6. 1 The problem definition

The Narkomanvård Committee defined the concept of narcotic drugs
as: "By narcotics or narcotic substances are meant those substances that
are designated by Swedish legislation as narcotics" (SOU 1967: 25:
22). As the committee stated, this is purely a juridical definition that did
not refer to the pharmacological properties of the substances. Drug
abuse thus was defined: "all non-medical use is abuse" (Ibid. 22). This
definition does not make any distinction between the kind of use,
experimental, occasional, or chronic.
In a memorandum to the Department of Social Affairs in 1966, the
drug situation was characterised by the committee in alarming terms:

The present situation is serious. From a social medical point of view, we are in the
middle of a surge of disease of an epidemic nature, but we have very insufficient
knowledge of the pathological picture and the course of disease, the background to
the epidemic, and the possibilities of mastering it (Ibid. 163).

However, in its first report, (SOU 1967: 25: 162) the committee added
that the analogy with an epidemic most of all was justified to describe
the emergence and dynamics of abuse. It did not provide any guidance
for countermeasures.
The outcome of the surveys accounted for in the report showed,
according to the committee, that drug abuse had disseminated among
certain asocial categories (Ibid. 75). Furthermore, severe abusers of
narcotics in need of treatment were presumably underrepresented in
relation to abusers of legal substances like barbiturates. This was
particularly true in the case of intravenous amphetamine abusers who
strikingly often had demonstrated poor motivation for care.
Furthermore, a survey conducted by Bejerot among detainees in the
house of detention in Stockholm had noted 1200 intravenous abusers
during the period April 1965 to June 1966 (Ibid. 109). The committee
estimated the number of intravenous drug abusers in Stockholm at
roughly a few thousand, many of whom were in need of medical care.
The situation was also worrying in Gothenburg and the Malmö/Lund
region in the south of Sweden, indicating that it was primarily a big city
phenomenon. However, in smaller cities minor local epidemics of
mostly cannabis and solvent abuse among youth were known (Ibid.
104).
The committee emphasised that the data sources (police, correctional
treatment, health and social services and juvenile care) on which the
committee's findings were based meant a selection of the drug-using
population. A side effect of this selection, according to the committee,
was a lack of data on milder (incidental abuse) forms of abuse. Results
from surveys among student populations or the general population
(normal population in the words of the committee) were not available
yet (Ibid. 110).
Cannabis use among youth was noticed but not regarded as a major
problem (yet). The committee concluded that very few cannabis abusers
were exposed to treatment (psychiatry). It could not account for the
prevalence of cannabis abuse among the general population, and results
from further surveys should be awaited (Ibid. 110). The committee also
concluded that empirical research showed contradictory assessments of
the harm caused by cannabis. Psychological dependence on cannabis
was reported but tolerance, increasing dosage, and physical dependence
did not seem to occur. Finally, the committee mentioned that cannabis
was judged by some observers to be a gateway to other forms of abuse
and addiction, for example, to heroin addiction in the US (Ibid. 25).
Discussing the risks of cannabis, the committee took the stand that
cannabis probably was less harmful than many other legal substances in
Sweden, but did not have any medical usage. When the pros and cons
had been weighed up, a prohibition was justified. Besides, according to
the Single Convention it was impossible to allow cannabis for other
than medical or scientific purposes (SOU 1967: 41: 38).
Another observation worth mentioning is that the committee in its
first report discussed abuse of medicines in general terms, of which
illegal abuse of narcotics was the most severe. However, abuse of
solvents among youth and hypnotics among somewhat older people
were deemed a serious phenomenon as well. In its second report "The
Control System", the terminology had changed to narcotics and other
addictive substances. This might reflect the ongoing process of
separating drug abusers from other categories of depended citizens.
Intravenous abuse of amphetamines was perceived as the most
serious problem and seemed to occur mainly among asocial groups, and
research was to be targeted at these categories. The committee noted a
lack of knowledge on the process of abuse of central stimulants and for
preventive as well as therapeutic reasons recommended further research
on this matter. Experiences so far had shown that abuse of these
substances to a large degree was a collective phenomenon. Loosely
organised sub-groups with an asocial core emerged and disappeared.
Rituals surrounded abuse and a sense of coherence often seemed to
exert a strong suggestive effect on the members. These social
psychological factors presumably contributed to recruiting abusers and
a remarkable fixation on abuse (SOU 1967: 25: 108­109).