September 1968 — VOL. 49, No. 9 —
Misuse of Drugs."
Some Facts
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Society is greatly troubled by wide-spread
reports of the use of drugs in harmful ways. This concern
arises from the fact that we do not now have to go to the
underworld to find people who abuse drugs, but come upon them
in all social classes and in all economic divisions.
No clear guidance is at hand about what steps to take. The
general ignorance about the nature and effect of various drugs
may be traced to the moral detestation most people have of
the improper use of drugs, and their consequent inclination
not to think about this unpalatable subject. Without information
about the incidence of the habit, and about the legal, medical
and social treatment of it, and the causes that give rise
to it, people are at a loss.
Account must be taken by those who are leaders in their
communities of these undoubted facts: in a mere half century
man has been flipped from the horse and buggy into the jet
plane and space travel, and within man himself old faiths
have crumbled without the development of strong new faiths
to replace them. These events cause hitherto unknown stresses.
The pressures and demands of society are too much for some
people, and they turn to drugs.
There is, however, a healthy spirit in Canada of disbelief
in drugs as the answer to weak knees and sick souls. As individuals
and as a nation we cannot allow ourselves to sink into the
position forecast by Aldous Huxley in his Brave New World
where all we need to do if we feel worried, anxious,
or upset is to take a pill.
Nevertheless, we are conscious that some people find it
easier to turn to chemical comfort than to learn to handle
their problems in a mature way. Having found a substance that
relieves his feelings, a man may return to it again and again
for help. Thus he becomes accustomed to depending upon the
drug instead of upon his own inner resources and those offered
by his family, by his church, by science and by society.
What is the condition of the person who allows himself to
become dependent upon drugs? It was strikingly described by
Dr. S. J. Holmes, Consultant Psychiatrist with the Alcoholism
and Drug Addiction Research Foundation of Ontario, to whose
articles and papers this Letter is indebted for much
basic and up-to-date information.
Dr. Holmes said to the Section of Psychiatry, Academy of
Medicine, Toronto: "We can depict man's moods as an ever-changing
pattern or spectrum. From hour to hour, influenced by inner
and outer events, man's ego moves to and fro across this spectrum.
At one end of the spectrum lies melancholia or depression;
at the other end is mania or extreme agitation. A normal person
stays in the middle range, straying into the extreme regions
only rarely; if and when he does enter these regions, his
social, psychological, endocrine and other biochemical factors
adjust, and harmony occurs. In the emotionally sick person
this healthy adjustment does not take place. The person at
the agitated end of the spectrum is tense and anxious, and
will respond to a drug that will soothe or tranquillize; the
person at the opposite end, whose load of depression is so
heavy that he can't raise his head and whose life is empty,
meaningless, valueless and void, will respond to a mood elevator."
In other words, an individual takes drugs because they offer
an easy short-cut way of escape from the reality in which
he is involved.
We must be careful in our application of the word "drug".
A drug is anything used as a medicine, and the preparation
of drugs has been an honourable profession for many centuries.
Pharmacy had its beginnings when human beings first recognized
a sensation of pain and consciously administered something
in an effort to relieve their discomfort. It may have been
a bundle of plant leaves wrapped around an open wound, or
perhaps a broth of tree bark drunk to relieve a burning fever.
The pharmaceutical industry has been continuous in its search
for better medicines. As research has progressed and as more
specific medications have become available, mankind has been
able to eliminate many of the diseases which were formerly
prevalent and of serious statistical importance.
However, drugs are not always taken with common sense. They
are used by people who feel small in the face of the complexities
of life, by people who seek a temporary feeling of importance,
by people who wish to depress their anxiety or to raise their
spirits, or by people who desire to experience hallucinations.
It is this unnatural self-indulgence that is the damaging
use of drugs.
What drugs do
Dr. Erik Jacobsen, of Copenhagen, co-discoverer of a substance
used in the treatment of alcoholism, suggests that there are
five properties of drugs that induce people to use them: (1)
They may combat fatigue ( stimulants such as caffeine, cocaine,
and amphetamine; (2) They may raise a person's mood ( alcohol,
barbiturates, morphine, amphetamine, meprobamate; (3) They
may banish worries ( alcohol, tobacco, morphine, meprobamate,
barbiturates; (4) They may induce sleep ( barbiturates, chloral
hydrate, alcohol; (5) They may bring dreams ( morphine, cocaine,
marijuana, mescaline, lysergic acid (LSD).
In the general run of cases there is little danger of becoming
a drug addict if taking the drug is properly supervised by
a competent physician. It is improper use of drugs that raises
problems, proceeding from habituation to dependency and addiction.
For some people, under some circumstances, any small amount
of certain substances is too much. They may form a relationship
with the drug that pushes them over the edge into dependency.
They are tempted to continue, to increase their consumption,
and finally they find themselves unable to stop. They have
increased the tolerance of their metabolic and nervous systems
so that they need more and more of the drug to attain the
same effect.
The World Health Organization defines addiction in this
way: "Drug addiction is a state of periodic or chronic intoxication
produced by the repeated consumption of a drug (natural or
synthetic). Its characteristics include: (1) An overpowering
desire or need to continue taking the drug and to obtain it
by any means; (2) A tendency to increase the dose; (3) A psychic
(psychological) and generally a physical dependence on the
effects of the drug; (4) Detrimental effect on the individual
and society."
The danger is not only psychological, but physical. In seeking
fast relief for his anxieties a man may reduce his awareness
of symptoms which warn him of severe physical disease. Then
he finds himself laid low by an ailment which, drawn to a
physician's attention in time, could have been cured or relieved.
Some drugs are regarded as being so dangerous that every
possible measure is taken by Parliament and its agencies,
by the medical profession and by pharmacists, to prevent their
use for non-medical purposes. These drugs may interfere with
bodily or mental functions in such a way as to harm the individual
and also to endanger other people.
Unaware of danger
Ignorance is the cause of much distress due to drugs. People
are unaware of the serious danger to their personality that
can result from habituation, or even the smallest uncontrolled
experiment with psychoactive drugs such as LSD and STP. Many
young people have said that they might not have been curious
enough to try drugs if they had known more about them.
One thing is certain. If young people on the verge ,
of becoming dependent upon a drug for relief from this or
that physical or psychological distress felt free to visit
a doctor without a feeling of guilt and without fearing that
they would be ridiculed, lectured, sermonized, or punished,
there would be less danger of addiction. Medical people are,
in the tradition of their profession, eager and willing to
lend assistance and leadership. It must be made known to the
young people that the help will be given without censure.
Most addicts are quite ambivalent in their desires with
regard to drugs, says Dr. Holmes, "They have a desire to stop
using which we can strengthen by acceptance and understanding
at all times whether initially or during relapse."
Family responsibility
There is a general belief that much of the venture into
drug-taking among young people stems from unsatisfying family
life. At some stage, the young person has failed to find in
his family that degree of understanding he expected. He has
been blocked in his search for maturity. He has not been given
assurance that he belongs in the scheme of things. He has
been forced to look elsewhere for satisfaction, perhaps within
a self that is distorted and deceived by drugs, or among a
group also experiencing the hedonistic state of rebellion
against parents, teachers and society.
Police have found that most parents are incredulous when
they are told that their children are indulging in drugs.
The police do not call at a home on such an errand in any
spirit of persecution or of reproach, but to inform the parents
and give them a chance to serve and save their children.
Wise parents will welcome the warning and respond to it
intelligently. They will not rant at their children, but will
first take a critical look at the state of their family as
a family. They will inquire into their own behaviour. Perhaps
they have neglected some constructive parental functions because
they were busy with business, sport or social doings. Perhaps
they have avoided administering needed discipline because
they thought it old-fashioned. Perhaps they have overlooked
this and that breach of what is expected of children because
they wanted the children to have more pleasure out of life
than they had. Perhaps they have no family programme to develop
sound personality.
Then, having started at the root cause, they will go on
to correct the defects. They will seek the help of professionally
qualified people for the rehabilitation of their children.
They will rebuild the family as a household distinguished
for its mutual interests, its close relationships, its affectionate
loyalties, its bond of union in which the welfare of every
member, whatever his needs may be, is recognized as the responsibility
of all.
Such a family will give no foothold to the ugliness of habituation
to drugs. Partnership in it will fulfil the emotional needs
of children, and keep their standards of thought and behaviour
far above the shoddy debauchment offered by drugs.
Some common drugs
It is well to know the properties of various drugs, so as
to understand their effects and their dangers. Dr. Holmes
lists them in this way: (1) Sedative ( a drug which depresses
the central nervous system, especially at its higher levels,
so as to allay nervousness, anxiety, fear and excitement;
(2) Hypnotic ( used to induce sleep; (3) Tranquillizer ( promotes
the sense of calmness and well-being without that degree of
depression of the central nervous system commonly associated
with the action of sedatives or hypnotics; (4) Stimulant (
by its action on the central nervous system it temporarily
enhances wakefulness and alertness, improves mood and lessens
the sense of fatigue; (5) Narcotic ( a term commonly limited
to drugs like opium, morphine, heroin, cocaine and marijuana.
It is a criminal offence for anyone to grow, import, sell
or possess a narcotic drug unless authorized.
The 1962 figures from the Narcotic Control Division of the
Department of Health and Welfare indicate that there are at
least 3,656 narcotic addicts in the country. The records of
the Royal Canadian Mounted Police from March 1966 to March
1967 show that there were 943 narcotics convictions, and in
the same period 1967-1968 there were 1,915 convictions.
Opium is of little significance in Canada's illicit market.
It is smoked almost exclusively by small groups of older persons
of oriental extraction. It is used as the source of material
for production of several beneficial drug products such as
laudanum and paregoric.
Heroin is made by acetylating morphine which is obtained
from opium. It is available only on the illicit market, its
import and manufacture having been prohibited since 1955.
Another compound found in opium is codeine, which can also
be made from morphine. This does not appear in contraband
traffic to any extent.
Cocaine, extracted from the leaves of the coca plant, has
been used medicinally for many years as a local anaesthetic,
but is used improperly for its stimulating effect on the nervous
system. It first affects the brain, causing restlessness and
excitement, and then moves through the rest of the nervous
system. Cocaine is not common in the illicit market because
of its cost and its short-lived effect.
The drug benzamphetamine, otherwise known as "pep pills"
and internationally called amphetamine, arouses mental energy,
abolishes fatigue, and gives a feeling of liveliness. Dr.
Jacobsen says this drug is not yet obsolete, but the world
has changed. Our cultural pattern has "changed its slogan
from 'efficiency' to 'deliver us from our hurry and worries'."
As a consequence the leaning is toward "peace" tablets instead
of energizing pills.
Hallucinogenic drugs, those which loosen the mind, have
the ability to induce sharp changes in states of awareness,
perception, and communication. Some personalities like the
"way out feeling" provided by such drugs as LSD 25.
The abusive use of LSD is entirely dependent upon illicit
sources of supply. Regulation by the government since 1963
controlled the distribution of LSD by the one pharmaceutical
company manufacturing the pure drug to a limited number of
investigators. Then growing publicity about the exciting experiences
users obtained created a new underground drug industry engaged
in the making and distribution of this dangerous drug.
Users of LSD, many of them in the hippie or beatnik fringe,
mistake apparent profundity of thought for high intellectual
standards. They suffer delusions in their effort to interpret
the peculiar things happening to them. They have chronic anxiety
reactions, and drift aimlessly through life without social
achievements to enrich their lives. They lay themselves open
to premature death, because LSD thwarts or removes natural
protective attitudes, sensible judgment, and the ability to
perceive and evaluate common dangers.
Marijuana is not a new drug. As long ago as 1936 its use
was a serious problem in the United States, where it had appeared
in high school circles and among other groups where narcotics
had never before been a problem. In the treatment and cure
of disease this drug has no value whatever, but it has become
the subject of debate as to its addiction liability, as a
cause of crime, and as the prelude to heroin addiction.
The principal effect of marijuana is upon the mind, says
a report of the United States Treasury Department. "Its continued
use produces pronounced mental deterioration in many cases.
Its more immediate effect apparently is to remove the normal
inhibitions of the individual and release any antisocial tendencies
which may be present." It may cause dangerous distortions
in time, space, motion and behaviour. It may give rise to
violent aggressiveness and uncontrolled violence.
The House of Commons was told in March 1968 that there had
been 1,415 prosecutions for offences involving the use of
marijuana in the preceding eleven months, compared to 94 prosecutions
in the previous twelve months.
Tranquillizers are drugs which have a calming influence
on worries, true or imaginary. Some are known to be addictive.
Useful when properly used, tranquillizers are not intended
for those who seek a chemically created world of tranquillity.
Their habitual improper use contributes nothing toward building
a problem-free way of life.
If barbiturates have been left to the last in this survey
of drugs, it is not because they are unimportant. Their improper
use presents a growing menace to society. Properly supervised,
barbiturates have a wide range of valuable medical uses. They
aid sleep and relieve anxiety; they are used in the management
of epilepsy and as sedatives in psychiatry. They have contributed
greatly to medical advance.
But the use of short-acting barbiturates as "goofballs"
is of serious concern. It is impossible to estimate with any
degree of accuracy the number of chronic barbiturate users
and barbiturate addicts in Canada, but it has been estimated
that the number exceeds that of opiate addicts several times
over.
One authority declares that the barbiturate problem is more
devastating than opiate addiction, causing more mental impairment
and more motor incoordination. Yet barbiturates in many forms
are easy to obtain by chronically anxious psychoneurotic people.
They produce all degrees of depression of the central nervous
system functions, and may lead to death. Poisoning may occur
accidentally when an overdose is taken as a result of impaired
judgment or impatience for sleep. The Dominion Bureau of Statistics
figures on causes of death in the year 1965 show that barbiturates
caused 262 deaths, more than 24 per cent of all deaths due
to the effects of poison.
Effects on society
Drug abuse is not something which affects individuals only:
it has an effect on society. Drug-taking is spread from the
addict to the non-addict through curiosity, daring and the
desire to be accepted.
The social contamination due to the drug habit is one reason
why the State tries to control consumption. Canada wishes
to protect its people.
William Kelly, Deputy Commissioner of the Royal Canadian
Mounted Police, declares that illegal drug use is the top
crime concern in Canada. He said in an interview in March
that narcotics offences increased by 110 per cent in 1967,
and added: "It seems that drug use among young people is now
the 'in' thing."
Laws are made by Parliament and enforced by the R.C.M.P.
and local police forces; there is rigorous Customs scrutiny
to prevent the importation of drugs illegally, and Canada
is one of many nations united to stamp out illegal international
drug traffic.
The law enforcement measures set forth society's expectations
and put limits on what is acceptable behaviour in the use
of drugs.
It is the function of the law to protect society, and many
problems associated with drugs can be treated by legal, moral,
and punitive methods. There is still left the matter of liberating
the individual, and the standing committee on justice and
legal affairs of the House of Commons recommended in March
that treatment be substituted for punishment in the case of
drug addicts. It recommended that drug addiction "be recognized
primarily as an illness."
There are many varied treatments advocated by medical and
mental experts. All cases of addiction are not alike, even
when they involve the same drug. They may require different
dietary, social, vocational, medical and recreational procedures
in different combinations. This is certain: withdrawal and
rehabilitation are not "do it yourself" projects. They require
competent guidance, therapy and help.
This is recognized by the Alcoholism and Drug Addiction
Research Foundation set up by the Province of Ontario. Its
study is directed toward learning about drugs likely to lead
to addiction, about what sort of persons become addicted to
various drugs, and about the processes of addiction itself.
It reports to doctors and other professional people and to
the public at large on its findings, in the hope that the
prevalence of addiction will be reduced.
Need for education
Dr. Holmes said in a panel discussion where the medical
profession was recognized as a leader in combating narcotics
addiction: "Although we commonly speak of drug addiction as
a disease, it is more properly a symptom of disease rooted
in social and economic conditions which tend to create dissatisfaction,
unhappiness, conflict, tension and strife in the minds and
souls of human beings."
Taking unprescribed drugs is not the answer to the problem
of living with things as they are. The number of persons who
are enjoying satisfying lives without drugs is far in excess
of those who become drug addicts.
There is no doubt about the need for education on this point.
Our troubling situation demands that education should start
at the grade school level and should be continued through
high school and into adult education. Parents need authoritative
and understandable information which they can pass along to
their children.
The proposals of the Montreal Protestant School Board in
an effort to discourage student drug use point this up sharply.
"We believe that only factual information well presented,
and not conjecture based on an emotional appeal, will have
an influence on our young people today. The responsibility
for communication of this information must be shared by educators,
parents, students and the public at large."
The Board proposes a five-pronged operation: films presented
by competent persons, an information kit for school principals
and guidance counsellors, student discussion groups, home
and school programmes, and an information booklet for teachers.
Most healthy young people see through the flimsy logic of
the drug appeal when the facts are presented to them in an
acceptable way. It is only by conveying to them the proper
attitude toward drugs that prevention of drug-taking for inappropriate
purposes can be attained.
Published by RBC Financial Group. All editions from the RBC
Letter collection are available on our web site at www.rbc.com/responsibility/letter.
Our e-mail address is: rbcletter@rbc.com.
Publié aussi en francais.
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