Section I

The Work of the Commission

APPOINTMENT OF THE COMMISSION
The Commission of Inquiry Into the Non-Medical Use of Drugs was appointed by the Government of Canada under Part I of the Inquiries Act
on May 29th, 1969, on the recommendation of the Honourable John Munro, then Minister of National Health and Welfare.*
The concern that gave rise to the appointment of the Commission is described in Order in Council P.C. 1969-1112, which authorized the appointment, in the following terms:
The Committee of the Privy Council have had before them a report from the Minister of National Health and Welfare, representing:
That there is growing concern in Canada about the non-medical use of certain drugs and substances, particularly, those having sedative, stimulant, tranquillizing or hallucinogenic properties, and the effect of such use on the individual and the social implications thereof;
That within recent years, there has developed also the practice of inhaling of the fumes of certain solvents having an hallucinogenic effect, and resulting in serious physical damage and a number of deaths, such solvents being found in certain household substances. Despite warnings and considerable publicity, this practice has developed among young people and can be said to be related to the use of drugs for other than medical purposes;
That certain of these drugs and substances, including lysergic acid diethylamide, LSD, methamphetamines, commonly referred to as "Speed", and certain others, have been made the subject of controlling or prohibiting legislation under the Food and Drugs Act, and cannabis, marijuana, has been a substance, the possession of or trafficking in which has been prohibited under the Narcotic Control Act;
That notwithstanding these measures and the competent enforcement thereof by the R.C.M. Police and other enforcement bodies, the incidence
• The Honourable John Munro was succeeded as Minister of National Health and Welfare by the Honourable Marc Lalonde on November 27, 1972.

Part One Introduction
of possession and use of these substances for non-medical purposes, has increased and the need for an investigation as to the cause of such increasing use has become imperative.
The Order in Council sets out the terms of reference of the Commission as follows:
That inquiry be made into and concerning the factors underlying or relating to the non-medical use of the drugs and substances above described and that for this purpose a Commission of Inquiry be established, constituted and with authority as hereinafter provided,
(a) to marshal from available sources, both in Canada and abroad, data and information comprising the present fund of knowledge concerning the non-medical use of sedative, stimulant, tranquillizing, hallucinogenic and other psychotropic drugs or substances;
(b) to report on the current state of medical knowledge respecting the effect of the drugs and substances referred to in (a);
(c) to inquire into and report on the motivation underlying the nonmedical use referred to in (a);
(d) to inquire into and report on the social, economic, educational and philosophical factors relating to the use for non-medical purposes of the drugs and substances referred to in (a) and in particular, on the extent of the phenomenon, the social factors that have led to it, the age groups involved, and problems of communication; and
(e) to inquire into and recommend with respect to the ways or means by which the Federal Government can act, alone or in its relations with Government at other levels, in the reduction of the dimensions of the problems involved in such use.

THE COMMISSION'S INTERPRETATION OF ITS TERMS OF REFERENCE
Although the preamble to the Order in Council authorizing the appointment of the Commission draws particular attention to certain kinds of non-medical drug use, the Commission is directed by its terms of reference to inquire into the non-medical use of the whole range of psychotropic drugs or substances. Thus the Commission has been concerned not only with the so-called 'soft' drugs, such as cannabis and the other hallucinogens, but with the 'hard' drugs, such as the opiate narcotics, and also with two of the most widely used psychotropic drugs, alcohol and tobacco. Some observers have suggested that the Commission should not have concerned itself with alcohol. For reasons indicated in subsequent sections we believe that this would have been an inexcusable omission that would have created a false impression of the true extent and relative seriousness of non-medical drug use. Moreover, the relationships between the various forms of drug use and the phenomenon of multi-drug use have made it imperative to consider as many of the classes of psychotropic drugs or substances as possible.

The Commission was appointed to inquire into non-medical drug use, but it has had to consider medical use insofar as it bears on non-medical use. The line between the two is not always clear. Medical use can develop into non-medical use. As we said in our Interim Report, prescription cannot be the sole criterion of medical use. Some drugs for which there is a medical use do not require prescription. The use which is made of drugs under prescription may not be in some cases a justifiable medical use. In
our Interim Report we defined medical use as use which is indicated for generally accepted medical reasons, whether under medical supervision or not, and non-medical use as that which is not indicated on generally accepted medical grounds. Moreover, it has been necessary for us to consider the bearing which the availability and use of drugs for medical purposes have on non-medical drug use. The medical use of drugs contributes to a climate of reliance on drugs for various purposes, and the availability of drugs for medical purposes creates a supply from which there may be diversion to non-medical purposes. Thus, in an inquiry into non-medical drug use, it is essential to consider the controls over the availability of drugs for medical purposes.
These two factors—the range of the drugs involved and the necessity of considering the implications of availability and use for medical purposes—have served to determine the scope of the inquiry. A third such factor, which is discussed in the next section, is the extent to which it is necessary, in considering what government may do, to comment on the role of other institutions and individuals in relation to non-medical drug use. Non-medical drug use is not only a matter of personal conduct but a social phenomenon. The inquiry into it has necessarily involved an examination of non-governmental as well as governmental influences on it.

THE PUBLIC HEARINGS
Because of the nature of the phenomenon—and the crucial role played by public attitudes—the Commission conducted public hearings across Canada. Theme were two sets of such hearings: one before the Interim Report and one afterwards. The schedule of these hearings appears in Appendix Q. The purpose of the hearings was not to attempt an accurate survey of opinion in Canada but to identify the issues and the range of opinion, and to afford an opportunity for public discussion. In this we believe the hearings were very successful. They provided an opportunity for adults and young people to exchange views at a time when strong feelings and, indeed, a polarization of opinion had built up over the issue of non-medical drug use. The hearings were conducted in a fairly informal manner, and in many cases in informal settings, with plenty of opportunity for participation by the audience after presentation of formal briefs. People of all ages spoke with candour, and often great depth of feeling, and the Commission received a vivid impression of the extent to which the problem of non-medical dr use had touched the lives and the concern of Canadians.

Before it began its public hearings, the Commission wrote to of 750 individuals and organizations inviting them to submit briefs or to ma oral submissions. In particular, the Commission solicited briefs fro federal and provincial government departments; law enforcement authoriti educational institutions and associations; members of university faculties a departments; medical and pharmaceutical institutions and associations; ack Lion research foundations; street clinics and other innovative services; c rectional and welfare organizations; bar associations; youth organizatic student organizations; and a wide variety of other organizations and it viduals having an evident concern or point of contact with the phenomer of non-medical drug use in Canada. In addition to specific invitations, gene public notices were issued and published in newspapers across the count inviting briefs and attendance at the hearings. The Commission receive( gratifying response to this invitation, and despite the relatively short ti available in some cases for the preparation of briefs, individuals and organizations made a very commendable effort to prepare submissions for the pul hearings which began in the middle of October 1969.

The Commission held public hearings in 27 cities, including Ottawa all the provincial capitals. It visited several cities twice. In addition to di regular public hearings, the Commission conducted hearings in 23 versifies, several junior colleges and high schools, and some informal setti of the youth culture, such as coffee houses in Montreal, Toronto and V couver. In all, the Commission spent 46 days in public hearings, and i estimated that it travelled about 50,000 miles. In addition, the members the Commission, both collectively and individually, held many private iv ings. The anonymity of witnesses was guaranteed where requested. The ture of the public hearings and the impression they made on us are more f described in our Interim Report.

The Commission received a total of 639 submissions from organizatiions and individuals, as follows: from organizationions 295 written and 43 oral submissions; and from individuals, 212 written and 89 oral submissions.
Oral submissions were recorded at public hearings and transcribed. In addition, many persons who were not identified by name spoke at the public hearings, and the Commission received hundreds of Ietters which are not classified as formal submissions. A full list of org anizations who presented submissions, written and oral, to the Commission is contained in Appendix P.

THE COMMISSION'S RESEARCH PROGRAM AND STAFF
The Commission research has been carried out by a staff of full-tint scientific personnel and outside researchers working under contract. The fix time research staff has consisted of a research director, research associates from various scientific disciplines and research assistants. Full-time staff members with the Commission during the production of this Final Report are listed in Appendix N. Former members of the staff, whose work contributed primarily to earlier Commission reports, are listed in those publications. The Commission's contract researchers and major consultants are noted in Appendix 0.

Under the guidance of the Commission's librarian, Ed Hanna, we have developed a collection of over 14,600 articles, books, briefs and other documents. In addition, we have had full access to the library and documentation facilities of the Addiction Research Foundation of Ontario, to the Library of the Department of National Health and Welfare, to the National Library, and to the National Science Library. We have also received considerable assistance from other libraries in Canada and abroad through inter-library loan and special subject searches. Examples of these are the U.S. National Institute of Mental Health Clearinghouse for Drug Abuse Information, the U.S. National Library of Medicine, and the Science Information Exchange of the Smithsonian Institution.

The Commission's research program consisted of some 120 projects, many of which are listed in Appendix R. In addition, there was a variety of miscellaneous investigations which were not formally classified as separate projects. The areas covered by the research program include: chemical and botanical factors; physiological, psychological and behavioural effects; extent and patterns of use; motivation and related factors; social context; mass media; legal and illegal sources and distribution; legal controls; law enforcement and the correctional system; medical treatment and related services; innovative services; information and education; prevention and alternatives to drug use; and the response of various institutions, including government, to nonmedical drug use. The methods employed in our research include critical review of technical and scientific literature and current investigations, surveys and interviews, participant observation, human pharmacological experiments, and chemical analysis of illicit drugs.

From the beginning of our inquiry it was apparent that there was a great need for more information concerning the nature and effects of the various drugs. Such information is essential for public policy and personal decisions, as well as programs of drug education. For these reasons the Commission invested a significant proportion of its resources in the study of drug effects. These efforts involved the use of data and information obtained by the various research methods mentioned above. The Commission's work in this area is reflected primarily in Chapter Two of the Interim Report, entitled "The Drugs and Their Effects"; Chapter Two of the Cannabis Report, entitled "Cannabis and Its Effects"; and in Appendix A of the present report, entitled The Drugs and Their Effects. Most of the work in this area has been conducted by the Commission's full-time research staff under the direction of Dr. Ralph D. Miller, Research Director, who drafted the above sections of the Commission's reports. Dr. Miller was assisted at various stages in this work by Research Associate Dr. Ralph Hansteen; by Research Assistants Joan Brewster, Pat Oestreicher, Marilyn Bryan, Barry Hemmings, Penelope Thompson, Linda Wright, and Richard Paterson; by consultant Dr. Zalman Amit; and by other members of the research and consulting staff.
The work in Appendix B Legal and Illegal Sources and Distribution of Drugs was directed by Research Associate Mel Green. He was assisted by Research Assistants Marcus Hollander, Ken Stoddart, Dave McLachlen, Ann Lane and others. Robert Solomon participated in the emperical research on law enforcement and the correctional system, directed by Professor John Hogarth, and, with the assistance of Mr. Green, is responsible for the work on the sources and distribution of opiate narcotics (Appendix B.2).
The preparation of Appendix C Extent and Patterns of Drug Use was carried out under the joint direction of Mel Green and Judith Blackwell, Senior Research Assistant. They were assisted by Research Assistants Gordon Smith, Marcus Hollander, Dave McLachlen, Florence Hughes, Carolyn Petch, by consultants Dr. Taylor Buckner and Dr. Stanley Sadava, and by other staff members.
The Commission's national surveys were conducted by the Survey Research Center of York University, under the direction of Sondra B. Phillips and the general supervision of Dr. Michael Lanphier. The surveys in the Province of Quebec were carried out by le Centre de Sondage de l'Universite de Montreal. Mel Green directed a project of participant observation in the summer of 1970 to determine patterns of non-medical drug use in certain urban centres of the drug subculture. He and Judith Blackwell also conducted a monitoring project in the spring and summer of 1972 by which the Commission sought, through contacts with informed observers across the country, to identify further developments in extent and patterns of drug use.
Appendix D Motivation and Other Factors Related to Non-Medical
Drug Use is based on research by full-time members of the staff and outside consultants. Dr. Lynn McDonald, former Research Associate of the Commission, made a significant contribution to the research on which this appendix was based, and Mr. Green and Ms. Blackwell played a substantial role in its final drafting. Consultants Dr. Roderick Crook, Dr. Zalman Amit and Dr. Jim Hackler also contributed background materials employed in preparing this appendix.
Research Assistants Ann Lane and Byron Rogers conducted the research for Appendix H Treatment Capacity in the Provinces. Ms. Lane and Brian Anthony carried out the background work for Appendix G Opiate Maintenance. Mr. Green provided much of the research for Appendix L Civil Commitment in California and Mr. Rogers did the investigation for Appendix M Innovative Services. Michael Bryan, Special Assistant and Editor, made a major contribution to the research on the correctional system and the drafting of Appendices I, J, and K.

CONSULTATION AND ADVICE
During the course of its work the Commission had the benefit of consultation and advice from a wide range of organizations and individuals. Many of these are listed in Appendices 0 and P. The Commission is especially grateful for the assistance it has received from federal and provincial government departments and services in connection with its research. In the preparation of this Final Report the Commission has made particularly heavy demands for assistance on the Health Protection Branch of the Department of National Health and Welfare, and in particular, the Bureau of Dangerous Drugs, the Drug Advisory Bureau, the Drug Research Laboratories, and the Field Operations Unit. We have also received valuable assistance from the Canadian Penitentiary Service, the National Parole Board, the Judicial Division and the Health and Welfare Division of Statistics Canada, as well as from several provincial government departments, including those concerned with probation. The Commission has continued to receive the full cooperation of the R.C.M. Police, as it has from the beginning of its inquiry.
Significant assistance was provided to us at various stages of our inquiry by the Addiction Research Foundation of Ontario. Information provided by Eric Polacsek of their Documentation Center and by the Foundation's library greatly facilitated our work, as did the chemical analytic services provided by Dr. Joan Marshman and her staff. In addition, we are appreciative of the generous advice and consultation provided from time to time by numerous other members of the Foundation's research staff. The personnel of the Narcotic Addiction Foundation of British Columbia have also been helpful in our work.
The Commission has received valuable assistance from a number of organizations and individuals in other countries. Particularly noteworthy was the assistance it received from the United States Bureau of Narcotics and Dangerous Drugs and other American law enforcement authorities in determining patterns of drug trafficking, from the U.S. National Institute of Mental Health, from the officials of the California Civil Commitment Program, and from public officials and treatment personnel in connection with the treatment of opiate-dependent persons in Great Britain. Members of the Commission and staff visited many foreign countries, observing conditions and consulting local experts, and attended most of the major scientific conferences around the world dealing with non-medical drug use. We also sought the views of experts from North America and abroad in a number of private meetings and symposia held in Canada.

ADMINISTRATIVE STAFF
James J. Moore, Executive Secretary of the Commission during the period in which the Commission produced its Interim Report, Treatment Report and Cannabis Report, was obliged to leave the Commission to take up another position in the fall of 1972. By the time he left, however, the work on the Final Report was well advanced, and it owes much to his participation in planning and direction. We take this opportunity to express our appreciation of his invaluable contribution to the work of the Commission.
Since Mr. Moore's departure the Chairman of the Commission has been ably assisted in administrative matters by Frederick Brown, who also carried out a variety of research tasks, and by Michael Bryan, who has had responsibility for coordinating all editorial and other operations involved in the preparation of this report for publication.
Appreciation must also be expressed to Mr. C. W. Doylend, Office Manager of the Ottawa office of the Commission, and his assistants, and to the secretarial staff for their devoted service.

THE REPORTS OF THE COMMISSION
This is our fourth and final report. It presupposes and relies, in varying degrees, on the previous reports, which are referred to as the Interim Report, the Treatment Report and the Cannabis Report. On certain points our perspective has evolved beyond that expressed in previous reports, and in some cases we have changed our views. Wherever we have been conscious of such a change we have drawn attention to it. As far as possible, we have attempted to profit from reaction to previous reports and from additional knowledge and understanding acquired in the intervals between our reports. The four reports reflect the evolution of our thinking over a period of approximately four years. This evolution is, of course, related to changes which have taken place during that time in the phenomenon of non-medical drug use and in the social response to it. Although the differences of opinion between members of the Commission on certain points have tended to increase with the passage of time and the concentration on the detailed implications of its general policy perspective, there has been a significant measure of cohesion and continuity in that general perspective, considering the highly subjective and controversial nature of the value judgments involved.
By and large we have regarded the four reports as having a cumulative effect, and we have not hesitated to reproduce parts of previous reports that we have felt were pertinent to matters being discussed in this report. Although the Interim Report was published in 1970 much of what was said there remains an essential part of the Commission's general perspective today. The Treatment Report is the principal statement of the Commission on this subject, but we have resumed the discussion of certain treatment issues in this report. Since a separate final report was devoted to cannabis, the present report has concentrated on the other psychotropic drugs, and in particular, on the opiate narcotics, the amphetamines and the strong hallucinogens. There has also, however, been considerable emphasis on other psychotropic drugs which are the subject of non-medical use, and in particular, on alcohol and tobacco. We have not attempted to carry the discussion of cannabis, in any significant degree, beyond the Cannabis Report, which must remain our final word on that subject. But there is much in the Cannabis Report that is pertinent to the discussion of other forms of non-medical drug use, particularly in the areas of law and scientific issues, and we have drawn on some of these discussions from the earlier report.

THE APPENDICES
The appendices of this report form an integral part of it. They are not background papers but contain our conclusions on the subject-matters with which they deal. The appendices reflect the findings and conclusions of all the members of the Commission There is no difference of opinion (at least any explicit difference of opinion) with respect to anything contained in them. The relationship between the parts of the report which are designated as "sections" and the appendices is simply one of convenience in the treatment and disposition of material. The chief purpose has been to try to avoid breaking the continuity of discussion by the intrusion of too much detail. The sections are chiefly concerned with conveying our general perspective, although in some cases they contain the whole of the discussion on a particular subject. They also contain our recommendations, although there are some exceptions, as in the case of Appendix M Innovative Services. On the whole, the appendices are intended to contain the detailed examination of certain subjects which is considered to be necessary or useful for a consideration of the various policy issues. As indicated, however, we have not followed an inflexible rule; generally there is discussion of a subject in both the sections and the appendices; in some cases the whole of the discussion is to be found in one or the other. The point to be emphasized here is that the appendices are as essential to an understanding of the Commission's perspective and assumptions of fact as are the sections of the report.

TRANSLATION
The four reports of the Commission were translated by Michel Coupal, director, and the staff of Les Traductions 530, Inc., Montreal, Quebec, who are to be commended for the high quality of their work.