Georgetown forum; Drug addiction and crime

Addiction and youthful crime the topic of the eleven hundred and seventy fourth consecutive broadcast of the Georgetown University radio forum. Another in a series of educational and informative programs from Washington D.C.. The Georgetown forum was founded in 1946. This is Wallace Fanning speaking to you by transcription from the Raymond Rice studio on the campus of George Stone University a historic Jesuit seat of learning in the nation's capital. Today's discussion will be addiction and youthful crime participating are Alan Schwartz a clinical assistant professor of psychiatry at the Georgetown University School of Medicine. Dr. David Lanham chief of Legal psychiatric services D.C. Department of Public Health and assistant professor of psychiatry the George Washington University School of Medicine and Dr. James L4 Oyo associate professor of psychiatry at Georgetown University School of Medicine.

Although youthful drug abuse and associated crime frequently are the subject of startling headlines we have the general public may not know the extent and nature of the problem in the urban world. One reason is the lack of sufficient data from which we can draw conclusions that are generally valid. Psychiatry is believe that drug use is a syndrome a combination of social psychological and physiological factors. Young people now form a large percentage of drug users and there is evidence that drug use is rapidly increasing not only at the college level but in high schools and even junior high. Today we have asked the chief of Legal psych psychiatric services of the District of Columbia Public Health Department and two members of the Georgetown University Department of Psychiatry to tell us without violating any confidences. Their experience with young drug users and youthful offenders which could give us more knowledge

of the causes and extent of drug abuse and its relationship to anti-social behavior. And we're going to begin by asking Dr. Lanham what is meant by addiction. This is this no simple question dancer because there have been many efforts to adequately define this problem. Perhaps the best definition I know of was one essayed by the World Health Organization several years ago in which they described they they don't no longer wanted to use the term addiction they preferred to use the drug. The term drug dependency and they defined it as a necessity to have the drug and to obtain it by any possible means. And the that which constitutes psychological dependence. They also spoke of a

physiological dependence in that when the person when the person had been using the drug and then ceased using it he would suffer from certain physiological conditions which are called a withdrawal or abstinence syndrome or state. Also they spoke of something called drug tolerance namely that in order to obtain the same effect from the drug run had to use increasingly large amounts of the drug. I think it's important at this point perhaps to distinguish between addiction dependency and abuse or perhaps rather than to distinguish to say that in current usage they are used somewhat interchangeably. That when people said now speak of addiction dependency or abuse they're speaking of areas which cross each other in certain places but certainly drug

in it drug abuse would be any condition in which one uses a medication excessively without a physician's prescription. You get into dependency. Your you're into you're in a state which is in flux and which may be more difficult to define. Dr. Schwartzberg hearing at this point yes I think what we're seeing clinically both on private and public health levels among our young people has increasingly to do with the subject of drug abuse. I see relatively few young people who are in a sense hooked on any single drug. But what I see are the number. Of young people who go from one drug to another and here I think we have to distinguish between some hardcore narcotics and various other kinds of drugs.

Dr. forward you and make will only be on a very basic distinction in any discussion about drug problems in cities or in the country today is the distinction between narcotic drugs and other so-called dangerous drugs both the law and the laws of the land and medicine and psychiatry make this distinction. The narcotics are those drugs that are opium and opium derivatives. The most notorious drug that's involved in drug dependency today and that group of course is heroin and then morphine and some other hard narcotics hard drugs come under the same heading. But just so much of what I think you were talking about Al in terms of clinical experience of many psychiatrists today and with young people is the use in abuse of a large variety of agents that are not narcotics

that the law sometimes recognizes as dangerous drugs and certainly medicine has. And this can include a variety of sedatives and stimulants and even hallucinogenic drugs. Certainly the the list sort of grows year by year might even include things like toggling which is involved in certain glue and glue sniffing kinds of practices. The sedative drugs are things like sleeping pills and vibratory. It's also some of the minor tranquilizers that we know also can be involved in drug abuse and drug dependency stimulants such as Sam Feder means a very common ingredient of diet pills and so forth. And then who is in a genic agents such as marijuana. LSD mescaline and the like. So I think the distinction between narcotics that the law has

traditionally recognized as a dangerous drug good drug and he's rather strict legal control and a whole group of other agents which has also been a problem in society. Yes I certainly would agree with you Jim and I think one thing that's particularly important is to see what the effect of drug taking is on the individual. Most drug taking that we're talking about occurs among young people in the Often the mid to late adolescent periods and increasingly occurring at much younger levels. And as I see it and think I think you would agree that what this does is to offer a passive means of mastering reality rather than an active confronting coping mechanism. And if a passive means of mastering

reality is utilized this becomes a means of attempting to cope in the future with all particular problems that develop. And it affords a means of in effect copping out such as we see often in college dropout students. I'd like to make a point here that we live in a drug oriented and drug permeated culture. And lastly attribute all the ills of the land to the youth of the land and I think it's important for us to remember that use often copies its elders in a caricature of way. And as a matter of fact from the time we get up in the morning until the time we go to bed at night the number of potions and lotions we put into ourselves and on ourselves is it was tremendous from the time one gets up in the morning and your

uses the fluoride toothpaste and pops the first Alka-Seltzer and then subsequently hits the martini at lunch time and perhaps two or three. The minor tranquilizers in their mouth alone the way they've used a considerable amount of drugs. And kids see this in middle class families it's not unusual for somebody who is smoking pot or using pills to say my father does it. My mother does it. I see them sitting in a martini haze when they eat dinner. I see them taking pills right along during the day and at night when they get up in the morning and to lose weight. And yet when the when Johnny does it there's a great uproar and great alarm. And there is a certain hypocritical double standard in some of this. Yes I think this is particularly true when we get into the controversy of alcohol

versus marihuana what we see clinically where a number of young people who confront their elders with the fact that you you drink and what's what's wrong with smoking pot and in effect why can't we make it legal if alcohol sales are legal. And of course as a psychiatrist It's my feeling that again the the use of pot no matter how widespread it is offered as a passive means of mastering reality and I think again we don't have any good figures on this problem as to the magnitude of Hughes we know it's increasing and I think particularly during the past year owing to the efforts of the National Institute of Mental Health the use of LSD has decreased dramatically thankfully. And but the use of marijuana seems to be on the increase.

Would you care to comment on where this marijuana question of course is such a sort of when the so hotly debated on campuses all over the country today. The adherents of marijuana and it certainly has its supporters at some very sophisticated level of the college population. But I think the point still has to be made is that in spite of the fact that we've known about marijuana for decades in that and had its use in the past usually in a small segment of our population that could traditional old time marijuana user was a musician and so forth. But we still don't know an awful lot about the dependency effects with marijuana nor do we know much about the physiological effects of marijuana and there are studies underway now to try to get some clear cut information medical psychological physiological data on marijuana the marijuana laws. There certainly are I

tough laws and the young person experimenting that with marijuana today faces some pretty stiff penalties in regard to to marijuana. Dr. foray is there any prima facie evidence that marijuana may have a carrier rating effect physiologically. But the repeated use of marijuana for when what little is known about it does not seem to involve addiction according to the definition it was given earlier by Dr. Lanham. However there there does seem to be a psychological dependency in some people on marijuana and there are hallucinogenic effects that are experienced by some marijuana users some marijuana users users will have visual hallucinations hallucinations that might precipitate more serious mental trouble in the young person might be using it.

I'd like to stress at this point however to keep the balance picture of this that there is perfectly valid evidence of the deteriorating effects of alcohol and tobacco that the evidence of the hazards to health from ordinary tobacco smoking and from alcohol we have a very valid extensive evidence to indicate that abuse of these substances are deteriorating. So I think simply the only thing we can say at this point is we don't know about marijuana probably we're going to find out about its adverse side effects. But it is illegal that that in itself because it's one of the major hazards of marijuana use is its illegality. Those are the facts and when people persist in using a substance in spite of the fact that it's illegal generally there is something more up psychologically in the nature of rebellion etc..

Dr. Schwartz. Yes I'm sure Rob we have no good figures on this problem. The best estimate that I've heard recently is the use of hardcore drug abuse is in the nature of 5 to 10 percent of the high school and college population. There are these the so-called mainline or so on as you said direct injections and so forth. Well I think again this is very much related to the social economic condition in which the young person finds himself and I think here we have to make a distinction between the ghetto inhabitant and those who are essentially middle class what I mean is when you say hardcore are are you talking about the opium addicts are we right that we are alone or what. Well I'm glad you asked that. I'm using hardcore in a different sense. What I meant was the chronic drug abuse here but

I think when we speak about the hard core drugs we are referring primarily to heroin morphine and these other narcotics as opposed to the hallucinogen the opiate derivative right it really was of the opium poppy. Right. And they and certain synthetic such as dye lot of Demerol certain synthetic opiates there what about the so-called pep pills and things of that nature where where do they come from and where do they fit into this picture. Well the the the chief So the so-called pep pills are the amphetamines and they they are now classed as dangerous drugs. Dangerous in what regard documented well this is a legal definition and defined under the Harrison narcotic act primarily as dangerous drugs namely that you can't be given a carte blanche prescription which can be refilled indefinitely anymore these prescriptions had to be

rechecked and refill renewed by a physician at least every six months. Before this we had people who were taking amphetamines and mixtures of amphetamines and barbiturates for years originally given a prescription to quote lose weight and then continued on it indefinitely. The amphetamines in my opinion are extremely dangerous drugs and I'd like to make that point at this time that heroin and the opiates are by no means even the most dangerous substances we have these combinations of barbiturates an amphetamine these are extremely serious in that they they are truly habituating. You need more of them to get the same effect and the withdrawal symptoms are extremely severe. You get into a chronic intoxicated state with slurred speech with drunken manner and when they're withdrawn

people develop serious convulsions and die. Elucidations convulsions and even death die in the day. The problem with the amphetamines is a great tendency to increase the dosage. I think they're more dangerous even than is now indicated in the current law. And particularly when people begin to get up to several of these things a day or in an evening. Truck drivers long distance truck drivers not infrequently take them to keep going so do many people now and you can develop a severe paranoid psychosis from the abuse of this drug. Even the threat of well even the drug oriented subculture recognizes some of these dangers that you speak about day to day. The jargon that you hear about speed kills refers to the lethality and abuse of threatening drugs particularly when they're used

as some people want to use them by introducing them intravenously and some astronomical dosages. I'd like to bring the discussion of back to where we divide this as drugs and youth crime. It would better work it out a little bit although I think the all of these things apply. But one part of our original definition was that. Drug addiction is a complex syndrome and as part of that it is a sociological phenomenon. Now I would like to say that probably most of the crime among young offenders results from the abuse and dependency addiction if you will to heroin. I think my only under-privileged now it's more appropriate to say culturally deprived individuals in the country the heroin abuse is

being is manifesting itself at younger and younger ages that people don't come for are born into the world at age 18 and one of the reasons we have trouble with statistics about juvenile users and so on is that that their first arrest as an adult felon isn't made until age 18. Then suddenly they're a drug addict. They're in court as an adult a drug addict charged with possession of heroin or something of this nature. But the truth is these kids begin to experiment with heroin they call it joint popping skin popping. So on at a much earlier age that they were I'm stressing the sociological aspect of this now. The peddlers are in the neighborhood. Many of the people who are slightly older than them are on drugs. It's the thing to do. There is a subculture in which individuals speak a language that's different from

the ordinary language about they they relate to each other in particular ways. It's not that this is the sociological aspect and this gets so exaggerated that individuals in fact continue to use the apparatus the needles the hypodermic syringe and the water and a drug which actually has been so rotted down with cornstarch or talcum or any other substance that no longer has very much physiological effect but they're still paying $2 a cap for. And in order to support this habit the individual has to steal some two three hundred dollars worth of merchandise a day to support a $50 a day habit. So here in lies the crime. I'd like to mention the dimension of crime among heroin users and particularly the typical her heroin user from the ghetto the type of crime that has been

seen over and over in criminal logical studies are crimes of petty larceny. Burglary and also prostitution and procurement that these are the kinds of deviancy that go hand in hand with with heroin like to make at least just mention here that the crimes that I mentioned do not involve necessarily violence and we don't think about the heroin heroin addict as being a necessarily a violent person attuned to violent crime. Now what I'd like to go back to Dr. Lamb's point about the sociologic conditions. I think that it's quite right when we use the term culturally disadvantaged because of course we have a very high rate of school dropouts and unemployed in the Negro ghetto in the ages 16 to 21. And these people with

the frustrated ambitions and frustrated aspirations tend to keep high and getting a euphoria and effect by being on marijuana. And of course as you indicated often have to resort to peddling the drug into petty larceny and prostitution in order to keep up the habit. Certainly we can't separate the drug use and abuse from the social logical and deprived conditions under which these people live. He has a drug addiction. It is after all a symptom. And this people are apt to mistake they're apt to think that it's a thing in itself that somebody is quote a drug addict. So we put him in a drug addict program therefore we've got him properly labeled and categorized and we can forget about him. That means he's different from the rest of us so we don't have to worry about him anymore. But the truth is that addiction is an effort to as Dr. Schwartzberg said cope with reality both inner reality and outer reality to cope with stresses

within the person hourly. Often times the use of drugs disguises very serious mental illness and symptoms. For example severe depression as an effort to deal with a severe underlying depression one may turn to pep pills marijuana LSD. Indeed heroin. And sometimes when the drug is removed you see the severe depression underlying it. On the other hand it may mask psychosis. It may be an effort to ward off psychotic behavior even as alcoholism is. The individual may use drugs as a way of dealing with overpowering forces within himself which threaten his integrity as an individual and when this is removed and this isn't part necessarily of the withdrawal symptom you will see a florid psychotic episode manifested so I'd like to end already I don't quite understand that.

I have a severe organization of personality with hallucinations hearing voices imaginary and magine airy beliefs. Hearing voices I said. I mean I'd like to add a happier note here on this rather morbid subject of heroin addiction. Recently in New York City there have been during the past several years experimental programs which have been quite successful in treating heroin addiction namely due to meth a dime maintenance programs of course along with the substitution of an opiate drug. We have to have extensive social and vocational rehabilitation for the drug user. This does not cure the underlying personality disorder and or a mass psychosis problems but it does offer a means of having the person in the community without interfering with physical and intellectual functions. We're down to a minute and half from there. Another program and you have

been devoting your attention to identifying the problem and despite its size and so forth but for a minute can anyone give me any ideas of what we can do about it and they should. Well I certainly think this that the efforts by the National Institute of Mental Health that public education giving giving kids and the publics the facts are as important as anything and I think parents need to know as much about drugs as do the teenagers and about the other side effects as a preventive device or to land in their own areas and I think that we could devote practically our entire manpower resources in psychiatry psychology and the behavioral sciences to this problem. And its solution and still have plenty of problem leftovers so it's obvious that we're going to we're

going to have to endeavor to get aboard and train more personnel and interest more people in this program over the years and there's no magic cure. We'd be like the drug abuser if we're looking for the magic solution to the problem. It's something that's going to be with us and we're going at the persistent working for decades to come. Thank you very much gentlemen for your discussion of addiction and youthful crime. My thanks to Dr. Alan S. Schwartzberg clinical assistant professor of psychiatry at the Georgetown University School of Medicine. Dr. David Lanham chief of Legal psychiatric services D.C. Department of Public Health and assistant professor of psychiatry the George Washington University School of Medicine. And to Dr. James L. furrowing associate professor of psychiatry at Georgetown University School of Medicine. You have attended the weekly discussion program the Georgetown University radio forum

broadcast of which was transcribed in the Raymond Rice studio on the campus of historic Georgetown University in Washington D.C. next week you will hear discussed a bench view of crime and a panel at that time will consist of the honor poet Joseph F. Ryan Jr. judge of the District of Columbia Court of general sessions on the Honorable Edward M. care and chief judge of the U.S. District Court for the District of Columbia. This program has been presented in the interest of public education by Georgetown University. Your moderator. WALLACE fanning this program was distributed by the national educational radio network.