of futility and frustration found in all minority groups doubly burdened by poverty and discrimination.

But the slums are not the only source of teen-age addicts. "Narcotics a Growing Problem of Affluent Youth" was the headline of a recent newspaper story which told of the "increasing number of young people from the substantial, the sophisticated, and the educated families of New York City and its suburbs who are using marijuana, LSD, barbiturates, and addictive narcotics." Occasionally individuals become addicts "accidentally," in the course of necessary medical treatment. By prescribing certain medication unwisely, doctors can cause addiction. Whether drug abuse is intentional or accidental may explain how a narcotic addict is made, but not why a particular individual succumbs.

AND WHY?

The why is not yet fully understood. Today many observers are inclined to regard as at least one basic factor the sociological pressures mentioned above: slum bleakness, poverty, minority frustrations, and the equally real and destructive forces - which may operate on poverty stricken and affluent alike—of unsatisfied adolescent drives, family disorganization, and the emptiness of purposeless lives.

Psychological dependence on drugs is perhaps much more important than physical dependence. But the physical effects of some drugs on the body cannot be underestimated. Changes occur, doctors say, in the individual's chemical structure, in as yet unknown and therefore uncontrollable ways. Once they have happened, the person is "hooked" - physically dependent, in a very real sense, on continuing doses of the drug.

Personality disorders have long been regarded as a primary explanation of drug addiction, but now it is recognized that there are also many other pieces to the puzzle. The personality factor fits in with the theory of social pressures by suggesting it is the reason some succumb while others, subject to the same pressures or similar ones, do not. The idea that narcotic addicts suffer from emotional or character disorders that predispose them to addiction has been described by the late Dr. Kenneth W. Chapman of the Lexington, Kentucky, federal hospital:

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"The potential addict is emotionally unstable and immature. . . The ordinary human being has normal defense machinery with which to meet life's disappointments, frustrations, and conflicts. But the potential addict lacks enough of this inner strength....

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All these explanations accept the thesis that drug addiction is an illness, not a fault of the individual or a sign of moral weakness. Nevertheless, some authorities insist that drug addiction, although not a crime, is utterly repugnant to the principles basic to the moral character of our people. It is not surprising, therefore, that law enforcement agencies dominated the campaign against narcotic addiction - indeed, were virtually alone in it- for half a century. Their approach tends to be punitive.

effect always tragic

Despite the conflict among various groups as to the cause of drug addiction, the effect of it has not changed since Albert Deutsch described addicts many years ago:

"Persons upon whom the narcotics habit fixes itself drift farther and farther from the challenges and opportunities of the everyday world. Often unable to earn an honest livelihood because of their compelling, all-consuming need for drugs . . . they are tragic misfits and failures, hunted and haunted, outcasts from normal society, with their goals reduced to a single essential to get the drug that provides a transitory escape from life, at whatever cost."

Other drug abusers. In a broad sense, the characteristics of addicts to "the dangerous drugs" do not differ markedly from those of narcotic addicts. In many instances they overlap in the same person. Doctors at the federal hospital at Lexington have reported that a number of opiate addicts turn to barbiturates as "tide-over drugs" when their money gives out or their regular source of supply is cut off. A significant number of patients at Lexington are "double addicts" — to both opiates and barbiturates.

Some observers believe that the tendency to take drugs has become so widespread that it affects society as a whole. Dr. Karl Evang, director of Norway's health services has written:

"It is my belief that we are overlooking a more serious health problem [than even narcotic addiction] . . . the increasing number of persons, not suffering from any disease, who do not feel

well unless they consume daily a quota of tablets, mixtures, or other drug preparations. One may very well call this a 'general drug dependence'. . . . We seem to be in danger of producing a behavior pattern in which drugs are being more and more regarded as a general substitute for healthy life habits."

WHAT CAN WE DO?

The many-faceted problem of drug abuse inevitably calls for many solutions. There is no single answer. No one has had enough successful experience in the field to claim final knowledge. Those who put forward suggestions and try them out find that their success is limited.

In this country organized efforts against harmful drugs have been made by both government and private forces since the beginning of the century and before. But, the ever-expanding problem seems, so far, to have outgrown even the most persistent efforts.

The disagreement, already noted, between differing approaches to narcotics control has sometimes been sharp. Advocates of one view regard it as a police matter, with two phases: (1) war against the international traffic in drugs and (2) control of the addict, with punishment the chief deterrent against his continuing his degraded way of life. Others, in medicine, psychiatry, and social science and now many in other fields, including government, while not denying the importance of police work, say that the addict is a sick person and must be treated as one.

The "sick person" viewpoint, both more humane and more in keeping with reality, seems to be winning out. That does not mean that the illegal distributors of narcotics should not be punished. Like other efforts, police measures have had some success, particularly in regard to their first objective, control of the international drug traffic. Moreover, by repeated seizures of shipments of illicit drugs and by the arrest of some of the shippers, federal agents and the police of New York and other localities have caused repeated "panics" times of short supply in the illicit market. Such shortages, in turn, have probably kept down the development of new addicts. While the problem of drug abuse in general has grown, it is possible that the number of known narcotic addicts has been virtually stationary for some years (al

though drug-related criminal activities and "the corrosive effect on youth" are believed to have increased).

These efforts to control the drug traffic are not to be underrated. Nor are the successes in treatment claimed by other workers: doctors, psychiatrists and other personnel of hospitals and out-patient clinics, private groups trying inspirational and spiritual approaches as well as self-discipline, and so on. Undoubtedly, the ultimate answer will be a mixture of techniques.

Some people believe that the flaw in all previous attacks on the drug problem was due to lack of facilities and money and public support that would make money forthcoming, from the government and elsewhere. Here, then, is a place where all of us can play a part. We can all join in and work for greater government appropriations to strengthen law enforcement as well as treatment programs. This is the fight against the drug traffic and for its victims.

THE FIGHT AGAINST THE DRUG TRAFFIC

Halting the traffic in narcotics is essentially a global problem. If the growth, manufacture, and distribution of narcotics could be limited strictly to the amounts and channels needed for medicinal and research purposes, the problems could be minimized. Since 1912 efforts at international control have been made through compacts among countries. These accords, reached first in the League of Nations and then in the United Nations, have succeeded in greatly reducing the sources of narcotics, but there are many loopholes in the international suppression of illicit traffic.

In some countries-notably the greatest producers of plants from which narcotic drugs are derived there are inadequate laws against selling or using narcotics, or else the laws are so poorly enforced as to be virtually inoperative. In some lands opium smoking and eating is tolerated much as we tolerate the drinking of alcohol. Although these countries try conscientiously, their attempts to restrict production and export of narcotics are sometimes feeble.

The amount of opium produced annually is estimated to be at least four times that needed for legitimate medicinal and research purposes throughout the world. A chain of illicit processing and transshipping points in the Near East, France, and Italy transforms the illegal overproduction from Turkey and Iran into morphine and

heroin. Burma, Laos, Thailand, and China also produce opium on a large scale. Much of the illegally manufactured narcotics finds its way to the United States, where the prices paid for them are the highest.

The legal price for opium is fixed by the Turkish government at about $7.50 a pound. But the opium poppy farmer who sells his product on the black market gets at least twice that amount. The product then passes through many hands as it moves along the lines of illicit traffic, jumping in price with each transaction. When heroin, derived from the raw opium, finally reaches American addicts the estimated price is about $19,000 a pound.

Elimination of such fantastic profits in narcotics is one of the purposes set forth by advocates of "maintenance dose" treatment, now forbidden by rules of the Federal Bureau of Narcotics. They suggest that if doctors could prescribe narcotics in small amounts for addicts, this would greatly reduce the volume of illicit trade by helping to take the profit out of it. However, the British government recently withdrew the right to prescribe narcotics for addicts from individual physicians, limiting it to psychiatrists in hospitals, in an effort to stop the increase in addiction.