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|Interim report of the Joint Committee of the American Bar Association and the American Medical Association on Narcotic Drugs, 1958|
Interim report of the Joint Committee of the American Bar Association and the American Medical Association on Narcotic Drugs
by Advisory Committee to the Federal Bureau of Narcotics
JULY 3, 1958.
Note: To fully understand this document, and the context in which it arose, you should also read these other documents which are in the Schaffer Online library:
Excerpts From Remarks by Mr. HARNEY
at Drug Addiction Symposium March 27, 1958
Read History, say the philosophers--read it and heed it, unless you wish to live through its mistakes. How true that is of the narcotic problem. How keenly it is brought home when we listen to latter day pontificating from many people whose acquaintance with subject dates back only to this decade.
We are here, it has been said, to bring Terry and Pellens up-to-date. Let us be sure we do not set them back 50 years.
In the early 1890's reports of Treasury agents showed great concern over the smuggling into the United States of huge quantities smoking opium--from factories in British Columbia among other sources. So great was this influx of smuggled drugs from Canada and so powerless were the officers to deal with it, that the Treasury surrendered to the dope traffic.
Despite the suggestions which have been made (here) which would indirectly bring about the same surrender, I hope we shall never see another instance in which this great Government will adopt such a craven course. To break up the smuggling racket - and how contemporary that sounds today--the United States cut the duty on smoking opium in half from $12 to $6 a pound and in 1895 the supervising Treasury agent complacently announced that while Canadian smuggling had fallen off, imports of smoking opium, legal duty paid at the port of San Francisco had increased greatly--to 138,000 pounds in that year.
Mind you, this was smoking opium, not medical opium, but a poison designed for the lungs of America on which a practical tax collector was interested in revenue only. Many of the people here are living testimonials to the distance we have come from that callous concept of the responsibilities of a government to its people.
I am confident that there always will be people of hard sense in this Government, like many in this group, who will not sell out the American people for the beguiling song of "Taking the profits out of the traffic". For what would it profit this country to change from our present system where the great risks in breaking the law have made profits sometimes very temporarily for a few on a thin trickle of dope. Do we want to change in a direction which might make for a smaller unit profit on a larger volume? Why do we talk about profits? Why should not we be concerned instead for that vast group of potential new addicts, the presently uncontaminated thousands who inevitably would be the victims of freely available drugs if we took the the profit out of the dope traffic.
There is much confusion respecting the progress or lack of it in this country in controlling the narcotic menace. As we see it, great strides have been made in reducing the traffic. Estimates which I believe credible, place the narcotic incidence in this country, prior to the early 1920's as 1 in 400 or 1 in 500. We saw a steady decline in addiction throughout the 1920's and into the late 1930's. I believe there are men in this room who can support me in the observation that in the 1930's, the average age of addicts coming into Lexington was roughly 1 year older every year. In effect,we had the problem licked. WhenWorld War II came along, the traffic was further circumscribed and plummented (sic) to an irreducible minimum. War of course had brought about result of the ultimate in law enforcement in controlling the drug. I recall that shortly after the war a congressional committee was seriously considering that the Lexington Hospital be closed. The Bureau of Narcotics opposed this move because we anticipated a post-war rise in addiction. The traffic and addiction remained at rock bottom as a mere trickle until 2 or 3 years after World War II. Then, it skyrocketed. That is the point at which some of our too articulate friends think the show began. The rocket did not go back to the incidence of the 1920's. In the early 1950's it burned out at a stage of less than 1 in 3,000 or less than one-sixth of our earlier addiction rate, and is orbiting in a slowly descending pattern now. So, essentially, the graph addiction trends in this country show a ski-jump profile. This is the pattern for the country as a whole. In vast areas of the United States, narcotic addiction did not reappear in any consequential amount, and having got on top of the problem there we do not think we will have any recurrence as long as realistic law enforcement continues to prevail in those areas. This is small comfort, of course, except as an example, to those spotty areas where drug addiction is far from the national average. Here a multitude of social and economic factors cloud the picture. The problem is so large that its mere volume contributes to a paralysis in dealing with it. But it is significant to me, that in these very areas we have not had as yet an effective, across-the-board law enforcement program or a comprehensive addict control and rehabilitation program in operation.
People question our figures but we think they are good approximations; they certainly are the best figures available and they are the only ones I have seen which have any relation to reality. They have often been validated by independent surveys. The figures are obtained by the same sort of process by which we obtain police statistics generally.
And we have other criteria. We work in the narcotic underworld. The salesman out in the territory often knows that business is good or bad before it is reflected in the boss' books. In 1920, an ounce of heroin cost $12 to $20. In the middle thirties, the same drugs cost $80 to $100 an ounce. Today, they cost $500 to $1,000 per ounce. In 1920, plush opium smoking joints could be found in large city in the country. These have completely disappeared. In 1920, many addicts, I would say most of them, had heavy habits, 5-10-15-20 grains per day. Many, many of them used cocaine to offset the effects of this huge intake. Cocaine has disappeared as a consequential drug. In 1930 the habits were much lighter. In 1937 and 1938 we got to the point of extreme dilution of heroin and very light habits. Army figures for World War II show a dramatic fall in addicts rejected compared to World War I.
I have not checked with any of the representatives here, but it is a long time since the hospital at Lexington has seen any sizable influx of persons with real habits. My information is that 9 out of 10 of our users of diluted heroin mixtures in Chicago fail to show anything except the most mild symptoms on withdrawal. The extent of the distress is "a gape and a sweat."
These and similar considerations should convince anyone capable of being convinced that we have made great strides in overcoming the narcotic evil in this country.
We represent here many disciplines, many points of view. We all look at a subject through our own particular keyhole. I think the most difficult thing we have in this field is to reconcile the various points of view, to weigh the relative importance of the various parts so as to arrive at a correct and undistorted picture of the whole creature. In that East Indian allegory, the blind men approached the elephant from different sides. The one who touched the flank said the elephant was like a wall. The one who grasped a leg said an elephant was like a pillar, and the one who seized the tusk said an elephant was like a spear. The man who grasped the trunk said an elephant was like a great hawser. The man that seized the tail said an elephant was like a small rope. At the risk of being inelegant, candor compels me to observe that some of latter day discussants of this problem are like a blind man who came so late that he missed even a grasp of the tail and stepped into stepped into something which gives him a mistaken conception of the creature.
Usually, I advance my opinion that the solution of the narcotic problem in this country is primarily one of law enforcement. Obviously, we must have help from the many other quarters represented here. Also obviously, the primacy of law enforcement is not the opinion here, otherwise, law enforcement might be spread more extensively on our agenda. Let us assume that this is essentially a medical problem. A great many years ago, you public health people seriously concerned about psittacosis. I understand that antibiotics may put you in a relatively improved position today. But because you then did not have any better or simpler way of coping a problem which should be coped with, you put the great Treasury of the United States in the business of chasing parrots. We tracked parrots from the low countries in Europe to Paris, and then by air to Mexico City and by truck to the Mexican border and we there intercepted birds, not for the sake of revenue, but in the name of medicine! We have no sure cure for addiction as yet not specific drugs or chemical as far as I know. Our hospitals can take credit for salvaging many addicts. Despite that, I still insist that the best cure for narcotic addiction is for it not to occur. I think that the best medicine is to try to control and stamp out the addictive chemical, illicit opium. It is sound medicine, I suggest, to contain the addict who spreads the know how and the way of life of narcotic addiction. Quarantine is one of the oldest and solidest procedures in public health. There can be many variations on the them of "Typhoid Mary." And however unpalatable, I think the truth is that the extended hand of medicine seldom reaches far enough to overcome the blandishments and seduction of opium until it has law enforcement to remove the all too willing victim from the arms of Lady Morphia and to physically place him within reach he is to have the advantage of what modern medicine can do for him. To the men of medicine here, I say do not let the soft-headed claque play down law enforcement as if it were something in opposition or a substitute for your work. If you do, you may be withering your right arm. Medicine, in this field, without the help of law enforcement would be smothered.
And now that I have cheerfully violated every tenet of my teaching and have done some lay practicing of medicine, let me be inconsistent enough to complain about the nonprofessionals who like to practice enforcement. These people say we are too tough. Legislative committees of our Senate, legislative committees of our House, committees of States like New Jersey, Ohio, Missouri, and Illinois and legislative committees in Canada have exhaustively examined this field in the past few years. They have talked to every expert and self-professed expert who offered himself and they invariably have agreed that one remedy is tougher law enforcement. This unanimous reaction should suggest to people of practical common sense who disagree that they might look around to see just who is out of step. Too often, instead, we have the armchair criminologist's theory that severity does not repress. Perhaps these people think that the brave Hungarian, the fiercely proud Magyar, is now a cowering, wretched, regimented slave because he loves the Russians.
The record is clear that despite temporary setbacks we have great strides in eliminating the narcotic drug evil in this coountry. The record is equally clear that much of this we owe to law enforcement. When I say that I think that rigid law enforcement severe penalties is one of our best hopes for the future, I would be less than frank if I did not save some reservations. Our hopes for a program of tough sentencing which would quickly strangle the commercial traffic are not being realized as promptly as we would like. We have encountered some indications of active proselyting judges against this program in which considerations which should be immaterial have been urged on them. We hope that the resistance in this quarter will die out as the efficacy of the program demonstrates itself where severe sentences are guaranteed. But much more ominous than that is what has been happening to law enforcement generally by the impact of judicial fiat from our top tribunal. People in Washington might be more aware of this than the country generally because of the legislative uneasiness developed from such decisions as that in the Mallory case. Actually, the erosion of police power has been practically a continuous process since 1942. This is a most curious development because this is an era in which police are more professional and well behaved than they have ever been in the history of this country. One wonders how the country survived under the "Police State" which must have existed before the court set out to remake law enforcement. It is necessary to make this statement if there is to be a full comprehension of all difficulties ahead. In as secret and professional a racket as narcotic traffic, the impact of every technical judicial obstacle is magnified. Law enforcement with your help will deal with the problem successfully but it will be a slower, tougher job unless there soon is a turn of the judicial wheel, as inevitably there must be if this republic is to escape anarchy.
To repeat, quarantine and isolation in my opinion are elemental in the control of infectious and contagious diseases. We certainlyy have a sort of transmittable characteristic in the drug addiction phenomenon. Generally it is the addict who translates to the neophtye as a great experience the abuse of a chemical that would otherwise be so much harmless dust. If we want to eliminate this health hazard promptly, we must work toward a program where we will quickly and surely take the addict out of society, place him in a drug free environment, and then cautiously let him back into circulation with a string attached. To what we have been able to do for him medically while he is confined, we add what supervision and aftercare can contribute. That supervision and aftercare will be more realistic because of that string attached. The rehabilitation of the addict is a worthwhile and necessary concern. Marginal and doubtful as he may be, and as he usually is, as a fellow human being he is entitled to the best effort we can give him. But since the best cure for narcotic addiction is for it never to occur, our chiefest and most practical concern must be with the nonaddict contemporary of the addict. To him me owe the most responsibility. For his safety and well being, we must cure or segregate the addict. The mere existence of an aggressive program of this nature should discourage the possible neophyte. If properly carried out it should do much to diminish the "fad factor" of addiction.
On September 23, 1958, Mr. Harney spoke before the Southern Governors' Conference at Lexington, Ky., on the narcotic problem.
On September 24, 1958, that conference adopted the following resolution:
NARCOTIC DRUG PROBLEMS
Whereas, the narcotics traffic and drug addiction contribute greatly toward commission of major crime and are destructive of human lives;
therefore be it resolved by the Twenty-fourth Annual Meeting of the Southern Governors' Conference that all States should be encouraged to strengthen narcotics law enforcement with penalties which will remove the profit from the dope racket; and
Be it further resolved that this conference urges the Congress and the States to take appropriate steps, with respect to the treatment and rehabilitation of addicts, to ensure the mandatory commitment and hospitalization of addicts and the availability of suitable, mandatory followup or post-hospitalization supervision by the States and the District of Columbia.