News in Perspective Program: Drug Use and Drug Abuse (1969)

a greater degree of coordination between England and the United States. Dr. Lewis, the Nixon administration has offered a rather stringent bill in Congress to deal with drug abuse. Do you think it will be passed and that it will be effective? - Yes, I think it will be passed, I have every hope that it will be passed, and I'm sure it will be more effective than the old existing legislation. It will obviate the other statutes that we have, put everything into one package, and instead of enforcing three sort of unrelated statutes, we'll have one bill to work with. - Dick, so far as you know, do the agencies dealing with drug addiction generally support the proposed new federal law? - Well, they've said little, but I assume that they do support a new stringent drug law, because after all, everybody that I've ever spoken to was in favor of arresting heroin pushers.

The point is, though, that whether they support it or not isn't really critical to the problem. I mean, I think that we're continuing to deal with this problem in legal terms when we should be dealing with it in medical terms. Well, before we speculate further on how we should deal with it, let's get a few facts. Let's take testimony from an expert. Dr. Michael Baden, Associate Medical Examiner of the City of New York. Dr. Baden has a special professional interest in drug addicts, dead or alive. In the museum at the Medical Examiner's office, the City Morgue, he has an exhibit of drugs and the devices used to administer them. Dr. Baden, do I understand that narcotics addiction is now one of the most important causes of death in New York City? - Mr. Daniel, I think that's correct. In New York City, drug addiction, heroin addiction in particular, is the leading cause of death in the 15-to-35-year age group, more people die of drug use

and drug abuse than any other single cause. - In that age group... - Yes? - How many per year? - This year, there'll be more than 900 deaths from drug abuse, in particular heroin addiction, of which about 90% are in that age group. - 90%... how does this compare with five years ago? - Five years ago, New York City, there were less than 250 deaths associated with drug addiction, - An almost fourfold increase then. -Yes. - Tell me, what kills: the drugs themselves or the way they are used? Demonstrate for us with some of your exhibits? - I think that to understand the effects of drugs on the body, especially heroin, one has to appreciate the matter in which it is taken. The various opiates, be it heroin, morphine, methadone, demerol, have for many years been very important medical drugs with important uses and do not cause any body harm as such, unless it's taken in the manner in which the, is taken by the addict.

The heroin bags -- heroin is sold in the various bags -- is taking a very unsterile manner. Because of the unsterility, the lack of sterility, arise the various infectious complications, such as hepatitis, tetanus, or lockjaw, infections of the heart and other organs. Also within the bags, the amount of drug is not clear, the heroin is mixed up with quinine and sugars and other substances, and this material is put into a cook or a bottle top, much as was seen in the opening film, taking up in the syringe, be it a homemade syringe or a medicinal syringe, injected intravenously. The complications arise because of the lack of sterility and the unknown amounts of drugs present in the packet. - Who are the principal victims of death by drugs? Are they Blacks? - Well in New York City, about 50% of the deaths occur in Black persons, 25% in white persons, and 25% in Puerto Ricans.

There's been a striking and alarming increase in the teenage use of drugs and deaths resulting thereof as Mr. Garelik mentioned, and perhaps 25% of the drug addicts, the heroin addicts in New York City are now 21 or years of age or younger. - What social or economic classes do they belong to? - Whereas 10 years ago, a large part came from the ghetto area, a large part of the drug problem came from the ghetto areas, we're seeing increasing numbers of deaths in the middle-class suburban areas, Queens and even Staten Island now have had increasing numbers of white middle-class persons dying of drug abuse. - Does it spread even farther than that beyond these outlying boroughs into the suburban counties in New York, New Jersey? - Our jurisdiction in New York City is the five boroughs but certainly there's been a marked increase in drug use throughout the state of New York, in many suburban areas. Much of it relates to the use of pills initially.

These are some pills taken from the places of death of persons, usually heroin addicts, but sometimes barbiturate addicts, amphetamine or speed addicts, persons who start using pills and then may use heroin with pills, without pills, and this has been an increasing problem. Of course marijuana is a different category of perpetual problem - A different category of perpetual problem, in what sense? Well, my personal view, coincides very much with what Dick Severo just mentioned. I think that to understand why people use drugs, one has to, in addition to deal with the law enforcement aspects of cutting down the availability of drugs, one has to go into the reasons why people use drugs, and a person who injects these needles and syringes in this self-destructive way, causing all kinds of scars and tracks in the arm, is mentally a lot sicker

than a person who smokes marijuana because his peers are smoking marijuana and who may go on to be a perfectly normal well-adjusted citizen later on. Our studies at the medical examiner's office indicate that the heroin addicts who die, the large majority of them have had anti-social records, juvenile delinquency, arrests, other types of anti-social acting out before they ever used heroin, and I think we can't approach the heroin addict in the same terms that we use, speak of the marijuana user, who's using it for perhaps a different reason, sometimes. - What's the remedy then? Medical treatment, psychiatric treatment, prison, the combination of all three? - I think it depends on why the person is addicted. I think in medicine, we've been on a wrong foot for a long time trying to cure cancer by using just one, looking for one magic solution. We would now realize there are many causes of cancers, therefore many cures for cancer. The same with drug users. There are many reasons why people use drugs.

Many of them, I think, will be susceptible and have been susceptible in pilot programs, to the group therapy, psychiatric approach. Other persons may be susceptible to drug maintenance programs. Others may have to be imprisoned. I think all of these areas have to be investigated as Mr. Garelik said and evaluated for what addict and what drug user does well in what kind of treatment modality, and certainly the law and medicine have to work together, it can't be exclusively one or the other. - One final question, Dr. Baden, how many drug addicts are there in the city of New York?