Drug Abuse

Additional Conclusions and Recommendations of Marie-Andrie Bertrand

INTRODUCTION
I hasten to stress that I am entirely in agreement with my colleagues' objectives of limitation, control and maximum possible reduction of hard drug use in Canada. I share their concern for restricting the use of opiate narcotics and strong hallucinogens, and for preventing the spread of such use to hitherto unaffected strata of the population. Not only do I share their objectives in this, but I propose even greater stringency than they with respect to the manufacture and illegal trafficking of hard drugs. My recommendations will include even more severe penalties and other measures that seem to me likely to be more effective in combatting illegal importation and trafficking than those proposed by the majority.

Reducing hard drug use in Canada, then, is our common goal. I cannot, however, concur with the measures proposed by my colleagues in pursuit of that goal. I do not believe that the best way to restrict or discourage hard drug use is by retaining the present laws making possession of opiate narcotics and strong hallucinogens a criminal offence. Nor do I agree with the recommendation that users of opiates be subjected to compulsory treatment.

In short, my position with regard to the handling of hard drug users differs from that of my colleagues on two points:

1) retention of simple possession of opiates and strong hallucinogens as a criminal offence (under the Narcotic Control Act and Part IV of the Food and Drugs Act); and

2) commitment of opiate-dependent persons for compulsory treatment; subjecting an individual against his will to measures intended to change his habits and life style.

I shall first explain my opposition to retention of the criminal offence of simple drug possession, even for hard drugs. I shall then give my reasons for rejecting the use of criminal process as a point of departure in the treatment of opiate-dependent persons.

Having discussed these two points, I shall put forward measures for dealing with drug users that seem to me more appropriate than recourse to criminal law. In particular, I shall describe certain educational and treatment programs which in my opinion should be substituted for criminal law sanctions. I shall also suggest controls that might be imposed and other action that might be taken with respect to traffickers and importers of drugs of all kinds.

THE FUTILITY OF THE OFFENCE OF SIMPLE POSSESSION AS A DETERRENT TO DRUG USE

There are objections of both principle and practicality to the invocation of criminal law against the authors of crimes without victim; a classic example of such crime is the possession of drugs for one's own use.

Using the criminal law for controlling behaviour which amounts only to an individual's personal life style, custom or private conduct is overreaching the intent of the criminal law, inasmuch as it overreaches the intended effect. Such application of the criminal law is in fact an abuse of a powerful instrument of control, with inescapable practical and moral consequences. Where there is no victim of a crime, and therefore no complainant, apprehension and prosecution take on a most singular character, requiring exceptional procedures and methods that amount to infringement of the civil liberties of individuals. Search, arrest and prosecution in cases of simple possession of drugs are precisely of this nature. In such cases it has been the State's will to set aside the normal presumption of innocence and the inviolable right to immunity from arrest and search of person and premises in the absence of a warrant; the State appears to regard the possession of opiate narcotics in itself as a grave danger, and persons suspected of it must at all costs be apprehended. Legal action against users of strong hallucinogens likewise involves exceptional procedures of arrest.

The degree of deterrence and control expected in justification of these special measures has simply not been realized. The number of convictions for heroin possession has risen from 243 in 1964 to 630 in 1972. Convictions for possession of strong hallucinogens have far from diminished (1,014 in 1970, 1,210 in 1972 for LSD and MDA). It is almost redundant to recall that convictions for cannabis possession have risen astronomically, from 25 in 1964 to 10,695 in 1972.

Furthermore, conviction or even apprehension statistics provide at best only a vague indication of the extent of use. Police reports alone record an increase in the number of known opiate addicts from 2,947 in 1964 to 8,958 in 1972, and these totals do not include professionals who are addicts (largely medicine-related) or persons who are drug dependent as a consequence of medical treatment. As the majority report observes, law enforcement agents have endeavoured to "contain" the phenomenon by keeping it in sight. Until recent years, the police knew or thought they knew most addicts and could identify newcomers among them. Events, however, have shown their control tactics to be ineffective to say the least. Nor have the penalties provided by law, even as severe as they are, prevented a million Canadians from smoking marijuana and hashish during the past year. Many people tend to think that cannabis users are no longer jailed, and that is one reason for the increased use of the drug, but in 1972 there were over 560 prison sentences meted out for simple possession of cannabis.

The evidence has to be believed. Criminal law prohibition of simple possession, despite the high cost of its application to opiates and cannabis, has not prevented convictions for simple possession from tripling in the case of opiates between 1964 and 1972, and from multiplying over 425 times in the case of cannabis. Furthermore, we would probably have to multiply the number of convictions by 100 to have an idea of the number of drug users there are at any given time. Both hard and soft drugs are now being used by new segments of the population, and these segments are so heterogeneous and scattered that the old police practices have become quite ineffective, as the majority report observes.

The use of the criminal law where possession and use of drugs is involved may strictly speaking be justified by the pedagogical intent of the law, as the majority report observes. The legislator, however, does not appear ever to have fully appreciated that aspect of the law. To be effective, the pedagogical intent should be clearly stated and tailored to the circumstances. In particular, prohibitions and penalties would need to be proportioned to the relative potential for harm attributable to each injurious substance. This is far from the case. The laws regarding possession are inconsistent and unrelated to the gravity of the consequences entailed in the use of the various drugs, for the user himself and for others. Alcohol, which is by far the most potentially harmful and most criminogenic psychotropic substance, is distributed under government control and enjoys great popularity. Tobacco, whose potential for harm is well established, is sold freely under the law except to minors. The amphetamines, which are not far behind alcohol in harmful and criminogenic potential, are not subject to criminal law prohibition of possession, and it is not recommended in the majority report that they should be made so, in recognition of the certain ineffectiveness and extreme awkwardness of such a measure—of the futility, in short, of any extention of the offence of simple possession. The barbiturates, which head the list in causes of death by suicide, are subject to no prohibition of possession and their controlled distribution does not work as intended. Prescription control is no deterrent for anyone who really wants them; recent polls carried out in Toronto show that young people obtain them with great ease. The minor tranquilizers are very accessible, prescription control being once again ineffective. Cannabis, whose real potential for harm is not established, is still classified as a narcotic. Though many courts tend to give relatively light sentences for possession of marijuana and hashish, under the law the possession of these drugs remains a punishable offence, and during 1972 there were still well over 500 incarcerations for simple possession. Volatile solvents, which have a high potential for harm, are subject to no legal prohibition whatever, and, desirable though it might be, control of their distribution and use would be quite impossible due to their wide normal use for household and other purposes. The strong hallucinogens, whose abuse can be extremely harmful but which are not apparently criminogenic and do not cause dependence, are subject to a prohibition of possession, but only under the Food and Drugs Act, whose "moral" impact certainly appears less onerous that that of the Narcotic Control Act. This impression is reinforced by the large number of witnesses appearing before the Commission who have recommended that cannabis be reclassified under the Food and Drugs Act rather than left under the Narcotic Control Act, on the ground that cannabis is not pharmacologically an opiate narcotic and does not warrant inclusion in the more "incriminating" statute.

As can be seen, the contradictions and inconsistencies in the legal classification of drugs are considerable, weakening the pedagogical value of the classification. Any lesson that might be drawn by Canadians from the inclusion of a substance in a strictly controlled category of drugs or medications is therefore lost. The ordinary citizen, seeing the assertions implied by the law frequently belied by pharmacological fact or the effects that he himself experiences in the use of drugs, has long since ceased to look for a relationship between the harmfulness of a substance and its classification under criminal law. In this domain, it must be said that the criminal law is thoroughly outdated and outworn.

It seems particularly illogical, ineffective and inhumane to use the criminal law against opiate dependents. If there is anything which ordinary citizens and scientists unanimously recognize, it is the high dependence-creating potential of the opiate narcotics. And yet in flagrant self-contradiction, on the one hand we define heroin and other opiate addicts as vulnerable and dependent individuals with a compulsive physiological or psychological drug need (or perhaps both), and on the other, we react to their dependence with police searches, apprehension, detention in police cells, criminal trials, fines and incarceration. We make criminals out of people whom we consider to be suffering physical and psychological disorders; we impose punishments which further alienate people who are already alienated enough, and often suffer quite sufficiently from that alone. What the opiate-dependent person needs is not harassment but compassion, not imprisonment but education and medical and psychiatric treatment.

Not only is criminal law prohibition proving ineffective in curbing the rising use of opiate narcotics and strong hallucinogens, but it creates illicit markets in which the cost of these drugs is exceedingly high and fluctuating and the supply uncertain. Since an opiate dependent's need for his drug is compulsive, most street addicts commit crimes against property and even crimes of violence when they no longer have the drugs they crave or the money to obtain them. And in this atmosphere of clandestinity and illegality, the black market, we can be sure, takes full advantage of the demand.

The State's expenditure of public funds in detecting, apprehending and convicting users of opiates and strong hallucinogens is not justified, in final analysis, by the results obtained. Until recent months, the police have claimed to know most heroin addicts, and have made a policy of arresting them from time to time. But many drug-dependent persons learn to live with this police harassment, which in any event does nothing to relieve them of their dependence. The inconvenience and risk of apprehension seem to be amply outweighed by the pleasurable effects and satisfaction to be had from continued use of opiate drugs. We have seen, furthermore, that today there is a whole new population of addicts who are unknown to the police. The same applies with slight variations in the case of strong hallucinogens.

COMPULSORY TREATMENT: AN ILLUSION

With the criminal law process as justification and point of departure for intervention, my colleagues propose that persons apprehended for simple possession of opiates and proven to be drug-dependent be subjected to a controlled course of treatment. The measures they suggest are certainly an improvement over the present situation; their inspiration is indeed a more humane philosophy than that underlying simple apprehension and incarceration, or methadone maintenance without alternative.

Nevertheless, in my opinion the process of catchment they propose, and its underlying principles, are irreconcilable with the intended goals.

What my colleagues envisage is that the dependent opiate user will be compelled to give up his dependence or transfer it to something else. It must be remembered, however, that drug dependence factors are of two kinds, physical and psychological.

It would seem that there are only two ways of overcoming the physical factors. The first is through a medication or substance which blocks the effects of the opiate, particularly heroin; this, called an antagonist, would be one additional weapon in the chemo-therapeutic armamentarium. The second is a substitution program, generally using methadone. Strictly speaking, substitution of one drug for another is not treatment.

The psychological factors of drug dependence are no less problematical. They are many and, depending on the individual, greatly varied.

It is illusory, in my opinion, to expect to overcome all these factors without the complete cooperation of the patient. Therapists attached to penal institutions are well acquainted with the dilemma. The best individual and group programs of compulsory therapy have failed so far because of the necessarily authoritarian framework and lack of free choice for patients. The compulsory confinement for education and possible treatment of the dependent person recommended by my colleagues is predicated on prior arrest, with imprisonment to follow, of course, if the patient will not accept any of the modes of treatment offered him during the period of his or her confinement. But apprehension and threat of imprisonment are generally regarded as a form of arm-twisting by opiate dependents, which is hardly conducive to any real change of attitude, and it is essentially change of attitude that my colleagues hope to achieve in order to bring about a change in habits and relief from the physical and psychological craving for drugs.

Compulsory treatment therefore seems to me to be a contradiction in terms. Furthermore, results obtained by the most highly regarded programs in the field are unimpressive. For example, the latest evaluation of Corona (California Rehabilitation Centre) shows that barely 20% of patients transferred from confinement to supervised outpatient status remain drug-free for as long as three years. There is reason to wonder whether a success rate of this order justifies our launching such a complex program, or the coercion to which thousands of patients would have to be subjected in order to achieve it, to say nothing of the social, moral and financial costs involved.

In inducing abstinence, the therapeutic communities appear to have the best record, but their capacity is very limited and they attract only a small percentage of chronic drug users, particularly since most impose total abstinence from the moment of admission; many of them, moreover, require that their clientele be strictly voluntary.

Methadone maintenance treatment ("treatment" being a misnomer here, since methadone is an opiate with equal or even greater dependence-producing potential than heroin) may be effective in preventing a patient from escalating his use of other drugs, given adequate supervision. Some parolees and probationers on methadone maintenance apparently work and lead relatively normal lives. Nevertheless, it must be admitted that methadone is simply the State's drug (the one tolerated and even offered by the State), whose major advantage over heroin is that it seems to enable some patients to function and hold more or less regular jobs. This raises the question of whether the State has the right to force substitution of one dependence-producing drug for another, particularly when it is known that there is illicit marketing and use of the substitute.

We should take a hard, unbiased look at the objectives of therapeutic intervention in the case of chronic opiate users. What are we treating them for, what are we aiming for, and why? Do we want dependent persons to become total abstainers, transfer their dependence from one substance to another, or to something quite different? What right has the State to dictate the substitution of one dependence for another? In short, what do we mean by "treatment"?

Take compulsory treatment; its very principle is highly questionable. There are serious ethical and socio-political implications in the State's intrusion on the private lives of Canadians on the pretext that their health is endangered. Surely there should be limits to the State's responsibility in the private lives of citizens. Otherwise we risk having the State stoop to a legalistic moralism as unwholesome and invidious as that exercised by churches and commercial interests at certain periods of history.

CONTROL AND LIMITATION OF HARD DRUG USE WITHOUT RECOURSE TO CRIMINAL LAW

I believe in the necessity of controlling and limiting hard drug use, but, contrary to my colleagues, I do not believe that this will best be achieved through recourse to criminal law with respect to users. I do not think that branding drug users with criminal records will induce them to break their habit or persuade others not to begin. It seems to me that the time has come for a more humane, more realistic, and in fact probably more practical attitude toward those who use hard drugs, particularly opiates. Criminal law prohibitions and other such measures should be supplanted by controls of other kinds reflecting a less punitive approach.

First of all, simple possession of opiates and strong hallucinogens should cease to be considered criminal acts. There should be no offence of possession or use for any of the drugs. This does not of course mean that hard drugs should be decontrolled completely; what we need is to replace the present system with a new set of more effective and more humane controls.

If there were no offence of possession, in what other ways could the State control the use of hard drugs? As I see it, there are five:

1. Limits on the importation, manufacture and marketing of drugs for medical purposes, whose abuse has created a climate that encourages the use of psychotropic substances in general.

2. Effective controls over the importation, manufacture and distribution of opiates and strong hallucinogens and safeguards against the diversion of legally manufactured drugs to illicit markets.

I shall return to these first two points later.

3. Confiscation of opiates and strong hallucinogens found in the possession of persons apprehended for reasons other than drug possession, and of large quantities of medical drugs for which no justification can be produced (a medical prescription, for example). This would involve no search, arrest without warrant or prosecution of drug users as such. However, just as a motor vehicle driver for a variety of reasons may be called upon to show his vehicle registration and driving permit, and possibly to demonstrate his fitness to drive, so persons found to be in possession of substantial quantities of injurious substances should have to show a medical prescription or other proof of recognized and legitimate need for them. Unauthorized possession, that is to say, the fact that they could only have been obtained illegally, would justify confiscation.

4. Information and education, the best of all methods for promoting desirable habits and attitudes. Well run, realistic and convincing publicity campaigns would help Canadians to make informed and sensible judgments about drug use. The slogan "speed kills", spread by the drug culture itself in Canada and the United States, has diverted many a speed user or potential user from this type of drug use (amphetamines taken intravenously). In Sweden, the dangers of speed have been very effectively publicized through graphic roadside billboards. The abuse of barbiturates and certain tranquilizers would justify such tactics. The torment of opiate dependence and the unenviable future in view for the heroin addict could be depicted in this way too.

5. Controlled, legalized sale of opiates. In view of the high relative dependence-producing potential of opiate narcotics, these drugs cannot continue to be prohibited as rigidly as they are at present. Provincial or regional clinics should be established for dispensing opium, heroin, demerol, methadone and other synthetic opiate derivatives to authorized purchasers at very moderate prices. A drug-dependent person who agrees to have his dependence determined and recognized, and to submit to monitoring (urinalysis or examination of needle traces on the skin), would be authorized to obtain the drug on which he is recognized to be dependent, or another, possibly less harmful one. If the chances of his being freed of his dependence were real, the clinic staff would try to convince him of it; they would propose gradual withdrawal through controlled reduction of dosage, or a substitute, which in turn he would try to give up progressively, or else various forms of individual or group therapy. Or it might be suggested that he swap his preferred drug for another, providing the substitution would be of real benefit both socially and for the user himself. The clinic should have no coercive power, however.

The patient would be required to take his drug at the clinic, for the first three or four months at least, to prevent the drugs dispensed from being trafficked; but the clinic would not insist that he take it orally instead of intravenously, since, if he did not feel capable of making the change, such a requirement might drive him back to the illicit market.

Clinic personnel, besides psychiatrists and other members of the medical profession, should include young people, former opiate dependents, psychologists and social workers who would research the patients' dependence histories. On the basis of the research, the psychiatrists and psychologists, assisted by the ex-addict staff, would propose forms of therapy likely to reach the true roots of each patient's dependence.

When I stress that drugs dispensed by these clinics should be very moderately priced, it is not to make them more easily obtainable, but to eliminate discrimination against the socio-ecnomically disadvantaged and to minimize the temptation to resort to illicit markets.

There are four important arguments for controlled availability of all opiates:

(a) The interrelation of two factors; the dependence-producing characteristic of these drugs, leading to compulsive efforts to obtain them, and the absence of legitimate supply. This is at the root of a great many crimes and other antisocial conduct on the part of users. The poor health suffered by many heroin addicts, besides, is more often attributable to the disordered life an addict must lead in order to satisfy his habit than to the drug effects themselves.

Criminal activity related to the obtaining of drugs would be considerably diminished with the existence of legitimate sources of supply. I am not under the illusion that all drug-dependent persons would accept the conditions of using the legitimate clinics for their drug supply, but, according to responsible observers, over 60% of the opiate-dependent population would be attracted to such a plan and would respect its strictures, and the percentage could be higher.

(b) The illicit markets would be deprived of two-thirds of their clientele, with obvious salutary consequences.

(c) The rather mystical qualities and overblown virtues of opiates (in the eyes of users) would assume more realistic proportions in a context of controlled legal distribution, and these drugs would thus lose much of their exotic appeal.

(d) If it is true, as some observers claim, that the early heroin user will often press his friends to try the drug, for both psychological and financial reasons (selling the drug to help finance his own supply, in particular), the incidence of such "contagion" could diminish greatly with the existence of legitimate sources of supply.

These clinics should be kept under continual surveillance and evaluation during at least the first three years of their operation. For this purpose a special committee or board should be given a mandate to examine the following in particular:

(a) the number and characteristics of those who identify themselves as drug-dependent persons;

(b) the operating costs of these "opiate-dependence clinics", in comparison with the costs of surveillance, apprehension, prosecution and incarceration of addicts under a system in which they must lead a deviate and criminal existence;

(c) year-to-year changes occurring in the clinic clientele; and,

(d) the extent of continued contact with and recourse to illicit markets among clinic clientele.

MEASURES FOR COMBATTING ILLEGAL IMPORTATION, MANUFACTURE AND SALE OF HARD DRUGS

BETTER USE OF POLICE RESOURCES

It is cynical, or at best singularly inept, for the State to keep police forces busy detecting and apprehending cannabis users, even opiate and strong hallucinogen users, while large quantities of hashish, marijuana, amphetamines, hallucinogens and heroin are being smuggled into the country every day and every week, and large quantities of legally manufactured amphetamines are being stolen or diverted from their original destinations and sold on the black market. It defies comprehension how the police can believe it useful, as they claim, to concentrate on arresting heroin addicts, whom they know and who are not necessarily causing any serious harm, while large thefts of medical drugs are being perpetrated and illegal importation of opiates goes on apace, virtually unchecked. The present manner in which police manpower and resources are being employed suggests that the State has no serious policy for the control of drug importation, manufacture andt trafficking.

The money and time spent on police surveillance and apprehension of drug users could be much more usefully employed:

1) in larger police formations than the present narcotics squads, composed of more highly specialzed police personnel with reliable, up-to-date knowledge of the illegal drug transfer and distribution networks (see Appendix B Legal and Illegal Sources and Distribution of Drugs);

2) in surveillance of pharmaceutical manufacturers, including analysis of foreseeable surplus production and what is done with it; and,

3) in detection of illicit laboratories.

Sporadic, spectacular (but all too infrequent) seizures of large quantities of heroin and cannabis* can hardly obscure two facts:

1) there is no shortage of these drugs in Canada; and,

2) on the admission of Interpol itself, barely ten per cent of the traffic in opiates is suppressed by law enforcement.

The demand for hallucinogens is apparently being met by imports and illicit laboratories.

As for amphetamines, used non-medically, we see from Appendix B that a significant proportion comes from legitimate Canadian and American manufacturers. We therefore cannot escape the fact that large surpluses of stimulants are being knowingly produced by recognized firms.

We have seen that, in the United States, not only have law enforcement agencies been unable to stop the illegal importation, manufacture and trafficking of drugs, but certain of their agents have been party to these criminal activities, with large sums of money passing into their hands. The possibility of a similar situation in Canada should be given close scrutiny.

ADDITIONAL PENALTIES FOR ILLEGAL IMPORTATION, MANUFACTURE AND DISTRIBUTION

Fines and penalties for tax evasion should apply as a matter of course to persons convicted of large-scale illegal importation, manufacture or distribution of drugs.

Criminal law penalties for illegal importation, manufacture and distribution of drugs should be reconsidered and proportioned:

1) to the real relative potential for harm of the various drugs;

2) to the quantities illegally imported, manufactured or distributed; and,

3) in the case of traffickers, to the youth and vulnerabiliy of the population reached by the illegal distribution.

The illegal manufacture of amphetamines or the shipment of legally manufactured amphetamines to fictitious customers or customers of uncertain identity should be punishable by from two to five years' imprisonment and heavy fines. Manufacturers who cannot account for thefts or disappearance of drug inventories should be liable to the same penalties as importers.

THE DANGERS OF IMMODERATE USE OF MOOD-CHANGING SUBSTANCES

The non-medical use of drugs in Canada is largely attributable to the very casual attitude throughout the country toward mood-changing substances in general.

1. The prescribing practices among physicians, spurred by the pharmaceutical industry and its salesmen, have encouraged a "pill-popping" mentality among Canadians.

2. Brewers and distillers have been wooing the populace with assurances that alcohol counteracts a great many evils.

3. Tobacco manufacturers have outdone themselves with their advertising, urging us to smoke for the same reason.

4. The Canadian and provincial governments, either directly with policy and legislation or through administrative decisions by senior officials, have on occasion helped to create and foster a climate in which the use of drugs, medicines and psychotropic substances of every description is taken for granted; what is worse, they quite commonly authorize penitentiary and prison wardens, and also medical and administrative authorities of hospitals, mental health services and homes for the aged to use or permit the use of tranquilizers, barbiturates and "sedatives" in all forms, gas, liquids, tablets, capsules and injections, daily and excessively, to a degree unjustifiable either medically or morally. Some institutions no longer even feel it necessary to justify multiple drug use for controlling or calming their inmates or putting them to sleep.

5. Both the State and the medical profession seem more obsessed with keeping control over the use of mood-changing substances than concerned about their harmfulness or the health and well-being of the people. Availability and use are supposedly controlled by prescription, but prescribing practices are ill-founded to say the least; the young and the poor, for instance, are denied access to medical drugs that well-heeled adults can and do have prescribed for them when and how they want, with the result that the privileged often make unnecessary, excessive and careless use of them, while the rest look on, and naturally enough are tempted to use them too if the opportunity arises.

RECOMMENDATIONS

1. At the close of three and one-half years of study, inquiry and reflection, my most urgent recommendation is that a permanent COMMISSION FOR THE SUPERVISION OF THE MEDICAL USE OF DRUGS be established at

the earliest possible moment, under the authority of the GovernorGeneral-in-Council, to examine the prescribing practices current in the medical profession and rectify them. It is also urgent that it inquire into the use of medical drugs in prisons, penitentiaries, mental hospitals and institutions for the aged and for disturbed and hyperkinetic children. Thirdly, this commission should exercise close and continued surveillance over all aspects of the importation and manufacture of drugs for medical purposes, especially amphetamines, barbiturates and tranquilizers.

2. (a) Simple possession of opiate narcotics and strong hallucinogens should cease to be classed as a criminal offence under Canadian criminal law statutes.

(b) There should be no offence subject to criminal law sanctions for possession or use of any of the drugs.

(c) Opiate narcotics should be legally classified with the controlled drugs.

(d) Opiate narcotics and strong hallucinogens found during police investigation of a suspected crime or misdemeanour should be subject to confiscation, failing production of a medical prescription or other justification of possession.

3. Provincial or regional clinics should be established in Canada with responsibility for the clinical and scientific determination of the true state of opiate dependence of any person who consents to submit to the tests necessary for the purpose.

4. These clinics, having determined a person to be a drug-dependent, should also be responsible for providing him with the substances necessary to him, at very moderate prices.

5. Special committees or boards should be appointed by federal and provincial health ministers to assure strict supervision of the operations of these clinics and to carry out a continuous evaluation of them during at least their first three years of operation.

6. Genuine efforts should be made by the various levels of government, in cooperation with the medical profession, colleges of pharmacists and parent and teacher assocations, to create in Canada a climate of moderation, restraint and control with regard to the use of drugs for medical purposes, tobacco, alcohol and other drugs.

The pharmaceutical, brewing, distilling and tobacco industries, having contributed to the current popularity and abuse of pharmaceutical products and psychotropic substances, should take steps to inform the public fully and effectively in future, with particular emphasis on the importance of moderation in the use of these harmful substances.

Educational campaigns, to be effective, must observe three conditions: the information must be strictly accurate; the authority of those communicating the information must be beyond question; information directed toward drug users must be couched in language current in their milieu, reflecting accurate and unpatronizing understanding of them.

* For 1972, the B.D.D. registers 2 convictions for importing heroin and 33 for importing cannabis; in the same year the courts handed out 11,431 convictions for simple possession of the various drugs prohibited under the Narcotic Control Act.