Recommendations
Pages: 37 to 39
Creation Date: 1962/01/01
The previous report of the Interdepartmental Committee on Narcotics was transmitted to the President of the United States of America on 1 February 1956. The present report contains a review of developments concerned with the narcotic drug problem since that time and an assessment of the problem as it exists at present. Extracts from the Committee's report relating to organizational matters and to recommendations are reproduced below with minor modifications.
The Interdepartmental Committee on Narcotics has reviewed the narcotics situation regularly through formal committee meetings and otherwise; and there has been a continuing pooling and interchange of information concerning the problem. Following its review of the subject early in 1960, the Committee felt that it would be helpful to obtain at first hand factual information and expressions of opinion from persons familiar with the problem of narcotics at the state and local levels. The Committee had already reviewed in detail evidence obtained by legislative committees which had conducted hearings throughout the country. Its own first-hand data, however, had been largely confined to materials reaching the five constituent departments in the ordinary course of business, supplemented by a review of formal and informal studies and reports prepared by other agencies, both public and private. It was felt that substantial benefit might be gained by an opportunity to explore the current situation further through informal meetings where statements could be received by the Committee, and oral questioning employed. In this way, the Committee would obtain the maximum benefit from the findings and recommendations of persons experienced with the problem in their own states and communities.
Accordingly, a series of public meetings was held by this committee composed of representatives of the Departments of State, Treasury, Justice, Defense, and Health, Education and Welfare, at Los Angeles and Sacramento (California), and New York City, during April and May of last year. Participating in those meetings were representatives of the state, county, and municipal governments, including the executive, judicial, enforcement, medical, and welfare agencies most directly interested in the problem. Representatives of civic and church groups, possessing practical experience with addicted members of the population, contributed to the very full coverage of the subject during these meetings. In all, 72 representatives participated in these meetings with the Committee.
In addition to very valuable oral testimony, the Committee was presented with copies of special studies and reports. The Committee feels that this series of meetings usefully enlarged its access to sources of important information, based upon informed current experience with the problem as it affects the communities concerned.
The Committee was accompanied at the public meetings by technical experts of the Bureau of Narcotics and the Bureau of Customs. While in the field, advantage was taken of the opportunity to view various field operations of the Bureau of Narcotics and to observe activities of the U.S. Public Health Service, the U.S. Coast Guard, and the Bureau of Customs in connexion with the entrance of persons, baggage and conveyance in the United States across the Mexican border and through the seaports of San Francisco and New York. Special attention was paid to the procedures followed with respect to the re-entry of persons previously registered as narcotics users; the search of persons, vehicles and baggage crossing the border; and the search of an incoming steamship of foreign registry.
The purpose of the present report is to bring up to date the Committee's earlier analyses of the problem, and to reflect in the revised recommendations for future lines of action those factors now found to be deserving of special emphasis, many of which have emerged from the Committee's studies and inquiries as above described.
The United States should continue its full participation in international and bilateral efforts to limit production and distribution of the narcotic drugs to the legitimate needs of medicine and science. Such efforts should be appropriately extended to assure adequate controls over the synthetic drugs found to possess similar properties. A single narcotics convention, under the auspices of the United Nations, is a measure which will clarify and strengthen the already high degree of co-operation between the United States and other nations.
We recommend that the United States Government continue to give its full support to the adoption of the single convention.
Enforcement efforts, on the international and domestic level, must be vigorously pursued to limit illegal importation to the irreducible minimum. Emphasis should continue to be placed on concentrating enforcement personnel in those limited areas of the country where the problem remains serious. The United States should stand ready to provide assistance of various types for suppressing the international narcotics traffic to both our neighbours who have contiguous land borders with us. Particular attention should be given to ensuring that all avenues for furthering co-operation with the Mexican Government are being fully explored and utilized.
The Committee recommends that the United States explore with Mexico the feasibility of establishing a mechanism for regular and frequent consultation between the two countries on narcotics and related problems.
The adoption of adequate penalties for offences involving traffic in narcotic drugs is evaluated by the Committee as being an important factor in the over-all reduction.
The Committee recommends that in those states where a substantial narcotic drug problem still exists, the subject of penalties be thoroughly examined.
In no section of the country where addiction is currently a problem of any proportions has adequate provision been made for the special hospital treatment required by narcotics addicts. Experience at the two federal hospitals, and a number of state and municipal institutions, indicates that these special requirements are definite, but perhaps less formidable than they have previously been considered to be. The need for a system of treatment for physical dependence, and the essential first steps towards psychological rehabilitation, can be included in the mental health programmes already well established in each of the states. It is essential that assurance of a completely drug-free environment be maintained; and that the determination as to when the patient may be prudently released be made by responsible medical advisers to the sponsoring authority. Systems of voluntary hospitalization have been found generally to be of small value and a waste of scarce hospital bed space.
It is recommended that the states consider the commitment of addicts under procedures similar to those applicable to mental patients in order to assure maximum effectiveness.
In its earlier report, the Committee suggested that consideration be given to the admission to the existing federal narcotic hospitals of patients under commitment by state authorities, with reimbursement to the Federal Government. While adoption of such a plan would necessarily reduce the availability of hospital space now open to voluntary patients, it is believed that a higher priority might advantageously be applied to patients under such commitment than to those applicants not subject to restraints imposed by the courts.
The Committee again recommends that legislation be sought from the Congress to permit existing federal narcotics hospitals to accept patients under commitment by state authorities, with reimbursement by the state to the Federal Government.
The Committee has been impressed by the value and thoroughness of research into the problems of addiction conducted under the auspices of the Department of Health, Education, and Welfare. In the course of its recent studies, the Committee has gained the impression that state and local authorities have not fully familiarized themselves with, or availed themselves of, the Federal Government's resources in the research areas.
It is recommended that continued support be given to such research; and that the states and municipalities be encouraged to participate fully in the light of the experience gained under their own programmes of control and rehabilitation.
It is recommended that medical associations, medical schools, hospitals and other training schools for doctors and nurses, particularly in those areas where there is still a serious narcotics problem, review their activities with a view to insuring that doctors and nurses are adequately informed on the diagnosis and treatment of narcotic addiction.
As the Committee stressed in its earlier report, it is apparent that even where fully adequate hospital treatment and facilities are made available, there will always remain the more difficult problem of guiding and assisting the addict in his final readjustment and return to normal life in a modern community. Full utilization of, and co-ordination between, all social agencies available within the addict's home community have seldom been attained; but the Committee has been encouraged by the efforts of a number of programmes which have been carried out under state, municipal, and private sponsorship. It is apparent that the individual addict needs a greater degree of guidance and supervision than almost any other class of patient; and that a substantial number of man-hours, covering a variety of developed skills, must be applied to his rehabilitation. The costs of such follow-up care appear inevitably to be high in proportion to other known demands for such services within a community. The Committee is unable to cite any one follow-up programme within its observation as having been sufficiently developed to serve as a model for general application. It has, however, noted that extremely promising results seem to have followed in a number of cases where very full, correlated efforts have been applied to small groups of addicts.
The Committee recommends the extension of such promising rehabilitation programmes; and the initiation of similar ones on behalf of additional groups.
The Committee has been struck by the fact that the character of the sponsorship - whether public or private - appears to be less important than the imaginativeness and patient thoroughness of the supervision applied to the addict. It would therefore appear that this may well be a field of interest to privately endowed foundations and civic organizations, as well as to state and municipal authorities.
The Committee has found some promising evidence that one of the more effective types of rehabilitation programme may well involve utilization of the parole mechanism.
It is recommended that the states review their laws to determine whether any amendments thereto are necessary to make it possible to develop such programmes. Similar review of federal laws should also be made.
Since the date of the last report, the Committee has given further consideration to the advisability of the use of special information concerning narcotic drugs in educational media - particularly in schools. The Committee continues to be seriously concerned that, unless such information is developed and used with the greatest care, it might tend to attract attention to and arouse curiosity over experimentation with narcotic drugs.
However, in view of the increasingly localized nature of the narcotics problem in the United States today, the Committee believes that in those locations where there is a significant narcotics problem the local educational authorities should consider the careful development of a programme for use in schools in the sensitive areas.
Despite the high degree of interest in the problem of narcotic drug addiction shown in many quarters, it still remains a subject on which divergent views are strongly held. This has perhaps been the more true because of the lack of a central mechanism for receiving and disseminating information concerning the growing body of experience, particularly in the fields of prevention, treatment and rehabilitation.
It is therefore recommended that the Department of Health, Education, and Welfare undertake to provide a clearing-house for reports and information concerned with these latter aspects of the problem, as the Departments of the Treasury and Justice have done with respect to matters concerned with enforcement.
Public and private organizations can be of the greatest assistance in such an effort if they supply periodic reports on their projects which are so prepared as to provide adequate basis for evaluation of the relative success of the methods used. Information on the types of project which have proven most successful can then be made available through the clearing-house to all interested.