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support such plans. Most addicts are not without good intelligence and some attractive personality characteristics. If these assets can be salvaged, not only will the numbers of addicts be decreased but there will also be the likelihood of reducing the number of young people who might otherwise become addicted, as addiction usually spreads by contact between addicts and predisposed young people.

The attempt has been made in this paper to present as comprehensibly as limited space permits, the arguments for and against the legal sale of narcotics, with certain historical and critical comments. Although these arguments have been presented as objectively as possible, for the information of the medical practitioners of the Province, it will nevertheless be obvious that the writer has been brought to the conclusion that the proposal for legal sale of narcotics, if adopted, would not not only fail to solve the addiction problems but would actually make them more serious than they are at present.

BIBLIOGRAPHY

(1) Drug Addiction in Canada: The Problem and Its Solution. Community Chest and Council of Greater Vancouver, Committee on Narcotics. (2) The Opium and Narcotic Drug Act, Canada, 1929, with Amendments to 1954, Queen's Printer, Ottawa.

(3) Opiate Addiction, Alfred Lindesmith, the Principia Press, Evanston, Ill., 1946 (?)

(4) Make Dope Legal, Alden Stevens, Harpers Magazine, November, 1952.

(5) Survey of Opium Smoking Conditions in the Far East, H. L. May, Foreign Policy Association, 1927.

(6) Japan and the Opium Menace, F. T. Merrill, Foreign Policy Association, 1942.

(7) Drugging a Nation, Samuel Merwin, Fleming H. Revell, 1908.

(8) Senate Report No. 6, U. S. Official Documents 1905-Report of Committee, appointed by the Philippine Commission to investigate the use of opium (in Far East).

(9) The Trail of Opium, Margaret Goldsmith, London, Robt. Hale, Ltd., 1939. (10) The War Against Opium, International Anti-Opium Association, Tientsin Press, 1822.

(11) The Harrison Act (United States of America), U. S. Government Printing Office, Washington, D. C.

(12) Opium Smoking in America and China, H. H. Kane, G. P. Putmam's Sons, New York, 1882

(13) Narcotic Clinics in the United States, U. S. Government Printing Office, Washington, D. C., 1953.

(14) Confessions of an English Opium Eater, Thomas de Quincey, J. J. Little & Ives Co., New York, 1932.

(15) Dangerous Drugs Act and Regulations, United Kingdom.

(16) Memorandum as to Duties of Doctors and Dentists (re dangerous drugs), His Majesty's Stationery Office, London, England, 1948.

(17) Drug Clinic Plan Opposed in Canada, R. S. S. Wilson (included as an annex in reference (13), Narcotic Clinics in the United States. (18) Shall the United States Adopt a New National Policy of Toleration and Maintenance of Narcotic Drug Addiction? G. H. Cunningham (not yet published publicly).

(19) Flight From Reality, Norman Taylor, Duell, Sloane & Pearce, New York, 1949.

(20) The Doors of Perception, Aldous Huxley, Clarke, Irwin & Co., Toronto, 1954.

EXHIBIT No. 13

DANGEROUS DRUGS ADMINISTRATION IN THE UNITED KINGDOM

Statement by Mr. John H. Walker, United Kingdom delegate to the
United Nations Narcotic Commission

Origins

The abuse of dangerous drugs occurs in the United Kingdom on a comparatively limited scale. By dangerous drugs I mean those drugs colloquially known in North America as narcotics, namely opium, many of its derivatives such as

morphine and heroin and their synthetic analogues such as demerol and methadone, Indian hemp (marihuana), and cocaine. There are well-known references in 19th century classical authors to the abuse of opiates in the United Kingdom, but Her Majesty's Government first became concerned with drug addiction as a colonial, not a domestic, problem. It was not until the First World War, when narcotics, and, in particular cocaine, began to be peddled in London that special legislation (which took the form of a wartime defence regulation) was thought to be necessary.

The creation of the League of Nations, and in particular of the Opium Committee of that body, led to the widespread adoption of a number of international conventions on the control of narcotic drugs (including the 1912 Hague Convention which the First World War made abortive for several years), and it is on the requirements of these conventions rather than on any domestic problem that United Kingdom legislation is based. Canada, of course, is a party to these conventions and it therefore follows that the systems of control in our two countries are necessarily based on the same principles, despite variations in the machinery for their enforcement arising largely out of constitutional and geographical differences. It is probably true to say that the Canadian system of control is slightly more detailed than our own.

Legislation and enforcement

The Minister responsible for the administration of the Dangerous Drugs Act 1951 in Great Britain is the Secretary of State for the Home Department (known as the Home Secretary). Northern Ireland is autonomous as regards internal control, but not as regards international trade. The law in Northern Ireland is virtually the same as in Great Britain. The Dangerous Drugs Branch of the Home Office is the body primarily responsible for the administration of the Dangerous Drugs Act. It consists of the Dangerous Drugs Inspectorate (the Chief Inspector, his Deputy, and three inspectors) and an office staff engaged in the issue of licences and import and export authorizations. As in Canada, the manufacture, import, export, possession, sale, supply, and procuring of dangerous drugs are all strictly regulated by a system of licenses and authorizations backed by inspection. A limit is imposed on the amount of drugs manufactured in order to comply with the requirements regarding estimates of the 1931 Convention for the Limitation of the Manufacture of Narcotic Drugs. Also in compliance with this convention, manufacturers are required to make quarterly returns of raw materials and drugs received into the factory, of drugs produced, of raw materials and products disposed of, and of the quantities remaining in stock. Wholesalers are required to make annual returns of imports and exports of certain preparations containing dangerous drugs for which import and export authorizations are not required (because the proportion of the drug in the preparation is very low). Physicians and retail pharmacists are not required to make returns but they are required to keep detailed records of dangerous drug transactions and to make them available to persons authorized to inspect them.

A number of services assist in maintaining control. The Dangerous Drug Inspectorate, which I have already mentioned, is the body specifically charged with this duty but it is naturally too small to undertake all the manifold duties arising in connection with control. Its members inspect the premises of manufacturers and wholesalers and supervise the issue of licenses, and import and export authorizations. They maintain close liaison with the police and customs, and lecture to those services on dangerous drug problems; and they keep in close touch with the regional medical officers of the Ministry of Health and the Department of Health for Scotland, and with the Ministry of Home Affairs in Northern Ireland. They also deal with many inquiries from doctors, pharmacists, the trade, and the general public.

The inspection of retail pharmacists' drug registers is carried out by the police, who are also responsible for the general enforcement of the law as regards criminal offenses.

H. M. Customs supervise lawful imports and exports of drugs and keep a sharp watch for contraband narcotics.

The regional medical officers of health inspect physicians' registers and generally advise doctors on compliance with the dangerous drugs law. They conduct inquiries on behalf of the Home Office but it is understood that they will not be asked to do this in any case where criminal proceedings seem likely.

Illicit traffic

Illicit traffic in the United Kingdom has never been very large and for many years now has been on a small scale. Traffic in opium, which is largely confined to persons of Chinese origin, has been declining steadily since the war. The traffic in Indian hemp, i. e. marihuana, on the other hand, is almost certainly on the increase. At any rate the seizures of this drug made in 1954 were appreciably heavier than in 1953, and for the first time there were clear traces of an organized international illicit traffic in Indian hemp. Illicit production of manufactured drugs is unknown, and illicit traffic in them virtually so, except for very occasional thefts from, e. g., hospitals or research institutions. Fraudulent prescriptions are not unknown, and occasionally an addict attempts to get a supply of a drug from a doctor on false pretenses.

In 1954 there were 39 seizures of opium, involving a total quantity of 29 kilograms of the drug. All of it comes from the Middle or Far Eeast, and is smuggled in ships. Of the 26 persons convicted in respect of offenses concerning opium, only 2 were British in the sense that they were natives of the British Isles, and these were convicted for allowing their premises to be used for the purpose of smoking opium. One Pakistani seaman was convicted for unlawful possession. All the other offenders were of Chinese origin.

In 1954 118 kilograms of Indian hemp were seized by the customs, as compared with 27 kilograms in 1953. The number of seizures rose from 44 in 1953 to 68 in 1954. It will be observed that the proportionate increase in the quantity of the drug seized is far greater than that in the number of seizures, the reason being that in 1954 the quantities of drug involved in each seizure tended to be much higher than in 1953. Indeed, nearly 40 percent of the seizures in 1954 were of quantities exceeding 1 kilogram and of these a third exceeded 5 kilograms. Seizures of quantities such as these have hitherto been comparatively rare.

Over 60 percent of the Indian hemp seized in the United Kingdom in the last 5 years has been found on the ships of one company whose vessels ply between Rangoon, Burma, and the United Kingdom.

Of

There were 140 convictions in respect of Indian hemp offenses in 1954, the highest number so far recorded in the United Kingdom in any one year. these 140 persons, all but 29 were of African, West Indian, or Asiatic origin. The majority (approximately 60 percent) of the Indian hemp offenses were committed in the Metropolitan Police district. A further 25 percent occurred in Liverpool.

For some time now the police and customs in the port principally concerned have been exercising particular vigilance with regard to Indian hemp, and there can be no doubt that the increase in the number of seizures and convictions for offenses in respect of this drug is due to some extent at least to this increased vigilance. But it seems certain that there has also been some increase in the traffic itself. Indeed, as the result of vigorous activity by the police and customs in Liverpool (hitherto the favorite port of entry), Indian hemp is now being imported through other seaports, particularly Avonmouth and the ports of South Wales. The traffic has reached a point where it has been found possible to anticipate the movement of 1 or 2 traffickers by noting the expected time and place of arrival of steamers from Rangoon.

As has already been stated there is little evidence of any regular traffic in manufactured drugs, but there was an important seizure at London Airport in June last year of 6 kilograms of crude opium alkaloid, containing 28 percent of anhydrous morphine. It is thought that this particular consignment was put on the wrong airplane, and was destined for somewhere in the Far East. In 1954, 48 persons were convicted of offenses involving manufactured drugs. 47 of these being British subjects and 1 an American citizen. The majority were addicts who obtained drugs unlawfully, usually by forged prescriptions or by obtaining prescriptions simultaneously from more than one doctor. Nine of them were medical practitioners, who obtained drugs for the gratification of their own addiction and a further nine were members of the medical or paramedical professions, who were convicted of technical irregularities, e. g., failure to keep drugs in a locked receptacle.

Penalties

Offenses under the Dangerous Drugs Act, 1951, are punishable on conviction or indictment by a fine not exceeding £1,000 (roughly $2,800) or imprisonment for a period not exceeding 10 years, or by both such fine and imprisonment. If the conviction is summary the corresponding maximums are £150 (roughly $420) and

12 months. If the offense related to the failure to keep proper records or to issue or dispense prescriptions in the manner prescribed, the maximum penalty is a fine of £50 ($140) if the court is satisfied that the offense was committed through inadvertence and was not preparatory to, or committed in the course of, or in connection with, the commission, or intended commission, of any other offense against the act.

In practice the maximum penalties are not normally awarded. The range of penalties imposed in 1954 was as follows:

In respect of opium offenses, sentences of imprisonment ranged from 28 days to 6 months and fines from £2 to £115 (roughly $5.60 to $305).

In respect of Indian hemp offenses, sentences of imprisonment ranged from 1 day to 3 years and fines from £1 to £125 (roughly $2.80 to $350).

In respect to manufactured drugs, sentences of imprisonment ranged from 6 to 12 months and fines from £3 to £100 (roughly $8.40 to $280).

Extent of drug addiction

Drug addiction in the United Kingdom continues to be small, and, save in one respect, has revealed little change over the past 10 years. The practice of opium smoking, which is almost entirely confined to the Chinese, seems to be gradually dying out. Unfortunately, hemp smoking appears to be on the increase. This is largely practiced by persons originating from outside the British Isles, more particularly from the West Indies, Africa, and Asia. There have been, however, a few instances of persons of European descent contracting the habit of hemp smoking, and it is the possibility that this habit may spread that is causing the Government some slight concern at the present time. British conservatism in the matter of social custom is a byword, and the likelihood of Britons taking to a drug addiction of the kind practiced elsewhere, which involves intravenous injection, seems very small; but hemp can be, and indeed usually is, smoked in a cigarette which looks very much like any other cigarette, and the possibility of this habit spreading is much greater since superficially it amounts to no more than the extension of a recognized and widespread social custom, particularly since it is known to be practiced by a small minority of persons in the entertainment business who are sometimes found in jazz clubs or dance music clubs, where large numbers of young people congregate in an atmosphere of excitement. In these surroundings the risk that hemp smoking may catch on to some extent cannot be ignored, and behind this there is the haunting knowledge that in other countries hemp habituation only too often leads to heroin addiction.

Addiction to manufactured drugs, so far as can be ascertained, remains very steady. The number of known addicts for many years has been around about 300. The number for 1954 was 317, of whom 148 were men and 169 were women. The majority of them are over 30 years of age; 72 of them are members of the medical and paramedical professions.

Drug addiction is not compulsorily notifiable in the United Kingdom and consequently these statistics necessarily indicate only those addicts known to the authorities. There is almost certainly some concealed addiction, but the Home Office is reasonably confident that this hidden addiction is small. It is the experience of enforcement officers in most countries that sooner or later a drug addict attracts the attention of the authorities, and while we consider that in an exceptional case an addict may succeed in avoiding official notice for a protracted period, this is thought to happen only rarely. It is very noticeable in the United Kingdom that when an addict is brought to the attention of the Home Office by one source, he is frequently reported quite independently by another source in a very short time. This rather confirms that addicts tend to attract attention to themselves.

The United Kingdom is a country whose population includes many organizations devoted to the suppression of vice and social reform. Matters like drunkenness, the sale of horror comics, prostitution, and sexual perversion are from time to time a matter of public concern revealed in Parliament, the press, and the pulpit. No such concern is expressed with regard to drug addiction, and it is significant that the society which interests itself in drug addiction is small, has a high percentage of overseas members and associate members and, to judge from its journal, devotes most of its attention to alcoholism. Offhand I can only recollect 2 parliamentary questions on drug addiction in 5 years.

From time to time the Home Office has received confirmation of its opinion that the degree of hidden addiction is small. One of the leading physicians in

the country, who lives and practices in a large provincial conurbation, asked over 70 local practitioners if they had a drug addict among their patients. None of them had. The physician himself was aware of one case in the district, which was of therapeutic origin. The chief constable of a provincial seaport (a city where, if drug addiction flourished at all in the United Kingdom, it would certainly be found) in response to allegations about the existence of vice and drug addiction in the city, and in particular among seamen of Asiatic origin, conducted a most thorough inquiry and found no evidence whatever of drug addiction. An American doctor, who at one time practiced in London, came over to England some 3 years ago to study the problem of drug addiction in the United Kingdom. The Home Office gave her the names of 1 or 2 doctors who were known to have some interest in the problems, but pointed out that there was little scope for specialization in this branch of medicine owing to lack of patients. She herself knew of a specialist, whom she proposed to see. When she finished her inquiries, she was good enough to call again at the Office and give her impressions. The specialist, on whose help she had confidently counted, had diverted his attention from drug addiction to rheumatism many years before owing to lack of patients. All the persons she had seen were in agreement that the problem of addiction was small.

There are 1 or 2 other minor pointers which suggest the same conclusion. For some years the metropolitan police isolated the figures for dangerous drugs in respect of theft from unattended motor vehicles. This practice was discontinued because the number of cases was so small that the information was worthless. The prewar practice of keeping statistics of all drug addicts admitted to prisons fell into partial disuse for the same reason. A recent survey of admissions to the principal prisons in Great Britain revealed that less than 2 dozen addicts were admitted in the 2 years ending December 31, 1954. The Northern Ireland prisons had not seen an addict for several years. The addicts were almost all sentenced for minor narcotic offenses. The "criminal" addict, i. e., the addict who is a confirmed criminal quite apart from his drug addiction, is virtually unknown in the United Kingdom.

Government attitude to drug addicts

The committee has already received a good deal of information about the prescription and supply of narcotics to addicts in the United Kingdom, both from the Minister of National Health and Welfare, the Honorable Paul Martin, and from Dr. G. H. Stevenson. I thought, however, that the committee would wish me to deal with this matter in some detail, even at the risk of repetition. The policy of the United Kingdom Government with regard to drug addiction is based on the report of a departmental committee on morphine and heroin addiction drawn up in 1924. This report sets out precautions to be observed in the administration of morphine or heroin (which at that time were for all practical purposes the only manufactured drugs giving rise to addiction in the United Kingdom). This committee discussed the precautions to be taken in the ordinary use of drugs in medical and surgical practice, and their administration to persons who are already victims of addiction. The committee concluded that morphine or heroin (and clearly the same arguments apply to addiction-producing drugs which have come into use since the committee reported) might properly be administered to addicts in the following circumstances :

(a) Where patients are under treatment by the gradual withdrawal method with a view to cure;

(b) Where it has been demonstrated after a prolonged attempt at cure that the use of the drug cannot be safely discontinued entirely on account of the severity of the withdrawal symptoms produced:

(c) Where it has been similarly demonstrated that the patient, while capable of leading a useful and relatively normal life when a certain minimum dose is regularly administered, becomes incapable of this when the drug is entirely discontinued.

This advice, which is given to doctors in an appendix to a departmental memorandum as to the duties of doctors and dentists under the Dangerous Drugs Act, is still the foundation of Home Office policy. It may be noted that the advice was given at a time when far less was known about the treatment of drug addiction than has since been discovered, particularly in North America, and it may well be that some modern expert opinion would consider one or both of the second and third criteria quoted above as out of date. This is outside my competence since it is purely medical matter, and so far the Home Office

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