B.3 AMPHETAMINES AND AMPHETAMINE-LIKE DRUGS

LEGAL SOURCES AND LEGAL DISTRIBUTION

The distribution of amphetamine (including dextroamphetamine), benzphetamine, methamphetamine, phenmetrazine, phendimetrazine, and their salts, is controlled by the Food and Drugs Act and the Food and Drug Regulations. These drugs are listed in Schedule G of the Act in which they are referred to as "controlled drugs". Prior to 1973, distribution of these amphetamine and amphetamine-like drugs was regulated in the same fashion as the barbiturates (see B.7 Minor Tranquilizers, Barbiturates and Other Sedative-Hypnotics, "Legal Sources and Legal Distribution", below). However, due to "the over-prescribing of these drugs by some medical practitioners . [and] concern about the public health implications of amphetamine abuse", the Food and Drug Regulations were recently amended with new and stricter provisions regarding amphetamine, benzphetamine, methamphetamine, phenmetrazine and phendimetrazine coming into effect on January 1, 1973.8 These drugs are now referred to as "designated drugs" which distinguishes them from the other "controlled drugs" in the Regulations. The amended Regulations restrict the right to "administer" (i.e., prescribe, give, sell, furnish, distribute or deliver) designated drugs to medical practitioners solely for the treatment of narcolepsy, hyperkinetic disorders in children, mental retardation (minimal brain dysfunction), epilepsy, Parkinsonism and hypotensive states associated with anesthesia. Animals may be treated with these drugs for the depression of cardiac and respiratory centres.

The Minister of National Health and Welfare may, however, authorize a practitioner to administer a designated drug for other purposes if he considers such use to be "in the public interest or the interest of science". The newly restricted conditions for which amphetamines may be prescribed are to be periodically reviewed by "advisory committees" appointed by the medical profession, and may be altered "if the evidence indicates it to be advisable".4

In all cases where a medical practitioner administers a designated drug to a patient, he must notify the Department of National Health and Welfare of the name, age, sex and address of the patient, or, where the patient is an animal, the address of the animal's owner, the name, dosage and dose form of the designated drug, the date the drug was first administered and the practitioner's name and address. If it is the practitioner's intention that the "administered" dosage be consumed within a 30-day period, he must send his "notification" to the Department of National Health and Welfare within 33 days of the first administration of the drug. If the drug is intended to be used for therapy exceeding 30 days, the prescribing practitioner must also submit the name and address of another practitioner who has confirmed the diagnosis of the patient's illness, and he is to include the date of this confirmation in his official notification which must be sent to the Minister of National Health and Welfare within ten days of the confirming consultation.

The Food and Drug Regulations contain provisions dealing with the labelling of designated drugs and prohibit their manufacture, sale, import and export by anyone other than an authorized licensed dealer. Hospitals are prohibited from dispensing or administering designated drugs without the authorization or prescription of a medical practitioner. Pharmacists may supply these drugs to hospitals and, upon receipt of a written or verified verbal prescription or order, to private persons. Licensed dealers, pharmacists and hospitals must keep records of all Schedule G drug transactions (including designated drugs) for at least two years in a form which can be readily inspected, and must notify the Minister of National Health and Welfare of any thefts or losses of these drugs.

The simple possession of designated drugs is not prohibited by the Food and Drugs Act; however, possession for the purpose of trafficking is prohibited by the Act.

Figures regarding the licit manufacture and sale of amphetamines between 1966 and 1972 are presented in Table B.8. There are no parallel figures for phenmetrazine (Preludin®) and phendimetrazine (Dietrol®) as they were not added to Schedule G of the Act until November 1, 1971. Prior to this date, these amphetamine-like drugs were listed in Schedule F of the Food and Drug Regulations and, consequently, the official estimated consumption of these specific substances was unavailable as the importation, manufacture and distribution of Schedule F drugs are not routinely monitored by any governmental control agency.*3' However, pharmaceutical market survey estimates of phenmetrazine sales between 1966 and 1972 are available, and these data—derived from a stratified random sample of Canadian drug stores, 'discount houses' and hospitals—are presented in Tables B.5 and B.6.

Other amphetamine-like drugs, such as diethylpropion (Tenuate®), pipradrol (Meratran®), and methylphenidate (Ritalin®), are listed in Schedule F of the Food and Drug Regulations, and, consequently, official consumption estimates are not available for these substances. Pharmaceutical market survey estimates of methylphenidate sales to drug retailers and hospitals have, however, been provided to the Commission, and these data are presented in Tables B.5 and B.6. The laws regulating the distribution of these drugs are the same as those which govern the minor tranquilizers and non-barbiturate sedative-hypnotics (see B.7 Minor Tranquilizers, Barbiturates and Other Sedative-Hypnotics, "Legal Sources and Legal Distribution", below). The simple possession of these amphetamine-like drugs is not prohibited by the Food and Drugs Act or its Regulations, but they may only be sold to the general public on a doctor's prescription.

Apart from phendimetrazine, all of the amphetamine and amphetamine-like drugs legally marketed in Canada are imported into this country in bulk or 'finished' form and then further processed and packaged for domestic distribution.
*    The Bureau of Dangerous Drugs' figures for 1972 show an estimated consumption of 30.2 kilograms of phenmetrazine and 3,332.3 kilograms of phendimetrazine."


LEGAL SOURCES AND ILLEGAL DISTRIBUTION

While 'speed freaks' have their own sources of illicitly manufactured stimulants (see "Illegal Sources and Illegal Distribution" below), the majority of the amphetamine and amphetamine-like drugs used non-medically or without benefit of prescription in Canada are legally manufactured by authorized pharmaceutical companies. Despite these companies' exercise of stringent precautionary measures, diversion of these substances to illicit channels of distribution still occurs. The extent of this diversion, however, is difficult to estimate. In the United States it has been calculated that between 8 and 12 billion amphetamine doses were manufactured annually during the 1960s,16' 42, 46, 50 and that between 30 and 50 per cent of this production was diverted to the illicit amphetamine market.25. 42 These total production figures represented sufficient amphetamine to provide every American with between 35 and 60 five-milligram doses every year, and led the United States House of Representatives Select Committee on Crime to note that "... the largest single source of speed [amphetamine] is the overproduction by legal manufacturers."*5°

* In response to such investigations, the United States Bureau of Narcotics and Dangerous Drugs established an American 1972 amphetamine production quota at approximately 80 per cent below the 1971 production level", 48' "

The over-supply of amphetamines does not appear to be as critical in Canada as in the United States. In fact, the per capita consumption of licitly manufactured amphetamines (as based on actual sales to retailers and hospitals) has declined by approximately 74 per cent between 1966 and 1972. Table B.7 illustrates the approximate per capita consumption of amphetamine drugs in Canada over this seven-year period for persons fifteen years of age and over.*

This decreased production of legitimate amphetamines has probably resulted in fewer opportunities for illicit diversion, but there is still a significant difference (as illustrated in Table B.8) between the amount of amphetamine available for medical use and the amount actually sold in Canada for the years 1966 through 1972. In this seven-year period nearly twice as much amphetamine was manufactured in Canada for domestic medical use (3,495.9 kilograms) as was actually sold to hospitals and retailers (1,958.0 kilograms). The cumulative difference between these figures (1,537.9 kilograms) represents, according to the Pharmaceutical Manufacturers Association of Canada, ". . imported amphetamine substances which are in the various levels or stages of inventory".19 Their very existence, however, provides the opportunities for illicit diversion at various manufacturing, refining, storage and transfer stages.
* The relatively small amount of amphetamine annually prescribed to hyperkinetic children has not been separated out of Table B.7. For conversion purposes, a usual single dose of amphetamine (including dextroamphetamine) is 10 milligrams, while the usual single dose of methamphetamine (which accounts for about one-sixth of legal Canadian amphetamines consumption) is five milligrams.

In the recent past, the amphetamine-like drugs—particularly Preludin® (phenmetrazine) and Ritalin® (methylphenidate)—were more widely available in some Canadian illicit drug markets than any of the pharmaceutical amphetamine preparations. Phenmetrazine was not transferred from Schedule F of the Food and Drug Regulations to Schedule G of the Food and Drugs Act until November 1, 1971. Consequently, phenmetrazine loss and theft data prior to this date are unobtainable as losses and thefts of Schedule F drugs are not routinely monitored. However, growing medical concern about the use of amphetamines and the easy street availability of Preludin® and Ritalin® suggested increased diversion of these substances. Importation, sales, thefts and losses of methylphenidate remain officially unmonitored, and adequate phenmetrazine-related statistics have not yet been compiled.*
In the United States, legally manufactured amphetamine and amphetamine-like drugs have been diverted to illicit channels of distribution through the smuggling of legally exported stimulants back into the United States (chiefly from Mexico), the ordering of drugs from mail-order drug wholesalers that do not verify their customers' credentials, and occasional instances of physicians trafficking in large quantities of amphetamines without prescrip-
tiono• 15, 24, 33, 34, 41, 50, 52 Cases of American physicians having operated
"anti-obesity clinics" from which they routinely distributed amphetamines, without examinations or follow-up observations, have also been noted.29, 44
Diversion on the scale recorded in the United States has not been documented in Canada, although several very large seizures of legally produced stimulants (one involving 54,000 Preludins® 38 and a second involving 12,200 Dexedrine® tablets1) have been reported within the past two years. Besides this diversion (the sources for which remain unknown), amphetamine and amphetamine-like drugs have been obtained through careless or excessive prescribing on the part of some physicians, visits to several doctors, the refilling of unauthorized prescriptions, the forging or altering of prescription forms, and relatively small thefts from doctors' and pharmacists' offices.t 7, 18 Depending on the initial size of the illicit supply, these drugs are subdivided for wholesale and retail sales, eventually reaching the street at between ten and fifty cents a pill. Most of those amphetamine and amphetamine-like drugs obtained through fraudulent prescriptions, however, are either used by the person who procured them or freely given away to friends.
* Reported thefts of phenmetrazine totalled 145 grams for the first six months of 1972."
t Thefts of legally manufactured amphetamines rose through the 1960s but declined slightly in 1971. According to the Bureau of Dangerous Drugs, 61 grams were reported stolen in 1966, 153 grams in 1967, 295 grams in 1968, 310 grams in 1969, 582 grams in
1970, and 424 grams in 1971.27, 29, 8° The accumulated reported thefts for this six-year period is equivalent to almost 200,000 ten-milligram doses of amphetamine.

Several seizures of counterfeit amphetamine pills and ampule-filling machinery have been documented in the United States.17. 46 However, most American illicitly manufactured amphetamine—and apparently all of that prepared in Canada—is available solely in a powdered form intended for the 'speed' market. The drug of choice is methamphetamine,* and the illegal laboratories which produce this substance are ordinarily located in the vicinity of a large speed-using clientele. Thus, 12 of 21 illicit methamphetamine laboratories seized by agents of the United States Bureau of Narcotics and Dangerous Drugs between 1966 and 1969 were in the State of California, serving the Haight-Ashbury speed scene.17 Similarly, Canadian 'meth' laboratories are thought to operate primarily in the Toronto area.
A speed laboratory requires a skilled (although not necessarily professional) chemist, a dependable source for the chemical precursors of methamphetamine, the requisite equipment to manufacture the drug, a relatively secure location and a modest capital outlay. The relative ease with which methamphetamine can be produced has led to the emergence of laboratories at various levels of sophistication. According to Roger Smith:
A speed laboratory may range from a well organized, highly efficient operation, capable of producing five to twenty-five pounds of speed per week consistently, to a kitchen or bathroom in a small apartment, producing less than an ounce a week, to a college chemistry laboratory where a student produces speed only occasionally, when he needs money or feels the chances of detection are slight."
The smaller laboratories may only involve one or two persons who produce methamphetamine (at a cost of about $200 a pound) and sell it themselves in ounces to lower-level dealers. In the larger operations, however, the methamphetamine will only cost around $30 to $50 a pound to manufacture and will be sold in multi-pound lots. The chemist (who is usually hired by those sponsoring the venture) will probably have little or nothing to do with the selling of the drug.

* Over 97 per cent of the seized amphetamine material destroyed by the Bureau of Dangerous Drugs during 1971 was methamphetamine." Seizures of all amphetamines have risen dramatically since the mid-sixties. According to the Bureau of Dangerous Drugs, 14,522 seized grams were officially destroyed between January 1966 and July 1972." The accumulated seizures for this six- and one half-year period is equivalent to nearly 3,000,000 five-milligram doses of methamphetamine. Furthermore, 3,200 grams of seized phenmetrazine (an amphetamine-like drug) were destroyed between January and July of 1972, and an additional 70 pounds (approximately 32,000 grams) of this drug were reported seized during one police operation in Toronto in January 1973." This single Toronto seizure is equivalent to more than one-third of all the phenmetrazine legally imported into Canada for domestic processing and distribution during the previous year. The usual single dose of phenmetrazine is 25 milligrams (i.e., one-fortieth of a gram).
t Illicit methamphetamine prices have risen dramatically over the past few years and are presently between 50 and 100 per cent higher than those quoted in this section.

In 1970, primary distributors were likely to pay between $500 and $600 a pound for large speed shipments or between $700 and $1,000 for individual pounds.t Some of these purchases entered the local market and others were transported (often by motorcycle gang members, many of whom are heavily involved in speed dealing) to secondary speed centres that were not serviced by their own laboratories. Much of the speed in Montreal, for example, came from Toronto or a few cities in the north eastern United States, and some of this speed was then carried to Quebec City and Halifax. The methamphetamine was then subdivided from pounds into quarter-pounds which, depending on the demand, the quality of the speed, and the distance from its manufacturing source, sold for between $250 and $400 each. True ounces were then sold for between $120 and $150 to lower-level dealers (usually speed users themselves) who diluted the drug with a variety of substances (such as dextrose or monosodium glutamate) and sold 'half-ounces' to street dealers for between $75 and $85 and 'quarter-ounces' for approximately $40 or $45. The street dealers (who are all 'speeders') diluted the speed further and then sold it in 'grams' or 'spoons' ($10 to $25), 'half-grams' ($5 to $15) and 'hits' (one, two or three dollars) to members of the using community.* Street dealers rarely realize their potential profit as they personally consume much of their dealing supply and, consequently, are considered fortunate to return their initial investment. As Smith has noted, "as in almost all illicit marketplaces, it is the top level personnel who realize substantial profits with minimal risks, and the individuals enmeshed in the deviant culture who assume the most immediate risks with little compensation."48
Credit arrangements exist at the top levels of the methamphetamine distribution system, but, at the lower levels, a down payment is a necessary prerequisite for credit advancement—and even then it is only extended to those few persons considered trustworthy. There is no credit in time of speed famines and cash is always demanded if the quantity sold is under one-quarter ounce. Small amounts of speed, however, may be purchased with valuable—and usually stolen—articles that are easily resalable.
Some speed distribution networks are highly organized enterprises with a stratified dealing structure, territorial rights and hired debt collectors.f However, these networks are usually relatively unstable below the quarter-ounce distribution level and street dealers are continually being replaced or are involved in the dissolution or re-establishment of dealing partnerships.
It is difficult to estimate the amount of speed consumed in Canada, but a minimum of between ten and twenty pounds a week does not appear unreasonable. If divided into 'grams' for street sales, this quantity of methamphetamine could gross between $2.5 and $5 million annually, with at least one-tenth of this amount reverting to the original manufacturers-distributors of the drug. However, personal consumption at various lower distribution levels is so great that it is unlikely that more than one or two million dollars changes hands in the speed marketplace every year. Compared to the extremely large amounts of money ultimately exchanged for drugs in the cannabis and heroin scenes, the speed market remains a relatively insignificant illicit financial institution maintained by physical need at the bottom and more mercenary considerations at the top.
* Quantities of speed weighing less than half an ounce are usually measured by eye with no recourse to scales, spoons or other standardized measuring devices.
t The use of physical force in the collection of debts contributes further violence to a scene that is already characterized by the casual possession and occasional use of firearms, and frequent `rip-offs' (thefts) and 'burns' (fraudulent sales).

References

1. Associated Press. 'Speed' haul said largest yet by U.S. customs. Gazette (Montreal), September 21, 1971: 41.
2. Broomfield, H. Halifax report. Sub-study of M. Green, Committed users study. Unpublished Commission research project, 1971.
3. Caldwell, E. Maker sent drugs to dummy outfit. New York Times, October 26, 1969.
4. Canada, Department of National Health and Welfare. New amphetamine regulations: Minister's statement. Press release No. 1972-206, Ottawa, December 28, 1972.
5. Canada, Department of National Health and Welfare, Bureau of Dangerous Drugs. Estimated consumption of schedule "G" drugs based on the deduction of exports from imports for calendar years 1962-1971 inclusive. Information communicated to the Commission, Ottawa, May 10, 1972.
6. Canada, House of Commons. Methadone and amphetamines-Statement on action to control abuse. Commons Debates, February 24, 1972.
7. Clement, V. R., Solursh, L. U., & Van Ast, W. Abuse of amphetamines and amphetamine-like drugs. Psychological Reports, 1970, 26: 343-354.
8. Drugs and Drug Abuse Education Newsletter. Amphetamine production cut 80%. Drugs and Drug Abuse Education Newsletter, February 1972, 3(2): 5.
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11. Geller, A., & Boas, M. The drug beat. New York: McGraw-Hill, 1969.
12. Globe and Mail. Largest speed seizure: Police believe drug ring broken. Globe and Mail (Toronto), January 19, 1973: 5.
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16. Grinspoon, L., & Hedblom, P. Amphetamines reconsidered. Saturday Review of Science, July 8, 1972: 33-46.
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38. Ottawa Citizen. Man is fined $500 in 'diet drug' case. Ottawa Citizen, July 19, 1971.
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40. Pharmaceutical Manufacturers Association of Canada. Brief submitted to the Commission, 1970.
41. Rawlin, J. W. Street level abuse of amphetamines. In J. R. Russo (Ed.), Amphetamine abuse. Springfield, Ill.: C. C. Thomas, 1968. Pp. 51-65.
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