a little town not far from here where the records in the drug store show that Out Of a population of 600 people, 60 used laudanum--- mostly women. The proportion in the past, by the way, was four female drug addicts to one male. That proportion is reversed today.

It is interesting to see Army records on narcotic addiction. Here are records you can rely on; these draftees are pretty well screened by the doctors. During World War 1, one out of 1500 was rejected for drug addiction. This was a good indicator of the general incidence of drug addiction, both our Bureau and the U. S. Public Health Service found. Then came all the international actions: reductions in world drug manufacturing totals. In World War 11, one out of every 10,000 was rejected for military service for drug addiction. This reduction makes us feel pretty good.

Wardens ask us what has happened to the drug addict; they don't see him any longer. By 1948 Congress was seriously considering closing the U. S. Hospital for the treatment of addiction. I argued that they should maintain it; that it was the only place in the world where research was being done. I pointed out that we were going to get an upsurge of addiction again as it is well

known that drug addiction always increases after a war. At that time there were only about 700 addicts in the hospital. Reason prevailed and the hospital was kept in operation. Data on the prevalence of drug addiction since World War 11 are available only on Selective Service registrants examined during September and part of November 1948, and represent highly depleted age groups. They show higher prevalence rates for drug addiction than the corresponding rates for World War 11. (The total rejection rate for all defects during this period was over twice as high as during World War 11.)

The over-all picture doesn't look too bad because we are not standing alone in this struggle. We have international action. Most of the states aren't doing too good a job but many cities are doing quite well. New York City, I think, is the only place where they have established a hospital for teen-age addicts, The Federal hospitals have to bear the burden of the whole country. You have to have all these things operating. You must apprehend peddlers

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and smugglers, and you must have all countries adhere to international treaties. If it weren't for the international action, we would have a million drug addicts in the United States.

We only arrest the peddlers; we don't go after addicts as such. About 70 percent of the peddlers are addicts. In the higher echelons of racketeers, addiction isn't usually found.

In the District of Columbia, there is much to be done. Experts are drafting legislation for compulsory treatment of drug addicts, but it's rather a difficult legal question to handle. It's always a serious matter to deprive persons of some freedom. I think it could be handled on a State and local basis. New Jersey has a law providing that an addict may be given one year as a disorderly person. The judge may suspend sentence if the addict submits to hospitalization. (A compulsory hospitalization Law for drug addicts in the District of Columbia was passed by the Congress in June, 1953)

At the risk of being repetitious, I shall have to refer to some of the points already raised for the sake of coherence. I hope you will bear with me.

In 1914 the Harrison Narcotic Act was passed, after efforts on the part of numerous persons. Dr. Lawrence Kolb, for example, felt that there were about 100,000 addicts on the East Coast alone. He also supported Mr. Anslinger's point that the ratio of men to women was inverse to what it is at the present time.

I am concerned primarily with the treatment of narcotic addiction. I beg your indulgence for not answering other questions.

In the past some States have attempted to handle and treat narcotic addicts cut off from their supply. Free clinics were also tried and closed as very unsatisfactory. The Harrison Narcotic Act, by the way, is a tax act. Federal offenders against the Harrison Narcotic Act were first sent to Leavenworth, Kansas. An old army annex was used for segregating addicts. It was felt that they were an unusual breed of criminals. They desired to prevent cross contamination.

Early in the 1930's a unit developed at Leavenworth for study and treatment-research in narcotic addiction. Dr. Himmelsbach

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did some work there. Later he came to Lexington and did a great study on withdrawal. Also in the early 1930's Dr. Lawrence Kolb, Sr., and Dr. Walter Treadway worked to develop special institutions for hospitalizing addicts. In 1935 came the opening of the hospital at Lexington. Actually, it is only a hospital in the most general sense of the word. It is a kind of penal institution, with certain hospital aspects. In 1938 the hospital at Forth Worth, Texas, opened, with 900 beds. The Fort Worth hospital is much less like a penal institution and has more of a hospital atmosphere.

Lexington has a program for research. The National Institute of Mental Health now operates an addiction research unit. From that much of our knowledge has been obtained, largely, of course, from the pharmaceutical angle. The unit is primarily charged with investigation of new drugs, in the unending attempt to find one which will be analgesic and non-addicting. It's surprising how close we have sometimes been to finding one. I have some doubts, though, that it will ever be obtained. There are 2,200 Federal beds available now for the treatment of narcotic addicts.

Now, to consider briefly the term "drug addiction." The Committee on Drug Addiction of the National Research Council furnishes us with this definition:

This offers very little assistance to us in understanding why a person takes the first dose. It does emphasize the compulsion to take drugs, and has important implications.

Since there is some misunderstanding, even among those interested in the drug addict, about the drugs concerned, we might say something about them. There are two groups, the excitatory (stimulant) drugs and the depressants. Cocaine is an excitatory drug; it gives temporary sensations of ecstasy, then extreme nervousness, then paranoid delusions. This is the prototype of the drug fiend of the yellow press. Cocaine is not a truly addicting

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drug, although users may compulsively continue to take it. Once they cease, there is no necessity to continue to prevent withdrawal effects. However, it is interesting to talk to addicts concerning cocaine; very few use it. One addict that I spoke to said: "If you aren't nuts before you use it, you sure are after." That summarizes the feeling of most addicts.

Marihuana is a depressant, in spite of early excitatory effects: exhilaration, euphoria, release of inhibitions, visual and auditory hallucinations. There is no physical dependency. Peyote, used by some Indians in the West, is also in that category. Other depressants include heroin, morphine, alcohol, barbiturates,

So far as the truly addicting drugs are concerned, a tolerance is developed, and there is physical illness when abruptly ceasing prolonged use.

It is often puzzling to doctors to have an addict who is physically ill, one with cancer, far advanced, for instance. It can't be determined that he needs drugs, yet he screams for them. These are difficult people to treat; they continually pose a problem. It might be noted that narcotic agents don't bother people using drugs for bona-fide illness.

It might be thought that a study of the physiological characteristics of addiction would give us some insight into why people use drugs, but it is very difficult for you and me to interpret what a person means by "feel normal ... .. get a bang," and so on. It is hard for us to appreciate what is involved in these subjective descriptions.

I would like to say here that we have developed certain premises accepted by those interested in drug addiction which we think offer the most rational explanation for addiction. We take drug addiction to be a symptom of personality disturbance, of character disorder all the way from a criminal psychopath through the major psychoses. We have not as yet developed screening paraphernalia to separate. We can assume, on the basis of present knowledge and extrapolating, that there are many more addiction-prone individuals running around in the world who have not yet had contact with drugs. That is reason enough, if there were no other reason, for the existence of the Commissioner and the whole control program. We feel that the potential

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addict is an emotionally unstable, immature individual seeking excitement and pleasure outside the usual realms, unable to adjust to pressures of today's world, the "lone wolf." He differs from the normally adjusted person in that he has no adequate defenses to handle anxiety. Drugs seem a substitute for inadequate or pathological defenses; they make him "feel normal." Experiencing some relief, he goes down the road in the flight from everyday living. He has a psychic need for drugs. The more drugs he uses, the more money he needs for drugs. Tolerance becomes a new factor, and any prolonged abstinence makes him feel real sickness, so that all else is forgotten. He may rob, steal, deny his family, sell home furnishings to obtain drugs. He may kill anyone who stands in his way. These are extreme examples, of course, rare in our experience.

Many user-peddlers are peddlers because of lack of funds to satisfy their habit. These are dangerous, especially because of their tendency to seek out others to use drugs.

What can be eliminated from the environment to help? Control represents a herculean task. With the few people that the Commissioner has, I don't see how he does as well as he does. There is a need for even greater controls than now exist.

Can the addict be cured? In the sense that TB can be cured, or arrested, yes. No, if you expect the addict never to return to the use of drugs. Any period of time of living without drugs for an addict is a sign of success. What can we offer an addict? First, he must submit to treatment in a drug-free environment. Second, he must be withdrawn humanely and gradually from drugs. Third, after withdrawal he must be allowed to recuperate, to recover his balance. During this period we can assay personality assets, make a prognosis. A relatively short period of addiction, of course, offers the best chance of success, provided that the personality defect is not sufficiently serious. About one fourth of those using drugs for a longer period of time have no serious, deep-seated psychosis. For the rest, it is difficult to foresee. Occasionally an esoteric factor comes into play, and an old addict will suddenly cease using drugs. There are, of course, many recidivists.

What can we do for cases with a good prognosis? We can

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offer them the chance to learn to work, to face their problems, to play. Incidentally, we have dropped the idea of "come to seek"; we find that those who come for psychotherapy of their own volition derive the least benefit from it.

The length of treatment has great significance, and we don't know much about it. The longer a patient stays at the hospital, the less likely he is to return. After six months, most patients seem to gain little from intramural treatment. Yet, after release from the hospital, there is very little chance for the addict to continue treatment outside. We must develop, I feel, some means to continue extramural treatment if we are to be successful in our treatment of addiction. These people need guidance, etc., for several months after release from the hospital. Many return to the same old problems, broken homes, etc. They are easily led to their old patterns of problem solving-drugs. We suspect that the more often this is repeated, the less the person is able to make the effort. Fifty-five percent of those admitted to the hospital are new cases. There is great need for cooperation between enforcement officers and medical officers. Post treatment for the addict is difficult. Society is gradually willing to forgive a prisoner, but not an addict. I think the never never land would be reached if the public could know that of the 18,000 addicts at Lexington from 1935 to 1952, 64 percent never came back, 21 percent came back once, 6 percent returned three times, and 9 percent came back four or more times. There might be increasing confidence in the possibility of restoring the addict to society.

So far as the clinics before World War I are concerned, why did they fail? Why do you think they are likely to fail?

On the "why they failed," I would like to refer you to the Commissioner, as my senior. He has been in this field longer and has some evidence on this.

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You couldn't handle the marihuana smoker under a system like that. He certainly wouldn't be licensed to get prescriptions from a doctor for marihuana. Dr. Chapman told you about the cocaine addict: "If you're not crazy before, you are after." I do not think you are ever going to license a cocaine addict to get supplies from the Government.

New York State had these clinics. Dr. Royal Copeland, who established them, said only about one third of those addicted ever would apply, and a lot of those took their drugs out and sold them to non-registered addicts. Corruption and blackmail developed. New York closed those clinics, and not at the request of the American Medical Association.

Shreveport, Louisiana, had the biggest clinic of all. The citizens made such an uproar that they closed it. Every thief within a hundred miles went to Shreveport.

No government in the world conducts such clinics, no matter what is said about England. What about all the seizures there? What about the trouble doctors are having keeping their bags from being stolen?

Our Supreme Court has ruled in several cases that it is unlawful to prescribe narcotics for an addict just to keep him comfortable. That is so far as our present law is concerned, of course. If there were a new law, there would have to be a new ruling.

Japan had clinics in Formosa. Dr. Tsungming To ran those clinics. He found that of the criminals arrested in Formosa, 70 percent were opium smokers who got supplies at cost from the government; 30 percent were non-smokers.

There are many obstacles. I don't think you could devise a system whereby everybody would go to the authorities to register. They would take part of their supply and sell it to the addict who wants to stay in the background.

From my knowledge, no two people are at the same level, and it would take more than Solomon to decide what an optimum dose would be, from a medical standpoint. As it is, we don't

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decide. From experience we have determined that almost any

dose will do in a brief withdrawal-five to seven days. A grain

of morphine a day seems to sustain any habit. Consider the addict placed in such a situation: if be would not get what be considered enough in the clinic, he would go around the corner and get it from a peddler. If you were to hand out a day's supply at

once, ten friends would come in and help out with his supply.

Twenty-four hour clinics would be necessary, and clinics all over

town.

The clinic idea is not a new one. It has been in print ever since the Harrison Narcotic Act was passed. When drugs could be purchased at low prices by addicts in this country, the imports in one year (1897) rose to unbelievable heights: crude opium 1,072,914 pounds; smoking opium 157,000 pounds; morphine 15,000 ounces. At that same rate of consumption--- if addicts were permitted to obtain drugs similarly in clincs today-we would have to import over 3 million pounds of opium a year, or ten times our present imports for medical needs, 350,000 pounds. That alone should be argument enough against the establishment of clinics.

You mentioned constitutional blocks to legislation for compulsory treatment of addicts. At least two States have laws for compulsory treatment of alcoholics.

An individual State can bring about compulsory treatment. I don't think the Federal Government can do it. Wisconsin and Minnesota have compulsory commitment. It is the same statute which provides commitment of insane persons. In those two states, one addict to every 25,000 of the population is the ratio. The addict doesn't want to be caught in one of those county hospitals with the insane. California had an institution for treatment of addicts. They picked up the addict as a vagrant. After a while

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the addict population decreased, and they abandoned the hospital. Now it's a problem again.

The problem of the compulsory commitment of addicts in the District of Columbia will be taken up tomorrow.

I am interested in any psychological studies carried on concerning pleasure, the hedonic scale.

I do not know of any studies like that. We have tried, however, numerous techniques to evaluate the pleasurable aspects of narcotics, with no success. I think it is largely a problem of the difficulty in appreciating what the addict gives us in his descriptions.

If pure heroin were used, would there be ill effects? Has there been any experimentation at Lexington using heroin alone? We have been using calcium glucanate intravenously. We can withdraw an addict with no ill effect. All that we look for is the usual hour that they take drugs, then beat them to it. So far we have found Do ill effects.

We have done very little experimentation with heroin. For one thing, heroin is absolutely illegal. Sometimes we get some to compare with synthetics. Heroin is a kind of super-morphine; it wears off much more rapidly than morphine. They say you take heroin for a "bang," morphine for "hold."

So far as the other question is concerned, many investigators in the past have tried various methods of substitution for narcotics, the so-called "sure cures for narcotic addiction." Many "cures" were studied by Dr. Kolb, Dr. Small, and others, and it was found that usually the drug used merely masked the symptoms of addiction. Seeing no particular value in masking the symptoms, we haven't seen any reason for substituting something else. Sometimes the "cure" has made persons nembutal addicts.

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My interest is in advice and suggestion in regard to formulation of legislation the objective of which is, of course, cutting down drug addiction. I have presumed from what the Commissioner has said here that effective means so far add up to heavy penalties which are successfully and conscientiously carried out upon apprehension of these people. I don't know if he would want to take the responsibility of suggesting what points in legislation are the more important ones for the Medical Society of the District of Columbia to back and suggest and argue for. That would interest me very much.

Being an enforcement officer, I naturally look at the results that we have accomplished in New Jersey, Pennsylvania, and Maryland. Maryland, particularly, is an outstanding example of what Federal and local government can do if they have good penalty legislation for the peddler-to make it so unprofitable he won't gamble. The increased penalty act was enforced to such an extent in Baltimore that repeal was demanded at the last session of the legislature--- a session which met only to discuss fiscal matters. The group trying to get repeal was interested in one case--- a college boy, a second offender. The women of Maryland and the American Legion marched on Annapolis, and the repeal bill died in committee. It's very difficult to make a case in Baltimore now. We send undercover men in there occasionally, and they just can't buy drugs. I don't say that that is the answer to our problem here in the District. I don't think you can get tough legislation here. We have the Federal Boggs Act, and we have the Uniform State Narcotic Act which makes drug addiction a misdemeanor. We must have understanding judges, and we must have a place to send addicts.

Stiff penalty legislation has done a lot of good in many States -stiff penalties for peddlers. We give thanks every day for Lexington because we get so many cases which involve need for treatment. You need stiff penalty laws, and you need to commit the addict for treatment.