assumptions that have been made regarding drugs are valid and whether official responses have produced workable programs. In many instances they have not.

Most of the discussion at the policy level tends to focus on the drugs themselves, ascribing to them an inordinate capacity for overpowering the human mind. Very often, policy makers characterize drugs as earlier generations did witchcraft and black magic. The social goal is exorcism. Each new treatment, educational or prevention technique is launched as the latest strategem for quashing the forces of evil.

While the chemical properties of the various drugs are important, there is nothing mystical or supernatural about their effects. It is the behavior that may be associated with drug use, such as crime, loss of productivity, disruption of the family unit and economic drain on the larger society, that should form the basis for policy planning. These are practical and tangible effects that we all can understand. Yet, these are problems that are associated with many factors, only one of which is drug use. It is with reference to all these factors that the plan of action must be formulated. Poverty, urban decay, lack of identity, the need to escape, boredom, apathy and other factors, as well as drug use, influence anti-social and asocial conduct.

Another aspect of the drug problem that this Report examines and which is the cause for much concern on the part of the Commission is the rapid institutionalization of the "drug abuse problem." The high degree of public concern has generated a shifting of large quantities of money, manpower and other resources at the federal, state and local levels to meet the problem and lessen the public concern. This response has created, in the short span of four years, a “drug abuse industrial complex."

With spending at the federal level alone of upwards of one billion dollars annually, with a rapid growth in bureaucracy, with an almost compulsive spending on drug projects without benefit of evaluation or goal setting, the drug abuse industrial complex has firmly established itself as a fixture of government and society.

The Commission is concerned that the underlying assumptions. about the problem and the organizational response of the "complex" may, rather than resolve or de-emotionalize the issue, tend to perpetuate it as an ongoing part of the American way of life. There is a real need to evaluate the present system to ensure that the government directs its efforts toward the achievement of success rather than the perpetuation of government activity.

There is an apparent unspoken assumption in this country that our drug problem is unique. Our travels to over 36 nations around the world showed us pointedly that such is not the case. Many other countries throughout the world have a drug problem. Some, such as

formal public efforts like our own. Others have not, either because they do not characterize the drug taking as a major governmental concern or because such behavior is well down the list of their national priorities.

Regardless of the nation involved, drug use, drug-induced behavior and drug dependence are common threads in the social fabric of humanity, from which almost no peoples or parts of the world are immune. How drug-using behavior is viewed depends in large measure on the unique conditions of each country. How the issue is resolved depends on how much effort a particular nation is willing to undertake and how much affluence there is to support large scale drug use. It is fair to say that a number of nations simply dismiss drugs as a problem by denying that it exists as a major problem in their country. We as a nation have not been willing to do this.

In this country, we have always had problems with drugs to some extent. The use of alcohol and tobacco is not a new phenomenon. The use of cocaine and opiate derivatives date from the Civil War and the use of marihuana dates from the early part of this century. To be sure, the use of drugs has increased, but what makes drugs such an issue now is their spread to all segments of society and the high visibility of their adverse impact on the public, especially through the mass media.

The perception that certain nations are more prone to drug use than others has a corollary between generations. Many Americans equate drug misuse with youth. While youth constitute a high risk group in our society and drug misuse is one of the high risk activities in which they engage, we must recognize that drug misuse is prevalent among the over-30 generation as well. Different drugs and different activities appeal more strongly to one age group than to another, if only because of conditioning and the maturation process. The use of alcohol, marihuana, barbiturates, heroin and other drugs appeals to different age groups because of their effects. The reasons people use drugs vary depending on their purported need for the drug. The drinking of alcohol may increase with age while the use of marihuana may decrease. The use of barbiturates may remain constant with age, but the pattern of use, moving from intermittent to continuous, may change as one grows older. The problem of drugs can and does affect all ages, although the reasons for and patterns of use may change markedly from person to person and from one community to another. The vastness of our mandate, rather than causing us to despair, has caused us to reevaluate the problem. By examining the underlying causes of drug use and misuse, and by examining how we, as a nation, are responding both publicly and privately, we have concluded that we can come to grips with the drug issue by redefining

our objectives realistically and by utilizing existing institutions more effectively. Unattainable goal setting and nearsighted responses to untested assumptions rather than realities will defeat us. We as a nation must make a commitment to a course of action, but only after we have carefully evaluated and tested our underlying assumptions. We must be willing to rethink the problem so that both short and long term goals are achieved. We must be willing to recognize that any institutional response to the problem will merely deal with the symptoms and that unless our citizens are genuinely committed to the values and goals, we can do no more than conduct a holding action. Law enforcement, education and rehabilitation can make inroads on the problem, but, together or separately, they cannot resolve it. Such resolution can only be achieved when we, as a nation, decide to abide by a fundamental decision to minimize drug usage and to deal with the underlying needs and causes.

The Appendices which form the technical reservoir from which the Report was drawn contain more specific information and supporting data which both the public and the research community can utilize in exploring various aspects of the drug issue in greater detail. The Commission published these materials to create a baseline of current knowledge in this field from which further studies can be undertaken.

This Report has been written on two levels; first, to determine what can be done now to move us towards a more socially satisfactory situation vis a vis drug use and second, to project into the not too distant future further refinements or changes if the present recommendations do not achieve any more success than we have had in the past. These two levels of recommendations are necessary since drug use patterns and institutional responses change over a period of time. Since drugs and their use vary according to changes in other aspects of the society, there should be no hesitancy to adjust public policy to meet or intercept the circumstances of the times. We must be willing to experiment; we must be willing to explore alternatives to what we are now doing. We must be willing to change when change is indicated.

chapter one

defining the issues

The need to solve the "drug problem" has been a recurrent theme of political and social commentary in the United States for most of the past decade. The apparent increase in drug use-itself defined as the problem-has precipitated a serious inquiry into its causes, a massive investment of social efforts to contain it, and a mobilization of medical and para-medical resources to treat its victims.

The Commission does not deny that a "drug problem" exists. We share the public's concern that an apparent rise in crime and other anti-social behavior may be related in part to drug-using or drugseeking behavior. Likewise, we share the public alarm over the attraction to drug use by large portions of this nation's youth, particularly when such use is indiscriminate and apparently oblivious to its risks. The lives and futures of our young can only be hurt by such behavior. We share, too, the frustration which comes from knowing that drug use spreads by example, and that a continuing growth in the using population augurs no better for tomorrow.

While recognizing that a drug problem exists, we cannot allow our distress to interfere with the performance of our mandate. We were