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Chapter 9, Part 1

Medical Science Publication No. 4, Volume II

30 April 1954




We will not begin by saying that narcotic traffic and narcotic addiction were not real problems, that they constituted only a situation in the Far East Command and in the Armed Forces Far East. Neither will we say it was an alarming situation that justified the sensational and sometimes hysterical approach which has been used on occasion.

Enforcement officials well know that adequate enforcement is not brought about by hysteria. Neither is it accomplished by an attitude of complacency. As has been said many times with reference to narcotics, eternal vigilance is the price of proper control.

Late in 1948 and in early 1949 the extent of the use of narcotics by military personnel in the Far East Command became known through the inauguration of a control and reporting system which has been steadily improved up to the present time. The control consisted of assigning military enforcement personnel in teams with indigenous enforcement personnel to apprehend both the users and sellers of the drug. It also consisted of providing more severe punishment for those apprehended in the traffic, and of meting out this punishment surely and promptly upon conviction. It eliminated mere rotation to the United States and bad conduct discharges for narcotic violators. It instituted penalties ranging from 1 to 5 years with a dishonorable discharge and total forfeiture of pay and allowances. It put teeth in efforts of authorities to dry up narcotic traffic among military personnel.

From the outset the menace of the use of narcotics and narcotic addiction was recognized in its true light. Otherwise the number of narcotic violators, which some military officials consider has been held to a minimum, may well have increased by geometric proportions.

Such recognition is necessary for proper control. However, on occasion a few persons have made claim to a new idea or a new ap-

*Presented 30 April 1954, to the Course on Recent Advances in Medicine and Surgery, Army Medical Service Graduate School, Walter Reed Army Medical Center, Washington,
D. C.


proach to the problem by suggesting that too much emphasis is placed on control; that narcotics would not be so widely used if made available at low prices; that the proper approach is for the government to, in fact, subsidized narcotic addiction by making narcotics available for the addicts. This proposed compromise with the destroyer of the very lives of the users is unthinkable, and was sufficiently experimented with in the United States some thirty-odd years ago to satisfy any knowledgeable person that nothing could be more dangerous for the health and safety of the nation than such a compromise.

Association with addicts and sellers of narcotics, and availability of narcotics are considered the two most important factors in the spread of narcotic addiction. Authorities make great efforts to reduce the availability of narcotics, to place them beyond the reach of the wavering prospect who has reached the point of possible contamination through association. Should the availability be increased, a nearly perfect condition would be created in some instances for the spread of addiction since it is characteristic of an addict to strive constantly to spread the drug habit among his associates.

Interrogation of users in the Far East Command produced the following information on this point: Almost invariably they began the use of the drug through association with people who themselves were users of heroin. The non-user was at first curious, but soon, if he did not dissociate himself from the group, his curiosity and the encouragement of the addicts led him to try a little heroin on a cigarette. From that moment he was on the skids to addiction. The use became more and more frequent, a craving for the heroin was acquired, and finally the victim found it easy to have someone introduce the heroin directly into his bloodstream. That someone might have been his "buddy" who had led him to the brink of destruction, or it might have been a prostitute or pimp in the place where the victim had learned he could obtain and use the drug. The move was always quick and sure from smoking to intravenous injection.

Some people are of the opinion that real addicts are rare among the number of narcotic violators that are apprehended every month, and that have been apprehended every month for the past 6 years, in the military organization in the Far East. The situation there, however, is not any different from that in the United States or any part of the world. It is sufficient to say that any person who measures out the heroin on a knife blade or nail file and gives himself an intravenous injection of 80 to 90 percent heroin is an addict. It is also recognized that such an individual has lost his effectiveness, that he is a liability, a threat to the security of the organization.

There is no place in our military organization for users of narcotics, for narcotic addicts, but it is considered unwise simply to release these


law violators and spreaders of narcotics and narcotic addiction to civilian life without proper and severe punishment. This is not only a strong deterrent to others, but it also removes the violator from society and the availability of drugs which is one of the best means of rehabilitation.

The extent of the use of narcotics among the Military in the Far East or in any other theater is known, of course, to the military authorities responsible for those troops. It is sufficient for our purpose to realize that one user, one addict, one person associating with addicts should be a danger signal that others in the organization are probably trafficking in narcotics. Addicts are found in twos, in fours, and where there are four there are more. It would be folly for any medical officer or any other officer or commander to be complacent or unperturbed about even one narcotic addict in the organization or unit. Therein probably lies the greatest value in such discussions of the subject as we are having today.

Every officer, particularly every medical officer, should have fundamentally the same approach to the problem of the use of narcotics in a command as a Provost Marshal. When the officers are all equally well acquainted with the real meaning of the use of narcotics by military personnel, with the extent of the use in any particular area or command, an effective plan of action can be devised to bring the situation under control. The violators can be apprehended and eliminated from the Military after proper punishment.

That use of narcotics cannot be tolerated in a military organization appears to be well known to malingerers who claim to be addicts to escape military service. These cases have been readily resolved by our agents assisting the military authorities. Rare indeed would be the individual who was inducted into the Military without his addiction to narcotics being detected. It would be practically impossible, although the individual might have some history of smoking marijuana which is often the prelude to heroin addiction.

Narcotic addicts are of their own making, and the addiction is usually acquired within a period of a few months when the two factors, association with addicts and sellers of narcotics and availability of drugs, are present. For all practical purposes there is no place in the world where narcotics are not available to those who seek them out, but the Far East Command and the Armed Forces Far East are in a particularly vulnerable area, an area where it is important that the Military be alive to the responsibility of carefully policing their own organization. The area is adjacent to the greatest supply of heroin the world has ever known. This supply of heroin is held by and is being trafficked in by the Communist regime of Mainland China. This is not a recent circumstance. For many years, the Communist


regime has financed its activities and spread addiction to other peoples through the sale of heroin transported and sold in other countries by couriers and agents of the Communist regime in China.

Financing Communist activity and support of the Communist regime have been made possible through the acquisition of foreign exchange and strategic materials in exchange for heroin and opium. The sale of heroin has been especially heavy in areas around military installations and is usually supplied to the owners of brothels by Chinese operating under Communist bosses who are responsible for the smuggling from Communist China. The sale of heroin is a method of obtaining funds at a favorable ratio, and at the same time accomplishes spreading of addiction.

While the incidence of drug addiction among the Military in the Far East Command is perhaps not high, the cost in lives, time, training, and morale constitutes the problem. From observation and experience, the truck companies, the quartermaster companies, and the AAA batteries appeared to have a relatively higher incidence. Perhaps contributing factors are mobility, availability of exchange commodities, and inactivity.

Military personnel addicted to narcotics have been found on the streets buying from shoe-shine boys, pimps, prostitutes, or other sellers; have been found hovering around make-shift tables in dilapidated lean-to's; have been found in huts in company with arm-scarred addicts both male and female; have been found to have the heroin hidden around the gun pits; have been found using heroin in dayrooms and libraries; have been found in boiler rooms preparing injections of heroin with the hot water; have been found preparing heroin injections in latrines; and have been found in their bunks with the heroin and injection paraphernalia stored under their pillows, in Bibles, in fountain pens, etc.

All those not smoking the heroin were using it intravenously. Some of their arms were terribly scarred, the veins having been pretty well shot out. There were a sufficient number of these to cause some units to institute regular inspections to locate these suspects. Of course the addicts go AWOL if possible to prevent such inspection. Others claim they fell on a barbed-wire fence and scarred the veins of their arms. Others fall back on the method of smoking the heroin, but this method becomes so expensive in supporting a big habit that the average addict will be forced to resume the tell-tale injections. Blood and urine analyses have also been used extensively with good results as detection devices.

The cost of obtaining the heroin in the Far East would be considered prohibitive for the average person, but not so for the addict who pays on the average of $2 for from 0.01 gram to 0.03 gram. In


larger quantities he may purchase 0.5 gram for $10, or on occasion even 1 gram at that price. The cost to the average user in the first stages of addiction is between $75 and $100 per month. Addicts who have acquired an average habit state they must spend from $150 to $200 per month for heroin. Such an amount of money is of course beyond the ability of the average soldier to pay without resorting to illegal activity. Thus it becomes a vicious circle. The individual would probably escape addiction were he not to associate with criminals and racketeers. Once he is addicted he must engage in other criminal activity to finance the purchase of the drug. He must pay for the privilege of digging his own grave.

At the present time the Bureau of Narcotics is encouraging the various States to pass legislation which will take the addicts off the streets. This in effect is the responsibility which the Military must undertake in apprehending addicts within their own organization.

Another program which appears to have merit is the post-custodial care, which means that a person receives some help and guidance after being released from custody. For the young addicts these programs appear to offer some hope of salvage. For the older and more confirmed addicts the percentage of permanent abstinence from the drug is considered very low.

It has come to be recognized that an addict needs more than an admonition. He cannot be left to his own volition as to the time required for rehabilitation. The addict must undergo a period of confinement followed by close observation if there is to be any hope for a cure with any permanency.

A minimum of 5 years confinement is recommended for sellers of narcotics. In many instances they are receiving 20-year sentences.

Military personnel engaged in the narcotic traffic are classified in a more serious category in that every trafficker apprehended must receive sure and severe punishment as a deterrent to others, as a means of eliminating narcotic addiction from our military establishment. Anything less poses a threat to the security of the military organization and to the United States.