For forty years the United States has tried in vain to control the problem of drug addiction by prohibition and police suppresslon. The disastrous consequences of turning over to the police what is an essentially medical problem are steadily becoming more apparent as narcotlc arrests rise each year to new records and the habit continues to spread, especially among young persons. Control by prohibition has failed, but the proposed remedies for this failure consist mainly of more of the same measures which have already proved futile
The number of heroin and morphine addicts (the use of marijuana, cocaine and other drugs is a separate problem not included in this discussion) is conservatively estimated by Mr. Harry J. Anslinger, head of the Federal Narcotics Bureau, at 60,000. This figure is a guess; its main virtue is that it is the lowest offered. Even so, the contrast with European countries is spectacular. For example, the English government reports slightly more than 308 addicts, known to the authorities in all of Brltaln, with a population of over 50,000,000. There are probably more addicts in the United States than in all of the other Western nations combined, and more juvenile users in New York Clty than in the whoIe oi Europe. Almost all English addicts are reported to be over thirty years old, while close to half of ours are under twenty-five. What is even more significant, European users appear to add to the crime problem in only a minor way, and the illicit traffic there is feeble compared to ours. The American market is the hub of the drug traffic in the Western hemisphere.
In recent years there has been a growing interest in the English system of control. General Sessions Judge J. J. Goldstein of New York meptioned it recently in connection with his advocacy of,a system of controlled legal distribution of drugs to users. Dr. Hubert S. Howe of New York has also long urged such a plan, adopted by the New York Academy of Medicine, and has made reference to the apparent success of the English system. Since about 1940, the writer himself has periodically suggested that an adaptation of the Brltlsh idea be tried in this country.
The crucial difference between the American and Brltish control systems is that the English physician is permitted to prescribe drugs regularly for the morphine addlct whlle the American doctor is not. The decision as to whether or not regular prescriptions are to be given to the English user is left to the doctor, usually after consultation with another medical man. He does not have to report on the addicts under his care; but records must be kept both by him aqd by the druggists who fill the prescriptions; Through these sources the British Home Office and the police can secure information about addicts and keep close watch on them. Addicts are arrested for obtaining supplies from illicit sources or from two medical sources simultaneously. The addict cannot be coerced into taking a cure, but there is pressure on the doctor to do everything in his power to persuade the user to quit the habit.
The British addict under medical care is included in the doctor’s panel of cases under the National Health Act. Apart from the taxes he pays under this act along with the rest of the populatron, the addict’s expenses for maintaining his habit consist only in the shilling (14 cents) paid for each prescription. It is therefore unnecessary for him to engage in criminal activities to get his drug. The black market is small, limited primarily to London and a few other large cities, and caters to users who either don’t know that they can place themselves under a doctor’s care or don’t wish to do so. Sometimes an addict will refuse medical care because he is afraid his addiction will become known, or because he does not want to try to cure himself of the habit. All black market activities are, of course, prohibited by law, and the addict who patronizes peddlers risks arrest and punishment. In 1954 about thirty addicts were arrested, most of them for forging prescriptions or obtaining supplies froin two doctors at once, and the majority were punished with fines up to a maximum sf $280. The smoking of opium and the possession and use of marihuana are completely prohibited.