Heroin Background Data:

Drug control in Britain was established between 1910 and 1930, with a solid grounding in public health and medical practice. This British approach to drug problems as public-health problems seemed especially attractive as an alternative to U.S. drug prohibition policies, even when the heroin problem in the United States was relatively small, back before 1960. Thus, beginning in the late 1940s, some Americans started to advocate the use of the British system in the United States—that is, a nonpunitive, public-health approach to the treatment of drug dependence, especially dependence on heroin.

In 1960, the drug problem was essentially a non-issue in the political life of Britain, although the structures for control in the two countries remained very different. In the United States, a prohibitionist policy continued in place whereby criminal penalties were imposed for heroin possession and use—and sometimes for being addicted to heroin. Physicians rarely treated opiate addicts and could not legally provide a known addict with opiates on a maintenance basis. As a result, from early in the twentieth century, virtually all heroin addicts purchased supplies from illegal heroin sellers. With the exception of a brief time during which maintenance programs were available, relatively few addicts sought drug treatment from doctors, and treatment for heroin dependence often was available only at two federal narcotic hospitals and select public and private facilities. In NEW YORK and CALIFORNIA, in particular, large numbers of heroin abusers were arrested and imprisoned for heroin sales, for possession, or for other crimes sometimes committed to gain funds to purchase illegal heroin (e.g., robbery, burglary).

In contrast, by 1960, Britain had had many years of experience with a "medical" or "public-health" policy for controlling heroin and opiates (originating with the ROLLESTON REPORT of 1926). Fewer than 100 heroin addicts and fewer than 500 abusers of all drugs were known in Britain in 1960. Persons identified by a doctor as being addicted to heroin or other dangerous drugs could be (and usually were) treated by a private practitioner. The physician was required to notify the Home Office of the names of the addicts but was at liberty to prescribe heroin or opiates for them in any amounts for long time periods. Their treatment became funded by the National Health Service after World War II, like any other medical service. No other treatment (at a clinic, hospital, or nonmedical facility) was available. Penalties for the illegal sale of heroin or opiates carried sanctions of less than a year and were rarely imposed. Few British prisoners were heroin addicts.

British drug policy has been and continues to be set primarily by Home Office staff in collaboration with leading physicians and addiction specialists. British law-enforcement and criminal-justice practitioners were largely excluded from policymaking—whereas their counterparts in the United States have a primary role in formulating American drug policy. Following the Rolleston precedent, several special committees issued reports establishing the basic directions of British drug policy. The first Brain Committee (1958) reaffirmed the Rolleston recommendation to provide heroin and allow maintenance doses of opiates; it opposed U.S.-sponsored proposals to prohibit heroin manufacture in Britain.

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