Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...

12a variety of committees of the American Medical Association dealingwith druss for over 20 vears, I am fully aware that physicians areextremely conservative about drug therapy. Codeine, for example,ranks high on the list of "most prescribed" drugs for the relief otcough and minor pains. It is a constituent of many mixtures whichare "prescribed for a varietv of sedative and antispasmodic effects.Whereas we do have effective substitutes for codeine which areknown to be safe, they have made relatively little inroads in the prescribingof codine. Furthermore, they do not substitute for codeine inall respects, particularly since they lack its analgesic and mild sedativeproperties. Relative costs, although not a compelling factor, must beconsidered. Tax-free morphine is now one of the cheapest compoundsavailable to medicine today.The paramount question then which confronts you, in my opinion.is not whether synthetics will substitute for "horticulturally derived"narcotics but rather whether outlawing the latter in favor of syntheticswill accomplish the objectives of significantly diminishing abuse ofall narcotic analgesics or, in fact, of even heroin itself.I say this because of several international situations. I just returnedfrom Japan last week where I consulted with the Minister of Health.They know exactly how most of the heroin and opium arrive in Japan,largely down the Mekong River from the countries which I mentionedearlier, transshipped through Macao in Hong Kong. From there itis smuggled into their many ports, some by air, but mostly by sea toKobe and Yokohama, et cetera.The Japanese have done a good job of heroin control. In 1964, theJapanese had a sharp rise in heroin abuse. They make an all-out effortto control this. They have available to them the facilities which Idoubt are available in the United States. In the first place, when theysay an all-out Government effort they really mean it. This goes fromthe Prime Minister on down. In the last 4 or 5 years they have helclseveral thousand public meetings all over Japan in which governors,states, mayors, even the Prime Minister participate. These are usuallyheld in theaters or a public auditorium and may be attended by asmany as 3,000 or 4,000 people. The hazards of drug addiction aregraphically portrayed.Furthermore, radio, television, newspapers, and other communicationmedia have made an all-out campaign against heroin.One of the things which I believe contributes significantly to theirsuccess is the fact that Japan has attacked one drug at a time ratherthan to try to hit the whole area of drug abuse. This goes back to 1955when they had the world's largest epidemic of stimulant drug abuse.In that year there were 55,000 arrests of methamphetamine abusers.Two years later they had reduced this by strong countermeasures to alevel of about a thousand arrests. This is the only extensive epidemicof drug abuse, with which I am familiar, in the world that has beencontrolled in such a short time. They later did a similar job of controllingheroin.One of the situations involves different attitudes toward authority.In Japan, when an expert goes on television, such as a professor in 'amajor university, people listen to him. I am certain this rarely occurs