Cited in the book, Narcotics, USA, is this example of how a typical gang of peddlers operates:

"One mob of 6 men and 2 women, the 'King and Queen' mob, was arrested *** in New York's West Harlem. The makeup of this mob illustrates the pyramiding nature of drug addiction.

"Rocco D'Agostino, 19, was described by the police as the tough guy who specialized in 'softening up' teeners, persuading them to become addicts. Another, Augustine Castilo, also 19, shamed kids into using dope by calling those who refuse 'sissies' or 'chicken.' A third member, Marcellino Morales, played a Don Juan role, infatuating young girls and then enticing them into drug use." Once started on drugs, addicts frequently turn to peddling to support their habit and the contamination spreads as addicts make new addicts.

We stress the contagious nature of addiction because, as we have said, it suggests the only practical answer to the problem. By making drugs legally available to addicts, either free or at a few cents a dose, the peddlers would be knocked out of business and the deadly chain of contagion would be broken.

Despite all the untold millions poured into the enforcement of narcotics laws and the hospital treatment of addicts, there is little doubt that drug addiction has increased in the past few years. Tragically, its most recent victims have been teen-agers.

The efforts of police to dry up the illicit flow of drugs are reminiscent of prohibition. As in that "noble experiment," the chief beneficiary has been the criminal. Racketeers have built a black market in drugs with sales running as high as $3 billion a year.

Attempts to reduce addiction through cures have been equally futile. The main treatment centers are the Federal hospitals at Lexington, Kentucky, and Fort Worth, Tex. Here, addicts are taken off drugs in a week or 2 and then held for an average of 4 months in the hope-usually vain-that the habit will be permanently broken.

A typical example of this is a 23-year-old boy who, leaving Lexington after voluntary treatment, made contact with a peddler in the Pittsburgh railroad station where he changed trains for New York. He was back on heroin before he reached home.

With a conservatively estimated relapse rate of 95 percent, the average cost of a single cure comes to over $4,000.

The plain truth is that the American people are paying a gigantic annual bill for law enforcement that is ineffective, treatment that produces few cures, and for countless crimes committed by addicts to obtain drug money.

One objection to the legalized distribution of drugs to addicts is that it would stimulate crime. Actually, the opposite is true.

Most addiction today is caused by morphine and heroin, the latter being the chief stock in trade of the peddlers. The important fact about these opium derivatives is that, unlike liquor and certain other drugs, they are strictly depressants. Morphine, after all, is given medically to kill pain and induce sleep.

Afater a shot of heroin, the addict frequently experiences a sharp, sexual thrill. Then, far from being ready for criminal or any other action, he rapidly falls into a drowsy, contented state. His painful anxieties and frustrations melt away. His fantasies take over as he listens to the radio or stares dreamily out a window. Often he simply falls asleep.

The point is that the addict does not usually commit crimes under the influence of drugs, but in order to obtain them.

The more an addict takes, the more he has to take since his body steadily builds up tolerance to drugs. A physician ordinarily prescribes an eighth-grain of morphine to relieve pain. Addicts may take as much as 2 grains every 2 hoursa dose that would kill an ordinary person.

As the required dosage climbs, so does its cost, sometimes reaching $100 a day. The addict becomes obsessed with the money aspect of his plight. He describes himself as having a $25 or a $50 habit.

Since the typical addict has no hope of earning the fantastic sums he needs. he turns to crimes such as shoplifting, picking pockets, pilfering from trucks, policy-slip running or drug peddling. Violent crimes, including murder, are rare. Women, among them teen-age girls, commonly earn this drug money by prostitution.

The irony of all this is that the $50 in illicit drugs for which the addict commits crimes is actually worth, at legal prices, no more than 30 cents.

Obviously, the clinic plan would not work unless it would have a strong appeal to the addict. We believe it would, not only on economic grounds, but also as

a way out of his nightmarish world. It would offer an answer to the questions constantly haunting the addict: "Will I be able to get a shot when I need itwill it make me sick-will it kill me?"

The fact is that the addict, an emotionally disturbed person, pays a stiff price for his artificial peace of mind. Soon after he starts his habit, chemical changes take place in his body. Now, if he goes without drugs for a day-sometimes only for hours-he is wracked by the dreaded withdrawal symptoms of cold sweating and shakes, vomiting, diarrhea and violent muscular cramps.

Caught in a double trap of physical and psychological dependence, the addict is menaced by ever more ominous dangers. The capsule or paper folder of heroin bought from a peddler is of unknown strength. It has been cut, often as much as 95 percent, with milk sugar, quinine or almost any whitish powder, and the addict lives in dread of killing himself with an overdose.

Worse still if, as often happens, he has been arrested and told the police where he buys his drugs, he is in terror of gang retaliation in the form of a "hot shot” in which cyanide has been substituted for heroin.

The legalized distribution of drugs to addicts would undo the mistakes made during the hundred years it has taken the narcotics situation to reach its present alarming state.

In 1914, responding to public pressure, Congress passed the Harrison Act. Its aim was to regulate the traffic in narcotics by various means, including the licensing of physicians to prescribe these drugs. The Harrison Act did not mention addiction and it expressly permitted physicians to give narcotic drugs for “legitimate professional uses."

In 1919 and 1920, the United States Supreme Court ruled that a physician in private practice could no longer prescribe narcotics except for such medical purposse as the relief of pain. Providing an addict "with narcotics sufficient to keep him comfortable" became a violation of the law. At one blow, addicts were cut off from all legal sources of supply, and the racketeers who had sprung up under Probition soon found an even more lush market in narcotics.

Cut drugs yielded a far higher rate of profit than bootleg liquor and were easier to handle. A pound of heroin picked up in Manchuria for $5, smuggled into the country and cut by local mobs could be retailed to addicts for as much as $40,000.

The plan we propose would at last free the addict from the clutches of the mobsters. The clinics would probably be set up under the direction of the United States Public Health Service and staffed by a competent team of physicians, psychiatrists and psychologists.

Here addicts would be given a hypodermic injection, by a physician, of the minimum daily dose of morphine needed to keep him free of unpleasant symptoms. These daily shots would be provided free, or at a nominal cost of a few cents. No drugs could be taken from the clinic and careful dosage records would be kept. The addict would be registered and provided with a tamper-proof identification card bearing his photograph, fingerprints, and the name of the clinic where he was being treated. In this way he would be prevented from going from one clinic to another.

Psychiatrists and others would try to induce addicts to undertake cures, and the community's religious, social, vocational guidance and job-placement services would be made available to help in their rehabilitation, if that seemed a possibility. Those who object to our plan point out that the narcotics clinics operated briefly in 1919 and in the early 1920's were failures. But these early clinics--and it is interesting to note that 1,500 addicts registered the first day they opened in New York-were little more than drug dispensing centers. Knowledge of addiction was still primitive and there were, with a few exceptions, almost none of the safeguards we propose. Even so, they were closed down before they were given a fair trial.

Another objection raised is that nonaddicts would be drawn to the clinics by the bait of free or cheap drugs. A new drug, Nalline, by neutralizing morphine. brings withdrawal symptoms in the addict within minutes. Since it has no effect on the person not on morphine, suspected nonaddicts could be easily weeded out by this simple test.

Still another flaw, it has been claimed, is that many addicts need several shots a day. True, but this problem can also be easily solved. Pharmaceutical chemists assure us that a depot form of morphine could be developed which would release the drug slowly in the body, for a period of 24 hours or longer if necessary.

Critics assert that it would be immoral for the Government to support what they call the vice of addiction. But this is not a question simply of vice or im

morality. Our basic assumption is that the addict is a physically and emotionally sick person who should be treated as such.

Actually, we are less concerned with the victims of addiction than with the rest of society, which now has little protection against the narcotics racketeers and the addicts' thievery.

We think the plan would work. It seems to us reasonable to believe that most addicts would welcome a source of clean, safe drugs. Their constant fear of illness and of sudden death that could result from an overdose or a "hot shot," would be relieved.

And of obvious benefit to society-they would abandon their frantic, interminable crime and their hooking of new addicts to get money.

As we see it, the clinics would bring these important gains: a reduction, by attrition, in the present number of addicts and in the recruiting of new addicts. A sharp fall in addict crimes. A drop in narcotics smuggling and peddling. Accurate information about the number of addicts and who they are. And new medical and psychiatric information of use in the eventual devlopment of a cure for addiction.

The clinic plan is not intended as an alternative to law enforcement, or narcotics hospitals, or much-needed research into the cause and cure of addiction. It would be an addition rather than a substitution. Quite simply, it would leave regulation of the drug traffic to law enforcement agencies and place the control of addiction where it properly belongs, in the hands of the medical profession.

Our proposal deserves serious consideration by the medical profession, the Federal Government, and the public. It offers the only sane approach to correcting the situation pungently described in these words by the noted authority on criminal law, Rufus G. King:

"All the billions our society has spent enforcing criminal measures against the addict have had the sole practical result of protecting the peddler's market, artificially inflating his prices and keeping his profits fantastically high. No other nation hounds its addicts as we do and no other nation faces anything remotely resembling our problem."

EXPERTS COMMENT ON THE BERGER-EGGSTON PLAN

The proposal to legalize narcotics is an excellent one. It could do much to remedy the present situation in which the law is not providing adequate medical service for the sick people it is prosecuting. The registering of addicts would return to the medical profession its need and right to study addiction with all the scientific tools at its disposal.

Only when the addict population can come out of hiding to receive medical study and medical treatment can America hope to come to grips with this tremendous sociomedical problem.-M. N. Nyswander, M. D., Member, American Board of Psychiatry and Neurology. Former psychiatrist at Lexington Federal Hospital for Narcotics Addicts.

Outpatient clinics for Government sale of narcotics under Government supervision with a program for control, treatment, and rehabilitation directed by a team consisting of medical doctors, sociologists, psychologists, and psychiatrists would be a great step forward in neutralizing the influence and affluence of professional dope peddlers. This could in my opinion, diminish by at least 50 percent the number of drug addicts in this country.-Judge Abraham L. Marovitz, Superior Court of Illinois, Cook County.

Narcotic drug addiction in America reflects the existence of criminal and unscrupulous characters who wish to enslave the narcotic addict for personal gain. The clinic population at the Medical Counseling Clinic of Provident Hospital shows that the treatment of addicts is mostly a medical problem. The narcotic clinic for the followup of addicts discharged from jails or hospitals to protect them from exploitation of the underworld is very urgent and very important.— Walter A. Adams, M. D., Director, Medical Counseling Clinic, Provident Hospital and Training School, Chicago.

There is a great need for the clinic program for the treatment of those addicted to narcotics. The basic reason for the failure of similar clinics in the past was due to the emphasis on the physical factors and the lack of emphasis on the emotional. If and when such a clinic is opened, the orientation should be a multi-disciplinary one, executed by a team of trained professionals.Samuel R. Kesselman, M. D., Neuropsychiatrist, Chairman, Committee on Correction, New Jersey Neuropsychiatric Association.

You have perhaps emphasized the free shot aspects and minimized the therapy and rehabilitation too much. Administering narcotics for the comfort of incurable addicts and to facilitate rehabilitation efforts for those who may be saved is only one phase of the clinic program.-Rufus King, Chairman, Committee on Narcotics and Alcohol, American Bar Association.

EXHIBIT No. 10

[Reprinted from Harper's magazine, November 1952]
MAKE DOPE LEGAL

Alden Stevens

(The human cost of the narcotics traffic and the danger to American youth have inspired Alden Stevens to seek a new approach on the basis of the experience of the past. He has discussed his proposal with governmental and medical experts.)

Everyone wants the illegal drug racket broken and crime by addicts stopped. Everyone wants teen-age addiction conquered and adult addiction reduced to a minimum. The fastest and surest way to accomplish these ends is to make dope legal.

This doesn't mean that drug peddlers should be licensed by the State and made respectable nor that morphine should be sold freely in drugstores. It does not mean that international controls should be abandoned. It is not suggested that the Federal narcotics hospitals should be closed. Illegal drug traffickers should still be prosecuted to the limit.

The plan proposed here is a modern development of an approach tried 30 years ago. This crude early effort showed great promises even though severely hampered by shortage of funds and shortage of time before it was cut down by ignorance and prejudice. Modern educators, welfare experts, physicians, and others have suggested safeguards and procedures which, added to the experience gained during this brief experiment, encourage the belief-shared by churchmen, citizens of the highest standing in the community, and incidentally addicts and ex-addicts-that this extensively revised plan offers an excellent prospect for public victory over narcotic addiction.

It is only fair to say that many experts disagree. Their reasons will be taken up later in this article. Careful analysis of the objections leaves this writer more convinced than ever that the new approach is a sound one.

Few people know that narcotics clinics were conducted during 1919 and 1920 in no less than 15 States. With a few possible exceptions all were closed by the Federal Government for reasons which seemed to many doctors and citizens at the time illogical and inadequate. Yet this action, exposed here for the first time in a magazine of general circulation, has made possible in large part the horrible business of dope pushing, teen-age addiction, and the crimes related to them.

The writer has talked with many addicts in recent weeks. He has talked with doctors about the problem, doctors both frightened and realistic. He has talked to enforcement officials of the Federal Bureau of Narcotics, social workers, churchmen, and citizens. And he is convinced that the problem is not being solved. It is, as New York State Attorney General Nathaniel Goldstein says, if anything, worsening.

Before outlining this suggested approach to the problem it should be emphasized that narcotic addicts are not "fiends." They are human beings, every pathetic, afflicted, unhappy one of them. Referring to them as "hoodlums" and "zoot-suit hellions" does not expel them from the human race. Furthermore, it has no effect upon their addiction, and it only makes their problems worse. Actually, many addicts are housewives. Others are businessmen, artists, musicians, doctors, nurses, politicians, lawyers, and clerks. Many others are hardly more than children, young people who should be cared for and treated with sympathy and understanding, who in all humanity should be rescued in a civilized manner instead of being driven into the underworld. These usually underprivileged adolescents, some through their own arrogant foolishness, far more through the ignorance, deception, and cowardice of others, are victims of something beyond human power to control, something certainly far beyond the power of a young person against whom the world conspires and whom the world is urged to despise.

Doctors agree that the full facts about addiction are not known, that there are many questions which remain unanswered, that there are many problems not yet solved. There are, however, some basic facts which have been established. The habit-forming drugs which are most important and which give the most trouble at the present time are heroin and morphine. Neither of these drugs incites anyone to crime. Both are depressants, not excitants. They tend to make users sluggish and dopey, weak, and subject to dreams. In rare cases when a person under their influence gets hallucinations he may become irrational and violent. But such cases are rare. People become much more violent from drinking too much alcohol than from taking morphine or heroin.

It is not the drug itself which drives the addict to crime. It is the need for the drug. The criminal path is almost inevitable because an addict must spend from $15 to $75 every day for his drug. Usually less alert than nonaddicts, less able to concentrate, less able to work (although many do hold down jobs), with less energy and less initiative, they can rarely earn what their addiction costs in addition to the regular costs of living. How many teen-agers living in city slums can honestly earn a hundred dollars a week? Answer, none.

Yet, robbed of willpower by the drug itself, his personality usually ravaged far beyond his own dulled realization, the addict will do anything to get his dose. He is completely unable to stand the excruciating withdrawal symptoms which occasionally (though rarely) end in death. These begin with heavy sweating and running eyes and nose, progress through an intolerable restlessness, high blood pressure, and gooseflesh, and culminate in fever, vomiting, diarrhea, and extremely severe cramps in the back, abdomen, and legs.

Is it any wonder that the problem of getting the next dose may occupy the addict's every thinking moment? The relentless urgency, coupled with fear of arrest, makes him tense and nervous. As tolerance to the drug builds up, an addict usually needs slightly increasing doses. Never being absolutely certain that he can get more drugs in time to avoid withdrawal symptoms, in constant fear of being picked up by police, never being quite sure whether his supply contains 10 percent, 3 percent, or 1 percent, he finds his need building up with a terrifying rapidity brought about by these very fears and doubts. Overdoses, sometimes caused by the fear that he will not be able to get another shot and sometimes by the fact that he doesn't know how much his supply has been cut, are common-and sometimes fatal.

The actual cash value of a day's supply of morphine for an average addict is about 30 cents. Except in very rare circumstances it can't be obtained for that because it must be bought in the illegal market from ruthless brigands.

And just as long as 2 pounds of heroin can be bought for $10 and when cut can be sold for $80,000, it will be cut and sold. Half a million enforcement agents (the Federal Bureau of Narcotics now has about 200) could not prevent this so long as addicts must have it no matter what crime must be committed to get the price.

Many States have, in the past few years, tightened laws against sellers, providing stiffer sentences and heavier fines. What effect has this policy had? It has driven the price of drugs sharply upward. It has thus made necessary more crime and more desperate crime by addicts who have no other way of getting money for the supply they need.

New York State has recently passed a law providing compulsory hospitalization of all minor addicts. The Federal Bureau of Narcotics wants to go further and forcibly hospitalize all addicts. What will be the effect of such a policy? Why, to drive the addict further underground and to make him cleverer than ever at hiding his drug and his addiction.

According to the New York City Mayor's Committee on Narcotics there were, in the summer of 1951, somewhere between 45,000 and 90,000 drug users in New York City alone. These figures are estimates, of course. The Federal Bureau of Narcotics says, and all experts agree, that there are no reliable figures on the total number of addicts. How can there be when every addict has, as one of his main problems, the need to conceal his addiction from the world? (Many gain incredible skill at this deception with years of practice.) How can there be figures when it is possible (as it is possible) for a person to become an addict in 3 weeks? How can a count be made on which to base any statement?

The mayor's committee does, however, give some figures which are reliable and revealing. In 1946, 281 persons in New York City were sentenced for violation of narcotics laws. In 1950, 1,031 were so sentenced, and in the first 9 months of 1951, 1,179 were so sentenced-more than 5 times as many per month during