Drug Abuse

CHAPTER ONE

THE COMMISSION'S INTERPRETATION OF ITS TASK

The Background of the Commission's Appointment

1. 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 29, 1969, on the recommendation of the Honourable John Munro, 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 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 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.

During the year or so preceding the appointment of the Commission, members of parliament had called for an inquiry into the use of drugs. One member spoke of 'the galloping increase in the use of marijuana and the increasing number of young people tragically being paraded daily before the courts' and of 'the extreme urgency of dealing properly with these cases'. In announcing the Government's intention to appoint the Commission, the Minister of National Health and Welfare spoke of 'the grave concern felt by the Government at the expanding proportions of the use of drugs and related substances for non-medical purposes'.

The Commission's Terms of Reference

3. The Order-in-Council authorizing the appointment of the Commission sets out its terms of reference 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 non-medical 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 had 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 Implications of the Terms of Reference

4. While the Commission's terms of reference make specific mention of the sedative, stimulant, tranquillizing and hallucinogenic drugs, they also require inquiry concerning other psychotropic drugs and substances. The Commission understands drug to mean any substance that by its chemical nature alters structure or function in the living organism. The psychotropic drugs are those drugs which alter sensation, mood, consciousness or other psychological or behavioural functions. These concepts are further clarified in Chapter Two of this report. A number of classifications of psychotropic drugs have been brought to the Commission's attention. Chapter Two presents the classification that has been accepted by the Commission. It also contains a detailed account of the psychotropic properties and medical and non-medical uses of certain of the drugs causing the greatest public concern. It is clear to the Commission that it would not be appropriate to confine its attention to the so-called 'soft drugs' such as marijuana, hashish and LSD. The 'hard drugs' such as the opiate narcotics, of which heroin is an example, have marked psychotropic effects. The amphetamines or 'speed' drugs which are popularly considered as hard drugs appear to be increasing in their non-medical use. Moreover, both the structure of present Canadian drug laws and the nature of the drug controversy make it impossible to consider the 'soft drugs' without reference to the amphetamines and the opiates. Indeed, the opiate narcotics have been and are an important reference point in, establishing the public perspective for the non-medical use of many other drugs. The Commission believes that it has properly focused its primary attention in the initial phase of its inquiry on the non-medical use of drugs such as cannabis, LSD and amphetamines by young people. However, we have had a growing concern for the facts and implications of the use of drugs such as alcohol and tobacco by people of all ages. These two drugs, both of which are psychotropic, remain the most popular drugs in non-medical use among both young people and adults. Adults generally seem unwilling to accept the fact that alcohol and tobacco are drugs, and often find it difficult to view the non-medical drug use of youth with reference to and in the context of the socially acceptable use of drugs by adults.

5. Two broad categories in which the use of psychotropic drugs can be classified are: (a) medical and non-medical use, and (b) legal and illegal use. While the distinction between legal and illegal use is simple and derives directly from the law, it is difficult to find a satisfactory definition of medical and non-medical drug use. Medical use of drugs is taken by the Commission to be use which is indicated for generally accepted medical reasons, whether under medical supervision or not; all drug use which is not indicated on generally accepted medical grounds is considered to be non-medical use. Thus, the occasional use of aspirin to control the pain of an ordinary headache is considered to be medical use, while the dependent use of large quantities of barbiturates obtained through one or more prescriptions is not. Clearly, non-medical use is not to be equated with illegal use. The use of alcohol by adults is generally non-medical but it is legal, whereas the use of marijuana is both non-medical and illegal.

6. The commission is invited to marshal the present fund of world knowledge concerning the non-medical use of psychotropic drugs and substances. Taken literally, this task is impossible, with the time and resources available to the Commission. The world literature on all the psychotropic drugs and substances is very extensive. There are over 40,000 items on alcohol alone at Rutgers University, a major centre of alcohol studies. There are estimated to be over 2,000 items on cannabis. Experts in the field have testified to the extreme difficulty of keeping abreast of the literature, particularly because of its multi-disciplinary character. There are only a few sources of comprehensive information on this continent: the Addiction Research Foundation of Ontario is by far the best equipped in this country; the National Institute of Mental Health in the United States provides a computerized data retrieval service. In Geneva, the World Health Organization of the United Nations possesses extensive bibliographical resources.

Collecting the available data and information is only one stage. It is also necessary to establish and apply criteria of scientific validity to such data and information. In many instances, the Commission is obliged to rely heavily on the work of experts who have themselves sifted and critically evaluated the available literature. It must form its judgements on the basis of the materials which they have identified as most relevant and reliable. The Commission cannot carry out a comprehensive bibliographical work for the whole range of psychotropic drugs and substances. It must try to seize upon the essentials in the present fund of knowledge as they bear upon the areas of concern and the issues in this inquiry.

7. The Commission is required to report on the current state of medical knowledge concerning the effect of psychotropic drugs and substances. This it has attempted to do in an interim fashion, in Chapter Two, entitled 'The Drugs and Their Effects'. The effects contemplated by paragraph (b) in the terms of reference are presumably the physiological and psychological ones, including their behavioural manifestations. The term 'medical' is rather too narrow as a reference to the expertise which is in the determination of drug effects since these are a complex result of many factors, including the expectation of the user and the social setting in which the drug is taken. In its interim brief to the Commission, the Canadian Medical Association stressed the multi-disciplinary character of the study required for a proper understanding of non-medical drug use. We have, therefore, interpreted the word 'medical' to refer broadly to all scientific knowledge concerning the effects of drug use. The language of paragraph (b) of the terms of reference suggests that it was not intended that the Commission would itself undertake original research into the effects of non-medical drug use. Although we do not exclude the possibility of some clinical or experimental work, particularly with respect to the effect of certain drugs on psychomotor functions, it is our opinion that with the time and resources at our disposal, and having regard to the research currently being conducted by such organizations as the Addiction Research Foundation and the National Institute of Mental Health, we should confine ourselves to carrying out a critical review of the existing knowledge and ongoing research, as well as attempting to identify research priorities and the role which the federal government can play in relation to research.

8. The remaining paragraphs in the terms of reference deal with the extent and the causes of non-medical drug use. They reflect a broad concern to understand the reasons for the increase in such use. They invite the Commission to attempt to place this phenomenon in a proper social and philosophic context. We cannot help feeling that this is one of the most important aspects of our task: one on which there is a compelling need for an understanding of current Canadian attitudes. This is implied by the allusion in paragraph (d) of the terms of reference to 'problems of communication'. To understand the factors underlying non-medical drug use and the problems for which government action may be indicated, it is necessary to consider not only the effects, extent, and causes of such use, but the range of social response and attitude which such use has elicited from government, other institutions and individuals. For non-medical drug use and the social response to it are interacting and mutually conditioning phenomena.

Methods of Inquiry

9. The Commission has used a variety of methods of inquiry. Because of the profound social significance of the non-medical drug use phenomenon and of the importance of personal and public attitudes to it, the Commission decided early to conduct public hearings in all of the provinces. It has attached particular important to these hearings. They have been used to foster the widest possible public discussion. In order to encourage the participation of young people, it was decided to hold some of the public hearings in more informal settings than may have been customary for such commissions in the past. In addition to the public hearings, the Commissioners have collectively and individually held numerous private hearings, have consulted with experts in several fields related to non-medical drug use, and have read extensively in the scientific and legal literature. The Commission has also received many communications, written and oral, from Canadians in all walks of life.

10. At the beginning of September, 1969, the Commission wrote to over 750 individuals and organizations inviting them to submit briefs or to make oral submissions. In particular, the Commission solicited briefs from: federal and provincial government departments; law enforcement authorities, educational institutions and associations; members of university faculties and departments; medical and pharmaceutical institutions and associations, addiction research foundations; street clinics and other innovative services; correctional and welfare organizations; bar associations; youth organizations; student organizations; and a wide variety of other organizations and individuals having an evident concern or point of contact with the phenomenon of non-medical drug use in Canada. The Commission received a gratifying response to this invitation, and despite the relatively short time available in some cases for the preparation of briefs, individuals and organizations made a very commendable effort to prepare submissions for the public hearings which began in the middle of October.

11. A list of the organizations and individuals who have been identified with submissions to the Commission in the initial phase of this inquiry is contained in Appendix A to this report, Fifty-five organizations have been represented at the public hearings at which they have submitted written briefs; twenty have been represented by oral submissions; forty-five have made written submissions to the Commission without appearing at a public hearing. Thirty two individuals have submitted written briefs and 45 others have made oral submissions at public hearings. In addition, there have been numerous oral submissions and interventions by members of the public who have attended the hearings. The Commission has also received several hundred letters from individuals, and a selection of these letters or excerpts from them is included in the Report as Appendix B. We emphasize that this selection is not intended to convey the weight of opinion in this correspondence, but simply to reflect something of the range of response.

12. In the initial phase of this inquiry, the Commission has held public hearings in the following centres: Toronto - October 16, 17 and 18; Vancouver - October 30 and 31; Victoria - November 1; Montreal - November 6, 7 and 8; Winnipeg - November 13 and 14; Ottawa - December 12 and 13; Halifax - January 29 and 30; St. John's - January 31; Fredericton - February 19; Moncton - February 20; Sackville - February 20; and Charlottetown - February 21; Kingston - March 5.

A special word may be appropriate concerning the nature of the public hearings. They have been conducted in a rather informal manner. There has been a considerable degree of audience participation. People have felt free to comment on formal submissions, and there has been a great deal of informal exchange among persons attending the hearings. On the whole, response to this style of hearing has been favourable, although there has been some criticism from one or two organizations who have expressed the opinion that we should not have permitted questions and critical comments from members of the public. Because of the nature of the phenomenon which it is required to investigate, the Commission is convinced that it has been essential to attempt to establish a true public forum for discussion of the issues. Most organizations have reacted favourably to this kind of inquiry. In addition to the more traditional settings of hotels and public buildings, the Commission has held public hearings at universities and from time to time in coffee houses that have become centres of the new youth culture.

Informal hearings have been held in the following universities: York University; the University of Toronto; the University of British Columbia; the University of Montreal; McGill University; Sir George Williams University; the University of Manitoba; the University of Winnipeg; the University of Ottawa; Carleton University; Dalhousie University; Memorial University; the University of New Brunswick; the University of Moncton; Mount Allison University; the University of Prince Edward Island; and in the following coffee houses: 'The Penny Farthing' in Yorkville, Toronto; 'The Bistro' in Vancouver, and the 'Back Door' in Montreal.

The hearings in these more informal settings have given the Commission direct and vivid contact with the opinions and attitudes of young people in Canada. All the Commission hearings have been recorded on tape, and in addition there has been a stenographic record. In many ways it is a matter of regret that an audio-visual record could not have been made, but the nature of the subject matter is such that the Commission felt obliged to protect individuals appearing before it from undue publicity. The media have cooperated with the Commission in respecting its request that members of the public should not be photographed while making submissions. In many cases, the submissions have been of a highly personal nature, and the hearings would have been much inhibited if they had been photographed. At the same time, the Commission has been intensely aware of the fact that it was listening to an unusual social commentary. Opinions and feelings have poured forth in the hearings with great spontaneity, particularly in the more informal settings. The Commission has been deeply impressed, and on several occasions, moved by the testimony which it has heard. It has been struck by the depth of feeling which this phenomenon and the social response to it have aroused. As a result of the initial phase of its inquiry, the Commission is more than ever convinced that the proper response to the non-medical use of psychotropic drugs is a question which must be worked out by the people of Canada, examining it and talking it over together. It goes to the roots of our society and touches the values underlying our whole approach to life. It is not a matter which can be confined to the discrete consultation of experts, although experts obviously have their role, and a very important one, to play.

13. A word should be said about the protection of witnesses. The terms of reference of the Commission empower it to take testimony in such manner as to safeguard the anonymity of witnesses. The Order-in-Council authorizing the appointment of the Commission provides:

That the said Commissioners may, if they deem the same expedient, cause a record to be made of the evidence which shall be given or produced before them, or any part of that evidence, as to the matters to be inquired into and reported upon and may direct that the oral evidence of witnesses, before them, or any such witness, shall be taken in shorthand by a shorthand writer, approved and sworn by the said Commissioners or one of them, and may direct that the oral evidence of any such witness may be so given and recorded, whether under oath or otherwise, without a disclosure of the identity of that witness, and that any evidence so recorded shall be certified by the person or persons taking the same in shorthand, as correct.

The notices which the Commission has published of its hearings have given prominence to this readiness to take evidence given privately and anonymously, and many witnesses have availed themselves of this opportunity. The Commission has also received a number of anonymous submissions through the mail. At the same time, concern has been expressed from time to time that the public hearings might be used for law enforcement purposes. As a result of an understanding at the outset of this inquiry with the officers of the R.C.M.P., the Commission has been able to assure the public that its hearings would not be exploited for law enforcement purposes. It has every reason to believe that this understanding has been respected. Although there have been rumours from time to time that law enforcement personnel have taken advantage of the hearings for purposes of investigation, no evidence of this has been brought to the attention of the Commission, despite public statements by the Chairman that any such instances should be reported to him.

The Commission has been very impressed by the candour with which people of all ages have come forward and spoken from a depth of conviction, and feeling about the phenomenon of non-medical drug usage and its relation to other aspects of social and cultural change today.

14. Altogether, it is estimated that nearly 12,000 Canadians have attended the hearings up to the end of February. The Commissioners have travelled some 17,000 miles, and in the months ahead they will continue to move back and forth across the country until every province and major city have been visited, as well as many of the smaller communities.

15. The Commission has had the benefit of a wide range of advice from experts in the field of non-medical drug use. It is only possible here to mention some of those who were particularly helpful.

The Commission has had several sessions with officers of the R.C.M.P, and has received the fullest cooperation from the Force in its attempt to understand the lessons of law enforcement in this field. In addition to the public submission of the Force, each Division prepared a brief, and the Commission has had the advantage of private hearings with officers from each Division. Moreover, research consultants of the Commission have been permitted to observe law enforcement by the Force at first hand. The Commission has also received a number of written communications from the Force in addition to its formal submissions. We can not speak too highly of the cooperation that we have received from the R.C.M.P., who went to particular trouble, on relatively short notice in the initial stages of the inquiry, to give the Commission the benefit of their experience. Whatever view one may take of law enforcement policy in this controversial field, we feel obliged to record our respect for the highly professional manner in which the R.C.M.P. have sought to per-form their duty in relation to this inquiry. We look forward to their continued cooperation as we deepen our study of the problems of law enforcement and the administration of justice in the field of non-medical drug use.

The Commission has also received a great deal of valuable assistance from addiction foundations, notably the Addiction Research Foundation of Ontario, the Narcotic Addiction Foundation of British Columbia, and OPTAT (Office de la Prevention et du Traitement de l'Alcoolisme et des Autres Toxicomanies). From the outset of its inquiry the Commission has had the benefit of frequent consultation with members of the Ontario Foundation, and the Commission's research staff have made extensive use of the bibliographical and documentary resources of the Foundation.

The Commission has also consulted with many other experts, in Canada and the United States. It plans to consult with many more, including experts outside North America, in the ensuing year. For the present, it would like to make special mention of the assistance which it has received from Dr J. Robertson Unwin, Dr Lionel Solursh and Mr Wilfred Clement, whose intimate knowledge of the Canadian drug scene from a scientific, yet deeply human perspective, has made their observations and advice invaluable. The Commission should also record its indebtedness for advice received in the early stages of the inquiry from Dr Helen Nowlis of the University of Rochester, Samuel Pearlman of the City University of New York, Dr Daniel Glaser of the New York State Narcotic Addiction Control Commission; members of the National Institute of Mental Health, and Department of Justice in the United States.

The Role of the Interim Report

16. We have had some difficulty in determining what should be the role of our interim report. In particular, we have been somewhat perplexed as to how far we are justified in coming to conclusions and making recommendations at this time. But we are required by our terms of reference to render an interim report, and we assume that something more is expected than a simple report of progress. We believe that what is expected, at the very least, is a report, which conveys our initial understanding of the subject matter of the inquiry and makes such recommendations as we feel are urgent and for which we believe we have a sufficient basis at this time. We hope it will serve to put the phenomenon of non-medical drug use in some perspective, to identify the issues, and to provide the basis for further consideration and discussion by the people of Canada. Further, by identifying certain attitudes, hypotheses, and tentative opinions, the interim report will serve, we hope, as a sounding board, eliciting further evidence and opinion, and indicating to us wherein our definition of the issues and our preliminary opinions may require revision.

17. The function of the final report will be to complete the picture begun by the interim report and to report upon the system of social response which we recommend for the phenomenon of non-medical drug use. The inquiry between the interim report and the final report will test the definitions of issues and the hypotheses reflected in the interim report, add necessary information with respect to the effects, the extent, and the causes of non-medical drug use, as well as the role played by the various aspects of social control and response, and lay the foundation for specific recommendations concerning these various aspects. The interim report is primarily concerned with a statement of the issues and applicable principles, and the final report is to be concerned with the detailed application of these principles to the development of a satisfactory system of social response.

We recognize, however, that the urgency of some of the problems involved in non-medical drug use and the time required to develop adequate resources to cope with them may indicate the appropriateness of certain recommendations at this time. This is particularly true with respect to preparations and organization for which considerable lead time is required. In such cases it may be sufficient to indicate the general direction which certain responses should take, leaving it to further study and consultation in the ensuing year to settle matters of detail.

18. Chapter Two on the effect of the drugs is offered at this time for two reasons. First, we have been profoundly impressed by repeated assertions of the need for more reliable information, and we hope that this chapter will serve a useful purpose as material for drug education. Secondly, we feel that it is an indispensable basis for the development of public understanding of the issues. In effect, in Chapter Two we disclose our initial assumptions concerning the effects of the drugs. Our

object is to identify the body of reliable and generally accepted knowledge, and to determine where the important uncertainties and gaps exist. We certainly concur in the impression which others have conveyed of a field of knowledge bedevilled by controversy, conflicting professional opinion, and uncertainty. Some observers question whether it is possible, in view of the intense feelings on this subject, ever to come to agreement on what should be accepted as scientifically known. Erich Goode in his article, 'Marijuana and the Politics of Reality', observes that 'the multitude of results from the many marijuana reports forms a sea of ambiguity into which nearly any message may be read'. He makes the point that whether a particular drug effect is good or bad depends on one's subjective point of view - the implications of the effect in term's of one's own system of values. Goode sees no possible reconciliation of these 'differential evaluations of the same "objective" consequences', and he concludes that 'the essential meaning of the marijuana issue is the meaning which each individual brings to it'. The Addiction Research Foundation of Ontario makes the same point in its preliminary submission to the Commission. It puts the matter this way:

However, after all possible information has been acquired and verified scientifically, the final steps in the formulation of legislation or governmental policy will be based upon value judgements. Even the classification of the effects of drug use as 'beneficial' or 'adverse' is a process of evaluation with respect to subjective standards.

The response to non-medical drug use is profoundly a matter of attitudes. At the same time we must make every effort to ascertain what should be accepted as scientific knowledge of the 'objective' effects. It is intolerable that the process of subjective evaluation should take place in ignorance of the objective facts. At the same, we would do well to heed Goode's caution that there is an inevitable tendency to select and emphasize those views of 'objective' facts which support our own subjective evaluation. And as Goode points out, with special reference to the La Guardia Report on marijuana, the various findings can be used to support conflicting points of view. Are we to conclude that the task is hopeless? We think not. We can certainly make progress by attempting to identify what should be accepted scientifically concerning the 'objective' effects, by pointing out the important areas of scientific controversy or lack of scientific knowledge, and by making explicit the value judgements underlying the conflicting views as to how the effects should be subjectively characterized. We believe it is helpful to clarify the issues of the debate.

Staff and Research

19. The members of the Commission and their staff are listed in Appendix C. The Commission is carrying out its task with a small nucleus of full-time staff and with research consultants on a part-time basis for special aspects of its study. The Commission's Research Associates, Dr Charles Farmilo and Dr Ralph D. Miller, are concentrating on psychopharmacological research into the effects of the drugs. Dr Miller is the author, with the assistance of Dr Farmilo, of Chapter Two on 'The Drugs and Their Effects'. Research that has been commissioned so far includes survey research to determine the extent and patterns of non-medical drug use in Canada, as well as Canadian perceptions of and attitudes towards this phenomenon, and legal studies, both doctrinal and empirical, of the various problems involved in the regulation of non-medical drug use. The section of Chapter Five dealing with the law is based in part on preliminary work by Professor Paul Weiler and John Hogarth.

Research is only part of the work that is involved in an inquiry of this kind. Special mention should be made of the administrative staff who have had to work under particular pressure because of the requirement of an interim report, impinging concurrently with the organization and conduct of the public hearings. We would like to express our appreciation of the work of Mr James J. Moore, Executive-Secretary of the Commission, who has had the general direction of operations and who has also participated in the writing of the report; Mr Jack Macbeth, who has been of great assistance in the organization of hearings and the preparation of the report; Mrs Vivian Luscombe who has supervised the secretarial staff of the Commission; Mr C. William Doylend, the Ottawa Office Manager, and other members of the administrative, secretarial and research staff.

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