of Defense witnesses disclosed plans for a world-wide epidemiological survey of drug use among all members of the armed forces, to be undertaken this year.

Nevertheless, certain insights may be gained from the available studies. It should be noted that these studies generally reveal drug use of a greater amount than do the medical and law enforcement figures given the staff. However, they seem to be lower than the subjective assessments of command particularly at junior levels. Among those studies most heavily relied upon in this report (all cited in the hearings record) are the following: (1) Patterns of Drug Use: A Study of 5,482 Subjects, by Black, Owens and Wolff, Fort Sill, Oklahoma, 1970; (2) Drug Use in Vietnam-A Survey Among Army Personnel in the Two Northern Corps, Stanton, 1969; (3) Marihuana in Vietnam: A Survey of Use Among Army Enlisted Men in the Two Southern Corps, Roffman and Sapol, 1967; (4) Marihuana in a Tactical Unit in Vietnam, Treanor and Skripol, 1970; (5) Marihuana Use in Vietnam: A Preliminary Study, 1968; and (6) A Study of Marihuana and Opiate Use in the 82nd Airborne Division, 1969. Of these, only the Stanton and TreanorSkripol studies used samples which included both officers and enlisted men; the others concentrated on enlisted men in the lower ranks.

Patterns of drug use shown by the most recent studies seem to be consistent with the findings from what is considered to be the most scientifically valid study of them all, the one by Stanton. He grouped nonusers, (1-20 times used), heavy users (21-199 times used), and habituated users (200 or more times used). He also sampled both incoming and outgoing troops. Overall, he found that 53.2 percent of enlisted men had used marihuana at least once in their lives. He also found a trend toward more frequent usage in Vietnam than had been reported two years earlier. Of the 50.1 percent who reported using marihuana in Vietnam, 20.5 percent were casual users, 11.9 percent were heavy users, and 17.7 percent were habituated users; in other words, heavy and habituated users were more numerous than casual

users.

Patterns of other drug use which Stanton found among soldiers leaving Vietnam included the following: (1) opium use was reported by 17.4 percent (9.8 percent casual users, 5.8 percent heavy users, 1.8 percent habituated users); (2) amphetamine use was reported by 16.2 percent (11 percent casual users, 4 percent heavy users, 1.2 pecent habituated users): (3) barbiturate use was reported by 11.6 percent (7.8 percent casual users) 2.7 percent heavy users, 1.1 habituated users); (4) heroin/morphine use was reported by 2.2 percent (1.4 percent casual users, .6 percent heavy users, .2 percent habituated users); (5) acid (LSD, STP) use was reported by 5.3 percent (3.2 percent casual users, 1.6 percent heavy users, .5 percent habituated users).

In general, it can be concluded from all these studies that drug use, at least among Army members, has been increasing with the passage of years since 1967, when the first study was conducted, and that a growing proportion of servicemen are entering the service with a history of drug use.

There is no pure stereotype of the drug user in the military, just as there is none in civilian society. While the great bulk of drug abusers are enlisted men of lower rank between the ages of 18 and 25, users may also be found in the non-commissioned and commissioned officer ranks; for example, a heroin-hooked sergeant at Fort Bragg was "the outstanding NCO in his company" or a colonel in Vietnam who became a "speed freak" from taking amphetamines to stay awake on long patrols and then used other drugs to get to sleep. While these extremes do exist, the age group of the typical user is much the same as it is in civilian society.

From the studies and from our on-site investigation we would ascribe the following characteristics to most drug abusers in the military: age 19-22, rank E-4 or below, unmarried, less than high school graduate, either draftee or non-career oriented enlistee, equally from field or support units on first overseas tour.

Other factors seem to be present in those who become regular or habituated users. These persons are generally from broken homes, have a lower education (are high school drop-outs), have insufficient personalities to deal with their fears and stress (passive-aggressive personalities, immature, situMonal adjustment problems, low-self-esteem, lack of long-term ambitions,

etc.) and are likely to become involved in other behavioral problems within the military society. In Vietnam, we were told that nearly all of the arrests for drug offenses were incidental to arrests for other violations, such as uniform violation, curfew violation, off-limits violations, etc. The cases which required medical treatment usually were those with these kinds of negative behavior patterns and with psychological problems which went beyond their drug use. At Fort Dix, New Jersey, many of those who were being held in the Special Processing Detachment were also drug abusers. The Special Processing Detachment is primarily a holding unit for individuals apprehended anywhere along the East Coast for being AWOL. They are sent to Fort Dix until their records can be located and their proper unit determined. This individual who is going to become a habitual user of drugs and who is going to become a problem for the military-in either medical or disciplinary terms-is an individual who has personality problems sufficiently serious that he would likely become a problem in whatever societal structure he is in.

It should be emphasized that the drug user-particularly the heavy useris likely to be a member of a peer group or sub-cultural group in which the taking of drugs plays an important role. For example, we were told that in Germany most arrests for drug abuse were made in groups. These arrests by the Criminal Investigation Division were usually the result of the infiltration of a group by an agent and when the arrests were made the entire group was taken.

The sub-culture is best illustrated by the experience at Fort Bragg, North Carolina. There the drug users leave the post to congregate in pads rented by small groups for the purpose of off-duty relaxation through drugs. These pads are characterized by psychedelic decorations, acid rock music, and by the mod dress of the participants. We were also told in several places that the figures on the extent of use were distorted depending upon which group an individual trooper belonged to. If the person questioned was a non-user, he associated with other non-users and tended to view all use in terms of his group; his estimates were usually low. The user on the other hand associated with other users and tended to feel that everyone used drugs.

B. The drugs being used

The kinds of drugs being used in any particular area depend to a large degree upon the extent to which they are locally available. In Thailand and Vietnam, there are few effective controls on the availability of any drug. Because of a lack of doctors, apothecary shops dispense virtually every manufactured drug and many herbs and other types of remedies. These are dispensed without a prescription to any buyer. Also in Thailand and Vietnam, as in most Southeast Asia nations, opium, particularly among the Chinese populations, has been the drug of choice of the natives. This and its derivatives, morphine and heroin, were reportedly supplied primarily by an organized network of Chinese operating in nearly all nations.

In Vietnam and Thailand marihuana was freely available. In Thailand, the members of the staff had no difficulty in procuring "tailored" marihuana cigarettes with filter-tips. These cost $1.50 for 15. In the United States a similar amount would cost at least five times as much. They can be procured from or through bar girls, taxi drivers, and even young children on the street. In Nakhon Phanom, Thailand, we were shown apothecary shops which dispense the various amphetamines and barbiturates which some Air Force troops use. These were small shops with an open front and shelves loaded with bottles and jars. Drugs were dispensed either by name or by describing a set of symptoms which led the shopkeeper to dispense whatever he felt would solve the problem.

The Southeast Asia marihuana is fresh and potent. Delta 9 Tetrahydrocannabinol (THC) is the active ingredient in marihuana. The average sample available in Southeast Asia contains between 3.5 and 4.0 percent THC. This is much higher than the average 2 to 4 of one percent THC which U.S.-grown marihuana contains. The preference for marihuana in Southeast Asia among U.S. troops is ascribed to ready availability, inexpensiveness, ease of cachement, non-addictiveness and the quality of the intoxication produced.

Stanton found a growing trend among U.S. troops in Vietnam toward the use of opium. This is available in liquid or powdered form. Among the departing enlisted men in his sample, only 6.3 percent reported having used opium before their arrival but 17.4 percent reported use upon leaving. However, the question has been raised as to whether these troops really know what they were using was opium. We also heard of opium being available in the form of "OJ's"-marihuana cigarettes dipped in liquid opium.

Stanton's 17.4 percentage figure for opium use in Vietnam places that drug ahead of amphetamines, or "speed," in popularity among the troops. The incidence of amphetamine use among outgoing enlisted men was 16.2 percent, up from 12.4 percent usage before their arrival in Vietnam. Barbiturates were favored by 11.6 percent. Other drugs used were heroin, morphine and "acid" (LSD, STP), with the use of "acid" actually showing a drop in the before and after figures.

We were regularly informed that there was an increase in the availability, experimentation with, and use of heroin. There seemed to be an increase in the hospitalizations for heroin withdrawal. Heroin is available in two forms: "Red Rock" heroin from Thailand (reportedly brought to Vietnam by Thai troops) and refined heroin. Red Rock is generally 3-4 percent heroin, 3-4 percent strychnine, and 32 percent caffeine. The refined heroin is in 100- and 300-milligram capsules containing 97 percent heroin as compared to the 5 or 6 percent heroin usually available in the U.S.

The two most commonly used amphetamines come in liquid form. They are Maxitone Forte and Obesitol, both of French manufacture. Maxitone Forte is taken orally mixed with Coke or used intravenously. Obesitol is taken orally. The barbiturates most commonly used in Southeast Asia are Binoctal and Aminotal, also of French manufacture.

In Germany, there is a plentiful supply of hashish, amphetamines, and barbiturates, and U.S. troops and their dependents have easy and inexpensive access to them. Hashish is by far the drug of choice and is in widespread use. It is reputedly brought in by "guest worker" nationals from growing countries such as Turkey, Pakistan, and Lebanon and by a number of criminal syndicates. We were told it is distributed by German nationals, by American military personnel and former servicemen who were discharged in Europe. "Uppers" and "downers"-amphetamine preparations, Librium, Valium and Darvon-may be purchased inexpensively over the counter, without prescription, in any German drug store.

LSD is also used in significant amounts by troops in Germany. This is either brought in from the U.S. or made in illicit laboratories in Germany. We had very little indication of heroin or cocaine use. Both the law enforcement personnel and the medical personnel had had very little contact with these drugs.

Regardless of location, marihuana and hashish usually is smoked in pipes or cigarette form. In Vietnam, the marihuana cigarettes are sometimes filled with Red Rock heroin and smoked. The amphetamines and barbiturates are generally taken orally but occasionally they are injected intravenously. Heroin is generally smoked (sniffed) by beginners and injected by heavy users.

It is important to note that most of the regular or heavy users are multiple drug users. They will substitute one drug for another if availability is a problem or will use a variety of drugs to meet their emotional needs. The takers of amphetamines will use barbiturates to come down off their high. Most of the users of hallucinogenic drugs such as LSD or STP also used marihuana.

C. When and where drugs are being used

It is difficult to disagree with the impression of an Army psychiatrist who says that "the use of drugs and alcohol can occur anywhere at any time." However, it is our general impression that it is more likely to occur on off-duty hours whether in the United States or abroad. It is also likely to occur away from the military post.

The most crucial question on time and place of use concerns the use of drugs in combat. In Vietnam, commanders universally told the staff that, because of the personal danger involved, there was far less smoking of marihuana in combat areas than in rear support areas. The same was stated commanders to the Department of Defense Drug Abuse Control Com

.

mittee Task Force headed by Jerome A. Vacek of the Marine Corps during its visit there in the fall of 1970. We were told that there was considerable self-policing among the troops while in combat areas because they did not want to endanger themselves or be endangered by another who might be "high" at a critical moment. However, there is evidence to contradict this. While he did not approach the question head-in, Stanton found "a slight positive correlation between marihuana use and combat exposure." While this shows that combat experienced troops probably were those who had the greatest marihuana experience, it does not necessarily indicate that they used it while actually in combat. Postel's study also indicates the same thing but adds that the usage came after combat "to calm down." Treanor and Skripol likewise found apparently increased usage with field-type duty; far greater numbers reported usage at large and small "LZ forward areas" than numbers reporting usage at "rear support areas." Reinforcing this was their further finding that an overwhelming majority of regular users (once weekly to once daily or more frequently) thought that marihuana should be permitted on fire-bases either during off-duty hours or whenever the individual chooses. Other individuals indicated in person to the staff that they had used marihuana in combat situations.

As noted above, the use of drugs at Ft. Bragg takes place primarily in rented "pads" away from the base and on off-duty hours. In Vietnam and Thailand, it is likely that most use takes place away from established posts because of availability of drugs and the likelihood of nondetection off post. In the career context, Treanor and Skripol found the highest incidence of marihuana usage during the first two or three years of a soldier's military service. They also reported that apparently there is a slight increase in usage as the first tour progresses, but not with those on extensions.

As for Vietnam, Stanton found that the probability was greatest that if a man was going to start using marihuana there, he would begin in the first three months, or certainly in the first six months. Conversely, amphetamines showed the opposite trend, with more enlisted men beginning use as their tour progressed.

D. Why drugs are being used

The reasons which have been presented to us as to why drugs are being used by young men in the military fall into two general categories. First, there are those which lie with the individual himself. Second, there are the external factors which arise in the individual's environment. The former are related to his ability to deal with his situation and the latter are those which place burdens upon him which he must deal with. If his ability to deal with environmental stresses is inadequate, or if the burdens of stress which the environment places upon him are unusual, the individual user will take one of the drugs available to help him cope with the situation.

As mentioned earlier, the habitual drug user is likely to be young, have a low education, come from a broken home, and have psychological and emotional problems which lead him to conflict in whatever society he happens to be in. These are individuals with a low self-esteem who are unable to meet most life situations. Other individual reasons presented to us are related to the attitudes held by many of the age-group from which the typical drug user comes. These include the following: (1) youth, being "now" oriented, are impatient and frustrated by the gradual process of social change; (2) middle-class youth reject the life goals of affluence and prestige held by their elders; (3) lower-class and minority youth are impatient and frustrated with the disparity between their goals and perceived opportunities to attain them "now," and they see the Establishment as trying to block them; (4) young people "get hung up somewhere along the developmental line" toward maturity, with a conflict developing between dependency and autonomy; (5) drugs are a means of acting-out behavior disapproved of by parents or the senior generation and thus help to concretely distinguish the "self" from Establishment norms. The latter point seems to be particularly valid in regards to the troops in Germany. There we found, to a greater degree than in Vietnam, an attitude of division between the enlisted or drafted lower rank soldiers and the "lifer" NCO's and officers. Perhaps these troops are using drugs as a means of setting themselves off from the older and higher-ranking personnel who use alcohol as their social drug.

Other factors lie with environment in which the young soldier finds himself. Pressures are put upon him which are difficult to cope with.. Prime yamong these is the lack of sense of value which many soldiers feel about their job. Treanor and Skripol found that job dissatisfaction seemed to correlate with marihuana use. This factor was also cited among many of the returned troops who have several months of stateside duty left before discharge. These men are given unfulfilling tasks to do while waiting out their time. This factor appeared to be particularly acute in Korea and Germany where there is little or no actual combat. Since the troop units there must be combat-ready, there is apparently much routine work aimed at preparing for inspections. A jeep driver in Germany, for example, told us that his only consistent job during the three months in advance of a unit-wide vehicle inspection was to "maintain" his own vehicle. A platoon leader said the only time the morale of his troops seemed to lift was when they were preparing to go on a tough training exercise, which was infrequently. There was widespread griping about the many "make work" jobs that troops were being given to do.

In Vietnam, stress from combat was cited as a factor. It was felt that some troops used drugs, particularly marihuana, to unwind or relax after combat. This is accentuated when the soldier moves from a stressful situation to a combat lull where only routine work is required of him.

Another important external factor is peer group pressure. There were indications that peer group pressure "to be one of the boys" was strong. The young man, placed in a new situation, seeking to establish his own identity, looks to join a group in which he will get approval and support. He may be trying to feel independent of his elders' authority and so when the group pressures him to conform by trying drugs, he finds it hard to resist. We heard reports of individuals being threatened if they did not conform to drug usage patterns but were unable to verify any of these.

We learned of several factors which tend to enhance the peer group situation. We were told that the non-commissioned officers generally did not live among their troops in barracks areas. The older "lifer" non-commissioned officer was regarded very negatively by the young soldiers. There was apparently little identification of the young soldier with the older, non-commissioned officers. Contributing to this problem is the fact that many of the young soldiers were coming from a sub-culture in civilian life which accepts the use of drugs. They not only would want to perpetuate their life style but would resent and resist those who might prevent them from living it. Another factor is the lack of acceptable alternatives to drug use to meet either stress or boredom. The soldier in Vietnam has little or no way of dealing with his frustration in any constructive fashion. Most towns are off-limits and those that are not are limited in what they have to offer. The primary activity when they are permitted off the post is drinking in the local bars and meeting with local women, most of whom are prostitutes. In Germany, the opportunities for meeting local girls are somewhat improved for white soldiers but an obvious problem exists for blacks who are also barred from certain German-operated "white-only" discotheques. In Vietnam, recreational facilities are generally unavailable and are advocated as an alterntive to drug abuse. However, it is questionable if these would be used, since in Germany we were told that there is a general lack of troop interest in recreational activities available-playing basketball, skiing, academic courses, even three-day expense-paid excursions.

In contrast to this picture is the experience of the Air Force in Vietnam and especially in Thailand. The extent of drug use was reported to be decidedly lower among the Air Force men at the four bases we visited in Thailand. The command personnel gave evidence that both arrest and medical statistics were much lower. The reasons which they gave for this lower use might be instructive: they stated that the typical airman tends to be older than the soldier; nearly all are high school graduates with a significant number having some college experience; they tend to identify with the military; they have good self-esteem; and they feel that they have something to lose if they use drugs. They also said that in Thailand, airmen were working a 12-hour-a-day, 7-days-a-week schedule and were doing tasks of a higher caliber. (In Thailand much of the more menial-type tasks are formed by local natives.) The Air Force personnel are said to have a high