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Medical Science Publication No. 4, Volume II

30 April 1954




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

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

Late in 1948 and in early 1949 the extent of the use of narcotics bymilitary personnel in the Far East Command became known through the inaugurationof a control and reporting system which has been steadily improved up tothe present time. The control consisted of assigning military enforcementpersonnel in teams with indigenous enforcement personnel to apprehend boththe users and sellers of the drug. It also consisted of providing moresevere punishment for those apprehended in the traffic, and of meting outthis punishment surely and promptly upon conviction. It eliminated mererotation to the United States and bad conduct discharges for narcotic violators.It instituted penalties ranging from 1 to 5 years with a dishonorable dischargeand total forfeiture of pay and allowances. It put teeth in efforts ofauthorities to dry up narcotic traffic among military personnel.

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

Such recognition is necessary for proper control. However, on occasiona 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 placedon control; that narcotics would not be so widely used if made availableat 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 usersis unthinkable, and was sufficiently experimented with in the United Statessome thirty-odd years ago to satisfy any knowledgeable person that nothingcould be more dangerous for the health and safety of the nation than sucha compromise.

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

Interrogation of users in the Far East Command produced the followinginformation on this point: Almost invariably they began the use of thedrug through association with people who themselves were users of heroin.The non-user was at first curious, but soon, if he did not dissociate himselffrom the group, his curiosity and the encouragement of the addicts ledhim to try a little heroin on a cigarette. From that moment he was on theskids to addiction. The use became more and more frequent, a craving forthe heroin was acquired, and finally the victim found it easy to have someoneintroduce the heroin directly into his bloodstream. That someone mighthave 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 victimhad learned he could obtain and use the drug. The move was always quickand sure from smoking to intravenous injection.

Some people are of the opinion that real addicts are rare among thenumber of narcotic violators that are apprehended every month, and thathave been apprehended every month for the past 6 years, in the militaryorganization in the Far East. The situation there, however, is not anydifferent from that in the United States or any part of the world. It issufficient to say that any person who measures out the heroin on a knifeblade or nail file and gives himself an intravenous injection of 80 to90 percent heroin is an addict. It is also recognized that such an individualhas lost his effectiveness, that he is a liability, a threat to the securityof 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 civilianlife without proper and severe punishment. This is not only a strong deterrentto others, but it also removes the violator from society and the availabilityof drugs which is one of the best means of rehabilitation.

The extent of the use of narcotics among the Military in the Far Eastor in any other theater is known, of course, to the military authoritiesresponsible for those troops. It is sufficient for our purpose to realizethat one user, one addict, one person associating with addicts should bea danger signal that others in the organization are probably traffickingin narcotics. Addicts are found in twos, in fours, and where there arefour there are more. It would be folly for any medical officer or any otherofficer or commander to be complacent or unperturbed about even one narcoticaddict in the organization or unit. Therein probably lies the greatestvalue in such discussions of the subject as we are having today.

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

That use of narcotics cannot be tolerated in a military organizationappears to be well known to malingerers who claim to be addicts to escapemilitary service. These cases have been readily resolved by our agentsassisting the military authorities. Rare indeed would be the individualwho was inducted into the Military without his addiction to narcotics beingdetected. It would be practically impossible, although the individual mighthave some history of smoking marijuana which is often the prelude to heroinaddiction.

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


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

Financing Communist activity and support of the Communist regime havebeen made possible through the acquisition of foreign exchange and strategicmaterials in exchange for heroin and opium. The sale of heroin has beenespecially heavy in areas around military installations and is usuallysupplied to the owners of brothels by Chinese operating under Communistbosses who are responsible for the smuggling from Communist China. Thesale of heroin is a method of obtaining funds at a favorable ratio, andat the same time accomplishes spreading of addiction.

While the incidence of drug addiction among the Military in the FarEast Command is perhaps not high, the cost in lives, time, training, andmorale constitutes the problem. From observation and experience, the truckcompanies, the quartermaster companies, and the AAA batteries appearedto have a relatively higher incidence. Perhaps contributing factors aremobility, availability of exchange commodities, and inactivity.

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

All those not smoking the heroin were using it intravenously. Some oftheir arms were terribly scarred, the veins having been pretty well shotout. There were a sufficient number of these to cause some units to instituteregular inspections to locate these suspects. Of course the addicts goAWOL if possible to prevent such inspection. Others claim they fell ona barbed-wire fence and scarred the veins of their arms. Others fall backon the method of smoking the heroin, but this method becomes so expensivein supporting a big habit that the average addict will be forced to resumethe tell-tale injections. Blood and urine analyses have also been usedextensively with good results as detection devices.

The cost of obtaining the heroin in the Far East would be consideredprohibitive for the average person, but not so for the addict who payson 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 even1 gram at that price. The cost to the average user in the first stagesof addiction is between $75 and $100 per month. Addicts who have acquiredan average habit state they must spend from $150 to $200 per month forheroin. Such an amount of money is of course beyond the ability of theaverage soldier to pay without resorting to illegal activity. Thus it becomesa vicious circle. The individual would probably escape addiction were henot to associate with criminals and racketeers. Once he is addicted hemust 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 variousStates to pass legislation which will take the addicts off the streets.This in effect is the responsibility which the Military must undertakein 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 releasedfrom custody. For the young addicts these programs appear to offer somehope of salvage. For the older and more confirmed addicts the percentageof 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 observationif 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 ina more serious category in that every trafficker apprehended must receivesure and severe punishment as a deterrent to others, as a means of eliminatingnarcotic addiction from our military establishment. Anything less posesa threat to the security of the military organization and to the UnitedStates.