Failure of Permissiveness

Only six years ago the British government and its top medical advisers were convinced that by treating narcotics addiction as an illness instead of as a crime, they had neatly confined the drug problem. Only 471 addicts were known, and only two of these were under 20 and on heroin. The practice of providing drugs cheaply, even to known addicts, through the National Health Service had eliminated most of the motive for smuggling dope or peddling it. The black market in pilfered prescription drugs was negligible. Britons could perhaps be pardoned for rather smugly contrasting this situation with that in the U.S., with its estimated 50,000 or more addicts and a high crime rate despite huge and costly efforts at suppression.

Now, however, Britain is disturbed over news that addiction has increased sharply and is still increasing. By the end of 1966, known addicts numbered almost 1,300, with probably 200 under 20 taking heroin. There was an uneasy suspicion that the true numbers might be four times as great. What had gone wrong with the famed British system?

There were isolated instances in which doctors had grossly overprescribed heroin--in one case, 1,500 tablets in four days for one patient. Some addicts used aliases to get multiple prescriptions from different doctors. Obviously, most of these extra drugs must have been passed along by the addicts to nonaddicts who wanted to experiment and eventually became hooked themselves. What broke down was not so much the system as the principle of permissiveness itself. The new offbeat generation, helped--so the British say --by an influx of a hundred or more junkies from the U.S. and Canada, exhibited a forbidden-fruit syndrome. Addicts and their experimenting friends found that they got more of a kick from illegally acquired fixes than from prescription pills. They even complained that stuff smuggled in was more potent than the domestic supply, whereas the opposite was true.

The government has now told Parliament it is time to crack down. But it is fearful that its efforts to curtail legal supplies of heroin might leave a vacuum into which smugglers and pushers will rush, making the "cure" worse than the present disease. Trying to balance on this tightrope, the government will soon introduce legislation with the following provisions:

> Addicts must be registered at a government office, but will still not be stigmatized as criminals.

> Only selected hospital doctors will be allowed to prescribe heroin and cocaine for registered addicts, and must guard against increasing doses.

> Groups of addicts will be steered to treatment in psychiatric hospitals.

Will this moderate change of course work? Says a government spokesman: "It's a gamble--we can't say what the outcome will be." But something must be done: the black-market price of heroin is already rising ominously.

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