A History of Impartial Reports Demands Reconsideration of Current Drug Policy

The recommendations contained in this reform strategy are consistent with the findings of many independent commissions that have evaluated drug policy alternatives in the past. We urge the Office of National Drug Control Policy to review these impartial scientific reports and rely on them as we have.

Many of these reports come from the United States, but some of the most insight-ful come from other countries. None calls for full legalization of drugs or views any of the drugs, including marijuana, as harmless, but each of the reports without fail calls for a gentle, humane approach to dealing with drug users and abusers. None of these great commission reports calls for a war on drugs, on users or on addicts. Some countries, notably Britain and Holland, have followed much of the advice of these non-partisan expert reports. Others, most notably the United States, have consistently ignored them.

Following are summaries of the key findings of these reports.

Indian Hemp Drugs Commission, Marijuana, 1893-94. This 3,281-page, seven-volume classic report on the marijuana problem in India by British and Indian experts concluded: "Vievving the subject generally, it may be added that the moderate use of these drugs is the rule, and that the excessive use is comparatively exceptional. The moderate use produces practically no ill effects." Nothing of significance in the report's conclusions has been proven wrong in the intervening century.

The Panama Canal Zone Military Investigations, 1916-1929. After an exhaus-tive study of the smoking of marijuana among American soldiers stationed in the zone, the panel of civilian and military experts recommended that "no steps be taken by the Canal Zone authorities to prevent the sale or use of Marihuana." The committee also concluded that "there is no evidence that Marihuana as grown and used [in the Canal Zone] is a `habit-forming' drug."

Departmental Committee on Morphine and Heroin Addiction, Report, 1926 (The Rolleston Report). This landmark study by a distinguished group of British doctors, appointed by the government, codified existing practices regarding the maintenance of addicts on heroin and morphine by individual doctors and recommended that they con-tinue without police or medical society interference. In coming to this conclusion, these physicians displayed a humane regard for the addicts in their care, perhaps due to their view of the nature of narcotic addiction: "the condition must be regarded as a manifesta-tion of disease and not as a mere form of vicious indulgence." The British addiction experts took pains to state that they did not agree with the opinions of "some eminent physician's, especially in the United States" that addicts "could always be cured by sudden withdrawal."

Mayor's Committee on Marihuana, The Marihuana Problem in the City of New York, 1944 (The La Guardia Report). This study is viewed by many experts as the best study of any drug viewed in its social, medical and legal context. The committee covered thousands of years of the history of marijuana and also made a detailed examina-tion of conditions in New York City. Among its conclusions: "The practice of smoking marihuana does not lead to addiction in the medical sense of the word." And: "The use of marihuana does not lead to morphine or heroin or cocaine addiction and no effort is made to create a market for those narcotics by stimulating the practice of marihuana smoking." Finally: "The publicity concerning the catastrophic effects of marihuana smoking in New York City is unfounded."

Interdepartmental Committee, Drug Addiction, 1961 (The First Brain Report). When the Brain Committee first met at the invitation of the Minister of Health, its mission was to review the advice given by the Rolleston Committee in 1926. That advice had been to continue to allow doctors to treat addicts with maintenance doses of powerful drugs when the doctors deemed it medically helpful for the patient. Brain I reiterated that advice and in this first report recommended no changes of any significance on the pre-scribing powers of doctors. This report expanded on one important point alluded to in Rolleston: the authenticity of the existence of "stabilized addicts." While many American experts doubt their existence, this report explained, "careful scrutiny of the histories of more than a hundred persons classified as addicts reveals that many of them who have been taking small and regular doses for years show little evidence of tolerance and are often leading reasonably satisfactory lives." Six "case histories of known stabilized addicts" were included in an appendix. They were mature, older patients, functioning normally on what would be huge doses of drugs by American standards. "Mr. F.," for example, a clerical worker, was receiving the equivalent of 200 milligrams of morphine tablets each day. It is likely that these patients and their doctors would be dealt with as criminals in the United States.

Joint Committee of the American Bar Association and the American Medical Association on Narcotic Drugs, Drug Addiction: Crinte or Disease?, Interim and Final Reports, 1961. This report was the result of the only major combined study of drug policy made by two of the most important professional societies in the country. Chaired by attorney Rufus King of Washington, D.C., the committee presented a direct challenge to the tough policies of Federal Bureau of Narcotics Director Harry Anslinger, a philosophical ancestor of the previous drug czar, William Bennett. 'The blue-ribbon committee included a senior federal judge and was advised by Indiana University's Alfred Lindesmith, one of the most distinguished addiction scholars in history. The report observed, "drug addiction is primarily a problem for the physician rather than the policeman, and it should not be necessary for anyone to violate the criminal law solely because he is addicted to drugs." The report concluded that drug addiction was a disease, not a crime, that harsh criminal penalties were destructive, that drug prohibition ought to be reexamined, and that experi-ments should be conducted with British-style maintenance clinics for narcotic addicts.

Interdepartmental Committee, Drug Addiction, Second Report, 1965 (The Second Brain Report). Brain II has been consistently misinterpreted by leading American scholars and officials It did not recommend the dismantling of the British prescription system nor the compulsory registration of addicts, as has been claimed. Instead, Brain II urged that (1) doctors who wished to prescribe "restricted drugs" to addicts for the purpose of maintenance be required to obtain a special license from the Home Office, (2) treatment centers be established for treating addicts who were to be regarded as sick and not criminal, and (3) doctors and other medical personnel be mandated to "notify" the Home Office when they encountered an addict in the course of their professional work. Origi-nally, the category of restricted drugs included heroin and cocaine; now, dipipanone has been added.

However, the core of the British system remains, and in recent years, has been reinvigorated. Approximately 200 doctors with special licenses are free to prescribe all drugs, including the restricted medicines, for maintenance of addicts. Also, any doctor, unlike in the U.S., may prescribe all of the other drugs for maintenance, including, for example, injectable morphine and methadone. Brain II in the end was aimed at controlling a few overprescribing doctors, not at adopting the American system of treating addicts as the enemy.

Advisory Committee on Drug Dependence, Cannabis, 1968 (The Wooton Report). This study report on marijuana and hashish was prepared by a group that included some of the leading drug abuse experts of the United Kingdom. These impartial experts worked as a subcommittee under the lead of Baroness Wooton of Abinger. The basic tone and substantive conclusions were similar to all of the other great commission reports. The Wooton group specifically endorsed the conclusions of the Indian Hemp Drugs Commission and the La Guardia Committee. Typical findings included the follow-ing. "There is no evidence that in Western society serious physical dangers are directly associated with the smoking of cannabis." "It can clearly be argued on the world picture that cannabis use does not lead to heroin addiction." "The evidence of a link with violent crime is far stronger with alcohol than with the smoking of cannabis." "There is no evi-
dence that this activity...is producing in otherwise normal people conditions of dependence or psychosis, requiring medical treatment."

Canadian Government's Commission of Inquiry, The Non-Medical Use of Drugs, Interim Report, 1970 (The Le Dain Report). The distinguished Canadian experts on this governmental commission were led by law school dean, later Supreme Court Justice, Gerald Le Dain. The report was similar to the other great commission reports in terms of its non-martial, calm approach to the facts and in its belief that marijuana use did not constitute a great threat to the public welfare. The official govermnental commis-sion was remarkable in the extent to which its report portrayed casual drug users as decent, thoughtful citizens whose views deserved the fullest possible hearing by the government in the process of developing drug control strategies.

A mother of four and a school teacher was quoted in the report as saying: "When I smoke grass I do it in the same social way that I take a glass of wine at dinner or have a drink at a party. I do not feel that it is one of the great and beautiful experiences of my life; I simply feel that it is pleasant and I think it ought to be legalized." The commission did not ask for that change immediately but instead recommended that serious consideration be given to legalization of personal possession in the near future. The report also urged that police and prosecutors go easy on casual users and keep them out of jail as often as possible.

National Commission on Marihuana and Drug Abuse, Drug Use in America: Problem in Perspective, 1973. This commission was directed by Raymond P. Shafer, former Republican governor of Pennsylvania, and had four sitting, elected politicians among its 11 members. The commission also had leading addiction scholars among its members and staff. It was appointed by President Nixon in the midst of the drug war hysteria at that time. While the commission supported much existing policy, it produced two reflective reports, this being the final comprehensive document, which recommended research, experimentation and humane compromise. The first recommendations of the commission were:
"1. Possession of marihuana for personal use would no longer be an offense, but marihuana possessed in public would remain contraband subject to summary seizure and forfeiture.
"2. Casual distribution of small amounts of marihuana for no remuneration, or insignificant remuneration not involving profit, would no longer be an offense."

National Research Council of the National Academy of Sciences, An Analysis of Marihuana Policy, 1982. The NAS Committee on Substance Abuse and Habitual Behavior was composed of some of the leading American experts on medicine, addiction treatment, law, business and public policy. These experts reviewed all of the available evidence on every aspect of the marijuana question. The committee then recommended that the country experiment with a system that would allow states to set up their own methods of controlling marijuana as is now done with alcohol. Under this approach, federal criminal penalties would be removed and each state could decide to legalize the drug and impose regulations concerning hours of sale, age limits and taxation.
In the same vein as all the previous major objective studies, this report stated that excessive marijuana use could cause serious harm, that such use was rare, and that on balance the current policy of total prohibition was socially and personally destructive. The report placed great emphasis on building up public education and informal social controls, which often have a greater impact on drug abuse than the criminal law. Regarding the possibility of disaster for our youth under legalization, the report observed: "...there is reason to believe that widespread uncontrolled use would not occur under regulation. Indeed, regulation might facilitate patterns of controlled use by diminishing the 'forbidden fruit' aspect of the drug and perhaps increasing the likelihood that an adolescent would be introduced to the drug through families and friends, who practice moderate use, rather than from their heaviest-using, most drug-involved peers."

Advisory Council on the Misuse of Drugs, AIDS and Drug Misuse, Part 1, 1988; Part 2, 1989. "The spread of HIV is a greater danger to individual and public health than drug misuse," declared the leading drug abuse and health experts of the United Kingdom who sit on this distinguished quasi-governmental advisory group. This concept operated as the guiding principle in this commission report, one part issued in 1988, one in 1989. In stark contrast to the Bush Administration's war plans the British council provided a comprehensive health plan that seeks to prevent the use of drugs, as is the American goal. However, the plan has realistic goals regarding drug abusers: absti-nence in the American mode, where possible, but above all else, health and life. Thus, the Advisory Council accepted the lessons of the "harm reduction" programs of the Liverpool area and recommended that they be spread to the entire United Kingdom. Some of these lessons involve needle exchanges and prescribed drugs for addicts.
The report even went beyond the Liverpool experience when these leading British experts quietly observed "we believe that there is a place for an expansion of residential facilities where drug misusers may gain better health, skills and self-confidence whilst in receipt of prescribed drugs," Thus, while the United States is planning more prison space for drug addicts, the United Kingdom is contemplating more hostels where addicts could be taught to live more healthy, more self-confident and more productive lives in the community whilst in receipt of prescribed drugs.

The Twentieth Annual Report of the California Research Advisory Panel, 1989. This panel, appointed by the state legislature of California to regulate all research on controlled substances, reviewed drug policy and recommended that "the legislature act to redirect this state away from the present destructive pathways of drug control." The report noted that we had followed a path of prohibition over the last 50 years and con-cluded this policy "has been manifestly unsuccessful in that we are now using more and a greater variety of drugs, legal and illegal." In addition, the failure of prohibition has resulted in "societal overreaction [that] has burdened us with ineffectual, inhumane and expensive treatment education and enforcement efforts." They recommended a move toward the formulation of "legislation aiming at regulation and decriminalization" and the winding down of the war on drugs.
The Research Advisory Panel made three specific recommendation for initial legislative action. These were:
1. Permit the possession syringes and needles.
2. Permit the cultivation of marijuana for personal use.
3. In order to project an attitude of disapproval of all drug use, take a token action in forbidding the sale or consumption of alcohol in state-supported institutions devoted in part or whole to patient care or educational activity.
The panel recommended immediate and innovative action, concluding it is "incon-trovertible that whatever policies we have been following over the past generations must not be continued unexamined and unmodified since our actions to date have favored the development of massive individual and societal problems."

The National Commission on AIDS, "The Twin Epidemics of Substance Use and HIV," July 1991. This indictment of current drug policy focuses on the relationship between the spread of HIV and drug use. The commission criticized the federal government's failure to recognize that these are twin epidemics and found that the "strat-egy of interdiction and increased prison sentences has done nothing to change the stark statistics" showing spread of AIDS by drug users. The commission singled out the Office of National Drug Control Policy for ignoring AIDS and "neglecting] the real public health and treatment measures which could and must be taken to halt the spread."
The Commission put forward five recommendations:
1. Expand drug treatment so that all who apply for treatment can be accepted into treatment programs.
2. Remove legal barriers to the purchase and possession of injection equipment.
3. The federal government must take the lead in developing and maintaining programs to prevent HIV transmission 'elated to licit and illicit drugs.
4. Research and epidemiologic studies on the relationships between licit and illicit drug use and HIV transmission should be greatly expanded and funding should be increased, not reduced or merely held constant.
5. All levels of government and the private sector need to mount a serious and sustained attack on the social problems of poverty, homelessness and lack of medical care that promote licit and illicit drug use in American society.
The National Commission on AIDS could be described as the echo of the British Advisory Council on the Misuse of Drugs in its report on AIDS and Drug Misuse, as it made virtually the same policy recommendations. The Commission concluded that "the federal government must recognize that HIV and substance use is one of the issues of paramount concern within the `war on drugs.' Any program which does not deal with the duality of the HIV/drug epidemic is destined to fail." 'The Commission urged the federal government to move away from a law enforcement approach in controlling drugs toward a public health approach which to date has "been seriously neglected." •