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Lethbridge Herald, The (Newspaper) - September 8, 1971, Lethbridge, Alberta -Wedneirfny, SlpUmbtr _ THI IRHIH.iSCiE HHUklO g Dave iiumpltreys Britain's experiment with drug users T ONDON: The dmg addict in Britain drops inlo Ills neighborhood drugstore daily lo pick up Ills free dosage pre- scribed in a clinic. He visits the clinic at least once a week for consultation with one or more doctors. He is a sick person. Two years ago Briain re- responded to a surge in addic- tion by setting up clinics to treat addicts. Staff doctors were licensed to prescribe nar- cotics for them. Ail doctors were compelled under law to report addicts to the govern- ment. It was a bold experi- ment in attacking Ihe addiction problem through slate-controll- ed treatment. It was also high- ly controversial, widely criti- cized. But it is producing results. There were registered narcotic addicls at the end of 3970, or 36 fewer than at the same time (lie previous year. This was the first reduction af- ter a decade of annual in- creases in the rate of addic- tion. Claims of success must be qualified by the short time the system has been operating. Since clinics were swamped patients during their first year, they have really only had one normal year. Yet that itself may make the results all the more interesting. The British themselves make no claims to success, much less to "curing" addicts. They sug- gest cautiously that Uie upward trend in addiction lias been re- versed. Statistics show a steady rise in the number of registered ad- dicts during the 19G0S. The an- nual rises in known addicts were 118 from 1963 to 1964, 174 from 1964 to 1965, 422 from 1965 to 1966 and from 1966 to 1907. However, the last figure re- fleclcc' the new law making it compulsory to report known ad- dicts. Statistics since 1967 are more accurate than the earlier ones. They showed an increase of only 89 during the first year of the clinics, 1963. The new statistics show a modest reduction in all age- groups for all types of narcotic addiction. Heroin users are re- duced from HH to 183. Those on melhadone were down from 1.011 to 992. And there were 255 on other narcotics like mor- phine and pclhidinc, foiir fewer then one yea- earlier. Obviously a system with many users outside it isn't ef- fective. There is no way of knowing how many opcrafc out- side it. But Jim Zacunc, a psychologist who has just com- pleted four years with the Lon- don Institule of Psychiatry's Addiction Research Unit, be- lieves the number is small. Police say the market for bootleg heroin has been greatly reduced. Some of it has been replaced by bootleg methadone. Some addicts on prescription are flogging part of it on the black market. The maximum penalty for possession of heroin without a prescription is seven years in jail. Tlie maximum for traffick- ing has been increased recenlly to 14 years. Although drug con- victions increased by more than between Iflfig and 1970, almost all the increase came for smoking cannabis. While the system is new, the attiludc is 50 years old. The re- port of Sir Humphrey Rolleston in 1926 established the attitude prevailing today. Addiction was a rare condition Ihen, the re- port said. It should be consid- ered an illness rather than "a mere form of vicious indul- gence." Doctors should be free to pre- scribe heroin or morphine to addicts "capable of leading a useful and fairly normal life" while taking non-progressive quantities of the drug. The gov- ernment kept a register com- piled from various sources, but contrary to popular belief it didn't entitle those registered to receive drugs. Between 1935 and 1955 the number of known addicts dropped from about 700 to 334. The system appeared lo be working until the mid-1950s. Be- tween 1955 and 1964 about 450 new heroin addicts came to no- tice. The new factor was tho high proportion of addicls in their early twenties. At first it was thought that the problem was illicit, import heroin. However, t h e report of a committee in 1965 decided oth- erwise. "The major source of said the report, "has been the activity of a very few doctors who ha-ni prescribed excessively for addicts." As a result of this finding, flic Brilish system as it is to- day ivas set up. For Ihe first lime doctors were compelled by lo notify the govern- ment of all known addicts. Twenty-five special drug treatment clinics, 16 in London with four-fifths of the drug ad- dicts, were established. Out-pn- lient rii'iig services were made available at other regular hos- pitals. A new law restricted the prescription of heroin and co- caine lo doctors on the staffs of treatment centres. Since Ihen doctors and pa- tients have been feeling their way. It has never been simply a case of the addict walking in and getting his drives. At first Ihe clinics were swamped, in- len'icws were inadequate and in some cases dosages were ovcrprescribcd. Dosages arc mailed to neighborhood drug stores to be picked up daily. Patients are subjected lo a scries of interviews. Doctors build up as thorough a case his- 1017 on each one as possible. The patient must visit the clinic at least once a week, ensuring thai a doctor-patient relation- ship is established. The patient must stay with one clinic throughout the treatment. In theory heroin is supplied only if other methods of treatment have failed. But the questions of when lo start the prescrip- tion and tire dosage have been lillle studied and are subject lo much controversy, Tire rale of cure is admit- tedly low. Mr. Zacune and his associates studied 37 heroin users over three years. Only one is completely drug-free. After one year six were off her- oin in favor of substitues. Af- ler Ihree years it is even high- er. Several are using only soft drugs like cannabis. Another study covering 65 pa- tients showed that nine, or 14 per cent were completely off drugs and that 28 per cent were considered to have broken their addiction. "I don't think England has a greater cure rate than any- where says Mr. Za- cune. Here a lot of addicts are switched from hard to soft drugs and "that may be as good a cure as you're likely lo get." This is reflected in the total supply of heroin prescribed through flic clinics. It is re- duced slightly monlh by month. Substitute drugs arc being pre- scribed in ever-rising amounts, although Hie actual, totals arc nol public. The statistics for lasl year also lell llic slory. There were addicl-s receiving mclha- done and only JH3 for heroin alone. Of Lhc 992 on mclhadoiie, were also being prescribed heroin. Yel in bolh categories Uierc were slightly fewer pa- tients then one year earlier. When possible, which isn't often, methadone is prescribed as a syrup, eliminating hazards of Ihe needle. Most i.s still pre- scribed for injection. And doc- tors arc skeptical thai melha- done will eliminate the taste for heroin in hardened addicls or lhat Ibey will take methadone in syrup. For many the needle is part of the addiction. The advanlage of the medi- cal approach, beyond doubt, is Lhal it eliminates the need for the criminal "way of life" so associaled with addiction in North America. The prescrip- tion, like most under the Na- tional Health Service, is free or almost so. There i.s no need for addicls lo find the ?25 or 3UOO a day they must have in North America lo buy their "fix" on an undenvorld-domi- nated black market. Twenty-five Canadian, addicls have been compared in Canada and in Britain in the first study of effects of flic two systems on the addict. H is assumed thai Canada, like Ihe U.S., treats its addicls as criminals ami Britain treats I hem as sick persons. The Canadians lived more useful, less criminal lives under treatment in Britian than they did in Canada, according to first details o[ the survey pub- lished in the July issue of Harper's Magazine. The study is bound to fan the drug addiction treatment con- troversy, coming as it does when the problem in Canada and the U.S. is spiralling and when there are new indications of success under the British system. All the more so because of the way it is used by writer Ed- ANNUAL STORE-WIDE 21 PIECES COMPLETE 3 ROOM GROUP Starts Tomorrow, THURSDAY Featuring many, many outstanding Furniture, Appliances and Carpet buys just like this fabulous 3 Room Group IMAGINE SEE THURSDAY'S HERALD for More Details Then, Come In and Really Save! 21 PIECES OF QUALITY FURNITURE FEATURING 3 piece wolnul finished bedroom iuilB Simmoni box tpring and 2 drelier lampi Sofa and chair (30 coven and colon lo choose from) Arborile collet table 2 arborile Hep lablei arboriU kitchen lobln 6 vinyl covered matching chain 2 lable lampi 326-5th SI. S. Phone 327-8578 OPEN THURSDAY AND FRIDAY UNTIL P.M. gnr May in Harper's to support his Ihcsis that llic British sys- lem works, conlrary lo popular U.S. belief. Brilish drug experts have been impressed by Mr. May's own conversion. He came to Britain convinced that (lie sys- tem of maintaining Ihe addict on prescription-controlled dos- age was a failure. He left a year later completely sold on it and advocating the British attitude if not the whole sys- tem for the U.S. Mr. May's exhibit A for the British system is the survey of Canadians carried out by Jim Zacune, new editor of a new Brilish drug treatment journal but for four years psychologist with the Addiction Research Centre at the London Institute of Psychiatry. Mr. Zacunc found the Cana- dians spent only two per cent of their addicled time in Bri- tain in jail compared lo 25 per ccnl in Canada. They were charged with 27 offences here, eight for major crimes, com- pared lo 102 offences and C8 for major crimes in Canada. Mr. May further quotes the Zacune study: "In Britain many one-time 'hustlers' be- came job holders and often led fairly normal lives on a daily heroin dosage 3V; times thai of the London addicts. I n Canada only one claimed to have worked steadily while ad- dicted. In England 13 worked full-lime and four worked part- lime. Six had held the same job for at least three years. Seven had semi-skilled or skill- ed manual jobs; two were of- fice workers; one was in sales; and tho rest worked as a crou- pier, housewife, student." (It is estimated that 40 per cent of addicts arc attending British clinics for treatment work.) Mr. Zacunc says he didn't in- (end lo give Ihe impression that British addicts are normal. "They lead pretty sleazy, lazy lives here, too, and there is some petty crime." But he says Britain is without the under- world connotations of the North American scene. The period of. Mr. May's sur- vey included some time before the system of clinics was set up in 1968. But doctors have always been able lo prescribe drugs to addicts all doctors before 1968, only those spe- cially licensed since. One of the Canadians was getting his drugs from one of the worsl of- fenders of Lhe so-called "junkie doctors" whose abuses led di- rectly lo tightening of Ihe pro- cedures. Mr. Zacune disputes Mr. May's use in Harper's of his own findings to support one system over another. "I have absolutely no way of knowing whether these 25 were typical of Canadian he says. He attempted to include but knows he didn't succeed in in- cluding all Canadian addicts who came to Britain during the early 1960s. Also, he says, what may be suilable treatment for a group of individuals is not necessarily the answer for an entire national society. Nor does Mr. Zacune claim the Canadians as support Tor the British approach. Bui he does think his concul- sions indicate some beneficial results for the British system as it applied to the group. He agrees with Mr. May that there is a lot of biased and unin- formed criticism of the so-called "British syslem" in North America. Britain has fortunate in never having Ihe occupational type of addict. Mr. Zacuns says it is highly questionable whether tire addict wouJd give up his way of life easily. Mr. May commeuls in his study: "It is Ihe recognition thai many addicts don't want to be cured no matter how much society wishes it were otherwise thai is the key ra- tionale for giving free narcotics at clinics." Bui Mr. Zacunc says Ihe im- portant difference in iype of Ihe Brilish and Canadian addicl could he the greatest problem clinics would face in Canada. Canada's vcleran hardened addicls probably like the asso- eialed and often criminal acti- vity, he suggests. What he does recommend is I'Ml more thoiighl be given in anada lo some adaptation of Ihc Brilish program, at least lo the extent of pulling addicts regularly in touch with medical help. In that IK agrees with Mr. May whose study he highly re- sports. Mr. May concludes: "With all ils shortcomings and imperfections, Ihe British effort confirmed for mo that America never will mnkc sig- nificant headway with the drug problem until it puUs in charge Ihe man who ullimalcly will lo solve it: Ihc doctor, not the (Herald Lomlon liurcau) A message from the young By Christopher Young, In The Oilawa Citizen "POLITICAL leaders have an obligation to listen lo the voice of young people for the substantive and moral intelligence it seeks lo convey. For all cf its uncer- tainty nnd confusion, the message is an honest and humanistic cry against a so- ciety which places technological advance- ment and bureaucratic cfficcncy before the needs of its citizens.'1 That paragraph, plucked cut of the mid- dle of the Committee on Youth report, sums up the whole volume its purpose, its value and its shortcomings. The report, two years in llic making, was delivered to Secretary of State Gerard Peltetier and published recently. It reflects veiy clearly the viewpoints current among at least the more articulate members o[ Canadian society between the middle teens and the later twenties. It ex- presses their idealism and impatience for social change. It reveals the internal con- tradictions of their philosophy. If demon- strates the difficulty they have in coining to grips with practical proposals. It is a confusion wilh which I, for one, can sympathize. Wlw among us will not agree that our society is too obsessed with quantity, with material growth, with economic statistics and consumption values? Yet who can think about the problem clearly and deny that the kind of social bcncfils so ardently desired by the authors of the youth report depend to a very great degree upon a productive and prospering economy? Tills unresolved dilemma weakens Ihe committee's argument, and it is compli- cated further by an insistence on the fash- ionable existentialism summed up in the bromide, "Do your own thing.'1 For example, the report deplores flic "work ethic1' the conventional view (hat people should aspire to work for a living; ivhile at the same time waxing properly indignant about the scale of unemployment. For anolher example, it attacks the kind of education available to young Canadi- ans; while protesting most effectively against the way in which access to higher education is biased against the lower in- come groups. Compounding these contradictions, it seems to suggest that education ought lo be more precisely tailored to the needs of employers a view that one might have expected to hear from the president of a large insurance company but hardly from the flower children. Ajid u" youth should do its own tiling, wliy shouldn't the middle-aged or the old do theirs? Yet these dilemnras lie at the heart of our political and social philosophy. They are not peculiar to youth; the iconoclasm of youth throws them into sharp relief. One of the best things about the report is that it makes few arbitrary distinctions between the 'generations. It emphatically rejects the notion that youth is a class, and it links the problems of disadvantaged youth with the self-perpetuating poverty cycle of families at the bottom of Ihe py- ramid. The and humanistic cry hp by youth. it is uticrcd for so ciely as a whole. It wants a belter world everyone and employs the "new sensi- bility" in the service of universal values. The report contains a number of con- crete proposals which ought to he adopl cd by tire authorities concerned. It should be obvious by now thai the student loan program is not working well, and that the whole system of financing higher education is heavily biased in favor ot the affluent. It has been said often enough and is IhorougliJy documented. Yet the system remains The waste of costly educational facilities, be-In sclrools and universities, is obvious lo the naked eye wlu'lc so many of the build- ings remain unused in the evenings and during lengthy holiday periods. The solu- tions have been clearly set forth: a trim- ester or quarterly system at university, a wider community use of schools at niglil. Yet UK waste continues. The Task Force on Government Informa- tion reported two ycare ago on the failure to commimicate to Canadians the facilities their taxes had made available for their use. Information Canada was set up to deal will) the problem. Yet the youth report still complains that young people often do not know about the programs that have been developed on their behalf. All these tilings deserve to be said again in the faint hope that eventually somebody will listen. The disillusionment of a gener- ation is a high price to pay for the lethargy of those who have it made. But when it conies lo large-scale inno- vation, the committee falters. Its trouble is perhaps symbolized in flic name P2 given the grandiose idea of community assemblies strung out across the nation, run chiefly by the 15-lo-2-5s, free of govern- ment biu'eaucracy, and financed we know not how. The name P2 is not explained in t h e report. It arises from the failure of tire committee lo agree on a name. Various ideas for greater participation were dis- cussed by the committee and were named for convenience Plan I, Plan 2, 3, 4 and so on. Plan 2 was (he winner, contracted to P2. If this small and relatively homogenous committee could not even agree on a name for ils central proposal, one is bound lo wonder what a national complex of community assemblies might agree on. Perhaps that is a confession of senility, but after all the system of representative democracy was developed in response to just such a need. Perhaps we should try harder to tune up our parliamentary insti- tutions, make them more responsive to the needs of all the people, before we consider setting up a parallel power of community assemblies, when could only be financed by the taxpayers but would not be respon- sible lo them. Anyway, it is an interesting report, and I fully agree that "political leaders have an obligation to listen." Predictable The Winnipeg Free Press jyjANITOBA Premier Schreycr is re- the position of every caring parent for ported to have said of the drug rec- ommendation in the federal government's youth report: "It's for the birds." What has the premier got against the birds? It is an odd thought thai when a govern- ment decides to launch a commiUee "on youth" it should advertise for people to sit on it at a working day. It might rea- sonably be supposed lhat a govemmcnl needing a report on youlh had people in mind who were qualified and whose exper- ience gave them some measure of mature judgment. This report, given the back- grounds of those who got the jobs, was almost painfully predictable. There is nothing new in it. Tlic legaliza- tion of soft drugs has been a partisan point for years. The Company of Young Cana- dians has been a dead loss since its incep- tion and many people have recommended iU end. Youth hostels have been the sub- jccl of debate for years, and who objects to them if Ihcy are properly run with proper rules, by the righl people, and at an appropriate cost to the user? Travel as a legitimate educational expense has been hundreds of years though they have al- ways regarded it as Hieir expense and not thai of their neighbors. The collect- ing of all these old hats by three bright young men is said to have cost The proposal lo abolish the cadets could have been foretold coming from this trio, if anybody had been interested in what they might, have to say. Their proposal for the legalization of soft drugs because they have "no physical effects" was also pre- dictable not only in the inaccuracy of its assertions bill in whal they left out about the social effects of drug taking. These gentlemen have had their day in the headlines at far loo great an expense to the taxpayer. The government at Otta- wa at least should have learned something alwul committees: it has set up enough of them; the public has had more than enough of Ihcm. There ir.ust be a place for reports thai hash over whal even-body is lalking aboul and come up wilh recommendations thai flow inevitably from one point of view. The government should pul tliis stale and useless document in that place. The Press is still free The Ottawa [inuij; of a Toronto reporter for refusing to reveal his sources does not mean an end to freedom of the press. Freedom of Ihe press docs not ir.can imil a reporter may conceal his sources; it means lhat a reporter may st.ile or whal he has discovered and a publisher may print it bolh subjecl lo Ihe general laws of libel and slander and sedition. The Iradition of courageous reporting and publishing in Canada is that Ihcir work is clone in llic knowledge lhal lliey may suf- fer for it and lhal Ihcy are willing lo suffer for il. Not special legal protection but their ethics and principles have kept Ihcm from revealing sources. Public opinion is the last ivsourcc be- hind IIw freedom of the press. If courts loo frequently fined reporters and publish- ers, the public would not sland for it. Tliere have been relatively very few of such fines in all Canada's publishing his- lory. It the PIT.--S lo obtain [.lie riflhl of a reporter or publisher nol In reveal his sources the public would, understandably, become uneasy. It is one thing for a re- sponsible reporter or publisher lo risk fine or imprisonment in publishing something he feels for the public good. It would bo quilc nnolher thing lo enable all reporters and publishers io know thai they may nev- er be obliged, on pain of fine, lo say where they got their information. Reporters or publishers wilh more imaginalion Uian in- tegrity could Ihen in perfect freedom de- clare mast anything and from whole cloth. Newspapers one way or anolher pay the fine assessed their reporters in earning out orders. The burden is easily borne, rn return UK press may continue with pride lo stale Uial it will nol reveal its sources and danai the consequences. That is con- sistent with the freedom of the press, and certainly with Lhe responsibility of Ihe press. Once the press asks for special free- doms o[ utterance nol given to the public, the public's esteem and faith in Ihe press will decline, will the press' f.iiih nnd Citccm in iliclf. ;