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The Traffic in Narcotics by Harry Anslinger |
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THE TRAFFIC
by H. J. ANSLINGER United States Commissioner of Narcotics And WILLIAM F. TOMPKINS United States Attorney for the District of New Jersey Former Chairman, Legislative Commission to Study Narcotics, General Assembly of New Jersey XI SOCIOLOGICAL IMPLICATIONS
THIS CHAPTER CALLS ATTENTION TO CERTAIN FACTORS INHERENT IN the over-all picture of Narcotics. Besides surveying addiction in the United States historically and outlining the general situation today, there will be found in the latter section-in the form of a discussion--- a review of the world situation and the questions that are being currently raised looking to a better solution to the problem. DRUG ADDICTION IN THE UNITED STATES Three quarters of a century ago, narcotic addiction in the United States was almost eight times as prevalent as it is today. In 1877, the estimated number of narcotic users was 1 in every 400 of the population; in 1952, the number was not more than one out of every 3,000. In 1909, when the first deterrent anti-opium law was passed in the United States, addiction to narcotics had become so widespread that imports of opium had reached the almost incredible figure of 628,177 pounds annually for a population of 50,000,000 people. Today, when the population is 155,000,000, annual consumption averages less than 861,000 pounds. When the Harrison Act was passed in 1914, there were perhaps 150,000 to 200,000 narcotic addicts in the United States, or about 1 in every 460. Remedial legislation had the effect of scaling down addiction until in World War I, only one man in 1,500 drafted was found Page 263
THE TRAFFIC IN NARCOTICS Page 264 to be a drug addict. (There was a deviation from a straight decline in a rather sharp upsurge after World War 1, and in 1924 it was estimated by the United States Public Health Service that there was I addict in every 1,000 of the population.) As the result of vigorous enforcement of the Federal narcotic laws, the figure had droped to 1 man in 10,000 in World War II. When that war ended, addiction was probably at the irreducible minimum. A temporary upswing in addiction occurred again in the postwar period, as predicted by the Federal Bureau of Narcotics. (See The Police and Narcotic Enforcement in Chapter VIII for discussion of teen-age addiction.) When hearings produced substantial evidence that stiffer sentences reduce both drug traffic and addiction, and that sentences had been getting progressively lighter to the point where they were no deterrent, Congress passed the Boggs Act which was approved by the President on November 2, 1951. Until passage of this law, the maximum sentence was ten years but the average sentence served was a year and a half; no distinction was made between first and subsequent offenses. The Boggs Act makes mandatory minimum sentences of two, five, and ten years in Federal convictions for drug trafficking-with no parole, probation, or suspended sentences for second or third offenses. The action of Congress in providing more adequate Federal penalty legislation and in restoring the enforcement personnel quota of the Bureau of Narcotics to prewar strength was of great help in halting the increase in drug addiction which, fortunately, was not general throughout the United States but was confined for the most part to the large cities in some six States. After the peak of the postwar increase in addiction had been passed (1950), the Bureau reported in 1952, with a reasonable degree of certainty, that the ratio of addiction was not more than I out of every 3,000 of the population. The drug addict population of the United States Public Health Service Hospitals was decreasing, and fewer juvenile addicts were coming to the attention of the authorities. Details regarding addiction surveys are given below.
SOCIOLOGICAL IMPLICATIONS Page 265 PREVALENCE OF DRUG ADDICTION IN 1877 In a survey conducted in 1877 in Michigan by the State Board of Health, it was estimated that the total number of drug addicts in that State was 7,763 when the State's population was 1,334,031, or 516 per 100,000. It was estimated that there were in the entire United States 117,000 addicts in a population of 46,000,000, or 1 in every 400. (In 1877 in Adrian, Michigan, there were 116 drug addicts out of a population of 10,235, or 1 in every 100 of the general population. In a survey made in 1938 by the Federal Bureau of Narcotics, no nonmedical drug addicts could be found in Adrian.) ARMY FIGURES ON DRUG ADDICTION IN WORLD WAR I COMPARED WITH WORLD WAR II In a letter dated September 28, 1945, addressed to the Commissioner of Narcotics from Major Harold F. Dorn, Director, Medical Statistics Division, Army Service Forces, it was reported that roughly 1 man in 10,000 selective service registrants examined for military duty during World War II was rejected primarily because of drug addiction. This was a reliable indication of an impressive decrease in drug addiction, in comparison with World War I figures, when there were 3,000 rejections for drug addiction in an army of 4,500,000 men, or 1 man in 1,500. DRUG ADDICTION IN 1924 In 1924, the United States Public Health Service made a survey on the prevalence and trend of drug addiction in the United States which indicated that there was at that time 1 addict supplied by the illicit traffic in every 1,000 of the general population. DRUG ADDICTION IN 1937-1938 During these years the Federal Bureau of Narcotics conducted a survey on the prevalence of drug addiction which showed that addiction had decreased to the extent that there were then less than 2 nonmedical drug addicts known to the authorities in every 10,000 of the population. While an actual count was not made in every State in the
THE TRAFFIC IN NARCOTICS Page 266 Union, it was considered that the extent of drug addiction shown in the following 15 States, representing 25 percent of the area and 27 percent of the population of the continental United States, was fairly representative of the remainder of the country:
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NARCOTICS AND CRIME; ITS IMPACT ON SOCIETY The most valuable and informative contribution to our knowledge of the relationship between drug addiction and crime is the statistical research conducted prior to World War II regarding opium smokers of the Japanese Colony of Formosa by Dr. Tsungming To of the Health Commission of Formosa, who is now a member of the faculty of Medicine, National Taiwan University, Taipeh, Formosa. After classifying 57,073 crimes committed during a seven year period by natives of Formosa, his records show that based upon the relative proportion of opium smokers to non-smokers, 70.83 percent criminality was found among opium smokers as against 29.17 percent criminality among non-smokers. In Formosa during the period covered by the survey, opium smoking was legalized and its users licensed by the government. The cost of the opium was a few cents a day. Under these conditions the only attributable cause for greater criminality among narcotic addicts than nonaddicts is the direct effect of the use of narcotics upon the moral fiber of the addict. Dr. To concluded that drug addiction causes a relentless destruction of character and releases criminal tendencies. This is particularly interesting in view of the fact that some persons in this country claim that addicts become antisocial after addiction because the high cost of contraband drugs practically forces individuals of marginal economic status to resort to illegal sources of income, usually through the sale of narcotics or larceny.
THE TRAFFIC IN NARCOTICS Page 268 The records of the Federal Bureau of Narcotics show a strong relationship between crime and drug addiction, both before and after the individual becomes addicted. The underworld has been for many years the principal recruiting ground for new addicts. In studies made of representative groups of narcotic law violators by the Bureau, it has been found that many criminals who had long previous police records of a nonnarcotic nature later became drug addicts.
BY WAY OF ILLUSTRATION As illustrations of criminal records of addicts (before addiction), the following are cited:
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In the records of 2,047 narcotic cases showing one or more prior convictions of the violators, there were shown 5,669 prior convictions of major offenses, and 2,309 prior convictions of minor offenses, or a total number of 7,978 prior convictions.
Many police officers throughout the country support the observations that drug addiction shows up as one of the later phases in the criminal career of the addict. The following is quoted from a letter written by the detective sergeant in charge of the Narcotic Division of the Bureau of Police, Philadelphia, Pa., to the Commissioner of Narcotics:
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The following excerpts are quoted from a letter addressed to the Commissioner of Narcotics by an Inspector of Detectives at Pittsburgh, Pa.:
A commanding officer of the Narcotic Detail of the Los Angeles Police Department made the statements that "at least 98 percent of all narcotic addicts are also engaged in other criminal activities"; and "a great many of the bank bandits, drug store bandits, kidnappers, etc. were found to be narcotic addicts." The records of the members of the notorious Whittemore Gang show that they all used drugs. One was condemned to be hanged, and two to suffer forty years' imprisonment each. A heroin addict in San Francisco, California, was convicted of murder during the early part of 1951. It was established beyond reasonable doubt that the murderer had taken an injection of heroin about one hour before the crime was committed. In Chicago, a narcotic agent saw a narcotic drug addict take an injection of heroin. About an hour later when the addict was taken into custody he violently resisted arrest and severely injured one of the arresting agents. A gang of four armed robbers who had committed numerous robberies in Chicago and elsewhere all were addicts, and according to the signed statement of one, they all took an injection of heroin shortly prior to perpetrating their crimes.
SOCIOLOGICAL IMPLICATIONS Page 271 The following paragraph is quoted from the book Dangerous Drugs by Arthur Woods, former Police Commissioner in New York City:
The following excerpts are quoted from statements made by an expert on narcotics, judge Twain Micbelsen of the Municipal Court, San Francisco, California:
Judge Michelsen, in refuting the observation that big-shot criminals are not addicts, cited some names and records of bigshot addicts as follows:
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Judge Michelsen quotes from a statement by a member of the Los Angeles Police Department:
The ranks of both addicted and non-addicted drug peddlers are filled with persons dedicated to a life of lawlessness, and the arrest and incarceration of these people on narcotic charges has incidentally protected the public from the depredations of thieves, robbers, and other vicious criminals engaged in organized crime. SOCIOLOGICAL IMPLICATIONS That crime and narcotics are interwoven is illustrated by the fact that narcotic drug violators are near the head on the list of all criminals in the United States having previous fingerprint records, which include crimes ranging from vagrancy to robbery, forgery, counterfeiting, burglary, and other serious offenses. Of the narcotic violators arrested during the year 1950, 70.3 percent had previous records and arrests. Listed below are the criminal records in a few run-of-the-mill cases of individuals convicted of Federal narcotic law violations in a six-month period:
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In addition to suppressing the narcotic traffic in itself, police activity against drug addicts is a very essential part of general police operations. Addicts in the great majority are parasitic. This parasitic drug addict is a tremendous burden on the community. As Superintendent R. S. S. Wilson, the noted narcotic expert of the Royal Canadian Mounted Police points out: "The ordinary criminal may attempt to go straight, perhaps reform or the fear of punishment deter him but not so the addict; for him there is no reform, 'no road back. For just so long as he is an addict so is he inexorably bound to a life of crime." The situation described below is cited as illustrating the losses suffered by the community through depredations of drug addicts. During a three-year period, two doctors in a certain Virginia city had the reputation of supplying addicts with morphine. The news of the ease with which prescriptions could be purchased and filled there spread to cities and states nearby, and about 500 addicts flocked there from North Carolina, the District of Columbia, Tennessee and cities in Virginia, South Carolina, Georgia, and Maryland. These addicts were known not to have a medical need for narcotic drugs and the majority of them had previous criminal records. The Bureau of Narcotics was unsuccessful twice in bringing these doctors to trial. Meanwhile, their business thrived. Before cases were finally closed against the doctors, crime in that city had increased due to the presence of those addicts, as shown by the following figures:
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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.
THE TRAFFIC IN NARCOTICS Page 276 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:
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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. THE TRAFFIC IN NARCOTICS Page 278 (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. DISCUSSION AT MEETING OF THE WASHINGTON PSYCHIATRIC SOCIETY ON THE CONTROL OF THE NARCOTIC ADDICT AND CONTEMPORARY PROBLEMS 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. The Commissioner: 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
SOCIOLOGICAL IMPLICATIONS Page 279 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.
THE TRAFFIC IN NARCOTICS Page 280 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
SOCIOLOGICAL IMPLICATIONS Page 281 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. Cocaine Traffic in the United States 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. Heroin 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. Addiction in the United States 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
THE TRAFFIC IN NARCOTICS Page 282 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,
SOCIOLOGICAL IMPLICATIONS Page 283 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
THE TRAFFIC IN NARCOTICS Page 284 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
SOCIOLOGICAL IMPLICATIONS Page 285 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) Dr. Kenneth W. Chapman: 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
THE TRAFFIC IN NARCOTICS Page 286 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: Addiction is a state of periodic intoxication detrimental to the individual and to society, produced by the repeated administration of a drug. Characteristics are compulsion to continue taking the drug and to increase the dose, with development of psychic and sometimes physiological dependence on the drug. Finally, maintenance of drug supply becomes the individual's paramount motivation. 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
SOCIOLOGICAL IMPLICATIONS Page 287 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
288 THE TRAFFIC IN NARCOTICS 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 SOCIOLOGICAL IMPLICATIONS 289 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. QUESTIONS Dr. Davison to Dr. Chapman: So far as the clinics before World War I are concerned, why did they fail? Why do you think they are likely to fail? Dr. Chapman: 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.
THE TRAFFIC IN NARCOTICS Page 290 The Commissioner: 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. Dr. Chapman: 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
SOCIOLOGICAL IMPLICATIONS Page 291 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 Commissioner: 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. Question to The Commissioner: You mentioned constitutional blocks to legislation for compulsory treatment of addicts. At least two States have laws for compulsory treatment of alcoholics. The Commissioner: 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
THE TRAFFIC IN NARCOTICS Page 292 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. Question to Dr. Chapman: I am interested in any psychological studies carried on concerning pleasure, the hedonic scale. Dr. Chapman: 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. Dr. Williams to Dr. Chapman: 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. Dr. Chapman: 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.
SOCIOLOGICAL IMPLICATIONS Page 293 Dr. Herbst: 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. The Commissioner: 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. |