Suppose there were people from another country who carried opium for sale to England and seduced your people into buying and smoking it: certainly your honor-able ruler would deeply hate it. ... Naturally you would not wish to give unto others what you yourself do not want.

Commissioner LinTse-lisu in a letter to Queen Victoria, 1839 (translated from the Chinese).

Before embarking on a historical review of drug control, we should perhaps stress that the drugs discussed represent only a selection from the range of psychoactive sub-stances in existence and that the period covered by our review does not span the entire history of drug control endeavors. Since ancient times most societies have sought to regulate the sub-stances men have used as drugs, whether tea or coffee or opium. But for this study we have abstracted from the range of drugs a limited number and from the historical sequence a circumscribed period of time. This was a period marked by increasing international cooperation, beginning in an opium conference attended by thirteen states and culminating in twelve multilateral treaties.*

The historical development of international arrangements for drug control parallels other forms of international cooperation and is in a sense neither novel nor unique. Its pattern of evolution closely resembles that of other subjects of international concern: the abolition of the African slave trade was one such, and the traffic in women and children towards the close of the nineteenth century was another. The sequence of international response seems to run from the convening of a conference of interested states and the passing of resolutions, to the drawing up of treaties, the setting up of international machinery, and the working out of intergovernmental arrrangements within the framework of the League of Nations and, later, the United Nations.

The sources of international action in the different fields of concern share a common context characterized by a rising public conscience at a particular time. This crystallizes into movements and pressure groups in individual countries. Few movements wielded as great an influence or had quite as many repercussions as the antiopium protest at the turn of the century. Among its overall consequences was the creation of a number of enduring international control instruments. In contrast, the results of the temperance movement against alcohol—at least insofar as inter-national action is concerned—are of a far more modest order.

The lesser impact of the temperance movement occurred, in spite of the fact that initially the antialcohol movement had a wider support than the antiopium movement. As early as 1808 the first American temperance society was founded in Saratoga, and twenty-five years later a total of six thousand local societies, with a membership of one million, had sprung up in the United States. In 1851 the state of Maine passed the first alcohol prohibition law. Then, from a home-based campaign, the movement went inter-national. Its influence spread to Ireland, England, and the Scandinavian countries, and it gathered much political momen-tum. In 1878 the first international alcoholism congress was held in Paris. In 1906 an international association was set up, and in the following year its headquarters was established in Lausanne, Switzerland, where it still functions. In 1910 some twenty-seven countries joined this organization. Meanwhile, a more radical counterpart, the International Prohibition Federation, had come into being. In spite of the pressure which these associations could exert upon public and international opinion, little headway was made by them in countries where wine was in daily use and was important economically. Although the temperance movement was essentially a feature of Western societies, its goals would have found much sympathy in the Muhammadan world.

In contrast to the antialcohol movement the antiopium movement was less widespread. It was primarily a British campaign leveled against the British-Indian-Chinese opium trade. The sentiment of opposition it represented was preceded by the Opium War of 1840-42 between Britain and China, which ended in China's defeat and laid it open to foreign trade and mission-aries. In 1874 the Society for the Suppression of the Opium Trade was founded in London and steady pressure was applied on the British Parliament from that time onwards to relinquish the opium trade. Towards the end of the nineteenth century the proportion of members voting in the House of Commons for the suppression of the trade showed a progressive increase (Lowes, 1966), signifying the growing support that the antiopium move-ment was gathering. A corresponding movement was underway in China and later in the United States. Years later, an antiopium bureau was set up in Geneva by A. E. Blanco, an ex-employee of the League of Nations and a former expert in the League's Opium Section. The bureau took upon itself the task of criticizing, for its ineffectiveness, the committee formed under the League to deal with the opium question.

These moral movements cannot be seen independently of other social forces. The British antiopium movement, encroaching as it did upon strong vested interests, would have had less success if it had not been for American backing. The U.S. adopted an antiopium position partly because there were economic reasons for doing so: it was a way of eroding the European domination of the trade with China. Thus the objectives of the moral crusaders coincided with, and were reinforced by, economic objectives (Musto, 1973:24; Taylor, 1969:30).

The Shanghai Commission, to which these developments even-tualrST led, was to have far-reaching consequences. No comparable event marked the history of alcohol control; there the closest approximation to collective effort was in the African-based regional control arrangement arrived at between the parties to the General Brussels Act of 1889-90 and included in the essentially antislavery provisions of the act. The antialcohol campaigners' efforts were largely home-directed, whereas antiopium sentiments were leveled against an essentially foreign habit. The prevailing social climate within which the two groups worked was thus dissimilar. However, it will be remembered that, paradoxically, opium was first used in the West; it was taken to China by Arab traders as a medicine, and the smoking of opium derived from tobacco smoking, another Western import, believed to have been introduced by the Portuguese to Formosa and from there to the mainland of China.

In 1906 a new edict banning opium was issued by the Chinese government in yet another effort to suppress opium, but the ban proved impossible to enforce as long as the system ushered in by the treaties ending the two opium wars held sway (this system placed what were in practice severe limitations on China's sovereignty). In that same year, two significant events occurred which provided some of the impetus for an international opium conference. First, the British Parliament passed a resolution in the House of Commons accepting the proposition of the anti-opium movement that the opium trade should cease. Second, Bishop Brent, a member of an opium investigation committee that had been set up to look into the use of opium in the Philippines (which had been ceded to the United States as a result of the Spanish-American War), wrote a letter to President Theodore Roosevelt proposing that steps be taken to seciire international action over China's predicament. The committee had found that opium smoking was a setious problem in the Philippines and that domestic legislation prohibiting the import of nonmedical opium had proved ineffective in reducing the illicit trade; it realized that domestic legislation had to be comple-mented by international action.

U.S. diplomacy then worked towards this end, and in January 1909 an international opium conference opened in Shanghai with the participation of thirteen powers. Prior to the conference an agreement had been reached between China and Britain for a one-tenth reduction of the Indian opium trade annually.

Among the nations gathered at the conference, the U.S.A., Great Britain, and China naturally dominated. The documenta-tion prepared for the conference largely followed the U.S. format and provided some idea as to the size of the opium problem in the world. Neither the presentation of the various reports nor the discussions to which they gave rise obscured the underlying conflict of interests between the participating countries. The debate revolved around, among other issues, the type of control to be advocated—whether prohibition or regulation, the latter being pressed for by the British, anxious to protect their Indian-Chinese trade. One of the matters of dispute was the scope of the commission's terms of reference: initial resistance to a discussion of the domestic drug situations of the participating countries gave way under the pressure of international opinion. Another issue was the question of whether the conference was competent to discuss matters of a medical nature: the proposal to consider medical matters was narrowly defeated (by a majority of one), the objection being that expertise for such a task was not sufficiently represented at the conference.

The conference ended in the adoption of nine resolutions, some of which were based on Chinese propositions, others on American and British proposals, and yet others on compromises struck between these two groups of propositions. A number of resolu-tions dealt exclusively with the Chinese opium question, but there was a resolution addressed to all governments calling for the general suppression of opium smoking (opium eating was not mentioned). Resolution 3, which stated that the use of opium for other than medical purposes was held by "almost every partici-pating country" to be "a matter for prohibition or for careful regulation," represented a compromise between the American and British positions. What was surprising, and perhaps more important, was a resolution on the problem of morphine and an injunction to take "drastic measures" to control its use, which was thought to be spreading. Control of trade was covered by Resolution 4, which pointed to the responsibility of all countries to prevent the export of opium to countries which had prohibited its idiport.

The Shanghai resolutions required a follow-up, and in fact another meeting was convened three years later, in 1912, this time at The Hague. Again, it was the United States which, through its diplomatic channels, made all the preparations. Conflicting interests were already apparent at this preparatory stage. The meeting was postponed at the request of Great Britain, which insisted on a formulation of the scope of the agenda so that it might include consideration of cocaine and morphine, the latter already touched upon in Shanghai. The British conditions were only partially met in that the detailed statistics on cocaine and morphine, which Britain insisted upon having for the conference, were not as thorough as they had been for opium; nevertheless, compiling them provided the British with some stalling time. In May 1911 an agreement consolidating the ten-year reduction of the Indian-Chinese trade was concluded, and this made the prospect of the planned conference more palatable to the British. An Italian suggestion to include cannabis in the agenda was not taken up, nor was a similar but independent proposal by Henry Finger to the American delegation, which he was to join. In addition to suggesting that something be done about "Hindoos" in California who demanded cannabis, he also proposed that a friend of his be allowed to supply, free, the finest California wine for the conference banquets—a proposal which Hamilton Wright, a senior member of the U.S. delegation, brusquely rejected.

Although there was no increase, over Shanghai, in the number of countries participating in the Hague meeting, the occasion nevertheless marked the beginning of a shift from a preoccupa-tion with China to a true internationalism. The old disagreement between the U.S. and Great Britain continued, but a new conflict also appeared. Germany, the leading country in drug manufac-ture at the time, was opposed to the control of cocaine. It attempted, but did not succeed, in removing the drug from the convention which was approved at the conference. It insisted, moreover, that the convention should have universal signature before it could go into effect. This was obviously a strategy to postpone controls. The text of the Hague Convention was by no means a strong one; it left the interpretation of control to the individual governments, and the regulations it called for on production and distribution were domestic rather than interna-tional. In addition to the convention a protocol was signed which pointed to the necessity for international control over the mailing of drugs and investigation into the problem of cannabis. Because of the peculiar ratification procedure maneuvered by the German delegation, the Hague Convention did not come into force before the First World War broke out; however, a large number of countries became parties to the Hague Convention through their ratification of the Versailles Treaty. It was the British government which took the lead in securing the ratification of the convention by this method (Buell, 1925:57, 107).

While these international moves were being made to bring opiates and cocaine under control, the adoption of strong measures against alcohol was being contemplated in a number of countries. In the United States, Iceland, and Finland these took the shape of prohibition, while in Canada and Norway they amounted to a partial prohibition. At the international level a measure of control was exercised by the League of Nations through its Permanent Mandates Commission, which supervised the working of the convention on the liquor traffic in Africa, which was signed at Saint Germain-en-Laye in 1919 and super-seded the alcohol stipulations of the Brussels Act. As the League of Nations was almost entirely European, and alcohol use is deeply embedded within the European culture, attempts by some countries to interest the League of Nations in alcohol control did not succeed. France, in defense of its wine industry, was the chief opponent of controls.

At the Paris Peace Conference, the involvement of the League of Nations in the drug question was secured by including in the Covenant a provision entrusting to the League "the general supervision over agreements with regard to the traffic in opium and other dangerous drugs." At the first assembly of the League, an Advisory Committee on Traffic in Opium and Other Danger-ous Drugs was created. The original European members of the Committee* were countries with opium monopolies in their Far Eastern colonies. Membership increased as time passed. The United States—a nonmember of the League—was not a member of the Advisory Committee, but it managed to participate actively in the work of the committee in a "consultative capacity." But it was the colonial powers and the drug manufacturing countries which largely dominated the picture. If the provisions of the Hague Convention were vague, the terms of reference of the Advisory Committee were equally so. That the control attempts it supervised were not effective was hardly surprising since those countries that would most feel the pinch of control were the ones supervising its application. The nickname which the committee earned—"the old Opium Bloc"—well illustrates this. Admittedly there were difficulties with obtaining adequate ùiformation from governments—this was as much, if not more, of a problem then as it is now—and this no doubt hampered the committee's work; but the fact remains that the economic interests which the members served were directly opposed to controls.

In other quarters forces were at work to bring about more stringent controls over the production of drugs. In the United States a resolution was passed in Congress in 1923 enjoining the president to exert pressure upon opium and coca-leaf producing countries to agree to direct limitation of production. In deciding in 1927 to widen the membership of the Advisory Committee to include "victim" countries, so that the dominance of those countries "most interested in manufacture or revenue" (Gibberd, 1933) might be diluted, the Assembly of the League was seeking the same end. Renewed talks at another international conference were proposed, and concrete proposals for a quantitative limita-tion of production were brought before the Advisory Committee by the U.S. These proposals were so controversial and so unwelcome that when they came to be discussed at the Second Geneva Conference in 1925, and acceptance of them was not forthcoming, the U.S. delegation walked out of the conference: At about the same time the Chinese delegation also withdrew because of the failure of the conference to agree on the suppres-sion of opium smoking.

Between 1924 and 1931, several new drug treaties were drawn up. Although the goal had been to achieve a system of quanti-tative limitation of drug production and manufacture, the form of control agreed upon by the contracting parties was not quite so comprehensive. The most salient features of the new legislation were: the regulation of drug distribution by the Geneva Conven-tion of 1925 and the limitation of the manufacture of opiates to the amounts necessary to meet medical and scientific needs by the Limitation Convention of 1931. (During this same period there was much public alarm at overproduction by drug manufacturers and massive diversions from legal supply channels.) Another important feature of the measures was the inclusion of cannabis in the 1925 convention on an Egyptian request, although this was not an item on the agenda.

By these conventions, new control organs were created. In 1929, the Permanent Central Opium Board, later renamed the Per-manent Central Narcotics Board (PCB) began its work.* To avoid governmental control, the PCB was composed of eight experts appointed in their personal capacities, not as government repre-sentatives. The 1931 Convention, which set up a system of estimates of national drug requirements, imports, and manufac-ture, also created the Drug Supervisory Body (DSB) to administer the system. The International Health Office in Paris (the Office International d'Hygiène Publique) and the Health Committee of the League of Nations (and, after 1946, the WHO), were among the appointing bodies. The official representation of international health authorities is a development worth noting.

The creation of new control bodies was prompted by, among other things, the ineffectiveness of the Advisory Committee on Traffic in Opium; conferring supervisory and administrative powers upon wholly new bodies was a tacit affirmation of the committee's unsuitability for the new tasks. As it was constituted, after all, the old committee had little chance of developing and pursuing rigorous control strategies. In contrast, the position which the new bodies took toward governments was firmer, but this firmness derived less from their members' relative freedom from governmental claims than from their being less over-whelmingly dominated by representatives of countries with vested interests in drugs.

Much of the work of the new bodies was concerned with obtaining reliable statistics from governments on drug production and transactions. This work was impaired by the political climate in the late 1930s and the period immediately before the outbreak of the,Second World War. While the results of their work, insofar as the effectiveness of control is concerned, are difficult to assess, the extensive information they collected provided a starting point for a sound data base, a prerequisite of planning.

On the other hand, the impact of the implementation of the 1925 and 1931 treaties was discernible in the sharp decrease in the supplies coming from legal drug manufacturers into the illicit market. But illicit drug trafficking did not abate, for clandestine factories were increasingly appearing as substitute suppliers. In 1936 a treaty designed to suppress the illicit traffic was drawn up and called for harsher punitive measure against drug traffickers in the penal systems of contracting parties. The initiative for this stemmed from the International Police Commission, the name by which the International Criminal Police Organization (INTERPOL) was once known.

After the Second World War the United Nations inherited the primary responsibility for drug control. The League of Nations machinery for the control of drugs was transferred almost wholesale into the institutions of the new system. The Advisory Committee on Traffic in Opium was replaced by the Commission on Narcotic Drugs, a functional commission of the Economic and Social Council (ECOSOC); the committee's standing secretariat services, hitherto provided by the League, were taken over by a section of the UN Secretariat which was designated the Division of Narcotic Drugs.

The UN period of drug control differs from the League days in several respects, one of the most significant of which is the number and variety of international agencies which became involved in the drug question in the later era. The expansion of the UN itself is reflected in the progressive increase in the number of countries (especially non-European ones) participating in drug affairs. An effect of multiagency involvement has been an increase in the number of contacts between different approaches to the drug question. Of the related agencies that have come into the picture, the most important by far is WHO, a specialized agency. VVHO has an obligation under the drug treaties to evaluate the properties of new drugs to determine whether they should be controlled. The part played by WHO in developing international drug policy is particularly noticeable in the in-creased emphasis upon treatment as a preventive form of control. Another potential contribution is the initiative WHO recently took to bridge the gulf between the handling of alcohol and of other psychoactive drugs. Previously in WHO, alcohol has been the province of the Mental Health Unit, while other psychoactive drugs have been the concern of the Drug Dependence Unit. Recently, a merger between the two at the administrative level has occurred, giving effect to what has been called the "combined approach," which sees the usefulness, in some instances, of considering alcohol and other drugs together.

The concentration upon opium continued after the Second World War and considerable effort was invested in the creation of an international opium monopoly. The project failed, however. Instead, an Opium Protocol, which was adopted in New York in 1953, attempted to limit production by less direct means than those envisaged by the international monopoly project. The most notable provision of the 1953 protocol was the limitation of the number of legitimate producers of opium for export to seven: Bulgaria, Greece, India, Iran, Turkey, USSR, and Yugoslavia. Other provisions were in a similarly stringent vein; not surpris-ingly, this treaty took ten years before receiving enough ratifica-tions to allow it to come into force.

The next major development was the consolidation and unifi-cation of all the treaties entered into since the Hague Conference of 1912. This effort resulted in the Single Convention on Narcotic Drugs of 1%1, which was aimed at replacing all but one of the earlier treaties, namely the 1936 treaty on the suppression of illicit traffic.

But the Single Convention was not a mere technical instrument for bringing together disparate pieces. In the control of cannabis, it signified a new policy—prohibition. Nominally, the convention effected a change in the structure of the control machinery: the PCB and DSB, which were in practice already unified (see chapter 6), were merged to form the International Narcotics Control Board (INCB). Furthermore, the convention contained recom-mendations to parties to provide facilities for the treatment, rehabilitation, and care of drug addicts.

The Single Convention nevertheless left outside its scope a number of substances which were causing disquiet in several countries and were considered suitable for control under this convention. As will presently be shown, the variety of psycho-active drugs which became available after the Second World War increased considerably. In 1949 the WHO Expert Committee on Habit-forming Drugs had commented upon the abuse of amphetamines, but this was not discussed by the Commission on Narcotic Drugs until 1955. In the case of barbiturates and tranquilizers, concern in WHO circles dated from 1950 and 1956, respectively, and in the Narcotics Commission from 1957. But action at the international level was not taken until much later, as all the while the international community was endorsing a policy of control at the national level. Initiatives taken by Sweden to have amphetamines placed under international control found growing support until, at a conference in Vienna in 1971, a Convention on Psychotropic Substances, including ampheta-mines, was adopted.* At the last count (February 1974), this convention had acquired only sixteen ratifications, a number insufficient to bring it into force.

All these developments have not affected the international community's long-standing preoccupation with opiates. In March 1972 another UN conference was convened, following a U.S. initiative, to consider amendments to the Single Convention. The stated objective of the conference was to strengthen the con-vention's provisions to deal more effectively with the illicit traffic in opiates. It is widely accepted that the Single Convention controls over opium production represented a relaxation of those arrived at in the 1953 Opium Protocol; thus what was attempted by the amendments was to bring about a return to the stiffer controls agreed upon by the parties to the 1953 protocol and rejected by the conference which adopted the Single Convention of 1961.

In 1970 the proposal was formally made by the United States that a special United Nations Fund for Drug Abuse Control (UNFDAC) be set up, to be administered by the secretary-general and to be sustained by voluntary contributions from different sources. Accompanying the proposal was an initial pledge of $2 million by the U.S. government. In April 1971 the fund came into being.

During the last three-quarters of a century the international interest in the drug question has clearly changed in scope as well as in outlook. This change was accompanied by a change in vocabulary. In the official documents of today words like "evil" and "vice" appear less often, and "addiction" is now often referred to as "dependence." One of the more popular contempo-rary phrases is "drug abuse control," which has come to be synonymous with curbing illicit use, reducing illicit supplies, treating addiction and a host of other activities. Confusion is inevitable and is not helped by the continued use of the word "narcotics" (which means, pharmacologically, drugs capable of producing both sleep and analgesia) for all the internationally controlled drugs, in spite of their different modes of action. Even so, the tendency is towards greater precision in terminology. The choice of words does have practical social consequences, but the change in UN parlance may not necessarily reflect changes in underlying beliefs and approaches (Christie & Bruun, 1968). Much lip service has been paid of late to the concept of affecting consumer "demand," but the thrust of international efforts is still being directed towards controlling supply.

It may be of help to the reader to tabulate the drug treaties according to their age and status. This is done in table 1.1. As the intention of this chapter has been to provide a background to the contemporary workings of the control system, rather than to offer detailed historical recapitulation, some of the treaties appearing in the table have not been mentioned in the text, being of lesser importance.

Running parallel to the events just recounted were changes in drug production and use in the world at large, changes closely interwoven with the progressive elaboration of international treaties. A look at the changes in the quantity and variety of drugs that have been produced over the years will provide a clue to the changing world drug economies which control endeavors have sought to influence and to which they have had to adjust.

In table 1.2 changes in the level of production of a number of drugs are shown.* Figures are provided for four points in time only, with intervals of twenty-five years between each of the first three points, beginning from 1909, the year of the Shanghai Commission, commonly regarded as the starting-point of inter-national drug control. It was for the Shanghai Commission that data on opium production were first collected on anything like a world scale. The twenty-five-year time span was selected so as to minimize the effects of the two world wars and artefacts created by short-term fluctuations of a possibly random character. A few notes of explanation may be necessary on the data presented.

First, it should be noted that there are considerable gaps in the data. For some drugs no production figures are available. This is the case, for instance, with barbiturates and amphetamines. Cur-rently, the only source of comprehensive information relating to sales totals by country of such drug groupings as barbiturates seems to be the Intercontinental Medical Statistics (IMS), an organization which, among other activities, supplies on contract to individual pharmaceutical manufacturers such information as the share of the market which a firm has in the sale of its products in a particular country. This information is confidential and is strictly for the use of those firms which subscribe to the service in question. But no data on aggregate production of the so-called "psychotropic drugs" are currently available on a world scale.* Statistics on these substances are being compiled by the Inter-national Narcotics Control Board in anticipation of its duties under the Vienna Convention (see chapter 16). The figures which appear in the table are mostly derived from statistics supplied to INCB by governments under their treaty obligations. But even with drugs for which statistical reporting has long been required, production information is incomplete. This is the case, for instance, with cannabis.

For another reason, caution should be exercised in interpreting the data presented. All the information given is based on declared, or reported, data supplied to the UN by individual countries; the information is thus only as good as the data of the country from which it is obtained.

The number and variety of drugs have greatly increased over the period under review. This reflects the rise of the pharmaceu-tical industry from before the First World War to its prominent place in the commercial sector after the Second World War. The period after the war was unique in its alertness to the importance of psychiatric illness (Hordern, 1968), and it was in this climate that the major tranquilizers made their appearance. More recently a number of minor tranquilizers such as chlordiazepoxide (Librium) and diazepam (Valium) have come on the scene. Predating all these were the barbiturates, the clinical use of which begatiat about the same time (1903) as nations were foregathering to lay the foundations of international drug control. Hordern notes that prior to the latter part of the nineteenth century "natural" hypnosedatives, such as alcohol and cannabis, were widely used, "and the new drugs that were introduced into clinical practice differed from the older agents in being synthetic, and in being free at first from the degradation and social misery the others sometimes produced" (1968: 117). Also preceding the tranquilizers were the amphetamines, first used for depression in 1936. But the ones to arouse the most public interest among the new "psychotropic substances" were the hallucinogens, notably LSD. To provide some idea of the importance which psychoactive drugs have come to assume, we reproduce below some figures on prescriptions for hypnotics, tranquilizers, and antidepressives, and ingredient costs of psychoactive drugs for one country, Britain.

The figures imply not only the wide extent to which these drugs are used but the heavy financial investment they represent.

To return to the world production table, it should be noted in relation to the figures for opium that the bulk of the world's licitly produced opium is converted to morphine, most of which (about 90 percent in some countries) goes in turn to make codeine. Since, under the international system of control, licit production of opium is more or less limited to the amount required to satisfy medical needs, the production figures can be taken roughly to indicate legal consumption level. However, the apparent decline in the consumption of opium, morphine, heroin, and cocaine must not be taken to mean an actual decrease in use; to these figures should be added illicit or unsupervised consumption. For opium, illicit production is estimated to be around 1,200 tons a year (INCB, 1%9). During the earlier period (1909-34) non-medical consumption accounted for a large part of the opium produced, while morphine manufacture absorbed a considerably smaller quantity. The picture for the later years has altered, and the quantity of opium smoked or eaten out of the total amount produced licitly is negligible. Most licit opium is consumed in the form of codeine. The alcohol statistics may not be entirely reliable either, and the comparability of the figures for distilled spirits, especially between the first and second points in time, is open to question. However, subject to this qualification, it is noteworthy that production of beer and distilled spirits decreased between 1909 and 1934. The effects of control attempts, the First World War, and the scarcity of raw materials may have contributed to this decrease. The increase of production between 1959 and 1970 appears to have affected the world pattern of drinking (Sulkunen, 1973).

Table 1.3 illustrates the geographical distribution of drug producers. Opium, coca leaves, and cannabis are produced predominantly in the economically poorer, or less-developed, countries while manufactured drugs are products of indus-trialized societies. This pattern reflects production economies generally, regardless of drug, in which primary products form the bulk of the exports by poor countries to rich countries. The division is less apparent in the figures for alcohol production, but on the whole the industrialized countries predominate.

This' pattern has implications also for the relation between production and consumption. In 1909 the leading producers of opium and alcohol were also big consumers. Industrialization and the development of international trade have weakened the link between production and consumption. Nevertheless, it is still manifest in the high level of alcohol consumption in the top two wine-producing countries, France and Italy, and in the large share of the world's consumption of pharmaceutical products by those countries which manufacture the bulk of them (Wortzel, 1971). There are exceptions: Algerian wine production, for example, is unrelated to Algerian consumption, and Turkish opium produc-tion to Turkish use of opium. Thus the distribution among countries of the total world production does not always correspond to the distribution of consumption.

Finally, we offer some general observations which will be elaborated in later chapters.

1. International drug control was initiated in response to a specific problem in a specific area of the world—opium in China. Opium and its alkaloids came to be the main focus of subsequent control efforts.

2. The pattern of international control evolved from measures to check unbridled opium trade and to suppress opium smoking to the regulation of international trade and the limitation of manufacture and production.

3. The introduction of cocaine into the international control scene was due to the delaying tactics of an opium power (Britain); its classification as a drug needing control was based on incom-plete documentation and uncertain evidence. Cannabis control appeared to be extempore.

4. International supervision of alcohol control was confined to Africa between the two world wars. Efforts to expand such control were unsuccessful.

5. WHO's role became more prominent as the number of medically prescribed dependence-producing drugs increased. This allows, in theory, more emphasis to be placed on the treatment of the drug addict rather than on the use of criminal sanctions.

6. Initiatives for more forceful control have mostly come from the U.S. Behind these initiatives were moral pressures, confidence in regulatory codes, economic incentives, and an active diplomacy.

7. The main obstacles to statutory international control have been the vested interests of the opium monopoly countries in the early phases, and of the drug manufacturing countries in sub-sequent periods.

8. The drug control system of the League of Nations was inherited by the UN. WHO's participation in international drug control is based on a statutory responsibility for evaluating drugs for control, and on an interest in the medical aspects of drug use. It has evolved a "combined approach" towards alcohol and other dependence-producing drugs.

9. Structural social changes between 1909 and 1970 were accompanied by:

—the appearance of a large variety of new dependence-producing industrial pharmaceutical products;

—shifting sources of the illegal trade in drugs under international control;

—marked changes in licit production, for example, a decrease in opium and heroin production and, although no general trend was discernible, an increase in the production of distilled spirits and beer in the 1960s.

* For detailed historical accounts the reader is referred to Eisenlohr (1934); Lowes (1966); Musto (1973); Owen (1934); Renborg (1947); Taylor (1969); Terry and Pellens (1928); and Willoughby (1925).

• The committee was composed of China, France, Great Britain, Netherlands, India, Japan, Portugal, and Siam.

* The abbreviation PCB will be used here, although PCOB and PCNB are more commonly used in other works.

* In the terminology of the Vienna Convention, "psychotropic substances" are depressants and stimulants of the central nervous system (tranquilizers, barbiturates, and amphetamines) and also hallucinogens.

* International treaties distinguish between production and manufacture, but here the term "production" is used to mean either or both.

* John Borland, who heads IMS in Britain, is said to be writing a book which contains these data.

* Source: Zacune and Hensman, 1971:57

t Sources: Hordern, 1968: 148; Annual Report of the Department of Health and Social Security for the Year 1971 (London: HMSO).