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researchers that "there are too many marihuana users who do not graduate to heroin, and too many heroin addicts with no known prior marihuana use to sup port such a theory. Moreover there is no scientific basis for such a theory." I Hearings on the Narcotics Rehabilitation Act of 1966 Senator Robert Kennedy stated that "the vast majority of marihuana users do not go on to use heroin." With respect to the notion that ordinary use of marihuana by normal ind viduals causes psychological damage the weight of scientific research rejects it All that can be said on the basis of present information is that the use of marihuana by psychologically predisposed people can cause temporary episodes of disorientation and that heavy and prolonged use of marihuana may be psycho logically debilitating. No doubt the small minority of users who do ultimately become social derelicts do impose upon their dependents and on society, costs for their medical and social care and additional costs because of the reduction in their economic productivity.

In short, on the basis of present knowledge it cannot be said that marihuana is more dangerous than alcohol or even that it poses as great a threat to longevir as do cigarettes. None of this is to deny that much additional controlled scientif research on the effects of marihuana use must be forthcoming before the govern ment can reach a meaningful decision on the legal treatment of marihuana, bat as concluded inthe report by Professor Michael Rosenthal to the Task Force of Narcotics and Drug Abuse of President Johnson's Crime Commission, "the daz gers of marihuana do not support the criminal treatment of the user solely for his own use."

At present we would not assert that legal control of the importation and cor mercial distribution of marihuana is wholly unjustified but there is no support whatsoever within the bounds of respectable debate for legislation which trea's marihuana, along with heroin, as belonging in the category of the most dangerous of controlled substances (which are divided by the Administration's bill among four categories).

The Association has substantial doubt whether the mere possession of mar huana is a proper basis for the imposition of any federal penalties, let alone the lengthy prison terms which the Administration's bill would impose. This eclusion is rooted in considerations which go substantially beyond the relative lack of dangerousness in marihuana use. Among the foremost considerations should '* the fact that untold millions of fine young Americans use marihuana, at least of occasion, youths who have no criminal tendencies whatsoever, and who ofter exemplify admirable character traits such as sensitivity, honesty, openness and high ethical, philosophical and artistic values. No good and much harm can come from deeming such people to be criminals, making them feel like despised out casts, and imposing on them and their loved ones the stigma of conviction and the ordeal of imprisonment. Indeed, such punitive treatment for conduct whi" significant elements of society find no more harmful than the use of cigarettes of tobacco will result in bitterness, cynicism, hostility and widespread disrespec for the law, and will deprive the government and society of the allegiance and goodwill of much of its youth and of much of value that they might otherwise have contributed.

Indeed, because of the widespread belief that prohibition of marihuana is ir rational, hypocritical and anomalous and because many users are attracted to marihuana because of the legal taboo, it is doubtful that laws against possessier can operate as a meaningful deterrent. Violations have occurred and will res probably continue to occur no less frequently than violations of National Pro hibition in the 20's. Legislation which, instead of deterring undesirable behavior has the effect of stigmatizing ordinary people as felons, and of making the la look arbitrary, ineffectual and unworthy of respect, is worse than a failure, it is a tragedy.

Another serious drawback of legislation prohibiting mere possession of man huana are the heavy costs of enforcement because of the inefficacy of the deter rent rationale and the difficulty of detecting offenders. The funds used to enfor laws against possession of marihuana would seem more wisely spent on or trolling the source and commercial distribution of all dangerous drugs.

Moreover, laws against possession are very difficult to enforce and invariabi create significant risks of undesirable and sometimes illegal or unconstitutiona

police practices such as the use of secret informers, entrapment, arbitrary searches and seizures, and other forms of what Mr. Justice Brandeis called "dirty business." Indeed when vast numbers of persons are engaging in a prohibited activity and enforcement agents must necessarily decide which violators are to be criminally charged, there is the real danger that such broad discretion will be used consciously or otherwise in a discriminatory and persecutory mannerreflecting the political, ideological, ethnic, and socio-economic biases of the enforcement agents.

Another factor which militates against federal regulation of possession is that even if ultimately found to be constitutional, it would unnecessarily encroach on a traditional domain of the states and deprive the states of an opportunity to experiment with other legislative responses to the problem.

The Association approves of tight controls, at least for the time being, on the importation, growth and commercial distribution of marihuana. We find regrettable, however, the failure of the Administration's bill to distinguish distribution by a commercial operator and distribution without sale by one friend to another. We are shocked by the fact that under the Administration's proposal if a 20-year old gives a 17-year old friend one marihuana cigarette, the former, even if he is a first offender, is subject to a minimum of ten, and a maximum of forty years imprisonment without the possibility of probation of parole!

In conclusion, the American Orthopsychiatric Association disapproves of federal legislation which would make possession of marihuana a federal crime and strongly disapproves of S. 2637 which imposes harsh penalties for the mere possession and noncommercial distribution of marihuana. The Association recommends that the Congress strongly reappraise the application of penalties for possession of each and every drug under legislative consideration.

THE DETERMINATION AND CLASSIFICATION OF DANGEROUS SUBSTANCES

Under the Administration's bill the Attorney General may add, delete or reschedule a substance as a controlled dangerous substance but he cannot remove any Schedule I substance (e.g., marihuana) to Schedules III or IV. In determining whether or how to classify a substance the Attorney General is required by the proposed statute to seek the written advice of the Department of Health, Education and Welfare and of a Scientific Advisory Commission but he is responsible for the final determination and classification. The Association believes that the determination of what substances are dangerous and to be controlled, and of the proper category of control, should be made by HEW rather than by the Department of Justice. The use and abuse of drugs in our society is essentially a problem of public health and welfare. Only after the nature and extent of a threat to public health and welfare are determined can meaningful decisions be made about law enforcement.

If one considers the statutory criteria, under the Administration's bill, for determination of whether a substance is to be controlled as dangerous, and the additional criteria for classifying a dangerous substance, it is obvious that HEW has far more experience and expertise to bring to these questions than does the Justice Department. The Administration's bill would have the Attorney General weigh the following factors, with respect to any drug whose classification as "dangerous" is under review: (1) its potential for abuse; (2) scientific evidence of its pharmacological effect: (1) the state of current scientific knowledge regarding the substance: (4) its history and current pattern of abuse; (5) the scope, duration and significance of abuse; (6) the risk, if any, to the public health; (7) its psychic or physiological dependence liability: (8) controls required by treaty or convention obligations; and (9) whether it is an immediate precursor of a substance already controlled. In determining a classification of a given dangerous drug (and thus the severity with which offenses involving such drug are to be treated) the Attorney General is to consider: (1) the potential for abuse; (2) the extent to which there is an accepted medical use; and (3) the safety of use under medical supervision. All but one of the above criteria for the two types of decisions are factors within the experience and competence of doctors, scientists, psychologists and sociologists-i.e., the types of personnel and experience within the particular ambit of HEW rather than the Justice Depart

ment. HEW is obviously far better equipped than the Justice Department to make the initial series of decisions regarding the nature of a drug, the effect and pattern of its use and abuse and the degree and type of controls warranted for the protection of the public health. HEW received its power based on division of responsibility in our democratic society which separates police from health functions and powers individually derived from differing views of how con munity and person are to be defended and protected. HEW is presently em powered to impose controls consistent with the maintenance of the public healt with respect to a wide range of drugs. We suggest that this mandate be broadened to cover all drugs, without artificial distinctions. Applying criteria sup plied by Congress, specific determination of the appropriate degree of control for individual drugs should be made by the Secretary of HEW, with the concurrenes of a board of independent qualified scientists and with appropriate standards for procedural fairness and administrative and judicial review. Once HEW, with independent expert assistance, determines the appropriate type of control of a substance in terms of medical, scientific and social criteria, then the Justic Department would carry out its traditional responsibility of enforcing the law to the extent authorized.

MEDICAL AND SCIENTIFIC RESEARCH

One of the principal reasons for the difficulties encountered in formulating legislative control of the distribution and use of various drugs is the absence of persuasive scientific evidence bearing on the individual and social pattern and effects of drug usage. In recent years bona fide researchers with valid and signif icant scientific projects have been severely hampered by legal and administrative obstacles, and much valuable research has been prevented or deterred by such roadblocks. Consequently there are many gaps in our knowledge which would probably have been filled had free scientific inquiry been permitted to follow its natural course. The Association believes that any legislation ultimately adopted must be designed to assist responsible scientific inquiry consistent with the de mands of public health and safety. Federal legislation should encourage and promote such inquiry, not hamper and stifle it.

The Administration's bill fails to take a clear stand in favor of maximizing responsible scientific investigation. Section 303 (f) requires that the Attorne General refer to the Secretary of HEW applications to engage in research of Schedule I substances (i.e., marihuana, the stronger hallucinogens, and heroin The Secretary of HEW is then to advise the Attorney General concerning the qualifications of the person or persons who will conduct the research, the substances to be used, the place where research will be performed, and the design the research protocol." We submit that these "standards" are so vague and nebulous as to provide no assurance whatsoever that all or even most legitimate bona fide researchers with valuable scientific projects will be granted the nece sary permission. The statutory ambiguities are further aggravated by a prevision in section 303 (f) which leaves unclear the relative authority of HEW and the Justice Department:

"Registration for the purpose of bona fide research with schedule I substances by a practitioner deemed qualified by the Secretary may be denied by the A torney General only on a ground specified in section 304 (a) (material falsit cation of application, conviction of a relevant felony, or suspension of a drug wal cense) or on the ground that the applicant's past practice or proposed procedures furnish ground for the belief that the applicant will abuse or unlawfully transfe such substances or fail to safeguard adequately his supply. . .”

Obviously the operative language of the proposed statute is so vague as to be susceptible to arbitrary and discriminatory application. Such licensing require ments, together with the provisions allowing administrative inspections on loos standards of justifiable cause. and requiring that special reports be filed by searchers on Schedule I substances, all within the final authority of the Depar ment of Justice, will substantially inhibit and deter valuable scientific resear In conclusion the Association believes that the Administration's bill fails: reflect and protect the needs. interests. and rights of the medical and scienti community, which in the long run are the needs. interests, and rights of th American people.

[graphic]

47TH ANNUAL MEETING March 23-26, 1970

Fairmont and Mark Hopkins Hotels San Francisco, California

THE URBAN SCENE

The changing dimensions of the urban scene demand exploration by the widest possible range of professions, including but not limited to the mental health and traditionally related disciplines.

People are the focus. We will examine issues confronting all people living and bringing up children in an urban society.

The entire urban framework will be explored: the historic, philosophic, sociological, psychological, economic and technological influences bearing on the city and its problems. The strengths of the city and its potential for enhancing the total life of the city person: mental, physical, intellectual, cultural and recreational will be our purview.

We will consider problems faced by people in all economic strata: the search for living space, safeguarding individual freedom of choice and privacy while maintaining law and order, identity and job crises of our youth, white racism, black racism, individual par ticipation in and accountability to the community, interactions between urban and rural conditions. We will look at the urban-suburban living pattern and at commuter responsibility to the city.

Issues in the area of mental health to be considered include: innovations in planning and delivery of mental health, medical and social services, centralization versus decentralization of services, government funding, citizen participation, medicare and medicaid, function of the schools and education for all age levels.

Contrast of United States government's passive rolein planning to meet urban problems with the government initiative and responsibility of other Western countries, demonstrations, strikes and violence viewed possibly as symptoms of "healthy expression," data banks and impact of middle class value systems will be discussed.

What needs to be done, how and by whom to solve the problems of city dwellers? What are the priorities? What are our resources and how can we use them best?

DIANA TENDLER, PH.D. and JAMES L. CURTIS, M.D.
Co-Chairmen, Program Committee

CORNELIUS LANSING, M.D., Associate Chairman,
Program Committee, Audio-Visual Program

ROBERT L. DEAN, M.A. and JAMES D. PEARCE III, PH.D.
Co-Chairmen, Local Arrangements and Publicity

An Association which will be a constructive leader in all phases of mental health for the society of its day and beyond, into a future which is now so entirely unpredictable, both for society and for ourselves.

LAWSON G. LOWREY, M.D.

The American Orthopsychiatric Association, founded in 1924, brings together 3293 anthropos educators, lawyers, physicians, psychiatrists, psychologists, nurses, social workers and sociologi in a collaborative approach to the understanding a treatment of mental health problems.

Uniquely problem-centered, the Association has pioneered and continues to stimulate the cross-fer of knowledge to broaden the horizons of the relate professions. It has encouraged the breakthrough to valuable new theories based on expanded from of research, leading to continued experimentation with new treatment programs.

The Constitution and Bylaws state these Purpo "To unite and provide a common meeting ground for those engaged in the study and treatment of problems of human behavior.

"To foster research and spread information concerning scientific work in the field of human behavior, including all forms of abnormal behavior" Orthopsychiatry

as a term was developed to project the idea of multidisciplinary treatment before the patient's problems become acute. This concept, so startling and new only 45 years ago, is today a respected keystone in theory and practice. It was the source the definition of health written into the United Nation's World Health Organization constitution In this significant document, health is described a state of complete physical, mental and social well-being and not merely the absence of disease a infirmity." This challenging definition, stated earlier by the White House Conference on Chik in 1930, was evolved almost entirely from the wort and thinking of AOA members.

Membership

has grown dramatically from 9 founding psychiat to the current roster of 3293. There are 1096 psychiatrists, 741 psychologists, 1071 social worker, and 385 other professionals in related fields colla as AOA members. They live in 46 states, the Dist of Columbia, the Virgin Islands and 19 foreign countries. Standards of admission have always be high and inevitably must remain so. Qualified professionals are encouraged to join. A memben committee reviews each application, which must the recommendation of three AOA members.

AOA Fellows are selected by the membership committee, reviewed by the Board of Directors a elected by the entire membership. Selection is based on the professional position and quality of and contribution to the Association's program Honorary membership has been awarded to m persons outside the professions who have made outstanding contributions to the Association's g

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