up the law with respect to the situation. Now, as we do it, after we do it, of course, we must beef up, if I may put it that way, the educational program. It should be in the schools and everywhere where young people gather, bringing to their attention in the most forceful way, from an educational standpoint, the dreadful harm that the abuse of these drugs will bring on individuals and our whole society. But to say we should not do any more than that is to say nothing, in my opinion, and I cannot really find words strong enough to express my disapproval of that course of conduct.

The house is on fire, and we do not need a lesson in how to prevent the starting of fires. What we need now is to put the fire out and go on with our fire prevention work. I think that is just about where we stand.

Senator YARBOROUGH. I think your conclusion here is well illustrated by the statistics you have that in Chicago alone there was a 60-percent increase in the arrests due to these drugs that stimulated people into committing violations of the law.

Senator DODD. Yes, Mr. Chairman. I could take a lot of your time, but I do not want to do it. Our record, however, is replete with testimony to substantiate that assertion from police departments all over this country. Shootings, brutal assaults, all kinds of horrible crimes. have been committed by individuals under the influence of these very drugs, and it is not just here and there, it is all over the country and, as you say, it is growing at a rate that is absolutely frightening.

Senator YARBOROUGH. I feel that perhaps the American Medical Association officers were thinking of the prescription phase of this. If they had before them the evidence that you have given, and Commissioner Larrick has given, they might well change their position.

Senator DODD. Yes, I hope they would. I think certainly most physicians, knowing the facts, would advocate that the law be strengthened and tightened up.

Senator YARBOROUGH. Thank you, Senator Dodd, for that very fine statement, and I congratulate you on your ability to condense it. Senator DODD. Thank you.

Senator YARBOROUGH. I congratulate you on your ability to condense that tremendous amount of factual information in so few words. Commissioner Larrick, would you come around for a few minutes. We do have a question or two.

Commissioner Larrick, I believe that under the bill the individual physician is not required to keep records on these drugs but the manufacturers are and the pharmacists are.

Mr. LARRICK. That is correct.

Senator YARBOROUGH. Now, I want to ask a general question. Through what channels do these drugs reach the public-what percentage through pharmacists, what percentage through hospitals, what percentage directly from physicians, and how much through illegal channels? What percentage of the 9 billion of these "goofballs" and "pep pills" the common terms for barbiturates and amphetamines? What proportion of them reach the public legally and illegally, in your opinion?

Mr. LARRICK. Accurate, statistically sound figures dealing with any completely illegal operation are impossible to obtain. But taking the best figures that we have, it is our view that on the order of about 50 percent of these drugs manufactured in the United States are not used in legitimate medical practice, either in private practice or hospitals or otherwise where legitimate medicines are prescribed and consumed. Senator YARBOROUGH. About 50 percent?

Mr. LARRICK. About 50 percent.

Senator YARBOROUGH. Well, take roughly a population of 190 million, say 200 million as a calculation; with 9 billion of these pills being consumed a year, what is that, about 45 of these on the average, or 45 a person per year?

Mr. LARRICK. Somewhere between 45 and 50 but, of course, the percentage of the people who actually consume them improperly is small, compared to the total population, so the people who do take them tend to take a great many.

Senator YARBOROUGH. Are there any statistical tables or have data been accumulated showing to what extent these are distributed through motels, not to truckdrivers, but to people driving across the country who are fatigued? Are these sold commonly like cokes and things, to pep people up as they drive along?

Mr. LARRICK. I do not think they are sold commonly, but I think that there is no question but that there has been extensive use of them by young people who are out for a thrill or a binge.

We have records of disturbances at dances where the inciting to the fighting and other unsocial acts was unquestionably stimulated by the taking of these pills.

We know of instances where college students who normally are quite well-behaved people, at examination times take the amphetamines to stimulate themselves to what they hope will be better grades, and sometimes they take too much, and they do themselves harm.

There have been drivers, entirely apart from the trucking industry-perhaps we overemphasized that, because it is very large-but unfortunately there are many circumstances where people who know about them, and know how they can get them and want to drive long hours do it, to their detriment.

There are certain types of entertainers who wish to stimulate themselves to great flights of competence and excitement in a performance who have taken amphetamines and some of these people in various categories get to the point where they take the amphetamines to stimulate themselves and then when it comes time to sleep they cannot sleep, so they take a barbiturate to put them to sleep, and it becomes a vicious cycle that eventually destroys them, and I think it is common knowledge that very famous people have used the barbiturates to commit suicide and we quite often find when we investigate these cases that these people for one reason or another have a history of excessive use of drugs.

Senator YARBOROUGH. Do you have any estimate of the sources of the legal distribution of these drugs as among pharmacists, directly through pharmacists, through hospitals, and through physicians? What are the percentages?

Mr. LARRICK. No, I do not have any breakdown other than that the legitimate use in toto is approximately 50 percent. We can probably get you an estimate if you wish.

As I said earlier, these drugs are extremely useful when they are competently used.

Senator YARBOROUGH. This legislation is no attempt to prevent the use of these drugs in a proper manner under proper prescription and proper guidance.

Mr. LARRICK. That would be a very bad effect, and the legislation has been carefully drafted to avoid that.

Senator YARBOROUGH. You have touched on this in your answer about people using some of these drugs to commit suicide. That brings up the question of the abuse of tranquilizers. Are the tranquilizer drugs taken in overdoses?

Mr. LARRICK. Yes, sir. In the study made by the President's Commission on Narcotic and Drug Abuse, some of the doctors who were participants pointed to cases where people had become addicted or had acquired the habit of taking these tranquilizers excessively outside of good medical care.

This LSD25 is an example of a type of drug that causes mental changes that is not now used very extensively for medical purposes, but is used quite extensively for nonmedical purposes. But the big problem with tranquilizers at the moment, as I see it, is that they do have capabilities of satisfying a nonmedical urge. When the Narcotics Bureau through very efficient enforcement made it increasingly difficult to obtain heroin, opium, and other narcotics, and made it more and more expensive, as the attorney general of California said, as described in the Senator's testimony, the users turned to the barbiturates and amphetamines. Similarly as we make it tougher to get the amphetamines and barbiturates under this legislation, they will unquestionably turn to other psychotoxic drugs, including the tranquilizers.

Senator YARBOROUGH. Have there been convictions for trafficking in illegal tranquilizers up to date?

Mr. LARRICK. I believe there have been a few. Our records would show that. I do not have it in my statement.

Senator YARBOROUGH. Senator Pell, do you have any questions? Senator PELL. I have one question, a rather detailed one.

I have become quite interested in this question of railroad trains and increasingly rough and rocky roadbeds that produce a ride that might be called sleepers rather than sleep-in drugs.

wonder if you had any opinion as to how prevalent the use of barbiturates has been as a matter of custom by travelers because of increasingly poor railroad service?

Mr. LARRICK. Senator Pell, I have been in Government a long time. and I learned not to try to be an expert in everything. So I do not know anything about railroads. But I do know that under all circumstances where people have difficulty in sleeping, real difficulty, there is a legitimate use for properly calibrated doses of barbiturates. Senator PELL. You would not hazard a guess because of the rocky roadbeds on the eastern coast, as to what percentage of travelers on socalled waker rather than sleeper cars take these pills?

Mr. LARRICK. I am afraid I could not estimate that, Senator Pell. Senator PELL. You would not know.

Along this line, are there such things as sleeping pills that are neither barbiturates nor narcotics?

Mr. LARRICK. When the antihistamine drugs first became available to the medical profession, it was noticed by some observing clinicians that a certain percentage of the patients who took the antihistamines for hay fever or other conditions became sleepy. So there was a firm or two which explored the possible use of the antihistamines for that purpose. Somewhat to the surprise of the medical staff of the Food and Drug Administration, it was proved to our satisfaction that there are certain antihistamines used in certain quantities which can safely be used by a substantial percentage of the population to induce sleep without the bad effects of the barbiturates.

Senator PELL. What would be the colloquial commercial names of those?

Mr. LARRICK. The name?

Senator PELL. Yes.

Mr. LARRICK. I can get that for you.

Senator PELL. I would like to know before going back to my own State.

Mr. LARRICK. Thank you, sir. We will supply that to you. You understand that while it works for some people it does not work for everyone. We hope it will work for you.

Senator YARBOROUGH. Any questions of the staff?
Thank you, Commissioner Larrick.

Mr. LARRICK. Thank you for this very fine hearing.

Senator YARBOROUGH. Mr. Ralph Rooke. Is he here? He is the past president of the National Association of Retail Druggists. Come around. If you have anyone with you that you wish to introduce, do so.

you may

STATEMENT OF RALPH R. ROOKE, CHAIRMAN, COMMITTEE ON NATIONAL LEGISLATION, NATIONAL ASSOCIATION OF RETAIL DRUGGISTS; ACCOMPANIED BY PHILIP F. JEHLE, WASHINGTON REPRESENTATIVE AND ASSOCIATE GENERAL COUNSEL

Mr. ROOKE. Mr. Chairman and gentlemen of the Committee on Labor and Public Welfare of the U.S. Senate, my name is Ralph R. Rooke. For 43 years I have practiced pharmacy in Richmond, Va., where I now own and operate two community drugstores. I appear here as chairman, National Legislation Committee of the National Association of Retail Druggists, which has its headquarters at 1 East Wacker Drive, Chicago, Ill.

The NARD, as you know, is a small business organization having a nationwide membership of more than 36,000 independent drugstore owners. The NARD speaks for these family pharmacists on all legislative matters affecting their professional and economic interests.

Accompanying me is Philip F. Jehle, Washington representative and associate general counsel of the NARD.

As we read the bill, S. 2628 is intended to assist the Food and Drug Administration in wiping out, once and for all, illegal trafficking in emphetamines, barbiturates, and such other drugs as are capable of producing serious psychotoxic effects. Toward this end, the bill provides for the following Federal controls on the manufacture, sale, and distribution of psychotoxic drugs:

(1) Production would be limited to pharmaceutical manufacturers registered with the Department of Health, Education, and Welfare. (2) Distribution channels from the pharmaceutical manufacturer through the patient, including drug wholesalers and retail druggists and all clinics and laboratories, but exempting medical practitioners, would be accountable for all such drugs manufactured, shipped, received, sold, dispensed, or distributed.

(3) All individuals and corporations handling such drugs would be required to keep detailed inventory records for inspection by FDA agents.

(4) FDA agents would be authorized to carry firearms while performing their inspections and investigations.

With pride and confidence, the NARD and its members do favor the praiseworthy objectives of S. 2628. Right thinking Americans everywhere support all efforts to suppress illegal trafficking in psychotoxic drugs. But, while endorsing the proposed legislation in principle and purpose, the NARD must also register its vigorous objection to the bill's provision granting FDA agents the right to inspect, among other business and professional records, the pharmacist's prescription files. In our judgment, S. 2628, however, meritorious its other provisions may be, should not serve as the vehicle for FDA's obtaining more enforcement authority than is actually needed and will be wisely used.

As the members of this committee know, FDA officials have tried for many years to get statutory authority to search the pharmacist's professional records, including his prescription files. However, with commendable consistency, the Congress has withheld such powers, in every instance where sought, on the grounds that the Food and Drug Administration could not justify its request. Unfortunately, though, the message implicit in these legislative decisions of Congressthe latest being in 1962 when the Kefauver-Harris drug amendments became law seems to have been lost upon those intent on grabbing new and broader authority for themselves.

On behalf of the NARD and its members in all parts of the country, I wish to state that the prescription file inspection authority being sought in S. 2628 by the Food and Drug Administration should be denied. Such powers would be:

(1) Unjustly discriminatory against the profession of pharmacy. Inexplicably, the prescription file inspection authority being sought in the proposed legislation would apply to all pharmacies, while expressly exempting all medical practitioners, many of whom do a rather large business in the dispensing of prescription medications, including psychotoxic drugs.

Frankly, the NARD and its members cannot understand why such discrimination against the profession of pharmacy should be found in the bill. No satisfactory explanation has ever been offered.

(2) We feel it is unnecessary. FDA agents already have sufficient legal authority to investigate all records, including prescription files of any person who may be illegally handling or disposing of amphetamines and barbiturates and other psychotoxic drugs. Where a search warrant for such investigation becomes necessary, it may be obtained by FDA agents in any Federal district court. Once probable cause has been shown, the warrant may be issued and the search may begin. Every competent, experienced law enforcement officer can tell you that he has no trouble getting a search warrant when he needs it.