The obvious advantages of this system are that it removes the major motives for peddling narcotics and for the creation of new users, puts pressure on the addict to seek medical care and removes his incentive to engage in crime. And even though the addict is not treated as a criminal, addiction has not spread. The plan, in fact, has the opposite effect by making the doctor rather than the peddler the prime source of drugs. Another of the great advantages of the system is that a mantle of decent privacy is thrown over the unhappy details.

In this country the history of opiate-drug control has been very different. Because American patent medicines in the 19th century often contained opiate derivatives which were not controlled, relatively large numbers of addicts were created who were not, however, generally regarded or treated as criminals. The problem then was in no way as serious as now. Criminal addicts were few, the illicit traffic minor in nature and addiction was largely confined to adults (about two-thirds of them women). Because drugs were legally available at low cost the user did not have to become a criminal to support his habit. Even so, an increasing concern with the dangers implicit in the unlimited availability of drugs led to the trial of measures of control late in the 19th century and in the first decade of the twentieth. Given time, this experimentation, guided by growing medical knowledge of the opiate drugs, might well have led to the establishment here of something like the English system. This did not happen because of the intervention of Federal authorities imbued with the prohibition mentality. The present system of drug control began with the passage of the Harrison Act late in 1914. This act made no mention of addicts nor did it in any way indicate how they were to be treated. It was a revenue measure designed to bring the flow of dangerous habit-forming drugs into the open through the exercise of the Government's taxing powers. All persons and firms handling such drugs were required to obtain licenses and to keep records of supplies received and dispensed. Penalties were provided for violations. An exemption was made for the prescribing of drugs "to a patient by a physician * * * in the course of his professional practice only." The interpretation of this part of the law became crucial in the early years of enforcement because on it hinged the whole matter of whether the addict was to be placed under the care of the physician or turned over to the police.

The

Between 1919 and 1925 a number of test cases-the Webb, Jim Fuey Moy, Behrman, and Linder cases-were brought before the Supreme Court. first three involved doctors who had flagrantly violated medical ethics by dispensing large quantities of drugs at high prices to addicts. Rufus King has pointed out in the April 1953 issue of the Yale Law Journal that these cases were in effect rigged by the Government. The prosecution wanted a court ruling which would prevent addicts from obtaining drugs from doctors. They evidently hoped that the unprofessional action of the doctors in these three cases would influence the court to decide against them, which it did. From the language of the indictments the Government was then in a position to argue that these rulings had established that any administration of drugs to addicts by medical men, even when done in good faith to achieve a cure, was illegal. The Linder case was designed to clinch the Government's position. Unlike the three earlier ones, it involved a doctor who had prescribed small quantities of drugs to a single addict in good faith and in what was clearly a professional manner. The Government attorneys asked the court for a ruling against the doctor on the basis of the precedent allegedly established by the earlier decisions. In this case, however, the court reversed itself by ruling against the Government. Despite this reversal, Federal narcotics authorities have continued to operate under a Treasury Department regulation which states that "a prescription issued to an addict *** to keep him comfortable by maintaining his customary use, is not a prescription within the meaning or intent of the act: and the person filling such an order, as well as the person issuing it, may be charged with violation of the law." Threatened with criminal prosecution, the majority of doctors naturally ceased to treat addicts; the minority found themselves in trouble with the narcotics agents, and in many instances were sent to prison.

In 1920 a radical change in the Government's attitude toward addicts became apparent after the enforcement of the drug laws was turned over to a newly formed unit in the Bureau of Internal Revenue which was also charged with liquor-law enforcement under the Volstead Act. From 1915 through 1919, the annual reports of the Collector of Internal Revenue included expressions of sympathy for the drug user and concern over the fact that previously respectable 86525-57- -6

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addicts were being turned into criminals by the operation of the law. The 1919 report notes that various local health authorities had been encouraged to consider the possibility of setting up clinics in which drugs could be dispensed legally to such persons. The 1920 report, however, reversed this stand. deplored the fact that some 44 local clinics had already been set up and announced that they were to be closed down. Neither the 1920 report nor any subsequent one expressed concern with the fate of the once respectable user who was being forced to the underworld to maintain his supplies.

It is a current myth that the clinics which operated between 1919 and 1923 demonstrated once and for all the perniciousness of any legal system of drug distribution and that they were closed solely because they failed. The facts are quite otherwise and more complex. It is true that the New York City clinic was generally admitted to have failed, but its failure was guaranteed in advance by the manner in which it was set up and operated. The stories of the other clinics vary. There is considerable reliable information extant about the clinic in Shreveport, La., established under Dr. W. P. Butler, which is discussed in some detail by Drs. C. E. Terry and M. Pellens in their book, The Opium Problem, a monumental and authoritative study. This clinic was originally set up by the Louisiana State Board of Health in 1919. In 1921 the board, after consultation with Federal narcotics authorities, withdrew its support and the institution was continued under the authority of the Shreveport City Council. In the same year it was unanimously endorsed by the Shreveport Medical Society; other medical groups and the local police also expressed their support. However, in 1923 the clinic was finally closed by order of Federal authorities in Washington. Dr. Butler reluctantly agreed to the closing after a conference with Federal narcotics agents who said they had been sent to shut down the clinic "because it was the only one left in the United States." When a Los Angeles clinic had been similarly closed in 1921, Dr. L. M. Powers, then health commissioner of the city, had remarked, "I have not been able to realize the actual purpose of the closing of our clinic for there has been some unseen motive prompting much opposition to clinics which I have not been able to comprehend."

The disappearance of the clinics marked the final triumph of the prohibition idea and the complete removal of the control issue from the medical domain. The drug problem is what it is today as the result of these moves by the Government. The huge illicit traffic, directed for profit by nonaddicted lords of the underworld, has become the focal point of new infection. These men are rarely apprehended or punished; it is the user, exploited by the system, who suffers the major portion of the heavy penalties that are imposed. Police suppression, by increasing the danger of distribution and reducing supplies, keeps up prices and profits.

It is a popular misconception that the increase of drug use among young people is entirely a postwar phenomenon. As early as 1921, Dr. E. Bishop, a noted authority on drug addiction, commented on the trend toward juvenile addiction and ascribed it to the prohibition control technique. Statistical evidence of the trend itself can be found in Uniform Crime Reports of the FBI over the last 24 years. In 1932, for instance, only 15 percent of narcotic law violators were under 25 years of age; in 1940, the figure had reached 26 percent; today is a little under 50 percent.

In 1930, drug law enforcement was separated from liquor law enforcement with the establishment, within the Treasury Department, of the Federal Bureau of Narcotics. Federal narcotics officials, both before 1930 and since, have combined their policing functions with an active and effective campaign in support of the punitive conception of drug control. The expression of dissident opinion was discouraged. How well their campaign has succeeded in mobilizing legislative and public sentiment is indicated by the fact that Congress, in 1951, passed laws that more than doubled the average prison sentence of Federal narcotics offenders. In January of this year a preliminary report of a Senate subcommittee indicated that the present Congress will again be asked to increase penalties, enlarge the budget of the Federal Bureau of Narcotics, and generally add to the punitive nature of the existing program. The report expressed sympathy for the addict but makes no distinction between him and the peddler. It admitted that the real culprits, the big profiteers of the traffic, are rarely caught, and proposed to deal with them by legalizing wiretapping. Although the report explicitly stated that the number of addicts in this country probably exceeds the sum total of those in all other western countries combined, no reference appeared in it to the control systems adopted abroad.

The treatment and cure of opiate drug addiction under the best of circumstances is very difficult. The main hope of control must be based on prevention. The punitive program now in operation neither prevents nor cures and it actually nullifies the rehabilitative measures that are being attempted. The addict belongs in the hospital, not in the prison. If we recognize that punishment cannot cure disease, if we want to take the profit out of the illicit traffic we need to return the drug user to the care of the medical profession-the only profession equipped to deal with him.

Chairman KEFAUVER. Next witness.

Mr. Terranova, we are very glad to have you here. Just sit down. I don't think we need to place you under oath. Let's get your name. Peter E. Terranova, former head of the Narcotics Squad; is that correct?

STATEMENT OF PETER E. TERRANOVA, FORMER HEAD, NEW YORK NARCOTICS SQUAD

Mr. TERRANOVA. That is correct, sir.

Chairman KEFAUVER. When did you retire as head of the squad? Mr. TERRANOVA. First of July of this year, sir.

Chairman KEFAUVER. Is that the New York State squad?

Mr. TERRANOVA. No, sir; New York City Police Department, Narcotics Squad.

Chairman KEFAUVER. How long were you connected with the squad?

Mr. TERRANOVA. Twenty-nine and a half years of police department, 5 years with the squad, was commanding officer. We built that squad from 32 men up to 200 men and women both.

Chairman KEFAUVER. What have you been doing?

Mr. TERRANOVA. I am now security director for the Bull Steamship Co. We use

Chairman KEFAUVER. What company?

Mr. TERRANOVA. Bull.

Chairman KEFAUVER. Bull Steamship Co.?

Mr. TERRANOVA. Yes, sir.

Chairman KEFAUVER. All right, Mr. Mitler.

Mr. MITLER. Inspector, I know apart from your function as head of the narcotics squad, you are also a student of this problem.

I want to first ask you your comment about the using of the English system or some aspects of it here in the United States, and then I will get back to your work in New York City.

Mr. TERRANOVA. The question that came to my mind when Dr. Lindesmith-and incidentally I read his book and I think it is a very fine one-came to my mind is that London alone admits to about 6,000 prostitutes, street walkers, and we have found that prostitution and drug addiction are very closely allied, so how could there only be 300 or 450 addicts in the British Isles? This was the big question that came to my mind. I can't understand that.

Mr. MITLER. Do you think that program is feasible in the United States?

Mr. TERRANOVA. I beg your pardon?

Mr. MITLER. Do you think any elements of the British program would be feasible in the United States?

Mr. TERRANOVA. It is a big step. Of course, being a law enforcement officer, I guess we just hate to give up the fact of enforcing the law, in other words, in joining them if you can't lick them.

But we do know that the old-time addict is going to have to have his drug. There is no question about it.

But will we create a condition, will we encourage it in the youngster, new person coming along, by acquiescence to this addition by the old-timer?

Iran has been licensing opium smokers, and 60 percent of the population was smoking opium in Iran when the present Shah took over the Government. He is discouraging that since he started his regime. He is outlawing the illicit traffic as much as he possibly can at this time.

He has stopped licensing new smokers. He has stopped licensing Government stores for dispensing narcotics. So here we are a new nation coming in, and we want to turn around and do what some of these old nations are experienced in and now changing their laws.

This is a program that will have to be studied and very, very closely and not just a brushoff or just over the surface. Dr. Howe's program, I think most of us are all acquainted with.

I worked with Dr. Howe personally for 5 years. I know him personally. I don't agree with his program a hundred percent and he knows it. There are lots of bugs to be ironed out in the whole thing. Mr. MITLER. Who is Dr. Howe?

Mr. TERRANOVA. Dr. Hugo Howe of the Academy of Medicine of New York has suggested this type of a program.

Mr. MITLER. There is a difference, isn't there? His program is the clinic program with drugs dispensed to addicts.

Mr. TERRANOVA. Mr. Mitler, we are always timid about the word "clinic" because of the failures in 1919, 1920, and 1921 in various parts of the United States.

In Dr. Howe's program the person would have to register, something I would approve of. All addicts should be registered. You can't fight something we don't know what you are fighting; we don't know how many addicts we have at any given point in the United States, nobody can point that out.

Mr. MITLER. Dr. Howe's program-under his suggestion there would be clinics where the drug addicts could go and get a supply; is that correct?

Mr. TERRANOVA. No, Mr. Mitler, it would be something quickly, I know the time is limited-so very quickly, the person would register, be placed in a hospital, determine whether they could or could not withdraw them and keep them off the drug, then they would be placed in the custody of a medical man, a doctor who would be licensed by the particular agency who would handle this whole thing and naturally it would have to be on a Federal basis, it could not be on a local basis because the community that would invoke, that would have every junkie in the 47 States right there to get his dope for nothing. Mr. MITLER. Turning to New York City, could you tell us briefly about the juvenile drug problem in the city of New York and bring it up to the 16-, 17-, and 18-year-old group, if you would.

Mr. TERRANOVA. Well, in 1951, we can go back that far, when we really started to get conscious, I think, of drug addiction, there were 3,661 arrests made, and of those 27 were under 16 years of age.

There were 775 between 16 and 20, including 20.

Chairman KEFAUVER. Wait a minute, 3,600 arrests made and how many were under 21?

Mr. TERRANOVA. 775 plus 27.

Chairman KEFAUVER. 802?

Mr. TERRANOVA. That is right, sir, and in 1952 there were 5,297, and under 21 there were 252 and 8, which makes 260; under 21, 260.

In 1953 there were 3,605, 556 plus 17 under 21.

These are arrests made by the New York City Police Department and not by any other agencies which, of course, the Federal Narcotic Bureau is very active in New York City.

And in 1954 there were 4,316, 729 plus 20 under 21.

In 1955 there were 5,232, and 681 plus 16 under 21. And the laws in 1951, the State legislature passed a law whereby all addicts who come to the attention of attending or consulting physicians must be reported by that physician to our State board of health.

From 1952, when the returns started to come in, up until October of 1955, there were 81 under the age of 16 had been reported. There were 2,507 between 16 and 20, and there are 11,608 or a total of 14,196. Now, there were 10,615 of male, and 3,581 female. You will see there was 11 percent under the age of 21 of known addicts in the city of New York; 57.9 percent Negro, 24.1 percent white, 14.9 percent Puerto Rican-we classify it that way, just to distinguish the raceand yellow, 3.1; 87.8 percent of the drug used was heroin in the city of New York.

Crimes to be committed by these people were approximately about eight categories starting with petty larceny as the first, burglary, prostitution, grand larceny, assaults, jostling, forgery, and armed robbery.

As you will notice the most serious one of them all, the armed robbery, there is the least of them as any. These people are very docile, and they don't go in for vicious crimes.

Mr. MITLER. Now, the narcotics squad was expanded about 1950 or 1951 in New York City.

Mr. TERRANOVA. 1951, in June of 1951 there were about 30, 32 members. The beginning of 1955 there were 200. That includes male and

female detectives.

Mr. MITLER. You are familiar with the program of the Riverside Hospital?

Mr. TERRANOVA. Somewhat, yes.

Mr. MITLER. Could you tell us what that is briefly?

Mr. TERRANOVA. Well, Riverside, who is in conjunction with a court of the magistrates system in New York City, narcotic term court, the boy or girl is presented before the magistrate, and this is not a criminal proceeding, to determine whether or not the child is or is not using narcotics, an addict, not just a user.

The child is sent to the hospital for 5 days' observation and at that time they would have time to decide, and if the child is an addict, they are sent back to the hospital for a period of, under the jurisdiction, for a period of 3 years, regardless of what age prior to 21. They could be 1 day before their 21st birthday and still could be put under the jurisdiction of this hospital for 3 years.