Senator HoWDEN. You are saying that drug addiction does not present a serious problem in England?

Mr. WALKER. Yes.

The CHAIRMAN. How many doctors would report it to the Home Office? Mr. WALKER. I cannot give a number, Mr. Chairman, because some may not come across a case in 10 years. Some of them do, and some of them do not. The vast majority have nothing to tell us.

Mr. LIEFF. Are you doctors encouraged to treat all types of addiction?

Mr. WALKER. Yes.

Mr. LIEFF. If a doctor was to treat a vicious addict, or what you call a "criminal addict," would he necessarily have to report that?

Mr. WALKER. No.

Mr. LIEFF. A doctor can give drugs for self-administration?

Mr. WALKER. Yes, provided he is satisfied it is in the interest of the patient. Mr. LIEFF. And if he "puts it over" on the doctor, the patient can set up a little trade of his own.

Mr. WALKER. I think sometimes that happens. You get a young, inexperienced doctor, who has never seen an addict in his life. I think sometimes the addict may get an excessive quantity, and he would probably use that to supply some of his friends; it is not necessarily trafficking in drugs in the remote sense but rather supplying it to friends.

Senator MCINTYRE. The doctor does not have to report that?

Mr. WALKER. No.

Mr. LIEFF. Mr. Walker, do you have peddlers or narcotics "pushers" in your white drug market?

Mr. WALKER. No.

Mr. LIEFF. Do you have any peddlers "pushing" marihuana, for instance? Mr. WALKER. We think they have some form of distribution organization. Undoubtedly the drug is coming into the country, and equally undoubtedly it reaches some of the people, and that means that certain men are "pushing" the drug. Mr. LIEFF. You think it is international traffic?

Mr. WALKER. Yes. We do not produce the drug ourselves, and it must be obtained from outside the country.

Mr. LIEFF. Is there any indication that some of the marihuana users have gone over to use heroin?

Mr. WALKER. There are some cases where we have found men who were heroin addicts who had previously smoked hemp. I do not know whether they used heroin before they smoked marihuana or not.

Mr. LIEFF. How do you explain the comparative freedom from drug addiction in the United Kingdom?

Mr. WALKER. Well, that is the $64 question.

Senator HODGES. I am sorry, I did not hear that last question.

Mr. LIEFF. I asked how Mr. Walker would explain the comparative freedom from drug addiction in the United Kingdom.

Senator HOWDEN. He did that by giving us the type of people who he considered were bringing in these drugs.

Mr. WALKER. That is not a complete explanation. I do not know whether I can give one.

Senator HoWDEN. It is just because in England, for many, many centuries, they have been so much in the habit of controlling things generally, that they can control these drug addicts with comparative ease, which is quite contrary to conditions in the United States and in Canada.

Mr. LIEFF. Could it be that since imports are confined to sea and air traffic, that they are easier to control?

Mr. WALKER. I think that is right. As we all know, our country, like some others, is cut off from Europe by the sea, and the imports have to come through the airports, or by ship.

Mr. LIEFF. Were you going to say a word to the committee about barbituates, and whether their use is on the increase?

Mr. WALKER. I would not like to say very much, because I do not think we have very firm information. Barbituates are not controlled, the same as narcotics. They are controlled in the same way as poisons. Their use is on the increase in my opinion, and we have the impression that too many people are taking too many pills, and that has increased the use of barbituates in too many cases. I think some have been taking them in place of other methods of terminating one's life.

Mr. LIEFF. I was told by someone who was reading about it that in 1952, out of 17,000 national health prescriptions, 9 percent were for barbituates.

Mr. WALKER. I do not remember the figure, but it would not surprise me if it were true, I would accept it as being a reasonable figure.

The CHAIRMAN. In regard to the criminal cases; I wonder if the condition is the same as it was in Great Britain in the days of my youth, where they looked down upon drug addicts as being of a lower class? That is, the criminal class would have nothing to do with addicts.

Mr. WALKER. That is still true. They regard an addict as dangerous and unreliable, and if necessary, they have been known to turn him over to the police to get clear of him.

The CHAIRMAN. I notice on page 8, you say:

"(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."

In our investigations, I think the evidence has shown that they receive what we call the "cold turkey treatment," that is, cutting them right off, and putting them in jail, and there has been an increase of sickness and deaths.

Mr. WALKER. We have never lost a prisoner yet. with older people, may be a more difficult question.

Whether you could do it

Senator HowDEN. We had one addict come before us in camera, who said as long as he was allowed to get a small amount of opium drug, he could fill a useful place in society, but if it was taken away from him, he was useless.

The CHAIRMAN. It was regarding the severity of the symptoms by cutting off the supply. In the jails they just cut them off.

Senator HowDEN. And develop such a degree of resentment that when a man is freed he goes right back to it.

Senator LEGER. When a doctor has an addict and is treating him, and he had ⚫ been taking from 4 to 6 injections a day, does he get what he asks for?

Mr. WALKER. In the way of payments?

Senator LEGER. No; in the amount of drugs.

The CHAIRMAN. Does the doctor give him the capsules for himself, or does he give him the injections?

Mr. WALKER. It depends on the circumstances. It is entirely the doctor's responsibility and it is up to him, as far as possible, to keep control of the issue of the drugs.

Senator LEGER. Supposing he was an addict and required six capsules a day; would he have to leave his work and go to his doctor to secure the capsules?

Mr. WALKER. It depends on the doctor. If it was a certain type of treatment, he might be given it for self-administration, but the risks there are very obvious. Senator LEGER. It is not compulsory?

Mr. WALKER. No, it is not compulsory.

The CHAIRMAN. How are the total of 5 inspectors able to carry on their duties with a population of 45 million, I mean the duties you have outlined this morning? They have a terrific number of duties: supervision, sale, import and export authorizations, dealing with the police and the customs, and so forth.

I was wondering how five persons could possibly adequately cover all those inspections and responsibilities.

Mr. WALKER. They are very busy men, as I have said. That is quite clear. But they can do it. The big detail of the inspections is done by the police and the medical officers of health. The number of wholesalers is comparatively small, and for the most part include reputable firms, whom we can be sure are not up to any criminal mischief. At worst, they may be charged with negligence, and then can be "hauled over the coals." The routine duties are conscientiously carried out, and it is not as big a job as it may appear.

Mr. LIEFF. Do the inspectors actually check the physical stocks?

Mr. WALKER. In the wholesalers' places, they can if they want to. However, they generally go by the store records, but they can look into the cupboards. The general inspection is done from the general appearance of the records and the stocks.

Senator HoWDEN. Your department is not very apprehensive of this opium drug habit?

Mr. WALKER. No; not at the moment.

Mr. LIEFF. How large a drug squad is there in the metropolitan area?

Mr. WALKER. I do not know. It is purely a police matter. It is not the custom of the police to have too many specialists, but there are men who are left on the job continuously.

Mr. LIEFF. Are there not 2 sergeants, and perhaps 1 inspector who specialize in that work?

Mr. WALKER. It would depend on what you mean by a "drug squad." The two sergeants and the inspector know a great deal about it.

The CHAIRMAN. Are there any further questions? If not, may I express the appreciation of the committee for your attendance here this morning?

We are putting on the record the fact that we received a brief from Mr. Vaille, the President of the United Nations Narcotic Commission, but there is some trouble in the translation, so we are placing it as an appendix. It is not clear at all. With your permission, we will place it as an appendix.

Senator MCINTYRE. I move a vote of thanks to Mr. Walker for the very important information he has given to this committee today.

Senator HODGES. I second that motion.

The CHAIRMAN. The meeting stands adjourned until 10:30 a. m., on Friday, May 20, 1955, to reconvene in the city of Toronto.

EXHIBIT No. 17

NARCOTIC CLINICS IN THE UNITED STATES

During and after the year 1919, 44 or more narcotic clinics or dispensaries were opened by municipal or State health officials in large cities throughout the United States in an experiment which it was thought might present a simple and easy solution of the problems arising from narcotic drug addiction. Drugs were sold to addicts at prices as low as 2 cents a grain.

There seems to be no doubt that the clinics were started in good faith, but at that time there was a general lack of familiarity with the facts regarding the addiction evil and, according to a report made in 1921 by a member of the committee on narcotic drugs of the American Medical Association, it had not been realized that:

"The vice that causes degeneration of the moral sense, and spreads through social contact, readily infects the entire community, saps its moral fiber, and contaminates the individual members one after another, like the rotten apple in a barrel of sound ones."

The 1921 report continues:

"Public opinion regarding the vice of drug addiction has been deliberately and consistently corrupted through propaganda. Cleverly devised appeals to that universal human instinct whereby the emotions are stirred by abhorrence of human suffering in any form, or by whatever may appear like persecution of helpless human beings; lurid portrayals of alleged horrible suffering inflicted on addiets through being deprived of their drug; adroit misrepresentation of fact; plausible reiteration of certain pseudoscientific fallacies designed to confuse the unscientific mind; downright false statement, and insidious innuendoes assiduously propagated are brought to bear on an unsuspecting public to encourage it to feel pity for the miserable wretches, whose name is legion, we are told, and whose sufferings, hysterically exaggerated, are graphically served up to be looked on as if they were actually being made victims of persecution by the authorities, who would deprive the wretches of even the drug they crave.

"The shallow pretense that drug addiction is a disease which the specialist must be allowed to treat, which pretended treatment consists in supplying its victims with the drug that has caused their physical and moral debauchery, * * * has been asserted and urged in volumes of literature by the self-styled specialists. "Significant articles of sensational character dealing with narcotic addiction have appeared in the public press during recent months, denouncing the alleged persecution of the addict and *** well calculated to create in their favour popular prejudice."

This same line of thought which prompted the clinic experiment in the early days of narcotic law enforcement has recently been exploited again as a solution of the present narcotic addiction problem.

The clinics were operated for varying periods and in one city as long as 4 years. The most comprehensive series of facts, having real scientific value, that had then been compiled anywhere in the world, was embraced in the published statistics gathered from analytical study of the nearly 8,000 cases of addiction registered and cared for in narcotic clinics during about 10 months by the department of health of the city of New York. These cases were subjected to most careful observation and study by specialists qualified to make scientific analyses

and arrive at sound conclusions. They reported, "We have given the clinic a careful and thorough as well as lengthy trial and we honestly believe it is unwise to maintain it any longer."

In some clinics careful physical examinations were given addicts before enrollment, and various methods of registration were practiced, including the furnishing of identfication cards containing physical descriptions, photographs and fingerprints of the addicts. (In clinics where the addicts were fingerprinted, numerous fugitive criminals were located and returned to the States where they were wanted.)

In some clinics addicts were given diminishing amounts of narcotics until reaching a minimum dosage which would prevent withdrawal symptoms; in others, cures of addiction were attempted in hospitals operated in conjunction with the clinics, as in New York City, if the addict would submit himself to treatment. In still others the customary dosage was maintained, or often increased upon the demands of addicts. Administration of drugs to addicts on the premises was attempted and proved to be completely unworkable because the addicts were unwilling to go the required distances to the clinics every 6 or 8 hours during the day and night when they wanted a “shot.”

By the end of 1925 all of these clinics had been closed by the various State authorities for the reasons quoted herein.

In New York City it was stated by the department of health that "the purpose of this narcotic clinic is to provide temporary care for addicts who have been patronizing profiteer doctors and druggists." The clinics practically eliminated this profiteering practice, but there suddenly mushroomed and thrived in its place a tremendous illicit traffic in narcotics which supplemented and nullified the reduction treatments of addicts in attendance at the clinics.

In a 1-year period in the early 1920's when these clinics were in operation, the volume of illicit peddling of narcotics reached the point where an incredibly large amount of 71,151 ounces of narcotic drugs was seized in the domestic illicit traffic or more than 14 times as much as was seized in 1952.

In New York State alone, when 16 or more narcotic clinics were in operation throughout the State, almost 4,000 ounces of narcotic drugs were seized in illicit channels during a year-or almost as much as was seized in the entire United States during 1952.

As an indication of the vast extent of addiction during the several years around 1920, four hospitals in New York and the United States penitentiary at Atlanta, Ga., reported 25,000 cases of drug addiction; and the New York City Prison reported 12,000 cases. (In all of the 25,000 cases where immediate and absolute withdrawal of the drug was routine practice there were no deaths resulting.) At Sing Sing Prison in 1920, the number of drug addicts received increased over 100 percent; in 1922 they increased over 500 percent, and in 1923 the increase was over 900 percent.

In 1922, 20 percent of the prisoners incarcerated in the Atlanta penitentiary were drug addicts; at the woman's workhouse, Blackwells Island, practically all prostitutes committed were drug addicts, and from 60 to 80 percent of all committed there were drug addicts.

This illustrates the situation with regard to crime and drug addiction during the period when the narcotic clinics were in operation.

In 1952, 7.8 percent of the prisoners committed to Federal institutions were narcotic addicts, and 1.4 were marihuana addicts.

THE NEW YORK CITY NARCOTIC CLINIC

Excerpts from report published February 1920 by S. Dana Hubbard, M. D., acting director, bureau of public health education, department of health, city of New York:

"The arrest of several trafficking physicians and druggists (in the spring of 1919) for violating the narcotic laws caused the department of health to open a relief clinic, which began as an emergency and was expected, naturally, to be only a temporary expedient, but the necessity was so acute, and attracted so much attention from those interested, that the commissioner of health decided to continue it for some time, in order to study this subject and obtain data regarding the problem.

"We feel that we have had an unusually wide and peculiarly general experience with drug addicts of all classes-classes so large as to make us think that others experience in this form of practice has not been nearly so extensive.

"The public narcotic clinic is a new thing. In fact, there are only a very few in existence and, if we may judge from our experience, they are not desirable, and do not satisfactorily deal with this problem. We have given the clinic a careful and thorough as well as a lengthy trial and we honestly believe it is unwise to maintain it longer.

"The clinic has been found to possess all the objectionable features characteristic of the so-called ambulatory treatment, as practiced by the trafficking physicians.

"From our experience with narcotic relief and registration in New York City, we now are of the opinion that the present law-the Harrison Act-should be strictly and uniformly enforced. To do so would bring these tipplers in drugs to the front, and would hurt no one, not even the users themselves. These opinions, while radical, are not given to belittle the opinions previously expressed by persons supposedly well-informed on this matter, but are the results of an actual practical and intimate working knowledge of this subject.

"Most-in fact 70 percent of the addicts, in our clinic, are young people (9 percent, or 743 out of a total of 7,646, were in the 15-19 age group); they have had no really serious experiences-surely none sufficient to occasion a desire to escape al lof life's responsibilities by recourse to the dreams of narcotic drugs; therefore the one and only conclusion that we can arrive at, is that the acquirement of this practice-drug addiction-is incident to propinquity, bad associates, taken together with weak vacillating dispositions, making a successful combination in favor of the acquirement of such a habit. Being with companions who have those habits, they, in their curiosity, give it a trial (similar to the acquirement of cigarette smoking in our young) and soon have to travel the same road to their own regret. (Reasons assigned by addicts for acquiring the habit were: Bad associates, 5,190, or 69 percent; illness, 1,994, or 26 percent; other causes, 280, or 5 percent.)

"The emergency relief narcotic clinic has brought out a mass of material, from which it is possible to study this problem, heretofore more or less vaguely thought about, and on which there were but few statistical data.

"Habits usually only affect the individual but, in drug addiction, indulgence appears to react on the community. The effect on the community is evidenced by debauching of its citizenry, by increase of crime and antisocial vices. The extent also spreads like a pestilential disease.

"There may be those who say drug addiction is a mysterious disease; that it creates a disease mechanism; that it is not a matter for the authorities, particularly for the department of health; ***

"Our opinion is that this habit is not a mysterious disease; there is a very general and complete understanding of drug addiction from the therapeutic standpoint among all who have dealt with it in institutions. In our opinion, drug addiction is simply a degrading, debasing habit, and it is not necessary to consider this indulgence in any other light than an antisocial one, and that those who are charged with correcting and preventing such tendencies should be stimulated to do so to their utmost, and all efforts exerted in this direction should be free from restraint, absolutely unhampered, and that all physicians interested in the general welfare of the people should earnestly encourage such action.

"There may be other views regarding the control and prevention of drug addiction, but we opine that this is the natural and sane one to be generally expressed. It can be safely said, without contradiction, that drug addiction, per se, is not a disease, nor to be so regarded any more than excessive indulgence in cigarettes (to which all of these addicts appear to be committed), or an overin