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THE BRITISH EXPERIENCE PDF Print E-mail
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Books - Drugs & The Public
Written by Norman Zinberg   

Britain, unlike the United States, has always permitted addicts to obtain and use drugs legally. A noncriminal approach to addiction has minimized social costs from both use of drugs and efforts to prevent that use. No black market in heroin has developed; addict-related crime is largely unknown; and the police have not had to intervene in the lives of drug users. In 1965 there were still fewer than 1,000 addicts known to the government.

In 1964, with new patterns of drug use emerging, the "drug problem" suddenly burst on the British scene. The rate of new addiction rose dramatically, while the age of addicts fell. The total number was small (a few hundred), but the very fact that an increase, chiefly among young people, had occurred was perceived by the public as a major social problem. At the same time thousands of other people began to use cannabis,* LSD, and other drugs. Almost overnight, drug use became a cause of anxiety, confusion, and eventually social conflict. The role and powers of the police expanded, and charges that they were abusing their powers increased. To an American observer, the British response to drugs in the late 1960s was indistinguishable from the emotions and tensions that drug use had provoked in Americans. Both nations were bewildered by this new phenomenon, and became increasingly anxious when their efforts and ardent hopes for a solution proved fruitless.

Beneath the similarities, however, the British experience remains distinctively different from the American. Contrary to reports that the British "system" has failed or has been replaced,' the medical model has managed to ride the storm and come to grips with the new problems of addiction. Where it has faltered, its mistakes have been no worse than those in America and, because of social and historical circumstances, much less costly. The most intractable problems have arisen not with heroin, but with nonaddictive drugs such as cannabis and LSD. In this area the British have been as irrational as the Americans, and as the 1970 Misuse of Drugs Bill shows, the problems there have been a repeat, in British style, of conflicts found in America.

The British experience has several lessons for those interested in developing a coherent, effective system of drug control—for example, the feasibility of providing addicts with drugs legally. But the British experience also confirms that an exaggerated, non-instrumental approach, where law functions primarily as a symbol, is bound to be self-defeating.

THE BRITISH SYSTEM—
THE MEDICAL MODEL

Both British and American drug laws were formulated in response to international treaties signed early in this century. The Dangerous Drugs Act of 1920 made it a crime to import, export, manufacture, supply, or possess without a license opiates, cocaine, or cannabis. The maximum penalty is ten years' imprisonment. In 1964 the Drugs (Prevention of Misuse) Act regulated for the first time the possession of amphetamines and hallucinogens. However, these drugs were treated more leniently (a maximum penalty of two years' imprisonment for possession, as opposed to ten under the Dangerous Drugs Act), and the act did not penalize sale of these drugs.

The chief difference between the American and British systems—and it is a significant one—is the legal position of the addict. Because the British medical profession defended its right to prescribe drugs to patients as it saw fit, drug addiction has always been treated as an illness, not a crime.

It is interesting to compare attitudes toward medical discretion in the United States and Britain. Both started from roughly similar positions. By 1900 each country had a sizable population of persons addicted to opium, largely as a result of uncontrolled patent medicines in the United States and of the use of laudanum (a mixture of opium and alcohol) in Britain. Both countries were active in the first international drug conferences that led to the Hague Convention in 1912. The signatories were obligated by this treaty to enact domestic legislation that controlled the opium trade. The resulting laws—in America, the Harrison Narcotic Act of 1914, and in Britain, the Dangerous Drugs Act of 1920—were identical in substance. Each proscribed the same acts of unlicensed export, import, sale, manufacture, and possession. The British penalties, providing a maximum of ten years, were in fact more severe than the five-year American maximum. Each law excepted doctor's prescriptions in the normal course of professional practice.

In the United States public perceptions of the addict changed abruptly after the passage of the Harrison Act. The doctor's right to prescribe was eroded by a succession of court decisions, and gradually doctors relinquished all control over the treatment of addicts. The problem became one of controlling crime. This initial definition of drug use as a criminal matter has influenced all subsequent policy decisions and public debate on the subject.

The question of the medical treatment of addicts was resolved differently in Britain. When a conflict over the legality of giving addicts drugs arose between the police and the medical profession, the question was referred for clarification to a committee of eminent physicians, known as the Rolleston Committee. In 1926 they recommended that narcotic drugs be lawfully prescribed to addicts where good medical practice required. Though never formally enacted into law, this became the foundation of British drug policy.2

The Rolleston Committee saw drug addiction as a medical problem to be treated like any other illness. Treatment was left to the individual doctor, informed by the committee's guidelines. No necessity or authority for police interference with the doctor-patient relationship existed. The recommendations also ensured that the British law, in most respects identical with the American, did not imbue prevailing attitudes toward drug use with hate and condemnation. In the eyes of the law and the public, drug addicts were sick people in need of medical treatment, not social-menaces deserving harassment and jail.

The British system worked quite simply. A person who for whatever reason was addicted to drugs went to his physician and, if found to be addicted and in need of drugs to prevent discomfort, received a prescription. Often the prescription was covered,by the National Health Service and cost no more than thirty cents. The Home Office kept informal records of the number of addicts, though neither addicts nor doctors were required to report. Drug inspectors periodically inspected pharmacists' and doctors' records. Some police activity occurred with cannabis and opium, but from 1945 to 1960 drug arrests never exceeded 300 annually (some of these were merely technical offenses). Britain, whose population was one-fourth that of the United States, had no more than 500 known addicts. The majority of these addictions were therapeutic in origin, and they clustered in the over-30 age bracket. With cheap legal supplies, a black market in heroin was unknown. There was no supply of heroin to initiate new users, and addict-related crime was nonexistent. The medical model, in short, was a rousing success.

The critical importance of the medical profession in maintaining this system is illustrated by the government's attempt in 1955 to ban all manufacture of heroin.3 It appears that this move was inspired by American attempts at a worldwide ban on heroin. The reaction of the medical profession was overwhelmingly negative. Two important medical rights had been infringed—the right to prescribe a drug that doctors felt had a legitimate medical use, even for nonaddicts, and interference with a medical prerogative without consulting the profession. Furthermore, it was felt that the addiction situation would deteriorate. Faced with a politically strong profession, the government eventually backed down and lifted the ban on heroin manufacture.

In the late 1950s pill-taking caught on as a fad among certain youth groups. The Brain Committee (a committee of physicians convened by the Minister of Health but known popularly by the name of its chairman, Lord Brain) was appointed in 1958 to review "in light of more recent developments" the Rolleston guidelines and the necessity to extend them to "cover other drugs liable to produce addiction or be habit-forming." In 1961 the Brain Committee reported4 that

. . . the incidence of addiction to drugs . . . is still very small and traffic in illicit supplies is almost negligible, cannabis excepted. This is mainly due to the attitude of the public and to the systematic enforcement of the Dangerous Drug legislation.

The report found "no reason to think that any increase was occurring" and again emphasized that "addiction should be regarded as an expression of mental disorder, rather than a form of criminal behavior."5

BREAKDOWN OF THE MEDICAL MODEL—
THE BRAIN REPORT

By 1964 the conclusions of the Brain Report were out of date. The public became aware and then alarmed by a growing addiction problem. In an atmosphere of emergency, the Brain Committee was recalled in July 1964 to reconsider the prescribing of addictive drugs. This time the Committee found an alarming increase in the use of addictive drugs and in abuses among doctors prescribing them. It learned6 that from 1959 to 1964 the total number of known addicts had risen from 454 to 753, the number of heroin addicts from 68 to 342, of cocaine addicts from 30 to 211. Even more alarming, unlike former British addicts, most of these new addicts were nontherapeutic in origin (328 of 342). Also the age of addicts had dropped drastically. In 1959 only 50 of 454 addicts had been less than 35 years old, and by 1964 nearly 40 percent were, 40 of them being under 20.

Why had this upsurge in addiction occurred? The Committee again found a "black" market nonexistent, but did discover a thriving "gray" market, dependent on drugs legally prescribed by doctors. It appeared that a small number of doctors had been prescribing legal, but excessive, doses of heroin to addicts. The addicts then used the excess to recruit friends to heroin use or to make a profit from other users who were reluctant or unable to have a doctor prescribe for them. In 1962, for example, one doctor had prescribed almost 600,000 tablets of heroin to adtlicts.7 The same doctor on one occasion had prescribed 900 tablets of heroin to one patient, and three days later prescribed another 600 "to replace pills lost in an accident." Other doctors had each issued single prescriptions for 1,000 tablets.8 Considerable, if less spectacular, quantities were also prescribed over a long period of time.

While in perhaps two cases (the notorious Drs. Petro and Swan), the physicians were overprescribing for gain, the situation arose primarily out of the medical profession's own reluctance to deal with addicts. Indeed, the Brain Committee found that the overprescribers "had embarked on the treatment of addicts out of a sense of duty because they felt that the treatment facilities elsewhere were were inadequate."6 Addicts did not make good patients. They were often unruly, clamored for higher doses, and were difficult to cure. Many doctors believed that their disease was the result of weakness, and for that reason felt more concerned about the organic maladies of other patients. The medical profession, in short, was prejudiced against addicts, and few doctors would treat addicts at all.

The problem arose when the few doctors who were willing to treat addicts opened their rolls to all addicts unable to obtain treatment elsewhere. In one year two of these doctors each had 100 addicts on his list, and they became known to all London addicts. They justified their prescribing of heroin as necessary to prevent a black market, to treat addicts who were rejected elsewhere, to publicize the lack of treatment facilities, and to cure addicts by providing maintenance doses. The Brain Committee found that these doctors had "acted within the law and according to their professional judgment."1° But overprescribing was inevitable in this situation. A typical consultation between addict and doctor resembled a union negotiating session rather than a professional consultation. The addict, knowing he could make enough money to live on by selling heroin at 1 a grain, would exaggerate his need to the doctor. The doctor, aware of this ploy, might prescribe half as much as he asked. Through acting, bluffing, and persuasion, the addict would eventually squeeze a few extra grains from the overworked physician who had a waiting room full of addicts." Or an addict might supplement his supply from another doctor. There was no time to observe what doses were needed, obtainiother medical opinion, or call the addict's bluff. With so few doctors willing to treat addicts, excessive prescribing and the resulting "gray" market were inevitable.

The Brain Committee's solution was to retain the medical model with modifications to control overprescribing. Restrictions so severe that addicts were prevented or discouraged from obtaining drugs legally would encourage a black market in heroin. To avoid this, the Brain Committee proposed restricting heroin and cocaine prescriptions to addicts, but did not limit the doctor's right to prescribe these drugs to ordinary patients. Doctors, by law, would need a license to prescribe heroin and cocaine to addicts. Only doctors on the staffs of special treatment centers attached to psychiatric units of hospitals and providing inpatient and outpatient treatment to addicts would be licensed. A doctor who disregarded these regulations could be struck off the register. The report still urged that "the addict should be regarded as a sick person . . . and not as a criminal, provided he does not resort to criminal acts."12 Second, it reaffirmed the autonomy of the medical profession: "Doctors should retain the right to prescribe, supply or administer any dangerous drug required for other patients in the treatment of organic disease."13 Some doctors resented even this limited restriction on their traditional prerogatives; but on the whole, it appeared a reasonable compromise, and was not strongly opposed.

Two other recommendations further strengthened the operation of the medical model. One provided for the "notification" of addicts to a central authority at the Home Office by any doctors coming into a professional relationship with them. Centralized records would prevent the same addict from obtaining drugs from more than one treatment center, and would provide epidemiological data. The second recommendation was to set up a mechanism to discipline doctors violating the prescribing restrictions.14 Rather than make noncompliance a crime, a medical tribunal usually concerned with professional matters would adjudicate whether a doctor had unlawfully prescribed heroin or cocaine to an addict. If a violation was found to have occurred, the sole sanction was the removal of the right to prescribe the restricted drugs to nonaddicted patients.

The Brain Committee recommendations, sensible and dispassionate as they seemed, did not guarantee an immediate solution to the heroin increase or to public anxiety, nor was there unanimity on the soundness of the committee's approach. There was first of all the problem of implementation, which the committee had noted with its qualification that "our proposals are dependent on such treatment facilities being readily available at short notice."15 For a while government delay and political jockeying made problematic the opening of the recommended treatment centers, and increased the likelihood of a black market developing to handle addicts' needs. Finally in 1967, two years after the report, the Dangerous Drug Act of 1967 was passed, incorporating the principal recommendations. However, despite a feverish public pulse, it was not until May 1968, the law's effective date, that the treatment centers were first opened. In the meantime, the problems referred to in the report had continued. In 1965 the number of addicts had increased to 927, with 134 under 20 years of age on heroin. The figures for 1967 were 1,729, with almost 400 under 20 taking heroin.

Furthermore, it was feared that the new restrictions on prescribing would not prevent the development of an American-style black market. Many young addicts might not voluntarily go to the treatment centers. Some experts suggested that greater powers, such as compulsory confinement of addicts during withdrawal be granted the government. It was also thought that the restrictions might divert users to other drugs and simply transfer the heroin problem elsewhere. Finally, maintenance doses for the young seemed out of keeping with the Rolleston philosophy of providing drugs only after other cures had been tried and had failed. No attempt had been made to cure many of the younger addicts.

Soon after they opened, it seemed that the treatment centers had avoided the problems feared and achieved some success in controlling the spread of heroin addiction. Dr. Dale Beckett, a doctor in charge of a treatment unit, reported in a television interview:1-6

I think they've been very effective indeed. . . . One had the fear that two opposite things might have happened: firstly, that there would have been so little heroin prescribed that the illegal black market would have become established, and this of course would have led to enormous difficulties in society. The opposite extreme would have been the gross overprescription of heroin, because of the relative inexperience of the psychiatrists in the treatment centers, but again this really hasn't happened. What seems to have happened is that a happy medium has been struck, and a little less heroin is now being prescribed than was prescribed previously.

Another doctor from a treatment center in London, when asked whether the treatment centers were working, answered:"

It depends on your aims. Ours were to control the spread of heroin addiction and control the amount of heroin on the market.

In this regard, we've been successful, I believe. I've seen only a few cases of heroin addiction. We have seen a spread of methadone and barbiturates.

The treatment centers have been able to hold down the spread of heroin addiction. The cure of existing addicts, however, is another matter altogether. It soon became clear that the outpatient clinics were only the first step in that process. The Advisory Committee on Drug Dependence has commented on the outpatient clinics and rehabilitation:18

We consider that rehabilitation begins with the first contact of the addict with the outpatient clinic. We are concerned that in some quarters these centers are being regarded as mere prescribing units without any positive objective. Outpatient clinics are also rehabilitation clinics. Their object should be to encourage the addict to accept hospital admission for withdrawal and to make use of the opportunity which prescribing gives to build a constructive relationship with the addict. For this purpose longer and more frequent visits by the addict are desirable than would be necessary if maintenance were the sole objective. . . . We visualize the outpatient clinics as being strategically placed to form the focal point for the whole process of rehabilitation.

If this process were to be successful, there had to be adequate staffing of a full therapeutic team, including social workers; hospital beds had to be immediately available for addicts willing to be admitted; and hostels providing short-term accommodation for homeless addicts on outpatient treatment had to be established.

THE NEW DRUG SCENE

The steady increase in heroin addiction after 1963 profoundly altered public perceptions and attitudes toward drug use. The medical approach had shielded drug use, both physically and psychologically, from public attention. Drug addiction had been generally perceived as a minor health problem, affecting a few hundred unfortunate people who had accidentally acquired drug habits and who caused no major difficulties.

Suddenly, almost overnight, drugs escaped from the clinic into the street, and then into the consciousness of a startled, unprepared public. Junkies became familiar inhabitants of the mass media. They were visible late at night in Piccadilly Circus and were reputedly plotting the subversion of young people.

Traditional ideas about addiction no longer applied. The new addicts were not therapeutic in origin, but were seeking kicks and thrills. They were associated in the public mind with seaside riots among mods and rockers, with the emerging youth culture and rebellion. An older addict expressed the resentment felt by many nonaddicts:19

Just a drag [the new addict], you know, because they don't take drugs because of some need or personal defect. It's just a case of exhibitionism with them, you know, the fact that "I'm a registered addict, take me," kind of thing. They go around with the hypodermic sticking out of their top pocket kind of thing, and just advertising the fact that they're on drugs, you know.

Finally, protection by the medical profession was no longer assured. In fact, the loose prescribing habits of doctors were one of the causes of the problem. When illegal methadrine, methadone, and barbiturate use became problems, again the medical profession was responsible. Bewildered and impotent, the public was confronted with a new social problem that seemed to threaten the very roots of society.

The rhetoric used to describe the drug situation captures much of the fear and anxiety disturbing the public. Invariably, addiction was likened to a bubonic plague, spreading at epidemic speed. Each addict was a "carrier" of the disease, liable to "infect" four or five other young people: newspapers reported how a single youth was the pathogenic agent responsible for the 30 addicts in Crawley New Town.2° To heighten the alarm, "experts" speculated on the number of addicts expected in the next few years. The more conservative estimate21 was 11,000 by 1970 or 70,000 by 1975. Inspector Terence Jones,22 a police specialist in drugs, commented:

The disease is spreading and it seems likely that in the not too distant future every town in the country will be infected. . . . Estimates have been made that by the 1980s there could be a million addicts.

Another writer summarized the situation in these terms: 23

There has hardly been another social problem which has aroused as much public attention as drug addiction in the course of the last twelve months. All the media of mass communication have combined in unleashing a veritable torrent of reports, comments, and suggestions. Drug addiction and drug abuse have been discussed and debated in virtually every forum of published opinion. Only those most directly affected—the addicts—have remained relatively inarticulate. . . . Public discussion has been characterized by a sense of foreboding, if not of impending disaster. Wild estimates have been made about the number of addicts which Britain will have in ten years' time. It seems as if .the measure of alarm is only equaled by the degree of perplexity which accompanies the search for an answer to the problem. It is sometimes difficult to tell whether the debate and the publicity have not assumed an almost independent existence—a dynamic of their own. . . .

The full flavor of the public atmosphere in the late 1960s is best illustrated by three typical news stories concerning drugs that received wide circulation, but little verification. The first was a report, which gained wide currency, that there was "Chinese" heroin in Soho.24 For a public concerned about addiction, and particularly the emergence of a black market, the very presence of imported heroin was ominous. By identifying it as "Chinese," and associating the drug in the public mind with the sinister world of opium dens, the report intensified worry and apprehension. The report turned out to be a complete fabrication; no evidence of foreign heroin was ever produced.25

A second story related the discovery of a new drug "many times more powerful than LSD" and "easily manufactured by any graduate chemist."26 This story was actually referring to the hallucinogen STP (dimethoxy-4-methylamphetamine), then being used by a small number of people in the United States, and which was much less easy to prepare than the story claimed. Newspapers and politicians publicized STP in a way calculated to confirm the public's worst fears of a new drug about to engulf Britain.

In the third story a research psychologist who had founded an organization to promote cannabis research and law reform was described as "the world's most dangerous man."27 To be objective, there were in 1968 greater dangers in the world than the possibility of easing the cannabis law. This characterization, however, and its predictable impact on the millions of readers aroused by the threat of drugs, is typical of the drug situation at this time.

Besides these and other deliberate scare stories in the press, there were some genuinely frightening aspects of the new drug scene. For example, there were the mercurial fads in drug use, which made it almost impossible for officials and legal policy to keep abreast of the latest developments. The public was threatened with wave after wave of drug use by users who were willing to switch drugs at will to stay ahead of the authorities. In 1967, for example, methadrine became a new problem. This was the fault of the medical profession: after the Brain Report many doctors had substituted methadrine for the cocaine usually prescribed to addicts with their heroin. Soon addicts were switching over entirely to methadrine. Although the drug is more dangerous than the heroin and cocaine it replaced, there were no legal powers to stop doctors prescribing it. When the supply of methadrine was finally cut off in 1969, mandrax became popular, another stimulant then legally prescribable. In 1970 barbiturates appealed to users seeking an injectable drug. The possibilities seemed endless, and the public felt that firm action must be taken.

These fears were made worse by the tendency already noted in the American context to see all drugs as equal threats and to exaggerate greatly the power of drugs. Newspaper stories almost invariably referred to "drugs," which could mean anything from cannabis to mandrax, without differentiating which drug was involved. Reports of cannabis offenses often referred to "junkies" and the "junkie menace," a lumping together of two radically different problems. The distortion and exaggeration are evident in the account of an Oxford undergraduate convicted of possessing cannabis. She ran "a junkies' paradise," and had enough cannabis to supply hospitals "for sixty years."28 The public belief in progression and in the enslaving, destructive power of drugs—attitudes familiar from our discussion of the United States—intensified the atmosphere of crisis.

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Public fears focused on the increase in heroin addiction highlight the British response to the drug scene. It was grossly disproportionate to the real dimensions of the problem. While the upward trend continued for the next few years (see table), the number of reported addicts never exceeded 3,000. By 1969 the rate of increase had dwindled, and the number of heroin addicts actually decreased by 1,450—many were being maintained on methadone in the outpatient treatment centers. When in 1965 heroin became a major issue, there had been an increase in the past two years of 300 users. Seen as an increase of 200 percent it was considerable; but in absolute terms, it was not a shattering blow to public health. In 1965 there were an estimated 350,000 alcoholics in Britain," and weekend drinking alone caused 28,000,000 lost man-hours on Mondays. In the same year 35,000 people died of lung cancer.3° Compared with heroin use in America, the increase was a mere flutter. A few blocks in Harlem contained more addicts, at considerably more cost, than all of Britain. Also, it was not clear whether the new addiction figures reflected an actual increase in numbers of addicts or were simply a more accurate count. Many addicts had postponed "registering"— going to a doctor themselves for drugs—for many months; it signified psychologically that they were "hooked,"3' a state they were able to deny they were in as long as they got drugs from friends. Finally, without taking account of population growth and greater stress from social change, the mere fact of an increase was misleading.

Even if it is agreed that the public health dangers of addiction were greatly exaggerated, other features of the situation fanned the temperature of public concern. One was the knowledge that nonmedical drug use of all kinds had risen drastically. Heroin addiction was merely the tip of an iceberg. Youthful drug use was thought to be expanding at a frightful rate, from "purple hearts" (amphetamines) in West End coffee bars and clubs to cannabis and, soon after, experimentation with LSD and heroin. The public became aware not of a single heroin or cannabis subculture, but of multiple drug subcultures, through which young people freely moved. Nor could drugs be dismissed as part of the London scene or an aspect of mods and rocker delinquency. All classes had their users. The nephew of a former prime minister died of a drug overdose at Oxford. In public schools and universities large numbers of students were found to be using drugs. At the same time, sales of medically prescribed drugs were increasing at an unprecedented rate. In 1966—one of the peak years of the "drug crisis"— four million prescriptions for amphetamine substances and fifteen million for barbiturates were issued.32

Public concern was also aroused by the conviction and selfrighteousness of young drug users. They wore bizarre clothes, grew their hair long, and challenged the authority of their parents. Both youth and drug use were inextricably associated with an emerging culture and life-style that clashed with traditional ideas. The drug users refused to acknowledge the wrongness of their drug use. In Gusfield's term, they were "enemy deviants."33 They attacked the norm; they transgressed, and heaped scorn and ridicule on its backers. This generated great hostility and anxiety in the older generation: not only were young people committing illegal acts that threatened the nation's capacity to "get on with" pressing national problems, but they were proclaiming the desirability, indeed the righteousness, of doing so.

International Times, the newspaper of the alienated young, and R. D. Laing articulated the full depth of the attack launched by the young. International Times delineated an underground counterculture slowly flowering under the decadent, sterile forms of, the old "bomb culture."" The counterculture had boundless energy, its own leaders, clubs, art forms, and encompassed all that was new and vital in an increasingly sterile society. Postindustrial capitalism, International Times argued, could not even provide basic social services, much less satisfy spiritual longings and the need for personal fulfillment. Drugs, which helped provide those experiences, were outlawed and their users suppressed because the spontaneity they inspired demonstrated the establishment's bankruptcy. R. D. Laing, in his Politics of Experience, states even more explicitly that the boundary of the real, and the right of adult society to define that boundary, was the issue. A decadent order incapable of satisfying basic human needs was maintained by a psychic dictatorship. The establishment defined consciousness arbitrarily, but in such a way that constructs such as an ego and the virtues of a scientific, mechanistic capitalism were essential. Drugs and psychic disruptions like schizophrenia toppled the ego's battlements and catalyzed creative, spiritual energies repressed by the dominant culture. They were thus tools in the political battle for consciousness.

In the face of such justifications of drug use, the public not unnaturally perceived users as determined to destroy society. Drug use threatened social chaos on two counts: it either turned people into addicts or made them cultural revolutionaries.

A third feature of the situation arousing public concern was the confusion surrounding the whole subject of drug control. Although few people condoned heroin use, there was considerable disagree--ment about the harmfulness of other drugs, and particularly over the role that the law should play in their control. The inflated urgency of the drug problem made firm opposition to all drugs seem the best and simplest approach. Doubts that some drugs could be used safely had to be stifled, because they threatened the whole edifice of strict prohibition.

Cannabis use, in particular, was ambiguous. It appeared to be a causative factor in addiction, was identified at law with heroin, and was extremely popular among young people. A tough position against its use was thus required. On the other hand, since there were legitimate doubts about its harmfulness, and more and more respectable people were using it apparently without ill effects, the possibility of a ten-year jail sentence seemed unwarranted.

The confusion surrounding cannabis was manifested by the events following the publication of a full-page advertisement in The (London) Times of July 27, 1967. The ad called the cannabis laws "immoral in principle and unworkable in practice" and demanded a reduction in penalties and legal differentiation from heroin. It cited the growing numbers of users, the paucity of evidence of ill effects, and the growing social costs of a law violated by thousands. Its signatories included psychiatrists, two Members of Parliament, and a Nobel Prize winner. The public heaped abuse on The Times for allegedly encouraging drug addiction, and a parliamentary debate on the ad followed. It is easy, however, to see how the Times ad could further the public consternation. Appearing a few months after the Dangerous Drug Act of 1967 enacted into law the second Brain Report, the ad undercut the bulwarks being constructed against heroin. It revealed the exaggerations in the public response to the drug problem and confused the public further by arguing that some drug use should be acceptable. Moreover, it suggested the possibility that the young people were, after all, right. In stressing distortions in the law, it raised doubts about the propriety of any legal control over drug use. The dominant mood was expressed by Mr. Channon in the Commons debate when he urged that an inquiry into cannabis take place "because we require urgent public action, and action which will convince young people."35

On the heels of awareness that a "drug problem" existed came urgent demands for action to halt "the spreading tide of drug use." Existing statutory controls seemed blatantly inadequate. They contained loopholes for overprescribing doctors, and were unable to cope with the fast-changing fashions of drug use. Moreover, inconsistencies and disparities in the treatment of drugs like cannabis, LSD, and the amphetamines undermined respect for the law, while the absolute nature of certain offenses and the enforcement practices of the police were criticized as unfair. Unfortunately, such wide-ranging questions as these are not best solved in an atmosphere of crisis. As we shall see, the public's fear, confusion, and growing demand for certainty about drugs strongly influenced the action taken.

As we have mentioned with regard to addiction, the public mood had facilitated government acceptance of the Brain recommendations, and prevented the normally strong medical profession from resisting limits on their prescribing authority. Indeed, in %this climate it is surprising that stronger measures against doctors or addicts were not included in the Dangerous Drug Act of 1967. The act merely enacted the careful recommendations of the Brain Report that doctors be licensed to prescribe heroin and cocaine.

But prescription by an unlicensed doctor was not made a crime. It only initiated a cumbersome administrative procedure before a medical tribunal which could eventuate in removal from the medical register. By contrast, American doctors had been systematically harassed in the decade after the Harrison Narcotic Act for their prescribing, and today are subject to stiff penalties for not reporting addicts to authorities. Similarly, addicts were subject only to the inconvenience of obtaining their prescriptions at a treatment clinic rather than at their doctor's office. Some voices urged compulsory commitment of addicts," but these had little support, while in the United States at that time millions were being spent in confining addicts to treatment "hospitals."

For Britain, however, despite its nonpunitive elements, the Dangerous Drug Act represented a novel departure that might have been impossible in a less anxious moment. For the first time the prescribing practices of the powerful medical profession were being restricted by the government. Also, the government had to assume responsibility for treating addicts, a problem hitherto in private hands. In this atmosphere acceptance of a relatively benign and rational solution to the problem of addiction can perhaps be explained by the political power of doctors, the shortage of medical facilities, and the attitude, ingrained from years of the medical model, that addicts were, after all, sick people. Toward cannabis users and others who claimed that the law was arbitrary or unfair, no such constraints prevented the public from venting its wrath. The remainder of this chapter describes the impact of those attitudes on the other issues of drug control that the explosion of drug use had uncovered.

THE WOOTTON REPORT

As we have said, cannabis, the opiates, and cocaine were regulated under the same act and subject to the same penalties. A single act of possession or sale of cannabis in any quantity could, like heroin, bring a ten-year jail sentence and a £.1,000 fine.37 Moreover, a person could be prosecuted if someone without his knowledge smoked cannabis on his premises. Strong drugs like LSD and methadrine were subject to the lighter penalties under the Drugs (Prevention of Misuse) Act, which did not make even sale a crime. And barbiturates were not illegal at all.38 Legal restrictions also made cannabis research difficult, if not impossible.

As the number of cannabis users increased, these provisions became a major cause of controversy. They also undermined the credibility of the law and alienated many young people from the legal system. Indeed, the pattern of convictions under the Dangerous Drug Act revealed an emphasis on prosecuting cannabis users:39

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In 1967, nine out of ten offenses were for possessing less than 30 grams.40

The Times ad sharpened the controversy surrounding the drug. As we have seen, the government responded by having the Advisory Committee on Drug Dependence study the question and make recommendations. A subcommittee chaired by Baroness Wootton prepared a report that was endorsed by the main committee and submitted to the Home Secretary in December 1968. The Wootton Report, however, was not able to dispel the confusion or hammer out a consensus on the question of cannabis. Indeed, it intensified the cannabis controversy and gave added weight to charges leveled at law. Since this incident reflects the interplay of social attitudes, we will examine the report and the reaction to it in detail.

The Wootton subcommittee was composed of twelve members. Lady Wootton was an energetic, highly respected life-peer who had made valuable contributions in the fields of sociology, law, and economics. Among its other members were an assistant commissioner of Scotland Yard, a magistrate, a research sociologist, and four doctors. For the purposes of the cannabis study, two noted pharmacologists were added to the committee. Over the course of eighteen months it heard witnesses, discussed findings, and surveyed the existing body of knowledge. Although legal restrictions prevented original research, it heard a wide variety of witnesses, including the president of the United Nations Opium Board, drug users, and experts with wide experience with cannabis.

The report concentrated on three topics: (1) the effects of cannabis in different cultures; (2) its role in the current drug scene; and (3) the legal provisions relating to its use. Noting the uniqueness of its work for the United Kingdom and the uncertainty surrounding certain aspects of cannabis use, the committee nevertheless found that it could, on the available evidence, form "a reasqnably clear picture of the use of cannabis in the United Kingdom."" In light of the evidence before it, it agreed with the conclusions of the Indian Hemp Commission (1893-94) and the LaGuardia Report (1944) that "the long-term consumption of cannabis in moderate doses has no harmful effects."42 It then summarized the clinical features of the drug and described the general configuration of use in the United Kingdom in terms of use, users, supply, and effects. Contentions that cannabis use produced psychosis or violent crimes were examined and found to lack empirical support. With regard to progression to heroin, the committee concluded that "it can clearly be argued on the world picture that cannabis use does not lead to heroin and . . . a risk of progression to heroin . . . is not a reason for retaining control."43 The committee also compared cannabis with other drugs in common use, such as alcohol, nicotine, caffeine, barbiturates, and tranquilizers. While it was not able to make any definitive comparison, it did note that social attitudes toward drug use were changing. It concluded" from the available evidence that

An increasing number of people, mainly young, in all classes of society are experimenting with . . . [cannabis], and substantial numbers use it regularly for social pleasure.

There is no evidence that this activity is causing violent crime or aggressive anti-social behavior, or is producing in otherwise normal people conditions of dependence or psychosis, requiring medical treatment.

The experience of many other countries is that once it is established cannabis-smoking tends to spread. In some parts of Western society where interest in mood-altering drugs is growing, there are indications that it may become a functional equivalent of alcohol.

In spite of the threat of severe penalties and considerable effort at enforcement the use of cannabis in the United Kingdom does not appear to be diminishing. There is a body of opinion that criticizes the present legislative treatment of cannabis on the grounds that it exaggerates the dangers of the drug and needlessly interferes with civil liberty.

The Wootton Committee, however, was not prepared to give cannabis a totally clean bill of health. It cited a number of imponderables concerning its chronic pharmacological effects, its mode of operation in the body, and problems in detecting its presence. As a drug capable of altering mood, judgment, and functional ability, cannabis was clearly as potent as alcohol, and could be fairly considered a dangerous drug. Accordingly, public health required restrictions on the availability and use. For this purpose, the committee concluded that there was no alternative to the criminal law and is penalties.

Although the Wootton Committee explicitly rejected "legalization" of cannabis for personal use, it did find that the dangers of the drug had been greatly exaggerated and that, accordingly, a reduction in penalties was in order. Cannabis users, it found, were often treated harshly and, in view of the relative harms, unfairly. It attributed this treatment to the harsh judgment contained in the law and the legal identification with drugs like heroin. In 1967, for example, of the 2,734 persons arrested for cannabis offenses, two thirds had no record of nondrug offenses. Nine out of ten offenses were for possessing less than 30 grams. And yet a quarter of all offenders went to prison, including 17 percent of first offenders. Accordingly, the committee recommended a reduction in penalties and a statutory separation from the opiates. Since a quantity limitation or presumption of intent created administrative problems in distinguishing between possession for personal use and sale, it was decided that

The only practical way to legislate for the situation over the next few years is to retain the principle of a single offense, namely, unlawful possession, sale or supply of cannabis or its derivatives. This offense should carry a low range of penalties on summary conviction but a substantially higher range on indictment. If such legislation were brought in we would anticipate that the police would proceed on indictment only in those cases in which they believed that there was organized, large-scale trafficking. Offenses involving simple possession and small-scale trafficking would, we hope, be dealt with summarily.45

. . . our main aim . . . is to remove . . . for practical purposes, the prospect of imprisonment for possession of a small amount and to demonstrate that taking the drug in moderation is a relatively minor offense . . . and not . . . an antisocial act or evidence of unsatisfactory moral character."

On summary conviction a fine of £100 and imprisonment for up to four months could be imposed. The prison sentence was felt necessary to deter small-scale suppliers who would not be deterred by a fine. However, the right to a jury trial was assured, and the judge's power to suspend sentence would mitigate even this possibility of jail. Sentences on indictment were reduced to be two years' imprisonment and an unlimited fine. The fine was to be reserved only for large-scale traffickers. Sentences, however, were to be kept under review, and changes made if the objective of preventing prison terms was not achieved, or other relevant information developed. Mr. Peter Brodie, the police commissioner, and Mr. Michael Scofield, the sociologist, filed reservations to these recommendations. Mr. Brodie thought that deterrence of the large-scale trafficker likely to be attracted by an increasing demand for cannabis would occur only if imprisonment was certain and recommended that the sentence for possession of substantial quantities not for use be five years. Mr. Scofield, on the other hand, believed that rather than have the question of imprisonment for personal use depend on a magistrate's discretion, a maximum fine of £50 should be allowed. On summary conviction for possession of less than 30 grams, he recommended that no penalty be imposed.

The Wootton Report* thus tried to bring the law closer to the practical realities and dangers of cannabis use by dissociating it legally from heroin and reducing penalties for personal use. Although information about the drug was far from complete, a convincing case for its relative harmlessness existed. Since further study and increased use might reveal dangers, particularly with chronic use, it was essential to guard against any encouragement of the practice. For the interim, however, the possibility of jail and the association with other dangerous drugs was undesirable. Accordingly, the Wootton Committee chose to lessen the ill effects of the law, while maintaining societal disapproval of the drug and strict control of its use. The penalty recommendations,,in fact, merely recognized the pattern of current sentences, which in 1967 were fines that averaged E 37.47

The Wootton Committee thus chose to tread a careful middle-of-the-road path that protected public sensibilities while reducing the greatest costs and injustices of the law. It firmly rejected legalization, but also refused to condemn cannabis users. Its final position was remarkably similar to the American Medical Association's 1968 report on marijuana, which, while recognizing dangers, strongly urged a reduction of penalties for users.

THE RECEPTION OF THE WOOTTON REPORT

On January 9, 1969, the report was published. In terms of attention and emotion, the reaction was explosive. Rather than quieting the cannabis controversy, as the Brain Committee had done with heroin, the Wootton Report intensified polarization and deepened the public's need to cling to a distorted view of cannabis. To maintain this view in face of the contrary findings of the Committee, the public resorted to avoidance and denial mechanisms which twisted the facts and recommendations of the Report into a more palatable meaning.

The press, with a few exceptions, capitalized on the public fear with bold headlines and strident editorial comment. The Express's headlines read "Storm over Pot-Smokers Charter," and quoted an unnamed psychiatrist as saying that the Wootton Committee "must be mad and haven't read the textbooks."48 The Mail and Sketch called the result "sadly muddled, and unconvincing," and saw it as "an official bid to take another step along the permissive society's road."49 The Sketch suggested "the best thing to do with the report is dump it in the waste paper basket."5° The Evening News printed a letter from a female addict who blamed her addiction on cannabis. All papers carried Dr. Elizabeth Tylden's comment that "the report was a junkie's charter and was merely haggling over how long it takes a drug to kill someone."5' These papers invariably refused to accept the Wootton Committee's finding that there was no causal connection between cannabis and heroin. Most editors found the Wootton Report's reasoning "tortured" or "unconvincing" for failing to draw a clear-cut boundary. If cannabis wasn't so bad, it was argued, why wasn't it legalized. If there was a possibility of harm, why encourage its use by lowering penalties.52 An intermediate position, adapted to the ambiguity of the situation, seemed intolerable.

During a period of two weeks, the issue was kept at boiling point. Newspapers reported the drug alarms then sweeping Sweden over, not cannabis, but stimulants. Several articles reported that the World Health Organization, then holding a convention, was opposed to the Wootton Report, while it actually supported reduction of penalties and objected only to legalization. The Wootton Report had tried to dissociate cannabis from other drugs, but the media grouped all drugs together. Numerous articles mentioned a "worldwide increase in drug-taking," discussing methadrine, heroin addiction, and reports of increased cannabis use in the same breath.53

On June 23, Mr. James Callaghan, the Home Secretary, took part in a debate in the House of Commons on the Wootton Report. Both Conservative and Labour members, led by Callaghan, rebuked the Wootton Committee. This debate further revealed the devices employed to maintain the prevailing view of drug use when a conflict arises. Most frequent were simple assertions contradicting the report, without citing other evidence. Mr. Quintin Hogg quoted a newspaper report claiming that cannabis produced "moral and social decay," aggressiveness, degradation of the personality, "misery, crime and unhappiness."54 Few speakers would accept that a distinction between cannabis and heroin was Valid, despite the report's contrary findings. The Home Secretary, for example, devoted the major part of his speech to discussing other drugs. He spoke of the dangers of an "easily manufactured" drug ten times more potent than LSD, cited statistics about the, rise in heroin addiction, and alluded to methadrine abuse. He claimed that "it is simply not possible to say that those who smoke cannabis do not move on to heroin."55 Another discrediting ploy was to charge the report with advocating legalization, although it clearly rejected that alternative. The Home Secretary's mind boggled at "the thought of licensing the sale of cannabis by the local tobacconist, off license . . . thereby creating centers where people will start on one drug and very easily move on to another."56

The Wootton Report, it will be recalled, refuted the progression theory and mentioned the possibility of future legal distribution only if forthcoming research showed no harm from the drug. When the report's recommendations were actually discussed, it was solely in terms of their symbolic overtones. Callaghan57 rejected the report:

I cannot reconcile the view that the wider use of cannabis should not be encouraged with the proposal that legislation brought in to reduce the existing penalties for possession, sale, or supply of cannabis would be bound to lead people to think that the government take a less than serious view of the effects of drug-taking. [Cheers] That is not so.

In his view, any liberalization of the law was a symbolic capitulation to the drug users and the values they represented, and therefore had to be rejected. The advocates of legal change were "another aspect of so-called permissive society, and I am glad if my decision has enabled the House to call a halt in the advancing tide of so-called permissiveness."58 Perhaps Parliament was most disconcerted by the report's failure to eliminate ambiguity with a clear-cut black-and-white solution to the problem. The need for absolute and utter certainty was evident in the persistent description of a reduction of penalties as "a step in the direction of legalization," in Callaghan's refusal to acknowledge the special position of cannabis, and in the claim that another law would only confuse the public. Distinctions among drugs and their effects would conflict with the view that all drug use was a serious social threat . In a final effort to discredit the report, Callaghan accused the committee of being "overinfluenced" by the "pot lobby,"59 and treated its conclusions as those of the lobby.

The response to the Wootton Report reveals a public so terrified by drugs that its reason and better judgment are overcome. In contrast, to the careful, moderate, well-reasoned report, the reaction of the press and Parliament is hysterical, illogical, and untruthful. The Wootton Committee is maligned and its conclusions ignored, misstated, or denied. Dominating the public response is the need to condemn drug use, apparently at all costs—to express the societal judgment that drugs are immoral and undesirable and, above all, to avoid any public action that could signify permissiveness toward drug use. The narrow question of the law and its reform became the arena for symbolizing a social judgment, which could not be compromised.

POLICE POWERS

Another problem awakened by the drug issue was the question of police powers and abuses in enforcing the drug laws. With a mounting public outcry over drugs, the role and powers of the police had expanded greatly. This development was new for both the police and the public. Although since 1920 (the first Dangerous Drugs Act) drugs had been officially a police matter, in practice there was little drug use to be concerned with. Arrest statistics for drug offenses, at a time when the most punitive American legislation was being enacted, showed minimal police activity:60

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After the second Brain Report, however, police took a renewed interest in drugs. Specialized drug squads were organized. The police saw a gap that they alone could fill. From 1965 to 1969 there was a 500 percent rise in the total number of drug convictions: 61

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Along with more stringent enforcement came charges that the police were using their powers arbitrarily or unfairly. Young people, in particular, criticized the police for discriminating against them because of their appearance. Complaints also came from other quarters. The home of Lady Diana Duff Cooper was raided by the police (no drugs were found),62 and The Times63 printed an outraged letter from a London schoolteacher who had been stopped and searched on the street while walking with her teen-age son. There were also allegations of "planting" and corruption.

For Britain these charges have special significance. The British policeman, traditionally regarded as honest, occupies a special position of respect that is increasingly rare in the United States. Police abuses in drug enforcement threatened to alienate certain segments of the public, and introduce hostility into their relationship. Occurring in a period of national adjustment, when young people and immigrant groups were testing the integrity of social institutions, and "law and order" became a political slogan, this was a serious matter. With doubt cast on the propriety of police actions, the whole question of the balance struck by the drug laws between individual liberty and law was thrown open.

The.issue is, of course, familiar from American experience. The difficulty of enforcing the drug laws tends to undermine police respect for legal restraints. The police are burdened with enforcing society's moral judgments, yet because such crime is consensual, and values of liberty and fairness equally demanding, the police lack the means for doing so. Jerome Skolnick finds the difficulty inherent in the nature of law enforcement in a democratic society: 64

Underlying this [problem] is a more general and fundamental issue growing out of the concept of law enforcement. This issue is the meaning and purpose of law in a democratic society. The idea of law enforcement in such a society, taken seriously, suggests that legally constituted institutions such as the police exist not only to preserve order, but to serve the rule of law as an end in itself. On the other hand, the circumstances of the operational environment, with its associated requirements that the police maintain order, might develop a very different conception of law in police, a conception without articulation or explicit philosophical justification, but existing nevertheless.

The police demand greater powers, or bend existing rules past the point of legality, to enforce laws that their own conception of order and perception of public need appears to require. The resulting practices often engender complaints from individuals, courts, or citizens, and create conflict with the police. The debate on police powers is often imbued with emotions arising from the issues originally creating the need for those powers. The desirability of police limitation then becomes a debate on drugs. The danger is that in staunchly defending the police, values central to democratic order and the rule of law are eroded. Both the American and British experiences suggest that as long as the public assigns to the police the job of enforcing its moral predilections and to this end is willing to tolerate incursions into democratic values—in Leslie Fiedler's words, "a few not quite Kosher searches and seizures"65—the relation of police and citizen will be subject to conflict and hostility, and police adherence to law will be undermined.

In Britain many of the problems arose out of the power granted the police in 1967 to stop and search persons suspected "on reasonable grounds" of possessing drugs illegally. This provision had been added to the 1967 Dangerous Drug Act on July 21, during Second Reading in the House of Lords, after most debate had already occurred. The broad police power to stop and s4earch people had been opposed several times in the past. In 1967 the police were not even empowered to arrest drug offenders, unless they were about to abscond or had no fixed address. It is interesting to note the problems that the Lords perceived warranted chancing the "slight possible risk of misuse" which these novel powers created: 66

The Association of Chief Police Officers have recently made a full review of the adequacy of police powers in relation to the drug problem. They feel strongly that to deter pushers and enforce restrictions on unauthorized possession of drugs, the police everywhere should be given power to stop and search suspected persons and vehicles. The government recognize fully that to extend police powers in this way is a serious matter, but we must balance the seriousness of the drug problem against the potential for infringing individual liberty.

The Government believe that there is a strong public demand that young people should be protected from the pushers and peddlars who exploit them. And we are convinced that the best way of affording that protection is to enable the police to play their part, by giving them the powers to stop and search. . . .
As the noble Lord said, we must do our best to stop this traffic if we can. When I say "stop" I am not talking about dealing with addicts; I am talking in particular about stopping the pushers getting new clients. At the moment the police have not the powers to do what they ought to do. A great deal of pushing, particularly in the earlier stages, is done on the street corner. The policeman may be watching, but he may not be close enough to see what is being passed. He knows very well what is going on, but there are difficulties about arrest and search. Therefore, it is absolutely essential to stop this pushing. The number of "pushers" is growing very fast, and it is essential that the police should have these powers. I seldom think that anything which is done by this Government is ever right, but because of this new clause, I forgive them all their sins.

A year later, during its investigation of cannabis, the Wootton Committee became aware of a growing hostility to the police resulting from these powers. It recommended "as a matter of urgency"lhat a public inquiry be made into them.67 In addition to abuses of the power to search—growing out of the vagueness of "reasonable grounds" and the tendency of some police to use the power against the young or unconventionally dressed—there were complaints about mass searches in youth clubs, planting of drugs on suspects, corruption, arbitrary denial of bail to drug offenders, and a variety of other matters relating to enforcement of the drug laws. The situation, according to the National Council of Civil Liberties (NCCL), was as follows: 68

The widespread public enthusiasm for controlling the "drug problem," which, in fact, comprises many different problems, places great pressure on the police force to take action and in the process to minimize the importance of respecting civil liberties of drug users, suspects, and members of the public alike. . . . The individual police officer is conscious of and shares public alarm. He is open to the temptation to bend the rules to secure the conviction of an individual he honestly suspects of having committed a drug offense.

A subcommittee of the Advisory Committee on Drug Dependence, under the chairmanship of William Deedes, a Labour MP, was convened in 1969 to study the subject. Its members included Police Commissioner Brodie, a magistrate, Scofield, Lady Wootton, and Professor Glanville Williams, a noted authority in criminal law. Their report, released in May 1970, illustrates again how the need to condemn drug users overrode the other interests to be balanced in a democracy.

Release and NCCL, two civil rights organizations, presented the Deedes Committee with evidence of incidents in which powers of search, arrest, and bail had been misused by the police. It appeared that the police concentrated on cannabis (72 percent of drug offenses in 1968), and that most of those arrests were for possession of small amounts (49 percent for possession; nine tenths of cannabis cases involved 30 grams or less). The legal profession supported strict controls over police powers and questioned the need for broad powers over cannabis offenders." The police, on the other hand, pointed out: 70

While the new provisions for stop and search were too retent for detailed assessment, it would be extremely difficult without them for the police to carry out the intention of Parliament to suppress drug addiction and drug peddling and to honor international agreements on drug offenses. The police felt strongly that proper account should be taken of the alarming increase in drug dependence in the United Kingdom, the pervasive influence that could be exerted upon impressionable young people by a minority kindly disposed to drug taking, and the increasingly sophisticated methods and expertise of offenders. They were concerned that any limitation of powers would encourage a more rapid growth in the number of offenses and be interpreted in many quarters as official acknowledgment that the misuse of drugs should not be treated too seriously.

However, there was no evidence that these powers increased the arrest of drug pushers or that searches helped in curtailing addiction.

The committee's report shows a sharp division between the majority and minority over the existence and solution of problems raised by enforcement. Scofield, Wootton, and Williams agreed that abuses existed and doubted whether the drug use justified a broad infringement of liberty. At the very least, they wanted some means to restrict these powers and make the police more accountable. The majority approach was described in Scofield's dissent:71

Whenever allegations of malpractice or injustice were brought to the notice of the sub-committee, time and energy were spent attempting to show that these allegations were not true. In the event it is usually very difficult to ascertain the truth or falsity of such allegations. My view is that our energies should have been devoted to devising a legal framework and administrative procedures so that the allegations could not even have been made. The question we should have asked is not "Did it happen?"—but "Could it happen?" If there is a source of misunderstanding between police and public, our object should have been to devise a safeguard so that the police are not even exposed to the accusation.

Instead, the majority repeatedly fell back on the gravity of the drug problem, the difficulties of enforcement, and their feeling that the public was willing to relinquish some measure of liberty in order to stop drug use:72

It is true that the advent and availability of these substances pose severe dilemmas. The difficulties are great; so, as far as our present knowledge goes, are the dangers, especially for the young. There must be protection against these dangers. That calls for a law which has to be enforced. The test is our will to enforce that duty.

We believe that the general body of the public appreciate and accept that enforcement of the drug laws cannot be carried out without police inquisitiveness. . . .

. . . The public wish to see the drug laws enforced. . . .

In their acceptance of the need for search powers, the majority did not consider the more general effect of broad police discretion on legal authority, nor recognize that the police practices could be a major source of alienation. Nor did it attempt to restrict the rise of this power, or provide remedies for its abuse. England does not recognize the exclusionary rule of evidence, whereby illegally seized evidence may not be admitted in court. Thus, the victim of an illegal search has no practical remedy for correcting the wrong. The majority also refused in the face of very strong evidence to acknowledge bail abuses. It did recommend that no one be searched solely because of his appearance.

The Deedes majority report suggests that their primary purpose was to reassure the police and public that there was strong support for the fight against drug use. This desire led them to overlook distinctions among drugs and the purposes for which they may be used, and to dismiss the importance of police relations with the young and other social costs. Again the majority, like Callaghan in the debate on the Wootton Report, approached the law as a symbol. Whether or not these powers actually helped stop addiction or harmful drug use, it was necessary that nothing be done that "could be interpreted . . . as official acknowledgment that the misuse of drugs should not be treated too seriously."73 The flaw in this approach was summarized by Dr. Malleson, a member of the Advisory Committee and a witness before the Deedes Committee, in a letter to the chairman of the Advisory Committee:74

The problem presented to society by the misuse of drugs is a serious one. But it is not so serious as to justify what is, for practical purposes, the removal of all rights for the protection of individual privacy from a substantial section of the population. This deprived section is, in effect, one-third of our young people —the less conformist third. The position is to be contrasted with the refusal of the adult community to accept comparable curbs on its own dangerous unlawfulness in the matter of random breathalyser tests.

. . . If it is held that massive infringements of individual liberty are to be accepted as permanent, their gravity should have been recognized and major counter-balancing innovations proposed. . . . Our society is becoming more divided; we cannot afford to have drug control laws which only drive further divisions between young people and adult authority.

MISUSE OF DRUGS BILL

Many of the new problems of drug control in Britain resulted from an inflexible and fragmentary legislative approach. The Dangerous Drugs Act of 1920, supplemented by frequent amendments, was called upon to solve the drug problems of the 1960s, when both knowledge and attitudes toward drugs had greatly changed. Inevitably this statute would appear arbitrary and inadequate to deal with problems unforeseen at the time of its passage. In rejecting the Wootton Report, the Home Secretary had alluded to these difficulties and made a plea for a new drug code:75

In the light of recent experience and the challenge ahead, there is a clear risk that each new fashion of drug-taking will find new gaps in the defences, which will only be plugged, too late, by voluntary steps or by ad hoc legislation. Therefore, I suggest to the House . . . that it would be better to have a single comprehensive code which would rationalize and strengthen the Government's powers and also enable them to act flexibly in the difficult and dangerous problems that are likely to arise in the years ahead.

In March 1970, the Labour government introduced the Misuse of Drugs Bill, which granted new powers to the government and departed in several significant ways from the old structure. This law is the product of the debate, Advisory Reports, and public attention centered on drugs for five years since the second Brain Report. Again, in the paradoxical treatment of different drugs, the ascendancy of public emotions is revealed.

THE BILL

Like the Dangerous Drugs Act, the bill makes it unlawful to import, export, manufacture, supply, or possess the scheduled drugs unless licensed to do so. The process by which this is done is new. Scheduled drugs are broken down into three classes, according to their relative harmfulness. For the first time all controlled drugs are included under one statutory scheme. Class A drugs include opium, heroin, morphine (and other narcotics), cocaine, synthetic cannabis, the hallucinogens LSD, STP, DMT, and DET, and injectable amphetamines. Class B includes all forms of natural cannabis, certain narcotic substances with a codeine base, and certain amphetamines. In Class C are stimulants considered to be less dangerous than the amphetamines of Classes A and B.

The government is given power to add or take away drugs in any class. This power was lacking under the old structure and created problems in dealing with new drugs. Penalties vary with the class of drug and the act committed. For the first time possession and supply are made separate offenses, with different penalties. Production or supply of Class A or Class B drugs is subject to fourteen years' imprisonment and an unlimited fine. The penalty for possession is seven years (plus fine) for Class A drugs and five years (plus fine) for Class B drugs. Class C drugs merit five years (and fine) for production or supply, while possession brings only two years (and fine). These sentences are new in several respects. The maximum penalty for supply and trafficking has been increased for all drugs, while that for possession of some drugs, like cannabis, reduced. The penalties for possession and supply of LSD and injectable amphetamines are greatly increased. Other provisions for the first time make it a crime punishable by the same fines as trafficking, for a physician to disobey an order or regulation issued concerning the prescribing of drugs. These orders may be directed to the prescription of whole classes of drugs, or they may be directed to a physician considered to be "prescribing, supplying, etc., controlled drugs in an irresponsible manner." The government can issue these directions without delay and suspend a doctor pending a final determination. This prevents a doctor who has been found to be overprescribing from continuing to prescribe pending a lengthy appeal. The doctor's rights are protected by a hearing and appeal from an adverse decision.

Other provisions of the Dangerous Drug Act remain essentially unchanged. It is still a crime to knowingly "permit or suffer" production or supply of controlled drugs and the smoking of cannabis on one's premises. However, the penalty has been raised to the maximum for trafficking for each class of drug. Existing police powers of search and arrest are unchanged. Mens rea, or knowledge, is specifically required for all offenses. Also, there is a provision making research easier. Finally, the Advisory Committee on Drug Dependence is continued as the Advisory Council and Expert Committee on the Misuse of Drugs, to advise the government on new drug problems and needed changes in the law.

ANALYSIS AND EVALUATION

The bill is an improvement in three respects. Most important is its power to control overprescribing by doctors. As we have seen, both heroin and methadrine became problems because physicians had prescribed irresponsibly. The 1967 Dangerous Drug Act attempted to close the gap by restricting the prescription of certain drugs to licensed doctors and by granting the medical profession responsibility for policing itself. But under that act it was not an offense to prescribe without a license, and the act covered only drugs listed in the Dangerous Drug Acts (opiates, cocaine, cannabis). Thus, when methadrine became a problem the government lacked statutory authority to restrict its prescription. It was obliged to work out an informal agreement between manufacturers and hospitals—hardly a satisfactory procedure for rapidly changing drug problems.

Similarly, the medical profession's discipline of its members was clumsy and slow. Pending a final determination of his case, a doctor may continue to prescribe. Dr. Petro, a notorious over-prescriber, was able to prescribe 24,000 30-mg ampules of methadrine in a single month after he had been found remiss, but before a final appeal had been made." By allowing the government to order a doctor to stop prescribing certain drugs, or prohibit all prescriptions of a drug, the bill facilitates the quick, effective action necessary to deal with drug problems.

The power granted in the bill to add or delete drugs in the scheduled classes was also sorely needed. When new drug fads came to light, the government could not readily bring them under control without enacting new legislation.

The final advantage of the bill is its attempt to classify drugs according to their relative danger and to distinguish between possession, and supply and production. For the first time cannabis is classified separately from heroin, and powerful drugs like methadrine are put in a more appropriate class. Differentiatibn of drugs is necessary to dispel the tendency to think of all drugs in the same terms, and thus obstruct measures ,suitable for one drug but not for others.

While the bill closes existing loopholes in the medical model, its chief defect is the contradictory treatment accorded nonmedical or recreational drug use. The premise of the bill is that any nonmedical drug use is drug misuse, for which severe penalties, including prison, are warranted. The punitive nature of the bill is evident in the classification of different drugs, the subtleties of which are not reflected in the penalty structure. For example, production and supply of Class A and B drugs are subject to the same maximum penalty, a result hard to reconcile with a scaling by "relative harmfulness." Thus, sharing a pipe or joint of cannabis with a friend is theoretically punishable by the same penalties as trafficking in narcotics or overprescribing methadrine. It is doubtful whether a single LSD session is more of a threat than amphetamine dependence, yet possession of the first may be punished by two years more in prison than the second. And barbiturates are not included in the bill at all. The change in cannabis penalties_the maximum for possession is half of the present ten-year penalty—is not much of a reform when compared with the Wootton recommendations. Casual users of cannabis—the great majority of drug users—would still find this bill arbitrary, discriminatory, and out of line with existing knowledge. Particularly punitive are the high penalties for the supply of cannabis, and the increased penalty for allowing cannabis to be smoked on one's premises. Thus, under the bill, one risks fourteen years' imprisonment by allowing a friend at a party to smoke cannabis. This penalty is the maximum for the most serious offenses under the bill.

These contradictions indicate an underlying confusion about the goals of drug policy. As we have seen, the drug explosion of the 1960s treated addicts and pot smokers quite dissimilarly. Addicts were allowed to obtain and use drugs, while cannabis users were jailed. Yet cannabis is a less dangerous drug. The bill continues this discrepancy and increases reliance on the police for enforcing nonaddictive drug use. Thus a cannabis user is "misusing" a drug and risking a long prison term, while a heroin user is neither "misusing" his drug nor committing a crime, as long as he obtains the drurfrom a doctor. The special status of addiction, however, is not consistently maintained in the treatment of addicts guilty of offenses under the act. No alternative to jail exists for addicts, even if their offense is related to their addiction. The Observer commented on this feature of the bill: 77

The Bill proposes to continue the practice of dealing with drug-takers as criminals, rather than as social deviants in need of various kinds of help that they are unlikely to get in prison. Nobody would seriously propose that alcoholics could be successfully deterred by prison sentences; why, then, should drug-takers? For legislation today to offer no remedy for social deviants other than imprisonment and to propose to regard every schoolboy who experiments with pot as a criminal is a piece of social nonsense.

By failing to look at the roots of the problem and to suggest remedies more in keeping with modern knowledge, Mr. Callaghan is in danger of accidentally helping to spread the fashion of looking sympathetically on those who see in drugs a socially useful form of escape, a harmless means of easing pains and releasing tensions, or a meaningful act of rebellion against society. . . . What is needed is a much more scientific and humane approach. . . . in so far as the bill offers no alternative to prison as a means of deterrence or treatment, it must be regarded as largely a waste of time and, possibly, even as a harmful measure. Its passage would be likely to put off the pressure of more radical measures possibly for another decade—a decade which may be decisive in determining whether the current fashion is to become an accepted part of our way of life.

The Misuse of Drugs Bill represents another exercise in symbolic lawmaking. Introduced a few months before an élection campaign in which a main issue was "law and order," it was hailed as a hard-line approach to drug users and drug pushers. Indeed, the penalty structure confirms its tough stance on drug use, particularly on cannabis. The penalties, in particular, must be viewed as symbolic. Even at the time of the Wootton Report, the avtrage cannabis user was usually being fined, rather than going to jail. The proposed penalties are unlikely to influence the sentencing of drug users, although they do provide a new weapon against major suppliers and unscrupulous doctors. More important, however, is the societal judgment, expressed through the new law, that drug use is automatically drug misuse—an immoral, antisocial act. The law functions as a symbol to reassure the public that the line against the chaotic and disorderly (symbolized by drugs) is firmly drawn and staunchly defended.

Resort to the police model, however, exacts a price. In this case, it is the acceptance of extensive police powers, arbitrary treatment of different drug users, erosion of the rule of law, and a growing alienation from legal authority. In the haste to condemn, the threat from drugs is exaggerated and the social costs of the laws are overlooked. In Britain a policeman may now search and detain a person on the street or enter his home and seize papers that he suspects are involved with cannabis use. The security gained against drug users has been offset by a decreased security against the official power of the state. Even where the state is benign the precedent is dangerous, and the possibility of injustice increased.

The British experience is curiously paradoxical on this point. It accepts the idea that serious social costs may flow from an ill-considered and emotional heroin policy, but denies that any costs could accrue from policy toward other drugs. Until such paradoxes are faced and resolved, the drug issue and the controversy it provokes will persist in disrupting the fabric of social life.

CONCLUSION

Although this survey of the British experience with the drug controversy is necessarily cursory, it is enough to show that national character difference is not the crucial variable in the success or failure of drug programs. Whenever the relative success of the British in dealing with heroin addiction—small number of addicts, little crime connected with drug use, fewer deaths—is cited in American discussions the automatic arguments against it are that (1) the British system is not working anyway, and (2) it only works because of the essential law-abiding nature of the average Britisher and his good relationship to the police.

Certainly the British system is imperfect in that the medical facilities for treatment and rehabilitation of addicts are grossly inadequate. Also, the British have come no farther than we in assessing addiction-prone people and devising fresh approaches to preventing addiction. Nevertheless, on any terms the situation is better in England. The rise in the number of addicts is numerically small, and considering the enormous amount of publicity drugs have received, it is astonishing that the number isn't larger. This applies also to the United States; there must be a sizable portion of young people, perhaps as high as 6 to 10 percent of the entire population, who, when there is a lot of shouting, must find out what the shouting is about. Hence, under the recent mass-media pressure a large rise in addiction can be seen as the moderate success of the largest advertising campaign in history.

The absence of drug-connected crime in England changes the entire embiance of the society. By any subjective or objective criteria one can imagine, the streets of London are safer than those of any large American city and drug policy is one important reason. On July 26, 1970, Sir John Waldron, London Police Commissioner, could confidently state in his annual report, "People can still walk abroad in London at night with little fear of being molested."78 Can you imagine what the police commissioner of New York City feels upon reading that?

Under the British system of licensed addicts, the heroin received is officially quality-controlled, as is the equipment to administer it. Almost all the gray-market heroin comes from the same source, so that the horrid uncertainty as to dosage which plagues the American addict and was a principal factor in the 1,100 addict deaths in the United States in 1969 simply does not exist. This does not mean that there are no drug-related deaths in England any more than the availability of clean needles and syringes means that there are no cases of infectious hepatitis. Addicts are often strange people. Much overdosing, both in the United States and in Britain, represents conscious or unconscious suicidal attempts. Addicts also tolerate frustration poorly and, in their haste, do not take careful precautions to ensure sterile injections. No doubt the addict personality type is similar in both the United States and Britain, and results differ only because the control systems are different.

The medical and social problems of drug use that have developed in the United States in the past decade have also developed in Britain. This enables us to dismiss the "national character" argument. We prefer to make little here of the racist nature of an argument that implicitly holds that the relatively homogeneous, Anglo-Saxon, rational English can handle a problem that the melting-pot, racially mixed, minority-group-plagued United States cannot. The important thing for us to notice about the British experience is that a long time ago, in 1920, they elected a medical model when the United States elected a police model. The drug-using population was essentially the group we think of as dependency-prone on psychological and sociological grounds. Given what we know now, it can be seen that the medical model worked far better.

However, once both countries were faced with a social drug problem—whether pills, joints, or LSD—both panicked. They identified drug use with a host of other issues—long hair, dirt, social irresponsibility, promiscuity, degeneration of values, political destructiveness, violence, crime, and indolence—and reacted with hysteria. We found the same public attitudes in the United States toward the social drug issue as we found in Britain, and the development of the legal position outlined in this chapter represents th c same preoccupation with moral control based on ideas of harmfulness that we find in the United States.

One more development—and one of the saddest—that indicates that differences in national character amount to less than might have been thought is the changing attitude toward the police. Alan Brian, in an essay in the New Statesman called "From Bobby to Fuzz,"79 'outlined the changing attitude of the British public, particularly the young, toward the police. It indicates that once search and seizure laws are adopted and differential law-enforcement procedures become frequent, even a mutual trust as strong as that between the average Britisher and the bobby can break down. Cannabis bedevils British society and its most trusted social institutions in much the same way marijuana has the United States.

The United States is more vulnerable. It is larger, more diverse; it has the Vietnam War; and with 50 percent of its young in institutions of higher learning, as opposed to 10 percent of the British, it has a far greater problem of student unrest. Perhaps the British can make the best of these advantages. With a working medical model already in operation, Britain is in a good position to lead in thinking through and putting into practice the changes we advocate.

* Cannabis sativa is the plant from which marijuana (the leaves and flowering tops) and hashish (the resin) are derived. In England it is predominantly used in the resin form. In this chapter we use "cannabis," to refer to any form of marijuana.

* it also discussed research, premises offense, education, control of synthetic cannabinols, and power of search and arrest.

 

Our valuable member Norman Zinberg has been with us since Sunday, 19 December 2010.

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