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Evidence to the House of Commons Home Affairs Committee Regarding the Use of Illicit Drugs

By Terence DuQuesne


Libertarian Alliance Pamphlet No. 5
ISBN 0 948317 07 8
An occasional publication of the Libertarian Alliance

Terence DuQuesne was born in Cambridge in 1942. Despite scholarships to Dulwich and Oxford, he was educated. His important study of sexological source materials, Catalogi Librorum Eroticorum, appeared in 1964.

His specialities include clinical pharmacology, on which he has contributed numerous articles and reviews for such learned journals as The Lancet, Psychiatry in Practice, and Primary Health Care.

DuQuesne's Handbook of Psychoactive Medicines (Quartet: London, 1982) has been widely acclaimed for its scholarship and lucidity. He is, inter alia, an orientalist, classical scholar, and translator, with a volume of poetry to his credit.

Terence DuQuesne has, with Edward Goodman, edited an annotated anthology on the restrictions of individual freedoms in contemporary Britain. Entitled 'Britain: An Unfree Country', this is to be published soon by Heterodox Books (and will be available from The Alternative Bookshop, 3 Langley Court, Covent Garden, London WC2, at 9.95UKP)

The author wishes to acknowledge the consistent encouragement of Edward A.C. Goodman, solicitor. Sincere thanks are due to Chris Tame and his colleagues for their enthusiasm and logistical support, and especially to Marilyn Daljord for her industrious intelligence. The usual disclaimers apply.

The views expressed in this publication are those of its author, and not necessarily those of the Libertarian Alliance, its Committee, Advisory Council or subscribers.

25 Chapter Chambers, Esterbrooke Street, London SW1P 4NN. Director: Chris R. Tame * Editorial Director: Brian Micklethwait For Life, Liberty and Property

CONTENTS

PREFACE by Chris R. Tame
I. INTRODUCTION
II. THE DRUGS: HEROIN
III. THE DRUGS: COCAINE
IV. THE LAW: HISTORICAL BACKGROUND
V. CURRENT LAW AND PRACTICE
VI. CONCLUSIONS AND PROPOSALS
REFERENCES
APPENDIX I - Detailed Recommendations
APPENDIX II - Major Acts and Statutory Instruments Relating To Controlled Drugs
RECOMMENDED FURTHER READING by Chris R. Tame

PREFACE
By Chris R. Tame

The libertarian position in favour of the decriminalization of all voluntary drug consumption is frequently misunderstood. It has been characterized as a position lacking any reasoned basis or as morally flippant. It has also, wholly wihout justification, been described as the result of unthinking adherence to abstract dogma.

The libertarian is in favour of the liberty of the individual. This means that the law should be kept to an absolute minimum. It does not mean that libertarians are in favour of, or advocate, drug use. They merely hold the view that this is something in which the state should not interfere. (It might be compared in this regard to most peoples' views on adultery. They may not personally approve of such behaviour but hardly wish the state to police marital fidelity or punish adulterers.)

The accusation of moral carelessness or frivolity is especially galling in light of the fact that Dr. Robert Lefever, who is a Libertarian Alliance Advisory Council member, devotes a considerable amount of his time to the treatment of addicts. He is also currently trying to establish a private centre for such treatment.

The Foundations of the Libertarian Position

The libertarian position on drugs rests on two related foundations. The first is the Lockean classical liberal view that all men and women possess a property right in their own persons, that they are "masters of [themselves], and proprietors of [their] own person, and the actions or labour of it"[2]. They can, therefore, use their bodies in whatever manner they see fit, other than to deprive others of that right. This does not mean that libertarians necessarily approve morally or view as wise any particular type of behaviour. The fact that libertarians believe Marxists, fascists and racists have the right to free speech does not make them in favour of those ideologies. Similarly, the belief that individuals have the right to ingest drugs, alcohol, or tobacco does not mean that libertarians favour any of these activities. The case for freedom is indivisible. Either adults have the right to run their own lives free from coercion or they do not.

The Perversity of Government

The libertarian case for the decriminalization of mood-altering drugs does not, however, depend only upon abstract philosophical argument. The fact is that the prohibition of drugs, like the attempted suppression of alcohol by the Volstead Act in America in the 1920s, simply does not work. It is ironic that much of the spurious outrage about drugs (and criticism of the position of the Libertarian Alliance) has emanated from Conservative circles. T. E. Utley recently wrote that one important conservative principle is the view that "whatever government does ... will almost always produce consequences other than the government intends". [3]

The prohibition of drugs is a classic case of counter-productivity, with consequences, such as Libertarian Alliance writer Nick Elliott describes as The Perversity of Government in his leaflet of that title[4]. He explains how criminalization and the resultant black market increase the number of addicts, render drug taking more dangerous and encourage crime. He concludes: "The common attitude to drugs is yet another example of the misguided paternalism that prevails in Britain. Once again, the consequences of state regulation are far worse than if voluntary trading was allowed".[5]

Proposed Legislation

The House of Commons Home Affairs Committee has recently produced its Interim Report on the Misuse of Hard Drugs. It recommends repressive new legislation containing a reversal of the burden of proof. The presumption that someone is innocent until proved guilty is one of the basic safeguards of English law and is contained in the UN Declaration of Human Rights and in the European Convention on Human Rights.

The Libertarian Alliance is therefore particularly pleased to be publishing the following critical evidence presented to that Committee by Terence DuQuesne. Mr. DuQuesne, who is a research pharmacologist, combines a principled commitment to civil liberties and the rule of law with a thorough and scholarly knowledge of the whole subject of drugs. This knowledge is urgently required.

The current deluge of media attention to drug abuse is largely characterized by profound ignorance. This adds to the atmosphere of social panic and facilitates increased state repression. It is tragically ironic that, as Mr. DuQuesne demonstrates, some of the most harmful consequences of drugs are those caused by legislative restriction.

The Libertarian Alliance is thus proud to publish his lucidly written and well-documented analysis which should initiate a more rational and informed discussion of the topic. The text as printed herein has been presented (in July 1985) in evidence to the House of Commons Home Affairs Select Conunittee referred to above. Some of its members have promised to consider carefully Mr. DuQuesne's recommendations. We hope they will.

Chris R. Tame, Secretary
The Libertarian Alliance

[1] For an account of Dr. Lefever's views see Simon Heffer, "Should A Fix Be As Legal As A Pint?", Medical News, November 1, 1984.

[2] John Locke, Of Civil Govemment, J.M. Dent, London, 1924, p. 138. And see Murray N. Rothbard, The Ethics of Liberty, Humanities Press, Atlantic Highlands, New Jersey, 1982, for an extended development of the Lockean approach.

[3] T. E. Utley, "Commentary", The Daily Telegraph, 8 July, 1985.

[4] Nick Elliott, The Perversity of Government, Economic Notes No. 1, Libertarian Alliance, London, 1985.

[5] Ibid., p.2.

ILLICIT DRUGS:
MYTH AND REALITY
By Terence DuQuesne

We leave physical force to those who use it as their best argument, satisfied that it never yet ultimately prevailed, and never will ... We hate the man who coerces, be he in patrician robes or a greasy black coat; we detest force. Law and order! the old plea. The sins of law are as many as the stones on the sea beach, but the future shall sweep them away as the past has done the thumbscrews and the rack -- both servants of the law and of the devil -- and order.
George Ives (1897) [1]

From the ethical point of view, how should we regard the absolutely ubiquitous use of intoxicants? As a blessing for humankind, to be accepted? Or as a curse to be combatted? I believe unequivocally that the former is the correct view. As we have seen, and as both the traditions of misty antiquity and more recent history have demonstrated, nature has pointed the way to man's use of narcotics. Contemporary evidence from everywhere provides confirmation that these drugs rank among those substances which most greatly benefit humanity. They are virtually indispensable and, though one is reluctant to say so, even necessary.
--Ernst von Bibra (1855) [2]

[We believe in] a Britain strong in support of personal freedom
--Margaret Thatcher (1983) [3]

I: INTRODUCTION

On the subject of increased international efforts to curb the supply and production of illicit drugs, one eminent author has written: "The police are everywhere active; but the illicit traffic still goes on. No amount of vigilance can check the smuggling of substances so highly concentrated, so portable and concealable, as morphia and cocaine ... All that has been done up to date is only 'a first step towards the limitation of the production of the raw material.' The sources of supply must be closed down." [4]

The above quotation is taken from an article by Aldous Huxley published in 1933, following a report by the League of Nations. More than fifty years later, the same alarums are being sounded, the same warnings given, the same actions proposed. A committee of the House of Commons has lately concluded a fact-finding visit to the USA. Its proposals have appeared, in June 1985, in the form of an interim report, which may be the basis for important changes in the law on dangerous drugs. [5]

In this essay the present writer, who has spent twenty years studying mood- modifying substances, seeks to provide informed comment on the Commons report and to help establish the facts. The social use of psychotropic drugs is a highly charged subject. It is also a field in which numerous myths and misconceptions are rife, among laypeople and in the medical profession. Neither press accounts, couched as they are in lurid and sensationalistic terms, nor the reports of "expert" groups, which are often tendentious and muddled, offer much help. Opinions tend to be polarized, as it were, between those who reflexively call for more controls and harsher punishment and those who call for medical and social solutions to the perceived problem of unlawful drug-taking. The parliamentarians, in their Report, have not merely added to the general confusion; they are set to amend British law in ways which undermine individual freedoms to an unprecedented extent. To shift the onus of proof from prosecutor to defendant, as is intended, would be to alter a fundamental principle of justice. Before one examines whether such steps can be justified, and what they are likely to achieve, it is necessary to clarify the nature and properties of the substances concerned. Only if legislators and others understand these matters, together with equally consequential factors such as set and setting, can rational and proper decisions be taken. Unfortunately, the history of British and American legislation and policy on psychotropic drugs has been bedevilled by ignorance and anomaly. More than one scholar has reminded us that the makers of public policy are not Platonic philosopher-kings, and that such laws "have been developed largely through myth, fantasy, and historical accident, interwoven with occasional rationality." [6]

Some instances of legal caprice are given later in this document.

Over the past two decades, rigorous research has been conducted, and valuable information collected, which bear on the issues under discussion. Significant findings have emerged, and attention to them is drawn here. Unfortunately these may be forgotten or lost amid the welter of rhetoric. Indeed, we have an opportunity for framing intelligent, humane, well- informed policies and legislation on drugs, which it would be foolish to miss. It is also high time that some of us searched our own consciences and held up our real motives to the light of day. If law is widely regarded as being hypocritical or just ignorant, it is likely to be honoured more in the breach, as has already occurred, and will not command respect.

II: THE DRUGS: HEROIN

The House of Commons report (hereinafter called "the Report") has focussed attention on three principal substances -- heroin, cocaine, and cannabis - which are very different from each other and whose only common factor is their illegality. According to the Report, heroin "has reduced large parts of America's inner cities to zones of indescribable despair, terror, and squalor" (para. 1). This is clearly a reference to the well-known squads of glazed-eyed dope-fiends who, apparently, commit every kind of crime and indulge in every nameless vice. The Report does not mention poverty, unemployment, overcrowding, or any of the real causes of inner-city decline, whether in New York or Glasgow. No: Western civilization is going down the tubes because of drugs.

So what is this heroin that can accomplish such devastation? Heroin (diamorphine) is a slightly modified form of morphine, the principal alkaloid of the opium poppy, Papaver somniferum. Morphine and heroin, together with several synthetic analogues, are prescribed to alleviate severe pain and to relieve intractable cough. [7]

Heroin is rapidly converted to morphine in the human body, and the effects of both substances are very similar. Heroin is slightly more potent on a weight basis and is thought by some to be marginally more addictive, though the evidence for this is unconvincing. [8]

Despite this, heroin may not lawfully be prescribed in the USA, except under the terms of a special licence from the Drug Enforcement Administration. Such permissions are very rarely granted, and heroin is scheduled among "hallucinogens" and other drugs not regarded as having legitimate medical indications. [9]

Morphine is, of course, widely used medically in the USA and in every other country.

Opium derivatives are regarded clinically as being very safe and of low toxicity. [10]

Experience of prescribing heroin and morphine to cancer sufferers has clearly shown that patients are often able to stay free of pain, on stable doses, for months or even years. Psychological and physical dependency are in this context rarely encountered. Discontinuation of drug (e.g. when patients recover) very seldom provokes the onset of withdrawal symptoms. [11]

Certain differences obtain when heroin is taken non-medically but it does not undergo any mystical transubstantiation. At the International Conference on Morphine Therapy held in 1983, one consultant observed: "Whilst no one would deny the potential for addiction inherent in all narcotics, the enormous consumption of benzodiazepine [tranquillizers], alcohol, and other psychoactive drugs suggests that our own attitudes to narcotics may be conditioned more by fears of criminal activity than by medical factors." The same specialist notes that "the price of illicit heroin in Manchester is now so low that a substantial habit can be supported by unemployment benefit." [12]

Physical problems associated with heroin are a function of the situation in which it is taken. The majority of those who try the drug, whether in the medical or the social setting, do not enjoy the experience, particularly the severe nausea which commonly occurs. Those who do enjoy the sensation are likely to repeat the experience only occasionally (e.g. at weekends) rather than compulsively. Professor Norman Zinberg of Harvard University, a pioneer researcher in the field, has recently established that the number of occasional heroin users in the USA is far larger than that of compulsive, or addicted, users. [13]

In a classic study of patients who had morphine and other opiates prescribed for them on a long-term basis, for relief of chronic pain, only 7 per cent were reported as having become addicted. [14]

It is worthwhile to consider briefly what is meant by the term "addiction," which is not necessarily the same as habituation or dependency. The World Health Organization has laid down criteria to distinguish between psychological and physical dependence, though both may co-exist. Physical addiction has two main characteristics: the development of tolerance (the need for an increased dose over time to achieve the same effect) and the onset of clear withdrawal symptoms when drug-taking is suddenly stopped. [15]

It will be obvious that alcohol is a drug of addiction in this sense: indeed, its withdrawal symptoms are often more serious, and certainly more likely to threaten life, than those associated with heroin. [16]

The other substances cited in the Report --cocaine and cannabis -- do not meet both criteria, and cannabis usually meets neither (see below).

So how does heroin, a safe and indispensable medicament, become a destructive scourge if not taken under medical supervision? Clearly, it does not. Yet such is the power of myth that, according to a study which accords with empirical observation, in a series of patients with terminal cancer more than half have been denied adequate relief of pain, i.e. administration of morphine. [17]

All this because of irrational prejudice on the part of physicians who, if anyone, certainly should know better. Even in an illicit setting, according to Dr. Gerry Stimson who has spent 25 years researching heroin, "there is little evidence that pure opiates themselves cause any direct physical damage when administered over long periods." [18]

Another specialist says that "an overdose due to [morphine and similar] narcotics in a medical setting should theoretically never occur." [19]

How then may we explain the apparent lethality of heroin? Fatal overdosages occur not because of the nature of the drug, but because of the circumstances of illicit use. Prescribed heroin is available, obviously, in pure forms (such as sterile ampoules) with an assured potency. But, on the black market, the substance is bought as powder: this tends to be unsterile and may be adulterated with other materials which bulk it out (e.g. lactose). There is no way, short of trying it, whereby a user can determine its level of purity, and this fluctuates markedly. Smoking is a moderately effective means of taking the substance, but intravenous injection provides a quicker onset of action. Heroin may be sterilized by heating but this is difficult. Pharmacists are discouraged from selling sterile disposable syringes and needles except to diabetics. It is hardly surprising, therefore, that some individuals re-use or even share injection equipment. So there is a hazard of infection with bacterial endocarditis or, more commonly, hepatitis. Despite the known effectiveness of a newly-developed, but expensive, vaccine against hepatitis B, screening for the condition and subsequent vaccinations of this at-risk group are "not planned" in Britain. [20]

On the physical shape of opiate-takers, a seven-year follow-up study comparing current users with former addicts failed to distinguish any significant differences in the general health of the two groups. [21] "it must be emphasized," writes Dr. Stimson, "that with a stable regular supply of the drug, with sterile injection techniques, and care of food and health, there appears to be no reason why an addict to opiates should not live out a normal life span." [22]

In 1968 the right of physicians to prescribe heroin and cocaine was drastically curtailed, under regulations which were consolidated five years later. [23] At this time, following overprescription by a handful of practitioners, treatment clinics were hastily set up. These were -- and are -- staffed by specially-licensed psychiatrists and were attached to local hospitals, chiefly in London. [24]

Increasingly, the prescription of heroin at these units declined. Patients were instead offered supply, daily from a designated pharmacy, of a substitute, the synthetic opiate methadone. The great majority of notified addicts now receive methadone, usually as an oral mixture, rather than heroin. [25]

Methadone has been given for many years to relieve severe pain and to control intractable cough. It is longer-acting than heroin. The idea of administering methadone to opiate habitues was that, if single oral doses were given each day, these would negate the effects of other drugs -- e.g. heroin -- taken subsequently. It was also believed by the scheme's American proponents that "methadone maintenance" helped previously unstable people to resume a more ordered existence, if only because they would not need to hustle to obtain heroin. However, methadone is at least as addicting, more toxic, and provokes longer-lasting, serious withdrawal effects. [26] In theory users of oral methadone should be healthier and less prone to criminal activity than heroinists. For at least a decade, a number of specialists on both sides of the Atlantic have been losing confidence in the use of methadone. [27]

Patients receiving methadone by mouth have been shown to be significantly more neurotic than those given injectable heroin. [28] The former are also much more likely than heroin users to resort to crime and to discontinue treatment. [29]

In fact, for about seven years, methadone has been available on the British black market: attenders at the drug clinics have been selling their methadone in order to buy heroin illegally. One consequence of this is the emergence of methadone as a drug of primary addiction.

III: THE DRUGS: COCAINE

"Persuading young people and their parents of the appalling consequences of drug abuse" (Report, para. 10) is likely to be difficult so long as the Commons committee deals in misconceptions and myths -- unless they refer to the already draconian penalties of the law, which they propose to make still harsher.

Cocaine is derived from the South American shrub Erythroxylon coca. For many years it was prescribed as a local anaesthetic and "tonic". It is a powerful stimulant of the central nervous system. Cocaine is still given for surface anaesthesia (e.g. as eye-drops). [30] Part of the reason for its linkage in the public mind with heroin -- despite their fundamental differences -- lies in the fact that cocaine is an ingredient of the "Brompton cocktail". This is a mixture based on morphine or heroin, which is given medically to patients with severe pain, commonly cancer sufferers. For a brief period in the 1960s, cocaine and heroin were prescribed concurrently for heroin habitues. Simultaneous injection of both drugs enhances opiate- induced euphoria. Cocaine has been thought to augment the drug's analgesic potency and to offset the drowsiness caused by morphine-type drugs. [31]

The Report asks us to believe that, in the USA, "each day there are 5,000 new addicts" to cocaine (para. 1). Leaving aside for a moment the numerical estimate, one must inform the Committee that cocaine causes "no physical dependence and therefore no characteristic withdrawal syndrome." (The above quotation comes from the pharmacologist's bible, Martindale's Extra Pharmacopoeia.) [32] So cocaine does not satisfy the major criterion for addiction as set forth above. Whether it is smoked or sniffed, or injected, it offers a rapid, energetic sensation of wellbeing of short duration (thirty minutes and often much less). There is a tendency among some users to repeat the dose, if the drug is available, and psychological craving -- as distinct from physical addiction -- may be intense. [33]

Opinions differ on whether recreational taking of cocaine is harmful. Lethal overdosage is very rare, though convulsions and coma may follow ingestion of huge doses. In certain individuals, prolonged use of large dosages causes a florid paranoid psychosis similar to that found among amphetamine takers. On the other hand, prospective studies conducted in the USA have shown up no major side-effects among recreational users, with the practice "well-integrated into the social rituals of a way of life." [34] No such research has been done in the UK.

For many centuries, the leaves of the coca plant have been taken -- usually by chewing -- by the people of central South America. Archaeological and literary evidence indicates that, in the Inca culture, coca was taken for purposes of divination. Such use was confined to royalty and shamans. Ordinary people did not partake. Only when the Spaniards conquered the continent was coca usage disseminated. From the sixteenth century, the Spanish put millions of local inhabitants to work in the gold mines under conditions of slavery: cocaine lessens fatigue and diminishes appetite, so these workers were "paid" with coca leaves. The conquistadors thus exacted the maximum work for the lowest cost, and in so doing created widespread habituation among the Indian population.[35]

Westerners caused similar problems for indigenous peoples during the Chinese Opium Wars. More recently it has been reported that in the kingdom of Nepal, where opium-smoking has been an established part of society for centuries, there are now some 12,000 heroin addicts. [36] Europeans have sown the wind: now they are reaping the whirlwind.

The Report urges "destruction of the crops from which drugs are produced as one essential part of the elimination of sources of supply" and proposes that the British government "should assist crop substitution and eradication programmes" (para. 8). Paraquat has been sprayed by the authorities on some Mexican cannabis fields: as a result, a number of fatalities have occurred in the USA among persons who had smoked marijuana -- not because of the drug, but because of its contamination with this highly dangerous herbicide. In the case of areas where the opium poppy is cultivated, it is improbable that such action would be taken even if the countries concerned were less inaccessible. We should remember that the CIA helps to maintain the fiercely anti-communist warlords, such as Kun Sa, who rule the Burma/Laos/Thailand Golden Triangle where their respective governments' writ does not run. The principal occupation of hill- farmers of this region is the cultivation of opium. Because Pakistan is considered to be of strategic importance to the USA, little is being or will be done to stop the refining of heroin there: Pakistan is now the major source of the drug in Britain. Crop substitution programmes, e.g. the persuasion of Thai farmers to grow strawberries instead of poppies, are beset by internecine conflicts between the various national and international agencies. One has the impression that they are cosmetic: an exercise in public relations.

IV: THE LAW: HISTORICAL BACKGROUND

"All those whom we consulted in the USA made no attempt to conceal their anxieties about the future of drug abuse. Some of our best informed witnesses suggested that the problem was almost out of control" (Report para.4). Apart from its tendentious moralism, the report would have us believe that use of "dangerous" drugs is a new phenomemon.

Plus ca change, plus c'est la meme chose. The most significant change, over the past century, has been one of social attitudes. As others have pointed out, in Victorian times fictional heroes as well as distinguished real people could take morphine or cocaine without being socially stigmatized. Comparisons are difficult, but consumption of both substances was very widespread by the turn of the present century. Morphine and cocaine formed the basis for a vast number of patent medicines, freely available to the public, which had supposed tonic or restorative properties. [37] The soft drink Coca-Cola, as the name suggests, originally contained cocaine, and coca leaves still form part of its secret formula. It is estimated that by 1900 between 2 and 4 per cent of the US population were regularly taking either morphine or cocaine. [38]

The first evidence of a cocaine "problem" in Britain long antedates the enactment of laws on dangerous drugs. In 1916 accounts appeared of soldiers and prostitutes dealing the drug. (The former were prohibited from supplying this under the Defence of the Realm Regulations.) That May the Metropolitan Police Commissioner urged restrictions on such activity by civilians, stating that traffic in cocaine was "rapidly assuming huge dimensions." [39]

The first comprehensive international treaty on drugs to which the USA was a party was the United Nations Single Covention on Narcotic Drugs of 1961. Over the preceding half-century, laws restricting possession and supply of opiates, cocaine, and cannabis were enacted in the UK, the USA and other Western countries. In Britain, between 1963 and 1971, four separate Acts of Parliament were passed and several additional regulations promulgated. It was in the early 1960s that cannabis began to be widely smoked. A quite unconnected phenomenon, except from the point of view of legal control, was the increase in the number of persons notified to the Home Office as being addicted to heroin and (despite its non- addictiveness) to cocaine. Until 1973 such notification, in respect of patients receiving certain drugs from physicians, was voluntary. The statistics thus gathered have always been an under-estimate. In 1960 the number of "registered" addicts was 437; by 1968 this had increased to 2,782 and at present totals about 5,000. [40] The perceived overprescribing of about a dozen doctors accounted entirely for the increase recorded in the 196Os: a "grey" market emerged, chiefly because addicts needed to sell a portion of their drugs to pay prescribers' fees. The total numbers of those involved were, in absolute terms, very small, although lurid press reports suggested otherwise.

It is important to note that, prior to 1970, there was practically no illegal importation of heroin, morphine and cocaine to the UK. In 1966, according to the Home Office, "illicit traffic ... is largely confined to small scale peddling in quantities of heroin that have been overprescribed by medical practitioners." The quantities of heroin and cocaine confiscated were so small as not to be recorded. [41] The following year, seizures of heroin amounted only to 1.14 kg and of cocaine to 0.26 kg, most or all of which were attributable to thefts from pharmacies. [42]

It can scarcely be coincidental that significant importing of heroin and cocaine began immediately following substantive changes in British law. In 1968, in response to recommendation from the Brain Committee [43], regulations were enacted whereby only specially-designated psychiatrists were permitted to prescribe heroin or cocaine for addicts. However, any registered practitioner may prescribe morphine, pethidine, and other opiates to addicts as to anyone else. The licensing restriction now covers the synthetic narcotic dipipanone. As has been reported above, a number of hospital-based Drug Dependency Units were set up. The restriction on other practitioners' right to to prescribe would, it was felt, contain the situation. From their inception, the new treatment centres prescribed drugs far less freely than the old "junkie doctors." It was believed that the "experts" in charge of the clinics, who, like Athena, were born fully-armed from the head of Zeus, would evolve rational treatment policies. [44] The principal treatment still offered is prescription of the substitute drug methadone in place of heroin (see above, p.8) Facilities for inpatient therapy, detoxification, and (where appropriate) rehabilitation at these units are wholly inadequate and in any case geared almost exclusively to opiate use. [45] The DDUs are chronically underfunded, staff turnover is high, and prospective patients must usually wait weeks for a first appointment. [46] As the DHSS Advisory Council has pointed out, facilities should be -- but are not -- available for "problem drug users" who may take a whole range of substances, such as barbiturates and amphetamines, as well as opiates or cocaine.[47]

From the time of their establishment, cocaine was not prescribed at the DDUs: the specialists had, perhaps, finally realized what users had long known, namely that cocaine may be bad, but it does not cause physical dependence. Seizures of illegally imported cocaine have risen from 6.4 kg in 1973 to 95.7 kg in 1983. The corresponding figures for heroin are 3.3 kg and 247.1 kg. [48] It is assumed that these statistics represent considerably smaller quantities than those which do find their way on to the black market. For several successive years, because the supply of heroin and cocaine has been so plentiful, black-market prices have continued to fall.

V: CURRENT LAW AND PRACTICE

"There should," according to the Report, "be intensified law enforcement against drug trafficking by HM Customs, the police, the security services, and possibly the armed forces" (para. 13[1]). This may refer to suspicions that a proportion of the drugs seized is already re-cycled by law enforcement agencies, or perhaps the Committee's syntax is as rational as its thinking. People may be excused for wondering whether current British law on drugs is too lax.

What cannot be contested is that the Misuse of Drugs Act 1971 (MDA), and the various Statutory Instruments amending this, contain many anomalies. [49] So far as drug offences are concerned, penalties under the MDA are already very severe. The maximum punishment, on conviction on indictment, for possession or supply of Class A drugs (including heroin and cocaine) is 14 years' imprisonment and/or an unspecified fine. The Police and Criminal Evidence Act 1984 even empowers police officers to conduct intimate body searches for Class A drugs. [50] Under the proposed terms of the Controlled Drugs (Penalties) Bill 1985 the maximum for such offenses would be life imprisonment. [51] And what will happen next year, when even this fails to act as a deterrent? Perhaps it will be proposed that offenders be hanged, drawn and quartered publicly. (Traffic in opium is a capital crime in Burma, where there are estimated to be some 2 million users.)

The imposition of harsher penalties would no doubt help to quench the spurious moral indignation of MPs. But that does not make them right. And the legislators have failed to think through the practical consequences even if further controls actually work. On 1 July 1985, the National Association for the Care and Resettlement of Offenders warned that Britain's prisons, in which 47,000 people are held in conditions which make mock of humanity, are so desperately overcrowded that further eruptions of violence in them can be expected. Some 40 per cent of their inmates have been incarcerated for non-violent crimes. Will the government build more gaols to house the hundreds of thousands who take substances of which it disapproves?

The Commons Committee is "wholly against any legalisation of marijuana or any reduction in efforts to combat its use" (para. 12). Its members "met no-one [in the USA] with any experience in drug abuse who would contemplate the de-criminalisation of cannabis." Evidently they did not look very hard. Perhaps they are unaware of the prestigious Washington- based Alliance for Cannabis Therapeutics, or of other distinguished medical specialists and organizations who believe such a step should be taken. We are treated to the weary fallacy of a "progression in addiction from marijuana to hard drugs" which has been so often, and so effectively, confuted that it should not be necessary to do so yet again. [52]

Cannabis (marijuana) is used socially by very large numbers of people in Britain, as in other Western countries. It has complex effects which are not wholly understood. Physical dependency on it, if this exists at all, must be very rare. [53] Many, even within the medical profession, are unaware that cannabis has several potentially important medical applications: for instance, it lowers intra-ocular pressure and hence may relieve the symptoms of glaucoma, and cannabinoids have potent anti-emetic activity. The latter is of consequence in minimizing the nauseating side-effects of anti-cancer drugs. [54] Yet cannabis is not available for prescription. It may be given lawfully only under a special licence issued by the Home Secretary: such permissions are rarely granted for clinical studies, despite repeated calls, and a real need, for further research in this area. Meanwhile, social consumption of cannabis is probably ineradicable. Its possession has been effectively decriminalized in several states of the USA, and in Mexico. The overwhelming majority of prosecutions under the Misuse of Drugs Act concern possession of quantities of small quantities of cannabis: in 1983, this accounted for about 24,000 of the total 26,000 drug offences. [55] The union of senior Customs officers has expressed its desperation about the successful interdiction of drugs. They have pointed out that their numbers have been increased only marginally, and that this increase has been more than offset by the number of those assigned to check VAT. The Customs officers have now recommended that persons attempting to import small quantities of cannabis should not be prosecuted. [56] According to the Customs Commissioners, 3,356 seizures were of cannabis of a total of 3,841 for all drugs during 1983-84. 112 cases involving importation of cannabis were compounded under Section 152 of the Customs and Excise Management Act 1979. [57] Such findings agree with those of the Drug Indicators Project: Britain is glutted with illegal drugs, which are therefore becoming cheaper. [58] Police officers complain that, because they are -- they claim -- undermanned, they confiscate drugs representing only "the tip of the iceberg." [59]

In the USA, census data from 1979 show that of a total of 23 million, 8.6 million young people drank alcohol, 4 million took cannabis, 2.8 million smoked tobacco, and 330,000 used cocaine at least monthly. [60] According to longitudinal studies from New York State, 99 per cent of the cohort had used alcohol, 79 per cent cigarettes, 72 per cent cannabis, and 30 per cent had tried cocaine. [61] These figures do not take account of prescription drugs.

The Report says "We found it frightening to be told that [US government agencies] aimed to do no more than 'hold the line,' i.e. prevent an increase in drug traffic" (para. 4). To this end "the Americans are now making a vast effort in terms of manpower and money co-ordinated at the request of President Reagan which involves every law enforcement agency and the armed forces." By the same reasoning, if the richest country on earth has to accept the current incidence of social drug use, just as a practical matter, what can Britain do except throw more rhetoric and money at the "problem"?

VI: CONCLUSIONS AND PROPOSALS

It will be obvious from the above account that much of what is commonly believed, by parliamentarians, by lay people, and by medical professionals, about social drug use is patently wrong. We certainly cannot attempt to rectify the situation, if indeed that is appropriate, without reliable information. Neither should we be influenced by the latest wave of hysteria stirred up by the media. Above all, we must try to free ourselves of prejudice.

Despite the stigma attached to the taking of "hard" drugs, a relatively high proportion of those who use heroin regularly stay healthy, keep employment, and are socially integrated. This was established more than a decade ago [62] and has been confirmed recently. [63] Of course, people whose lifestyles are already chaotic will not have such difficulties helped by the taking of powerful drugs. And then there are those who consume heroin or cocaine, or other substances, recreationally and intermittently. [64]

Far more work is required on the substances used, and the set and setting in which this usage occurs. When expert committees meet, "more research" is always a recommendation. In seeking to determine whether cannabis was really harmful, the British Advisory Council could not state unequivocally that damaging effects occurred as a result of cannabis use. Further studies were called for. [65] Yet it is practically impossible for reputable clinicians to obtain the required Home Office licences in respect of cannabis and other drugs, even when the subjects of proposed experiments are already seriously ill and could benefit directly from such treatment. [66] In the USA, research on medical and social actions and applications for cocaine, psychedelics and other substances of "abuse" is made almost equally hard to conduct. As a leading pharmacologist has put it: "In this area of research, as in many other areas that have become charged with social and political overtones, there is an unfortunate enthusiasm with some researchers to search only for negative findings, to emphasize hazards out of context in the hope that such statements might dissuade the potential drug user from exploration with these chemicals." [67]

Social drug-taking must be seen in its wider context, also. If legislators are mounting a further campaign against drugs of abuse, they should at least be consistent. I wonder how many members of the Commons Committee drink alcohol or smoke tobacco. The direct consequences of smoking cause 50,000 premature deaths in Britain each year. Three quarters of a million people, at least, are ill as a direct result of drinking liquor. [68] By comparison, heroin and cocaine are benign.

There are several points here. One is that the government, according to the prohibitionist argument, cynically exploits people's need for euphoria by levying heavy taxes or other duties on alcohol and tobacco, both of which are still widely advertised. Lip service is paid to the idea that the consumption of these drugs should be discouraged, but because vast sums are raised for the exchequer it is obviously thought expedient to maintain the status quo.

Then again, a perfectly valid moral argument is adduced. Those who drink alcohol or smoke would be up in arms if any administration sought to ban these substances. We would be told, in no uncertain terms, that this was a matter for personal responsibility, for the exercise of free choice in a democratic society. By what divine right does some arbitrary authority seek to circumscribe such a basic individual liberty?

The answer is that legislators tend to be self-serving and hypocritical. It appears fashionable to be seen to be for motherhood and against sin. If religion is the opium of the people, bigotry is the cocaine of the powerful. Condemning the use of certain drugs today serves a similar purpose to the burning of witches in former ages. Collective guilts are projected on to identifiable minorities, whether these are drug users, gays, or black people. [69]

The fact is, too, that we live in a medicated society. About 10 per cent of British women take diazepam (Valium) regularly, and every tenth night's sleep is induced by a sleeping-pill. Psychological and physical habituation to prescribed tranquillizers presents a vastly greater social "problem" than the so-called abuse of illegal substances. Between 10 and 25 per cent of hospital admissions at casualty departments occur because of severe side- effects from medicines, which are often prescribed ignorantly and irrationally. [70] The biggest drug dealers are the multi-national pharmaceutical companies; their corresponding small-time pushers are our physicians. Yet how often do we see headlines in tabloid newspapers excoriating drug houses for causing, directly or indirectly, iatrogenic dependency?

We should get our thinking straight, and aim for consistency. The drugs whose use we do not like will not go away: the additional sanctions proposed will not even shut the door now that the horse has bolted. A major step would be to follow the example of Spain, in de-criminalizing the possession of controlled drugs. Also, little as one likes the idea of returning responsibility to doctors, who are probably more to blame for the situation than anyone, the right to prescribe heroin, cocaine, and cannabis should be restored. With one qualification: these substances should be available only on the National Health Service. At present, some practitioners in the Harley Street/Devonshire Place "Golden Triangle" amass fortunes by, in effect, selling prescriptions for desired drugs to those who are rich or well-enough connected socially to use their services. Then, after a couple of years' trial, the situation would be re-assessed. If the US government, with all its resources, can do no more than stop the growth in the incidence of drug trafficking, then we too should face up to reality. We do not abolish le diable au corps by trying to suppress it.

In the current climate of hysteria, reasonable and intelligent people who might otherwise contribute to the debate are understandably reluctant to do so. In private, many deplore the opinions and proposals of the Commons Committee. Apart from professional opprobrium, such people may be inhibited because Special Branch may become interested. A former senior policeman, in 1981, explained on television the criteria for "subversion," which included advocating "the acceptance of certain drugs." This was one of the criteria for Special Branch concern in South Australia -- they follow a model which obtains in the UK. [71]

As Aldous Huxley put it in 1933: "Governments advocate prohibition, which is like advocating the surgical excision of the pustules as a cure for smallpox. The only rational way of dealing with the drug and drink problem is, first, to make reality so decent that human beings will not be perpetually desiring to escape from it; and, second, to provide them, wherever they should feel the imperious need of taking a holiday, with a physiologically harmless method of escape.

"The money which is spent in trying, quite vainly, to enforce prohibition ought to be spent on biochemical researches for the purpose of discovering the ideal substitute for alcohol, cocaine, and opium. A century or so too late, the official philanthropic mind may perhaps come to realise this; but for the present it seems to be committed to the absurd and mischievous policy of prohibition."

REFERENCES

1. IVES G, letter of 1897, quoted in SIEVEKIND P (ed.), Man Bites Man: The scrapbook of an Edwardian eccentric, George Ives (Jay Landesman: London, 1981) 5

2. von BIBRA E Freiherr, Die narkotischen Genussmittel und der Mensch (Nurnberg, 1855) 396-397 (translation by T. DuQuesne)

3. THATCHER M, speech to annual Conservative Party Conference, Blackpool, October 1983 (official transcript)

4. HUXLEY A, Poppy and mandragora, Sunday Referee, 19 March 1933

5. House of Commons: Fifth Report from the Home Affairs Committee, session 1984-85: Misuse of Hard Drugs: Interim Report (HMSO: London, 1985) (hereinafter quoted as "Report" followed by paragraph number)

6. SAPER A, The making of policy through myth, fantasy, and historical accident: the making of America's narcotics laws, British Journal of Addiction 69 (1974) 183-193

7. DuQUESNE T, Handbook of Psychoactive Medicines (Quartet: London, 1982) 283-317

8. PARKHOUSE J, PLEUVRY B J & REES J M H, Analgesic Drugs (Blackwell: Oxford, 1979) 46-47

9. Controlled Substances Act 1978 (21 USC 801) Schedule I; Controlled Substances Act Regulations 1978 (reproduced in Code of Federal Regulations vol. 21 [Department of Justice: Washington, D.C., 1 April 1978])

10. STIMMEL B, Pain, Analgesia, and Addiction (Raven Press: New York, 1983) 108-111

11. Narcotic analgesics in terminal cancer, Drug & Therapeutics Bulletin 18 (1980) 69-72

12. CLARKE I M C, The role of narcotics in intractable pain control, in WILKES E & LEVY J (ed.), Advances in Morphine Therapy: the 1983 International Symposium on Pain Control (Royal Society of Medicine: London, 1984) 69-72 (= International Congress & Symposium Series no 64)

13. ZINBERG N E, Drug, Set, and Setting: the basis for controlled intoxicant use (Yale UP: New Haven, 1984) 64-69

14. EVANS P J D, Opiates in the management of chronic pain, in BULLINGHAM R E S (ed.), Opiate Analgesia (WB Saundon: London, 1983) 71-94 (= Clinics in Anaesthesiology no 1)

15. DuQUESNE T, op. cit. 302-303

16. RITSON E B & CHICK J D, Dependence on alcohol and other drugs, in KENDELL R E & ZEALLEY A K (ed.), Companion to Psychiatric Studies, ed. 3 (Churchill Livingstone: Edinburgh, 1983) 412-438

17. PARKES C M, Home or hospital? Terminal care as seen by surviving spouses, Journal of the Royal College of General Practitioners 28 (1978) 19-30

18. STIMSON G V, Heroin and Behaviour: diversity among addicts attending London clinics (Irish UP: Shannon, 1973) 6

19. STIMMEL op. cit. 125

20. Hepatitis B vaccine, Drug & Therapeutics Bulletin 23 (1 July 1985) 49-50

21. OPPENHEIMER E, STIMSON G V, & THORLEY A, Seven Year follow-up of heroin addicts: abstinence and continued use compared, British Medical Journal II (1979) 627-630

22. STIMSON op. cit. (1973) 7

23. Misuse of drugs (Notification of and Supply to Addicts) Regulations 1973, (HMSO: London, 1973: SI 799)

24. STIMSON G V & OPPENHEIMER E, Heroin Addiction: treatment and control Britain (Tavistock: London, 1982) 49-61

25. Statistics of the Misuse of drugs in the United Kingdom 1983 (Home Office: London, 1994) Table 11 (Home Office Statistical Bulletin 18/94)

26. DuQUESNE op. cit. 130-132

27. TAYLOR W J R, Narcotic substitution therapy, in McMAHON F G (ed.), Psychopharmacological Agents (Futura: Mount Kisco, NY, 1974) 227-248 (Principles and Techniques of Human Research & Therapeutics series)

28. GOSSOP M R, A comparative study of oral and intravenous drug- dependent patients on three dimensions of personality, International Journal of Addictions 13 (1978) 135-142

29. HARTNOLL R L, MITCHESON M C, BATTERSBY A, BROWN G, ELLIS M, FLEMING P & HEDLEY N, Evaluation of heroin maintenance in controlled trial, Archives of General Psychiatry 37 (1980) 877-884

30. DuQUESNE op. cit. 65-66

31. MELZACK R, The Brompton mixture, Canadian Medical Association Journal 120 (1979) 435

32. Martindale's Extra Pharmacopocia, ed. 28 by J E F Reynolds & A Prasad (Pharmaceutical Press:London, 1982) 914

33. JERI F R (ed.), Cocaine 1980 (Lima, 1980) (Proceedings of the Interamerican Seminar on Medical & Sociological Aspects of Coca &. Cocaine)

34. Images of cocaine, Lancet II (1983) 1231-1232

35. NARANJO P, Social function of coca in pre-Columbian America, Journal of Ethnopharmacology 3 (1981) 161-172

36. STANGLIN D & PRINGLE J, Terror in a tranquil land, Newsweek 1 July 1985, p 49

37. BERRIDGE V & EDWARDS G, Opium and the People: opiate use in nineteenth-century England (Allen Lane: London, 1981) 218-222

38. TOCUS E C, Regulatory aspects of drug abuse, in GORDON M (ed.), Psychopharmacological Agents vol. 4 (Academic Press: New York, 1976) 166

39. SPEAR H B, The growth of heroin addiction in the United Kingdom, British Journal of Addiction 64 (1969) 245-255

40. Statistics of the Misuse of Drugs 1983 op. cit. para. 3 & table 4

41. Home Office: Report to the United Nations by Her Majesty's Government on the working of the international treaties on narcotic drugs for 1966 (Home Office: London, 1967) paras. 42-26

42. Ibid. for 1971 (Home Office: London, 1972) paras. 42-43

43. Ministry of Health: Drug Addiction: second report of the Interdepartmental Committee (HMSO: London, 1965) ("Brain Report" 2)

44. DuQUESNE T, Medicinal regulations: confusion worse confounded, Primary Health Care 2(1) (1984) 15

45. JUDSON H F, Heroin Addiction in Britain (Harcourt Brace Jovanovich: New York, 1974) 38-62

46. STIMSON & OPPPENHEIMER op. cit. (1982) 205-225

47. Department of Health & Social Security: Report of the Advisory Council on the Misuse of Drugs: Treatment and Rehabilitation (HMSO: London, 1992)

48. Home Office: Statistics op. cit.(]993) Table 2

49. DuQUESNE T, Update on the Misuse of Drugs Act, Primary Health Care 3(2) (1985) 14

50. Police and Criminal Evidence Act 1984 (c 60) section 55

51. Controlled Drugs (Penalties) Bill 1985 (Bill 31. HMSO: London, 1985) section 1

52. DuQUESNE T, Cannabis and the rule of law, Lancet II (1981) 581

53. ZINBERG op. cit. 196

54. LEMBERGER L, Potential therapeutic usefulness of marijuana, Annual Review of Pharmacology & Toxicology 20 (1980) 151-172

55. Home Office: Statistics op. cit. 1983, table 1

56. Society of Civil & Public Servants (Executive Grade): Customs & Excise Group: Customs Controls in the United Kingdom: updated evidence to support a claim ... (London, September, 1984) paras. 2.2, 4.4, & 6.3

57. Treasury: 75th Report of the Commissioners of Her Majesty's Custom and Excise for the year ended 31 March 1984 (HMSO: London, 1984) para. 44 (Cmnd 9391)

58. HARTNOLL R, An overview of Herion and Other Drugs in Britain (Drug Indicators Project/SCODA: London, 1984) 5

59. DUQUESNE op. cit. (1982) 9-11

60. TURNER C E, Statement to the Permanent Subcommittee on Investigations, US Senate (White House Office of Policy Development: Presidential Adviser on Drugs, Washington, 18 November 1981) 2-3

61. Epidemiology of drug usage, Lancet I (1985) 147-148

62. STIMSON op. cit. (1973) 130-169

63. STIMSON & OPPENHEIMER op. cit. 130-136

64. ZINBERG op. cit. 69-81, 153-156

65. Advisory Council on the Misuse of Drugs: Report of the Expert Group on the Effects of Cannabis Use (Home Office: London, 1982) 4

66. ROSE M, Cannabis and the rule of law, Lancet II (1984) 138-139

67. SHULGIN A T, Psychotomimetics, in GORDON M (ed.), Psychopharmacological Agents vol. 4 (Academic Press: New York, 1976) 133

68. The challenge of addiction, Lancet II (1984) 1019-1020

69. SZASZ T S, Ceremonial Chemistry: the ritual persecution of drugs, addicts, and pushers (Routledge & Kegan Paul: London, 1975) passim

70. DuQUESNE op. cit. (1982) 10-12

71. House of Commons: Fourth Report from the Home Affairs Committee, Session 1984-85: Special Branch (HMSO: London, 1985) 26, 37

APPENDIX 1:
Detailed Recommendations

(1) The Misuse of Drugs Act 1971 has been heavily amended and otherwise altered by numerous Statutory Instruments (see Appendix 2 below). This has led to widespread confusion as to the detailed provisions of relevant law on dangerous drugs. It is proposed that a comprehensive Bill be drafted which, at least, would remove a number of the anomalies of current legislation.

(2) Under current UK law, certain drugs (cocaine, diamorphine, and dipipanone) may be lawfully prescribed for addicts only by specially designated psychiatrists. Since cocaine is not prescribed for drug addicts, not least because it is not a drug of physical addiction, this regulation shoud be amended. Any registered medical practitioner should be able lawfully to prescribe or supply cocaine to persons who now use the drug illegally;

(3) Except that prescription of cocaine, and of other controlled drugs, should be confined to practitioners who work within the National Health Service. (Private practitioners should still be able lawfully to prescribe controlled drugs in treatment of organic illness or injury.) At present there is a problem which concerns the ready prescription of various controlled drugs (including amphetamine stimulants) by some private doctors. Private prescribing of this type has not attracted the same degree of scrutiny as has that carried out within the NHS.

(4) It is anomalous that only diamorphine (heroin) and dipipanone (and cocaine; see above) are restricted to prescription to addicts by licensed psychiatrists. Morphine, methadone and pethidine, for example, are as likely (or not) to provoke dependence as diamorphine and dipipanone. Therefore prescription of these opiates to addicts should either be confined to licensed psychiatrists or else all registered practitioners should be able lawfully to prescribe any of these drugs. The present writer favours the latter option.

(5) Any concern about perceived overprescription of controlled drugs could be allayed by a system of statutory maximum daily permitted doses. Such a scheme applies in West Germany and in Norway. It is important that patients who are chronically or terminally ill, whose proper requirement for pain-relievers of the morphine type is very variable, be not further penalized. However, statutory maximum doses could be applied to other types of abusable drugs such as amphetamines and similar stimulants, and to barbiturates. Exceptions could be made in the case of amphetamines prescibed in treatment of narcolepsy (perhaps the sole legitimate medical indication for their use) and for barbiturates such as phenobarbitone when given in treatment of convulsive disorders (e.g., epilepsy).

(6) Since the UK is a signatory of the UN Single Convention on Narcotic Drugs of 1961, a substantial list of substances is automatically restricted. These include numerous compounds which are not used clinically. National and international systems of scheduling controlled drugs are essentially based on the chemical configuration of the substances concerned. This is not a rational basis for restriction, since several drugs which are closely related to morphine or pethidine have little or no capacity for abuse and dependency and are therefore added to schedules of drugs exempted from control (diphenoxylate is an example). A more rational system would be to classify substances -- which do not necessarily require to be named -- which bind to particular receptors in the human body. Opiates, for instance, bind to three such receptors and control could be achieved on this basis. Current law capriciously includes some drugs with low abuse potential and excludes others which tend to be habituating. Among the latter are partial narcotic antagonists such as pentazocine. Despite reports of widespread abuse (especially in the USA) this is not a controlled drug. Pentazocine has been restricted in France.

(7) The Misuse of Drugs Act is so tightly drawn that legitimate research into drugs controlled under its provisions is often difficult or even impossible. The present writer has held informal discussions with pharmacologists and others who believe that, under current legislation, it would be impossible lawfully to conduct any prospective study of social cocaine use. This is because cocaine may be administered only by certain licensed practitioners (see main text). Researchers observing drug use in its social context could themselves be prosecuted under the Misuse of Drugs legislation (e.g., for conspiracy). It is proposed that Schedule 4 of the Misuse of Drugs Regulations 1973, which determines drugs which are available only under special licences from the Home Secretary, be deleted. If physicians are felt to be behaving unethically, there are many controls already available (e.g., disciplinary tribunals).

(8) According to reliable information, manufacturers of controlled drugs for medical purposes are experiencing difficulty in obtaining supplies of raw materials such as opium and coca leaves. This is anomalous at a time when these substances are very widely available illicitly. It is proposed that drugs seized by law enforcement agencies should be available to manufacturers for legitimate medical use.

(9) Possession of cannabis and cannabis resin should be de-criminalized. There is a de facto recognition that use of this drug is ineradicable: importation of cannabis may be compounded under section 152 of the Customs and Excise Management Act 1979. The use of cautioning in respect of cannabis offences is increasing. 10 of the 52 police force areas accounted for some 85% of the 1,200 instances of use of cautioning during 1983. Additionally, the Metropolitan Police Guidance for Professional Behaviour (1985) recommends that in certain situations, if police officers observe the smoking of cannabis, no action should be taken.

(10) Since penalties in respect of drug trafficking may be increased, present definitions are inadequate (e.g., possession with intent to supply). In the milieu of opiate use, for example, drugs are frequently shared, sold, borrowed and otherwise distributed. The distinction between "user" and "dealer", as employed in debates and medical literature, frequently has no validity.

(11) According to its Fifth Report, the Commons Home Affairs Committee would in certain circumstances place the onus of proof in drugs cases on the defendant rather than the prosecution. Unless there are explicit and adequate safeguards (e.g. against entrapment), this would serve little practical purpose and could be a precedent for alteration of other areas of criminal law.

APPENDIX II:
Major Acts And Statutory Instruments Relating To Controlled Drugs

(1) Misuse of Drugs Act 1971
(2) Misuse of Drugs Act 1971 (Modification) Order 1973 (SI 771)
(3) Misuse of Drugs Act 1971 (Commencement No.2) Order 1973 (SI795)
(4) Misuse of Drugs (Designation) Order 1973 (SI 796)
(5) Misuse of Drugs Regulations 1973 (SI 797)
(6) Misuse of Drugs (Safe Custody) Regulations 1973 (SI 798)
(7) Misuse of Drugs (Notification of and Supply to Addicts) Regulations 1973 (SI 799)
(8) Misuse of Drugs Act 1971 (Modification) Order 1983 (SI 765)
(9) Misuse of Drugs (Amendment) Regulations 1983 (SI 788)
(10) Misuse of Drugs (Notification of and Supply to Addicts) (Amendment) Regulations 1983 (SI 1909)
(11) Misuse of Drugs Act 1971 (Modification) Order 1984 (SI 859)
(12) Misuse of Drugs (Amendment) Regulations 1984 (SI 1143)
(13) Misuse of Drugs (Designation) (Variation) Order 1984 (SI 1144)
(14) Misuse of Drugs (Safe Custody) (Amendment) Regulations 1984 (SI 1146)
(15) Criminal Law Act 1977 section 28 (schedule 5) and section 52
(16) Customs and Excise Management Act 1979 section 152 and Schedule 1
(17) Police and Criminal Evidence Act 1984 section 55
(18) Controlled Drugs (Penalties) Act 1985

(NB This list is not comprehensive)

A NOTE ON FURTHER READING

Libertarian Alliance Advisory Council member Dr. Thomas Szasz has written a penetrating study of the whole subject in his Ceremonial Chemistry: The Ritual Persecution of Drugs, Addicts and Pushers (Routledge and Kegan Paul, London, 1975). Although it is now out of print, second-hand copies are frequently available at The Alternative Bookshop, 3 Langley Court, Covent Garden, London, WC2). Terence DuQuesne's A Handbook of Psychoactive Medicines (Quartet Books, London, 1982) is invaluable (and is also available from The Alternative Bookshop).

The libertarian approach to social and moral freedom can be found outlined (albeit relating to a different topic) in Chris R. Tame, Prostitution, The Free Market and Libertarianism (Libertarian Alliance, London, 1985). A forthcoming LA pamphlet entitled The Case For Moral Freedom greatly amplifies the comments made therein. A good brief account of the libertarian view of civil liberties can be found in Chapter 6, "Personal Liberty", of Murray Rothbard's For A New Liberty (Macmillan, New York, 1973).

Nick Elliott's The Perversity of Government illustrates its theme in relation to the counterproductive effects of the "welfare" state, consumer protection legislation, and anti-drug laws. In 1984 the Libertarian Alliance also gave evidence to the Department of Health and Social Security, the Department of Trade and Industry and the British Medical Association in a report entitled Why the Government Should Stop Harassing the Tobacco Trade. This report will also be published this year and is obviously germane to the issues discussed in this pamphlet.

Chris R. Tame, Secretary
The Libertarian Alliance