PART II Opiate Addiction as a Social Problem

CHAPTER13 POSTSCRIPT-1968


Since the publication, twenty years ago, of the preceding analysis and evaluation of the social problem of opiate addiction, the principal changes that have occurred have been that the problem has become much worse and that the inefficiency, injustice, and cruelty of the control system have increased and become more obvious, A rough indication of the magnitude of the increase is that in 1966 the Federal Bureau of Investigation in the Uniform Crime Reports lists a total of more than 6o,ooo drug arrests in comparison with a 1947 total of about 3,400, with an arrest rate in 1.966 between five and six times that of 1947. Prompted by the Federal Bureau of Narcotics, the national legislature and state legislatures have sought to remedy the patent inefficiency of the system mainly by increasing the rigidity and cruelty of the anti narcotics laws. The principles of justice and fair play, it was felt, had to be sacrificed for the sake of deterrence. The sacrifice was futile. The new legislation seems to have been based on the assumption that if a given measure of injustice does not produce the desired social effects the obvious remedy is to have more injustice.

As the narcotics laws have become increasingly punitive, professional and public opinion has largely swung over to an ostensibly medical orientation toward the addict. This attitude has manifested itself primarily in expressions of opinion and in the invention of new semantic devices to make old practices seem more palatable; it has not been expressed, at this writing, in any legislation which substantially changes or improves the addict's status with respect to the criminal law. Programs of compulsory civil commitment represent ways of punishing addicts under the guise of treatment; what is new in these programs is the vocabulary rather than the practices. However, it seems probable that the thrust of the ideas in the new words is gradually filtering into the legislative halls and that it will ultimately lead to substantive and basic changes in legal definitions.

The most pronounced and perhaps the most significant change in the narcotics situation during the last three decades may well have been in the area of public opinion. During and immediately before World War II, addiction seems to have been at a low ebb, and the government's policy was challenged only now and then by a few "rear-guard snipers." There were so few of these that the Federal Bureau of Narcotics was able, even with its limited manpower, to exercise a kind of individual surveillance over them. The bureau's line and its manufactured statistics were in the main accepted without question even for some time after the war as narcotics arrest rates rose precipitously year after year. In an effective buck-passing job, the blame for the spread of the habit was first placed on the shoulders of judges, but, as the situation continued to deteriorate, the bureau, its policies, and the punitive system itself were increasingly questioned. Currently, the agencies and officials that constitute "The Establishment" supporting the status quo are generally on the defensive almost everywhere except in a few groups of the far right and in the legislatures. In the latter, the police continue to be viewed as the final authorities on most aspects of the narcotics problem, and it is often argue(] that all that is required to solve the problem is to increase their freedom of action. The same solution is proposed for virtually all other problems of sin, vice, and crime.

Another indication of the changed climate of opinion is the widespread knowledge in the United States today that most European countries handle addiction as a medical rather than a police problem and that all of them combined probably have a smaller problem than that of New York City alone. Discussion and debate in this area tends to focus on British practices. The American citizen probably has a better understanding of British practices than of American ones. This is because the former are relatively Simple and consistent and are reported in a fairly honest and straightforward way with a minimum of the statistical fakery that is traditional in the United States.

During recent years, as has been pointed out by both American and British "establishment" spokesmen, there has been a marked increase in opiate addiction in Britain as well as in other European countries. This has given aid and comfort to the opponents of reform, who argue that it demonstrates that the magnitude of the problem is essentially unrelated to the nature of the control system. Inconsistently, it is then contended that before any changes are made in the American system there should be extensive research and experimentation to determine what the effects of the changes will be. Those who interpret British experience in this manner usually fail to mention that the increased prevalence of addiction in that country, which they take as evidence of the failure of the system, involved an increase in the official totals of addicts from about 350 to something over 900. They also neglect to mention that the contributions that British and other European addicts make to the crime problems in their countries continue to be negligible.

In general the current American situation may be described as one in which agencies and officials with vested interests in the status quo seem to be fighting a delaying action against an overwhelming tide of change. These agencies and officials increasingly feel compelled to adopt the treatment vocabulary and to give lip service at least to the non punitive ideals. The growing discrepancy between the professed ideals and the actual practices is becoming more and more noticeable to more and more people. Ultimately this will probably mean that legislators and public officials will have to bring what they do about addicts into a better alignment with what they say about them.