17. It is not only youth who must be intelligently indoctrinated about the effects of narcotics-there is likewise need for the education of parents, teachers, lawenforcement officers, and other community youth leaders. It is, therefore, recommended that the State department of justice establish a broader program of assistance to counties and/or cities in setting up training courses and institutes for such adults, so that they may intelligently and accurately recognize the signs of potential addiction.

18. It is recommended that the State department of justice receive adequate appropriations for the production and dissemination of educational and informational mediums.

19. Recognizing that the home must share the responsibility of prevention, it is, therefore, recommended that the schools and parent-teachers organizations expand their programs of parent education and family life education classes and intensify their efforts to enroll more parents in such classes.

20. Teachers often recognize signs of personality maladjustment sooner than parents; it is, therefore, recommended that more and better guidance and counseling services, both psychiatric and psychological, be provided by schools. 21. It is recommended that communities organize community councils in which the citizens, together with the community agencies-governmental, fraternal, church, and educational representatives-may join together to study the needs of their communities and to plan how to provide the necessary services. 22. Recognizing that needed services are now being given in nine California cities by the department of mental hygiene through its mental outpatient clinics, it is recommended that this service be increased and the clinics extended.

23. The committee received ample medical and other testimony attesting to the fact that alcohol is a narcotic drug. It was stated by Committee Member Karl M. Bowman, M. D., that: "Alcohol cannot be left out as a cause of juvenile delinquency, that it is far more important in this respect than marihuana, and produces far more crimes of violence and is just as much a precursor of heroin as is marihuana."

The committee felt that the problems identified with the ingestion and abuse of alcohol are so numerous and perplexing that a separate study of this drug should be undertaken by the committee at some date in the near future. Penalties

It is recommended that the following three distinct phases be kept in mind in considering the question of penalties:

I. The addict.

II. The addict who peddles to supply and support himself.

III. The professional nonaddict peddler.

Any change or purported legislation on penalties takes on meaning only in relation to this differentiation in offenders.

I

24. It was, therefore, recommended that a new section of the penal laws be enacted providing that a person who is an addict may voluntarily surrender himself to any superior court and, upon being found to be an addict, the court shall place said person on probation and, as a condition thereof, shall send such person to a suitable State security hospital for cure and treatment. Such conviction shall constitute a misdemeanor for all purposes. It is further recommended that the judge, in his discretion, shall be able to impose as a further condition of the probation, a direction that upon the addict's discharge from such security hospital he should submit himself to outpatient psychotherapy treatment at an outpatient clinic.

Such hospitals and clinics should be first-class institutions, staffed by the best available doctors and psychiatrists, and maintained at public expense.

25. It is further recommended that this security hospitalization be established as part of the new medical center of the department of corrections and shall be for the treatment of men.

26. It is likewise recommended that a proper treatment facility for women be established at the present institution at Corona.

27. It is recommended that the records of said addicts' voluntary commitment be sealed and, should the addict successfully complete his treatment of probation, he may then return to court, and by motion under section 1203.4 of the Penal Code be relieved of all penalties and disabilities resulting from the conviction.

II

28. With regard to the addict who peddles to support himself, it was recommended by the subcommittee on penalties that the court be given discretion under this same section to determine whether such person should be given consideration as outlined in No. I above, or prosecuted as a peddler. If such discretion is given, the court should then have the power to recommend to the prosecutor that the charge be changed to being a "user of narcotics" and dismiss the charge of peddling in the interest of justice. The courts could then proceed to order a penalty, the same as provided under No. I hereof.

29. If, however, the court, in its discretion, believes that said addict-peddler is a danger as a peddler, then there should be enacted into law one penalty of State prison for not less than 5 calendar years of incarceration, and not to exceed 15 years. This sentence should apply whether the person suffered a previous conviction of a felony or not. Such person should be incarcerated in the place of incarceration, as provided in Part I above, until the treatment phase of his sentence is completed, and then should be subject to transfer to another institution as directed by the department of corrections.

30. The duration of treatment before release shall be determined by a board of three members appointed by the director of corrections.

Editor's note: These recommendations listed under No. II carried by a vote of-Yes, 12; No, 6; not voting, 4.

III

31. The subcommittee on penalties recommended that the law be changed with regard to the professional nonaddict peddler, that will charge one penalty for selling, transporting, furnishing, or giving away of narcotics, or offering to do any of these things-that said penalty be a minimum of 10 calendar years to life, said minimum to apply whether such person has a prior felony conviction or not.

32. The subcommittee further recommended that there be created a statutory presumption that the illegal possession of a narcotic in excess of an amount specified in section 11392 of the Health and Safety Code is with intent to sell or otherwise illegally dispose of such narcotic.

33. It is generally recognized that addicts obtain the money for the support of their addiction from some illegal enterprise. In order to relieve society of this condition it is recommended that: After an addict who has received treatment for his addiction to the extent that competent medical authorities believe any further attempt at rehabilitation to be futile, such addict shall, by certification of such authorities, be permanently confined to a State institution.

IV

34. The committee further recommended that, as to Nos. II and III above, the court would not be, by law, prevented from giving probation if under the particular circumstances the court felt such to be proper, instead of the heavy penalties fixed by law.

V

35. None of the foregoing recommendations relate to marihuana.

36. It is further recommended that all other penalties relating to narcotics, and especially those relating to vehicles, doctors, pharmacists, and in relation to prescriptions as now contained in sections 11000-11576, except 11391, which relates to places of treatment, remain unchanged.

37. It is likewise recommended that the dangerous drugs section of the Health and Safety Code, sections 29000-29043, remain unchanged.

TREATMENT FOR NARCOTICS ADDICTION IN CALIFORNIA

That part of California's narcotics problem which is borne by the State mental hospitals is a small one, and the number of nonpsychotic narcotics addicts committed to State hospitals gives little evidence to indicate whether narcotics addiction or just the awareness of it is increasing in this State.

Last year there were 327 persons committed as narcotics addicts (214 male, 113 female). On the whole, treatment is similar to that offered for those ad

dicted to alcohol; vitamins, subcoma insulin, tolserol, and hyocine for quick alleviation of withdrawal symptoms, and then whatever psychotherapy and rehabilitation therapies are indicated. However, since those hospitals who have any such patients at all usually have perhaps 1, or at the most 3 or 4 at any 1 time, it is difficult to stabilize a specific program for them. Length of stay is little more than the minimum 3 months (maximum to 2 years), and there are many recidivists in this group. Norwalk, as soon as adequate carbon dioxide therapy equipment is received, plans to institute a program to treat some of their alcoholic as well as narcotic drug addicts in this manner; particularly those where it is quite apparent that addiction is a result of anxiety and chonic tension.

Since most narcotics addicts are involved in crimes of one sort or another in order to get the money for the drugs, few of those arrested ever find their way to the State mental hospitals.

There is also provision for commitment of addicts to habit-forming drugs such as barbiturates. There were 51 such admissions last year.

There is some evidence that addiction to some of these habit-forming drugs may present a greater medical (and perhaps social) problem than even the narcotic drugs, since physiological dependence is so great.

NARCOTIC COMMITMENTS-STATE HOSPITALS

Recent concern over an apparent increase in the use of narcotic drugs has led to a survey of Department of Mental Hygiene records with the discovery that commitments for narcotics addiction have almost tripled in the past 5 years. During 1946-47, 86 persons were so committed to State hospitals and during 1950-51 the figure was 227. Commitments of all types only increased about one-fifth as much during the same period. The actual number of drug-addict admissions during 1950-51 was 246, counting those actually committed as drug addicts under section 5355 of the Welfare and Institutions Code; those committed under other sections subsequently diagnosed as nonpsychotic narcotics addicts; and those whose primary diagnosis was mental illness but who were also addicted to the use of narcotics.

At present, new admissions for narcotic addiction are averaging 25 a month. Average length of stay in the hospital for this type of patient was 8 months. Ninety-five percent of the patients were discharged as having benefitted from hospitalization. Of the remaining 5 percent, about half were discharged as unimproved and half as cured.

Since by far the greater majority of narcotics users come under the jurisdiction of Federal authorities, these figures are by no possible means a reliable indication as to whether or not more and more people in California are becoming narcotics addicts. Most narcotics addicts come to the attention of authorities charged with some form of crime; therefore, the vast majority are either given the "iron cure" of imprisonment or are sent to a Federal hospital. The California law provides that "if evidence is submitted showing that a person is of bad repute or character apart from his habit *** and that there is a reasonable ground for believing that the person, if committed, will not benefit from treatment, the judge shall not commit the person to a state hospital."

The value of the statistics quoted above is in the indication that there might be more and more acceptance of the belief that narcotic addiction is basically a medical problem and requires medical treatment. The laws as now constituted provide the opportunity for anyone who wants to be helped to have himself committed to a State hospital without stigma, much the same way an alcoholic is committed.1

Once the narcotics user becomes a responsibility of the department of mental hygiene, there is no discrimination between his sickness and the sicknesses suffered by thousands of California citizens now in the State hospitals. Perhaps considering the narcotics user as a medical problem is the first step towards solution of the social problem.

1 Welfare and Institutions Code, sec. 5350 et seq.

Admissions to State mental hospitals diagnosed as drug addicts without psychosis, by age at admission

1948-49 1949-50. 1950-51.

Commitments under welfare and institution, sec. 5355 (narcotic)

1

Chairman KEFAUVER. Senator Langer.

Senator LANGER. You said you had some other suggestions. What were they?

Mr. NEEB. I have one other suggestion in relation to this, and I might explain it this way: The stopping of the importation of drugs with the customs officers and the narcotics officers is a tremendously difficult problem. The only way you can do it is the way we stopped the cocaine problem.

You don't have a cocaine addiction problem in America today, and the reason is very simple: They smashed up all the factories down in Central America and Peru where they were making it, and they did it with the fine cooperation of those governments.

Now, our suggestion is this: We are sending, spending millions and billions of dollars in aid every year to other countries, and I would suggest that the Congress of this country seriously consider refusing to grant any aid whatsoever to any nation which will not enter into a workable agreement to stop the export of opium and its derivatives from that country.

We recently sent a great deal of money to Yugoslavia. They export four times as much opium out of Yugoslavia, according to our information, as they need to grow for any medicinal purposes. Of course, it is proper to grow opium to make morphine and things of that sort, but they are growing a lot more of it than is necessary.

One of our friendly countries is Turkey. But you can buy narcotics, I understand, in Turkey about as easy as you can buy tobacco. Those countries are not carrying their weight when it comes to stopping the export from their own country of the basis of heroin, within which is the black substance that comes out of the opium poppy. And I think the Congress could very well give serious consideration to at least saying or proposing that we stop aid to countries that do not aid us in this terrible problem.