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

BELGIUM

Belgian narcotics laws impose registration, license and record requirements on the narcotic traffic at all levels: import, manufacture, sale and distribution. Drugs may be dispensed only on prescription, and prescriptions must tally with the doctor's record book and inventory. Nine inspectors constantly check the records of Belgium's 4,000 pharmacies (in a population of 9 million).

Formerly, if it appeared from prescriptions that the doctor was prescribing drugs irresponsibly, the inspector could refer the matter directly to the Department of Justice, which might initiate a prosecution. This has been changed, and the new procedure is for complaints to be referred to a Commission Medical Provinciale. There are nine of these commissions, established on a regional basis, and each inspector (who is also a pharmacist), belongs to one commission. This change is for the protection of doctors, who used to be subjected to almost certain disgrace and ruin in their professions by being put on trial on complaint of the Justice Department regardless of the outcome.

Doctors are also subject to the jurisdiction of one of the provincial medical boards, semi-public bodies presided over by a judge, which have authority to censure them for misconduct or, in flagrant cases, to deprive them of their right to practice medicine. There have been few actions against medical practitioners under these provisions.

Addiction is not a crime per se, but addicts frequently commit petty crimes in connection with sustaining their addiction, so that they are liable to prosecution. The Justice Department uses this as a lever to compel submission for voluntary treatment (detoxification), which is provided in special sections of public mental health facilities. The number of persons in institutions for this purpose varies from ten to twenty-five.

There is probably some illicit trafficking. Convictions for forging prescriptions for narcotic drugs average ten per year. Addiction is almost always medically induced at the outset. In 1954 the pharmacy inspectors detected 203 new addicts in the course of checking prescription records (which is done periodically and does not cover all pharmacies every year); 8 doctors, 3 pharmacists, and 2 addicts were convicted of offenses involving prescriptions; sentences ranged from 15 days to 3 months (suspended in both addict cases), and fines from 500 to 2000 Belgian francs ($10 to $40).33 If a doctor has an addicted patient for whom therapy has failed, he may report the fact to the Commission Medical Provinciale and, with the Commission's approval, he may then proceed to set up a stabilizing regime. He is protected in this, since the local inspector is a member of the Commission. But the number of instances in which such arrangements have been made is trifling.