The Addict: Criminal or Cripple?

...Stanley F Yolles, nimh director, a psychiatrist, points out that heroin addiction is an illness mainly of young people, the age group with the highest potential for rehabilitation Yet juvenile arrests involving the use of drugs, President Nixon told Congress, rose by almost 800 per cent between the years 1960-67 "Half of those now bemg arrested for the illicit use of narcotics are under 21 years of age " Experts are reluctant to talk about "cures" of this chronic, relapsing illness But there have been cures The best cure, of course, is the obvious one when drug dependents can stop using drugs altogether, and manage to stay off them with help This is the route of Synanon Foundation, Inc , with its fascinating network of residential houses in California A self-help organization, Synanon relies on ex-addicts to assist newcomers (many of them straight out of the country's jails and penitentiaries) to break completely with their old drug dependence In its drug-free environment, Synanon over the past dozen years can boast the largest bloc of exaddicts in the country—some 1,500 boys and girls, men and women, living, workmg, helping one another, going to school and college, and contributing to the communities m which they have developed their own lifestyle Certain other small self-help centers, adapting Synanon techniques, have sprung up in various cities and account for some hundreds more ex-addicts, but with varying degrees of success And m New York City, a methadone-mamtenance program expects to help rehabilitate some 5,000 heroin addicts, restoring them to families and jobs (Methadone, an addictive drug, is used as a "substitute drug" m this state-supported effort, to block the hunger for hero-in) As can be seen from this random sampling of attempts at cures and rehabilitation, the large majority of addicts by far—in the hundreds of thousands—are on the street, unable or unwilling to enter these programs For them, home is the street, the "fix," the robbery, the mugging, the prostituting to pay for the illicit drug Unlike alcohol, where a person can take a drink or two and not become an alcoholic, heroin is nearly always addictive No beginning user believes this, and even sophisticated addicts have told me confidently after a prison term and hitting the street again, "I ain't got a big habit I know when to stop just using once in a while " But they never know when to stop, which accounts for the shocking rate of relapse (75-90 per cent, and 100 per cent in some neighborhoods) From the large body of studies, scientific and lay, one thing is clear Reliance on criminal sanctions will not solve the problem A medical problem needs a medical solution With the shift in public opinion to this understanding, one need only recall that the bootleg issue was not solved by harsher laws, and legislation did not settle matters of morallty The Establishment had allowed the whole till to become the property of the international crime syndicates It still does with respect to drugs called illicit Once again Band-Aids are being proposed to cover up deep wounds m society, now no longer just a ghetto problem but touching "nice" boys and girls from middle-class families Teachers are bemg asked to take on the responsibdities of doctors, sociologists, psychiatrists and the pohce in their classrooms, to detect and halt the spread of addiction So the emphasis remains on a prosecution rather than a public and mental health approach This deplorable state of affairs is traceable to the policy of the Bureau of Narcotics, adopted in the early 1920s Before then, as the National Council on Crime and Delinquency (nccd) reminds us, although this country had many addicts, they were not criminals Those who needed treatment went to clinics or doctors Under present laws, a doctor who gives drugs to an addict faces possible indictment, prosecution, humilation, and loss of his license to practice He may also go to j ail for his humanity For the Bureau of Narcotics, contrary to Supreme Court decisions, adopted regulations forbidding doctors to administer maintenance doses of addicting drugs to addicts Justice John Murtagh of the Supreme Court of the State of New York, now presiding over the pretrial hearings of the Black Panthers in the Criminal Court, has written "Perhaps nowhere is the cruelty of the [present] policy more evident than m the Criminal Court of New York City As many as fourscore addicts confront judges of that court on a single day In his heart, the judge knows that there is little or no hope for any of them Yet he must go through the motions of supporting an enforcement program which, he is convinced, is creating more serious problems than it solves Addiction is a condition of human degradation It cries out for humane tolerance and Chnstbke charity The time has come to reassess our approach " Such a reassessment is long overdue from the Federal government, and is being demanded by many leading citizens "It is an outrage," Congressman Edward I Koch (D -N Y ) charged last week, "that the Federal government is currently spending only 1/14,000 of its total budget on narcotics Judge Amos Basel of the Criminal Court has gone on television to support legalization of addicting drugs for those who depend on them He has endorsed a bill introduced by New York State Assemblyman Franz S Leichter that would make it possible to register addicts to receive doses of heroin and/or other hard drugs legally in state climes, under medical controls Paul O'Dwyer, who is seeking the Democratic nomination for United States Senator from New York, has urged the testing of a plan by which the addict would be given his needed drugs each morning under Health Department supervision (much as the methadone substitute is distributed legally) "He will have no necessity to go m and rob anybody's pocketbook, burglarize anybody's home, and we will dispose of the Mafia immediately—there will be no profit in it " Dr Mark Tarail, director of the Maimomdes Community Mental Health Center in Brooklyn, which has many addicts m its therapy program, says "I'm for legalization of the medical use of addictive drugs for the treatment of addicts This will take the profit and the criminality out of drugs Immediately you solve one social problem, namely, crime, violence and tremendous profits for the syndicate " And Dr Bruno Bettleheim, professor at the University of Chicago and an authority on adolescent behavior and emotionally disturbed youth, told a recent seminar on addiction in New York "The doctors, not the criminals, should control narcotics" He recommended, as do many experts, the British approach of legally disposing addictive drugs under medical control The British have never allowed their doctors to abdicate, or the police and the underground to take control In the United Kingdom, the "drug dependent" is truly regarded as a sick person, not a criminal He receives the drugs he needs legally, m order to contmue life as a social person He receives a prescription for his dose under the National Health scheme, and for a few shillings gets it filled at the corner chemist This enables him to live nearly normally with his family, in the community, on the job Recently, the British government changed its method of dispensing drugs from private doctors to clinics, but its philosophy of leaving the problem to the medical profession has never changed "Establishment" experts have lately reported a "marked increase" in drug addiction in Britain, and such reports, in both Britain and America, undoubtedly give comfort to those who would rely on the prosecution approach What they usually fail to mention is that the "marked increase" involves, m Britain, an increase in official totals of 1,349 addicts in 1966 to 1,729 in 1967, and an estimated 2,000 in 1970 known to the Home Office, there are possibly another 1,000 oi 2,000 involved m illicit purchases And what they always fail to mention is that the British addicts' contribution to crime is negligible The evidence is by now overwhelming The present tragic plight of narcotic addicts in the United States—untreated, turning to crime, killing themselves through overdoses—can only worsen unless the government is forced, through enlightened public opinion, to reassess its approach to the problem...

...BY GERTRUDE SAMUELS In New York, a 17-year-old Barnard College girl, a freshman from Chicago, is found dead in a Bronx apartment where students had been sniffing heroin at a party the night before, police describe the apartment as "a regular factory" for the production of hard drugs A 12-year-old boy ods (overdoses) and kills himself m a hajl bathroom in Harlem by shooting herom into his arm A 12-year-old daughter of a wealthy East Side psychiatrist is picked up by police following a three-day drug binge, saying "I take hash, pot, lsd, heroin, speed, anything I can get A 16-year-old football player in the Bronx, a 17-year-old Brooklyn boy, a 19-year-old Staten Island boy all die from drug abuse As this article is being written, the Medical Examiner's office announces five more deaths from heroin poisoning of young people under age 21 Such are only the extreme cases of hard drug abuse reported in the past few weeks, scaring the hell out of New Yorkers And why not7 In 1960, 15 cases of teenage deaths from drugs were recorded, m 1964, 38, m 1969, 224 In the period 1965-69, 2,935 persons of all ages died of drug abuse Then there are the "walking dead"—known to the World Health Organization as "drug dependents," and to Americans as drug addicts, junkies, dope fiends An estimated 100,000 prowl the streets ot New York alone, and probably two or three times that figure are spread throughout the country No one can say for sure, there are no reliable statistics to be gleaned from police or hospital records Owing to a government policy which relies on criminal sanctions to enforce the drug laws, doctors deal with addicts at their peril—while the high financiers of organized crime and the dope racket are rarely brought into court for sentencing The tragedy of this picture today is that more and more Americans do understand that drug addiction is a medical and not a criminal problem, that the hard-drug users need medication and psychiatric help to encourage them to cope with their illness—and hopefully be cured of it Even hard-nosed policemen, detectives, judges, district attorneys, legislators, perhaps because the problem is suddenly coming alive to them in their own homes, are beginning to appreciate that the user and the small-time pusher who is addicted is, as one who prostitutes for her "fix" put it, "really crying out for help" To properly focus the situation one must, at the outset, separate the "soft" from the "hard" drugs, specifically distinguish between marijuana and heroin Marijuana—or pot, tea, weed, grass—a "soft" drug, is a mild hallucinogen that is not narcotic like heroin and is not addictive Its effects resemble those of alcohol and, studies show, are just as numerous, ranging from nothing to nausea, exhilaration and a feeling of liberation Marijuana is a social and not a medical problem, and despite the risk of a prison sentence for smoking or being caught with a reefer, between 10-20 million Americans are using pot Not only are the punitive laws no deterrent, but it seems certain that the eventual legalization of pot is no pipe dream The strong reaction to this comes from those who fear that its use leads to addiction?to the use of stronger drugs such as heroin National Institute of Mental Health (nimh) doctors m Washington point out that this danger does exist for some," but "it is not now generally believed that the marijuana smoker goes to hard narcotics as a logical progression " The real social and medical problem is with the chronic, relapsing illness of heroin addiction The "why" of it is rooted in many causes One of them is the fact that we are a longer-lived nation today, thanks to the control of diseases once epidemic and endemic (tuberculosis, pneumonia, diabetes) "We are also," says Dr Sidney Cohen, director of nimh's Division of Narcotic Addiction and Drug Abuse, "a drug-using society, oriented at an early age to the idea that there's a pill or drug for what's wrong with us Although you would imagine that affluence would automatically bnng happiness," the white-haired psychiatrist told me recently, "this is not so at all The luxury of leisure has brought boredom—a disease of leisure—and a loss of direction Middle-class parents provide—but also deprive deprive young people of the opportunity to experience the stresses of life This makes for a prolongation of adolescence in the affluent society You don't have to take on responsibility Yet responsibility, stress, struggle, defeat, frustration?that's how people grow, by enduring, by coping with them "In the ghetto," Dr Cohen continued, "it's almost the opposite picture Here the world is so hopeless, dismal and frightening that the people feel hopeless about the future, and are led into drug-takmg behavior Certainly in the numbers of drugs consumed, including the rmnd-altermg drugs, I think we're the Number One country in the world " For most addicts, heroin is the drug of choice A synthetic alkaloid (known also as horse, H, Boy, Joy Powder, stuff), it is synthesized from morphine but several tunes more powerful than the parent drug Producing or importing heroin in the United States has been prohibited by law since 1925, leading to an immensely profitable big business in the drug for the underworld Dr...