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MARIHUANA-HASHISH EPIDEMIC AND ITS
IMPACT ON UNITED STATES SECURITY
HEARINGS
BEFORE THE
SUBCOMMITTEE TO INVESTIGATE THE
ADMINISTRATION OF THE INTERNAL SECURITY
ACT AND OTHER INTERNAL SECURITY LAWS
OF THE
COMMITTEE ON THE JUDICIARY
UNITED STATES SENATE
NINETY-THIRD CONGRESS
SECOND SESSION
MAY 9, 16, 17, 20, 21, AND JUNE 13, 1974
Printed for the use of the Committee on the Judiciary
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U.S. GOVERNMENT PRINTING OFFICE
33-371 O WASHINGTON : 1974
For sale by the Superintendent of Documents, U.S. Government Printing Office
Washington, D.C. 20402 - Price $4.00
■-,,
COMMITTEE ON THE JUDICIARY
JAMES O. EASTLAND, Mississippi, Chairman
JOHN L. McCLELLAN, Arkansas ROMAN L. HRUSKA, Nebraska
SAM J. ERVIN, Jr., North Carolina HIRAM L. FONG, Hawaii
PHILIP A. HART, Michigan HUGH SCOTT, Pennsylvania
EDWARD M. KENNEDY, Massachusetts STROM THURMOND, South Carolina
BIRCH BAYH, Indiana MARLOW W. COOK, Kentucky
QUENTIN N. BURDICK, North Dakota CHARLES McC. MATHIAS, Jr., Maryland
ROBERT C. BYRD, West Virginia EDWARD J. GURNEY, Florida
JOHN V. TUNNEY, California
Subcommittee To Investigate the Administration of the Internal
Security Act and Other Internal Security Laws
JAMES O. EASTLAND, Mississippi, Chairman
JOHN L. McCLELLAN, Arkansas STROM THURMOND, South Carolina
SAM J. ERVIN, Jr., North Carolina MARLOW W. COOK, Kentucky
BIRCH BAYH, Indiana EDWARD J. GURNEY, Florida
J. G. Soorwine, Chief Counsel
Raymond Siflt, Jr., Minority Counsel
John R. Norpel, Director of Research
Alfonso L. Tarabochia, Chief Investigator
RESOLUTION
Resolved, by the Internal Security Subcommittee of thlie Committee
on the Judiciary, That the testimony of Dr. Hardin B. Jones taken in
executive session on May 21, 1974, and the testimony of Dr. Forest S.
Tennant and David O. Cooke taken in executive session on June 13,
1974, be released from the injunction of secrecy and printed in the
same volume with the public hearings of May 9, 16, 17, and 20, 1974,
all on "The Marihuana-Hashish Epidemic and Its Impact on U.S.
Security."
James O. Eastland,
Chairman.
Approved : September 4, 1974.
(n)
CONTENTS
Page
Introduction V
Thursday, May 9, 1974 1
Thursday, May 16, 1974 49
Friday, May 17, 1974 147
Monday, May 20, 1974 199
Tuesday, May 21, 1974 265
Thursday, June 13, 1974 287
Testimony of —
Andrew C. Tartaglino, Acting Deputy Administrator, Drug Enforce-
ment Administration 2
Dr. Harvey Powelson, University of California at Berkeley 18
Dr. Henry Brill, regional director. New York State Department of
Mental Hygiene 30
Dr. Donald B. Louria, New Jersey Medical School, Newark, N.J 36
Maj. Gen. Frank B. Clay, Deputy Assistant Secretary of Defense,
Drug and Alcohol Abuse 43
Dr. Robert G. Heath, chairman. Department of Psychiatry and Neu-
rology, Tulane University 50
Dr. W. D. M. Paton, the professor of pharmacology, University of
Oxford 70
Dr. Morton Stenchever, chairman. Department of Obstretrics and De-
partment of Gynecology, University of Utah 84
Dr. Gabriel Nahas, professor of anesthesiology. College of Physicians
and Surgeons, Columbia University 92
Dr. Akira Morishima, associate professor, Department of Pediatrics,
College of Physicians and Surgeons, Columbia University 109
Dr. Robert Kolodny, Reproduction Biology Research Foundation, St.
Louis, Mo 117
Prof. Cecile Leuchtenberger, head of Department of Cytochemistry,
Swiss Institute for Experimental Cancer Research, Lausanne,
Switzerland 126
Dr. Julius Axelrod, chief, Section of Pharmacology, Laboratory of
Clinical Science, National Institute of Mental Health 142
Dr. John A. S. Hall, chairman, Department of Medicine, Kingston
Hospital, Jamaica 147
Dr. H. Kolansky, associate professor of psychiatry, University of Penn-
sylvania School of Medicine 154
Prof. M. I. Soueif, chairman, Department of Psychology and Philos-
ophy, Cairo University, Cairo, Egypt 177
Dr. Andrew Malcolm, member, Drug Advisory Committee, Ontario
College of Pharmacy, Toronto, Canada 182
Dr. Phillip Zeidenberg, research associate in psychiatry, Columbia
University 189
Dr. Conrad Schwarz, associate professor. Department of Psychiatry,
University of British Columbia 200
Prof. Hardin B. Jones, professor of medical physics and physiology,
assistant director, Donner Laboratory, University of California at
Berkeley 206, 265
Keith. Cowan, Prince Edward Island, Canada 250
Dr. Forest S. Tennant, former chief, Special Action Office for Drug
Abuse, U.S. Army in Europe 288
David O. Cooke, Deputy Assistant Secretary of Defense, accompanied
by Dr. John F. Mazzuchi, Brig. Gen. W. A. Temple, Col. Frank W.
Zimmerman. David N. Planton, Comdr. S. J. Kreider, Col. Henry H.
Tufts, Col. Wayne B. Sargent, and Col. John J. Castellot 314
(m)
APPENDIX
Page
Statement of Dr. Arthur M. Zimmerman, professor of zoology, University
of Toronto, Toronto, Canada 341
Articles from scientific publications —
Delta-9 Tetrahydrocannabinol: Localization in Body Fat (Science,
January 26, 1973) 344
Inhibition of Cellular Mediated Immunity in Marihuana Smokers
(Science, February 1, 1974) 347
Chromosome Breakage in Users of Marihuana (American Journal of
Obstetrics and Gynecology, January 1, 1974) 349
Marihuana : Effects on Deep and Surface Electroencephalograms of
Rhesus Monkeys (Neuropharmacology, 1973) 356
Marihuana — Effects on Deep and Surface Electroencephalograms of
Man (Arch Gen Psychiat, June 1972) 369
Cerebral Atrophy in Young Cannabis Smokers (The Lancet, Decem-
ber 4, 1971) 383
Cannabinoid Content of Some English Reefers (Nature, May 17,
1974) 393
Clinical Effects of Marihuana on the Young (International Journal of
Psychiatry, June 1972) 396
Toxic Effect of Chronic Marihuana Use (Journal of the American
Medical Association, October 2, 1972) 402
Cannabis as a Long Acting Intoxicant (Paper) 413
Article concerning Taxonomic Classification of Marihuana (Micro-
gram, publication of Drug Enforcement Administration, Feb-
ruary 1974) 418
Miscellaneous Material Ordered Into the Record
Commentary on Dosages Used in Studies of Marihuana in Rhesus Monkeys
(Submitted by Prof. Robert G. Heath, M.D.) 382
Letter from Prof. William Paton to Senator Gurney 392
Anarchist Cookbook, the, excerpts from 419
Turn On/Tune In/Drop Out (Berkeley Barb, May 20, 1966) 422
Drugs (Disorientation: Notes for the Underdog) 423
Resolution on Cannabis of the General Council of the Canadian Medi-
cal Association 424
Biographical Notes of Department of Defense Witnesses 425
(TV)
INTRODUCTION
BY
Senator James O. Eastland
Chairman, Senate Subcommittee on Internal Security
I consider the hearings which are the subject of this record to be
among the most significant ever held by the Senate Internal Security
Subcommittee, or, for that matter, by any committee of Congress. The
widespread interest already generated by the hearings suggest that
they may play a role in reversing a trend towards national disaster.
Without public awareness, our country has become caught up in a
marihuana-hashish 1 epidemic that probably eclipses, in gravity, the
national epidemics that have had so debilitating an effect on the popu-
lation of a number of Middle Eastern countries. Speaking about this
matter, Mr. Andrew C. Tartaglino, Deputy Administrator of the DEA,
made this statement at the opening hearing on May 9, over which I
presided :
The traffic in, and abuse of, marihuana products has taken
a more serious turn in the last two or three years than either
the courts, the news media, or the public is aware. The shift
is clearly toward the abuse of stronger, more dangerous forms
of the drug which renders much of what has been said in the
1960's about the harmlessness of its use obsolete.
The epidemic began at Berkeley University at the time of the famous
1965 "Berkeley Uprising." Not only was pot-smoking embraced as a
symbolic rejection of the establishment, but, together with the "dirty
speech movement," the right to pot became an integral part of the
catalogue of demands of the uprising. From Berkeley, the marihuana
epidemic spread rapidly throughout the American campus community.
Then it spread down into the high schools and junior high schools —
and within the last year or two it has begun to invade the grade
schools. It has also spread into the ranks of professional society and
of the bluecollar workers, so that all sectors of our society are today
affected by the epidemic. Today it is estimated that there are some
millions of regular marihuana users in the country, and the evidence
indicates that they are graduating rapidly to the stronger hemp drugs,
hashish and liquid hashish.
The spread of the epidemic has been facilitated by the fact that most
of our media and most of the academicians who have been articulate
on the subject have been disposed to look upon marihuana as a rela-
1 Marihuana and hashish are both derived from the cannabis, or hemp, plant. Marihuana
consists of the leaves and female flowers ; hashish comes from the resin of the plant.
Hashish is roughly 8 to 10 times as strong as marihuana.
(V)
VI
tively innocuous drug. (How the myth of harmlessness came to be so
widely accepted is also part of the subject of this testimony.) There
were some who even held that marihuana was a good thing, while most
held that there really wasn't too much to worry about.
Taking advantage of the confusion and widespread ignorance, a
variety of movements seeking the legalization of marihuana came into
existence. They gathered strength rapidly. In fact, by early this year
concerned scientists and government officials were almost ready to
throw in the sponge because the battle looked so hopeless.
This situation, by itself was reason enough for concern. The Internal
Security Subcommittee decided to look into it because of internal
security considerations affecting the armed forces of the United States,
and because of the evidence that clearly subversive groups played a
significant role in the spread of the epidemic — both as propagandists
and as traffickers. It was established, for example, in previous hearings
of the subcommittee, that Timothy Leary's Brotherhood of Eternal
Love had for a number of years been the largest producers of LSD and
the largest organized smugglers of hashish in the country.
The hearings focused heavily on scientific evidence of physical or
psychological harmfulness, because this was basic to any assessment
of the impact of cannabis on security.
Important new scientific evidence had emerged within the last few
years. But this evidence remained fragmented, sometimes inconclu-
sive, and almost invariably completely unknown to the public. The
situation was further confused by contradictory evidence and by the
emergence of several best-selling books suggesting a more tolerant
approach to marihuana.
One of the principal reasons why hard scientific evidence has been
so slow in emerging is that it is only within recent years — in fact,
since 1970 — that accepted procedures for the quantitative analysis of
marihuana have been established and that carefully standardized
strains of marihuana have become available for research purposes.
In the absence of standardized research materials and standardized
analytical procedures, research scientists in the past, working with the
utmost conscientiousness, often came up with sharply conflicting find-
ings. Within the last few years, thanks to a remarkable program that
has been developed at the University of Mississippi,2 marihuana re-
search is today moving forward without these handicaps — and, as this
volume of testimony dramatically demonstrates, this research is pro-
ducing some highly dramatic results.
2 The program Is known as the Marihuana Project of the Research Institute of Pharma-
ceutical Sciences, which is part of the School of Pharmacy at the University of Mississippi.
The program was established in 1968, as part of a national program of research, by Dr.
Coy Waller, formerly Vice President in Charge of Research at Meade-Johnson and con-
sultant to the National Institute of Mental Health, who today serves as the Director of
the Research Institute. The first Director of the Marihuana Project, from 1968 to 1971, was
Dr. Norman Doorenbos. Since 1971, it has been under the direction of Dr. Carlton Turner,
who also serves as Associate Director of the Research Institute.
In addition to standardizing the marihuana used for research purposes, Dr. Turner's
scientists have developed analytical methods which enable them to give accurate readings
on ten different cannabinoids contained in marihuana samples — a few years ago, they
were able to analyze for only three cannabinoid components. The marihuana the Institute
cultivates is now used routinely for all research projects sponsored through the National
Institute of Mental Health, while the United Nations Narcotics Commission has recom-
mended that the analytical procedures developed at the University of Mississippi be used
worldwide.
If today we know far more about marihuana than we did two or three years ago, it is
thanks in large measure to the pioneering work done at this internationally unique research
center.
vn
In the recent hearings, it was obvious that one of the first things
that had to be done was to bring together the bits and pieces of recent
research in an organized manner, because only in this way would the
total significance of these findings become comprehensible. The sub-
committee, therefore, issued invitations to some 20 prominent medical
researchers and psychiatrists. Most of them were American, but six
other countries were also represented in the panel of scientists. The
pro-marihuana cabal could assail a single scientist whose research per-
suaded him that marihuana was a very dangerous drug: this they
could get away with. But abuse and character assassination would no
longer be persuasive at the point where it was demonstrated that a
large number of top-ranking scientists who had done research on
cannabis were convinced that it is a drug with deadly consequences.
With the assistance of several scientists who are internationally
known for their research on cannabis and other drugs, the subcom-
mittee staff put together a master list of scientific witnesses who, be-
tween them, could cover the newly available scientific evidence in a
broad spectrum manner.
Among the eminent scientists who appeared before the Subcom-
mittee were :
Dr. Harvey Powelson: Research Psychiatrist, Berkeley Univer-
sity; Chief of the Psychiatric Division of the Student Health Serv-
ice at Berkeley from 1964 to 1972.
Dr. Henry Brill: Regional Director of the New York State De-
partment of Mental Hygiene; member and/or chairman of drug de-
pendence committees of American Medical Association, National Re-
search Council, the World Health Organization, and the FDA; senior
psychiatric member of the Shaf er Commission.
Dr. Donald Louria: Chairman, Department of Preventive Medi-
cine and (Community Health, New Jersey Medical School ; Chairman
and President, New York State Council on Drug Addiction, 1965 to
1972.
Professor W. D. M. Paton: Head of the department of pharma-
cology at Oxford University ; Chairman of committee overseeing the
British Government's drug research program; author of a standard
textbook on pharmacology and widely recognized as one of world's
leading pharmacologists.
Professor Morton Stenchever: Chairman of the Department of
Obstetrics and Gynecology at the University of Utah Medical School.
Dr. Gabriel Nahas : Research Professor at the Columbia University
College of Physicians and Surgeons ; simultaneously Visiting Profes-
sor at the University of Paris.
Dr. Akira Morishima: Research geneticist; Associate Professor,
Department of Pediatrics, Columbia University College of Physicians
and Surgeons; Chief of the Division of pediatric endocrine service at
Babies Hospital, New York.
Dr. Cecile Leuchtenberger of Switzerland : Head of the Depart-
ment of Cell Chemistry at the Institute for Experimental Cancer Re-
search in Lausanne ; founder and first Director of Cell Chemistry De-
partment at Western Reserve University.
Dr. John A. S. Hall : Senior Physician and Chairman, Department
of Medicine, Kingston Hospital, Jamaica, since 1965 : Associate Lec-
turer in Medicine, University of West Indies and visiting Assistant
Professor of Neurology at Columbia University.
vin
Dr. Robert Kolodny: Director of the endocrine research section
at the Reproductive Biology Research Foundation in St. Louis.
Professor M. I. Soueif : Chairman of the Department of Psychology
and Philosophy at Cairo University ; member of World Health Or-
ganization Panel on Drug Dependence; author of classic study on
consequences of hashish addiction in Egypt.
Professor Nils Bejerot : Karolinska Institute, Sweden ; author of
"Addiction and Society" and several other standard texts on the epi-
demiology of drug abuse. Widely recognized as one of foremost inter-
national experts in this field.
Dr. Andrew Malcolm: Toronto psychiatrist; member, Drug Ad-
visory Committee, Ontario College of Pharmacy; formerly Senior
Psychiatrist, Rockland State Hospital, New York (1955-1958) .
Dr. Harold Kolansky : Currently Associate Professor of Psychia-
try at the University of Pennsylvania School of Medicine; twice
President of the Regional Council (Pennsylvania, New Jersey, Dela-
ware) of Child Psychiatry; Director of Child Psychiatry, Albert
Einstein Medical Center, Philadelphia, 1955-1969 ; Chairman, Depart-
ment of Psychiatry, Albert Einstein Medical Center, 1968-1969.
Dr. William T. Moore: Currently Associate Professor in Clinical
Psychiatry, University of Pennsylvania School of Medicine ; Associate
Professor of Child Psychiatry at Hahnemann Medical College for 13
years up until 1972 ; for the past five years Director of Training, Di-
vision of Child Analysis, Institute of Philadelphia Association for
Psychoanalysis.
Professor Robert Heath : Chairman of the Department of Psychi-
atry and Neurology at Tulane University Medical School.
Dr. Phillip Zeidenberg: Professor of Psychiatry at Columbia
University ; Chairman of the Drug Dependence Committee of the New
York State Psychiatric Institute.
Dr. Julius Axelrod. Nobel Prize winning research scientist at the
National Institute of Mental Health.
Professor Hardin B. Jones : Professor of Physiology and Professor
of Medical Physics at the University of California, Berkeley ; Assist-
ant Director of the Donner Laboratory of Medical Physics at Berkeley.
Dr. Conrad Schwarz : Associate Professor, Department of Psychi-
atry, University of British Columbia and Consultant Psychiatrist to
the Student Health Service; Chairman of the Drug Habituation
Committee of the British Columbia Medical Association.
Dr. Forest S. Tennant, Jr. : Medical Director for several drug
abuse programs in the Los Angeles area ; officer in charge of the drug
abuse program of the U.S. Army Europe, 1971-1972.
the scientific findings
That our hearings succeeded in achieving their objective has been
demonstrated by the dramatic increase of interest, on the part of the
scientific community as well as the press, in the new scientific evidence
on marihuana. For example, a recent issue of Science magazine
(August 23, 1974) points out "the notion that marihuana is harmless
has enjoyed a high degree of acceptability with only a minimum of
scientific support. . . . Since 1969, when the federal government began
making marihuana of controlled quality available to research sci-
entists, evidence suggesting potential hazards has accumulated at a
rx
rapid pace. Those five years of research have provided strong evidence
that, if corroborated, would suggest that marihuana in its various
forms may be far more hazardous than was originally suspected." I
think it worthy of note that ten of the scientists whose findings were
quoted by the article in Science were among the witnesses who testified
in the subcommittee's recent hearings.
The collective testimony of the eminent scientists who came to
Washington to testify may be summarized as follows :
(1) THC, the principal psychoactive factor in cannabis, tends to
accumulate in the brain and gonads and other fatty tissues in the
manner of DDT. This was established beyond challenge by the re-
search of NIMH Nobel Laureate, Dr. Julius Axelrod, and his associ-
ates. As a corollary of this, they found that THC persists in the body
long after the act of ingestion. In some parts of the body, residual
amounts could be found as much as a week after ingestion.
(2) Marihuana, even when used in moderate amounts, causes mas-
sive damage to the entire cellular process :
(a) It reduces DNA and RNA synthesis within the cell, which
in turn sharply reduces the mitotic index, or the rate at which
the cells give birth to new cells. (Nahas, Morishima, Zimmerman,
Leuchtenberger, Paton)
(b) In the case of the T-lymphocytes (the cells involved in the
immune process) , marihuana use at the three-times-a-week level
results in a 41 percent reduction in cell birth. (Nahas and associ-
ates)
(c) It results in far more cells with defective chromosome
complements — from 38 to 8 chromosomes instead of the normal
complement of 46. (Morishima)
The findings of five of the scientists who testified converged on the
central theme of cellular damage. Other research that had been done
in this field was also referred to. Professor W. D. M. Paton of Oxford
University, one of the world's leading pharmacologists, summarized
this recent research in these terms :
Numerous such effects have now been described, including
actions on microsomes, on mitochondria, on neurones, fibro-
blasts, white blood cells, and on dividing cells, affecting
metabolism, energy utilization, synthesis of cellular constitu-
ents, and immunological responses.
On the specific question of cellular damage, additional evidence is
becoming available almost by the week. Since Dr. Nahas testified, for
example, his findings on damage to the immune cells have been con-
firmed by two nationally prominent medical scientists, Dr. Louis
Harris and Dr. Louis Lemberger. Other aspects of cellular damage
will be covered in several research papers, prepared under official au-
spices, which are shortly to be published.
Needless to say, the confirmation that marihuana does such serious
damage to the entire cellular process opens up an entire spectrum of
frightening possibilities.
(3) Tied in with its tendency to accumulate in the brain and its
capacity for cellular damage, there is a growing body of evidence
that marihuana inflicts irreversible damage on the brain, including
actual brain atrophy, when used in a chronic manner for several
years. Psychiatrists who testified said that they knew of many cases
of brilliant young people who went on prolonged cannabis binges,
and then tried to go straight — only to discover that they could no
longer perform at the level of which they had been capable. (Heath,
Powelson, Kolansky and Moore, Paton) Professor Paton referred to
animal experiments which demonstrated that rats exposed to mari-
huana had smaller brains than rats which were not exposed, and to
research by Dr. Campbell and associates in England which found brain
atrophy in a group of young cannabis smokers comparable to the
atrophy that is normally found in people aged 70 to 90. Professor
Heath reported that, in experiments with rhesus monkeys exposed to
marihuana, highly abnormal brain wave patterns persisted after the
marihuana was withdrawn, suggesting long-term or permanent dam-
age to the brain.
(4) There is also a growing body of evidence that marihuana ad-
versely affects the reproductive process in a number of ways, and that
it poses a serious danger of genetic damage and even of genetic
mutation. Scientific testimony presented pointed to the following
conclusions :
(a) Male hormone (testosterone) level was reduced by 44 per-
cent in young males who had used marihuana at least four days
a week for a minimum of six months. (Kolodny)
(b) Sperm count was dramatically reduced in the same group
of marihuana smokers, falling almost to zero with heavy smok-
ers, so that they had to be considered sterile. (Kolodny) A simi-
lar result was found with mice. (Leuchtenberger)
(c) Very heavy smoking in a number of cases resulted in im-
potence. Potency was recovered in some of these cases when mari-
huana was given up. (Kolodny, Hall)
(d) In animal experiments, the spermatids (the precursors of
the sperm cells) were found to be abnormal in the sense that
they carried reduced amounts of DNA. (Leuchtenberger)
(e) Regular marihuana use, even down to the once a week
level, results in roughly three times as many broken chromo-
somes as are found in non-users. While further research is nec-
essary, this suggests the possibility of genetic abnormalities.
(Stenchever)
(f ) In a number of animal experiments, marihuana was found
to cause a very high rate of fetal deaths and fetal abnormalities,
including runting and lack of limbs — the thalidomide effect.
(Paton)
(5) Chronic cannabis smoking can produce sinusitis, pharyngitis,
bronchitis, emphysema and other respiratory difficulties in a year or
less, as opposed to ten to tioenty years of cigarette smoking to produce
comparable complications. (Tennant, Paton, Kolansky and Moore)
Professor Paton pointed out that emphysema, which is normally a
condition of later life, is now cropping up with increasing frequency
in young people, opening up the prospect of "a new crop of respiratory
cripples" early in life.
(6) Cannabis smoke, or cannabis smoke mixed with cigarette smoke,
is far more damaging to lung tissues than tobacco smoke alone. The
damage done was described as "pre-cancerous." (Tennant, Leuchten-
berger) Although further research is indicated, preliminary observa-
XI
tions suggest that marihuana may be a far more potent carcinogen
than tobacco.
(7) Chronic cannabis use results in deterioration of mental function-
ing, pathological forms of thinking resembling paranoia, and ua mas-
sive and chronic passivity'''' and lack of motivation — the so-called
"amotivational syndrome." (Powelson, Bejerot, Zeidenberg, Malcolm,
Schwarz, Jones, Kolansky and Moore, Hall, Soueif, Tennant)
Describing the zombie-like appearance of chronic cannabis users,
Dr. Tennant said: "Major manifestations were apathy, dullness and
lethargy, with mild to severe impairment of judgment, concentration
and memory . . . physical appearance was stereotyped in that all
patients appeared dull, exhibited poor hygiene, and had slightly
slowed speech. . . ."
Several psychiatrists suggested that the total loss of their own will
would make a large population of cannabis users a serious political
danger because it makes them susceptible to manipulation by extrem-
ists. (Powelson, Kolansky and Moore, Malcolm)
THE SOCIAL CONSEQUENCES OF THE MARIHUANA EPIDEMIC
The scientific evidence presented to the subcommittee points to an
array of frightening social consequences, or possible consequences.
(1) If the cannabis epidemic continues to spread at the rate of the
post-Berkeley period, we may find ourselves saddled with a large
population of semi-zombies — of young people acutely afflicted by the
amotivational syndrome. There is evidence that many of our young
people, including high school and junior high school students, are
already afflicted by the "amotivational syndrome." The general lack
of motivation of the current generation of high school students is a
common complaint of teachers. Some of them point out that the
growth of this phenomenon in recent years has roughly paralleled the
spread of the cannabis epidemic.
(2) We may also find ourselves saddled with a partial generation
of young people — people in their teens and early twenties — suffering
from irreversible brain damage. Their ability to function may im-
prove if they abandon cannabis, but they will remain partial cripples,
unable to fully recover the abilities of their pre-cannabis years.
(3) The millions of junior high school and grade school children
who are today using marihuana may produce another partial genera-
tion of teenagers who have never matured, either intellectually or
physically, because of hormonal deficiency and a deficiency in cell-
production during the critical period of puberty. This fear was
expressed in particularly urgent terms by Dr. Paton and Dr. Kolodny.
As Dr. Paton put it, we may witness the phenomenon of a generation
of young people who have begun to grow old before they have even
matured.
(4) There are other frightening possibilities, too. There is the
possibility of which Dr. Paton spoke that we may develop a large
population of youthful respiratory cripples. And there is the pos-
sibility— which can only be confirmed by epidemiological studies —
that marihuana smokers are producing far more than their quota of
malformed or genetically damaged children.
( 5 ) There is the growing body of evidence that marihuana use leads
to indulgence in other drugs.
xn
(6) If the epidemic is not rolled back, our society may be largely
taken over by a "marihuana culture"— a culture motivated by a desire
to escape from reality and by a consuming lust for self-gratification,
and lacking any higher moral guidance. Such a society could not long
endure.
These are some of the reasons why we cannot legalize marihuana,
and why society cannot remain indifferent to the epidemic.
THE EPIDEMIC POTENTIAL OF CANNABIS
What makes the prospect even more terrifying is the extraordinary
epidemic potential of cannabis. It is doubtful that any other drug in
common use today has a comparable potential.
I do not underestimate the damage done by the abusive use of
alcohol. But the nature of alcohol places certain limitations on its
epidemic spread. It is impossible, or at least very difficult, to take a
quart of whiskey or a six-pack of beer to one's place of work, or, in the
case of a teenager or grade schooler, to take it to school. If one did take
it to school or to work, it would be difficult to find the time during the
work day or during school hours to get oneself really intoxicated on
alcohol. And if a worker or a student did manage to get himself stoned
on alcohol, he would be given away by his drunken stagger or by the
smell of alcohol on his breath.
But with marihuana, there are no such limitations. It is cheap
enough so that even a fourth or fifth grader can afford to buy a joint
or two with his weekly allowance. It is compact enough so that a few
joints can easily be concealed on the body. All it requires is a 10 or 15
minute break to get thoroughly stoned. And, apart from a tired and
passive look which may suggest that the user is short on sleep, there
are no telltale symptoms ; the user, though stoned, does not walk with
a stagger, nor is there any odor on his breath. A student could sit
through an entire day in a cannabis stupor, and learn nothing — and
his teacher would be none the wiser.
On top of this, users of marihuana suffer from a much more com-
pelling urge to proselytize and involve others than do users of alcohol.
One can attend a cocktail party and drink ginger ale and not be har-
rassed and pushed by one's cocktail friends to get in on the act and
drink. At pot parties, the pressures are infinitely greater.
Another factor contributing to the spread of the cannabis epidemic
is the tremendous potency of the material available and the ease with
which it can be concealed and transported. A pound of "liquid
hashish" — a concentrated distillate derived from either marihuana
or hashish — would theoretically be enough to intoxicate a city of 15,000
people.
Still another factor is that, with marihuana and hashish, chronic
abuse begins at a use level which would be insignificant with alcohol.
A person who took a drink of whiskey once a week or even three times
a week, would be considered a light drinker ; it has yet to be argued
that alcohol consumption at this level can do any damage. But a person
who smokes marihuana three times a week or more is generally con-
sidered a chronic smoker; and there are some scientists who insist
that even once a week smoking constitutes chronic use. In support
of this contention, they point to the facts that THC persists in the
xin
brain for a week or more after smoking, and that some of the research
covered in our recent hearings found dramatic changes even at the
once a week level (cf. Stenchever on chromosome damage).
Finally, there is the almost unbelievable rate at which — if it is
readily available — a cannabis user can escalate from occasionl social
use to chronic and massive abuse. It generally takes years before a
chronic drinker escalates to a quart a day. But, according to Dr.
Tennant, GI's who arrived in Germany as casual marihuana users,
would a month or two later be consuming 50 or 100 grams — and in
some cases up to 600 grams — of hashish monthly. Three grams of
hashish a day, it should be pointed out, is roughly 12 times the
amount required to produce a hashish intoxication.
WHERE THE EPIDEMIC STANDS TODAY
There are conflicting estimates of the number of chronic cannabis
users in our country. According to some estimates, there are roughly
20 to 25 million people who have used marihuana in one degree or
another, but only one to two million who may be considered regular
users. According to the estimate of NOEML (National Organization
for the Reform of Marihuana Laws), the total number of Americans
who have been exposed to marihuana runs close to thirty-five million,
while the number of regular users is past the ten million mark.
Figures on seizures of marihuana and hashish submitted to our
hearings by the Drug Enforcement Administration strongly suggest
the validity of the higher estimate. According to DEA, federal seizures
of marihuana over the past five years have increased tenfold, to a total
of 780,000 pounds in 1973, while federal seizures of hashish over the
same period of time increased twenty-five fold, to a total of almost
54,000 pounds. These figures do not include seizures by state and local
law enforcement authorities. Assuming that ten times as much got into
the country as was actually seized — a fairly conservative estimate —
this would mean that total consumption of marihuana in 1973 was
probably close to ten million pounds, while total consumption of
hashish probably exceeded 600,000 pounds. (These estimates make
some allowance for non-federal seizures — for which no figures are
available.)
These are truly staggering quantities when one understands just how
potent marihuana and hashish are and how little is required to become
intoxicated. No one could possibly get intoxicated on an ounce or two
ounces of hard liquor. An ounce of hashish with a 10 percent THC con-
tent is sufficient for a hundred intoxications ; an ounce of marihuana
with a 1.5 percent THC content is enough for roughly twelve intoxi-
cations. And when it comes to "marihuana oil," or "liquid hashish," as
it is sometimes called, the THC content of which can run as high as
60 to 90 percent, we have a substance with an almost lethal potential for
mass intoxication. One drop of liquid hash is enough to send the user
into the stratosphere, while a pound of the strongest variety would be
enough to intoxicate a population of 15,000.
These figures provide some clue — but only a partial clue — to the
damage done by the massive quantities of marihuana and hashish con-
sumed in our country last year.
XIV
THE EMERGENCE OF AN ALCOHOL-CANNABIS EPIDEMIC
It must be emphasized that those who are caught up in the cannabis
epidemic are not using marihuana or hashish as a substitute for al-
cohol. With increasing frequency they are being consumed together.
The scientists who testified before the subcommittee were agreed that
adding marihuana to alcohol, or alcohol to marihuana, does not pro-
duce an arithmetic effect but a synergistic, or compounding, effect. The
combination of the two intoxicants produces a far more potent and
dangerous form of intoxication, whose short and long term conse-
quences we still know very little about. While there are reported to be
some 10 million problem drinkers in our country, the overwhelming
majority of those who use alcohol are what we call social drinkers,
who take it occasionally and with moderation. But at the point where
a person takes one drink of whiskey with a joint of pot, we are no
longer dealing with a social drinker — we are dealing with someone
who is suffering from a highly dangerous form of intoxication.
In its own right, the scale of the current cannabis epidemic would
give us plenty to worry about and so is the scale of alcohol abuse. The
emergence of an alcohol-cannabis epidemic is even more worrisome.
THE MYTH OF HARMLESSNESS
The spread of the epidemic has been facilitated by the widespread
impression that marihuana is a relatively innocuous drug. This im-
pression has been shared by liberals and conservatives, by laymen and
judges, and even by people actively involved in the war on drugs. For
example, in March of 1973 an advisory committee consisting of some
40 prominent D.C. citizens filed a report urging the complete legaliza-
tion of marihuana on the ground that :
No demonstrable medical evidence is available to support
the assertion that marihuana use is hazardous or detrimental
to the physical or mental health of the user.
The widespread acceptance of the myth of harmlessness has been
due to several things. Certainly a role of some importance was played
by the militant pro-marihuana propaganda campaign conducted by
many New Left organizations, by academicians sympathizing with the
New Left, and by the entire underground press, ever since the Berke-
ley uprising.
Some of this propaganda was positively euphoric on the virtues of
marihuana. Dr. Joel Fort of San Francisco, a member of the Sociology
Department of the University of California and a former consultant
on drug abuse to the World Health Organization, had this to say on
the subject: "Cannabis is a valuable pleasure giving drug, probably
much safter than alcohol, but condemmed by the power structure of
our society." An article in "The Sciences" by L. Greenwald in 1968
went even further. "Marihuana," said Greenwald, "restores to the stu-
dent his ability to feel in an often hostile environment, and the liberat-
ing action of that drug is going to allow him to experience more inti-
mate social contact."
But the myth of harmlessness has been stimulated in even greater
degree by a number of highly publicized writings and by reports, some
XV
official, some unofficial, which have taken a rather benign attitude
toward marihuana. A major role was also played by the generous at-
tention which the media bestowed on militant drug enthusiasts like
Timothy Leary and Jerry Kubin. The damage was further compounded
by the virtual blackout imposed by much of our media — at least until
recently — on adverse scientific evidence about the effects of marihuana.
The result has been that Congress and the American public have been
exposed for years to an appallingly one-sided presentation of the
marihuana controversy.
Another factor contributing to the myth of harmlessness was the
selective manner in which the Shaf er Commission Eeport was handled
by the media. This report, as several witnesses pointed out, contained
a number of apparently contradictory passages, which made it possible
to write a story suggesting caution or to write one suggesting that its
emphasis was on tolerance. But it did contain quite a number of fairly
strong cautionary passages. It was for the purpose of setting the rec-
ord straight on the Shafer Commission Report that one of the first
witnesses heard by the Subcommittee was Dr. Henry Brill, who had
served as senior psychiatric member of the Commission. This is what
Dr. Brill had to say on the subject :
I am concerned about the misinterpretations which have
developed with respect to the marihuana report of that Com-
mission. These misinterpretations result from reading the re-
assuring passages in the report and ignoring the final conclu-
sions and recommendations, and the passages in the report on
which they were based. As a result it has been claimed that
the Commission's report was intended to give marihuana a
clean bill of health, and as a covert, or indirect support for
legalization of this drug in the near future, or as a step in
that direction. Nothing could be further from the truth.
From my knowledge of the proceedings of the Commission,
I can reaffirm that the report and the subsequent statements
by the Commission meant exactly what they said, namely that
this drug should not be legalized, that control measures for
trafficking in the drug were necessary and should be con-
tinued, and that use of this drug should be discouraged be-
cause of its potential hazards.
It was because of this pervasive imbalance in dealing with the
question of marihuana that so many intelligent people have been under
the impression that the scientific community regards marihuana as
one of the most innocuous of all drugs. Part of the purpose of our
recent hearings was to correct this imbalance — to present the "other
side" of the story — to establish the essential fact that a large number
of highly reputable scientists today regard marihuana as an exceed-
ingly dangerous drug. We make no apology, therefore, for the one-
sided nature of our hearings — they were deliberately planned this way.
MARIHUANA AND THE LAW
In previous statements, I have made it clear that I am opposed
to the decriminalization of marihuana use and that I believe some
penalties have to be retained. However, a man would have to be devoid
XVI
of compassion if he did not sympathize with the plight of a youthful
offender who was caught smoking marihuana because he succumbed to
peer pressures or to the bad advice he received from older students
and from a small but vociferous group of academicians. (The aca-
demic propagandists for marihuana are protected by the First Amend-
ment, but in my judgment they are far more culpable than the young
people who have heeded their advice ! ) In most cases involving youth-
ful offenders, especially first offenders, the purpose of justice is not
served by sentencing them to prison and giving them criminal records.
Our federal laws and many of our state laws have in recent years been
modified in a manner that reflects a more compassionate approach,
and the law is further tempered by the compassionate understanding
which the great majority of judges have for the problems of young
people.
Although there is still some unevenness in the state laws governing
the use of marihuana and although there is always room for review
and improvement, in practice very few young people are being sent
to prison for simple possession of marihuana, especially when they
are first offenders. On this point, there is such broad agreement that
I feel it is no longer at issue.
But there is a militant lobby in our country which has been agi-
tating and lobbying for the complete legalization of marihuana. As
a stepping stone in that direction, they are working for the complete
decriminalization of simple possession. This means that personal use
of marihuana would no longer be covered by criminal law, that it
would not even be considered a misdemeanor under the law. These
matters still are at issue — and I truthfully believe that they cannot
intelligently be decided without an assessment of the known and po-
tential dangers posed by marihuana use.
Not all drugs are equal — no one. for example, has yet proposed
that we deal with coffee and heroin, or tobacco and heroin, in exactly
the same manner. And the evidence I have presented in the preceding
pages should be sufficient to establish that the dangers of cannabis
are much closer to the dangers of heroin, in scope and quality, than
they are to the admitted but far more limited dangers of coffee or
tobacco — or, for that matter, alcohol.
The scientists who testified before the subcommittee were unani-
mous on the point that it made no sense to send young people to prison
for simple possession of a few joints of marihuana. On the other
hand, they were strongly opposed to legalization, and not one of them
spoke in favor of decriminalization. They expressed the belief that
it would seriously undercut any national effort to discourage mari-
huana use if all penalties were removed for simple possession, as the
Shafer Commission had recommended — and which remains the con-
tinuing objective of the pro-marihuana lobby. Dr. Brill, who, as a
member of the Shafer Commission, had voted in favor of eliminating
all penalties, indicated to the subcommittee that he was now re-
thinking this recommendation.
Commenting on the proposal that the decision on whether or not
to use drugs, and especially marihuana, should be left to the indi-
vidual, Dr. Andrew Malcolm, a distinguished Canadian psychiatrist,
called for a combination of education and the law. Said Dr.Malcolm :
It is necessary to have some external restraint when, indeed,
some of the people are incapable of exercising internal re-
XVII
straint. But those people who propose [that the matter be
left to] "wise personal choice" usually are unalterably op-
posed to any kind of external restraint. It is very foolish, be-
cause what we need, in fact, is both of these elements.
Dr. Phillip Zeidenberg, Chairman of the Drug Dependence Com-
mittee of the New York State Psychiatric Institute, while he held that
the marihuana epidemic could not be eradicated by legal measures
alone, nevertheless strongly opposed legalization and said that there
have to be some penalties for use. These were Dr. Zeidenberg's words :
I believe that legalization will turn on a "green light"
which will enormously increase the number of chronic heavy
users, just as it has in every other country where de facto
legalization exists. Once this happens, marihuana will be-
come an integral part of our social structure and take on
complicated social and symbolic significance, as tobacco and
alcohol already have. Once this happens, it will be virtually
impossible to remove it.
Ultrapunitive measures taken against individuals occasion-
ally using the drug can only lead to the backlash of pressure
for legalization. Offenders should be given light, but signifi-
cant sentences, enough to be a sufficient deterrent to repeated
use. Chronic heavy users should be offered psychiatric treat-
ment, not jail The job of the law is to find the appropriate
deterrent so that the marihuana problem is kept as a minor
drug-abuse problem without crucifying errant adolescents.
Warning about the drive to legalize cannabis in the United States,
Professor Nils Bejerot of Sweden said :
The demand for legalizing cannabis has been strongest in
those countries which have had the shortest experience and
the weakest forms of the drug. Correspondingly, I consider
that as a psychiatrist one's attitude to cannabis becomes more
negative the more one sees of its effects.
If cannabis were legalized in the United States, this would
probably be an irreversible process not only for this country
and this generation, but perhaps for the whole of Western
civilization. As far as I can see, another result would be a
breakdown of the international control system regarding
narcotics and dangerous drugs.
The pro-marihuana lobby brandishes the statistic that there were
some 400,000 arrests nationwide for marihuana offenses last year. They
do so in a manner which creates the impression that some 400,000
young people went to jail because they were caught with a few joints
in their possession. The actual situation is quite different,
The number of arrests involving marihuana was very high, among
other reasons because virtually every petty criminal arrested for shop-
lifting or burglary or mugging or other similar offenses had mari-
huana in his possession at the time of his arrest. But according to many
reports, our law enforcement authorities — federal, state, and local — in
most cases do not even bother to make arrests when they find young
people smoking marihuana or in possession of less than an ounce.
The cases that do come to court for the most part receive suspended
sentences or fines, while most states now have a provision in their laws,
33-371 O - 74 - 2
XVIII
similar to the provision in the federal law, calling for the expunging
of the record for first offenders after one year, if parole is satisfac-
torily completed.
However, the law is uneven from state to state. Some states, while
they have the theoretical power to send first offenders to prison, in
practice rarely use this power. But here and there, it must be conceded,
simple possession is still punished by prison terms.
I believe it would be helpful in dealing with this situation if the
federal law and state laws could be brought into basic harmony on the
question of marihuana. I do not suggest that the states slavishly adapt
their laws to the current federal model ; in many respects, in fact, I
think federal law has something to learn from existing state statutes.
There is one state statute that does not recommend itself as a model :
that is the marihuana law recently adopted by the State of Oregon.
Under this law, simple possession of small quantities of marihuana is
not treated as a violation of the criminal law but as a civil violation —
something akin to a parking ticket. While the maximum fine provided
is one hundred dollars, in practice the fines imposed rarely exceed
thirty dollars. And those thus fined, if they can afford it, can go on
collecting marihuana violations just as freely as some chronic illegal
parkers collect parking tickets.
This approach, I submit, is altogether too permissive and just
doesn't take into account the serious social damage done by marihuana
or the compelling need to protect society against the spread of the
habit. It doesn't take into consideration the basic fact that all drug ad-
diction— including marihuana addiction — is like a contagious disease.
Society can't remain indifferent to the spread of this disease.
The law must be framed in a manner that makes it unmistakably
clear to young people that smoking marihuana is a crime against so-
ciety. This is something that decriminalization would completely
destroy. I believe that the kind of escalated penalties provided by
state law in New Mexico, to give one example, make much more sense.
Under this law, the possession of one ounce or less for a first offender
is punishable by a fine of $50 to $100 and /or 15 davs in jail. The jail
sentences are rarely imposed, but this much discretion is given to the
judge. The penalty for repeat offenders is a fine of $100 to $1,000
and/or one year in jail. Suspended sentences are frequently given and
there is provision for expunging the record after one year.
New legislation governing the use of drugs requires the most careful
consideration by Congress because — as Dr. Bejerot pointed out conces-
sions to tolerance, once made, are very difficult, if not impossible, to
eradicate. However, as far as marihuana use is concerned, I believe
that the philosophy guiding such legislation miqrht well be based on the
opinions expressed by Dr. Zeidenberg and the other scientists who
testified before the subcommittee. I think there is much merit to Dr.
Zeidenberg's proposal, for example, that instead of jail sentences, we
might consider sending chronic abusers for a period of time to an
institution where they will be given intensive education on drugs and
psychiatric treatment if thev need it.
When it comes to the pushers and the traffickers. I think our federal
and state laws have got to be reinforced. I find it an outrage that, over
and over again, criminals caught in the possession of hundreds and
even thousands of pounds of marihuana get off with very light sen-
tences or even with six months suspended sentence. For the pushers
XIX
and traffickers, there have got to be heavy minimum sentences, and
they have got to be mandatory.
The suggestion has been made that it might help to break up the
traffic in drugs if offenders at every level — users, pushers, and small
and intermediate traffickers — could be assured of suspended sentences
if they cooperated by identifying the source, or sources, from which
they had obtained their drugs. This is a proposal which merits serious
consideration.
There are some who argue that tough law enforcement is not the
answer to the drug problem, that we won't be able to deal effectively
with the drug problem until we eliminate our slums, eliminate pov-
erty, eliminate unemployment, and create a social utopia. I am all in
favor of doing everything we reasonably can do to improve the qual-
ity of our society. But the fact is that every year since the early six-
ties has witnessed a massive increase in the amount we spend for new
social programs — and the same period of time has witnessed a stagger-
ing increase in our drug protein.
No drug problem has ever been controlled by decriminalization or
by social reforms. In every country where the drug problems have
been effectively controlled, it has been thanks to strong laws against
both the use and sale of the drug. That is how it is controlled in Com-
munist countries ; and that is how it has been controlled in some non-
Communist countries, both authoritarian and democratic. There is no
serious drug problem, for the indigenous population or for the GI's,
in either Taiwan or South Korea. Nor is there one in Japan. The con-
trast between Germany and Italy is most instructive in this connection.
In Germany, where drug laws are lax and law enforcement ineffective
because it is fragmented among the Laender, or states, there has been
a runaway epidemic of hashish consumption among the American
GI's. (According to Defense Department witnesces, this situation has
now improved significantly — although it still remains serious.)
In Italy, where the drug laws are mn<rh stronger, drug use among
GI's has been kept to a minimal level. The GI's in both countries are
basically the same. The difference is the law.
THE 1SEED FOR A NATIONAL EDUCATION PROGRAM
The scale of the marihuana-hashish epidemic makes it essential that
we embark — with as little delay as possible — on a national educational
program directed in the first place to our young people.
Can the facts that are assembled in this volume be communicated
to young people who are disposed to be skeptical about information
they receive from "the establishment?" I am convinced that this
evidence can be communicated to young people and can influence
them — because it is far more graphic, far more persuasive and far
more authoritative than any information that has heretofore been
available for marihuana education programs.
Dr. Forrest Tennant, who was in charge of the U.S. Army drug
program in Europe from 1968 to 1970, told the subcommittee that at
one point he had actually given up on anti-cannabis educational pro-
grams because the material at that time was not too persuasive, and
while the programs discouraged some GI's, they stimulated the cur-
iosity of others, so that there was no real net progress. He expressed
XX
the conviction, however, that armed with the recent evidence that had
been presented to the subcommittee by so many eminent scientists, it
would be possible to mount an educational program that GI's would
find credible. The fact is that no young person wants to run the risk
of irreversible brain damage, and no young male wants his male hor-
mone level reduced by more than 40 percent or his sperm count reduced
to close to zero. Nor does any young person, boy or girl, want to run
the risk of genetically damaged children. These are dangers that
young people will respond to.
There is an even larger matter that should be considered by every
young person who finds himself yielding to the temptation of drugs
or to peer pressures. Whatever each of us does, affects, for better or
for worse, all those around us. And the fact is that every young person
who takes marihuana or hashish or other drugs, drags down not only
himself, but drags down his friends, drags down his family, drags
down his community, drags down his nation. I would commend to
every young person who is prepared to stop and think the wise words
of Dr.* Gabriel Nahas, one of the eminent scientists who appeared as a
witness before the Subcommittee :
One may wonder... how long a political system can
endure when drug taking becomes one of the prerequisites
of happiness. If the American dream has lost its attraction,
it will not be retrieved through the use of stupefying drugs.
Their use only delays the young in their quest to understand
the world they now live in and their desire to foster a better
world for tomorrow.
A final word of an editorial nature. So many scientific papers and
supporting documents were left with the subcommittee by the wit-
nesses that the inclusion of all of them would have made this a docu-
ment of almost prohibitive length. In the interests of economy,
only a portion of these documents have been included in the Ap-
pendix. I particularly regret that it was not possible to include a
bibliography of some 800 cannabis research papers which Professor
W. D. M. Paton of Oxford prepared for the subcommittee, because this
volume was already in page proof at the time of its arrival. I ask the
indulgence of the scientists who gave supplementary material to the
subcommittee which has not been included in the printed Appendix.
Hopefully, this material can be included in a followup study or
documentation.
On behalf of the subcommittee, I want to thank the many dis-
tinguished witnesses who gave so generously of their time to make
these landmark hearings possible.
MARIHUANA-HASHISH EPIDEMIC AND ITS IMPACT ON
UNITED STATES SECURITY
THURSDAY, MAY 9, 1974
U.S. Senate,
Subcommittee To Investigate the
Administration of the Internal Security Act
and Other Internal Security Laws
of the Committee on the Judiciary,
Washington, D.C.
The subcommittee met, pursuant to notice, at 11 a.m. in room
2228, Dirksen Senate Office Building, Senator James O. Eastland
presiding.
Present : Senators Eastland and Thurmond.
Also present: J. G. Sourwine, chief counsel, and David Martin,
senior analyst.
Senator Eastland. The hearings on which we are embarking
today deal with the "Marihuana-Hashish Epidemic and Its Impact
on the United States Security." They represent an extension of the
previous hearings the subcommittee has held on the world drug
situation, which have already resulted in eight volumes of published
testimony. In opening these hearings, I want to repeat just a few
of the points I made in a statement I put out yesterday.
Over the past 5 years there has been a runaway escalation in the
use of marihuana and hashish. What was once a campus phenome-
non has moved down to the high schools and the junior high schools
and the grade schools, and upward into the ranks of adult society.
The spread of the cannabis epidemic has been facilitated by a
massive and perplexing imbalance in the published information
generally available to the public on the subject of marihuana. There
are competent scientists who believe that it is relatively harmless.
On the other hand, there is a large body of scientists of interna-
tional reputation whose research on cannabis has convinced them
that it is a highly dangerous drug, and this in many different ways.
When a conflict of opinion exists within the scientific community
on a question as important as marihuana, the Congress and the
American people are entitled to a fair presentation of both sides
to this controversy. In fact, however, there has been widespread
publicity for writings and research advocating a more tolerant
attitude towards marihuana — while there has been little or no
publicity for writings or research which point to serious adverse
(l)
consequences. The writings are there, the research papers by eminent
scientists are there, the books are there — but very few people know
about them. One witness who will appear before the subcommittee
will testify that in campus bookstores in the United States, Canada,
and England, virtually all of the literature he found on marihuana —
and he found a lot of it— took a tolerant attitude toward it or even
advocated legalization.
It is because of this strange imbalance in dealing with the ques-
tion of marihuana that most intelligent people are under the im-
pression that the bulk of the scientific community looks upon mari-
huana as a relatively innocuous drug. Part of the purpose of the
forthcoming hearings will be to inquire into, and document, the
extent of the imbalance. In doing this, we shall, in effect, be pre-
senting the "other side", so that the Senate and the American people
will have a better understanding of both sides of this controversy.
In this morning's hearing our witnesses will present an overview
of the cannabis epidemic from the time of the 1964 Berkeley upris-
ing, which marked the beginning of the campus epidemic, to the
present day. Our witnesses this morning are Dr. Harvey Powelson
of the University of California; Dr. Henry Brill of Pilgrim State
Hospital in New York; Mr. Andrew C. Tartaglino of the Drug
Enforcement Administration; Maj. Gen. Frank B. Clay of the De-
partment of Defense; and Dr. Donald Louria of the New Jersey
Medical School.
Gentlemen, I want to thank you for taking the trouble to come
before the subcommittee to testify on the subject of our inquiry.
In the interest of saving time, I would like to ask that you all rise and
be sworn simultaneously. If you would come forward, gentlemen.
Do you solemnly swear the testimony you are about to give will
be the truth, the whole truth, and nothing but the truth, so help
you God?
Dr. Powelson. I do.
Dr. Brill. I do.
Mr. Tartaglino. I do.
General Clay. I do.
Dr. Lotjria. I do.
Senator Eastland. Mr. Tartaglino, will you come forward?
TESTIMONY OF ANDREW C. TARTAGLINO, ACTING DEPUTY
ADMINISTRATOR, DRUG ENFORCEMENT ADMINISTRATION
Mr. Martin. Mr. Tartaglino, a few questions for the purpose of
establishing your qualifications. You are Acting Deputy Admin-
istrator of the Drug Enforcement Administration?
Mr. Tartaglino. Yes, sir; I am.
Mr. Martin. You have held this position since July 1, 1973?
Mr. Tartaglino. That is correct, sir.
Mr. Martin. Prior to that you held a number of important posi-
tions in various agencies concerned with the enforcement of our
drug laws ?
Mr. Tartaglino. That is correct, sir.
Mr. Martin. Your first assignment in this field was with the Fed-
eral Bureau of Narcotics, in which you served as a criminal investi-
gator from January 1963 to April 1966?
Mr. Tartaglino. That is correct, I served as criminal investigator.
Mr. Martin. That is not reflected in the biography which we
were given. Then, you have been active in the field of enforcing our
drug laws for more than 20 years ?
Mr. Tartaglino. That is correct, sir.
Mr. Martin. Mr. Tartaglino, before you start your statement,
will you tell us briefly what you mean by the words "hashish'5 and
"cannabis*', I think it would help people to have a clearer under-
standing of your testimony.
Mr. Tartaglino. It means all the preparations of the cannabis
sativa plant of which there is but a single species. It includes the
typical marihuana cigarette, hashish, marihuana or hashish oil, et
cetera.
Mr. Martin. Marihuana and hashish are not basically different
substances ?
Mr. Tartaglino. That is correct, they come from the same plant.
What I have brought with me this morning is an internal publica-
tion which sets out pretty much in detail what we mean when we
are discussing broader terms. If you like, I will submit that for the
record.
Mr. Martin. May that be admitted in the record, Mr. Chairman?
Senator Eastland. Yes.
[The document referred to may be found in the appendix, p. 418.]
Mr. Martin. Thank you, Mr. Tartaglino, you may proceed with
your statement.
Mr. Tartaglino. Mr. Chairman and distinguished members of the
subcommittee: My name is Andrew C. Tartaglino and I am the
Acting Deputy Administrator for the Drug Enforcement Admin-
istration within the Department of Justice. Today I am appearing
before you on behalf of Mr. John E. Bartels, Jr., our Admin-
istrator, who is presently out of the country on official travel. Ap-
pearing with me as counsel is Mr. Gene K. Haislip, also of DEA.
I am pleased to appear before your committee this morning in
connection with its continuing inquiry into the illicit traffic in, and
abuse of, marihuana. There is perhaps no more controversial sub-
ject in the area of drug control.
Marihuana has become the focus of an organized campaign de-
signed to make its use a legally sanctioned and permanent feature
of our society. Persons who take this position are fond of citing
the emotional propaganda of the 1930's which referred to it as the
"killer weed". But anyone familiar with the pro-marihuana litera-
ture of the present can see that they have indulged in equally
exaggerated misrepresentations in the opposite direction. I believe
that some of the data I have to present today will show that their
point of view is equally out of date.
The details of the medical and scientific facts concerning mari-
huana abuse are matters which I prefer to leave to the doctors and
scientists whom you have invited to appear before you today. My
own view is that it is a potentially harmful substance which we
should not permit to become an accepted part of our society. Those
of us in law enforcement have felt that the dangers inherent in this
drug would become more apparent with increasing research ; and we
believe this is in fact now occurring. The earlier views of some
observers in the 1960's were based on examination of short-term
users of marihuana of a relatively low potency. Concern has in-
creased now that scientific investigators have been able to study the
the effects of chronic use.
A major factor encouraging this conservative point of view is the
steady trend toward the abuse of more potent marihuana prepara-
tions such as hashish and hashish oil. This trend can be seen in the
figures attached to my statement which show that seizures of
hashish have increased by 2,274 percent during the last 5 years to
a total of almost 27 tons for calendar year 1973. Incidentally, when
Mr. Bartels, our Administrator, testified before your committee in
October of last year, the hashish seizures for the first half of 1973
were below the rate of the previous year. Now that figures for 1973
are complete, they exceed the previous year by 12 tons.
The mission of the Drug Enforcement Administration, however,
is the suppression of the traffic in marihuana products and not their
use which is primarily a problem for the Nation's health and edu-
cational authorities. While most of the drug law enforcement effort
is conducted at the State and local level, the Federal Government
through the DEA is uniquely suited to fulfill a broader mission —
that of disrupting marihuana and hashish traffic which is organized
at the interstate and international levels. To this end, our enforce-
ment effort is focused on stopping the flow of the drug at, or near,
its foreign source and in disrupting commerce in marihuana at its
highest level where the apprehension of violators can have the most,
impact. We have found that the closer the point of interdiction is
to the source of the drug, the greater is the quantity handled by a
decreasing number of people. This is the target at which we aim in
order to achieve optimum results.
The traditional source of marihuana reaching the United States
is Mexico. It is illegally cultivated for this purpose on "marihuana
plantations" in remote areas where little control is exercised bv the
central government. After harvesting and packaging, it may then
move into the United States concealed in the normal stream of
commerce, or by clandestine means utilizing aircraft, vessels, four-
wheel drive vehicles, or body-packs.
Beginning with 1970, substantial quantities also began to arrive
from Jamaica which has now become another principal source of
supply. Lesser amounts are now being smuggled from Colombia
as well, and hashish may originate from any one of several Middle
and Far-Eastern countries, principally Morocco, Lebanon, Afghan-
istan, and Nepal.
There has been as much misrepresentation of the nature of the
traffic in marihuana as there has been regarding the drug itself.
Many have the impression that this traffic is somehow unlike that
involving other drugs; that it is conducted more informally by stu-
dents and young persons for reasons other than profit. This is no
more the case today than it is with heroin or other contraband.
The traffic in marihuana is often a highly organized, well financed
venture involving hundreds of thousands of dollars of illegal profits.
The persons who engage in it are essentially the same criminal types
who organize other forms of illicit drug traffic and have the same
propensity for violence. For example, just last month, two uni-
formed U.S. Customs Patrol officers were found murdered near
Nogales, Ariz., together with a suspect whom they had killed in a
gun battle. This man was found seated at the wheel of a truck con-
taining 200 pounds of marihuana which he had attempted to drive
from the scene.
Perhaps one of the most extraordinary investigations illustrating
the scope to which this marihuana traffic has grown is an investiga-
tion now in progress in Florida. This involves a group of successful
professional and white collar financiers and their associates who
refer to themselves as the "Gainesville Marihuana Dealers Associa-
tion". The organization was first detected by the Florida Department
of Law Enforcement. In November of last year, agents of our Miami
regional headquarters joined with the State officers and U.S. Cus-
toms and Internal Revenue Service agents in a joint task force
known as "Operation Panhandle".
Although the investigation is still in progress, enough has been
learned to permit an estimate of their activities. During the 6
months in which the task force has been operating, this group has
smuggled approximately 80 tons of marihuana into the United
States. The drugs obtained through supply connections in Jamaica,
and occasionally Colombia, and brought into predetermined land-
ing points along the Florida panhandle by vessels carrying multiton
loads. The drugs will then be convoyed by as many as 10 to 15
trucks in a single shipment to special storage areas on horse farms
or orange groves owned by the association members. During de-
liveries, countersurveillance teams are established by the violators
in watchtowers along the approaches to the storage areas. Later, the
marihuana will be delivered by trucks, carrying one to several tons,
to various association customers in any of the 32 affected States.
Thus far, the investigation has resulted in the arrest of 19 indi-
viduals, the seizure of 35 tons of marihuana and the seizure or
impoundment of $1,250,000 of association funds. A brief description
of several other representative cases is attached to my statement.
In one of these a 153-foot 45-ton freighter was used in an attempt to
smuggle 3,700 pounds of hashish from Morocco.
In spite of the fact that cases of this size and complexity have
become common, large segments of the public persist in the view
that trafficking in marihuana is a small affair indulged in by juve-
niles. One result of this is that sentences meted out to large-scale
marihuana traffickers are frequently inadequate.
During the fall of last year, a special conspiracy unit comprised
of Federal, State, and local officers was formed to investigate the
activities of a suspect named Martin Williard Houlton, believed to
be engaged in large-scale marihuana smuggling. When the investi-
gation was finally completed, the intelligence indicated that Houlton,
a 54-year-old proprietor of a Columbus, N. Mex. motel and bar,
maintained a small air force of 20 high-speed aircraft which aver-
aged 18 smuggling trips per week between Mexico and the United
States. On each occasion, some 500 to 700 pounds of marihuana
would be brought into the United States for distribution.
After obtaining advanced court authorization for a wire intercept
information was at last obtained of the plans for a specific smug-
gling flight. On the day in question, a DEA agent conducting
aerial surveillance from a DEA aircraft was able to monitor the
takeoff of three of Houlton's aircraft, which were later observed to
land and load suspected contraband. Aerial surveillance was main-
tained on the returning flight by DEA and U.S. Customs aircraft
and shortly after the planes landed on a small airstrip near Colum-
bus, Houlton and several of his associates were arrested in posses-
sion of 2,300 pounds of marihuana.
In February of this year, Houlton was found guilty by a New
Mexico State court and given an 18-month suspended sentence and
a $1,000 fine. Neither he nor any of his associates who were con-
victed with him, have served any time in prison for their extensive
crimes.
The inescapable conclusion which we draw from the examples and
statistics which I have cited is that the traffic in, and abuse of mari-
huana products has taken a more serious turn in the last 2 or 3
years than either the courts, the news media, or the public is aware.
The shift is clearly toward the abuse of stronger, more dangerous
forms of the drug which renders much of what has been said in
the 1960's about the harmlessness of its use obsolete.
During the same period, the organization of the marihuana traffic
has likewise increased in both size and complexity. Thus, the way
in which the public, the judiciary, and oftentimes the law enforce-
ment community, conceives of the marihuana problem is out of date,
and our responses to it are similarly inappropriate. The purpose
which I hope to serve in appearing before you this morning is to
help bring about an awareness of this change.
Thank you, Mr. Chairman, I will now be pleased to respond to
any questions which you or other committee members may have.
Mr. Martin. There are a number of charts and tables attached to
the statement, Mr. Chairman; may the charts be incorporated into
the record?
Senator Eastland. Yes.
Mr. Martin. Mr. Tartaglino, you have prepared a number of
charts you wish to show the members of the committee; would you
want to run through them quickly ?
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Mr. Tartaglino. The first chart illustrates the illicit marihuana
and the second chart the illicit hashish by year from 1969 to 1973,
removed by Federal agents alone. You can see that when we speak
of hashish, seizures have increased from roughly a little more than
2,000 pounds in 1969 to 53,000 pounds in 1973, or some 27 tons. We
have gone from 1 to 27 tons in a very short space of time.
In marihuana you can see a very similar increase. We have gone
to some 375 tons that were removed in 1973.
Mr. Martin. 780,000 pounds?
Mr. Tartaglino. Yes, I am reducing that figure to tons; and that
is just an illustration of how we have grown from 35 tons in 1969.
I might add that as recently as 10 years ago, the only hashish
that was found in the United States was probably a quarter pound
in the sole of some seaman's shoe that he brought over for his own
use. I recall when our seizure was under 10 pounds a year. But, in
1969 we exceeded 1 ton, and of course last year we have gone to 27
tons.
Mr. Martin. I think it might be useful to let people know what 1
pound of hashish can do. A quart of whiskey can only get a few
people drunk, but how many people can get drunk on a pound of
hashish ?
Mr. Tartaglino. Well, I would have to go into a discussion of the
potency of it, but what you say is roughly correct.
This third chart shows the arrests for cannabis State, local and
Federal; the yellow is Federal, we have gone from 333 arrests in
1969 to over 1,500 last year.
You can see local enforcement agencies in 1972 arrested almost a
quarter of a million people in the United States for cannabis viola-
tions, hashish and marihuana.
In the map that you see before you we have tried to give you an
illustration of generally the areas that are affected in the United
States today ; the purpie arrows illustrate hashish ; the orange illus-
trates marihuana. We also have represented there on this chart the
largest marihuana seizure on record, 42 tons in Jamaica; a single
seizure of marihuana which was destined for the United States. The
largest domestic seizure last December, 20 tons in Florida. In hashish
the largest domestic seizure, 3,700 pounds, almost 2 tons, in Miami,
in March of this year. The largest foreign seizure, 12 tons in Karachi,
Pakistan.
10
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Senator Eastland. What is the difference between marihuana and
hashish ?
Mr. Tartaglino. Hashish is derived from the resin of the mari-
huana plant; it is a more concentrated form of marihuana.
Mr. Martin. What is the difference in strength?
Mr. Tartaglino. It has a great deal more potency. We measure
marihuana preparations by their tetrahydrocannabinol content. Reg-
ular manicured marihuana has 1 to 2 percent tetrahydrocannabinol;
hashish has 10 to 15 percent. So, it has perhaps seven times the
strength.
Senator Thurmond. Several times the strength?
Mr. Tartaglino. Seven times the strength.
Senator Thurmond. Seven times the strength.
Mr. Tartaglino. Yes, as a general rule.
Mr. Martin. And then when it comes to liquid hashish, I believe
Mr. Bartels has testified that you have samples going up to 90
percent THC content?
Mr. Tartaglino. That is correct, we have samples running all the
way from 35 to 40 percent THC contents ; and it is possible to make
it up to 90 percent. That is relatively new on the market and cer-
tainly a most dangerous form.
Mr. Martin. I believe Mr. Bartels also testified that a drop of
this on a cigarette is enough to send one off into the stratosphere —
that is, 90 percent THC?
Mr. Tartaglino. That is correct, that is the maximum content.
Mr. Martin. I have a few questions — and I would like to suggest
Mr. Chairman, that the charts and maps they have prepared, or
photographs of them, be received for the record.
Senator Eastland. As exhibits, yes.
Mr. Martin. Thank you very much for your testimony. Mr.
Tartaglino. When Mr. Bartels, your Administrator, was here, he was
testifying on the Brotherhood of Eternal Love; that is an organi-
zation founded by Dr. Timothy Leary; is that correct?
Mr. Tartaglino. That is correct, sir.
Mr. Martin. Do you remember off-hand how many tons of hashish
the Brotherhood was able to smuggle into the United States before
you were able to close down on them?
Mr. Tartaglino. We will have to check our statistics, it was in
excess of 20 tons.
Senator Thurmond. How much?
Mr. Tartaglino. In excess of 20 tons.
Mr. Martin. 40.000 pounds.
Mr. Tartaglino. Yes, sir.
Mr. Martin. From Mr. Bartels' previous testimony, and from
your testimony today it is apparent that over the past few years
smugglers have been operating with much more massive quantities
of marihuana and hashish?
Mr. Tartaglino. That is correct, a shift of such massive quantities
that they are going from aircraft to ships, which is a major change.
Mr. Martin. Now, the figures in the charts you have shown us
reflect only the quantities interdicted by the Federal law enforce-
13
ment; they do not reflect the quantities seized by local and State
law enforcement authorities?
Mr. Tartaglino. They reflect the quantities seized by Federal
law enforcement authorities in cooperation with foreign authorities
where we have liaison or offices abroad; they do not include local
seizures.
Mr. Martin. If you included local seizures, the total quantities
removed from the illicit market would be substantially higher for
marihuana and hashish than the figures we have in the charts?
Mr. Tartaglino. Absolutely.
Mr. Martin. Now, I have here a few items dealing with massive
seizures of cannabis in recent weeks, in Puerto Rico and Mexico.
On March 23 San Juan reported a seizure of some 700 pounds of
marihuana coming from Colombia; and there is a second item from
San Juan, dated March 28, which speaks about the seizure of almost
8,000 pounds of marihuana, $10 million worth. Do you have a record
of either of these seizures?
Mr. Tartaglino. We would have a record of it, but I don't have
it with me here, sir.
Mr. Martin. But you would not have a record of seizures made
by local authorities?
Mr. Tartaglino. If they were made by local authorities, we may
just have a newspaper item we collect for routine information. But
if it was a local authority, we would not have that in our statistics.
Mr. Martin. And I would simply note for the record that the
third item, dated Acapulco, March 30 — these items all fall within a
week — reports a seizure of 6V2 tons of marihuana, 13,000 pounds,
by the Mexican police. That's a big chunk of marihuana.
Is there any doubt in your mind that the United States was the
target area for this massive seizure of marihuana in Acapulco?
Mr. Tartaglino. There is no doubt in my mind. We can reasonably
suppose that most of the large seizures are traditional traffic to the
United States.
Senator Thurmond. Mr. Chairman, I want to commend you for
arranging these hearings ; and I want to express my appreciation to
the witnesses who are appearing here, too ; I believe we have hearings
set for the 16th and 17th, and I hope I can attend these hearings.
Today I'm tied up in the Armed Services and we scheduled $9 bil-
lion for our Armed Forces; I ask the chairman to excuse me for
that reason. But, I did want to come by and show my interest in
these hearings, they are extremely important. I am scheduled to
chair these hearings on the 20th, and I am looking forward to that
time, too. I don't know of any subject more important, especially
affecting our young people than this question of drugs.
Mr. Martin. I have a few questions I would like to ask you, Mr.
Tartaglino, about your chart dealing with the increase in cannabis-
related arrests. The chart shows far fewer arrests by the Federal
authorities than by the local authorities. Would this be because the
Federal authorities concentrate on the large-scale smuggling oper-
ators, while most of the arrests made by local authorities have to
do with small-scale possession?
33-371 O - 74
14
Mr. Tartaglino. We had a criteria that we utilized, and we set
our sights at large-scale interstate traffic, and international traffic.
We do that in coordination with local and State authorities. So,
your answer is correct, sir.
Mr. Martin. Now, in terms of the actual quantities of cannabis
seized or interdicted, the Federal authorities probably seized far
more from the illicit market than the local authorities?
Mr. Tartaglino. Yes, sir.
Mr. Martin. Is it true that the local law enforcement authorities
in most parts of the country are less rigorous than they used to be
in arresting young people who have a joint or two of marihuana in
their possession; do you have any impression on that?
Mr. Tartaglino. t don't believe I could accurately answer that
question.
Mr. Martin. Eight. Would it be reasonable to infer that the tre-
mendous increase in cannabis arrests by State and local authorities,
tied in with the figures in your own charts, points to a sharp increase
in marihuana and hashish consumption in our country?
Mr. Tartaglino. There is no question about that.
Mr. Martin. Could this increase in cannabis interdictions por-
trayed in your charts be the result, at least in part, of improved
enforcement capabilities?
Mr. Tartaglino. I think we can say that there is increased awareness
by local, State, and Federal enforcement, of the dangers.
Mr. Martin. Do you have more men?
Mr. Tartaglino. We have more men than we had 4, or 5 years ago.
Mr. Martin. Better technology?
Mr. Tartaglino. Better technology; we have more individuals
involved in this war; we have better State-Federal programs in
metropolitan enforcement groups throughout the United States;
task forces, local, State, and Federal.
Mr. Martin. But you don't believe that the tremendous increase
can be explained entirely on the basis of improved enforcement ca-
pability ?
Mr. Tartaglino. Absolutely not.
Mr. Martin. I note in table No. 6 attached to your statement that
interdiction of heroin went down from 1,541 pounds in 1971 to just
over 1,000 pounds in 1972, and 483 pounds in 1973. This isn't because
you slackened your efforts against heroin?
Mr. Tartaglino. No, we feel that we have made some inroads
in the heroin traffic. I think that the seizures that have been made,
and the recent reduction in seizures reflect a decrease in the traffic.
I will have to develop this more. I think it is directly related to a lot
of cooperation overseas, better groups in the United States working
on it, increased manpower, increased resources, et cetera. We are in
our 26th, or 28th month of what we refer to cautiously as a heroin
shortage. There definitely is a heroin shortage in the United States.
Mr. Martin. Generally speaking, the reduction in the amount
of heroin interdiction more or less corresponds to what we know
about the decrease in actual heroin use in this country?
Mr. Tartaglino. That is correct.
Mr. Martin. And the next question is, wouldn't this reinforce
15
the assumption that the tremendous increase in the interdiction of
marihuana and hashish does in fact correspond to the amount actually
consumed ?
Mr. Tartaglino. I think our understanding is that the increased
seizures mean that there is a lot more coming in, yes.
Mr. Martin. Right. Those are the only questions I have.
Mr. Sourwine. You have three attachments covering specific
cases, I think they should go in the record, Mr. Chairman.
Senator Eastland. The attachments will be received for the record.
[The material referred to follows:]
Hashish Smuggling: East Coast Surveillance
On March 1, 1973, the Air Police at Orly Airport, Paris, France advised
DEA that two individuals had been observed carrying $297,000 in American
currency. An investigation had been initiated on Donald and John Griffin
who arrived in the United States from France in December 1972 and who
were planning to return to Europe via the SS Michelangelo accompanied
by four automobiles. Further investigation identified these individuals as
being active in the Miami, Florida area where they had purchased two luxury
imported automobiles, a Maserati and a Lamborghini for $33,850. Both ve-
hicles were paid for in five and ten dollar bills taken from a clear plastic
bag issued by a national hotel chain. The subjects' motel was located and it
was ascertained that they and other accomplices had rented a 30 ft. sailboat
at North Palm Beach, Florida subsequently returning that boat for a larger
vessel. Nine months later the same group attempted to rent another sailboat
but were discouraged by the company's inquiries as to their purpose in rent-
ing. Alerted by the Marine Company, DEA located the two subjects reg-
istered at a Juno Beach, Florida motel under assumed names. DEA surveil-
lance established that the two subjects were subsequently joined by two
additional subjects. Three of the subjects rented a 22 ft. motor home and
spent two days driving through Northern Florida and Southern Georgia.
DEA vehicle and aerial surveillance was maintained and they were observed
examining the Atlantic Coast and the St. Johns River while using naviga-
tional charts.
Upon returning in the motor home the subjects conducted numerous forays
out of their two motels using the motor home and a rented automobile.
Using the auto, two subjects visited a boat yard and then proceeded to a
wooded section adjoining the inter-coastal waterway where they remained in
the woods for a brief period and then joined their cohorts in the motor home
several miles away. Later the same day all four subjects revisited the wooded
site and subsequently two of them went to the boat yard they had visited
earlier and were observed proceeding south in the inter-coastal waterway in
an 18-ft. motorboat. At midnight the motorboat was observed returning
toward the boat yard with its running lights off. The motor home was sur-
veilled with the four subjects as it drove to the wooded site along the inter-
coastal waterway where it parked for a short while then proceeded to Ft.
Pierce, Florida for the night. The following day the motor home was driven
to Palm Beach Gardens, Florida where the four subjects registered at a
motel and were soon joined by a fifth conspirator and subsequently by a
sixth conspirator, a known narcotic violator from New York. The mobile
home and three subjects proceeded to Jacksonville, Florida later in the day
and registered at a motel where they were joined by 'the other three subjects
who drove in a rented automobile. The rented car was then exchanged for
another vehicle.
The following day the New York violator departed for New York via com-
mercial aircraft and for the next two days DEA agents maintained aerial
and vehicle surveillance on the five subjects as they proceeded north. During
the course of the surveillance, agents seized traces of hashish from one of
their recently vacated motel rooms. During the evening of October 29th
through October 30th the subjects were under constant surveillance as they
operated out of their Annapolis, Maryland motel. They placed foreign tele-
16
phone calls and recontacted the New York City narcotic violator and also
telephoned a local resident. The rented auto was spotted from the air at a
local farmhouse which had been telephoned earlier. The subjects attempted
counter-surveillance techniques as the car and motor home established con-
tact and moved to the farmhouse area. When the motor home stopped to let
traffic pass, surveilling agents arrested the three occupants. The interior of
the motor home was pungent with the odor of marihuana substance and
1183 lbs. of hashish and 46 lbs. of hashish oil were seized. DEA agents
then drove the motor home to the farmhouse where they were greeted by
four additional individuals and two of the subjects who were unaware of
the fact that occupants of the motor home were federal agents. Arrests were
made and an automatic weapon, additional hashish and marihuana, and two
Citizen's Band radios were seized.
Follow-up investigation established a smuggling conspiracy involving citi-
zens of the United States, England, Australia, and South Africa who con-
trolled a fleet of yachts operating out of France and Spain via Lebanon to
the United States. It was established that over 3,000 lbs. of hashish had been
smuggled into the United States by this ring on four occasions. Five subjects,
in addition to the eight arrested, have been identified and are under active
investigation at this time.
Hashish Smuggling From Pakistan
In November 1973, a confidential informant reported to DEA agents at
Karachi, Pakistan, that an individual, later identified as Mohammed Sultan,
had approached him seeking assistance in locating someone who would
smuggle one to two tons of hashish into the United States. Following instruc-
tions of the DEA agents, the informant told Sultan that he knew a U.S.
diplomat who was being transferred back to the U.S. and would probably be
willing to send the hashish with his personal effects.
On November 6, 1973 a DEA agent was introduced to Sultan as being the
diplomat. Sultan accepted the agent and stated that he wished to ship 1,000
kilograms of hashish. Sultan expected the deal to bring a profit of $1,000,000
of which Sultan was to get half, with $400,000 going to the Agent and $100,000
to the informant. The agent said he would be flying to the U.S. in a day or
two after packing his household effects. Sultan then said the agent could
make an additional $40,000 by taking 100 kilograms with him on the aircraft.
On November 8, 1973, Sultan gave the agent $500 advance toward expenses.
At this same meeting Sultan asked if the agent could take 150 kilograms of
hashish on the plane instead of 100 kilograms, explaining that someone would
meet the agent in New York and pay him $60,000 for the hashish. The agent
accepted.
On November 15, 1973, Sultan introduced the agent to his partner Makil
Ashraf and to Salim Hraoui who was to be the recipient in New York. On
November 18, 1973, the agent again met with Sultan, Ashraf, and
Hraoui and arrangements were made for delivery of two tons of hashish to
the American Consulate, ostensibly for inclusion with the agent's household
effects. Later the same day Sultan called the agent and said he was unable
to locate a truck. The agent then obtained a Consulate truck and drove it,
as instructed by Sultan, to the Pakistan Textile Plant at Karachi, where it
was loaded with two tons of hashish. This same date, Sultan delivered to
the agent $2,500 additional expense money. The hashish was subsequently
turned over to Pakistan Sea Customs.
On November 19, 1973, the agent proceeded to the Pakistan Textile Factory
at Sultan's instruction, and picked up seven suitcases containing 151 kilo-
grams of hashish. The agent retained a representative sample of approxi-
mately seven kilograms, for delivery to New York, and turned the balance
over to Pakistan Sea Customs.
On November 20, 1973, the agent arrived in New York and met Salim
Hraoui. When the agent told Hraoui the hashish was ready for delivery
Hraoui paid the agent $35,000. Hraoui was arrested as he went to a vehicle
to obtain the hashish.
On the night of November 22, 1973, Mohammed Sultan was arrested in
Karachi. He subsequently admitted that he had an additional quantity of
about 10 tons of hashish concealed in 55 gallon drums at the Pakistan Textile
17
Factory. DEA agents and Pakistan Customs officers went to the factory,
found and seized the 10 tons of hashish.
This operation removed over 12 tons of hashish from the market and re-
sulted in the arrest of the principal defendants. Prosecution is pending as of
April 29, 1974.
"Sea Trader"
During February 1974, information was developed which indicated that a
group of individuals had been smuggling tons of marihuana from the Carib-
bean into the United States, including New York, Louisiana, and Florida.
Information was also developed that this group had been planning to bring
a large load of hashish from Morocco. Intelligence indicated that the load
would be 7,000 pounds and would be transported on a vessel later identified
as the "Sea Trader." The "Sea Trader" is a 153 foot, 45 ton gross freighter,
registered out of Panama. The "Sea Trader" was believed to be in Morocco,
departure date unknown, and attempts to locate were initiated, and alerts
were posted in the continental United States.
On April 9, 1974, information was received that the "Sea Trader" was
dead in the water with engine trouble at a point approximately 150 miles
south-east of Bermuda.
DBA requested the assistance of the U.S. Coast Guard who dispatched a
long range search plane to locate "Sea Trader" and conduct a search for
any vessel enroute to contact "Sea Trader" and attempt to offload the hashish.
The U.S. Coast Guard Cutter "Gallatin" was dispatched and proceeded at
the fastest possible speed to attempt to take the vessel in tow to the nearest
U.S. Port.
On April 10, 1974, Coast Guard Cutter "Gallatin" arrived on scene and
relieved sea going Tug Robin VIII of the tow. "Sea Trader" would not agree
to be towed to the nearest U.S. port but agreed to have "Gallatin" tow "Sea
Trader" to protected Bahamian waters.
On April 12, 1974, "Sea Trader" was anchored within the 3-mile limit of
Bahamian waters and two other boats approached to assist the "Sea Trader."
"Sea Trader" was boarded by Drug Enforcement Administration and Ba-
hamian authorities and subsequent search revealed 70 bags containing ap-
proximately 3,700 pounds of hashish. Nine subjects were arrested and two
vessels were seized by the Bahamian authorities.
The contraband and subjects were returned to Nassau for criminal pro-
ceedings. DEA will initiate conspiracy indictments in the United States.
Mr. Sourwine. Your charts and tables, sir, appear to indicate that
the rate of increase of hashish is substantially greater than the rate
of increase of marihuana. For instance, over a 5-year period the
marihuana increase is roughly 10 times; the hashish increase is 22
times. Do you take that as an indication that hashish is in some de-
gree replacing marihuana, that the user is starting out with pot
and graduating to hash?
MARIHUANA AND HASHISH REMOVED FROM ILLICIT MARKET BY FEDERAL AGENTS (IN POUNDS)
Calendar year-
1969
1970
1971
1972
1973
Marihuana:
Total
73, 108
185, 096
308, 048
514,812
782, 033
Domestic (DEA)
9,924
59, 840
3,344
9,092
148, 772
26, 422
21, 380
201, 558
85, 110
51,897
365, 421
97, 494
51,379
Ports and borders (Customs, INS)...
DEA/foreign cooperative.
489, 961
240, 693
Hashish:
Total
2,247
7,256
22, 188
30, 094
53, 333
Domestic (DEA)
239
1,602
406
234
3,811
3,211
882
6,900
14, 406
1,151
8,754
20, 189
641
Ports and borders (Customs, INS)...
7,235
45, 457
18
OPIUM, HEROIN, AND COCAINE REMOVAL FROM ILLICIT MARKET BY FEDERAL AGENTS AND ARRESTS
1969
Calendar year—
1970
1971
1972
1973
Total domestic removal (in pounds):
Opium 25 30 58
Heroin . 427 691 1,541
Cocaine 208 730 602
Total DEA/foreign cooperative seizures
(in pounds):
Opium 1,590 1,360 1,440
Morphine base 706 811 2,271
Heroin 395 301 937
Cocaine 35 75 346
DEA Federal arrests:
Heroin
Cocaine >950 » 1,104 « 1,923
Other narcotics
State and local arrests: *
Heroin and cocaine... 67,945 108,427 114,573
66
1,036
916
120
483
1,347
17, 379
2,104
2,416
801
50, 746
2,262
821
1,015
2,159
1,231
63
2,169
1,645
47
92.364 ....
> Reported as narcotics arrests.
2 Source: Uniform crime report.
QUANTITIES OF DRUGS SEIZED'
[In kilograms)1
Calendar year—
1968
1969
1970
Cannabis:
Herb 1,471,408
Resin 37,253
Opium.. 40,153
Morphine 813
Heroin 546
Cocaine 158
1, 825, 769
3, 073, 638
32, 237
41,574
40, 729
29, 308
846
543
463
567
152
460
'Source: 25th Session, Commission on Narcotic Drugs (Sept. 22, 1972).
Mr. Tartaglino. I definitely think so, I agree with that.
Mr. Martin. Thank you very much, Mr. Tartaglino.
Mr. Tartaglino. Thank you, sir.
Mr. Martin. Dr. Harvey Powelson will be our next witness.
Senator Eastland. Identify yourself for the record, sir.
TESTIMONY OF DR. HARVEY POWELSON, UNIVERSITY OF
CALIFORNIA AT BERKELEY
Dr. Powelson. I am Dr. Harvey Powelson, from the University
of California at Berkeley. I want to thank the chairman and the
committee for having me here today, I am honored and pleased.
Mr. Martin. Before you read your statement, Dr. Powelson, I
would like to ask you a few questions for the purpose of establish-
ing your qualifications. Now, you have a degree in medicine and a
degree in psychiatry from the University of California?
Dr. Powelson. That's right.
Mr. Martin. You have been a practicing psychiatrist since 1951?
Dr. Powelson. That's correct.
Mr. Martin. You held a clinical appointment on the faculty of
19
the University of California Medical School until you resigned
from the faculty last year?
Dr. Powelson. That's correct.
Mr. Martin. You have also served on the faculty of the Psycho-
analytic Institute in San Francisco?
Dr. Powelson. That's right.
Mr. Martin. You served as director of the psychiatric department
of Kaiser Hospital in Oakland, Calif., for 8 years?
Dr. Powelson. That's correct.'
Mr. Martin. You are currently serving as a research psychiatrist
at the University of California at Berkeley ?
Dr. Powelson. Yes, sir.
Mr. Martin. You are also currently serving as mental health offi-
cer of Calaveras County ?
Dr. Powelson. Yes.
Mr. Martin. You served from 1964 to 1972 as director of the
psychiatric department of the Student Health Service at the Univer-
sity of California at Berkeley?
Dr. Powelson. That's correct.
Mr. Martin. All right, Dr. Powelson, will you proceed with your
prepared statement. The mike is not working too well, so, if you
would keep your voice level up it would be helpful.
Dr. Powelson. In 1965, I was chief of the Department of Psy-
chiatry in the Student Health Service at the University of Cali-
fornia in Berkeley. It was the first year of the student riots. It was
also the first year that hallucinogens were becoming widely used
and I, as the person responsible for mental health on that campus,
was vigorously involved in the debate about psilocibin, LSD, and
mescaline.
In the spring of that year a reporter for the Daily Californian,
the student newspaper, asked for my opinion on marihuana. At that
time I lacked any direct experience as a physician with marihuana
users. The medical literature was sparse, but in general seemed to
be saying that there was no proof of long term harmful effects from
marihuana. I summarized this for the reporter and said there was
no proof of harm and that it probably should be legalized and con-
trolled. In general, this view met with approval from most of the
students and most of my professional colleagues.
In 1965, the use of marihuana spread throughout the Berkeley
campus. Simultaneously its use was spreading to all the colleges
and universities across the country. From the campus communities
it spread at an accelerating rate through the surrounding commu-
nities. By now its use is subject to no age, social or geographic
barriers.
My place of observation was unique. I was there at the beginning
and in my work I was actively involved with students not only as
a psychiatrist but as a teacher, and as a participant in a 4-year
research project studying maturation and growth, in college stu-
dents. In addition, I was routinely meeting with deans and admin-
istrators who were dealing with the drug problem and the students
20
who were in academic and/or disciplinary difficulties as a consequence
of the use of marihuana and its derivatives.
Most importantly, I was in daily contact with the constant flow
of students through the student health service and the psychiatric
clinic and hospital.
During the period I am speaking of, from 1965 to 1972, the clinic
saw approximately 2,000 to 3,000 students a year as outpatients and
about 150 to 200 students a year who were mentally ill enough to
be hospitalized. Naturally, I didn't see all these students but the
people who ministered to them were all under my supervision. I
personally interviewed about 200 students a year; many were seen
for a single hour, others were seen as intensively as 2 to 3 times a
week for varying lengths of time up to and including 5 years.
During this time, from 1965 to 1972, an increasing number of
patients were using marihuana. My best guess, based on surveys
and impressions is that more than 90 percent used it at one time or
another in college. More than 50 percent used it "socially", approxi-
mately 1 or 2 times a week; and about 10 percent were heavy users,
at least 1 time daily.
My first important shift in thinking occurred as a result of ob-
servations made during psychotherapy with a young man, S., who
was bright enough to be getting his law degree and Ph. D. simul-
taneously and competent enough to be learning to fly and deal in
real estate at the same time. As we proceeded in our work together,
I came to know S.'s way of thinking; how he thought. Most of us
do this without thinking about it. All of us come to know to some
degree the way our friends and colleagues think. In therapy, the
opportunity to hear someone think out loud about a problem im-
portant to him maximizes the opportunity to come to know how he
uses or misuses logic, remember clearly or not at all does or does
not exercise good judgment about his own thinking and whether or
not he is able to know his own feelings. We had made enough head-
way so that S. had begun to be able to observe and understand his
own thinking. Periodically we had hours, I was seeing him twice
weekly, when his thinking became mushy. If I tried to follow him,
my head began to spin. When I protested that he'd become impos-
sible to listen to, he would argue that his own experience was that he
was thinking more clearly, more insightfully, than ever. On one
such occasion, he mentioned that he had been to a party 2 nights
before where he'd had particularly good "grass". In Berkeley, in
1968, that was not a particularly memorable remark, but we thought
there might be some connection with his thinking. This same series
of events occurred often enough so that I finally was able at times to
post diet that S. had had some "mind-expanding drug", usually
marihuana.
S., because he was a good observer, helped show me another aspect
of the thinking disorder I'm describing. Central to his difficulties
was a paranoid stance toward the world. By this I mean a style
of thinking characterized by a constant suspicion that one is being
21
controlled, for example, by the establishment, the system, et cetera;
and simultaneously a constant unwitting search for people and
situations which will do just that; drugs, demagogues. If this man-
ner of thinking is carried further, it blends into the condition
usually called paranoia. Here the subject is controlled by voices,
God, or whatever, and at the same time he is very often "against his
will" being controlled by a State hospital or jail. S. was forever
talking about his search for something or someone he could trust.
He very frequently clutched to himself people who were totally un-
trustworthy and hurt and rejected others who manifestedly ad-
mired and liked him.
When he had used marihuana, his thinking became more paranoid,
that is, he became more mistrustful of me, for instance, and at the
same time he became more wily so that he talked glibly, using cliches,
theories, and "insights", all to avoid noticing concretely and imme-
diately whatever he was really doing and feeling in his relationship
with me, as well as his relationships outside. In short, the patho-
logical part of his thinking was exaggerated in two ways, he was
more suspicious, et cetera, and he was more adept at fooling himself
about what he was up to, while simultaneously maintaining how
"aware", "in touch" and "loving" he was.
S. continued in therapy but also continued to use marihuana and
hashish. Toward the end of his therapy, I had decided that so
long as he muddled his thinking in this way, there was no use con-
tinuing. He, however, suffered a fatal accident — as a result of an
error in judgment — before his therapy actually terminated.
As I was becoming familiar with these effects of marihuana on S.,
I gradually learned to pick up signs when they were more subtle.
I came to observe the same changes in others, that is, that mari-
huana exacerbated the pathological aspects of their thinking.
These observations were made before controlled studies began to
give us clues as to the nature of the mental changes taking place
which could explain these phenomena. The committee has undoubt-
edly heard or will hear of the studies by the Hollister group at
Stanford on what they call "temporal disintegration" which seem to
be changes secondary to the loss of immediate memory and the loss
of an accurate time sense. There are also corroborating studies from
Utah, clinical studies by Kolansky and Moore, X-ray studies by
Campbell in England, and a study on students by Schwarz at the
University of British Columbia to cite a few of the most relevant
studies made on subjects comparable to the ones I'm describing.
Following the above described observations, I saw the same pic-
ture more and more frequently. The essence of the pattern is that
with small amounts of marihuana, approximately three joints of
street grade, memory and time sense are interfered with. With
regular usage the active principles cause more and more distorted
thinking. The user's field of interest gets narrower and narrower as
he focuses his attention on immediate sensation. At the same time
his dependence and tolerance is growing. As he uses more of the
22
drug, his ability to think sequentially diminishes. Without his
awareness, he becomes less and less adequate in areas where judg-
ment, memory and logic are necessary. As this happens, he depends
more and more on pathological patterns of thinking. Ultimately all
heavy users, that is daily users, develop a paranoid way of thinking.
After I had become aware of the generality of this sequence an-
other reporter from the Daily Californian interviewed me to see if
my opinions had changed in the interim. In the course of that inter-
view, I realized in a concrete and explicit way that they had. The
headline read, "Psychiatrist says pot smokers can't think straight".
This time the response of the community and colleagues was not
so approving. It is an interesting fact that questioning the claims of
marihuana users leads to much more anger, vilification, and charac-
ter assassination than does the opposite stance.
In subsequent years in Berkeley, both at the clinic and in my
private practice, I have observed the long-term effects of cannabis.
Originally, my observation was that students who had "dropped
out" into the "drug scene" and were attempting to return, were find-
ing it difficult if not impossible. A frequent story is that the young
person has become aware that the life he's been leading is unsatis-
factory and unproductive. He then stops drugs for 6 months, or so,
and reenters the university. When he returns to school, however,
he finds that he can't think clearly and that, in ways he finds difficult
to describe, he can't use his mind in the way he did before. Such
people also seem to be aware that they have lost their will_ some-
place, that to do something, to do anything, requires a gigantic
effort — in short, they have become will-less, what we call anomic.
An irony here is that they have now achieved the freedom they
sought. They need an external director. They are ripe for a
demagogue.
The changes in the capacity to think in some subjects are long
lasting if not permanent. One of my original, 1967, subjects was a
member of the junior faculty. He "dropped out" and used hashish
exclusively for 18 months in daily doses. When he realized that it
was interfering with his physical coordination he stopped all drugs.
Two years subsequent to this he returned to the University. He
found that he could not do mathematics at a level which he had
found possible before; 3V2 years later, his conviction was that the
change was permanent. My own observations of him and other such
gifted people have led me to the same conclusion, that is, that the
damage may be permanent.
My stance toward marihuana has shifted to the extent that I now
think it is the most dangerous drug we must contend with for the
following reasons:
(1) Its early use is beguiling. It gives the illusion of feeling good.
The user is not aware of the beginning loss of mental functioning.
I have never seen an exception to the observation that marihuana
impairs the user's ability to judge the loss of his own mental
functioning.
23
(2) After 1 to 3 years of continuous use the ability to think has
become so impaired that pathological forms of thinking begin to
take over the entire thought process.
(3) Chronic heavy use leads to paranoid thinking.
(4) Chronic heavy use leads to deterioration in body and mental
functioning which is difficult and perhaps impossible to reverse.
(5) For reasons which I can't elucidate here, its use leads to delu-
sional system of thinking which has inherent in it the strong need to
seduce and proselytize others. I have rarely seen a regular marihuana
user who wasn't actively "pushing".
As these people move into government, the professions, and the
media, it is not surprising that they continue as "pushers", thus
continuously adding to the confusion that this committee is com-
mitted to ameliorate.
That's the end of my formal statement. I want to document just
briefly the last statement as to the extent, with examples of the
kind of avalanche, of propaganda
Mr. Martin. One clarification, Dr. Powelson, when you talk about
pushers, you don't mean people going out selling it in the street,
you mean ideological pushers?
Dr. Powelson. That is the reason I put quotes around it. I am
talking about people who don't sell it, who are actively engaged in
getting other people to use it, that is what I am describing. When
they become active in government, or professions, and so on, the
same thinking process continues, it now becomes an ideological type
of pushing.
Mr. Martin. You mentioned several exhibits that you wish to
offer for the record.
Dr. Powelson. Yes; one of the most active groups is called
NORML.
Mr. Martin. These are groups that call for what — the legaliza-
tion of marihuana?
Dr. Powelson. The NORML group, called the National Organi-
zation for the Reform of Marihuana Laws, they are pushing for
legalization, as does the official handbook for marihuana users, "A
Child's Garden of Grass". Let me read a few chapter headings ; "The
Effects of Grass", "Grass As an Aphrodisiac", "Games To Play While
Stoned", "Acquiring Grass", "Using Grass", "Stashing Grass". They
put out a series of stamps with the words "Liberate Marihuana". Also
a shoulder patch, tote bag, and a constant stream of propaganda
material.
Mr. Martin. That is the official insignia of the organization?
Dr. Powelson. Yes, the insignia on the stamps, shoulder patch and
tote bag.
Senator Eastland. The documents will be admitted.
[The documents referred to follow :]
24
THE OFFICIAL HANDBOOK
FOR
MARIJUANA
USERS
A CHILD'S GARDEN OF GRASS is a
wildly funny examination of every aspect
of the sub-culture which exists among the
millions of marijuana users. When you finish
this book you will know all there is to know
about the use of the weed from first joint to
final effect. A CHILD'S GARDEN GT
GRASS covers:
THE EFFECTS OF GRASS
GRASS AS AN APHRODISIAC
GAMES TO PLAY WHILE STONED
ACQUIRING GRASS
USING GRASS
STASHING GRASS
*
$2.95
"Books about drugs are surely in,
especially those dealing with mari-
juana. None is more popular than
"A Child's Garden of Grass."
Gene Shalit, NBC's Today television
program.
"It has something to say to those
who have, to those who haven't
but want to, and even to those who don't
want to but would like to stay informed."
TIME Magazine
" More sincerely helpful information about buying, growing,
cleaning, smoking and eating grass than is available in nearly all the other pot
books . . . perfect." Rolling Stone Magazine
REVISED EDITION, CONTAINING ADDITIONAL AND UP-DATED MATERIAL
25
TOTE BAG SOLD BY NORML
(National Organization for Reform of the Marijuana Law)
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26
Mr. Martin. Apart from NORML, are there any other organiza-
tions involved in the lobbying to legalize marihuana?
Dr. Powelson. Yes, sir, in California there is a group called
"Amphoria", they are openly coming out for the advancement of
marihuana. Some of the pernicious ones to my mind are the ones
that pose as educational organizations, for instance the National
Coordinating Council on Drug Education. It puts out a newsletter
called "National Drug Reporter". It labels itself a non-profit drug
education consortium of 130 national, professional, law enforcement,
government, youth and service organizations and corporations, a co-
ordinated effort to find rational approaches to drug abuse prevention.
I think anyone looking at the newsletter gets the message very
clearly that that is not what it is doing. It is passing out informa-
tion which is essentially what I would call pushing.
Mr. Martin. That is information in support of marihuana, or the
legalization of marihuana, is that what you mean ?
Dr. Powelson. That is all through the text. For instance, the
books that they suggest are all promarihuana. Here is an item that
I picked up because I am familiar with the group and know what
they are talking about, "Review of the National Committee on
Marihuana", sponsored by Amphoria, produced by Ray Films, inter-
viewed the noted drug authority John Captain, Dr. Davis — it's
available from Ashbury Films, 707 Kirby Street, San Francisco.
I think it's not unfair to say this is a typical example
Mr. Martin. Could you raise your voice a little, Dr. Powelson,
when you talk?
The organization you mentioned is the National Council for Drug
Abuse ?
Dr. Powelson. The National Coordinating Council for Drug
Abuse Education.
Mr. Martin. Do you know who the officers of that organization
are?
Dr. Powelson. The president is Paul Perito, the vice president is
Michael Sonnenreich.
Mr. Martin. Do you know who these gentlemen are?
Dr. Powelson. The only one familiar to me is Michael Sonnen-
reich, who was the executive director of the staff of the Shafer
Commission, the President's Commission on Marihuana.
Mr. Marten. It has been suggested by some people, Dr. Powelson,
and among them Mr. Edward M. Brecker, a drug analyst for Con-
sumers Union, that marihuana might be a more benign substitute
for alcohol. I would like to quote a passage from Mr. Brecker and
have your comment on it. Mr. Brecker said, "A knowledgeable
society, noting a few years ago that some of its members were
switching from alcohol to a less harmful intoxicant, marihuana,
might have encouraged that trend. It may not be too late to present
that simple public health message"
What do you think about that?
Dr. Powelson. Well, he is wrong on two counts, one is that it is
not a substitute; it is, among the young people in particular, being
used more and more together.
27
Second, when used together, alcohol plus marihuana, they mutually
reinforce each other. Finally, I don't agree that marihuana is a more
benign drug than alcohol, I think it is more dangerous for the
reasons I discussed, and others, too.
Mr. Martin. Well, that runs counter, as you know, to the popular
impression, that alcohol is far more dangerous. Can you give us any
more reasons why you consider marihuana to be more dangerous than
alcohol ?
Dr. Powelson. The one I mentioned is the effect on thinking.
Senator Eastland. Could you raise your voice a bit?
Dr. Powelson. The one I mentioned is the effect on thinking. Sec-
ond, marihuana, as used by the regular users, say it is used twice a
week, the concentration in the brain is cumulative — it stays in the
brain. So that people who are using marihuana are subclinically
stoned all the time.
Mr. Martin. Using marihuana how often — once a week — twice a
week?
Dr. Powelson. They then use one joint to raise the level of feeling
again, but are still under the effect. Alcohol leaves within 24 hours,
marihuana is in for days to months. Its effect on the brain is much
more rapid than alcohol. The mental effect that I have been describ-
ing from marihuana take in the neighborhood of 3 years. That
much has been demonstrated. Alcohol takes ten times that time. It
is also very probable that it causes lung cancer.
Mr. Martin. It has been suggested, Dr. Powelson, that legaliza-
tion might reduce marihuana consumption by depriving it of the
"forbidden fruit" attraction. Do vou think there might be something
to that?
Dr. Powelson. No, I know of no evidence that that is true. I be-
lieve that the law has several effects, one is, simply educational; it
is also important for the people who don't want to use it that they
be able to say to themselves or others that they are afraid of the
consequences. So, I think the "forbidden fruit" theory has very little
claim to plausibility.
Mr. Martin. Would it be possible, in your opinion, to legalize
marihuana, and keep hashish and liquid hashish illegal?
Dr. Powelson. I see no way to do that.
Mr. Martin. Do you believe in removing all penalties for simple
possession for personal use, which is, as you know, one of the recom-
mendations of the Shafer Commission?
Dr. Powelson. No, I do not, for the reasons I already mentioned.
I want to keep some kind of penalties, partly to retain the sanction,
partly for educational reasons and partly for young people who
want to stay away from it.
Mr. Martin. What kinds of penalties would you suggest keeping?
Dr. Powelson. Well, essentially the ones we have in California
now. what they amount to is a misdemeanor for possession. The user,
with a small amount, is put on probation with the _ provision of
erasing the arrest from his record after a period of time after the
probation is terminated.
Mr. Martin. There are many reports, Dr. Powelson, over the past
28
5 or 6 years, that high school teachers in all parts of the country
have been confronted by a steady year-by-year decline in student per-
formance. They find students are less motivated; students seem to
find it more difficult to focus and understand; they work less; they
are more unruly. The result has been that many teachers who used
to enjoy teaching find the profession increasingly difficult and are
thinking of getting out of it ; and this is supposed to be a nationwide
trend.
In your judgment, could this phenomenon be related to the up-
ward spiraling epidemic of cannabis use in high schools ?
Dr. Powelson. I suppose it could be; I don't have any way of
proving it, or knowing whether there is, or is not, a connection. T
can answer concretely from my own experience that individuals,
once they begin using cannabis, for a number of reasons their aca-
demic performance falls off. No. 1, again, it interferes with their
thinking at some point; No. 2, motivation becomes less and less.
anybody can attest to that on a college campus or high school
campus. The trouble is that there are so many other things going
on simultaneously. I think one of the things about drugs, the younger
the user, the more likely the effect will be— the effect on maturing
and learning will be greater. That is, the younger the user, the
greater the effect.
Mr. Martin. You mentioned other factors and phenomena. What
are the other factors?
Dr. Powelson. The whole educational system is undergoing major
changes. Just last week one member of the Berkeley School Board
said in the process of choosing a new superintendent of the schools.
"We are not interested in a superintendent of schools who wants
to teach reading and writing; we are interested in a superintendent
who wants to teach our kids how to seize power." And that was
seconded by another member of the school board.
The superintendent of schools, when he took office, said, "There
are no failures of students, there are only teachers that are failures."
When all the students heard that, of course, that was a prime kind
of notice that they didn't have to try anymore. So, I think we have
many alternatives. The schools in Berkeley are financed by the
Federal Government. They don't teach reading and writing, they are
teaching people to feel good. All of these things are going on, and
I think the use of drugs and the deterioration of the school system
are probably parallel and intertwined.
Mr. Martin. You feel they go hand in hand?
Dr. Powelson. I do.
Mr. Martin. There are conflicting views, Dr. Powelson, as^ to
whether or not marihuana leads to violence. What is your own view
on this, based on your personal experience ?
Dr. Powelson. The fact that there were exaggerated reports in
the 1930's that were referred to by a previous witness, I agree to.
On the other hand, I first believed that marihuana users, when they
were high, they were cool and loving. I have come to see thatthis
is an intermediate stage, fantasy, or illusion. They look amiable
29
enough, but when you begin interfering with the use, to take it away
from them, you can have a very ugly situation.
My own experience is that with heavy users, when they are
crossed in the area of their use of drugs, or their ideology, you run,
as I said, into very ugly situations.
Mr. Martin. That concludes my questioning, Mr. Chairman.
Mr. Sourwine. May I ask a question of Dr. Powelson?
Senator Eastland. Of course.
Mr. Sourwine. Sir, my understanding of the summarization, what
you told us with respect to decreasing performance among high
school students and its possible relation to marihuana or cannabis
use is, that a substantial number of students use the drug, and you
know it will affect the downgrading of the average performance
level. But, the fact that the average performance level goes down
doesn't necessarily increase the use of hashish or marihuana; that
might be caused by a number of other factors that you mentioned.
Dr. Powelson. Yes.
Mr. Sourwine. You gave us a discussion of what appeared to be
to me the overall effects of use of cannabis. You talked about a student
designated as "S.", who continued to use marihuana and hashish. It
wasn't clear whether he moved progressively first to larger quanti-
ties of marihuana and then hashish. Is that the way it went?
Dr. Powelson. It doesn't follow a pattern. This particular young
man, he was also wealthy and spoiled, and he moved very fast from
marihuana to hashish because he was looking for highs, he didn't
"progress." The usual pattern, I would say. is using low-grade qual-
ity, and then, as people become tolerant, they are looking for more
and more highs, and they are moving gradually from better quality
marihuana to hashish. But some people jump immediately from
one to the other. This particular person jumped immediately from
marihuana to hashish.
Mr. Sourwine. One final question, sir. You discussed an increasing
number of patients who were found to be using marihuana. Now,
there was at the same time, from 1965 to 1972 an increased use of
marihuana in the entire student body; was there not?
Dr. Powelson. That is correct.
Mr. Sourwine. Can you relate in any way the percentage of in-
crease, or the degree of progression in the student body, to the per-
centage of increase or degree of possession of marihuana among your
psychiatric patients?
Dr. Powelson. We did surveys all the way through, in which we
compared our students in the student health service, in the psychiatric
clinic, with the general population, and we never found any differ-
ence. The students in the Student Health Service were not using any
more, or any less, than the general population.
Mr. Sourwine. In other words, you are saying you were examining
more psychiatric patients who used marihuana because there were
more users among the student body as a whole, rather than because
marihuana made them psychiatric patients.
Dr. Powelson. That is correct.
33-371 O - 74 - 4
30
Mr. Sourwine. Thank you. I have no further questions.
Mr. Martin. Our next witness will be Dr. Henry Brill. Would
you come forward? You have a prepared statement, Dr. Brill, on
your qualifications, so it won't be necessary for me to question you
on your qualifications.
Dr. Brill. Thank you.
Mr. Martin. Would you identify yourself?
TESTIMONY OF DR. HENRY BRILL, REGIONAL DIRECTOR, NEW
YORK STATE DEPARTMENT OF MENTAL HYGIENE
Dr. Brill. I am Dr. Henry Brill of West Brentwood, Long Island,
N.Y., where I am regional director in the New York State Depart-
ment of Mental Hygiene.
I have submitted a curriculum vitae which states my qualifications
in the field of drug dependence. These qualifications include past or
present membership and/or chairmanship of the American Medical
Association, the World Health Organization, and the FDA. I also
had for almost a decade major responsibility for the development of
the narcotic treatment program for New York State.
I am here today as an individual and not as a representative of
any organization, but I was a member of the National Commission
on Marihuana and Drug Abuse 1 throughout its period of operation,
and I am concerned about the misinterpretations which have devel-
oped with respect to the marihuana report of that Commission. These
misinterpretations result from reading the reassuring passages in
the report and ignoring the final conclusions and recommendations,
and the passages in the report on which they were based. As a re-
sult it has been claimed that the Commission's report was intended
to give marihuana a clean bill of health, and as a covert, or indirect
support for legalization of this drug in the near future, or as a step
in that direction. Nothing could be further from the truth.
From mv knowledge of the proceedings of the Commission, I can
reaffirm that the report and the subsequent statements by the Com-
mission meant exactly what they said, namely that this drug should
not be legalized, that control measures for trafficking in the drug
were necessary and should be continued, and that use of this drug
should be discouraged because of its potential hazards.
Mitigation or abolition of penalties relating to private use were
recommended purelv on practical and humane grounds. The position
is clearly stated in the closing pages of the first Report "Marihuana—
A Signal of Misunderstanding", specifically on pages 150-178.
Among the cautionary statements one can list the comments on hazards
of prolonged and heavy use, on page 66; the paragraphs on be-
havioral effects, psvchological dependence, and possible organ dam-
age and psychosis," page 59 ; and the hazards of further spread of
the habit, on pas;e 82 ; the notes on the amotivational syndrome, page
86 ; and the association of marihuana use with other drug use, page
46. On pages 119 and 120 we find an account of the consensus of
i Marihuana— A Signal of Misunderstanding— First Report of the National Commission
on Marihuana and Drug Abuse ; U.S. Government Printing Office. Washington, D.C.. 1972.
31
the medical profession that marihuana use constitutes a hazard to
the individual, that the drug should not be legalized, and that m re
research is needed. On page 175 we find a statement concerning the
need to detect and punish persons operating vehicles and other dan-
gerous equipment under the influence of marihuana.
Contrary to what has been claimed there never was any intention
to indicate in the Commission's report that we already knew enough
about marihuana in 1972 to justify its legalization. Instead a major
section of the report is devoted to the need for more research.
In summary I would say that I found myself in complete agree-
ment with the conclusions of the Commission and my attitude was
reinforced by personal observations in mental hospitals here and in
Greece, Morocco, and Jamaica during my work with the National
Marihuana Commission.
Scientific reports which have become available since the report
was written confirm still further the need for caution. The newer
data includes clinical reports which have continued to become avail-
able concerning complications of acute and chronic use; descriptions
of mental deterioration and acute psychotic attacks 2 3 after cannabis
in reports from India ; evidence of high incidence of impaired lung
function ; 4 further data on flashbacks in LSD users which seem to be
associated with subsequent marihuana use;5 and reports of acute
psychotic reactions from even small amounts of cannabis in certain
cases.
Finally, one should note the comment from Jamaica 6 7 in the West
Indies where the effects of cannabis had been thought to be rela-
tively benign; among the middle class it is now found to be asso-
ciated with school dropouts, transient phychoses, panic states, and
adolescent behavior disorders. In general the effects of the drug
continue to be noted as subtle and insidious. I would like to empha-
size that one way to describe the effect of cannabis : it^ is subtle
and insidious, but harmful reactions in the heart and circulatory
system are suspected, and there are indications of adverse reaction
in the body's anti-infection chemistry.8
Finally, some older issues are being reopened and evidence is that
physical dependence does occur with very heavy use and that with-
drawal leads to physical sickness in man and in animals.9 These are
but a few illustrations chosen almost at random to show that the
latest scientific literature strongly supports the cautionary position
of the Commission. I may add that in my own view marihuana must
still be classed as a dangerous drug, dangerous to enough people to
2 Psychotic Reactions Following Cannabis Use in East Indies, G. S. Chopra and J. W.
Smith'; Arch. Gen Psychiatry, Vol. 30, January 1974, p. 24-27.
3 Bhang Psychosis, V. R. Thacore : B. Jour. Psychiatry (1973) 123, p. 225-229
4 Adverse Reactions Associated with Cannabis Products in India, Wm. Grossman:
Annals of Internal Med. 70: (3) 529-533,1969.
5 Marihuana Flashbacks, M. D. Stanton; Amer. Jour, of Psychiatry, 130: 12, Dec. 19T8,
p. 1399-1400. „ _ ,_ T , „„ . .
9 Australia-New Zealand Meeting. Report of paper by M. Beaubrun ; Jamaica Psychi-
atric News, December 19, 1973, p. 9. M , „,,.,„ m„„f
•Drug Abuse in Different Cultural Grouns in Jamaica — Summary for Oct. 15-19 meet-
ing, Svdney, Australia, M. J. Beaubrun; Mimeo (undated).
8 Inhibition of Cellular Mediated Immunity in Marihuana Smokers, G. Nahas ; bcience,
6» Tolerance to and Dependence on Cannabis, S. Kaymakcalan ; Bull, on Narcotics. Vol.
XXV, No. 4, December 1973, p. 39-47.
32
warrant full control. I don't distinguish sharply between hashish and
marihuana; these are different concentrations of the same principle.
This concludes my statement, Mr. Chairman, and I would now be
pleased to answer any questions which you and the committee may
have.
Mr. Martin. Thank you very much, Dr. Brill.
You said you were concerned over the misinterpretations that de-
veloped with respect to the Shafer Commission report. I want to
quote what you said, "These misinterpretations result from reading
the reassuring passages in the report, and ignoring the final con-
clusions and recommendations."
Now, who was responsible for these misinterpretations, was it the
media, was it the academic community, promarihuana pressure
groups ?
Dr. Brill. It is hard to point the finger at anybody, but I think
there is a great deal of wishful thinking involved; and a lot of
people wish that this source of pleasure were completely harmless,
and therefore it was rather easy to believe in it, and to shut off all
negative information that might be available.
Mr. Martin. Can you give us a clearer idea of what you have in
mind?
Dr. Brill. Yes, I think it also could be said that the information
which has been available in the public media in the last year or two
has tended to emphasize the harmlessness of marihuana, and to
understate the other side of it.
Mr. Martin. To get a clearer idea of what you had in mind by
this statement, Dr. Brill, I would like to ask a few questions on an
article on the Shafer Commission's report, which appeared in the
U.S. News and World Report on April 7, 1972. The heading on this
article was, "Evils of Marihuana — More Fantasy Than Fact?" Do
you think that conveyed a fair representation of the essential thrust
of the report?
Dr. Brill. I don't think it did. I think it could mislead, especially
in view of the "wishful thinking" that many people had in this field.
Mr. Martin. Let me quote a few items selected by the U.S. News
from the report, and ask for your comments on that. The article in
U.S. News quoted the report as saying, "Cannabis does not lead to
physical dependency. No tortuous withdrawal syndrome follows the
sudden cessation of chronic heavy use of marihuana." Has that been
established in any way in recent research ?
Dr. Brill. Yes, there is a recent publication, and I think I have
given you a reference on the subject, a publication in the U.N.
Bulletin on Narcotics, which indicates that after heavy administra-
tion real withdrawal symptoms can be elicited in animals, monkeys;
and there is a strong suspicion they do occur in human beings.
However, in all fairness, ordinary level use does not produce physi-
cal withdrawal symptoms. It does, however, in some people, lead to
a considerable amount of irritability; and Dr. Powelson mentioned
that.
Mr. Martin. Irritability which could be translated into violence
under certain circumstances?
33
Dr. Brill. Well, among certain people under certain circumstances.
I am not convinced that as a drug marihuana specifically is marked
by violence in our culture. Other cultures have described it, and
that is a curious contradiction that still remains to be clarified.
Mr. Martin. The second question on the U.S. News article: The
article says : "Recent research has not yet proven that marihuana use
significantly impairs driving ability or performance." In the light of
recent research, pointing to some serious defects in driving ability,
don't you agree that this finding might have to be reconsidered ?
Dr. Brill. I think it may well have to be reconsidered, but I would
want to see it proven that the drug is safe for driving under field
conditions. We have enough hazards on the roads without taking
chances with intoxicants. That still remains to be tested in the lab-
oratories to the satisfaction of some people. It stands to reason that
an individual who is intoxicated with a substance that interferes
with measurement of time and distance, that may produce hallucina-
tions, may very well be a hazard on the road.
May I add one more thing. We had an interview with a mari-
huana using group in Chicago when I was with the Commission. We
point blank asked them what they thought about having people
ride motorcycles under the influence of marihuana; and these were
marihuana users, middle-class cultured people. They agreed com-
pletely that that was not a good mixture, and they would not approve
of it. So, they must from their own personal experience have felt
there must be some interference with efficiency.
Mr. Martin. That would correspond with the knowledge that
every drinker has when he is intoxicated — that he doesn't drive as
well when he is under the influence of alcohol?
Dr. Brill. I think so.
Mr. Martin. On the nature of the epidemic in the United States,
the U.S. News quoted the following paragraph, "We are inclined
to believe that the present interest in marihuana is transient, and
will diminish in time of its own accord, once the symbolic aspect
of use is deemphasized, leaving among our population a relatively
small coterie of users."
Wouldn't you say that the statistics that were presented here today
suggest that things may be moving in the opposite direction?
Dr. Brill. I am afraid they do. Of course all drug abuse, if you
want to call it that, all use of drugs for social and recreational pur-
poses has a fad-like quality to it; but there is no evidence that was
presented here today to indicate that we are in a downswing.
Mr. Martin. From the several replies you have given, Dr. Brill,
it is apparent you believe that new scientific evidence which has
emerged since your report was written — it was written in late 1971,
beginning of 1972 — would make it necessary to reconsider a number
of your findings and recommendations. Is that a correct statement?
Dr. Brill. Well, when the report was written we fully recognized
that the conclusions would have to be reconsidered in the light of
advancing knowledge. Knowledge is advancing, and I think that all
these conclusions could very well be subject to reconsideration as
time goes on, yes.
34
Mr. Martin. Do you feel, for example, that this new knowledge-
might perhaps point to the need for reconsidering the Commission's
recommendation that all penalties be removed for simple possession
of small quantities of marihuana? Would you for example now
favor, as Dr. Powelson apparently does, the retention of some minor
penalty for possession, perhaps a warning the first time, a fine the
second time, a stiffer fine the third time, and so on?
Dr. Brill. I might very well, although I must admit that I don't
pretend to have any knowledge of the law, or the effectiveness of the
law in this field. So, I intend to restrict my comments to what the
hazards are. How they are to be viewed by the law really would
fall outside my domain.
But as an outsider I would have to agree that some kind of a
minor penalty might very well be considered.
Mr. Martin. Would it be correct to infer from the answer you
have already given, Doctor, that if the Shafer Report would be re-
issued today in an updated version, you would consider it important
to extend the report to include references to the recent research you
referred to, and perhaps amend some of your recommendations in
light of this research?
Dr. Brill. It is hard to second-guess a group like the Commis-
sion; but as to the first part of your statement, it is certainly true,
it would have to be brought up to date. How that would influence
the final outcome I wouldn't be able to say. And in making this
reply, I have in mind the long, extensive discussions that occurred.
These conclusions were not hatched out extemporanously, they were
the result of a great deal of discussion and thought.
Mr. Martin. In your statement you used the words "insidious and
subtle" — the phrase "insidious and subtle" — to describe the effects of
cannabis. Could you spell out in some more detail what you mean
by "insidious and subtle"?
Dr. Brill. Dr. Powelson has already referred to one aspect, and
that is the chronic effects of cannabis. The chronic disabling effect
of alcohol tends to become fully apparent after 10 to 20 or more
years after excessive alcohol abuse, whereas in the case of cannabis
this slides in insidiously, and within 2 or 3 years an individual has
problems, and it takes some technical and professional experience to
realize where this came from because the symptoms look like a
rather nonspecific loss of social and economic capacity, and nonspe-
cific general withdrawal from the competitive life; and^ a general
tendency to be lost in pseudo-elevated forms of conversation, a syn-
drome which doesn't point to anything in particular unless one is
familiar with this drug.
Now, in the acute effects, the short-term effects, especially when
small doses are used, there is very little to see; only when heavy doses
are used, when there are pathological intoxications can one see a
real explosive immediate effect.
Now, contrast that to alcohol where an acute intoxication leads
to slurred speech, ataxia, and symptoms that can be picked up im-
mediately, including the odor on the breath. It is far more difficult
to identify someone equally intoxicated from marihuana. He can
35
straighten up and with an effort of will can really compensate for
all of the disabilities to superficial examination.
Mr. Martin. You made the point, Dr. Brill, that the media in
general covered the report of the Shafer Commission in a one-
sided manner, that they ignored, or misrepresented in some cases the
basic thrust of your report. Has this one-sidedness carried over to
other areas? Would you agree or disagree, for example, with the
chairman's opening statement, and I want to quote what he said,
"There has been widespread publicity for writings and research
advocating a more tolerant attitude towards marihuana, while there
has been little or no publicity for writings or research which point
to serious adverse consequences."
Dr. Brill. As I read what is in the media, and hear it, I must
admit that the favorable side for marihuana is more heavily pre-
sented than the unfavorable side. I can't agree with this kind of
emphasis ; I think it needs more balance. There have been both sides
presented in many cases, but overall I am afraid that the statement
is quite correct.
Mr. Martin. The chairman also said in his opening statement the
purpose of these hearings was to present the other side, the side that
by and large has not been heard by the Congress and the American
people, so that both the Congress and people would have an under-
standing of both sides of this controversy.
Would you concur in the judgment that the presentation of the
other side is badly needed?
Dr. Brill. I think it is. I think it needs to be emphasized. The
Commission report, I thought, presented a fairly balanced picture;
but what emerged from it, in the public consciousness, was quite un-
balanced. So, I would completely agree: the negative side of this
picture, the unpleasant side, has to be faced.
Mr. Martin. The subcommittee has received evidence that noted
scientists whose research and analyses pointing to serious adverse
consequences have come under violent personal attack, including
public and private harassment from members of promarihuana
lobbies, and even members of the scientific community associated
with the promarihuana lobby. Do you have any personal knowledge
of such attacks on fellow scientists?
Dr. Brill. I have seen this happen on several occasions, yes; I
was quite distressed by it.
Mr. Martin. Mr. Chairman, I have no further questions.
Mr. Sourwine. Sir, Tom what }Tou have just told us about physi-
cal dependency among heavy users of cannabis, and withdrawal
effects, is it fair to summarize by saying that in light of all that is
now known on the subject, it is not scientifically correct to call
cannabis, marihuana or hashish, a nonaddictive drug?
Dr. Brill. That is a very difficult scientific question to answer; it
can produce physical dependence, so I think if this information is
confirmed by subsequent studies, then we will have to revise our
opinion. But, it would be premature to make a major change on
the basis of the very few studies that are as yet available.
Mr. Sourwine. Dr. Brill, in an area like this, and attempting to
36
form a judgment about an issue such as this, isn't it true that it's
not a question of a popularity contest, or a vote; if no ill effects are
found in the drug over a period of sufficient time with enough in-
vestigations and experiments, then we may say that it is a safe
drug. But, as soon as you do find under controlled experiments,
properly carried out, evidence of danger, you may no longer call
it a safe drug; is that correct?
Dr. Brill. I think that is entirely correct, but I must say that the
argument, where the line is drawn about how safe, or how unsafe —
my own personal opinion is that this is sufficiently unsafe, so that
it should not be legalized. There are some people who say that no
drug is safe, all drugs are unsafe, all drugs are the same. I think
this is misleading, and I think that this drug is unsafe for enough
people, so that it should not be made generally available.
Mr. Sourwine. I have no further questions.
Senator Eastland. Thank you, Dr. Brill.
Mr. Martin. Our next witness, Mr. Chairman, is Dr. Donald
B. Louria from the New Jersey Medical School. Dr. Louria, would
you come forward?
TESTIMONY OF DR. DONALD B. LOURIA, NEW JERSEY MEDICAL
SCHOOL, NEWARK, NJ.
Dr. Louria. I am Donald B. Louria, professor and chairman, De-
partment of Preventive Medicine and Community Health, New Jer-
sey Medical School, Newark, N.J.
Mr. Martin. I would like to ask you a few more questions for the
purpose of establishing your qualifications, Dr. Louria. You are a
graduate, cum laude, of the Harvard Medical School in 1953?
Dr. Louria. That's correct.
Mr. Martin. You served as chairman of the Subcommittee on
Narcotics of the Medical Society of New York County from 1965
to 1966?
Dr. Louria. That is correct.
Mr. Martin. You served on the Council of the Committee on Alco-
holism and Drug Abuse, Medical Society of the State of New York
from 1966 to 1969?
Dr. Louria. That's right.
Mr. Martin. You were chairman and president of the New York
State Council on Drug Addiction from 1965 to 1972?
Dr. Louria. Yes, sir.
Mr. Martin. You are the author of three books on drugs, "Night-
mare Drugs", "The Drug Scene", and "Overcoming Drugs"?
Dr. Louria. That's correct.
Mr. Martin. Thank you very much, Dr. Louria, will you proceed
with your prepared statement?
Dr. Louria. I have been asked to briefly review the epidemiology
of drug abuse in this country from the point of where we are and
how we got there.
In the 1930's, the major problem was, of course, heroin, and the
evidence suggests that this drug, used primarily within economi-
37
cally deprived communities represented an escape from psychological
pain or from the depressing effects of a relentlessly bleak environ-
ment. In striking contrast, the startling epidemic of the 1960's and
early 1970's in which marihuana, LSD, and heroin were all partici-
pants, was propelled by a virtually monolithic hedonistic focus in the
United States. This dominance of the search for pleasure has been
abetted by our marvelous communications proficiency that permits any
given fad to spread throughout the country virtually instantaneously.
The division of Drug Abuse and Biostatistics of the Department
of Preventive Medicine and Community Health at the New Jersey
Medical School in Newark have been analyzing the nature and sever-
ity of the drug scene in suburban communities in northern New
Jersey for the past 5 years. These surveys of some 20,000 teenagers
have been conducted by cross-sectional analysis in a substantial num-
ber of junior and senior high schools and by longitudinal analysis
in two communities.
The data show that the three major reasons listed by the students
for drug use — the influence of the peer group, curiosity, and the
search for pleasure — have not changed during that 5-year period.
Interestingly, if one looks at over 20 factors that to a greater or lesser
extent promote drug use, the statistical evidence shows that far and
away the most important is the influence of the peer group.
The studies performed longitudinally suggest that the use of
illicit drugs is reaching a plateau in this country. I am talking
now primarily about our own studies, and what we found in the
past couple of years is conversant with most of the other studies in
the country. The results can be best illustrated by looking at the
results of a recent questionnaire study of grades 10, 11, and 12 in
one high school. In the survey conducted during the last academic
year grade 12 — last year's seniors — showed an increase in use of a
variety of drugs, including marihuana, hashish, LSD, and cocaine.
Grade 11 was substantially different, there was a continuing in-
crease in marihuana use, but use of every other drug was stable. In
grade 10, marihuana use was stable and use of all other illicit drugs
declined. These are extremely encouraging results, the first we have
seen since the start of this epidemic. There is at present no reason for
either precipitous or hysterical action on the one hand, or insouci-
ance on the other.
Three of the trends are particularly worthy of note:
First, it appears that the slope of the curve of increasing use in
grades 11 and 12 has flattened; that is, the rate of increase in the
last year has slowed.
Second, there is a substantial decrease in the ratio of regular or
weekly use of marihuana to experimentation with this drug. In
other words, there are more people who are experimenting but rela-
tively fewer who are regular users. Furthermore, there is increasing
evidence that the relationship of marihuana to other drugs is dimin-
ishing. There continues to be a great deal of experimentation with
marihuana, but a smaller percentage of marihuana experimenters
will utilize drugs such as hashish. So, I think in terms of the cur-
rent epidemiologic studies it is improper to suggest that virtually
38
everybody who uses marihuana will also play around with hashish.
Certainly in our study that is not true, and the figure— marihuana
smokers who use hashish— ranges from 12 to about 50 percent, de-
pending on the school group studied.
Third, the girls have, by and large, now caught up to the boys,
and in some areas surpassed them in overall prevalence of non-
medical drug use.
In regard to marihuana, there is, of course, a continuing contro-
versy over its legalization. It seems to me that, thus far, the deci-
sions have been made without serious consideration of the two maior
issues. Surely, we would all agree the drug is neither horrendouslv
dangerous nor perfectly safe, but this has been known for oyer 100
years. The two egregiously neglected issues are (a) the relationship
between use of marihuana and the use of a drug such as LSD, and
(b) the number of intoxicants we wish for general use in our society.
We have been particularly interested in seeing whether there is
a relationship between the frequency of marihuana use and subse-
quent use of LSD. We have carried out three epidemiologic studies,
all of which show similar results and are appended as graphs 1 to
4. It may be seen that the more often marihuana is used, the more
likely it is that an individual will experiment at least once with
LSD. In one of the three studies, for example, the infrequent user
of marihuana had a 4 percent likelihood of using LSD; for the
monthly user, the chance of using LSD increased to 9 percent; the
weekly marihuana user had a 22 percent likelihood of experimenting
with LSD, and among those who used marihuana more than once per
week, the likelihood of trying LSD increased to 44 percent. The results
in the other two studies we have carried out were similar. In fact the
daily marihuana user in the studies we performed, and various studies
across the country that were performed has a likelihood of using
LSD somewhere between 65 and 85 percent.
Mr. Sottrwine. In the use of LSD?
Dr. Lotjria. Eight.
In the absence of contravening data and in the presence of other
supporting studies, the relationship we have found between mari-
huana and the more dangerous drug, LSD, appears reasonablv
secure. We do not imply that marihuana use compels use of more
dangerous drugs. In fact, excluding the daily marihuana user, the
majority of those smoking marihuana will not use LSD or similar
drugs. Furthermore, as I emphasized before, our data suggest that
the relationship between marihuana and hashish, or marihuana and
LSD is actually diminishing, not increasing, as far as our studies
are concerned.
However, the relationship between regular use of marihuana and
the use of LSD subsequently does exist ; and this fact virtually man-
dates further analyses. We obviously must look at the possible rea-
sons for this relationship, and we must ask ourselves whether mari-
huana legalization would inadvertently bring with it the increased
use of more dangerous agents such as LSD. In any case, we should
not legalize it until we have carefully looked at the relationship and
decided precisely what it means, and what it portends.
39
The second major issue to me is the overriding one. This is the
number of intoxicants we wish in our society. Currently, we have
three major legal drugs of pleasure, caffeine, nicotine, and alcohol.
Caffeine is relatively safe; nicotine is said to cost us between 60,000
and 300,000 deaths and $19 billion in economic loss each year; alco-
hol costs us at least 40,000 and probably nearer 100,000 lives yearly
and at least $15 billion in economic loss per year. The question is.
do we wish to add a fourth intoxicant, marihuana, to our other three ?
If we do legalize marihuana, we will impose this fourth intoxicant
on our children, grandchildren and great grandchildren, for once a
new intoxicant is legitimatized and accepted by the public, it can-
not subsequently be arbitrarily proscribed. That is what we learned
from prohibition. The obvious question is, how many intoxicants can
we have for general use and still remain a vigorous and productive-
society? No society can afford an unlimited number of unrestricted
intoxicants. It seems to me we need to consider this very carefullv
indeed. George Bernard Shaw said, "We are made wise not by the
recollections of our past but by the responsibilities of our future."
It is not our present pleasures that should be our major concern,
but rather the effect a fourth legal intoxicant will have on the well-
being, happiness and prosperity of future generations.
It is important to stress that the only question before our societv
is whether to add new intoxicants to those already troubling us. I
personally believe this is the wrong question. What we should be
considering is substitution of less toxic pleasure-giving substances
for alcohol and/or tobacco. It is after all somewhat mind-boggling
to realize that in the United States there are about 2 million deaths
each year and that somewhere between 5 and 15 percent of these can
be directly or indirectly attributed to alcohol and tobacco.
In preparation for this I rearranged some of our fatality statistics
for each year and came up with some data intriguing to me, namely
that our legal intoxicants cause more deaths than all diseases, in-
cluding pneumonia and tuberculosis reported yearly by the Center
for Disease Control. Indeed, if we do rearrange these figures to
allow these intoxicants as listed as a cause of death, the five leading
causes of death in the United States are: (1) heart disease, (2) cancer,
(3) stroke, (4) legal intoxicants, and (5) accidents. And we are talk-
ing about adding more intoxicants.
It seems to me only prudent and logical to concentrate more on
reducing the morbidity and mortality from legal intoxicants before
adding new ones with their own dangers. The only new intoxicant
that could be added without much debate would be the one that is
turly harmless and marihuana is clearly not innocuous. I personallv
would like to see us consider substituting two less toxic agents for
alcohol and tobacco, or alternatively, we could consider substituting
marihuana for alcohol and modifying tobacco to reduce its cardio-
vascular toxicity and its cancer causing proclivities.
Whatever the decision, it should be based on a careful and dis-
passionate consideration of the number of intoxicants available in
our society, their relative risks, and our legitimate needs for mind-
altering, pleasure-giving substances. I do not feel there is anything
particularly arcane or complicated about the marihuana issue. Surely,
40
we ought to be able to approach it intelligently, make sensible deci-
sions and then utilize our energies to solve the far more important
problems facing our society, which, if allowed to fester, threaten
both our meliorism and our future.
Mr. Martin. Thank you very much, Dr. Louria. Before I proceed
with the questions, I believe you provided some charts, the first of
which is the relation of frequency of marihuana use to likelihood
of LSD use.
Dr. Louria. That's correct.
Mr. Martin. It shows an upward curve — the more marihuana is
smoked, the more likely they are to indulge, experimentally or re-
peatedly, in LSD use. Why do you think there is a special relationship
between marihuana use and LSD use?
Dr. Louria. Let me emphasize first that we have two somewhat
opposing trends. One is, as I indicated in my testimony, that experi-
mentation continues, although leveling off; and within the experiment-
ing group the relationship between occasional experimentation with
marihuana and utilization of the other drugs is diminishing, not
increasing.
On the other hand, among those who utilize marihuana regularly,
the relationship between that and the utilization of LSD persists.
Now, your question is why, and we don't have the answer, and
nobody else has the answer. I think we can say that the first graph
indicates that this is by and large a straight line relationship; the
more frequently you use marihuana, the more the likelihood is that
you will use LSD ; there is a clear statistical correlation.
Does this mean that marihuana drives one to LSD? Of course
not. There are at least seven potential reasons to explain this rela-
tionship, and in fact two of them could be utilized favorably in the
argument for legalization of marihuana; those two include first the
concept of the thrill of illegality. In other words, once you use the
drug you then are beyond the pale of what is accepted as normal
in society; and it is more easy then for you to slip into the use of
other illegal drugs.
Second, the same person who sells you marihuana sells you LSD,
therefore, remove marihuana from the illegal relationship with LSD
and you break that chain.
The other five potential reasons would, to me anyway, militate
against the legalization of marihuana. The first of these is curiosity,
one of the major reasons for the use of illicit pleasure-giving drugs
in our society. An ancient saying that goes, "A man should live if
only to satisfy his curiosity". That in itself may explain a good deal
of this relationship.
Second is hedonism — that is we are very much a pleasure-oriented
society that has a great deal of difficulty in subordinating its pleas-
ure to goal-directed activities. And if a society is concentrating as
much as we are on pleasure, it's almost inevitable that those who
enjoy mind alteration of one kind, such as marihuana, and use it
regularly, will opt for more potent drugs that produce similar
"hidis".*
Third is the influence of the peer group. Our study, and every
study performed across the country, indicates that if you are in a
41
multidrug using peer group you are much more likely to be a multi-
drug user.
Fourth, I think that 10 years from now we might find that there
are valid biochemical or physiologic interrelationships between a
drug such as marihuana, and a drug such as LSD. I emphasize, there
is not one iota of evidence now to support that hypothesis, but I
think it is possible that there is a relationship.
Fifth, I think it is terribly important to emphasize that at least
in our experience and the experience of others, among those with
substantial covert or overt psychological abnormalities use of one
drug is often followed rapidly by multidrug use. I have always felt
that those who urge the legalization of marihuana were frequently
at least suggesting that an individual could always decide his drug
use on a volitional, carefully thought out basis. That just is not true
for people who have psychological problems. We have found that
they are often virtually propelled into severe multidrug use.
Again, I have to emphasize that we have no specific knowledge
why this relationship between marihuana and LSD exists. What
bothers me — and I must say it bothers me about the Commission
report, as I testified before, is that the report talked about an ana-
chronistic and invalid relationship between marihuana and heroin.
We always maintained there was no significant relationship be-
tween marihuana use and heroin use, and that is still true; but for
the life of me I can't understand why the National Commission
would hear noncontravened testimony on the relationship between
a different drug, LSD and not even mention it in the report, in-
stead discussing only this old relationship long shown to be invalid,
between marihuana and heroin.
Mr. Martin. Dr. Louria, I will just ask a few more quick ques-
tions. We have one more witness, and we will have to move on as
rapidly as possible.
There seems to be a rather basic conflict between the picture you
presented — a tapering off of the cannabis epidemic at the high
school level — and the statistics that were presented here this after-
noon by the Drug Enforcement Agency, showing a massive increase
in interdiction of both marihuana and hashish, going up year by
year; and also a massive increase in the number of arrests on the
Federal and local levels for cannabis offenses.
Could there be some explanation for this? For example, in your
own report you made the point that girls are now using a lot more
marihuana than they used to, and have caught up pretty well with
the boys. So, while the boys have tapered off, the girls may have
compensated ?
Dr. Louria. That is true.
Mr. Martin. In addition to that, your report doesn't make any
reference to the phenomenon of marihuana increase in grade schools,
and actually there is very little research material on that? I think
you will agree with that.
Dr. Louria. Yes.
Mr. Martin. We know it's there, we know that a lot of it has
gotten down to the fourth and fifth grade level; but we don't have
any statistics on it.
42
Dr. Louria. Well-
Mr. Martin. There is a substantial amount of marihuana beinsr
consumed at the grade school level, but we don't have any serious
calculations on that, or estimates ; would you agree with that ?
Dr. Louria. I would agree with that to the extent that we have
studied junior high schools.
Mr. Martin. I am talking about grade schools.
Dr. Louria. Well, we find the utilization in the suburban, pre-
dominantly white schools that we studied in the junior high schools,
of small amounts. So, there was no reason at all in our commu-
nities to study grade schools. I personally think there is exaggera-
tion about how severe the problem is in the grade schools. At least
in the majority of communities it is really a very small problem.
And as a matter of fact, there is nothing inconsistent with the data
developed by the law enforcement agencies. We are measuring differ-
ent things and there are bound to be discrepancies until the pheno-
mena are analyzed over a prolonged period. So, I don't see any dis-
parity between those data, and the data I presented.
Mr. Martin. One more question. There is another unmeasured
area. It is generally agreed that marihuana has also moved upward
into the ranks of adult society. People are now indulging in both
marihuana and hashish, something they didn't do 10 years ago. The
estimates that have been made, surveys that have been conducted,
by and large don't touch this group. This is another area where
there may have been a substantial increase in cannabis use without
any accurate ability to accurately assess it.
Dr. Louria. Oh, yes; I don't think there is any question about
that, a substantial part of the increase you have. been talking about
may be related to chronic, but not ordinarily heavy use in the post-
college age.
Mr. Martin. Right. One final question, and then we will have to
move on to our next witness.
You spoke of the possibility of substituting marihuana for alcohol
as an intoxicant. Do you think that is a realistic proposal in view
of the political and social and other difficulties affecting such a
substitution ?
Dr. Louria. No, I don't think that is likely going to come to pass,
and I would personally oppose it on the grounds that marihuana
isn't safe enough to be substituted for alcohol. The only point I
would like to stress is that I don't think we can look at marihuana
in a parochial fashion. You have to do it in terms of our total in-
toxicants, and the question of substitution to me is a very germane
one. I can't, for the life of me, figure out why a society allegedly as
intelligent as ours should tolerate hundreds of thousands of deaths
a year due to our legitimate intoxicants. I think there is something
we can do about that, either by substitution, or more effective
education.
Mr. Martin. But not by the substitution of marihuana?
Dr. Louria. No, I just put that in as something that people talk
about. My own convictions, are parallel to the other witnesses this
morning, especially what Dr. Brill just said, namely that marihuana
43
has enough dangers so that it would not be a proper drug in the
present form to substitute for alcohol.
Mr. Martin. Thank you very much, Dr. Louria.
Gen. Frank B. Clay, of the U.S. Army is our final witness.
General Clay, in the interest of expediting, I would suggest that
instead of spending the time to establish your qualifications you
provide a brief resume for the record. Is that acceptable to you?
General Clay. Yes.
Mr. Martin. Would you identify yourself for the record?
TESTIMONY OF MAJ. GEN. FRANK B. CLAY
General Clay. Mr. Chairman, I am Major General Frank B. Clay,
Deputy Assistant Secretary of Defense, Drug and Alcohol Abuse;
it is a pleasure to be here today.
As Deputy Assistant Secretary of Defense for Drug and Alcohol
Abuse, I am responsible for the prevention of drug abuse in the
armed services through education programs, the identification of
service members who abuse dangerous drugs and alcohol, and the
short-term rehabilitation of those military drug abusers who will
cooperate with their own treatment.
While DOD continues to vigorously investigate and prosecute
serious instances of criminal drug abuse, such as selling and traffick-
ing, that area is outside my realm of responsibility. These subjects
can best be discussed by representatives from the Office of the
Deputy Assistant Secretary of Defense for Administration who are
concerned with law enforcement and are scheduled to appear before
you at a later date.
As is the case with all drugs of abuse, the use of cannabis in any
form continues to be regarded as a violation of the Uniform Code
of Military Justice. While the Department of Defense does not
condone nor tolerate the use of any psychotropic or mind-expanding
drug by its members, we are aware that many impressionable young
people are caught up in drug abuse through peer pressures, ioneli-
ness, boredom, and a high degree of exposure in certain foreign
lands. These young people are certainly not criminals, but young
Americans who may have been exposed to drug abuse on our high
school and college campuses.
We, therefore, have made a deliberate effort to use a firm but
humanitarian approach to the identification, treatment, and re-
habilitation of these young service members, and have resorted to
disciplinary action only as a last resort in those instances not in-
volving purely personal use or possession for personal use.
Despite this revised approach during the last 3 years, we believe
that the use of cannabis or its derivatives, or any other harmful
drug is incompatible with our military missions. In some instances
where we are unable to successfully treat a service member for drug
abuse, we find it necessary to discharge that person from the
service with a referral to the Veterans' Administration for the long-
term treatment DOD is unable to provide. This is the Department
of Defense Policy now in force with regard to cannabis and all
other dangerous substances. This policy includes measures to pre-
44
elude the service entry of habitual drug abusers by thorough screen-
ing and interview at the Armed Forces Examining Entrance Sta-
tions; to prevent drug abuse through a vigorous education program
at all levels ; to identify drug abusers through our urinalysis screen-
ing program and other methods ; to provide a voluntary self-referral
to treatment program which guarantees exemption from punitive
action for personal use and possession; and, finally, to treat and
rehabilitate those drug abusers amenable to such effort to restore
them as useful members of society without their records reflecting
drue: abuse.
The abuse of cannabis continues to be of a serious nature in the
Armed Services: but since we are unable to chemically detect this
drug in body fluids as we can morphine-based drugs, amphetamines,
and barbiturates in our urinalysis screening program, we have no
irood reliable data on the incidence of the abuse of this drug in the
Armed Services. However, the U.S. Army in Europe, a location
where the incidence of cannabis abuse is believed to be hierh, has
conducted a continuing survey of its personnel — and the results are
in exhibit 1.
TABLE l.-CANNABIS USE BY USAREUR PERSONNEL (SURVEY DATA)
Average all ages February 1974 survey by age groups
Feb-
Januarv August ruarv
Previous 1973 1973 1974 20 and 25 and
Frequency of use surveys survey survey survey under 21-22 23-24 older
Cannabis: ._....« „ , 1C 0 ■> s
Daily (in percent) 10-15 10 8 7 15 9 3 3
At least once (in percent) 40 48 53 K- 78 62 47 II
Usable survey responses. 16,700 1,374 1,463 1,759 - --
Source: Commandwide sample survey of cannabis use by U.S. Army, Europe (USAREUR) personnel. Data provided by
headquarters, USAREUR.
The February 1974 results show that 7 percent of those surveyed
admitted to the daily use of cannabis and 46 percent of those sur-
veyed stated that they had tried cannabis at least once. Even though
this survey was a relatively small one with under 1,800 respondents,
the true incidence rate of cannabis use of other than an experi-
mental nature will probably be somewhere between these two rates.
T have included as exhibit 2 some other survey data which may also
be pertinent.
WORLDWIDE SAMPLE SURVEY REPORTING MARIHUANA USE AMONG ARMY ENLISTED GRADES FEBRUARY 1974
TABLE 2.-SELF-REP0RTING OF THE USE OF MARIHUANA OR HASHISH DURING THE LAST 6 MONTHS BY ENLISTED
GRADE
Note: Survey question: Which term best describes your use of marihuana or hashish during the last 6 months7
Total
Re-
E-l E-2 E-3 E-4 E-5 E-6 E-7 E-8 sponses
Never 48.2 55.6 55.8 65.2 85.0 94.8 96.6 96.4 69.4
Rarely 14.9 13.2 12.1 11.3 6.1 2.1 1.7 .4 9.4
Sometimes"" " 19-4 15.8 15.3 11.0 5.6 1.8 1.0 1.2 10.8
55 ::::::::::::::::::::::::: 5 15.4 ie.8 n.e 3.3 1.3 .7 2.0 10.4
Note: Total sample population 13,070.
45
You may also be interested to know that even though we are
presently unable to detect cannabis in our drug screening program,
ongoing research by a major pharmaceutical firm holds the promise
of a radioimmunoassay test which will identify the heavy users of
cannabis products, such as hashish or oil of hashish. AH of our
drug screening laboratories are now being converted to the radio-
immunoassay technology at the present time, and we will be ready to
apply this test as a very fine deterrent if a successful assay is developed.
The derivatives of cannabis also pose special problems for the
Armed Forces which were not expressed in the Shafer Commission
report of 1973. As you know, the basic active ingredient in plants
of the genus cannabis is tetrahydrocannabinol or THC. Most
ground marihuana as presently used in this country contains from
about 0.5 to 2.0 percent THC. Hashish, the dark brown resin col-
lected from the tops of cannabis plants contains about 10 percent
THC Hashish oil of cannabis, produced in a manner similar to the
percolation of coffee, yields an even more potent dose which may be
as high as 90 percent THC. Because of this extraordinary potency,
one small drop of the oil placed on a regular cigarette and smoked
can make an impressive "high". These two highly potent derivatives
of cannabis certainly pose a much greater danger to service mem-
bers than just the casual use of plain ground marihuana, regardless
of the psychological or physiological effects which may exist with
cannabis in its unmodified form.
As to the physical impact of cannabis used in small amounts by
the casual or recreational user, it may interfere to a degree with
physical performance which depends upon visual function. In rela-
tively high doses which are common to the daily user of hashish or
oil of hashish, cannabis regularly produces hallucinogenic effects,
abnormal sensations such as numbness, difficulty with thinking, con-
centration or speaking, and altered perceptions.
The psvchological impact upon service members is analogous to
the overall effect on man in general as noted by other research. Can-
nabis use may be associated with certain less severe psychological
reactions, such as depressive and panic reactions, particularly in
inexperienced users. There is evidence which suggests that sudden
exposure to unusually high doses, as might be the case at the present
time with hashish as used by the newly arrived soldier in Germany,
might cause a toxic psychosis. Other research shows that it is also
probable that cannabis is a factor in some cases of chronic psychosis
and lack of motivation, which conditions could have an adverse
effect on the field performance of service members.
The essence of this report, therefore, is that while the DOD is mak-
ing vigorous efforts to prevent the use of cannabis products by service
members and to restore to effective and reliable functioning all
individuals identified with problems attributable to cannabis and
other drugs, we strongly support the continued control of all canna-
bis and its derivatives as dangerous substances. The Department of
Defense also strongly supports the continued vigorous investigation
into the effects of cannabis use. The results of such research can
46
have an important bearing on the future combat readiness of the
armed services.
As I mentioned before, matters involving security and law en-
forcement as related to the use of cannabis are beyond my realm
of responsibility in the Department of Defense. However, it is my
personal judgment as a line officer of some experience that service
members who habitually use cannabis are security risks in certain
assignments.
In anticipation of your questions regarding psychological and
physiological effects of cannabis which may not be in my field of
expertise, but medical in nature, I have brought an associate with
me, Col. John J. Castellot, Sr., who is an Army medical officer and
Chief of the Office of Alcohol and Drug Policy in the Office of the
Surgeon General of the Army.
If you have questions other than those involving law enforcement
matters, we will be happy to answer them at this time.
Senator Eastand. Thank you, General.
Mr. Martin. General Clay, the subcommittee has received enough
information from various sources to indicate that the cannabis epi-
demic is creating some fairly serious security problems. We have
heard, for example, of service members who have been involved in
trading sensitive information for bags of pot or hashish.
Do you personally know of such cases? I am not asking for spe-
cific case histories because we will be going into the impact of can-
nabis and security in the Armed Forces in more detail in executive
session later; but have you heard of such cases?
General Clay. I have heard of such cases second-hand. I have no
direct knowledge of them.
Mr. Martin. Have you heard, or seen any reports that the wide-
spread distribution of pot and hashish played a significant role in
the riots aboard an aircraft carrier just over a year ago?
General Clay. No, I haven't.
Mr. Martin. This is one of the matters that we will want to
look into.
General Clay. I would imagine this information would be avail-
able from the Navy's drug and alcoholic abuse officers.
Mr. Martin. Have the Armed Forces given thought to the point
made by Dr. Powelson that it makes people more suggestible, more
easily manipulated by agitators?
General Clay. I think there has been thought given to it, but that
certainly is not within the realm of my responsibility.
Mr. Martin. Right. Isn't it true, General Clay, that the U.S.
Armed Forces in Vietnam, just before the heroin epidemic broke,
were afflicted with a major epidemic of cannabis abuse ?
General Clay. That is correct.
Mr. Martin. Very strong cannabis, on the average 5 percent THC
content. And it was bad enough so that in some units it seriously
affected their fighting ability '?
47
General Clay. We understand that to be true.
Mr. Martin. Now, your presentation doesn't make it quite clear,
General Clay, whether the Armed Forces have experienced the same
qualitative escalation from marihuana to hashish as has been the
case in the civilian sector. Do you find more hashish now than you
found previously?
General Clay. I think so, I think in Germany you will find that
hashish is the principal drug of abuse.
Mr. Martin. Your chart in exhibit 1 suggests that there has been
a marked decline in cannabis use in the Armed Forces over the past
several years. These figures, of course, are based on voluntary responses
to questionnaires, are they not ?
General Clay. Yes, they are.
Mr. Martin. Now, this chart runs completely counter to the charts
about the civilian sector that have been presented today by the Drug
Enforcement Administration. On page 5 of your statement I notice
that you indicate some personal skepticism over the fact that only 7
percent of the servicemen admitted to daily use of cannabis; and
that 46 percent stated that they tried cannabis at least once.
Now, you point out, and I think correctly, that the incidence of
use other than of an experimental nature probably would be some-
where in between these figures ?
General Clay. Right.
Mr. Martin. What this adds up to, really, is that, in the absence
of something like the urine test you can't get an accurate picture
from a voluntary reporting system?
General Clay. That's correct.
Mr. Martin. If you consider the cannabis epidemic the biggest
drug problem now confronting our Nation and our Armed Forces,
do the Armed Forces have a specific educational program geared to
the cannabis epidemic?
General Clay. Not specifically to cannabis, but to drugs in gen-
eral, we have a vigorous and widespread educational program in all
of our service schools and throughout our military units.
Mr. Martin. Is there any emphasis on cannabis ?
General Clay. On all drugs. Cannabis is not singled out specifically.
Mr. Martin. Would you know whether this program is kept right
up to date with new scientific information on the adverse effects of
cannabis ?
General Clay. Yes, I think I can say that it is. If there is new
information it is made available to the troops in the field; we do
our best to keep current.
Mr. Marten. I have one suggestion I would like to offer. You
may have seen the report of recent research conducted by Dr.
Kolodny of Masters & Johnson, demonstrating that male cannabis
users suffer up to a 44 percent drop in male hormones; and the
sperm count goes down to the point where heavy users become clin-
ically sterile; and that very heavy users sometimes become im-
48
potent. Wouldn't that information have a lot of impact on the
average GI?
General Clay. Yes, I am sure it would; and as a matter of fact
Dr. Hardin Jones from California, Berkeley, discussed that with
members of my office and our troops stationed in Germany.
Mr. Martin. Dr. Hardin Jones, by the way, will be one of our
witnesses in the final session on May 20th.
Those are the only questions I have. Mr. Sourwine, do you have
any questions?
Mr. Sourwine. No.
Mr. Martin. That concludes our session, General Clay. Thank you
very much for coming here, and I want to thank you for your
testimony, which I feel is very useful.
[Whereupon, at 1 :20 p.m., the subcommittee adjourned, subject to
the call of the Chair.]
MARIHUANA-HASHISH EPIDEMIC AND ITS IMPACT ON
UNITED STATES SECURITY
THUBSDAY, MAY 16, 1974
U.S. Senate,
Subcommittee To Investigate the
Administration of the Internal Security Act
and Other Internal Security Laws
of the Committee on the Judiciary,
Washington, B.C.
The subcommittee met, pursuant to notice, at 10:35 a.m., in room
1224, Dirksen Senate Office Building, Senator Edward J. Gurney
presiding.
Also present: J. G. Sourwine, chief counsel and David Martin,
senior analyst.
Senator Gurney. The subcommittee will come to order.
Today we shall be continuing our hearings on the marihuana-
hashish epidemic and its impact on U.S. security.
The hearing today will focus on the medical effects of cannabis.
For the purpose of this hearing we have brought together a panel
of internationally distinguished scientists who have done major
research on cannabis. Among them are: Prof. Kobert Heath.
Dr. Gabriel Nahas, Dr. Akira Morishima, Dr. Robert Kolodny,
Prof. W. D. M. Paton, Dr. Morton Stenchever and Prof. Cecile
Leuchtenberger.
The marihuana-hashish epidemic began as part of the Berkeley
uprising of 1964. From there it spread out to the other campuses
across the country. Then it spread down into our high schools —
then our junior high schools — and now our grade schools. It has also
spread upwards into the ranks of our middle class adults, and later-
ally into the ranks of our blue collar workers.
The charts which you see before you present the major essential
facts about the scope of the cannabis epidemic.
As you will see, over a 5-year period, from 1969 to 1973, inter-
ceptions of marihuana by Federal agents rose tenfold to a total of
782,000 pounds last year, while hashish seizures over the same pe-
riod rose twenty-five-fold to a total of 53,300 pounds.
These are staggering figures — all the more staggering when you
consider that they do not take into account the many seizures ef-
fected by local law enforcement agencies, and when you consider,
too, that probably 8 to 10 times as much cannabis gets into the
country as is seized or intercepted.
(49)
50
What this means is that the United States last year probably
consumed in excess of 8 million pounds of marihuana and 60,000
or more pounds of hashish.
From the scientists who will be testifying at today's hearings
we shall be learning something of what this means in terms of the
damage done to the bodies and minds of the American people.
It is my hope that today's hearings will mark the beginning of a
new period of public awareness.
There has until now been a pervasive impression that the majority
of our scientific community think marihuana isn't really too harm-
ful. This feeling has been shared by teenagers and adults, by aca-
demicians and newspapermen, by members of the middle class and
members of the working class. This is the principal reason for the
scope of the present epidemic.
It is my hope that the hearings which we shall be conducting
today, tomorrow, and Monday, will set the record straight on this
point.
To save time, I would ask the witnesses to rise and be sworn as a
group.
Mr. Martin. Would the witnesses please come to order and stand
behind their name plates?
Senator Gurnet. Will you all raise your right hands please.
Do you swear the testimony you are about to give will be the truth,
the whole truth and nothing but the truth, so help you God?
Dr. Heath. I do.
Dr. Nahas. I do.
Dr. Morishima. I do.
Dr. Kolodny. I do.
Dr. Paton. I do.
Dr. Stenchever. I do.
Dr. Leuchtenberger. I do.
Senator Gurnet. The first witness will be Dr. Robert Heath. Will
you identify yourself for the record, please?
TESTIMONY OF ROBERT G. HEATH, M.D., D.M.SCI.
Dr. Heath. My name is Dr. Eobert Galbraith Heath. I am a psy-
chiatrist and neurologist and chairman of the Department of Psy-
chiatry and Neurology at Tulane University School of Medicine.
My training background is in neurology from the Neurological
Institute of New York and in psychiatry from the Pennsylvania
Hospital in Philadelphia, and in psychoanalysis from the Psychiatric
Institute of Columbia University of New York.
I trained in research in neurophysiology in the laboratories of the
College of Physicians and Surgeons at Columbia University of New
York. I have been chairman of the Department of Psychiatry and
Neurology at Tulane since January of 1949 and during that period,
in addition to teaching and practicing psychiatry and neurology,
have been involved in research attempting to correlate brain activity
with behavioral phenomena and to investigate the basis of a variety
of neurological and psychiatric disorders.
Senator Gurnet. Just one or two other questions, Dr. Heath. You
51
received your medical degree from the University of Pittsburgh in
1937, is that correct ?
Dr. Heath. In 1938.
Senator Gurnet. 1938.
Dr. Heath. That is correct.
Senator Gurnet. And you have been professor and chairman of
the Department of Psychiatry and Neurology at Tulane University
School of Medicine in New Orleans since 1949 ?
Dr. Heath. That is correct.
Senator Gurnet. You have been a member of the International
Board, Advisory Board, of the International Journal of Neuropsy-
chiatry since 1959, is that correct? You are a member of the Ad Hoc
Advisory Committee on Schizophrenia of the National Institute of
Mental Health, is that correct?
Dr. Heath. Correct.
Senator Gurnet. Did you, in 1972, receive the Gold Medal Award
of the Society of Biological Psychiatry for pioneer research in the
field?
Dr. Heath. Correct.
Senator Gurnet. And are you the author of several books in the
field of psychiatry and psychology?
Dr. Heath. That is right.
Senator Gurnet. And the author and co-author of approximately
250 scientific papers?
Dr. Heath. That is correct.
Senator Gurnet. Is there any other information that you feel the
committee ought to have about your qualifications as an expert in this
field?
Dr. Heath. I can't think of any more, Mr. Gurney.
Senator Gurnet. Will you proceed with your statement then, Dr.
Heath.
Dr. Heath. Senator Gurney and members of the committee, we
have been involved in research, as I have indicated here, to determine
if marihuana or the principal active ingredient, tetrahydrocanna-
binol does, indeed, induce objective changes in brain activity and in
brain structure ; whether or not marihuana smoking produces severe
behavioral pathology or brain damage, or both. This is an issue that
is still confused and unsettled today. Several clinical studies have
been reported in the scientific literature which suggest that frequent
and prolonged smoking of marihuana has deleterious effects on be-
havior and the brain. Other authorities have insisted that mari-
huana is an innocuous agent — that reports of its deleterious effects
have failed to take into account the influence of several variables,
such as the smoker's use of other drugs or his preexisting behavioral
or brain abnormalities.
The most notable and consistent clinical changes that have been
reported in heavy marihuana smokers include apathy approaching
indolence, lack of motivation often referred to as an emotional state,
reduced interest in socializing, and attraction to _ intense sensory
stimuli — they like to listen to loud music, floating lights, and so on.
Less frequent are reports of overt psychotic behavior characterized
52
by losing contact with reality, having hallucinations and so forth,
and the induction of dyskinesias — abnormal muscle movements.
In the Tulane laboratories, data gathered from a small number of
uncontrollable epileptic patients who were undergoing brain surgery
for their epilepsy, have revealed consistent alterations in function
of specific deep brain sites. Techniques involved in the treatment of
their epilepsy were rather unique. Electrodes were implanted into
specific structures deep in the brain as well as over the surface.
With these techniques we were able to obtain information on brain
function that could not be obtained with the more conventional re-
cording techniques. Some of the patients involved were chronic
marihuana smokers. During the course of their treatment, we per-
mitted them to smoke marihuana cigarettes while recordings were
being made, with these special techniques, from otherwise unavail-
able brain sites. The deep brain sites affected by the smoking were
those where we had, over the years, made correlations between brain
activity and alerting, awareness, and feelings of pleasure.
One particular region of the brain that will be referred to fre-
quently, is the septal region. Activity in this region has been con-
sistently correlated with emotionality and feelings of pleasure. In
schizophrenic patients, this region functions abnormally and this
accounts for the lack of pleasure responsivity in the schizophrenic.
Because it is connected with the sensory relay nuclei, the systems
for perception of various sensations such as sound, light, touch, and
movement, its abnormal functioning affects these other systems, and
this can account for the disturbances of perception such as the hal-
lucinations that psychotic patients experience.
This region was affected when these patients smoked marihuana.
That was a preliminary study and on the basis of it, we elected to
do more intense study where we could control all of the variables
that I previously mentioned. This degree of control is possible, of
course, only in experiments with animals and could not be done with
human patients. By using animals we were able to eliminate the
variables — and I repeat them — the use of other drugs and a pre-
disposition to mental or emotional illness.
The dosage of marihuana smoked in these monkeys was rigidly
controlled and precise methods were applied for studying brain
activity in the animals; parameters for study which could not, of
course, be used routinely for studying marihuana in humans since
we implanted electrodes into the brain. The question for which we
sought an answer was: "Does marihuana induce significant irre-
versible effects on behavior and on brain function, or on the struc-
ture of the brain?" This report is a preliminary survey of the data
collected from our first long-term investigation, now nearing com-
pletion, of the effects of marihuana in rhesus monkeys.
Several cannabis preparations, all obtained from the Narcotic
Addict Rehabilitation Branch of the National Institute of Mental
Health, were used for smoking: marihuana with a high content of
delta-9 THC, tetrahydrocannabinol; inactive marihuana, devoid of
active cannabis compounds; and for intravenous injection, pure
delta-9 THC, that thought to be the most important active ingredi-
ent of marihuana.
53
For smoking the monkeys with marihuana, a special apparatus,
designed in our laboratories and pictured in figure 1, was employed.
If you have any questions, Senator, or members of the committee,
please interrupt me but it is probably better to explain as I go along.
This is a device by means of which we could assure the delivery of
an accurate dose. The marihuana to be smoked was assayed to quan-
titate the active ingredients, then an exact amount was weighed out
based on a dosage commensurate with the known dosage of mari-
huana that people use, the same amount per unit of body weight.
This was put into the pipe as shown here — figure 1 — and attached
54
to a respirometer. The smoke was pulled into the respirometer by
an electric motor and that smoke accumulated in the respirometer was
then delivered into the monkey's nasopharynx through this tubing
[photograph], at a rate commensurate with the rate of inhalation
of human smoking.
Mr. Sourwine. Mr. Chairman, may I ask it be the order of the
chairman that any photographs, charts, tables produced by the wit-
ness may go into the record.
Senator Gukney. Yes, it is so ordered. They will be made a part
of the record.
Dr. Heath. Delta-9 THC, the presumed important active compo-
nent of marihuana, at a dose relative to the quantity of this in-
gredient absorbed from the smoked marihuana, was given intra-
venously through an indwelling intravenous cannula. I won't detail
the methods of preparation. Since a high percentage of the active
ingredient is lost in smoking, the intravenous dose of the delta-9
THC was determined in accordance with the animal's response. The
dose was approximately 18 percent of the amount of THC contained
in the smoked marihuana.
For control smoking with inactive marihuana, the amount of
starting material was equated with the amount of marihuana and
the total amount of marihuana was equated with the amount of the
raw product in the active preparations.
Ten rhesus monkeys were used in these experiments, some pre-
pared with deep and surface brain electrodes and some which were
unoperated to control for the variable of the effects of implanted
electrodes. There are sockets that can be plugged into and the
monkey has some 30 leads in various predetermined brain sites accu-
rately implanted by a special device we use.
Those monkeys that were operated were allowed to rest for at
least 2 weeks after surgery to assure they were fully recovered from
implanting the electrodes and until their recordings from all brain
sites had returned to normal.
The procedures used in this investigation enabled us to learn both
the immediate — acute — and long-term — chronic — effects of mari-
huana and delta-9 THC on brain function and behavior of monkeys.
To determine the effects of long-term exposure, one group of mon-
keys, which corresponded with human heavy smokers of hashish, a
concentrated cannabis preparation, was smoked three times per day,
5 days a week, for 6 months; another group which corresponded
with moderate human hashish smokers was smoked two times a week
for 6 months. The amount of delta-9 THC contained in the material
employed for the moderate hashish smoking corresponded closely with
the weekly dose levels that is consumed by the average marihuana
smoker in the United States.1 Two monkeys were given delta-9 THC
once each day, 5 days a week over the 6-month period.
I shall talk about the effects of marihuana and delta-9 first as a
summary statement and I will then go into detail on each aspect of
the experiments — the acute aspect and the chronic aspect.
With exposure to the smoke of active marihuana, all monkeys de-
pose levels correspond to those In clinical study by Tennant. F. S., and Groesbeck.
C. J. Psychiatric effects of hashish. Arch. Gen. Psychiat. 27.- 133-136. 1972.
55
veloped acute [immediate] distinct alterations in behavior and those
with depth electrodes showed significant alterations in brain record-
ings. Similarly, with intravenous administration of delta-9 THC,
the monkeys developed acute [immediate] changes in behavior and
in brain-wave activity from some deep brain sites. With the passage
of time, these monkeys ; that is, those exposed to the smoke of active
marihuana and those given injections of delta-9 THC at regular
intervals, developed chronic [persistent] changes in brain activity.
These changes outlasted the immediate period of an hour or two
after the conclusion of the smoking and were found to be present
up to 5 days later. Those monkeys exposed to inactive marihuana,
that is with the active ingredient, THC removed, showed neither
acute nor chronic effects.
I'll now describe the acute effects in detail. For this I refer to
figure 2. The acute effects of marihuana were most pronounced in
the monkeys during the early exposures to the smoke and became
less evident with passage of time, that is, with repeated smoking.
The immediate behavioral effect was reduced awareness. They were
what is generally referred to as "stoned" and responded less to all
forms of sensory stimuli, tending to stare blankly into space. You
could stick them with pins or put your finger in their mouths with-
out concern, and this is impossible with normal rhesus monkeys as
they are rather hostile animals.
Four of the six monkeys in this group were prepared with depth
electrodes and distinct alterations were seen in recordings from
specific deep sites of their brains — the most consistent changes oc-
curing in the septal region, hippocampus and amygdala. If you look
at figure 2, the sixth channel down is the hippocampus, labeled HIP.
SMOKED MARIHUANA
F3 -T3
F4-T4
L T C» - R 0 Cx
ROCi-RTCi
TCG
L HIP
R LAT AMY
R LAT GEN
R A SEP
L P SEP
L MES RET
R CUNEIF
L RAPHE
L A HYP
R CBL F«
EKG
TCG
BASELINE
PRE MARIHUANA
I
ITJWrmTjTTTni
F|!TTHT'pTn
ACUTE EFFECT
574mfl/kg tf-THC
1 -■ - • ' . ■ v . ' •' v-V
mrnimip.jYfiiniiii "'Jff jSTJ'P
MONKEY ZCIHA
56
A9-THC
F3-T3
F4-T4
LTCi-RO
ROCl-RT
TCG
L HIP
R LAT AMY
R LAT GEN
R A SEP
L PSEP
I MES RET
R CUNEIF
L RAPHE
L A HYP
RCBL FAS
EKG
TCG
%v yn'Fr'w.* MM^**f*<HI*
ACUTE EFFECT
POST OTmfl/hg IV rf-THC
V^w,-.'. '.'■■ ■ ■■■' ■"■."'''.i'-'.'.v ■•**'•'.'.',.. xJnMUfI
»«tfci>~»..w w»hn«rlMK»|K!,M^^
TrTTT:l r'TTimillllllllllllllllllll hTTTrTTTTITTlTT'
PRE MARIHUANA
F3-T3
F4-T4
L T Cx - R 0
R 0 Cx - R T
TCG
L HIP
R LAT AMY
R LAT GEN
R A SEP
L P SEP
L MES RET
R CUNEIF
L RAPHE
L A HYP
R CBL FAS
EKG
TCG
I
CHRONIC EFFECT
AT 24 WEEKS (3X/OAY, 5 DAYS/WEEK)
3.74mg/«g rf-THC
^\w*W"*1***', 'N***** /X^"****"' S|Ml»rt'*»-'
r
i
44444444444444444444444444Tu4lw44-
u^muuwxwuuuuuuuuuuli^^
TT|iTrrTr|-TiT,T |||TimT^rnTrvM'M'Mi!'!":iiii' |PiruirTT;pr|>r.(iT
MONKEY ZCIHA
57
A'-THC
CHRONIC EFFECT
BASELINE »T 24 WEEKS II X/Mr.J MrS/WEEK)
PRE tf-THC OTmg/hg I.V. rf-THC
F3-T3
L T Ci - fi 0 Ci /" "ss^--,v ■ * "^^./^v
BOCl-BTCi ,.».
TCG
R LAT AMY n***** -"'• ^z^^/- Y'-SV'^^^^^^V^"",* vw'i-- V-**'.W'v — ^^>Vv^^V»^*'1^'-rf''^w^""'(~^vf™vH"VJ~
R LAT GEN **y->.-Vi^JV"'-^V'/:^ ^a__~vv- — iV—-.1- — "-W^ — .V — .' ^A^ft*_^w»-
L MES RET
R CUNEIF
L RAPHE
L A HYP
TCG
■-minium mum |im.-rrr nui'minui 'viiiiiniiiiiiii:|ppif||fiilHpjjT
MOIWEY ZFI49
Key To Brain Wave Tests
1. F3-T3 — Frontal Cortex to Temporal Cortex.
2. F4-T4 — Frontal Cortex to Temporal Cortex.
3. L T Cx-R O Cx— Left Temporal Cortex to Right Occipital Cortex.
4. R O Cx-R T Cx — Right Occipital Cortex to Right Temporal Cortex.
5. T C G — Time Code Generator (for computer).
6. L HIP — Left Hippocampus.
7. R LAT AMY— Right Lateral Amygdala.
8. R LAT GEN— Right Lateral Geniculate.
9. R A SEP— Right Anterior Septal.
10. L P SEP — Left Posterior Septal.
11. L MES RET — Left Mesencephalic Reticulum.
12. R CUNEIF— Right Cuneiformis Nucleus.
13. L RAPHE— Left Raphe Nucleus.
14. L A HYP — Left Anterior Hypothalamus.
15. R CBL FAS— Right Ceribellum Fastigius Nucleus.
16. E K G — Electrocardiogram — Pulse.
17. T C G — Time Code Generator (for computer).
Senator Gurney. Will you identify, Doctor, which chart you are
reading from now?
Dr. Heath. This is figure 2. It is headed Smoked Marihuana Base-
line on the left, Acute Effect on the right.
Senator Gurney. I am sorry.
Dr. Heath. If you will look at the amygdala and the hippocampus
channels, you see the most dramatic changes. There are changes in
other sites' too, but of a much lesser magnitude. Let me add that this
is a very inadequate way of presenting this data but it is the only
way I can under the circumstances. When we do a recording we
record for at least 20 minutes and usually up to approximately an
hour and then we look at the entire record. The record fluctuates —
one time the change will be at one site and then as you go on they
will shift to another site and so on, and the only way you can
get a complete and comprehensive picture is to look at the entire
recording.
58
Another way to get a comprehensive picture is to use videotape
and if the committee wishes, I can provide them. We use a split-
screen videotape showing the animal in one corner and the ongoing
record on the rest of the screen. As you see the animal displaying the
behavioral effect from marihuana smoke, you see the changes coming
on in his brain recording. That is really the clearest way of present-
ing it. But here, as I say, we have an inadequate way of presenting it
as it is just a very brief sampling of an entire record.
You can see under the acute effects of marihuana smoke changes
in many sites. The amygdala, septal and hippocampus show the most
pronounced changes and these are brain areas where activity has
been correlated with various specific emotional states. The septal
region is the site for pleasure — stimulating it activates pleasure
feelings. When its activity is impaired, as it is in schizophrenia,
you have a lack of pleasure and a reduction of awareness towards a
sleepy, dreamy state. The changes we found with marihuana, in some
ways, resemble the changes we recorded from schizophrenics.
Senator Gurney. Which one are we talking about now — which
line?
Dr. Heath. This is the septal recording — labeled SEP — the
eighth and ninth channels. As I say, this is a very brief sampling
and with ongoing records there are changes, but of a lesser degree,
in other sites. The changes are increases in amplitude, that is, the
height, and in frequency, that is, the length of the wave.
Senator Gurney. And for the record, I am asking, I understand
but I am asking these questions so that we can set the record
straight. The charts on the left are the normal lines before the
marihuana was smoked and the lines on the right are the lines
after the effects of the smoking marihuana, is that correct?
Dr. Heath. That is correct. But I wish to point out that the sites
most profoundly affected were those that had to do with emotionality.
To repeat, the septal region, when it is acutely activated as with an
electrical stimulus or with chemicals, induces pleasure. When you
spontaneously feel strong pleasure, it produces a change in the re-
cordings. Contrariwise, when activity in the septal region is im-
paired, then there is a reduction in pleasure responsivity.
With the acute smoking of marihuana you do get a pleasure
response in humans and you find this reflected in their recordings.
Iii contrast and most significant, however, is the finding that
with chronic usage you begin to get recording changes indicating
that the area is impaired in its function and that is associated with
a reduction in pleasure responsivity, a lessening of motivation and
a reduction in awareness. That, then, is the acute effect of smoking
marihuana.
I will reiterate again that the sites that had to do with emotionality
are directly connected with the relay nuclei in the brain for sensory
perception. This is a possible physical explanation for the finding
that when emotionality is grossly impaired (whether it be in a
schizophrenic or as a result of an intoxicating drug) it affects the
septal region, hippocampus and amygdala and is often accompanied
by hallucinations and the other altered perceptions which these
people experience.
59
Mr. Sotjkwine. Mr. Chairman, may I ask one question which I
think will help the record? Doctor, would it be possible for you to
tell us as you did with respect to the septal region what controls or
reactions are specifically associated with the hippocampus and the
amygdala?
Dr. Heath. That constitutes approximately 25 years of work and
I was almost hoping you wouldn't get into that. The controls have
been a lengthy background of experiments with hundreds of monkeys
and with a total of some 60 or TO human subjects in whom we have
implanted electrodes into these sites in a treatment program for
otherwise unbeatable neurological diseases and some psychiatric
disorders. We have techniques by which we implant electrodes into
specific sites in humans for treatment, and they remain in place for
periods up to a year or more. During this period of study for diag-
nosis and treatment, we have been able, through a variety of tech-
niques, to establish meaningful correlations between brain activity
and behavior. For example, we obtained recordings when the pa-
tient was in different mood states and thereby establish correlations
between brain activity at specific sites and varying mood states. We
stimulated a number of specific deep sites in the brain and we were
then able to establish how that alters behavior. We have admin-
istered drugs which modify behavior and further established the
brain changes associated with those behavioral alterations. This, at
best, only briefly summarizes the extensive background work that we
have compiled over the years against which the present experiments
are being conducted.
Mr. Sourwine. Is it fair to say, sir, that the question I asked can-
not be simply answered as in the case of the septal?
Dr. Heath. Yes, it cannot be simply answered. It would take a
lengthy dissertation and I don't believe we can get into that here.
We do, however, have these documented on film. The only way to
know what is going on in the mind is to have someone that can talk
to you. As such, animal experiments are limited. I think that is a
general statement pertinent to the information you are seeking.
Shall I proceed?
It is important to point out that no consistent or notable changes
were seen in the scalp recordings of these four monkeys and none
were seen in the conventional scalp EEG (electroencephalogram)
recordings obtained from the two unoperated monkeys, and no con-
sistent changes on scalp EEGs have been reported in human mari-
huana smokers. I am pointing this out because usually the only
technique that can be applied to human subjects is the conventional
scalp EEG.
These acute behavioral changes and recording changes subsided
within 1 hour after exposure to the smoke.
No visible changes in behavior or acute changes in brain record-
ings were obtained in monkeys which were exposed to the smoke of
inactive marihuana, suggesting that what we found was directly
related to the active ingredients in the marihuana. Further evidence
was the active ingredient, delta-9 THC administered intravenously
once a day, 5 days a week, which consistently induced distinct and
60
immediate changes in behavior and recordings in the two implanted
monkeys. These effects were more pronounced than those obtained
with the smoke of active marihuana. The two monkeys were more
reduced in awareness and the recording changes, while occurring in
the same brain structures as in the monkeys which were smoked,
were more profound. The changes consisted of the development of
frequent high-amplitude spiking, most pronounced and focal in the
septal region.
This is the brain site that is most profoundly affected in schizo-
phrenia. Changes with delta-9 THC were more focal in the septal
region and the magnitude of the change was somewhat greater than
with the smoked marihuana. It appears, then, that this produces a
more potent effect on this pleasure site; first turning it on and then
with overdosage and continued usage, it seems to destroy the activ-
ity of this site; the latter state being similar to that which we have
in some psychotic behavior. These recordings resembled those we
have previously obtained from the septal region of severely disturbed
psychotic patients.
The chronic effects, which I think may be most pertinent to these
hearings, were the most impressive to us. Those monkeys prepared
with depth electrodes which were exposed regularly to active mari-
huana (heavily smoked — three times per day, 5 days a week; mod-
erately smoked — two times a week), over a period of time began to
show evidence of irreversible alterations in brain function about 3
months after onset of the experiment. The precise brain regions
affected were, again, the septal region, hippocampus and amygdala.
These chronic effects were manifested by the recording changes
which outlasted the acute effects of the smoke— that is, they per-
sisted through the weekends when the monkeys were not exposed to
smoke for 2 days. They were present on the Monday morning follow-
ing and we have let them go as long as 5 days and these effects were
still present. It appears that they are persistent, but to say that they
were permanent, requires the passage of more time and further
investigation. Our previous experience with similar situations would
lead us to assume that this chronic smoking of marihuana has prob-
ablv produced irreversible changes in brain function.
It was interesting to us that these distinct and persistent brain
alterations were temporarily corrected, being replaced by a different
type of altered brain activity, when the animals were again ex-
posed to the marihuana smoke. This phenomenon suggested that the
marihuana had induced permanent changes of a tvpe that could be
temporarily alleviated bv acute exposure, seemingly paralleling the
well-known pattern of the drug-dependent person who gains tempo-
rary relief from deprivation by taking more of the drujr.
In two unoperated monkeys which were heavily smoked with ac-
tive marihuana, only scalp recordings could be obtained; no changes
were reflected in these conventional recordings. I again cite the im-
potence of phvsiological techniques of only scalp recordings used
routinely on human subjects. That is the reason, of course, that
people report often that there are no changes in brain functions.
61
They use a scalp EEG, a technique which is unable to pick up these
changes.
Chronic exposure to inactive marihuana smoke did not produce
notable behavioral or recording alterations in the monkeys.
Persistent recording changes from specific deep brain sites, the
septal region, hippocampus and amygdala, appeared in the two
monkeys to which delta-9 THC was intravenously administered 5
days a week in 2 to 3 months after the study began. As with the
monkeys exposed to marihuana smoke, these changes persisted over the
weekends. You will note in figure 5 that there is a high amplitude
spiking in the sixth channel indicating a change in the hippocampal
function.
Also, in the septal leads (9th and 10th channels), you will find
high amplitude sharp spiking and this has a great deal of signifi-
cance. This is what we refer to as "epileptiform activity" and indi-
cates that there is damage to that site or the cells in the vicinity of
that recording electrode.
With regard to physical complications in this experiment, two
monkeys out of the 10 died during the course of these studies. Their
recording and behavioral data are included in the effects cited
herein. One monkey died 3!/2 months after onset of the experiment
and the other animal died after 5y2 months after the onset. One had
implanted electrodes and the other was unoperated. Both were in the
heavily smoked active marihuana group (chronic exposure) and both
died of respiratory complications.
The brains of these two animals have been studied histopathologi-
cally and the preliminary report indicates minimal structural altera-
tion of cells in the septal region of the brain.
Our protocol requires us to continue to study the behavioral and
recording changes in the surviving monkeys for 1 month beyond the
drug exposure period of 6 months. At that point, the monkeys will
be sacrificed and their brains will be carefully perused and prepared
for study by electron and light microscopy to yield more finite data
about structural changes that may have been induced in association
with the consistent physiological alterations that I have described.
Regarding behavioral effects, the behavioral data concerned with
long-term effects of marihuana smoking and intravenous delta-9
THC have not been sufficiently analyzed to report them at this time.
There are, however, behavioral changes which have been documented
which are not solely due to the acute effects of the drug.
In summary of this experiment I am reporting to you that the
smoke of active marihuana, that is, with a high content of delta-9
THC. induced in the rhesus monkeys, consistent and distinct changes
in recordings from specific deep brain sites in association with be-
havioral alterations.
(2) When the monkeys were regularly exposed to these drugs,
at both moderate and heavy dose levels, persistent — perhaps irre-
versible— alterations developed in brain function at specific deep
sites where recording activity has been correlated with emotional
responsivity, alerting and sensory perception.
33-371 O - 74 - 6
62
(3) Heavy smoking of active marihuana induced respiratory com-
plications which proved lethal to two monkeys after Sy2 to 5y2
months.
(4) Preliminary histopathological data suggest that structural
alteration of cells at focal brain sites may be associated with the
persisting physiological changes.
Incidentally, the sites in the brain where we have gotten these most
pronounced and persistent changes are in areas which show on pneu-
moencephalograms. Damage at these sites would correspond with
the findings of Campbell, et al., published in Lancet in 1972. Their
studies were with human subjects and adolescents who were smoking
marihuana for a very long period of time who showed some behav-
ioral symptoms and had enlarged lateral ventricles.
Senator Gurnet. Thank you, Dr. Heath. Members of the panel,
I have a vote in the Senate now and I am going to have to recess
the subcommittee briefly while I go and vote. The subcommittee is
recessed at the call of the Chair.
T Short recess.]
Senator Gurnet. The subcommittee will come to order. First of
all, I want to apologize to the panel here. We have a very contro-
versial bill on the Senate floor, the issue known as busing, so I am
going to be back and forth quite a bit in the morning.
Dr. Heath, I am going to ask a few general questions and then
the counsel will ask more questions about the more technical aspects
of your testimony. First of all, how long have you been doing re-
search on marihuana?
Dr. Heath. About 4 years.
Senator Gurnet. Is it your conclusion, Dr. Heath, from the re-
search you have done in these 4 years that marihuana is a dangerous
drug?
Dr. Heath. When I first began to work with marihuana I was
much in keeping with the ideas that were prevalent in the scientific
arena at that time that marihuana seemed to be a relatively innocu-
ous agent. It produced relaxation and no one had established that it
produced any significant damage, nor that it was strictly addictive.
But as I have gone on with the experiments observing the effects in
humans, both clinically and as part of the research program, I
began to feel that this is a very harmful drug. This drusr seems to
produce real and significant damage, and my data, I believe, sub-
stantiates the fact that this is a drug which has strongly deleterious
effects with probable destructive effects on the brain in heavy users.
I think most of my colleagues, at least the ones that I have dailv
contact with in the medical school and particularly those who are
in charge of the psychiatric or mental health section of the student
health clinic at Tulane, have become more and more concerned with
the marihuana problem, as students using it are showing distinct,
often severe and lasting effects.
So. in summary, as time has gone on, and I have become per-
sonally more acquainted with and interested in the effects of mari-
huana, both clinically and experimentally, I have come to feel in-
creasingly that this is a dangerous drug.
63
Senator Gurney. You mentioned that you were concerned about
the use of marihuana among the students at Tulane University. I,
of course, don't intend to single out Tulane — it is a typical American
university like the others everywhere — but would you say that mari-
huana use on your campus is fairly widespread among the students?
Dr. Heath. Yes, we have done surveys from time to time, and T
think they are fairly accurate. In the surveys students had no reason
not to answer the questions candidly and it is in quite wide usage. I'm
sure this is true in other campuses as well.
Senator Gurney. What percentage of usage among the students
did your surveys show ?
Dr. Heath. Well, surveys have varied, depending what your cri-
teria are. In other words, if you include the occasional experimental
user, the percentage is much higher than if you only consider
those that use it very frequently. There are gradations — those who
smoke daily, those who use it several times a week, and those who
smoke on the weekends to those who have experimented only once
or twice. I would say, considering only those who have used it to a
significant extent, that the statistics range as high as 30 to 40 percent.
Senator Gurney. What do you call a fairly consistent usage — how
many?
Dr. Heath. Two or three times a week.
Senator Gurney. Now this is a marihuana cigarette, I presume?
Dr. Heath. Correct. I would consider two to three marihuana
cigarettes per week and doing it on a regular basis to be significant.
Senator Gurney. And it is your opinion from the result of your
research that the persistent use of marihuana two or three times a
week regularly does produce permanent brain damage?
Dr. Heath. It would seem unlikely that marihuana of low po-
tency smoke of two or three times a week would produce brain
damage. We were using considerably higher dosage in our experi-
ments. Moderate smokers — moderate being based on hashish con-
sumption— corresponds to the upper levels of social consumption
that would amount to smoking considerably more than two or three
marihuana cigarettes of the potency level prevalent on our campus.
The dose range would be about the level that would be consumed if
a person were smoking three average marihuana cigarettes per day.
We are talking about dosage on a per kilogram level between our
monkeys and our humans — not total dosage, of course. In the future,
if the funds are provided, we will smoke monkeys at a lower dose
level commensurate with the amount of active ingredient that is
consumed by an individual smoking three to five cigarettes per week.
This would mean repeating the entire study at this dose level and
would involve considerable additional expense — but until we do this
I will not be able to answer with precision the question you raised.
Senator Gurney. Would you care to offer an opinion about the
persistent use of marihuana by your students, if that would produce
brain damage?
Dr. Heath. We have numerous instances in which the students
using marihuana have gotten into difficulty one way or another. But
there are, of course, many variables in the life of students and this
64
is what makes clinical data in some instances questionable. But as
you see a number of patients where smoking marihuana is in the
foreground of the clinical picture, you do begin to feel that this is
an agent which has harmful effects, and one which reduces the effec-
tive capability of many students in both their personal life relation-
ships and their academic performances. Speaking as a clinician,
without being able to back it with precise hard data such as we have
in animals, it seems probable that the continued use of marihuana is
reducing the potential ceiling level of functioning of a number of
these students, both emotionally and academically.
Senator Gurney. You mentioned about 4 years ago when you be-
gan this study you felt that marihuana was, as I recall, not a harm-
ful drug, a rather innocuous drug. But you have changed your
opinion on that?
Is it also true that this is a prevailing opinion among a wide-
spread portion of our population today — that marihuana is an in-
nocuous and is not a harmful drug?
Dr. Heath. Yes. I see the point you are making and I think it
accurately reflects the prevailing attitude amongst younger members
of our society, both high school and college students. If you speak
with them they quote certain authorities and opinions from members
of their own group to the effect that this drug is innocuous.
Senator Gurney. Another question that I think is important.
There is a prevailing opinion, I think, certainly among the users —
the young people and the adults too, so far as that is concerned —
that marihuana can be equated to alcohol as a drug; that marihuana
really isn't any more harmful than alcohol. "Would you care to ex-
press your opinion on that?
Dr. Heath. Yes, I think I can express that even more firmly be-
cause it can be backed with hard data from our animal studies. If
I may, I would just like to state that the probable reason so many
believe that marihuana is innocuous is because there really has not
been any significant amount of hard data collected until recently
to determine whether it does or does not produce damaging effects
on the human, particularly on the brain.
I think our data are some of the first real objective data that
have shown that marihuana does produce persistent effects, at least
in brain function. Until this sort of data had been collected people
were going on hearsay. I think it is important to separate what is
soft or impressionistic opinion from factual data, and the factual
data hasn't all come in yet. The investigators you have gathered
here today have all been in the process of collecting some hard data.
Senator Gurney. Realizing then that the data are not complete,
because we do want to be careful in making conclusions and state-
ments, but from your own studies, I take it, your opinion is that
marihuana is a far more dangerous drug than alcohol ?
Dr. Heath. I believe that is correct. We have used alcohol as a
control in our studies, both with human patients and with the ani-
mals. I am perplexed as to why this analogy was made between
marihuana and alcohol since we have gathered more information,
65
except that on a social, clinical basis both produce relaxation and a
feeling of euphoria. But when you begin to study brain activity in
relationship to these compounds they are drastically different. Alco-
hol does not produce these profound specific recording changes that
I have been showing you as a result of marihuana and the active
ingredient delta-9 THC. It produces some diffuse, rather minor
alterations, that you would expect if you spontaneously were some-
what more relaxed.
Alcohol does not get in there and directly and profoundly affect
brain function as the cannabis preparations do. They have a strik-
ingly different physiological effect on the brain. Of course, alcohol
does affect the liver and it has been shown objectively with many
recent experiments that it ultimately can affect the brain, but you can
use alcohol for a long period of time without producing any sort
of persistent damage. People might drink rather heavily for 25 or
30 years and never get into serious trouble so far as alterations in
their brain is concerned. But with marihuana, as the facts are be-
ginning to accumulate, it seems as though you have to use it only
for a relatively short time in moderate to heavy use before persistent
behavioral effects along with other evidence of brain damage begin
to develop. As I have said, these animal data are hard data. As data
accumulates they are beginning to confirm what many of us have
suspected from clinical experience with marihuana users; namely,
that this produces distinctive and irreversible changes in the brain.
Senator Gurnet. One final question, Dr. Heath. Do you think that
the use of marihuana should be legalized ?
Dr. Heath. You know, I think that is a little bit out of my ball
park and into yours.
Senator Gurnet. All right.
Dr. Heath. I think it is my job to collect information for you to
use in making that decision.
Senator Gurnet. I guess so.
Dr. Heath. And I would rather avoid commenting on it.
Senator Gurnet. You have a good point. Counsel will have ques-
tions now to ask you — Mr. Martin.
Mr. Martin. I have a suggestion to make, Mr. Chairman. So that
the record will be more comprehensible for the lay reader, I would
like to suggest that Dr. Heath provide us, if it isn't too much trouble,
with a diagram showing the location of the segments of the brain
about which he has been talking today, and a brief description of
the major functions controlled by these segments. Would that be
possible. Dr. Heath?
Dr. Heath. Yes, that could be produced.
Senator Gurnet. The diagram will be included as a part of the
record.
66
[The diagram referred to follows :]
SOMATIC ANO
VISCERAL
AFFERENTS \
Fig. 1. Scliema of the limbic system. OB — olfactory bulb; LOT — lateral olfactory striae; INS— insula; I'll—
uncinate bundle; PIJ — diagonal band of broca; AM Y(I — amygdala; SCH — subcallosal radiations; HYP -liyuo-
tlialamus; AT — anterior thalamus; MH — mammillary body; MTT — maiumillothalamic trace (Vicq D'Azyr's
Tract); ATlt — anterior thalamic radiations; ST — stria terminalis; UAH -halienula; MKH medial forebrain
bundle; SM — stria medullaris; HPT — hal>enulointerpe<luncular tract (fasciculus retroflexus of Meynert); IP —
interpeduncular nucleus; LMA — limbic midbrain area of nauta; (i -nucleus of (iuddeu; ('(J — central gray; (*C—
corpus callosum.
Mr. Martin. The EEG charts that you have shown us, Dr. Heath —
would it be accurate to describe them as a quantitative reading of
aberration from the normal in the brains of monkeys and humans
who have been exposed to marihuana? Does a more violent aberra-
tion of the brain wave pattern from the normal pattern mean that
the brain has been more severely affected?
Dr. Heath. Yes, in general, that is true. In regard to your major
question about quantitating, yes, they can to some extent be quanti-
tated and we have been quantitating those.
If you will note on those records there are two channels labeled the
TCG, time code generator. We can put this physiological data on.
tape, and then we can put it into the computer for a quantitative
analysis of the changes that have occurred in terms of the amplitude
67
changes and the frequency changes, which are the basic important
constituents of an EEG record.
Mr. Martin. You spoke about the parallel work you conducted
with alcohol in monkeys and humans, Dr. Heath. Would it be pos-
sible to provide us for the record with a set of parallel EEG charts
for alcohol, with a commentary on the difference between the mari-
huana and alcohol ?
Dr. Heath. Yes. As a matter of fact I have published articles on
that comparison. One was on humans, in the Archives of General
Psychiatry, I believe, in the early summer of 1972. And the other
was on monkeys where alcohol was used as a control substance, and
that was published in the Journal of Neuropharmacology in 1973 —
I will send you reprints of both if that is satisfactory.
Senator Gurnet. That is, and these will be included in the record
as well.
[The documents referred to may be found in the appendix, pp. 349,
356.]
Mr. Martin. Do the aberrations from the normal appear to be
more marked in any one segment of the brain than in other segments,
and, if this is the case, what would you say this implies?
Dr. Heath. Yes. The sites that are most profoundly affected are
the septal region, hippocampus, and amygdala and this is where the
lasting effects have been occurring.
The septal is part of the deep rostral forebrain, the front part of
the brain in depth and, as I indicated, this is the site where we have
been able to localize pleasure responsiveness. This is the center of
our physiological system for pleasure. Whenever you spontaneously
feel pleasure this side fires off, and if you stimulate it, intense feel-
ings of pleasure are induced. When you have diseases such asschizo-
phrenia where pleasure is impaired, this region is functioning ab-
normally. The fact that this drug, marihuana, initially turns it on
and activates it like an electrical stimulus, is the reason that people
use the drug. That is the fundamental attraction of addictive drugs —
they make you feel good.
Ultimately, of course, since they are squeezing out the essential
chemical constituents of this physiological system, it becomes ex-
hausted; you then need to take increasing amounts of the drug,
until the system is completely exhausted and the drug no longer
induces an' effect. The drugs' aren't putting in anything. They're
just squeezing out what you have there already. Ultimately, the
cells become depleted and can't respond.
Mr. Martin. You mentioned schizophrenia. Is it accurate — I
have heard this, I am not sure that it is so — that you have a
similarity between the brain wave patterns of marihuana smokers and
schizophrenics ?
Dr. Heath. In some of them that is correct. In particular, in these
animals that have been chronically exposed, we are beginning to see
changes of the sort we see in the psychotic schizophrenic patient.
This septal region recording abnormality is seen with any form of
psvchotic behavior — schizophrenia or other brain pathologies caus-
ing psychosis. For example, if a brain tumor grows there and knocks
out these cells you get psychotic too.
68
Mr. Martin. Is the motivational factor — is this controlled by the
hippocampus or what segment?
Dr. Heath. The septal region, hippocampus and amygdala, which
are integral parts and richly interconnected, are parts of this moti-
vational system. But the septal region is much more tied in with
pleasure and thus with motivation. We do things because we get a
reward. Thus, motivation is tied in with pleasure.
Mr. Martin. The aberration from the normal which you found in
the segments of the brain associated with motivation — could these
aberrations have anything to do with the so-called amotivational
syndrome ?
Dr. Heath. Yes, I think this is the correlation. This is the pleas-
ure system and if its function becomes impaired then you lose your
motivation. There is a physiological basis for motivation.
Mr. Martin. One final question. One of our witnesses last Thurs-
day was Dr. Harvey Powelson of California, Dr. Powelson served
as director of the Psychiatric Division of the Student Health Service
at Berkeley from 1964 to 1972, and he saw the beginnings of the
epidemic, and he saw it burgeon, and then he saw it take over the
campus. And he changed his mind as a result of this exposure, as
a result of the exposure to hundreds — literally hundreds — of students
who had gone on marihuana and hashish and had suffered irreparable
damage in his opinion, as a result of this. He told us that he was
convinced of the existence of irreversible brain damage and that it
was produced in a relatively short time, as you suggest is a possibilitv.
He related the history of a brilliant student of mathematics who
had abandoned his studies when he embarked on a heavy cannabis
binge and then about 2 years later he decided to pull himself to-
gether and come back. So he laid off for a long time, went back to
school, became functional — but he just couldn't do the complex math-
ematical calculations he was able to do before, even a year later.
Does this correspond to anything in your experience?
Dr. Heath. It very closely parallels my own experience both clin-
ically and in my research. I haven't seen the numbers of patients
who are marihuana smokers that Dr. Powelson has. He was in a
very unusual position. We have a much smaller student body and I
have seen some of the students personally. But our experience paral-
lels his. You describe another very interesting phenomenon which I
would like to comment on, and that is that when a person stops
using the drug, they do show some improvement. They do not, how-
ever, get back to their baseline level of functioning. This is true with
any insult to the nervous system; whether it be a stroke, a trauma
or a hit on the head, the initial effects are much greater that the
long-term effects. When you get an insult to the nervous system, even
though the immediate effects are very profound, there is a tendency
for it to clear up but only partially. There is always some permanent
residual effects which hangs on and I think this is what Dr. Powelson
described. Much of the immediate toxic effects clear up when you
stop smoking but the consequences of that toxin having been there
for a long time may permanently damage some cells which then
can't recover.
69
Mr. Martin. That concludes the questions that I have to ask, Mr.
Chairman.
Senator Gurnet. Do you have any questions, Mr. Sourwine ?
Mr. Sourwine. I have a few Mr. Chairman. I will try to be brief.
Sir, you have in a number of ways appeared to imply that the re-
sults received or discovered in experiments with monkeys are reli-
able criteria or at least reliable indicia with respect to what can be
expected under similar or identical circumstances in the case of a
man. Is this true ?
Dr. Heath. That is correct.
Mr. Sourwine. Oh, in part of your discussion you referred to
either 8 or 18 percent of delta-9 THC contained in smoked mari-
huana. Was that 18 or 9 percent?
Dr. Heath. When we smoked the monkeys with marihuana we
had an assay of the percentage of THC in that preparation, and
then, on a per weight basis, weighed out the amount of marihuana
for that particular monkey to smoke. That was based on what heavy
or moderate hashish users would smoke. When we were trying to
relate the intravenous delta-9 THC to the ingestion of active ingredi-
ents through the marihuana smoked, we at first thought we would give
the total amount intravenously that the monkey was getting by
smoking it. But when we did that we nearly killed the monkey. It
has been known that smoking is not the most efficient way for get-
ting the active ingredient. We adjusted the dosage so that we would
get a good effect on the monkey without risking its life, and came
out with a total dose of 18 percent.
In other words, when we have the delta-9 THC, we could only
give 18 percent of the delta-9 THC contained in the marihuana they
smoked.
Mr. Sourwine. What I was trying to get at is this question. Does
that mean, as it appears to, that in smoking a monkey can get and
does get roughly five times as much of the delta-9 THC as it would
take to kill him if he got all that at once? In other words, is a
monkey getting a lethal dose in the smoking?
Dr. Heath. There are a number of ways of interpreting that fact
that I gave you. One is that taking it into the lungs is not the most
efficient way of getting the active materials into the bloodstream. A
lot of it is lost in smoking — that is the most important factor.
Mr. Sourwine. Thank you, sir. You told us that for controlled
smoking with inactive marihuana, the amount of starting material
was equated with the amount of marihuana in the active prepara-
tions. Would you tell us for the record what was this equation?
Dr. Heath. Right. Here is the way that is done, backing up again.
With the marihuana we knew how much delta-9 THC was in it, and
we knew the dose per kilogram of weight we were going to give, so
knowing the strength of the marihuana we would then weigh out
the total amount of the crude weed which contained the active mate-
rial and thus gave the dose that we wanted.
In our control, where we were using inactive marihuana we would
just weigh out the same amount of material that was calculated for
the monkeys smoking active marihuana.
70
Mr. Sotjrwine. But that was deactivated?
Dr. Heath. Deactivated.
Mr. Sotjrwine. It was marihuana with its teeth pulled?
Dr. Heath. That is correct — exactly.
Mr. Sotjrwine. Now, Professor, I believe I have just one more
question. Did your protocol permit you to draw conclusions consti-
tuting or underlying comparisons between the deleterious effects of
marihuana and the deleterious effects of just the smoke without the
tetrahydrocannabinol ?
Dr. Heath. I am sorry, sir. I didn't follow your question.
Mr. Sotjrwine. I am asking whether under your protocol for these
experiments you were in a position to draw any conclusions, any
comparisons, between the damage or the results of the effects of the
marihuana smoking as compared with similar or somewhat similar
effects, if any, involved in the mere smoking of tobacco or detox-
ified
Dr. Heath. Eight. We didn't get
Mr. Sotjrwine. Detoxified marihuana.
Dr. Heath. We got neither immediate nor lasting effects with the
detoxified marihuana. It looks like the effects on the brain are due
to the delta-9 THC, possibly along with other specific ingredients.
We have used tobacco as a control in other studies we reported,
and it does not induce these changes either. So the conclusion would
be that neither smoke, per se, tobacco, nor inactive marihuana in-
duces the changes with which we are concerned.
Mr. Sotjrwine. The last part of the question. You indicated in
your statement that there were monkey deaths due to respiratory
problems, apparently caused by the smoking of the monkeys. Do vou
have any indication whether these problems were caused merely by
the products of smoking, aside from the delta-9 THC ?
Dr. Heath. Yes. I think I will have to speculate but there is an
awful lot of "junk" in marihuana that is bound to be extremely
harsh and irritating. Marihuana is much more harsh and irritating
than tobacco and produces considerable irritation in the respiratory
tract of these animals. We feel this was the reason the two animals
developed pneumonia and subsequently died.
Mr. Sotjrwine. I have no further questions.
Senator Gtjrney. Thank you, Dr. Heath. Let me thank you for
your most important and constructive testimony from your research.
The subcommittee is grateful to you for being here this morning.
You have made a great contribution in your study in trying to find
out about the effects of marihuana.
Our next witness is Professor Paton.
Would you identify yourself for the record, Professor?
TESTIMONY OF DR. W. D. M. PATON, THE PROFESSOR OF
PHARMACOLOGY, UNIVERSITY OF OXFORD
Dr. Paton. I am professor of pharmacology in the University of
Oxford. I originally trained in physiology in Oxford, qualified in
1942 in medicine, did a residency, and then pathology for a year, and
71
then during the war entered the service of the Medical Research
Council to work on diving and submarine problems. My own interest
in cannabis was aroused by a conference on adolescent drug de-
pendence in 1966, from which it seemed that in modern terms the
sort of pharmacological work that was needed, was not really being
initiated, and I began my work in 1969.
Senator Gurnet. Just one or two other questions, Professor, to
pin down the record. You were trained as a physiologist in Oxford,
where you took your first degree in 1938?
Dr. Paton. I took my degree in 1938 at Oxford.
Senator Gurnet. And then after being a clinical student at Uni-
versity Hospital London, your degrees of bachelor of medicine and
bachelor or surgery from Oxford were in 1942?
Dr. Paton. Correct.
Senator Gurnet. And you were a house physician at the Univer-
sity College Hospital, London, and also a pathologist?
Dr. Paton. Yes.
Senator Gurnet. And how long was that?
Dr. Paton. The residency was 6 months. Then I did a year in
pathology at a sanatorium.
Senator Gurnet. You are the author, with J. P. Payne, of "Phar-
macological Principles and Practice", which is one of the standard
textbooks on the subject in the English-speaking world?
Dr. Paton. It was, I would not claim it is now, when one has
failed to revise it. It is now about 6 years old.
Senator Gurnet. You are chairman of the Editorial Board of the
British Pharmacological Society;
Dr. Paton. Yes, that is right.
Senator Gurnet. And are you the chairman of the Committee on
Drug Dependence of the British Medical Research Council?
Dr. Paton. I am.
Senator Gurnet. Could you just briefly tell us what the British
Medical Research Council is?
Dr. Paton. Our Medical Research Council is roughly equivalent
to your National Institutes of Health.
Senator Gurnet. I see.
Dr. Paton. I served on the Council for 4 years. I have chaired a
number of its committees and I am now chairman of this particular
committee.
Senator Gurnet. How long have you been involved in the study
of cannabis?
Dr. Paton. I started thinking and reading about it back about
1966. My own work on it, directlv experimenting with it, started in
1969.
Senator Gurnet. Would you proceed with your statement ?
Dr. Paton. Some of mv earlier work has been relevant : on anes-
thetics (dating back to 1944 in connection with narcosis in diving
and submarine escape), and on opiates (from 1949). The statement
that follows rests partly on this work, partly on my own informal
contacts with drug users, and partly on a review of the recent re-
search on the effects in animals and man (written together with Dr.
72
K. G. Pertwee and Dr. Elisabeth Tylden) which forms three chap-
ters in "Marihuana" ed. R. Mechoulam, Academic Press, recently
published. Of this work (400-500 papers), usually only a small
fraction is referred to in official reports and other writings. My
bibliography now reaches over 700 papers which have material
that is important in them. I will try to bring out what appear to me
the salient points of all this work, interpreted from my pharma-
cological experience, and taking for the most part the point of view
of preventive medicine.
It is sometimes said that cigarettes and alcohol are as bad as, or
worse than cannabis, yet they are "legal" — why should not can-
nabis be too? I should like to say that I will compare these later
from the pharmacological point of view and from my own attitude
in this field, that of preventive medicine. But, before doing this,
I think one must review the actions of the cannabis, particularly
because very little publicity indeed has hitherto been given to many
of these actions.
Senator Gurnet. Professor Paton, I wonder if you could explain
to the subcommittee and to me especially, because I really do not
know, what is the difference between the term cannabis and mari-
huana and hashish ?
Dr. Paton. Cannabis is a botanical term, the name of a plant.
There has been a considerable variety of terms. This is a botanical
term. Marihuana is the term usually given to the plant without
any special treatment, dried for use. Hashish is a name where the
resin, chiefly in the flowering heads, is in some way or other par-
tially purified. You can do this in various ways, if you simply
press a whole lot of the flowering tops of plants together the resin
aggregates; and according to how far you push this you get a
richer and richer preparation. I think it is worth stressing that the
dividing line, this is my view, between marihuana and hashish
is not a very good one. You can get hashishes which have decayed
and they may have quite a loss of THC content; and you can get
marihuana such as some people have grown in England from seeds,
and just the leaves contain a remarkable amount of THC.
I shall use the term cannabis rather than marihuana, since the
use of the latter word may suggest a sharper distinction from hash-
ish than in fact exists (both are mixtures of cannabis resin with
other material from the plant), and perhaps also begs the question
whether or not it would be possible to legislate differently for them.
The first point to stress is that cannabis is a complex mixture of
chemicals; I am not sure of the latest score, but there are certainly
50 identifiable substances in it. At least six of these are known to
have a biological action: tetrahydrocannabinol (THC), propyl-THC,
cannabidiol, cannabinol, and a group of water soluble materials
giving alkaloidal reactions. This affects, inter alia, the suggestion
that one might permit a preparation containing up to 1 or 2 per-
cent THC to be marketed : this would only be feasible if THC were
the only active principle. It also means that pharmacological or
other studies which are limited to THC have only a restricted rele-
vance to problems of human usage of cannabis.
73
FAT-SOLUBILITY
Second, and possibly the most important single fact about can-
nabis, apart from the* fact of its psychic action, is that THC, the
main psychically active principle, is intensely soluble in fat, as we
pointed out in 1970. It has an octanol/water partition coefficient of
about 6,000 to one, over 10,000 times that of alcohol. Correspond-
ing to this is a low solubility in water. Its fat solubility is greater
than that of industrial solvents, and is exceeded only by substances
like DDT. The other cannabinoids share these properties. This solu-
bility gives it an affinity for, and ability to traverse, the fatty ma-
terial in cell-membranes.
From this physical property follows: (a) the activity of cannabis
by all routes of administration; (b) its cumulative effect, and the
persistence of effect when drug is withdrawn it tends to persist
in the body because it is sitting in the fatty areas which cannot be
washed out by the watery system of the body. (We take water in
at one end and lose it at the other— rinsing the body all the time —
to put it colloquially.) ; (c) its passage into all parts of the body,
including brain, adrenal gland, ovary, testis, and foetus; (d) the
diffuseness of its effects because it is able to reach every cell in the
body; (e) the overlap in its effects with those of one important
group of fat-soluble materials, the general anesthetics such as
chloroform.
Perhaps I should say a special word about the brain, where per-
haps the most important fatty material in our bodies is located,
though in much smaller percentage than (say) in adipose tissue.
Here, too, cumulation of THC and its first two metabolites has been
found.
TOXICITY
(a) Fat affinity and cumulation in the body in themselves are not
necessarily harmful, even if cumulation is undesirable in principle.
The fundamental test is a biological one, whether toxicity is cumula-
tive. This has been found to be the case; for a mouse, it requires
one-tenth as much cannabis to kill if given in repeated daily doses
as if given in a single dose. Similar cumulative toxicity has been
found for THC and in other animals and by more delicate methods
than lethality. Inferences must not be drawn, therefore, from re-
sponses to single exposures to the likely effect of repeated doses.
(b) "We have found that toxicity, as judged by loss of weight and
lethality, is associated with the fat-soluble fraction of cannabis;
THC appears to be the main, but not the only, substance responsible.
It appears impracticable, therefore, to dissociate the psychic and
the toxic effects.
(c) The question of lethality in man is important. It is often said
there have been none. Since few practitioners would know how to
diagnose a death caused, or contributed to, by cannabis, and since
it could not at present be proved by forensic analysis, only scanty
information can be expected in any case. The case reported by
Heyndrickx et al.,1 in the light of this, is rather convincing.
1Heyndrlckx, A., Scheirls, C, and Schepens, P. (1969), J. Pharm. Belg. 24. 371.
74
Possibly more important is to point to three ways in which can-
nabis could indeed cause or facilitate death although proof in a
particular case would be difficult, (a) It produces a considerable
tachycardia,2 and this may be associated with electrocardiographic
changes and ventricular extrasystoles.3 It is not at all impossible
that this, in unfavorable circumstances in a chronic user, could
progress to ventricular fibrillation 4 and death, (b) It causes a dila-
tation of peripheral blood vessels, corresponding to the hypotensive
action in animals. This probably underlies the "fainting attacks"
reported in the literature as well as by my own contacts. This in-
volves "postural hypotension," in which the capacity of the body to
correct for the upright position fails, and the blood drains from
the brain. As with other hypotensive drugs, if the subject could not
become horizontal either deliberately or by falling— for example,
because he was in a chair — blood supply to the brain might fail,
(c) Cannabis, chiefly because of its cannabidiol content, can poten-
tiate and prolong the action of barbiturates — as well as other drugs
used in medical treatment. This could mean that a nonlethal dose of.
barbiturate became lethal.
Regardless of decisions about the law, one wishes that all can-
nabis users were aware of these possibilities.
TERATOGENICITY
Administration of cannabis during the vulnerable period of
pregnancy has been found to cause fetal death and fetal abnormal-
ity in three species of animals. The deformity includes lack of limbs —
reduction-deformity. The factor responsible has not been identified
but does not appear to be THC although new work is showing that
THC kills a majority of fetuses and in the remainder produces an
increased incidence of stillbirth and stunting. The effect is dose
related, an important thing to establish if cause and effect are
considered.
These results are sometimes dismissed on the grounds that any
drug in sufficient dose will be teratogenic. While this is not quite
accurate, there is evidence that serious disturbance of the mother
can have such an effect. This gives an added importance to the cri-
terion suggested by Robson and Sullivan which I would adopt;
that a result should be taken as significant when the teratogenic dose
is a small fraction of the dose lethal to the mother. This is the
case with cannabis, and is in contrast to other drugs, including
nicotine and aspirin.
A very important question is whether cannabis directly affects
the genetic material, that is, nucleic acid. Early reports of inter-
ference with cell division indicated this. These have been confirmed.
Dr. Nahas' and Dr. Morishima's reports here have clinched the issue.
One must notice that general anesthetics as a class can also produce
fetal abnormality. A provisional hypothesis for teratogenicity, there-
fore is that this action of cannabis reflects its fat solubility and re-
2 Acceleration of the heart rate.
3 Extra beats of the heart originating not, as normally, in the auricles, but In the
ventricles themselves.
* A condition where the ventricular contraction becomes uncoordinated, and cardiac
output falls.
75
lation to anesthetics, and constitutes a sort of anesthesia, for in-
stance, of limb buds developing in the fetus at critical periods—
hence the reduction-deformity. It must be stressed that all I have
said refers simply to the development of the fetus. There is also
the question whether the genetic material, perhaps as a result of in-
terference with cell division is altered — giving life to heritable
defect.
CARCINOGENICITY AND LUNG PATHOLOGY
Like the tar from cigarettes, reefer tar is carcinogenic when painted
on mouse skin. Cannabis smoke produces changes in cultures of lung-
tissue, and Dr. Leuchtenberger will be mentioning this, including
loss of contact-inhibition between cells. THC in low concentration
resembles the carcinogen methyl-chlolanthrene in generating malig-
nancy in rat embryo cells incubated with a murine leucemia virus,
but is slower in action. The irritant effect of the smoke on the respi-
ratory tract is well known to users and is associated with bronchial
pathology.
These effects are becoming very important. Originally, one was
uncertain about their significance, and about what the balance would
be between the facts that more cigarettes than reefers will normally
be smoked in any one day, whereas inhalation and retention of the
smoke is much deeper and more efficient with the reefer.
Senator Gurney. Would you describe what a reefer is to the com-
mittee ?
Dr. Paton. A reefer is a marihuana cigarette prepared in dif-
ferent ways in different parts of the world.
But now lung damage, in the form of emphysema, is being re-
peatedly recorded and I was very interested to hear, in Dr. Heath's
presentation today, of the respiratory condition of his monkeys.
Emphysema is normally a disease of much later life; but now the
quite unexpected — to me, at least — prospect of a new crop of respi-
ratory cripples early in life, is opening up. Originally, I thought
the cancer risk was the main problem ; cannabis has never been used
extensively in a society with an expectation of life long enough to
show a carcinogenic effect in man, until recent years. In effect, a
new experiment in cancer epidemiology started 5 to 10 years ago.
To this I would now add respiratory pathology generally; and be-
cause it shows itself early, just as with cigarette smoking bron-
chitis is an early warning of that pathology, I believe that medical
epidemiological studies of pulmonary pathology of cannabis are on
a wide scale, are now urgent for getting an early warning of a
carcinogenic situation.
CELLULAR EFFECTS OF CANNABIS AND THC
Numerous such effects have now been described, which we can
often class as cell pathology, including actions on microsomes,1 on
mitochondria,2 on neurones, fibroblasts, white blood cells, and on
dividing cells, affecting metabolism, energy utilization, synthesis of
1 Structures inside the cell, particularly liver cells, responsible inter alia for detoxl-
catlon.
2 Structures Inside cells responsible for energy production.
76
cellular constituents, and immunological responses. To this we must
add the recent observation that chronic administration of THC to
young rats leads to a reduction in brain and heart weight. Such
effects are to be expected, rather than a matter of surprise, from a
drug with a high affinity for lipid in a cell membrane. It should be
noted that the local concentrations of THC or its metabolite in the
cell membranes will be far higher than those in the blood ; theoreti-
cally, one would expect a concentration factor of several hundred;
experimentally, concentrations of 600-fold with brain and 380 with
red cell membranes.
An important aspect of these effects is what they imply for matura-
tion of an individual; we are concerned not only with the effect of
a drug on a mature adult, but also what it does to schoolchildren
down to the ages of 11 and 12, still developing in many ways. The
interference by cannabis with both cell metabolism and cell divi-
sion is very worrying.
Mr. Sourwtne. Mr. Chairman, may T ask one question ? Am I cor-
rect in understanding the gist of what you are saying is this: that
widespread use of marihuana is likely to produce in our children a
generation of little old people?
Dr. Paton. I think that is a little further than that in what I am
saying, but it is a very accurate description. It is only an opinion
but it is a very accurate expression of it,
Mr. Sourwtne. And no one could predict what the third genera-
tion would be in that case, could they ?
Dr. Paton. No.
THE RELEVANCE OF ANIMAL WORK
It may be argued that actions in animals are of little relevance to
man. However, the pharmaceutical industry, and the bodies which
supervise it, do not operate on this pre-Darwinian principle. Diffi-
culties chiefly arise when an inordinately high safety factor has
been stipulated. But there is also misunderstanding over rates of
dosage. It is to be expected that small animals will require propor-
tionately larger doses — per unit body weight — than man, just as
they need proportionately more food, because of their faster meta-
bolic rate. One can estimate a mouse dose on this basis as 10 times
that of man; taking this together with the rates of human use re-
ported in WHO Special Keport No. 478 — up to or exceeding 10
milligrams per kilogram THC per day — it appears that almost all
the experimental work reported in animals is relevant to man. The
conclusion is reinforced by the NIMH-sponsored toxicity studies on
monkeys. A daily dose of 50 milligrams per kilogram orally of THC
killed one of six monkeys; damage to the pancreas, ulcerative colitis,
and myeloid hyperplasia were noted. This result, at doses which
proved partially lethal at only 10 times some rates of human con-
sumption, makes no allowance for contribution by other toxic ma-
terials in cannabis.
TOLERANCE
I mentioned high rates of human use. People have expressed in-
credulty at this, yet it is well established. I would like to deposit an
article on consumption in a group of English students.
77
Senator Gurnet. The article will be received in the record and
made a part of the record if it is available.
[The article referred to may be found in the appendix, p. 393.]
Dr. Paton. This is perhaps the best evidence yet, since the com-
position of the actual reefers being used was measured ; uses ranged
up to 199 milligrams THC per day. around 20 times the ordinary
dose for a high. By itself it shows the degree of tolerance that is
achieved, with the resulting need to take high doses for an effect, By
the same token, toxicity and accumulation at these levels must be
considered.
DIFFICULTIES IN THE EXTENSION OF ANALYTIC WORK TO MAN
Although there are a number of human studies on the effects of
single small doses, there is still no systematic modern study of the
bodily effects of continued cannabis administration. One reason is
that while limited dosage is acceptable for volunteers, dosage over
a prolonged period at the higher rates of use at least in my view,
is not. It would be possible to study users themselves, if a method
of urine and blood analysis existed capable of verifying their actual
consumption.
If I could interpose here, near Oxford people have bought horse
manure and smoked it as cannabis. There are other similar examples
that are known by people familiar with the field.
Senator Gurnet. That's a pretty dirty trick.
[Laughter.]
Dr. Paton. Biochemical verification, however, is at present not
practicable; as a result only the subject's testimony as to his rate of
consumption of a substance of unknown composition is available,
and this is hardly sufficient. Once methods of analysis of body fluids
are adequate, the position should improve considerably.
PSTCHOLOGICAL EFFECTS IN MAN
It is nevertheless possible and useful to construct a rough com-
posite picture of all of the psychological effects in man, if one
brings together a number of things.
(a) The neurophysiological observations, in man and animals, of
the kind which Dr. Heath has already discussed, of hypersynchron-
ous discharges from the deeper parts of the brain — not the cortex —
as a result of giving cannabis or THC. These discharges have been
termed "epileptiform."
(b) The observation by Campbell and his colleagues of an ap-
parent loss of brain substance in the deeper regions, in a group of
young chronic cannabis users. This needs further exploration, and
it is likely that it is now possible with new noninvasive radio-
graphic techniques.
Senator Gurnet. What do you mean. Professor, by loss of brain
substance?
Dr. Paton. Dr. Campbell's paper [see appendix, p. 383] has been
deposited in an earlier hearing, and what he observed was, if you
inject air into the spinal cord and you adjust the position of the
patients head, you can get it to track into the inner fluid-filled cham-
78
bers of the brain called the ventricles. He then x-rayed them and
in short, found in a series of 10 the ventricles were significantly
larger than in a series of 13 best controls that he could obtain. Be-
cause the skull is a rigid box, if there is a larger empty space inside
it the total substance of the brain must be correspondingly reduced.
It was on that type of observation that he thought there must be a
reduction in the mass of the brain, and it pointed also to the locali-
zation where that reduction was taking place. There was a very in-
teresting change of shape of ventricles that became rounded; and
that suggests the loss of substance was in fact in adjacent regions to
the ventricles — a point which Dr. Heath has already taken up at
this meeting.
(c) The cumulative property of THC, and its affinity for fat and
hence for cell membranes.
(d) The numerous psychiatric reports of gradual psychological
change, which becomes less and less readily reversible, the longer
the cannabis exposure. [This was first pointed out by Dr. Brom-
berg 1 in this country in 1939, although delayed recovery may well have
been known in the Moslem community in medieval times; see
Schwarz, J. Amer. Med. Assn. 223, p.* 195. 1973.] This suggests
something permanent or semipermanent.
(e) The fact that most of the elements of this psychological
change — paranoid feelings, change in mood, cognitive impairment,
loss of memory, loss of concentration, amotivational state, introspec-
tive preoccupation with internal imagery, hallucination — can be re-
versibly produced by single doses of THC or cannabis in normal
volunteers.
(f) The ability of cannabis to affect cellular metabolism and cell
division.
These findings converge to a remarkable extent in supporting a
prima facie view that repeated cannabis use acts on the deeper parts
of the brain — where sensory information is processed and mood con-
trolled; that this is at first reversible, but becomes more persistent
as cumulation occurs, and that later irreversible changes occur with
loss of brain substance, due either to interference with the capacity
of brain cells to synthesize their requirements or to interference with
cell division.
It is quite likely that all this would be accepted and acted upon,
by the cannabis user, were it not for the visual imagery, and —
here cannabis is very like nitrous oxide — the euphoria and the con-
viction of insight and cosmic significance.
Mr. Sourwine. Nitrous oxide is laughing gas ?
Dr. Paton. Laughing gas.
COMPARISON WITH ALCOHOL AND TOBACCO
One may summarize this as follows: (1) Alcohol is taken, often
diluted with food, and often for taste or to quench thirst rather than
for psychic effect; it is eliminated in a few hours, there is little or
no evidence for carcinogenicity or teratogenicity particularly if
nutritional defect and correlation with smoking are allowed for;
iBromberg, W. (1939). J. Amer. Med. Assn. 113, 4.
79
psychotic phenomena only occur after heavy and prolonged dosage :
it occurs naturally in the body of animals, and probably also in
man; it has valid medical uses for nutrition and as a vasodilator;
it escalates only to itself; the price paid for overuse is paid in
later life.
(2) Tobacco is taken partly for relaxation, partly to assist work,
and there is some evidence of an improvement in mental function;
the nicotine in it is rapidly metabolized and noncumulative ; the evi-
dence suggests that it is the tar that is carcinogenic, and the risk
can be reduced if inhalation is avoided, nicotine being absorbed
through the mouth; it is not teratogenic; no psychotic phenomena
occur; it is not a natural constituent; it has no medical use; it does
not escalate; the price paid for overuse is paid in later life — reduc-
ing life expectancy from about 75 years to 70 years.
(3) Cannabis is taken specifically, and usually by itself— some-
times with other drugs — for its psychic action ; it is cumulative and
persistent; its tar is carcinogenic and failure to inhale reduces its
effect considerably; experimentally it is teratogenic; psychotic phe-
nomena may occur with a single dose; it is not a natural constitu-
ent; prolonged trial in medicine from the 1840's led to its abandon-
ment from pharmacopeias; it can predispose to the use of other
drugs; the price for its overuse is paid in adolescence or in early
life.
Senator Gurnet. I am going to have to interrupt here, Professor
Paton. I have another vote and that means I have just enough time to
get there, so I will recess this until later.
[A recess was taken.]
[Whereupon, at 12 :45 p.m., the hearing was recessed, to reconvene
at 2 p.m., this same day.]
Afternoon Session
Senator Gurnet. The subcommittee will come to order. We will
begin by finishing the statement of Professor Paton.
STATEMENT OF DR. W. D. M. PATON, PROFESSOR OF PHARMA-
COLOGY, UNIVERSITY OF OXFORD— Resumed
Dr. Paton. I would like to summarize the last point I was making
by saying it seems to mc that cannabis shares the disadvantages of
alcohol and tobacco, together with its own psychotogenic and bio-
chemical actions, its chronic effects being accentuated by its cumula-
tive tendency, giving it much earlier adverse action.
THE QUESTION OF LEGALIZATION
I should like to turn now to the question of legalization, about
which, of course, I speak only as an individual.
(a) Viewing cannabis as if it were a new pharmaceutical prod-
uct, I could not agree to approval being given to the introduction,
for general and repeated consumption, of a substance shown experi-
mentally to be carcinogenic, teratogenic, and cumulative, and able
to interfere with a variety of cellular processes, until it had been
80
shown, quite unequivocally, that, for some reason, humans were
exempt from the actions concerned.
(b) There is no rational dividing line between cannabis and
other drugs such as LSD or some opiates. A high dose of cannabis
overlaps with a low dose of LSD, in its hallucinatory and psycho-
tomimetic action, and with the less active opiates, in respect of
analgesia, euphoria, and "day-dreaming" state. In fact, since can-
nabis is unique among these drugs for its cumulative action, I
would put it lower in the list for legalization than some others. One
needs to ask, what other drugs can produce prolonged cognitive
impairment in a young person?
(c) In a similar way, it does not seem feasible to me to propose
legalization of cannabis of limited potency. There is in fact an
analogy with alcohol here: we have marihuana, 1-2 percent THC,
and weak beers, 2 percent alcohol; hashish, say 8 percent THC,
wines, 8-15 percent alcohol; and so to speak, "hard hashish," that
is hashish oil, on the illicit market — up to 30-40 percent THC, hard
liquor, 30-50 percent alcohol. To suggest one could legislate for 1 or
2 percent THC is like suggesting one could legislate for weak beer.
It would remove none of the present objections to cannabis legis-
lation, while yet allowing the drug to be used.
(d) The significance of progression from cannabis to other drugs
has been much discussed, and my own 1968 paper severely, but
fallaciously, criticized. The fallacy was exposed, inter alia, by R. C.
Pillard in "the New England Journal of Medicine (197) 255, '416-7).
The final report of the Le Dain Commission concluded as regards
LSD that "the use of cannabis definitely facilitates the use of LSD
or predisposes a certain number of individuals to experiment with
it." The arguments they give, including the relationship between the
nature of the two drusrs and the findings that over 95 percent of
those who had used LSD had used cannabis, were the same as those
I had advanced in respect of heroin and cannabis. My argument
also cited the remarkable temporal coincidence between cannabis
convictions and heroin addiction in the United Kingdom; evidence
of this sort has not been provided in respect of LSD.
Today, with the further evolution of drug use, it seems clear that
depending on availability of drug, various patterns of progression
are possible, in which one would include cannabis to opiates, can-
nabis to LSD, and cannabis low potency to cannabis high potency.
Simple reasons can now be seen; that cannabis increases suggesti-
bility— this was referred to in the Wooten Report in Britain, in
1968 — impairs memory, that is, your capacity to remember the
criteria by which you judge your actions; and that it overlaps in
pharmacological actions with opiates — euphoria, analgesia, day-
dreaming state, and with LSD — visual imagery. It is therefore well-
suited to providing a halfway house, converting one major step
directly to use of opiates, LSD, or hashish, into two smaller and
more easily accepted steps.
The growth of polydrug use may now have made it impossible to
define patterns of progression accurately. But I would still hazard
the opinion that no program to get rid of opiate addiction or LSD
use will really succeed until cannabis use declines. Cannabis can
serve as well to cause relapse, as to initiate drug use.
81
(e) The last point in weighing up the virtues and disadvantages
of legalization, of which I am merely putting one side, of course,
concerns the age of those involved. If someone dies of alcoholism
or lung cancer at the age of 50 onwards, that is a loss; but the in-
dividual has had 30 years of adult life, and the chance to make
his own contribution. But the adolescent, dead or socially inacti-
vated by 20 years old, has never even had a start on mature life;
the loss, both* for him or her, and for society, is incalculably greater.
Senator Gurnet. What do you mean. Professor, by socially inacti-
vated ?
Dr. Paton. It means that he is brought to a state where he can-
not make the ordinary contribution one expects. That the Jobs he
does, the building up of family, the role he plays in society are
just so much less than his potential.
Senator Gurnet. Caused by the excessive use of marihuana or
cannabis ?
Dr. Paton. Yes. One is referring to so many pictures. With a
drug addict, that is a complete pattern. But I do not believe it is
necessary to postulate full development of classical drug addiction;
some of the boys that I see who have had a university training and
now are doing trivial jobs, if they go on like that for 5 years at a
vital period in their life, I think that is going to mean a measure
of social inactivation.
THE DIFFICULTY OF FRAMING A POLICT
My own opinion is that it would be disastrous to make it legal
even to possess cannabis. If one talks, not to lawyers or sociologists
who are concentrating on penal problems, but to schoolchildren and
students, at least in the United Kingdom, it is not at all clear that
a majority would even wish for this to happen. But nevertheless,
there would be for the foreseeable future a large number of people
breaking the law, just as they do over speed limits, customs regula-
tions, and income tax return. It seems that one would have to treat
a cannabis possession similarly.
I might say I find it dimcult to extrapolate from English to
American practice here. We do not have traffic tickets. We have,
it is a court offense, and I do not want to be misinterpreted by say-
ing that I think cannabis possession should be treated too trivially.
I am still thinking of it as a court offense. One has to treat can-
nabis possession similarly accepting that the majority of offenses
would not be recognized, yet maintaining the legal position about
it. Viewing it in this way might, indeed, help to deglamorize it.
But something more is needed. It would be quite right for the
debate to sharpen our criticism of alcohol and tobacco. Further, for
a significant number of youngsters, who have found a reward or
consolation, or pleasure in cannabis, there is the question, "If not
pot, what?" It is for the framing of a constructive answer to this
question that new creative thinking is urgently needed.
Senator Gurnet. Thank you, professor. I have a lot of questions
I would like to ask but we have had such a situation over there
in the Senate floor today that we lost about half of our time so I
82
am going to let counsel do most of the questioning so we can get
at the areas that we want to put in the record. I just do want to
ask you one question.
You said, in your statement you said you spent a good deal of
time upon the effects upon cells of cannabis and so I would ask you
this question : in your opinion, does the use of cannabis result in
permanent cell damage to the human body ?
Dr. Paton. I think you have to specify the cell. It seems to me
it is quite clear from the recorded evidence about bronchial, pulmo-
nary pathology that you can say there are cells that were damaged.
I think the fundamental question one is getting at in that question,
well, there are two points. It has been said that cannabis does not
affect cells ; a popular book on the subject says no sign of cell damage
has been recorded. That is just false. There are many such recorded
things in an experimental wrj.
But the real question, to my mind, is does it cause cellular dam-
age in the brain of an irreversible kind ?
Senator Gurney. That was the next question I was going to put.
Dr. Paton. And I do not think we can say other than that there
is a high probability of that. What this needs is top class neuro-
pathology to be done as microscopical sections or electromicroscopic
photographs showing the change and until that is done people can
disbelieve it. But I think the probabilities are high.
Senator Gurney. In any event, the use of cannabis certainly has
a dramatic effect upon cells in the brain.
Dr. Paton. Yes. Functionally, there is no doubt about the effect
on them.
Senator Gurney. Counsel.
Mr. Martin. Just a few questions. General Lewis W. Walt, when
he reported to the subcommittee on the world drug situation in
1972, described marihuana as a kind of universal threshold drug
through which young people make their entry into the drug cul-
ture— the drug of first preference. Would you consider this an
accurate description ?
Dr. Paton. On a simple question of fact in British surveys, at
least, it is not always a drug of first preference, and I think if one
wants to look generally one has at least to put amphetamines along-
side.
I do not know whether it is the occasion of entry into a culture
or a cause of the culture. I was very struck, despite its, I suppose,
descriptive character, by the paper by Drs. Kolansky and Moore —
I think it is being talked about later — which showed not only that
with people receiving cannabis, their personality and behavior went
a certain way, this was known, but also that if they gave up using
cannabis they tracked back in their religions or in matters such as
habits or family breakdown, or loss of jobs; and I have begun to
wonder, as other people have, whether it is not that cannabis is
an entry to a culture but that cannabis creates an outlook which
generates a culture. So that I do not quite want to accept General
Walt's remarks and I just make those comments on them.
Mr. Martin. Thank you.
Now, it is also widely believed in this country that marihuana does
83
not lead to tolerance or habituation. That statement has figured in
a number of reports. Does this conform with your own experience ?
Dr. Paton. I have had no direct experience in man, just in re-
ports, but it seems to me the evidence shows it is false. It seems
to me it has been shown to be false since Mayor LaGuardia's re-
port in the 1940's. They had experiments there which showed users
were three times more tolerant than nonusers, and all the evidence
since then has substantiated this.
So far as I know, the only reason to suefffest that it is not true
is what I regard as a rather poorly controlled study by Drs. Weil,
Zinberg and Nelsen which, of course, is very well known.
Mr. Martin. You mentioned the fact. Professor Paton, that you
have by this time accumulated some 700 scientific research papers
on marihuana since you first embarked on this study some 5 or 6
years ago. Would you be prepared to offer an estimate of the
consensus of these papers?
To put the question a little differently, do you see any trend in
either direction on the part of cannabis research scientists around
the world ?
Dr. Paton. I think scientists as a body tend to feel vulnerable
about value judgments, and I would say the bulk of these papers
rather try to avoid saying cannabis is good or cannabis is bad.
At the same time I think, and I will not put it stronger than
this, there is a mental reserve which has begun to appear in the
scientific literature and I certainly notice this at scientific meet-
ings. There was a meeting a fortnight ago in England where I was
surprised at the caution about cannabis expressed. I would link
this, perhaps going beyond your question, by saying that I think
too, there has been a change in the nature of the work; that now
in what I call cell pathology, analytic work on cellular behavior,
there is a great deal of recent work of that kind, and much less
functional experimental psychology studies, although that goes on.
I suspect that these two trends are linked. People are seeing how
important it is to ask, we will call it experimental functional or
pathological or cellular questions, and that the changes toward
reserve of attitude and in experimental techniques in fact are linked.
Mr. Martin. If I understood your remarks correctly, Professor
Paton, what you said implies that you have met very few cannabis
research scientists who now take a tolerant or benign attitude to-
ward cannabis, who feel that it is not seriously harmful and we do
not have to be terribly concerned about its spread through society.
Dr. Paton. I do not usually raise this subject with them because
it is in the area where one feels vulnerable. But wherever I have
raised it, I would say that your statement is absolutely right. Now,
practically, none of them are willing to let cannabis go free.
Mr. Martin. That concludes my questions, Mr. Chairman.
Senator Gurnet. Mr. Sourwine.
Mr. Sourwine. I have one. Mr. Chairman.
Professor, am I correct in my understanding from your testi-
mony about teratogenicity that when a pregnant woman smokes
marihuana her baby is in danger ?
Dr. Paton. Yes.
84
Mr. Sourwine. I have no other questions, Mr. Chairman.
Senator Gurnet. One final question, Professor. You mentioned
in your comments on the psychological effects of cannabis, you
mentioned down here that there were paranoid feelings, changing
mood, cognitive impairment, loss of memory, loss of concentration,
that sort of thing, and you mentioned that in respect to this could
be reversibly produced by single doses of the chemical THC.
My question is, do you have anything to say on the continued
and persistent use of cannabis ? Would' it bring permanent para-
noid feelings in these other matters that I just referred to?
Dr. Paton. My own thinking about this starts with a paper by
Dr. Bromberg I mentioned earlier. He did not himself analyze
it in this way but if you do analyze it1 you end up roughly like
this about a number * of psychopathological responses which he
studied as a clinical psychiatrist; you find if the person consumed
cannabis iust a day or two they recover very quickly from the
psychopathology. If it had been weeks it might take some days.
Tf it had been months it would take weeks. If it was longer than
that it became months or more.
This agrees with everything I have seen privately. I do not think
we can name the numbers involved. But you know, so long as one
sees these results, I do believe that it is a major thing; so much so,
if I can say so, that my own future research, for which the Medical
Research Council has given me a very substantial grant, is going
to be to try to throw light on what is happening not only after
cannabis but after alcohol, and barbiturates, in the way of pro-
longed damage. The evidence as it stands makes me believe either
that the drug is persisting as such for much longer than we think
even on existing evidence — which would just suggest for months
at most — or that cells have been killed or very badly damaged and
that time is required for repair. Or, and this is a third possibility
which has not been suggested, that something is made in the body
from the drug, what one calls a reactive intermediate, which com-
bines in a new way with constituents in the membrane of the cell
to produce more or less permanent changes in function. These are
three different things, and my own personal research effort is going
to try to discover which and what the laws governing these are.
Senator Gurnet. Well, thank you very much, professor, for your
contribution to this panel and these hearings.
We will take our next witness, Dr. Stenchever.
Doctor, would you identify yourself for the record ?
TESTIMONY OF DR. MORTON STENCHEVER, UNIVERSITY OF UTAH
Dr. Stenchever. Yes; I am Dr. Morton Stenchever, chairman of
the Department of Obstetrics and Department of Gynecology of the
University of Utah.
Senator Gurnet. I will go into a few questions regarding your
background to determine your expertise.
You obtained your medical degree in 1956 at the University of
Buffalo?
1 See table III, page 352, in "Marihuana," ed. R. Mechoulain, Academic Press, 1973
in chapter by W. D. M. Paton, R. G. Pertwee and Elisabeth Tylden.
85
Dr. Stenchever. Correct.
Senator Gurnet. You completed your residency in obstetrics and
gynecology at Columbia Presbyterian Medical Center in 1960?
Dr. Stenchever. Yes, sir.
Senator Gurnet. And you had a post-doctoral fellowship m the
field of mammalian cell genetics— or what is that— cytogenetics—
you can see I am no doctor — at Case Western Reserve University in
Cleveland in 1962?
Dr. Stenchever. Yes, sir.
Senator Gurnet. And since 1965, you have been in charge of two
major laboratories working in the field of human and mammalian
cytogenetics ?
Dr. Stenchever. Yes. Cytogenetics.
Senator Gurnet. The first laV oratory you took charge of was at
Case Western Reserve ?
Dr. Stenchever. Yes.
Senator Gurnet. Since 1970 you have been in charge of a re-
search laboratory at the University of Utah, where you also serve
as chairman of the department of obstetrics and gynecology?
Dr. Stenchever. Yes, sir.
Senator Gurnet. And you are the author of a medical textbook
entitled, "Human Cytogenetics" ?
Dr. Stenchever. Yes, sir.
Senator Gurnet. And the author or coauthor of some 50 scientific
papers?
Dr. Stenchever. Yes, sir.
Senator Gurnet. Generally, what are they on ?
Dr. Stenchever. The majority are on genetics.
Senator Gurnet. The most recent article that you coauthored
was entitled, "Chromosome Breakage in Users of Marihuana", which
appeared in the January 1974 issue of the American Journal of
Obstetrics and Gynecology ?
Dr. Stenchever. That is correct.
Senator Gurnet. All right, Would you proceed with your state-
ment, Doctor?
Dr. Stenchever. Yes. The statement I am presenting today is
essentially the report on research conducted by a team consisting of
myself, and my colleagues, Terry J. Kunysz and Marjorie A. Allen,
at the University of Utah College of * Medicine, Department of
Obstetrics and Gynecology. Basically, this research was performed
during 1971 and 1972. It was recently described at greater length
in the January issue of the American Journal of Obstetrics and
Gynecology.
The observation that psychoactive drugs could cause chromosome
damage in users was introduced by Cohen and associates and others
several years ago. It was first reported that chromosome damage oc-
curred because of the use of lysergic acid diethylamide, LSD. How-
ever, a number of studies since that time have cast doubt on whether
the drug actually damages chromosomes in users and in a recent
review of the literature, Lang concluded that it probably did not.
Most users of LSD also use other drugs, particularly marihuana.
Gilmour and coworkers found no increase of chromosome aberrations
in light users of marihuana. However, they did find an increase in
chromosome breakage in 11 heavy users. In most cases, these users
were taking multiple drugs. In a study of rat cells. Pace and as-
sociates could find no significant increase in chromosome breakage
after exposure of the cells to marihuana in vitro. Studies by Neu
and colleagues and by myself and Marjorie Allen yielded no in-
creased incidence of chromosome breakage in the in vitro experi-
ments in human cells exposed to delta-9-tetrahydrocannabinol, THC,
one of the active ingredients in marihuana. Marihuana, however, is
a composite of a number of agents and its effect on chromosomes is
still to be defined.
It was the purpose of our study to report the results of the effect
of marihuana use on the chromosomes of a group of healthy college
students.
Forty-nine users — 29 males and 20 females — and 20 control sub-
jects— 12 males and 8 females — were studied concurrently. The
average age of the users was 22.3 years, with a range of 17 to 34,
and the average age of the control subjects was 28.7 years, with a
range of 13 to 52 years. All of the users were college students.
Some of the controls were college students while others were mem-
bers of the staff working at the university. I might add it was diffi-
cult to find people who were not using marihuana. No individual
in the control group has been exposed to any drugs or medications
for 6 months prior to the study, other than an occasional aspirin, and
none had been exposed to ionizing irradiation for at least 6 months.
A complete medical history was taken on all individuals in the
study, as was the recording of the use of alcohol, nicotine and
caffeine. The use of marihuana was tabulated for each user accord-
ing to the date and amount used, classification of the drug as esti-
mated by the user, and any other drug used concurrently. All users
smoked as their means of ingestion. Marihuana had been used for
a minimum of 6 months and a maximum of 9 years, with an aver-
age of 3 years, and previously had been used between 5 hours and
30 days prior to the study.
The studies were carried out on blood leukocytes — these are white
blood cells — and tissue culture and harvesting techniques were of a
standard type used in our laboratory for several years and reported
on many occasions, and in keeping with techniques used in other
laboratories. When slides of chromosome spreads were prepared,
they were coded so that the observer would not know whether the
slides were from a study or control patient. One hundred consecu-
tive intact methaphase spreads for each individual were scored
for chromosome damage, including gaps and breaks, and for the
presence of abnormal chromosomes. Every abnormal cell was photo-
graphed for careful analysis. We were scoring methaphase plates —
these are cells which are undergoing mitosic cell division, and that
is the time at which you can see the chromosomes most clearly. A
chromosome, for those of you who are not acquainted with it, is a
structural entity in the cell nucleus which contains the genes and,
therefore, is dircetly related to the phenomenon of heredity.
87
RESULTS
Five basic questions were asked during the study. The first was
"Does marihuana use cause chromosome damage?" There was an
average of 3.4 cells with chromosome breaks — range 0 to 8 — per
100 cells per user and 1.2 cells with breaks — range 0 to 5 — per 100
cells per control subject. In other words, 3.4 percent of the cells in
the users showed damage, 1.2 percent of the cells in the controls
showed damage. The difference was significant at the p < 0.05 level.
While there was an increase in abnormal chromosome forms seen
in the users group over those in the controls, however, the numbers
of cells involved were small enough that no statistical analysis
could be carried out.
Question 2 — "Does the concurrent use of other drugs influence
the extent of chromosome damage?" Twenty-seven users of mari-
huana reported the use of no other drugs during the period of mari-
huana use, whereas 22 reported the use of other drugs, including
barbiturates, amphetamines, tranquilizers, mescaline, LSD, and
heroin. Chromosome damage in users of marihuana alone averaged
3.1 cells with breaks per 100 cells, whereas users of marihuana and
other drugs averaged 3.7 cells with breaks per 100 cells. The differ-
ence was not statistically significant.
Question 3 — "Does the frequency of use relate to the extent of
damage?" For the purposes of this study a light user was considered
to be an individual who used marihuana one time or less a week
and a heavy user a person who used marihuana two or more times
a week.
Senator Gurney. When you say using marihuana, are you talking
about smoking one cigarette ?
Dr. Stenchever. If they smoked one cigarette once or less a week
they were considered light users. If they smoked two or more a week
they were considered heavy users, a bit different from the definitions
you heard this morning but this was the standard we used.
Light users had used the drug between 6 months and 9 years
with an average of 2.9 years and had last used the drug 18 hours
to 30 days before the study, with an average of 5.4 days. Heavy
users had used the drug 9 months to 7 years with an average of
3.4 years and had last used the drug 5 hours to 5 days with an
average of 1.4 days prior to the study. Twenty-seven users fell into
the heavy use category and had an average breakage rate of 3.8
cells per 100 while 22 users were in the light category and had a
breakage rate of 3.2 cells per 100. The difference was not significant.
The fourth question involved whether or not the use of caffeine
concurrently with marihuana influenced the extent of chromosome
damage. While very few of the individuals did not use caffeine, the
spread among nonusers of percent breakage was such that there
seemed to be no effect additive by the use of caffeine over the use
of marihuana alone.
The fifth question was "Do male or female subjects respond dif-
ferently to marihuana with respect to chromosome damage?" No sta-
tistical difference could be seen between them, the 29 male subjects
having a breakage rate of 3.7 and the 20 female subjects a break-
age rate of 2.9 cells per 100, a nonstatistically significant difference.
88
DISCUSSION
All data from the study including historical data was computer-
ized and multifactorial analysis carried out. That is, we compared
all factors to all other factors in computerized fashion. The only
positive correlation of statistical significance was the use of mari-
huana and the presence of chromosome damage.
A fault of previous studies had been that frequently the drug
users had been individuals on multiple drugs and with poor eating
and hygiene habits. The individuals in our study were all college
students with good nutrition and, for the most part, good hygiene.
The study did not demonstrate which ingredient in marihuana was
capable of doing the chromosome damage and future studies in
our laboratory on in vitro and animal studies will hopefully deter-
mine this point. The study did not shed any light into the ques-
tion of whether or not this chromosome breaking agent or any other
chromosome breaking agent is capable of causing abnormalities of
unborn children, an increased mutation rate, or an increased inci-
dence of cancer. However, all of these possibilities are potentially
there and only further studies of a more detailed nature will be
able to answer these questions. It is of interest that a recent study
published in the Journal of the American Medical Association by
Jacobsen and Berlin entitled "Possible Keproductive Detriment in
LSD Users" pointed out that there was indeed a higher incidence of
abortion rate and fetal abnormalities in 140 women and their con-
sorts who were using LSD. Unfortunately, in reading this paper
it became evident that 100 of these individuals were using mari-
huana as well. The ability to pinpoint actual problems with any
specific drug is difficult in a human experiment because humans
tend to experiment with a number of different drugs and also, of
course, are subjected to many other variables in their life style.
In conclusion, we feel our data have demonstrated that there is an
increased chromosome breakage rate in users of marihuana and that
this apparently is not related to the extent of use of the drug, as
light users had about the same damage rate as did heavy users. We
have not demonstrated a link between marihuana use and an in-
crease in fetal damage or fetal loss, in mutagenesis or in the in-
creased incidence of cancer. We have demonstrated a need to identify
the agent in marihuana which causes chromosome damage and our
data would suggest that further studies in both human and animals
should be undertaken to determine if indeed this agent is capable
of damaging fetuses, causing an increased mutation rate and pos-
sibly being related to the development of neoplasms.
Senator Gurnet. Well, as I understand it, Doctor, your studies
do not show, even though there was chromosome damage, exactly
what the effect of that would be. But let me ask this question. Are
there any medical studies that show what the effect of chromosome
damage is ?
Dr. Stenchever. Most of the data on what chromosome damage
means is tangential. For instance, in people who are irradiated
there is a higher incidence of abnormal children and a higher in-
cidence of cancer development and they indeed have an increased
number of chromosome breaks in their circulating: cells and in the
89
cells of other tissue. In people from certain families, where familial
conditions tend to be associated with increased chromosome break-
age rates, in other words, more fragile chromosomes, the incidence
of abnormal children and cancer is higher in these families. A
number of agents such as the anticancer drugs are capable of
breaking chromosomes and indeed have been associated with a
higher incidence of malformation in fetuses. So it is tangential
data. When you find a chromosome breaking agent, what you have
is an agent which is capable of getting into the nucleus of a cell
and causing damage. What you see in chromosome damage is the
process of cell damage.
Now, there are a number of conditions where rearrangements for
chromosomes occur, in other words, two chromosomes breaking and
exchanging parts in the healing process leading to well-known medi-
cal abnormalities which are diagnosable and which are associated
with chromosomal abnormalities. And there is a whole slew of these
conditions.
One has to ask how do you get to this? What makes these people
have rearranged chromosomes, and we suspect somewhere along the
line breakage took place and rearrangement took place? So an agent
which can break chromosomes can conceivably lead to these types
of problems.
Another thing that an agent that can break chromosomes can
potentially do is damage the genes in the chromosomes and, there-
fore, bring about a mutation, and a number of breaking agents are
indeed mutagens, so we have that information.
Now, the other thing that is potentially there is that the damage
to the nucleus may injure the cell in such a way that it may elude
the body's basic filtering defense mechanisms and lead to a neo-
plasm. We know most cancers do come from one cell and that is
a cell that somehow eludes the body defense mechanisms and
there are probably people who are more likely to do this than
others. In other words, cancer-prone individuals. So if chromosome
damage takes place in these people they are at greater risk of de-
veloping cancer than other people.
Senator Gtjrney. Mr. Martin.
Mr. Martin. Is it correct, Dr. Stenchever, that the research which
you conducted with your colleagues in the first research which ex-
perimentally substantiates that marihuana results in chromosome
breakage ?
Dr. Stenchever. Yes, sir.
Mr. Martin. You make the point in your paper that prior re-
searchers, or a number of prior researchers, have come up with
different findings, that is, they found no evidence of breakage. How
do you account for the difference between the results they obtained
and the results you obtained ?
Dr. Stenchever. Well, I think there are a lot of reasons for that.
Basically, most of the studies were small studies, where a number
of variables were not controlled, such as the use of other drugs. I
believe that in coding and scoring for breaks one must take great
care in doing it blindly because if one does not then research bias
comes into it whether you are for or against what you are look-
ing for. It is only human to only see what you want to see.
90
In our laboratory all of the studies that we have ever carried
out in the area of chromosome damage have been done blindly so
that the individual doing the scoring does not know from where
the cells came and I think that has been one of the bigger criticisms
that have come to the previous studies.
Mr. Martin. In examining all the facts in retropect, Dr. Stenchever,
do you believe that you and your colleagues controlled all of the
factors in your experiments as carefully as they could be controlled ?
Dr. Stenchever. Well, we controlled bias because there was no
way that the individual doing the scoring could know who it —
which individual had furnished the blood. We tried to control the
other variables by taking as careful a history as we could, and by
computerizing all of our data and doing multifactorial compari-
sons so that we could identify at least which areas were statistically
significant. In that respect I would say we probably controlled the
variables. Of course, when you deal with humans you can only
go by what they tell you and I think this is the biggest problem
with human experimentation.
Mr. Martin. Has anyone faulted your research on the basis of
inadequate controls or procedures?
Dr. Stenchever. Not since it was published.
Mr. Martin. As you know, or as you are probably aware, your
study does not agree with a fairly recent study performed on mari-
huana smokers in Jamaica. This study found no evidence of chromo-
some breakage. In fact, they found nonsmokers had chromosome
damage slightly more often than smokers. Would you be prepared
to offer a comment on the difference between this finding and your
own findings?
Dr. Stenchever. Well, I did have the privilege of seeing a reprint
of this material, and there were a number of differences between
that study and our study, as I recall. There may have been some
technical problems in that the people reporting reported on 25
chromosome spreads per individual and then lumped all of their
data together so they were comparing the total number of cells from
users with the total number of so-called controls. I think this is a
hazardous thing. You have to consider each individual separately
and you have got to do enough cells so that you can overcome the
artifacts of small numbers, and 25 is a very small number.
The suggestion that only 25 cells were scored would make me
think they had technical difficulties because in our laboratory it
would be possible to score 10,000 cells if you had the urge to do
so. We get lots and lots of material to work with. But there are
tissue culture laboratories that probably have not gotten far enough
along in their technique to where this is possible, and when I see
very small numbers reported it implies to me that probably the
technique is at fault. When the technique is at fault then a tre-
mendous number of other variables that can influence the perform-
ance in tissue culture come into play and with critical data.
Control groups in our laboratory consistently have breakage rates
of between 1 and 2 percent. And as it has turned out here, 1.2 per-
cent and that is what we find year after year after year. I be-
91
lieve their control group showed a much higher number of break-
age which would again imply there were other factors at play.
I think, all in all, I would have to say I would really have to
see the specifics of their data but I would guess there were tech-
nical variances there that one could criticize.
Mr. Martin. You state that your research has satisfied you that,
contrary to previous impressions, LSD is not responsible for human
chromosome breakage. In the light of this, would you say that LSD
is safe to use or reasonablv safe to use ?
Dr. Stenchever. If I had to choose, I would probably use mari-
huana. I think LSD is potentially a very dangerous drug and, the
fact, that we could not prove it broke chromosomes would not
detract from my saying that it is a drug that should not be used.
One thing I think about the study of marihuana was their inability
to find chromosome damage in pure LSD users and our observation
that LSD users from previous studies had all been using marihuana
and, at the same time, we were doing a series of studies on repro-
ductive failure in our laboratory looking at couples who were in-
fertile or having habitual abortion looking for chromosome reasons
for their problem and, it became apparent that almost without ex-
ception when we found chromosome breakage in these people _ we
could elicit a history of marihuana use. It could be due to wide-
spread use of marihuana in the community and in no way is sci-
entifically valid but nontheless these two observations, the fact we
were seeing damage in marihuana users and we were finding no
damage in pure LSD users, we were fortunate enough to have a
smaller group, which led us into the experiment I just reported.
And I must say we did an in vitro study tissue culture study with
THC which turned out to be almost negative and I almost lost
interest in doing the current study because I thought we were deal-
ing with a drug which did not break chromosomes. But having
done this study I am convinced that marihuana is a breaking agent.
Mr. Martin. Have you been the object of any attacks or abuse
as a result of your work on marihuana and chromosome damage?
Dr. Stenchever. Well, I think that basically what happens is
people want to hear what they want to hear, and when I first pre-
sented these data in a conference a year ago it was picked up by the
newspapers, as one would expect. It was hot copy, and without any-
one having the opportunity to look at our data or our studies a
number of criticisms have come up. They said it obviously was
wrong, and I was attacked because I was an obstetrician and, there-
fore, knew nothing about genetics. Of course, they did not real-
ize I had had training in genetics as well, and a number of kinds of
superficial criticism came up which implied to me that people did not
want to believe marihuana was a damaging drug.
But I will say this: since the paper was published I have had no
criticisms so I think when people had a chance to look at the data
they become more reasonable.
IVIr. Martin. That concludes my questions. Mr. Chairman.
Senator Gurnet. Mr. Sourwine.
Mr. Sourwine. None, sir.
92
Senator Gurnet. Just one question of interest to me. Do you have
any problem in getting; subjects to test there at the university?
Dr. Stenchever. The problems I have are in finding controls.
Unfortunately, marihuana is in very wide use even on our campus.
I do not know whether it is this year but 3 years ago I polled 100
students and 98 had tried marihuana at least one time.
Senator Gurnet. How about LSD ?
Dr. Stenchever. LSD has fallen off in its use. When I find some-
one who has used LSD by and large, they are using a lot of dif-
ferent drugs, they are experimenting at a higher level than just
marihuana smoking.
Senator Gurnet. I am told that this hearing room has been re-
served beginning a few minutes from now, so we will go to room
1318. That is down the hall to the right around the corner. I am
sorry we have to do this but we thought we would be finished long
before now. Room 1318.
[Whereupon, the hearing was moved to room 1318.]
Senator Gurnet. The subcommittee will come to order again.
I hope you are patient.
Dr. Nahas, would you identify yourself for the record, please?
TESTIMONY OF DR. GABRIEL NAHAS, COLUMBIA UNIVERSITY
Dr. Nahas. My name is Gabriel Nahas, I am a research professor
of anesthesiology at the College of Physicians at Columbia
University.
Senator Gurnet. I will ask you a few questions about your back-
ground, you were born in Alexandria, Egypt, in 1920?
Dr. Nahas. Yes.
Senator Gurnet. You entered the University of Toulouse Medi-
cal School in 1938 ?
Dr. Nahas. Yes.
Senator Gurnet. While you were at the medical school during
World War II, you played an important role in the French Resist-
ance movement, is that right?
Dr. Nahas. Yes.
Senator Gurnet. For your activities in the French Resistance, you
received the Legion of Honor and the Croix de Guerre from the
French Government, the Order of the British Empire from the
British, and the Presidential Medal of Freedom with Gold Palm
from the United States, is that correct ?
Dr. Nahas. Correct.
Senator Gurnet. Your citation for the Medal of Freedom stated
that it had been awarded for your services in directing an evasion
network that had been responsible for the escape of 200 allied air-
men, half of them Americans, is that correct?
Dr. Nahas. Yes.
Senator Gurnet. I certainly want to congratulate you.
Doctor, on your qualifications, you received your medical degree
from the Toulouse Medical School in 1944 ?
Dr. Nahas. Yes.
93
Senator Gurnet. And you were subsequently given a Ph. D. in
physiology from the University of Minnesota Medical School in
1953?
Dr. Nahas. Yes.
Senator Gurnet. And from 1954 to 1955 you served as chief of
the laboratory of experimental surgery at the Hospital Marie
Lannelongue in Paris, and from 1957 to 1959 you served at Walter
Reed Hospital as chief of the respiratory section of the department
of cardiorespiratory diseases ?
In 1959 you joined Columbia University as associate professor
and director of research in the department of anesthesiology? In
this post you have had the rank of full professor from 1962 to date?
You also serve as an adjunct professor at the Institute of Anes-
thesiology of the University of Paris, Faculty of Medicine?
Dr. Nahas. Yes.
Senator Gurnet. And you are the author or coauthor of more
than 400 scientific papers, and the author as well of a number of
monographs ?
Dr. Nahas. Yes.
Senator Gurnet. In December 1972 you published a work entitled
"Marihuana, Deceptive Weed?"
It is accurate, is it not, that this book was given the cold shoulder
by all of the TV talk shows; that the New York Times failed to
review it, even though it had favorably reviewed some half-dozen
books that were promarihuana ; and that finally 16 faculty members
of the Columbia University College of Physicians and Surgeons this
last January 28, sent a joint letter to the editor of the New York
Times Book Section, urging that they let your book be reviewed,
in the interest of balance and fairness, is that correct ?
Dr. Nahas. Yes.
Senator Gurnet. Did the senders ever receive a reply to this letter ?
Dr. Nahas. No.
Senator Gurnet. Could you provide a copy of the letter for the
record ?
Dr. Nahas. Yes.
[The letter referred to follows :]
College of Physicians & Surgeons of Columbia University,
Department of Neurology,
New York, N.Y., January 28, 1974-
Mr. John Leonard,
Book Review Editor,
New York Times Book Review Section,
New York, N.Y.
Dear Mr. Leonard : The undersigned have read with interest the book by
Dr. Gabriel Nahas, "Marihuana, Deceptive Weed." Dr. Nahas, after thoroughly
discussing the scientific, medical and social aspects of marihuana concludes
that its usage is quite harmful to man and society. This stand contrasts
with that of other authors such as Dr. L. Grinspoon and Mr. E. M. Brecher
who minimize the danger of this drug and advocate the legalization of mari-
huana sales. The books of these authors were favorably reviewed in the
Sunday New York Times Book Review Section.
It seems therefore only fair to us that a Review of the book by Dr. Nahas
be also published by The Times, so that the other side of the marihuana
33-371 O - 74
94
story be also presented to your readers. This Review would be especially
justified, since recent scientific evidence indicates that marihuana induces
cellular damage in man.
Sincerely yours,
William M. Manger, MD, Ph.D.
William A. Blanc, M.D., Professor of Pathology ; Robert A. Esser,
M.D., Instructor of Psychiatry ; Henry C. Frick, M.D., Professor
of Clinical Obs. & Gyn. ; Allen I. Hyman M.D., Asst. Professor
of Anesthesiology ; George A. Hyman, M.D., Assoc. Clinical
Professor of Medicine ; Joannes H. Karls, M.D. Assoc. Professor
of Anesthesiology ; Donald W. King, M.D., Professor of Pathol-
ogy; Ferdinand F. McAllister, M.D., Professor of Clinical Sur-
gery; William M. Manger, M.D., Ph.D., Instructor of Medicine;
Lester C. Mark, M.D., Professor of Anesthesiology ; Kermit L.
Pines, M.D., Assoc. Professor of Clin. Medicine ; Herbert
Rackow, M.D., Professor of Anesthesiology ; Ralph W. Richter,
Assoc. Clin. Professor of Neurology ; Sidney C Werner, M.D.,
Professor of Clinical Medicine; Phillip Zeidenberg, M.D., Ph. D.,
Professor of Psychiatry ; and Henry Brill, M.D., Lecturer in
Psychiatry, also, Member, National Commission on Marihuana
and Drug Abuse.
Senator Gurnet. Thank you. Dr. Nahas. We will now proceed
with your statement, if you will, please.
Dr. Nahas. I am honored to be invited to testify as a scientific
witness before this distinguished committee of the U.S. Senate. For
the past 25 years I have worked in the laboratory as a physiologist
and a pharmacologist, investigating the effects of different drugs on
body function. In the past 4 years I have concentrated on studying
the biological effects of marihuana products. I was also able to make
field surveys in areas of heavv cannabis usage in North Africa.
One of these surveys was performed under the sponsorship of the
National Institute of Mental Health with Dr. Zeidenberg from
Columbia University and Dr. LeFebure from the College de France
in Paris. We visited the Rif Mountains of Morocco. \7v> were in-
formed at that time by the Under Secretary of Health of Morocco
that heavy marihuana users were more susceptible to tuberculosis
which in that area constitutes a major public health problem. This
considered opinion from one of our colleagues, along with my own
observations which related a condition of general physical deteriora-
tion to chronic marihuana smoking, led me to investigate the effects
of this drug on the immunity system of man. This immunity is a
function of white blood cells, the T-lymphocytes, which specialize
in fighting virus infections and destroying substances foreign to the
body such as cancer cells or tissue transplants.
With my colleagues, Dr. J. P. Armand, Dr. N. Suciu-Foca, and
Dr. Akira Morishima, we studied in our laboratory at the College
of Physicians and Surgeons of Columbia University, 51 marihuana
smokers, 16 to 35 years of age who had smoked an average of three
cigarettes of marihuana a week for 4 years. This study was pub-
lished in the February 1 issue 1974 of Science and I will not dupli-
cate this study by reading it to you. I will just summarize it and then
present to you our latest work.
Senator Gurnet. Is it fair to say that that is a heavy usage of
marihuana ?
95
Dr. Nahas. No, not heavy usage as it has been defined in the
Marihuana Commission report or Shafer Commission. Heavy use
in the Marihuana Commission report refers to several cigarettes a
day. The average amount of cigarettes smoked by these young peo-
ple were three to four cigarettes of marihuana a week, which would
be called rather moderate usage.
These subjects did not use other drugs, although some of them
also smoked tobacco and drank alcoholic beverages. We sampled
blood from the arm vein of these subjects and isolated their lympho-
cytes (special white blood cells). These cells were challenged with
special substances which normally make them divide and grow. Such
a test, the blast transformation test, is presently used to measure the
strength or response of the immunity system of the body. We per-
formed this test on marihuana smokers and on control subjects who
did not use the weed, but smoked tobacco and drank alcoholic bever-
ages. The immunity response of the marihuana smokers was 40
percent less than that of the nonsmokers. Furthermore, their re-
sponses was similar to that of patients with cancer, or kidney grafts —
treated with immunosuppressants — who were tested and who pre-
sented documented evidence of an impairment of their immunity
system. These findings on man were verified on rhesus monkeys
studied with Dr. Carolyn Daul in the laboratory of Dr. Robert
Heath at Tulane University. These monkeys were made to smoke
measured amounts of marihuana several times a week for 3 to 5
months by a technique described by Dr. Heath this morning. We
studied the blastogenic response of the lymphocytes of these monkeys
and compared them to that of lymphocytes taken from monkeys who
were not "smoked". The blastogenic response of the lymphocytes
from the monkeys which were smoked was decreased by 52 percent.
This was true for the two monkeys which subsequently died in this
study.
Mr. Martin. Could you define what you mean by blastogenic
response ?
Dr. Nahas. I mean that their immunity response as measured by
this test was decreased to less than 50 percent of the controlled re-
sponse in the monkeys which were not smoked.
Mr. Sotjrwtne. May I ask a question? Do you conclude from this,
Dr. Nahas, that marihuana is an immuno-suppressant ?
Dr. Nahas. Well, in the test tube, yes. One cannot, as I will dis-
cuss later, one cannot document presently that marihuana smokers
present a clinical decrease of their immune response which would be
indicated by an increased incidence of virus disease, and of such
things as cancer. This we cannot say. The only thing we can say
is that the lymphocytes do not respond as normally as, that is to
say, as the lymphocytes of subjects that do not smoke marihuana.
Mr. Soubwine. It is not just a case of not responding normally.
I understood you to say it is a 50-percent reduction.
Dr. Nahas. Yes. in response.
Mr. Sourwixe. It is cut in half ?
Dr. Nahas. That is correct, yes.
96
Mr. Sourwine. Thank you.
Dr. Nahas. We are continuing to study the immune response of
these primates with Dr. Heath.
The mechanism of this decrease in the division of lymphocytes
was clarified in another series of experiments to be described by Dr.
Morishima who showed that these lymphocytes from marihuana
smokers could not increase the DNA production required for their
proper division. DNA (deoxyribonucleic acid) is the basic chemical
contained in the core of all our cells. DNA carries the genetic code
and allows each daughter cell to be identical to the mother cell
from which they derive.
Mr. Sourwine. May I bother once more, Mr. Chairman ?
I think it will help clarify the record. Is it true, Doctor, as I
understand it, that there is and must be an increase in the pro-
duction of DNA before the cell division takes place?
Dr. Nahas. That is correct.
Mr. Sourwine. This is a necessary, a prerequisite, so that what you
are saying here is that there was an inhibition of the necessary in-
crease which would have permitted cell division. In other words,
this is the basis, the explanation, for the reduction in cell division?
Dr. Nahas. That is correct.
Mr. Sourwine. Thank you, sir.
Dr. Nahas. Similar observations were also made on lymphocytes
sampled from subjects who did not smoke marihuana. These lym-
phocytes were incubated in a test tube with very minute amounts of
chemicals isolated from marihuana. These lymphocytes presented the
same impairment in division and DNA production as those taken
from marihuana smokers.
Mr. Chairman, I have prepared several exhibits and I would like
to have your permission to enter them into the record.
Senator Gurnet. They may be admitted.
97
exhibit 1
MIGRATION INHIBITION
FACTOR
NORMAL ( 100 %)
Cancer 40'60 %
Transplant Patients 50 %
Marihuana Smokers 40 %
PHYTOHEMAGLUTININ LYMPHOBLAST
LYMPHOCYTE (PHA) TRANSFORMATION
Technique used to test the immunity response of man
98
Dr. Nahas. Exhibit 1 is a brief description of the technique used
to test the immunity system of a subject. Lymphocytes sampled
from the patient are incubated or "cultured" for 72 hours in a
test tube with a substance PHA which will cause the cells to in-
crease the formation of DNA and then to divide. This increase is
indicated by the growth of the cell in the diagram.
Senator Gttrney. These exhibits are the ones that are attached to
your prepared statement ?
Dr. Nahas. That is correct, yes.
Senator Gurnet. They will all be admitted in the record.
Dr. Nahas. The ability of these cells to increase the formation of
DNA may be evaluated by the rate of uptake of radioactive thymi-
dine. Thymidine is a precursor, a building block so to speak, essen-
tial for the formation of DNA. Molecules of thymidine can be made
radioactive, and the rate at which they are incorporated by the
lymphocytes can be measured on a scintillation counter (an instru-
ment which measures radioactivity). You will note that after the
lymphocyte has been stimulated to grow it will produce a number of
substances, interferon, transfer factor, and so on, which are used to
defend our body against disease. Note that if the normal lympho-
cytes from a group of healthy volunteers have a rate of thymidine
incorporation of 100 percent, that of marihuana smokers is de-
creased by 40 percent. The ability of the lymphocytes of marihuana
smokers to produce DNA is similar to that of the lymphocytes of
the cells sampled from cancer patients.
99
EXHIBIT 2
H - THYMIDINE UPTAKE OF T LYMPHOCYTES IN MARIHUANA SMOKERS
COMPARED WITH NORMAL AND IMMUNE SUPPRESSED SUBJECTS
PHA
MLC
SUBJECTS
NO. TESTED
CPM
SE P
NO. TESTED
CPM
SE
P
NORMAL CONTROLS
81
23250
1878
81
26400
1789
MARIHUANA SMOKERS
51
13779
1195 <0.00O5
34
15679
2867
<;o.oos
CANCER PATIENTS
PRIMARY TUMORS
16
17501
480 <0.0005
16
14894
3067
< 0.0005
REGIONAL SPREAD
23
13345
2533 <0.0005
23
15816
1970
<0.0005
DISTANT SPREAD
21
10516
2594 <0.0005
21
8968
2053
<0.0005
TRANSPLANT PATIENTS
24
12307
1712
<0.0005
UREMIC PATIENTS
26
12001
1360
<0.0005
EXHIBIT 3
Uptake of H -delta -9-THC
by human lymphocytes
(in CPM)
Time
r
15'
30'
60'
120'
240'
Without PHA
487
±
35
893
±
92
856
±
61
651
±
118
824
±
88
930
±215
With PHA
517 ±39
903 ±76
872 ± 32
881 ±22
822 ± 114
790 ± III
100
exhibit 4
C2 H5OH
10
- 6
io"5 io"4 io"3
M CONCENTRATION
- 2
Inhibitory effects of the cannabinoids (marihuana products)
delta 9 tetrahydrocannabinol (THC), cannabinol (CBN),
cannabidiol (CBD) on PHA induced lymphocyte transforma-
tion as measured by H thymidine incorporation after three
days of culture. This effect is compared to that of aspirin,
caffeine and ethyl alcohol (C2H5OH). All experiments
were done in triplicate cultures. The counts per minute
(CPM) given are the average count of 4 to 5 parallel cultures
± standard error. Inhibition of lymphocyte transformation was
calculated in reference to the CPM of the control culture.
The dotted line represents % of thymidine uptake of unstim-
ulated cells. A concentration of 1 (f marihuana products
(THC, CBD, CBN) would correspond to 30 mg, which
would be the average amount contained in a 1 gram mari-
huana cigarette. A concentration of 1 0 alcohol would
correspond to 5gm, the amount contained in a glass of wine.
101
Exhibit 2 details our results as they are actually measured by the
scintillation counter, with the figures that we obtained from the
counter. In these experiments two different substances were used
to stimulate the lymphocytes into growing and dividing. The PHA
and the MLC test. "Roth gave similar results.
Exhibit 3 summarizes an experiment which indicates that one
of the most active substances in marihuana. THC. does penetrate
into the lymphocytes rather rapidly. This experiment was per-
formed with radioactive THC which was incubated with the lym-
phocytes. After 15 minutes THC has reached a plateau in the cell.
Exhibit 4 illustrates our latest series of experiments which were
performed with Dr. Hsu and Dr. DeSoize. In these experiments,
lymphocytes taken from subjects who did not smoke marihuana
were incubated with some of the chemical substances isolated from
marihuana, THC, CBD, CBN, compounds which were given to us
by the National Institute of Mental Health. Of these substances
onlv THC is "psychoactive", impairs psychomotor performance,
and is considered the major biologically active substance of mari-
huana. In this experiment it is made clear that not only is THC
immuno-suppressive but that also the two nonactive substances in
marihuana, CBN and CBD have a similar effect. As a matter of
fact, it seems that these nonactive substances have a greater potency
to inhibit DNA formation in the lymphocytes than does THC.
Mr. Sotjrwine. Mr. Chairman, for the sake of the record, might
I inquire? You used the phrase nonactive substances. You really
mean substances formerly deemed to be nonactive and you now
have proved they are active, is that correct ?
Dr. Nahas. Yes. Such an experiment comes as no surprise to
Dr. Paton, who has repeatedly emphasized that THC was only one
of the many substances in marihuana to change cellular function.
Note that the potency of these cannabis products to impair the pro-
duction of DNA by lymphocytes is about 50 times greater than
that of aspirin and caffeine, and note also that it takes concentra-
tions^ 10,000 times greater for alcohol (C2H50H). And even with
sufficient concentrations 10,000 times greater there is no effect on
cell division. Therefore, as far as DNA formation and cell di-
vision is concerned alcohol has very little effect in this experiment
as already mentioned by Dr. Paton.
Senator Gurnet. Doctor, at this point for the sake of the record,
would you define what the chemical substance CBD, and CBN are?
Dr. Nahas. Yes. CBN is cannabinol and CBD is cannabidiol.
These two substances are present in the leaves and flowering tops of
cannabis, and in the so-called low qualitv "grass" the concentration
of CBN is quite high while that of THC is low. And it is interest-
ing to note that insofar as DNA production is concerned, even
some people who smoke low grade marihuana might still impair
their lymphocytes. Now, on this chart
Mr. Sourwine. Forgive me, please, I have become confused and
if I may be permitted, may I ask two questions? You have said
that the potency of these cannabis products to impair the produc-
tion of DNA by lymphocytes is 50 times greater than that of aspirin
and caffeine. In other words, it takes 50 times as much aspirin or
caffeine as it does THC to cause the impairment. And then you
102
say it takes concentrations 10,000 times greater for alcohol to have
an effect.
So that we can understand this, how much alcohol is involved m
a concentration 10,000 times greater than the amount of cannabis
which will impair the production of DNA by lymphocytes ?
Dr. Nahas. Well, such concentrations are never reached in the
bloodstream of man, they would amount to 5 percent of alcohol. The
highest concentration is, I think, 1 percent — no, the concentration
of alcohol which is associated with intoxication is 50 milligrams per-
cent. And I say that the concentration we use in this experiment is in
excess of 500 milligram percent. So 10 times more than what is con-
sidered a state of intoxication.
Mr. Sourwine. You mean in order to have this kind of an effect
on the formation of DNA by the lymphocytes it would take a con-
centration of alcohol in the blood of 50 percent?
Dr. Nahas. No, 500 milligrams percent that is 500 milligrams of
alcohol in 100 milliliters, or y10th of a liter of blood.
Mr. Sourwine. 500 milligrams percent ?
Dr. Nahas. 500 milligrams percent or more.
Mr. Sourwine. Would inhibit it ?
Dr. Nahas. This would result in the death of the subject.^
Mr. Sourwine. The percent of cannabis products which will in-
hibit it must be almost infinitesimal, 1/10,000's of that, is that right?
Dr. Nahas. That is right.
Mr. Sourwine. A mere trace in the blood.
Dr. Nahas. Well, more than a trace, something which can be
measured.
Mr. Martin. How many milligrams would be involved?
Dr. Nahas. Well, to give you an idea, a marihuana cigarette, con-
tains an amount of cannabinoids — cannabis products — correspond-
ing to 10 to the minus 4 — about 30 milligrams.
Senator Gurnet. We are talking about exhibit 4 ?
Dr. Nahas. Yes.
Mr. Martin. State that.
Dr. Nahas. 30 milligrams of cannabis products — of THC and other
marihuana constituents.
Mr. Sourwine. You cannot translate milligrams into the blood. If
it takes 5 percent alcohol in the blood to cause this damage and
1/10,000's amount of that, then 5/10.000's of cannabis products must
be enough in the blood to cause the damage, is that right ?
Dr. Nahas. Well, Mr. Chairman, these experiments are experi-
ments which are made in vitro, in the test tube.
Mr. Sourwine. I am not challenging you, sir, I am only seeking
light. We have these figures here, 50 times, 10,000 times, and I am
trying to relate them.
Dr. Nahas. Well, it is easy to relate them in the test tube because
the volume there is small and exact concentration of these substances
can be measured. However, in the body, especially for cannabis
products, it is very difficult to measure the exact amount which is at
any time in the plasma.
Mr. Sourwine. Then, your 10,000 times is not a direct relationship
to the percentage needed in the blood. Your 10,000 times is related
to the actual amount in concentrated form in the test tube?
103
Dr. Nahas. That is right, yes.
Mr. Sourwine. All right. I have no further questions, Mr.
Chairman.
Senator Gtjrney. Proceed.
Dr. Nahas. But what I want to say is that the concentration of
THC. CBD. and CBN which in the test tube inhibits DNA forma-
tion, is reached in the plasma of man, if you refer yourself to the
studies, to the few studies, where plasma concentrations of canna-
binoids are available.
Now, it would, therefore, appear that lymphocyte production of
DNA as measured by the incorporation of 3H thymidine is impaired
by marihuana products. The ability of delta-9 THC and of other
cannabinoids to limit 3H thymidine incorporation by lymphocytes
in cell culture, although not previously described, is consistent with
some of the characteristics of these compounds which are not soluble
in water and accumulate in fat. The reduced incorporation of 3H
thymidine after exposure of the lymphoctyes to concentration of
cannabinoids which may be reached during chronic cannabis con-
sumption could decrease body defenses as claimed by some of our
colleagues in North Africa. Such an outcome would be damaging
when it is desirable that these defense mechanisms remain intact as
in the cases of cancer and other poorly understood diseases. The
clinical significance of these observations can only be assessed by
what are called "epidemiological investigations". These investiga-
tions, patterned after the "Framingham studies" of tobacco smokers,
are exceedingly expensive; they would have to be carried out on a
large population of marihuana smokers to be studied year after year
for several decades. In this investigation an appraisal of the immune
response of the marihuana user should be systematically studied so
as to better appreciate the development of the many different patho-
logical conditions in which the immune system plays an important
role.
However, these observations, taken in the general context of the
damaging effect of marihuana on the DNA of dividing cells, are
indicative that long-term marihuana usage by a significant fraction
of the American population would constitute a major public health
problem.
Thank you, Mr. Chairman.
Senator Gurnet. Thank you, Doctor.
As I understand it then, not being a scientist, I am not sure I
understood what all these figures mean, but I think I understand
what you are saying, that is, the use of marihuana severely reduces
the user's, a user's resistance to disease in sickness, is that another
word for it ?
Dr. Nahas. Well, that is what it might do in the long run. Actually,
what we have shown is that the use of marihuana decreases the
ability of the cells to fulfill their function of dividing rapidly. The
lymphocytes are cells which have to divide rapidly whenever the body
is attacked by a virus, for instance. In marihuana smokers we found
that these lymphocytes do not divide as rapidly as well as those
sampled from people who did not smoke marihuana. But we have
not made an epidemiological study which would be required to corre-
late a higher incidence of all types of disease with length of the
104
marihuana smoking, similar to those which have been done with
tobacco smokers.
It is only in the past 12 years that tobacco smoking has been cor-
related with cancer, heart disease and other unhealthy conditions.
Before that there was no physical evidence that such a correlation
existed, although it did exist in fact.
Senator Gurnet. But the inference is that use of marihuana makes
people more susceptible to illnesses without defining all the various
illnesses ?
Dr. Nahas. That is an inference which only further studies would
be able to determine.
Senator Gurnet. Yes.
Mr. Martin. In the study just reported you collaborated with
three senior scientists of the 'College of Physicians and Surgeons of
Columbia University. We are going to introduce Dr. Morishima, who
was one of your collaborators. Could you tell us something briefly
about the qualifications of your other two collaborators?
Dr. Nahas. Dr. Suciu-Foca is an immunologist and is chief of the
Laboratory of Clinical Immunology of the College of Physicians
and Surgeons. She has a world-known reputation, especially in the
techniques that we used and which she has perfected.
Dr. Jean Pierre Armand is also an immunologist and he is associ-
ate director in the Cancer Institute of the University of Toulouse in
France.
Mr. Martin. So these were all eminently qualified scientists who
worked with you ?
Dr. Nahas. Yes. Such a study required many different disciplines
and in order for these studies to be valid one has. to work in conjunc-
tion with very competent people in different specialties.
Mr. Martin. In order to clarify a point about which I feel there
may have been some misunderstanding, I would like to suggest the
advantage of trying to transfer from percentages to quantities.
Would it be roughly accurate that in order to get intoxicated on
whiskey you need 10 to 15 ounces ?
Dr. Nahas. I beg your pardon?
Mr. Martin. Ten to 15 ounces, a third to half a bottle to get intoxi-
cated with whiskey
Dr. Nahas. Yes
Mr. Martin [continuing]. Roughly.
Dr. Nahas. Yes.
Mr. Martin. Or 8 to 15 ounces.
Dr. Nahas. Yes.
Mr. Martin. Certainly, 1 ounce would not do it.
How much THC do you need to get yourself stoned?
Dr. Nahas. Well, in* terms of ounces a very small percent of an
ounce, I would say 10 milligrams.
Mr. Martin. Ten milligrams.
Dr. Nahas. That is about one thousandth of an ounce.
Mr. Martin. About one thousandth of an ounce?
Dr. Nahas. About one thousandth of an ounce, I would say.
Mr. Martin. So that 1 ounce of pure THC would be enough
for
Dr. Nahas. One thousandth of an ounce, I beg your pardon.
Mr. Martin. One thousandth of an ounce?
105
Dr. Nahas. Yes.
Mr. Martin. So that 1 ounce of pure THC would be enough for
1000 intoxications. We are talking about two substances
Dr. Nahas. Yes.
Mr. Martin [continuing]. Whose capacity for intoxicating people
is really poles apart. I mean, you need a tiny, tiny amount in one
case and a fairly large amount in the other case ?
Dr. Nahas. That is correct.
Mr. Sourwine. With great respect, in intoxication a high is not
necessarily the same thing as the inhibition against production or
the formation of DNA you testified about earlier. A man may get
drunk on alcohol without any inhibition of the formation of DNA?
Dr. Nahas. That is right.
Mr. Sourwine. I mean, as I understand it, he cannot get a high on
pot without some measure of such inhibition ?
Dr. Nahas. Without, well, over a period of time, that is true, yes.
Mr. Sourwine. All right.
Dr. Nahas. You can take a drink every evening and not impair
your DNA, that is correct. But you cannot smoke a marihuana cig-
arette every day and not run the risk of impairing DNA in some
of your dividing cells.
Mr. Sourwine. Yes, sir.
Mr. Martin. Dr. Nahas.
Dr. Nahas. Yes.
Mr. Martin. I believe you have stated that your research raised
the possibility of serious genetic damage if the cannabis epidemic
remains unchecked. Would you like to comment on that, or would
you like to leave that for Dr. Morishima?
Dr. Nahas. I think Dr. Morishima is much more competent than I
in that.
Mr. Martin. Does the amount of cannabis being consumed in the
United States today — that is, based on rough calculations which, in
turn, are based on what we know about the quantities interdicted by
the Federal authorities — does the amount being used justify the
term "epidemic"?
Dr. Nahas. Well, certainly, it does since I think you calculated
that about 50 cigarettes containing 10 milligrams THC have been con-
sumed in 1973 by every single citizen of the United States, including
newborns.
Mr. Sourwine. You mean a quantity equal to 50 cigarettes per per-
son has been consumed?
Dr. Nahas. Well, upon that basis it certainly is an epidemic.
Mr. Sourwine. It is a different thing from saying that everybody
in the country has consumed 50 marihuana cigarettes.
Dr. Nahas. I agree.
Mr. Martin. Point conceded. You have in recent years, Dr. Nahas,
attended a number of national and international conferences on
cannabis research?
Dr. Nahas. Yes.
Mr. Martin. Eoughly, how many would you say you have at-
tended ?
Dr. Nahas. Four or five, maybe a half-dozen. There have been
many.
106
Mr. Martin. Has there been any discernible trends at these con-
ferences? Would you be prepared to venture an estimate on the
percentage of the scientists at these conferences who lean toward the
conclusion that marihuana is relatively harmless and the percentage
whose findings have convinced them that it is a very dangerous
drug ?
Dr. Nahas. Well, I think Dr. Paton did answer this question in
a very appropriate fashion and I would certainly agree with what
he said. You see, the scientist is essentially a human being who is
swayed by public opinion like any other human being. Before 1960
the majority of scientists had all agreed marihuana was dangerous,
very much so, and then came this great new wave of marihuana use
and public opinion did change and then in some respect it did in-
fluence the opinion of the scientists, because the facts did not. We
were told 4 or 5 years ago that marihuana was harmless but there
Avas no hard fact to support this contention, and there was a very
strong body of historical evidence indicating that it was very harm-
ful. But many people were swayed by this new fashion. So I think
that the opinion of scientists is very much influenced by the fashion
in which they live. Your question is difficult to answer.
Mr. Martin. When we talk about historical evidence, what you
are saying in effect is that over the centuries wise men in many
countries have been very critical of cannabis, and have warned
against its use, even though they did not have the advantage of
modern scientific technology?
Dr. Nahas. That is correct. Yes.
Mr. Martin. This was based on empirical observations?
Dr. Nahas. Yes, and they still do. I am sure in the countries which
I visited, in Morocco and elsewhere, they will never find by them-
selves evidence for the physical damage that cannabis has produced
in their population because they do not have the tools to do it. But
still they believe that it is most harmful.
Mr. Martin. What you are saying, if I understand your remark,
Dr. Nahas, is that the mere fact that Shakespeare did not have a
degree in psychology from Harvard does not mean that Shakespeare
was ignorant of human psychology?
Dr. Nahas. That is correct.
Mr. Martin. Coming closer to the present, it is accurate that an
international scientific conference convened in 1924 under the aus-
pices of the League of Nations, voted unanimousy to list cannabis
as a dangerous substance and they voted to cooperate with each
other in seeking to eradicate it?
Dr. Nahas. Yes.
Mr. Martin. Did the scientists who attended this conference have
the hard scientific evidence that we have today?
Dr. Nahas. None at all. As a matter of fact, this conference had to
be prolonged because some of the officials from the west who attended
the conference asked the Egyptian delegate to present them with
hard facts indicating that marihuana was harmful and he could not
find any.
Mr. Martin. In short, their vote was based primarily on these
centuries of empirical observations to which you referred earlier?
Dr. Nahas. That is correct.
107
Mr. Martin. You do not feel they were wrong in voting as they
did, despite the lack of hard scientific evidence?
Dr. Nahas. Yes.
Mr. Martin. If the United States ever legalized marihuana, what
is your judgment of the effect this would have in the United States
and internationally ?
Dr. Nahas. Well, it is difficult to predict what would happen. I
think that Dr. Bejerot will tomorrow discuss this problem and he
is pretty well qualified for it.
I can just convey to you a feeling, impressions and opinions of
the Public Health officials in the North African countries I visited.
These public officials are convinced that marihuana usage is harm-
ful to their people and to the society, to the social structure in which
they live. They want the help of the United States to give them
funds in order to produce substitute cash crops instead of marihuana,
which constitutes the only cash crop in some areas of Morocco. So
when you inform these officials that there is a probability or possi-
bility that marihuana might be legalized in the United States, and
you say that it could be made commercially available, they look at
you with great incredulity.
Mr. Martin. A final question. Has your research been funded by
any Government agency or is it privately funded?
Dr. Nahas. It is privately funded.1
Mr. Martin. You have obtained no Government funds?
Dr. Nahas. Until now I have not obtained any Government funds,
and it is a very expensive venture.
Mr. Martin. Did you apply for Government funds?
Dr. Nahas. I did.
Mr. Martin. Your application was apparently rejected?
Dr. Nahas. But it is being now reconsidered.
Mr. Martin. Thank you.
Dr. Nahas. It was rejected, yes.
Mr. Martin. I have no further questions, Mr. Chairman.
Senator Gurnet. When did vou first apply for Government funds,
Doctor?
Dr. Nahas. I first applied last October when I had assembled a
body of knowledge sufficient to indicate that there was a certain area
in my research where interesting and fruitful information could be
found.
Senator Gurnet. And this application is still pending?
Dr. Nahas. We are reapplying.
Senator Gurnet. Mr. Sourwine.
Mr. Sourwine. I have two questions, Mr. Chairman.
Doctor, at the conclusion of your statement you said that your
observations taken in the general context of the damaging effect of
marihuana on the DNA of dividing cells are indicative that long-
term marihuana usage by a significant fraction of the American
population would constitute a major public health problem.
Would you tell us what you consider to be a significant fraction?
5 percent, 10 percent, 20 percent?
1 Mostly from a gift from Mr. Henri G. Doll and one from the Phillipe Foundation.
108
Dr. Nahas. No, I said that it would be, it might be a small per-
centage. I think that in a population at large there is only a relatively
small percentage, let us say, to be kind, 12 percent, which is active,
creative, and which is responsible for much of the creativity in the
society. If just a small percentage of this 12 percent, let us say,
2 or 3 percent falls off this would create a very serious problem
already.
Mr. Sourwine. Well now, when you use a general figure like "sig-
nificant percentage" you are talking about a percentage of the whole
population, not a percentage of some elite group, are you not?
Dr. Nahas. That is correct, But I am
Mr. Sourwine. What percentage of the whole population consti-
tutes a significant fraction of the population, in your opinion?
Dr. Nahas. Well, a fraction which is statistically significant, so
this may not be very high, I would say it is 5 or 10 percent.
Mr. Sourwine. Well, how many, what percentage of the American
population are now using marihuana ?
Dr. Nahas. The figures are, I think, between 10 and 15 percent,
Mr. Sourwine. Then, we are now in a situation in which mari-
huana constitutes a maior public health problem, is that right?
Dr. Nahas. I think it does; well, this is my personal opinion.
Mr. Sourwine. That is all I am asking for.
Dr. Nahas. If marihuana will continue to be consumed in the
United States at the rate at which it was consumed in 1973 on the
basis of the figures which were given to us, I think that in 10 years
it will be a major public health problem, yes.
Mr. Sourwine. You are a very careful man in your statements, sir,
which I am sure is the proper scientific attitude, and I mean no
offense by this question. You have told us that in order to have
appropriate and normal resistance to disease, lymphocytes must
divide quite rapidly in case of an invasion. You have told us that the
use of marihuana inhibits this division by approximately 50 percent
through the inhibition of the production of the deoxyribonucleic acid,
am I correct so far?
Dr. Nahas. Yes.
Mr. Sourwine. Then, you declined to make a judgment that this
meant that the use of marihuana reduced the resistance of the user to
disease, Is that not a little bit like saying if you introduce into the
blood a noncoagulating factor to the extent that the blood will seep
through the tissues, there is still no assurance that the man is going
to bleed?
Dr. Nahas. Well, I have to keep toeing the scientific line which says
that as long as there is no evidence you cannot conclude.
Mr. Sourwine. All right, sir, I have no more questions.
Senator Gurnet. It is my understanding, just to complete the last
line of questioning, that there have not been that, there has not been
that much experimentation to actually prove that marihuana, the use
of marihuana prevents resistance to certain diseases because it has not
been experimented, is that not what you are saying?
Dr. Nahas. There have not been enough actual observations. But
if I were to bet personally, I would certainly bet that the incidence
of disease in chronic marihuana smokers would be much greater than
in those who do not smoke marihuana. I would make that hypothesis,
I would bet on it.
109
Mr. Sourwixe. Thank you, Doctor.
I understand our next witness is Dr. Morishima. Doctor, will you
identify yourself for the record, please?
TESTIMONY OF DR. AKIRA MORISHIMA, COLUMBIA UNIVERSITY
Dr. Morishima. I am an associate professor of the department of
pediatrics of the College of Physicians and Surgeons at Columbia
University. I am the chief of the division of pediatric endocrine
service at Babies Hospital.
Senator Gtjrxet. Perhaps if you do not mind, I could ask some
questions which will start us in at the beginning and establish your
qualifications, Doctor.
Dr. Morishima. Yes, sir.
Senator Gurxey. You were born in Tokyo in 1930 ?
Dr. Morishima. That is correct, sir.
Senator Gurxey. You are currently a citizen of the U.S. ?
Dr. Morishima. Yes, I am.
Senator Gurxey. And you received your medical degree from the
School of Medicine, Keio University in Tokyo in 1954 ?
Dr. Morishima. That is correct, sir.
Senator Gurxey. And you subsequently received a Ph. D. in medi-
cine from Keio University for your work in the field of cytogenetics.
Dr. Morishima. Yes, Mr. Chairman.
Senator Gurxey. How would you define cytogenetics?
Dr. Morishima. It is a discipline in which genetics of cells are
studied.
Senator Gurxey. And you have been associated with Columbia
University from 1956 to the present time — apart from a 2-year stint,
from 1966 to 1968 as assistant professor of pediatrics at the Univer-
sity of California in San Francisco ?
Dr. Morishima. That is correct, sir.
Senator Gurxey. And you have served as pediatrician or pediatric
consultant at a number of major New York hospitals?
Dr. Morishima. Yes, I do.
Senator Gurxey. And you have for several years been a member of
the endocrine disease advisory committee of the New York City
Department of Health?.
Dr. Morishima. Yes, I am.
Senator Gurxey. And you are the author or coauthor of 32 scien-
tific papers, with a heavy emphasis in the field of cytogenetic
research ?
Dr. Morishima. That is correct, sir.
Senator Gurxey. Is it accurate to say you are basically a geneticist?
Dr. Morishima. Yes, who specializes in the subdivision of cell
genetics, if you will.
Senator Gurxey. Very well. Will you proceed with your statement,
Doctor?
Dr. Morishima. Mr. Chairman, I am honored to be invited to
testify as a scientific witness before this distinguished committee.
During the past few years, I have been examining the cytogenetic
changes in heroin addicts. My interest in cannabis originally stemmed
from this study. The vast majority of heroin addicts we were able
33-371 O - 74 - 9
110
to study smoked marihuana, at least on occasions, and therefore it
became important to examine separately the effects of marihuana
smoking. It is of interest that the preliminary observation on mari-
huana smokers suggests that some cytogenetic changes in these
subjects are dissimilar to those found in heroin addicts.
We obtained lymphocytes from peripheral blood of heavy mari-
huana smokers — at least once per week for minimum of 1 year — and
cultured the cells in vitro for 72 hours, stimulated by phytohemag-
glutinin, PHA. At the end of this culture period, cells were exposed
to colchicine and a hypotonic solution, then, were fixed, all in a
rigidly prescribed manner. This method is a standard technique used
for examination of human chromosomes, and is commonly employed
in diagnosis of diseases caused by chromosomal aberrations. The
method is very similar to that used for detection of chromosomal
breakages in marihuana smokers by Dr. Stenchever l and in users of
lysergic acid diethylamide, LSD, by Dr. Cohen8 and his associates
in 1967.
When the specimens of three marihuana smokers were compared
with those of age and sex matched nonsmokers, the mitotic index, or
the proportion of those cells in process of cell division, was noted to
be only 2.3 percent in marihuana users, compared with 5.9 percent for
the controls. Although the significance of this difference was not clear
due to the small number of subjects studied, it suggested that activity
of cell division may be decreased in marihuana smokers.
However, in the marihuana samples, we noted that a large propor-
tion of metaphase nuclei contained a significantly decreased number
of chromosomes than the normal human complement of 46 chromo-
somes. Metaphase is a brief stage of cell division during which each
chromosome is clearly visible.
[The table follows :]
MITOTIC INDEX
Number of
subjects
Mitotic
Index
(percent)
Number of
cells
examined
Marihuana smokers 3
2.37
5.94
60, 173
Controls - 3
59,000
LABELED CELLS BY USE OF W-THYMIDINE DURING THE 50 HOURS OF CULTURE
Number of
subjects
Labeled
cells i
(percent)
Total cells
examined
Marihuana smokers - - --- 3
10.44
29.81
1.245
1.631
i More than 10 grains per cell.
Mr. Chairman, I have prepared several figures. I should like to
refer to Exhibit 1.
Senator Gtjrney. These will all be admitted in the record.
1 Stenchever M. A. ; Kunysz, T. J., and Allen, M. A. "Chromosome Breakage In Users
of Marihuana." Am. J. Obs. Gyn., 118 : 106, 1974.
2 Cohen, M. M. ; Marinello, M. J., and Back, N. "Chromosomal Damage in Human
Leukocytes Induced by Lysergic Acid Diethylamide." Science, 155 : 1417, 1967.
Ill
* t *^*
\ii
* >a%
112
Dr. Morishima. In exhibit 1 a normal metaphase cell with 46
chromosomes is shown in the left upper corner. Cells with 38, 24, 11,
and 8 chromosomes, respectively, are shown in the remainder of this
figure.
Mr. Sotjrwine. What is the significance of a cell with 34 or 11 or 8
chromosomes ?
Dr. Morishima. These are abnormal cells which are seen only in a
very small percentage among the normal controls.
Mr. Sotjrwine. Will they take part in reproduction ?
Dr. Morishima. They probably will, at least for one or two cell
generations but after that I have no evidence to support whether or
not they can or cannot.
Mr. Sotjrwine. Thank you.
Dr. Morishima. In exhibit 2, I have summarized the study.
In marihuana smokers, 30.6 percent of the cells examined had 5 to 30
chromosomes, whereas only 7 percent of cells were found to have such
a chromosomal complement in the control group. The small percent-
age of abnormal cells in normal individuals is thought to arise during
the process of preparing the slides, and is considered a technical
artifact. However, in marihuana smokers, the incidence of metaphase
cells missing a large number of chromosomes was over fourfold
greater than that in controls. This incidence was so high that I have
not encountered a comparable phenomenon m any other clinical
situations in 15 years of experience in cytogenetics. Judging from
the microscopic findings, there were reasons to believe that this
observation could not be explained merely on the basis of technically
induced artifacts. Although this study included only a few patients,
and is still incomplete due to lack of funds, I believe that the data
are sufficient to suggest that marihuana smoking results in severe
EXHIBIT 2
PERCENTAGE
OF METAPHASES
WITH VARYING NUMBER OF CHROMOSOMES
NUMBER OF CHROMOSOMES
1 "4
5-10 1 1-20
21-30 over 30
3.17
3.17 3.17
4.76
85.71
5.17
3.02 2.26
2.64
86.88
CONTROL
0.00
1 00 0 00
1 00
9800
mean
2.78
2.40 181
\
280
/
90.20
V
7.01
METAPHASES COUNTED
954
7.57
8.33 9.84
2 1.96
5227
2.1 1
7.74 7.74
25.35
5 7.04
MARIHUANA
SMOKERS
5.44
4.26 1 .47
5.29
83.52
mtan
5.04
6.78 6.35
\
17.53
/
64.28
V
30.66
METAPHASES COUNTED
956
113
disruption of the normal process by which chromosomes segregate
into succeeding generations of cells, at least when cultured in vitro.
Dr. Nahas has already mentioned the decreased ability of lympho-
cytes obtained from marihuana smokers to synthesize DNA in culture.
In this regard, I should like to mention a study which confirmed his
observation. Tritiated thymidine, which is a radioactive precursor of
DNA, was added to the culture medium of lymphocytes for 50 hours
in this experiment. After washing the cells to remove any radioactive
thymidine not already incorporated into the cells, the specimens were
placed on slides. Photographic films were then placed in contact with
the cells so that the incorporated radioactivity could be observed by
use of a microscope — autoradiograph. In marihuana smokers only
10.4 percent of all cells were found to have incorporated the tritiated
thymidine, in contrast to 29.8 percent for the nonsmokers. This ob-
servation suggests that a larger proportion of lymphocytes of mari-
huana smokers is incapable of cellular reproduction in vitro.1
It is of interest that the apparent decrease in mitotic index and di-
minished DNA synthesis of the lympocytes of marihuana users is
very different from the cytogenetic findings obtained in heroin
addicts.
As summarized in the third exhibit, the mean mitotic index of
lymphocytes obtained from heroin addicts was 11.8 percent, signifi-
cantly greater than that of controls, with a mean index of 6.6 percent.
Since most of the addicts were also users of marihuana, it may be
speculated that their mitotic index would have been even greater if
they had not smoked marihuana.
Senator Gtjrney. I wonder, so we can understand as laymen now
perhaps you had better say for the record, Doctor, what do you mean
by in vitro and what do you mean by in vivo ?
Dr. Morishima. Mr. Chairman, in vitro here I refer to in-test-tube
situation. In vivo, I mean, in life.
Senator Gurnet. Life.
Dr. Morishima. May I proceed ?
Senator Gurnet. Yes.
Dr. Morishima. Since lymphocytes constitute an essential compo-
nent of cellular immunity and chromosomes are basic units of in-
heritance at the cellular level, it seems logical to anticipate potential
danger in immune defense system, development of cancer, germ cell
production, genetic mutation and birth defects. Unfortunately, little
is known of the effects of cannabis in these areas. Many of these can
be examined systematically and rapidly utilizing the presently avail-
able technology. On the other hand, it is prudent to keep in mind
possibilities of long-term effects which can be studied only by long-
range epidemiological investigations. It was only 2 years ago that
diethylstilbesterol, once a commonly prescribed female hormone, was
implicated in vaginal cancer of female offspring of mothers who were
treated with this agent some 15 to 20 years before.
Thank you, Mr. Chairman.
In exhibit 4, the results of the in vitro study is shown.
When lymphocytes obtained from 11 normal subjects were exposed
to morphine sulfate of various concentrations in culture, a complete
1 Nahas, G. G. ; Suciu-Foca, N. ; Armand, J. P. and Morishima, A. "Inhibition of
Cellular Mediated Immunity in Marihuana Smokers." Science 183 : 419, 1974.
114
inhibition of DNA synthesis occurred at 1.32 X10"1 mM. This concen-
tration is estimated to be about 100 times the concentration found in
the blood of fatalities from acute overdoes of morphine. At concen-
tration of 1.32 X10~7 mM an enhancement of DNA synthesis was ob-
served. This concentration is approximately 1/1000 of the blood con-
centration of fatalities. Thus, in contrast to cannabis, derivatives of
opium alkaloids appear to stimulate DNA synthesis and cell division
of lymphocytes in culture at an appropriate concentration.1
Considering the various studies of Drs. Stenchever, Leuchten-
berger 2 and Nahas together with the data presented, I believe that
we can conclude that there is an increasing body of evidences to sug-
gest that cannabis can affect the process of cell multiplication and
induce profound cytogenetic changes. While these in vitro studies do
not directly indicate adverse effects in vivo, they do implicate poten-
tial health hazards.
EXHIBIT 3
-
i
1
MITOTIC INDICES IN CULTURED
LYMPOCYTES OF
HEROIN ADDICTS
CONTROLS
ADDICTS
i
1
SUBJECT
TOTAL CELLS
MITOTIC
SUBJECT
TOTAL CELLS
MITOTIC
EXAMINED
INDEX (%)
EXAMINED
INDEX (%)
AM.
2400
13.07
AH.
2400
20.25 '"
•
1
VS
2563
3.45
L.D.
21 14
1 6.65 '"-
A.M.
2338
4.40
E.R.
3665
9.95
S.B.
2788
6.92
W.J.
9329
5.46
MX.
1 2,770
7.78
ST.
7398
8i0
ScB-
1 0,000
4.86
ca
8600
1 7.83
S.D.
1 0,000
5.66
N.S.
9000
4.62
AM
8991
8.26
SC.
8486
10.74
W.H.
7480
4.90
6.39i 0.970B.E-)%
MP.
8493
12.68
1 1.82 t I.8271SZ J%
P-«0.05
1 Milstein, M. ; Morishima. A. ; Cohen, M. I. and Litt, I. F. Effects of Opium Alka-
loids on Mitosis and DNA Synthesis. Ped. Res. 8: 118, 1974 (Abstract).
3 Luctenberger, C. : Leuchtenberger, R. and Schneider, A. Effects of Marihuana and
Tobacco Smoker on Human Lung Physiology. Nature, 241 : 137, 1973.
115
EFFECT OF MORPHINE SULFATE ON T CELLS OF NORMAL SUBJECTS
O T-
I.32XIO-' 1.32X10-3 I32XI0-* I.32XI0-6 I.32X 1 0~6 I32XI0-7 I.32XI0-8 I.32X 1 0"9
Senator Gurnet. Thank you, Doctor. I guess I should have per-
haps asked each of the panelists about this but let me direct a ques-
tion to you. I take it, really, there has not been that much study on
the effects of marihuana, is that true?
Dr. Morishima. Not in the chromosomal level, as far as I know.
There is Dr. Stenchever's work, the one which came out from the
Jamaica study and the one I presented to you just about summarize
the current knowledge.
Senator Gukney. Is it true — and I am asking this question also of
the other panel members in the areas they have been investigating- —
there really has not been much research done on marihuana and its
effects?
For the record, I will say each of the panelists shook their heads
in the affirmative — no, there has not been that much research done.
Mr. Counsel, do you have any questions ?
Mr. Martin. Just a few questions. I would like to ask Dr. Mori-
shima to respond to the questions as briefly as possible in the interest
of time, and I would like to ask the two remaining witnesses when
they testify if they will perhaps abbreviate their prepared remarks
somewhat, and also to make their replies to questions as brief as pos-
sible so that we can wind up the hearing this afternoon.
Dr. Morishima, if I understood you correctly, what brought you
together with Dr. Nahas and his research on marihuana, in which you
116
joined him, was your earlier studies on the cytogenetic effects of
heroin ?
Dr. Morishima. That is correct, sir.
Mr. Martin. I would like to ask you to amplify on your closing
statement in which you mention the effect of diethystilbesterol. You
said, if I understood you, to be prudent we must keep in mind the
possibilities about the long-term effects — about which we will only
learn from long-range investigations in the future. Do you mean that
the effects may not be noticeable in this generation or perhaps for
another generation ?
Dr. Morishima. That is precisely what I mean in this statement,
sir. For example, when diethystilbesterol was used during the preg-
nancy of the mother who was carrying the female offspring, the effect
was not seen in the mother at all. She never expressed adverse effect,
and it was only when the female offspring reached beyond the puberal
age, cancer of the vagina was discovered and diethystilbesterol was
then implicated in production of this cancer. So I believe that similar
kinds of situations can occur in the marihuana usage. Particularly I
am concerned with the fact that marihuana seems to accumulate in
the gonads, that is, ovaries and the testicular tissue. And I am par-
ticularly concerned about the ovaries rather than the sperms because
the ovaries contain a finite number of eggs at the time of female
birth. They do not increase, they die progressively. They are endowed
with a definite number of eggs which cannot be reproduced. So if a
damage is done one can shed those damaged cells year after year
after puberty.
Mr. Martin. You said that your personal research in other areas
tended to supplement and confirm the research which you have con-
ducted jointly with Dr. Nahas. Who funded this personal research to
which you referred ? Were you able to find Government support for
your work, or foundation support, or private support?
Dr. Morishima. I am totally unfunded in terms of marihuana re-
search at the moment. However, I do have a contract with the city of
New York to investigate cytogenic changes in heroin addicts and,
therefore, I am allowed under the agreement to undertake certain
pilot studies which are relevant to the heroin addiction.
Mr. Martin. Have you applied — submitted an application — for re-
search support?
Dr. Morishima. I applied to NIH in conjunction with Dr. Nahas.
Mr. Martin. And it was this application which was turned down
and is apparently now being considered?
Dr. Nahas. Resubmitted.
Mr. Martin. Resubmitted. Thank you very much. I have no further
questions, Mr. Chairman.
Mr. Sourwine. Just one, Mr. Chairman.
Dr. Morishima, in telling us about the effect of heroin and other
opium alkaloid derivatives upon DNA synthesis preceding cell divi-
sion, you brought into my mind this understanding and I want to ask
you if it is correct. Heroin and marihuana differ greatly, perhaps
most greatly in the fact that heroin and other opium alkaloid deriva-
tives can totally inhibit the cell division — a bad effect — in heavy con-
centrations but may actually increase it or stimulate it — a good effect —
117
in sufficiently small concentrations, whereas there is no quantity of
marihuana that does any good, all of it does harm ?
Dr. Morishima. Counsel, I do not want to imply increased DNA
synthesis, per se, is good. If one takes that position we must glorify
leukemia as a good disease and, therefore, being variations from the
normality to me is bad either way. All I am saying is that with heroin
there is an increase in DNA synthesis, and in marihuana there is a
decrease. In test tube situation, at least, if you give enough you can
kill off the cells with the morphine sulfate, which is not a surprise.
You can kill cells with almost anything ; if you give high enough con-
centration, sugar will do it, sir.
Mr. Sourwine. I thank you. No further questions, Mr. Chairman.
Senator Gurney. Thank you, Dr. Morishima.
Our next witness is Dr. Robert Kolodny.
Dr. Kolodny, would you identify yourself for the record?
TESTIMONY OF DR. ROBERT KOLODNY, REPRODUCTIVE BIOLOGY
RESEARCH FOUNDATION, ST. LOUIS, MO.
Dr. Kolodny. I am Dr. Robert C. Kolodny of the Reproductive
Biology Research Foundation in St. Louis, Mo.
Senator Gurney. Let me ask just a few questions on your qualifi-
cations, Doctor. I understand you received your medical degree in
1969 from the Washington University School of Medicine in St.
Louis ?
Dr. Kolodny. That is correct.
Senator Gurney. And you served, you have served since 1973, as
director of the endocrine research section of the Reproductive Biology
Research Foundation in St. Louis?
Dr. Kolodny. That is correct.
Senator Gurney. And you have also served since last year as in-
structor in the department of medicine of the Washington University
School of Medicine?
Dr. Kolodny. Yes, sir.
Senator Gurney. You are a captain in the U.S. Army Medical
Corps Reserve?
Dr. Kolodny. Yes, sir.
Senator Gurney. And you are the author of 13 scientific papers?
Dr. Kolodny. Yes, sir.
Senator Gurney. Will you proceed with your statement ?
Dr. Kolodny. Yes.
Mr. Chairman, it is indeed an honor to testify as a scientific wit-
ness before this committee in an area of current controversy. I have
been asked to describe recent research that my colleagues and I have
done on the physical effects of cannabis use. I want to stress that Dr.
Gelson Toro, a biochemist and director of our laboratories, and Dr.
William H. Masters, the director of the Reproductive Biology Re-
search Foundation, have been instrumental in the planning, perform-
ance, and analysis of these studies. My testimony today reflects the
views of these eminent scientists, in addition to my own thinking. I
would also like to acknowledge the invaluable assistance of Mr. Rob-
ert M. Kolodner, a fourth-year medical student from Yale Univer-
sity, who participated in the first phase of our investigations.
118
Kesearch in medicine proceeds along certain basic lines of endeavor
when any drug is being considered. A thorough understanding of
drug effects is initially obtained through animal experimentation,
with particular attention to identifying and devising means to mini-
mize toxic effects of the compound being tested. The world has
learned, through unfortunate experience, the price of inadequate
studies in this phase, specifically with regard to drug effects in preg-
nancy. Animal safety is not a panacea for human usage, however,
since the consequences of use of any drug by the human may be
considerably different from the animal model.
Continuing to speak in broad terms, human drug studies are meth-
odologically limited in many ways. Ethical considerations must be
given the highest possible priority by the scientist; therefore, exper-
imental plans that might be ideal from a scientific viewpoint— that
is to say, plans that may allow the fullest answer of the particular
question being examined — must often be discarded in favor of a less
precise method. Time limitations are also relevant to this discussion,
because the question of safety of drug use — and I emphasize that I
am speaking of any drug, including aspirin — cannot accurately and
fully be assessed for many decades, particularly when we consider
the reproductive consequences a drug may have. In addition to the
above, we must realize that a multiplicity of factors may influence the
very areas we wish to evaluate — thus, studies of aspirin's effects on
weight gain would be influenced by intercurrent illness, other drugs
employed — both for their intrinsic effects and for how they might
interact with aspirin — diet, social pressures, and physical activity, to
name just a few.
For a valid scientific conclusion about drug effects, we must ques-
tion the design of an evaluating study, particularly in light of how
well controlled the study was ; that is to say, how carefully have the
investigators worked to insure that what they are observing are ac-
tual effects of the drug in question, and not effects attributable to
random variation or constant bias from a known or unknown source.
Research in cannabis effects on humans has not always been per-
formed or presented with objectivity. Many studies have been severely
limited by indiscriminately including multiple drug users, thus fre-
quently raising more questions than providing useful information. As
an example of such research, I would like to comment briefly on the
study entitled "Cerebral Atrophy in Young Cannabis Smokers," that
was introduced in testimony before this committee on September 18,
1972. In the 10 cases reported, all 10 men had used LSD — many of
them over 20 times as — well as cannabis, and 8 of the 10 had used
amphetamines. One subject had a previous history of convulsions, four
had significant head injuries, and a number had used sedatives, bar-
biturates, heroin, or morphine. On the basis of these facts, speculative
connection between cannabis use and brain damage is highly suspect.
Unfortunately, this type of report is typical of much of the research
done in this field.
Before discussing specifically the effect of cannabis use on humans,
I would like to state that my colleagues and I feel that, in areas of
major significance, the physical effects of cannabis use are not well
documented by animal studies. To the best of our knowledge, there
119
are no reports on the effects of cannabis on spermatogenesis in pri-
mates or even in mammals
Mr. Martin. Spermatogenesis is the process of producing sperm?
Dr. Kolodxt. This is correct. There are no reports in the literature
describing changes, if any, in reproductive hormones in animals given
cannabis chronically or acutely; and the hormonal studies reported
to date represent, at best, incomplete and, at worst, irresponsible sci-
entific methodology. In as important areas as impairment of fertility
or possible teratogenicity — production of physical defects in the de-
veloping embryo — animal experimentation has proceeded slowly and
left important questions unanswered.
A brief examination of the background literature may be informa-
tive. In 1965, Miras reported that female rats maintained on a diet
containing 0.2 percent marihuana extract for several months showed
a significant reduction in fertility and a reduced growth rate. Tera-
togenicity was not observed. Persaud and Ellington, used cannabis
resin at a dosage of 16 milligrams per kilogram of body weight in-
jected into pregnant rats on days 1-6 of gestation, caused complete
fetal resorption; in a subsequent report, dosage levels of 4.2 milli-
grams per kilogram of body weight on days 1-6 of gestation were
shown to have a variety of teratogenic effects. These effects included
syndactyly — webbing between the digits — in 72 percent of the ani-
mals, encephalocele — hernia of the brain — in 57 percent, phocomelia —
abnormal development of the limbs, with the "seal-flipper" appear-
ance also encountered with thalidomide — in 15 percent, complete ab-
sence of a limb or limbs in 2 percent, and protrusion of the bowels
from the abdomen in 30 percent. Similar work was then repeated by
Greber and Schramm in 1969, with litters from female hamsters
receiving marihuana described with the following abnormalities:
"fetuses with head, spinal, and whole body edema, phocomelia, om-
phalocele, spina bifida, exancephaly, multiple malformations, and
myelocele."
Pace, Davis, and Borgen reported impaired fertility but not abso-
lute sterility in female rats given either delta-9 or delta-8 tetrahydro-
cannabinol by injection — 20 or 40 milligrams per kilogram of body
weight — on alternate days for a 30-day period. Harbison and Man-
tilla-Plata showed that delta-9 tetrahydrocannabinol was transferred
across the placenta and was embryo or fetocidal in mice, but no ob-
servation of fertility was possible since drug administration began
after conception.
It must be stressed that these animal studies cannot be accurately
transferred to humans because of obvious differences in the high doses
employed and the mode of administration utilized. However, it is ap-
parent that there is a potential risk in cannabis use during preg-
nancy, and that, at present, there are no adequate studies of women
who have used cannabis during pregnancy with relation to the health
of their children.
Reproductive studies of cannabis effects in male animals have been
far fewer in number. Merari, Barak, and Playes reported that delta-
1(2) tetrahydrocannabinol caused deterioration in sexual perform-
ance in rats, which they attributed to "reduced sexual motivation."
No histologic or endocrine studies were done, however. Ling and his
120
coworkers administered delta-1 tetrahydrocannabinol to adult male
rats for 4 days, but did not report any alteration in gonadal activity.
However, they did not measure hormone production or sperm counts
and did not examine histologic section of the testes. It is indeed dis-
quieting that there are no careful, controlled studies of chronic or
acute cannabis effects on male reproductive physiology in animal
species.
Galen, approximately 18 centuries ago, has been cited as stating that
"Hempe * * * by much use thereof * * * dryeth up the natural seede of
procreation" and "doth refraineth Venereous desires." Much specula-
tion currently exists concerning cannabis and sexuality, but system-
atic controlled studies of this area have been conspicuously lacking.
We have recently published a report in the New England Journal of
Medicine entitled "Depression of Plasma Testosterone Levels After
Chronic Intensive Marihuana Use" that we hope will be viewed as an
invitation to scientists across the world to direct their attention spe-
cifically to possible reproductive consequences of marihuana use.
This report describes our studies in a group of 20 men aged 18 to 28
who had each used marihuana at least 4 days a week for a minimum
of 6 months, without use of other drugs during that interval. In the 6
months before the study began, these subjects averaged weekly con-
sumption of 9.4 joints of marihuana, with some subjects averaging as
much as 18 joints per week. The overall duration of marihuana use —
although not at this dosage level — averaged approximately Z\Z2 years
for the group. One subject had used the drug regularly for 8 years.
The duration of marihuana use at least 4 days a week in this group
averaged 11.1 months.
Men were chosen for this study, after meeting the first criterion of
use of marihuana at least 4 days a week for a minimum period of 6
months, according to the following criteria : no history of use of any
drug by injection except under a physician's care; no history of in-
gestion of LSD or other hallucinogens, amphetamines, barbiturates,
cocaine, narcotics, hypnotics, or sedatives in the preceding 6 months ;
no history of using male or female sex hormones; no history of en-
docrine disease; no history of hepatitis or other liver disease; and
alcohol intake not more than two ounces per day.
Twenty healthy men who had never used marihuana and who met
the other criteria described above served as a control group. These
men were matched with the test group for age and for cigarette-
smoking habits. The ages of these men were also 18 to 28 years.
At this point in my discussion, I would like to emphasize the fact
that we did not provide marihuana for the men we studied, nor did we
ask them to continue their drug use pattern. It also should be stated
that we did not supervise their use of marihuana, and specifically that
they did not engage in marihuana use in our laboratories or offices.
We investigated blood levels of a variety of hormones that are im-
portant in reproduction. The principal male sex hormone, testosterone,
was found to be approximately 44 percent lower in the group of men
using marihuana chronically and frequently than in the group of men
who had never used this drug. This finding was not uniform in all the
men studied, however, and it appeared to be related to the amount of
marihuana used. Men who averaged 10 or more marihuana "joints"
121
per week had significantly lower testosterone levels than men who used
fewer than 10 marihuana cigarettes weekly.
Interestingly, a standard test which measures the capacity of the
testes to produce the male sex hormone showed that in all four sub-
jects tested while thev continued marihuana use, normal responses were
found— blood levels of testosterone rose from 121 to 269 percent. This
would seem to indicate that the effect of marihuana is not directly on
the male sex organs, but is at a higher regulatory center, which might
be either the pituitary gland or the hypothalamus, a part of the brain
quite important in hormone regulation.
Three subjects discontinued the use of marihuana for a 2- week pe-
riod, and in each instance, a significant increase was seen in blood
testosterone during this time. It would therefore appear that the
testosterone-lowering effect of marihuana may have been only tempo-
rary.
Six of 17 men tested showed sperm counts that were below normal,
with some of these men in the area that is considered sterile. Of course,
we do not know if the lowered or sterile counts were present before
these men began using marihuana. We also do not know if these counts
might increase if marihuana use is stopped. This is because it would
require a minimum of 3 to 6 months off the drug to evaluate this, since
it takes approximately 8 or 9 weeks for a generation of new sperm
cells to come to maturity, and at any time there are many generations
of sperm cells within the testes.
Two of the 20 subjects using marihuana reported impaired sexual
functioning. In one instance, a man who had experienced potency
problems intermittently over the preceding year was asked to stop us-
ing marihuana, and now, 10 months later, has not had further sexual
difficulties. We have also seen two patients, who were not part of this
research study, where frequent long-term use of marihuana was asso-
ciated with impotence and lowered plasma testosterone. In both these
instances as well, discontinuing the marihuana use led to normal sex-
ual functioning.
We would like to point out that this study has a number of problems
that need to be considered for a careful interpretation of our findings.
First, the sample size is quite small, so that it is not possible to accu-
rately generalize our findings to all young men using cannabis this
frequently. We do hope that others will enlarge these and related
studies in controlled investigations. Second, we have no absolute veri-
fication that the marihuana users were not also using other drugs that
might lower hormone levels or affect sperm production. Third, we
have no knowledge of the purity or potency of the marihuana used by
these men. Therefore, we reiterate our position that this work raises
an area of serious concern, but does not answer specifically the ques-
tion of safety in marihuana use.
There are theoretical possibilities that might be related to our find-
ings beyond those that I have discussed. Since at least some of the
active constituents of marihuana have been shown to cross the pla-
centa, there may be a significant risk of depressed testosterone levels
within the developing fetus when this drug is used by a pregnant
woman. Since normal sexual differentiation of the male depends on
adequate testosterone stimulation during critical stages of develop-
122
ment, occurring approximately at the third and fourth months of
pregnancy, it is possible that such development might be disrupted.
Theoretically, there is also the possibility that marihuana use by the
prepubertal male may delay the onset or completion of puberty or
may interfere with bone growth, if a suppression of pituitary or
hypothalamic function occurs. Neither of these possibilities has been
investigated.
Drs. Masters, Toro, and I have been involved in further research
into marihuana effects on male hormone status, where we have
measured the effects of acute marihuana use on the hormone levels of
experienced smokers. In this experimental setting, we are working
with highly controlled conditions, and because these subjects are
hospitalized, we can be sure they are not using any additional drugs,
including tobacco and alcohol.
In the initial phase of these studies, which is all I am able to re-
port about today, four men have been evaluated during the first 3
hours after smoking a single marihuana cigarette of known potency.
This testing is done after they have abstained from any marihuana
use for at least 2 weeks, and it is done in a standardized format so
that variations in activity or time of day do not occur. Two days
prior to the test day, each subject undergoes a series of blood samples
to coincide with the samples to be obtained during the test : In this
way we can evaluate possible stress effects of obtaining the blood
sample as well as variation related to time.
In each instance, plasma testosterone levels dropped significantly
lower than the level immediately prior to smoking marihuana, with
the decreases attributable to marihuana ranging from 10 to 36 per-
cent, with an average decrease of 27 percent. We plan to expand
these studies, and a full report will be prepared within a year.
In addition, the Reproductive Biology Research Foundation has
submitted to the N.I.H. a proposal to study the effects of chronic,
intensive marihuana use by women in the reproductive age range
specifically designed to evaluate their hormonal status and sexual
functioning. If approval and funding for this proposal are obtained,
such studies could begin in the near future.
To summarize our opinion on the issue of legalization of mari-
huana, we must state that from a scientific viewpoint, there are too
many unanswered questions to warrant such a change in current laws.
The resolution of these questions may present convincing evidence
of either the safety or danger of marihuana use, but until such defini-
tive information is available, we consider it of paramount import to
encourage careful and objective research in this field.
However, we wish to draw the distinction between our role as
scientists and as concerned citizens. Scientists do not and should not
make or enforce laws, and our position is simply that of wanting the
legislators and the public to be well-informed on all sides of this
issue.
Believing that the question of legalization of marihuana is pre-
mature, we would now like to state our personal hope for a move to-
ward the decriminalization of marihuana possession. When mari-
huana possession is a felony, society as well as the individual pays a
high price indeed, measured not only in dollars and time, but in
123
immeasurable disruption of lives. The attention of law enforcement
agencies has been necessarily diverted from other areas of concern,
and yet there has not been a decrease, but a marked increase, in the
use of this drug.
Thank you, Mr. Chairman.
Senator Gtjrney. Thank you, Doctor.
Mr. Martin.
Mr. Martin. Thank you, Mr. Chairman.
Dr. Kolodny, as you know, there is a widespread belief, especially
among young people, that marihuana enhances one's sexual life. Is
this borne out by your own research or by the research of any other
scientists with whom you are familiar?
Dr. Kolodny. There has been no research evidence that indicates
that marihuana acts as a sexual stimulant, In point of fact, although
our studies were not directed at answering this question, the finding
of lowered testosterone levels and impotence in at least some men
using marihuana points to the fact that an opposite effect from that
so popularly stated may, in fact, be going on at least in some users of
the drug.
Mr. Martin. Could it be that as a result of the general euphoria
which results from marihuana use, young people who use it are under
the impression that their sexual powers have been enhanced, when
this is not in fact the case?
Dr. Kolodny. This is one possibility, certainly. Another might be
that the perception of feelings might be altered but the actual per-
formance not changed or possibly even diminished somewhat but
that the perception of the experience was altered in some way.
Mr. Martin. Is there enough evidence to make possible a compari-
son of the effects of alcohol and tobacco in the reproductive system
as opposed to the effects of marihuana which you have described ?
Dr. Kolodny. Yes, sir, I think there is and I base my comments on
work that I have conducted as well as work done by others. Alcohol,
when used with high frequency in terms that would generally be con-
sidered alcohol abuse, certainly can produce disruption of normal
hormone balance and lowering of testosterone and can produce actual
wasting of the testicular tissue as well as other feminizing changes
in the male such as enlargement of the breasts.
The effects of excessive alcohol use on the production of sperm are
less clearly understood, but apparently alcoholism can result in de-
creased sperm production. However, our studies of the acute use of
alcohol, that is, the effect of the immediate effects of graded amounts
of alcohol on blood levels of testosterone, indicate no drop at differ-
ent times of day and under different conditions in experiments that
were very carefully controlled. Our evidence having to do with mari-
huana, although I label this as preliminary evidence, shows that
marihuana does have a sudden effect of lowering testosterone values
within a matter of hours.
The effects of cigarette smoking on reproduction have been greatly
exaggerated, I believe, in the popular press. There is currently no
good evidence of which I am aware, based on my own work or work
of others, that cigarette smoking decreases hormone production or
decreases sperm production.
124
Mr. Martin. Your study mentioned several cases of impotence re-
sulting from heavy marihuana use. Do you know of any other medi-
cal reports that would tend to confirm this finding?
Dr. Kolodny. There have been anecdotal reports, as this report is
also, mentioning the occurrence of impotence associated with heavy
cannabis use in both Jamaica and in portions of the Mideast. How-
ever, these studies have not been done carefully enough to delineate
what the actual mechanisms are. Animal studies have shown that at
least in the rat a deterioration in male sexual performance has been
described but the animal literature is very, very sparse on this point.
Mr. Martin. In the research paper on which your testimony today
is based, you mention the possibility that there may be some relation-
ship between the effects of marihuana on the reproductive system and
the passive behavior — sometimes referred to as "the amotivational
syndrome" — which many observers have noted in regular marihuana
users. Could you elaborate on this briefly ?
Dr. Kolodny. Yes, sir. In elaborating on this I would like to label
what I am saying as very highly speculative but nevertheless it does
have a theoretical basis. There is in existing literature a correlation
between levels of testosterone and aggression, and I use that term in
the scientific sense, not in a sense of socially deviant behavior. When
testosterone levels get low. usually ambition and aggression get low.
This has been documented in animals, in primates and in the human
in a variety of different studies over the past 5 years.
In theory, if the reports of alteration of behavior patterns in heavy
cannabis users are accurate, the basis for this so-called amotivational
syndrome may potentially be the decreased testosterone level.
Mr. Martin. A very interesting speculation, Dr. Kolodny. I hope
it is pursued scientifically.
If cannabis products impair the DNA of sperm cells, as some re-
searchers now report, could this imply the possibility that the sperm
of marihuana smokers thus affected might produce genetically dam-
aged offspring ?
Dr. Kolodny. Mr. Martin, that is a very difficult question to an-
swer, and I think I would have to say that it cannot be answered on
the basis of any research that has been done. That possibility, I be-
lieve, would exist but I would like to qualify what I am saying by
the statement that much of the testimony today, I think, has been
couched in terms of scientific opinion rather than actual scientific
fact, and I would like to distinguish my answer there as my opinion,
that is, that such genetic damage might occur, but it would require
careful studies in the human to know whether that is happening.
Mr. Martin. In your statement, Dr. Kolodny, you said that your
findings are preliminary, and that there will have to be more research
before these findings can be firmly established. I have a philosophical
question. Should a scientist publish findings which he considers to be
preliminary ?
Dr. Kolodny. Mr. Martin, I would answer this question in this
way. I think it is a good question. I believe that it is the responsibil-
ity of a scientist to call the attention of other scientists to possible
areas of research for their consideration. It is also my personal belief,
and I will so state it, that there is no piece of scientific research that
125
can be fully accepted until it has been repeated by at least one in-
dependent party, that is, who has not participated in the original
work. This process of the replication of scientific experiments, I
think, is a fairly accepted one in the academic community, and I use
the word preliminary in that sense, that while I have full confidence
in the findings in the small group of men we studied I will have more
confidence when other researchers have enlarged these studies.
Mr. Martin. You stated in your prepared statement that you would
be opposed to the legalization of marihuana ?
Dr. Kolodnt. That is correct.
Mr. Martin. That is, complete legalization ? Could you briefly state
the basic reasons for your opposition to legalization ?
Dr. Kolodnt. Yes, sir, I will try to summarize those reasons. I am
restricting my remarks to my own field of expertise, which is the
field of reproduction, but I do acknowledge the testimony of other
scientists in different areas that I think speaks toward the same
point, and that is as Dr. Morishima pointed out, there are many re-
search areas that have simply not been fully enough studied for us
to even begin to make a statement of safety in marihuana use.
In my particular area there is evidence currently, based on both
animal and human experimentation, that indicates the possibility of
consequences that potentially are serious ones, and in light of these
possibilities, which I would mention briefly as disruption of sperm
production, the possibility of birth defects, the possibility of impair-
ment of hormone balance and the possibility of either inhibition of
puberty or disruption of normal sexual differentiation during fetal
development, I think until answers to these questions are more fully
known that it would be extremely poor judgment to consider legal-
ization.
Mr. Martin. A further question on marihuana and the law. You
said that you favor rewriting the marihuana law so that simple pos-
session would be decriminalized. I think this is something upon which
just about everyone agrees and very few young people, if any — I sup-
pose there are some — are being sent to jail today for simple posses-
sion. But there are some who argue that a penalty, even if a minimal
penalty, should be retained in order to make it clear to young people
that society has to protect itself against this, and society does not
approve of its use. Other people feel that any kind of punishment is
counterproductive. What is your own thinking on this matter?
Dr. Kolodxy. I think that is a good question and I do sincerely
hope that no one is being jailed today for simple possession. The use
of sanctions of the law in the form of perhaps a fine or some other
appropriate punishment, if one chooses to use that word, is certainly
a necessary thing if one is not going to legalize the drug, and I am in
favor of retaining legal sanctions but decriminalizing from the view-
point of an actual jail sentence, and I do specify for possession of
the drug.
Mr. Martin. All right, thank you for clarifying your position on
this matter.
Did I understand correctly that your studies that have recently
been conducted have been funded by NIH ?
Dr. Kolodnt. No, sir.
126
Mr. Martin. Or you have applied for funding ?
Dr. Kolodnt. We have applied for funding for doing a similar
study in females to look for reproductive consequences of cannabis
use. We are currently carrying on research that also has been funded
by a private source. The Frederick Ayer Foundation has provided
our funding.
Mr. Martin. I have no further questions, Mr. Chairman.
Senator Gurnet. Mr. Sourwine.
Mr. Sourwine. No, thank you, sir.
Senator Gurnet. Thank you very much, Doctor. I appreciate your
testimony here on a very important subject.
Professor Leuchtenberger, I am sorry you have to wait so long.
You have been very patient and we certainly welcome your testi-
mony, Professor. Could you identify yourself for the record ?
TESTIMONY OF PROF. CECILE LEUCHTENBERGER, HEAD OF THE
DEPARTMENT OF CYTOCHEMISTRY AT THE SWISS INSTITUTE
FOR EXPERIMENTAL CANCER RESEARCH, LAUSANNE, SWITZER:
LAND
Dr. Leuchtenberger. I am Prof. Cecile Leuchtenberger, and I am
the head of the Department of Cytochemistry at the Swiss Institute
for Experimental Cancer Research, Lausanne, Switzerland.
Senator Gurnet. I will ask a few questions here to establish your
qualifications.
I understand you are a biologist who has had special training in
experimental cancer research, cytology, cytochemistry and biophysics,
is that correct ?
Dr. Leuchtenberger. Yes.
Senator Gurnet. And that you received your Doctor of Philos-
ophy in Biology at Columbia University in 1949 ?
Dr. Leuchtenberger. Yes.
Senator Gurnet. And that you continued your advanced education
at institutes in Sweden and in Switzerland?
Dr. Leuchtenberger. Yes.
Senator Gurnet. And from 1950 to 1959 you were head of the De-
partment of Cytochemistry at the Institute of Pathology, Western
Reserve University, in Cleveland?
Dr. Leuchtenberger. Yes.
Senator Gurnet. As a matter of fact, you established this depart-
ment, did you not?
Dr. Leuchtenberger. Yes, I did.
Senator Gurnet. And you subsequently worked at the Children's
Cancer Research Foundation and the Children's Medical Center at
Harvard University?
Dr. Leuchtenberger. Yes.
Senator Gurnet. From 1956 to 1962, you served as a member of the
advisory committee of the American Cancer Society, and you also
served on its committee on research on lung cancer ?
Dr. Leuchtenberger. Yes.
Senator Gurnet. And your research has at different times been
127
supported by the U.S. Public Health Service and the World Health
Organization, in addition to various foundations?
Dr. Leuchtenberger. Yes.
Senator Gurnet. And you are now an associate professor at the
medical school of the University of Lausanne in Switzerland?
Dr. Leuchtenberger. Yes.
Senator Gurnet. And you have also lectured extensively at Euro-
pean and American universities?
Dr. Leuchtenberger. Yes.
Senator Gurnet. And you are the author of over 130 scientific
papers?
Dr. Leuchtenberger. Yes.
Senator Gurnet. All told, you have had more than 30 years expe-
rience in cancer research, and 26 years of experience in cell research ?
Dr. Leuchtenberger. Yes.
Senator Gurnet. I understand you reside in Switzerland but you
are an American citizen since 1944, is that correct?
Dr. Leuchtenberger. Yes.
Senator Gurnet. We will be glad to have your statement, Doctor.
Dr. Leuchtenberger. Mr. Chairman, let me thank you first for the
honor to be invited to report about our research studies on marihuana
before this distinguished committee. We started our experimental
studies on marihuana in 1970 and I would like to say this work was
done in collaboration with Prof. Dr. Rudolf Leuchtenberger M.D.,
experimental pathologist. The marihuana was obtained after permis-
sion of the Health Department of the Swiss Government, from Dr.
Olav J. Braenden, director, United Nations Narcotics Laboratory,
Geneva, Switzerland and the work was supported by the World
Health Organization.
Our experimental work on marihuana has been concerned so far
with three principal questions.
(1) What effect has smoke from marihuana cigarettes on the respi-
ratory system, and how does the effect compare with that of smoke
from tobacco cigarettes?
(2) What effect has smoke from marihuana cigarettes on the cell
metabolism, in particular, what is its effect on the genetic material,
that is on the DNA?
(3) "What effect has smoke from marihuana cigarettes on the
spermatogenesis ?
Experimental exploration in this direction appeared to us neces-
sary because in spite of the fact that smoking of marihuana has be-
come a widespread human habit, there was hardly any information
concerning effects of marihuana cigarette smoke itself on the respira-
tory system and other tissues and their cell metabolism.
Furthermore, during our extensive experimental studies concerning
the role of tobacco cigarette smoke in lung carcinogenesis and its
effect on cellular DNA metabolism of the respiratory system, we had
developed model systems permitting to examine effects of fresh smoke
on tissues, cells and DNA under standardized conditions.
. There is no intention on my part here to impose on you any techni-
cal details but I think for a better understanding of the results which
128
we will discuss here today, I would like to say, if I may, just a few
words about the model systems which we used.
There are two main model systems which we used, and which are
actually complementary to each other.
In the first model system we expose cultures prepared from animal
or human lung to puffs of fresh smoke from marihuana cigarettes.
Now, this model system is particularly suitable to assess time se-
quential alterations in cells and tissues, after short- and long-term
exposure.
In the second model system we use inhalation experiments in mice
with marihuana cigarette smoke. I would like to say that inhalation
experiments in mice pose a difficult problem because man is the only
individual who inhales voluntarily the smoke either from tobacco or
marihuana cigarettes. However, we have developed a machine which
permits individual mice to inhale repeatedly one puff of smoke al-
ternating with fresh air thus imitating as closely as possible the habit
of human cigarette smokers. This model system permits us to assess al-
terations in the respiratory and other systems after short- or long-
term inhalation of marihuana cigarette smoke in living animals.
For a better understanding of the results to be discussed, a few
words should be said at least in regard to the methods employed in
analysis of the genetic material DNA. We used special quantitative
cytochemical technics, such as radioautography, microspectrography,
and microfluorometry. The unique character of these methods lies not
only in the possibility that an analysis of DNA can be made in a
single cell, or in part of a cell, such as the nucleus or the chromo-
somes, but also that the DNA analysis can be made in situ in micro-
scopic preparations, in other words, without destroying cell or tissue
architecture. Thus, it is possible to make a direct comparison between
morphology and DNA behavior on the same cell and from cell to cell
at the microscopic level.
There are three different types of experimental studies which we
have carried out so far, and on which the following results were
obtained.
STUDY 1 : A COMPARISON BETWEEN EFFECTS ON MOUSE LUNG CULTURES OF
SHORT-TERM EXPOSURE TO SMALL DOSES OF SMOKE FROM CIGARETTES
MADE OF TOBACCO AND OF SMOKE FROM CIGARETTES MADE OF THE SAME
TOBACCO BUT TO WHICH MARIHUANA WAS ADDED
In the first experimental study we exposed mouse lung cultures to
puffs of fresh smoke from tobacco cigarettes without marihuana, and
then the same cultures to puffs of fresh smoke from tobacco cigarettes
to which marihuana was added. In these experiments we used a rela-
tively low dose or, as we say in technical terms, a small puff volume
of the cigarette smoke and a relatively short exposure.
It was found that addition of marihuana to tobacco cigarettes pro-
duced a smoke which was much more harmful to these mouse lung
cultures than was the smoke from tobacco cigarettes without mari-
huana. From the data given in figures 1 and 2, it can be seen that daily
exposure to two puffs (puff volume 8 ml) for 5 consecutive days to
129
cigarette smoke without marihuana did not produce significant alter-
ations in the cultures, when compared with nonexposed control cul-
tures. On the other hand, the same type of exposure to cigarette
smoke with marihuana evoked significant alterations in cell morphol-
ogy, cell division, DNA content and DNA synthesis.
The frequencies of all these alterations were statistically significant
when compared not only with frequencies in nonexposed control
cultures, but also when compared with frequencies in cultures ex-
posed to tobacco cigarettes without marihuana.
The finding that after exposure to smoke from tobacco cigarettes
with marihuana there were many abnormalities in cell division and
a shift from the constant normal DNA content in cells towards higher
DNA amounts or polyploidy (fig. 2), deserves special attention,
because both types of alterations are often observed in precancerous
or cancerous lesions.1
EFFECTS OF FRESH SMOKE (2 PUFFS DAILY FOR 5 DAYS) FROM CIGARETTES WITHOUT AND WITH
MARIJUANA (0,4% TETRAHYDROCANNABINOL) ON MORPHOLOGY, MITOTIC INDEX AND DNA. SYNTHESIS
IN EPITHELOID CELLS OF LUNG EXPLANTS FROM SNELLS AND C 57 BLACK MICE.
TYPE OF
EXPERIMENT
CONTROL
CIGARETTE SMOKE
WITHOUT MARIJUANA
CIGARETTE SMOKE
WITH MARIJUANA
ABNORMALITIES
OF CELLS
(+)
++
MITOTIC INDEX
(n,= 54)
0,28 i 0,07
0,39 t 0,002
0,610,11
pCo =.0005
pCi = .025
DNA CONTENT (F.M.)
(n2 r 450)
FREQUENCY OF NUCLEI
2 DNA
4 DNA
2_
1
p = .0005
DNA SYNTHESIS
(3H TdR)
In, = 15 )
FREQUENCY OF
LABELED CELLS
10,9 i 2,1
13,6 i 2,6
19,2 t 1,9
pCo=.01
pCi =.05
"
(+) = DOUBTFUL
(+) - + = SLIGHT EFFECT
++ = PRONOUNCED EFFECT
F. M * = FEULGEN MICROSPECTROGRAPHY
n, = NUMBER OF CULTURES EXAMINED
n, = NUMBER OF CELLS MEASURED
1 The results mentioned here were published in more details under the title "Mor-
phological and cytochemical effects of marihuana cigarette smoke on epithelioid cells
of lung explants from mice" (Leuchtenberger C. and Leuchtenberger R.) in "Nature,"
vol. 234, No. 5326, pp. 227-229, 1971.
130
'is. 2
COMPARISON BETWEEN EFFECTS OF FRESH SMOKE
(2 PUFFS DAILY, 5 DAYS) FROM ONE UNFILTERED CIGA-
RETTE WITHOUT AND WITH DIFFERENT DOSES OF
"MARIJUANA" AND THC,ON THE DNA CONTENT#OF EPI-
THELOID CELLS (^=1200) FROM LUNG EXPLANTS
OF SNELL'S MICE.(N2=3)
KX>
80-
60
40
20
0
100
80
60-
40
20
0
CONTROL
100
80
60-
40-
20-
|4DNA|
100
80
60-
40
20-
0
UNFILTERED CIGARETTE
100 -|
80
60
40-
20
0
i !
100-|
80
60
40
P^
UNFILTERED CIGARETTE WITH "MARIJUANA"
oo-
100
0,5 gr. 80
0,4°0THC
80-
2 DNA
60-
60
40-
20-
p = 0,025 40
20
0-
4 DNA
— 0
100-]
1 9r- 80
0,4°(,THC
60
p = 0,0005 ^
4 DNA
\
20-
0,5 gr.
400THC
2 DNA
4 DNA
•
AMOUNT OF D.N.A.
N,= NUMBER OF CELLS MEASURED N2 : NUMBER OF EXPERIMENTS
* FEULGEN MICROSPECTROGRAPHY
131
STUDY 2 : A COMPARISON BETWEEN EFFECTS ON HUMAN LUNG CULTURES OF
SHORT-TERM EXPOSURE TO LARGER DOSES OF SMOKE FROM CIGARETTES
MADE OF KENTUCKY STANDARD TOBACCO AND OF SMOKE FROM CIGARETTES
MADE OF MARIHUANA ONLY
If we come now to the second type of the experimental study, here
we used human lung cultures, because after all it is the human prob-
lem in which we are interested. We used human lung cultures from
adult and fetal lungs, and compared effects of smoke from cigarettes
which were made from tobacco only — whereby we used the so-called
Kentucky standard tobacco — with effects of smoke from cigarettes
which were prepared with the same paper but made from marihuana
only.
For this study on human lung cultures larger puff volumes, 25 mil-
liliters of smoke were utilized than in the study on mouse lung cul-
tures, 8 milliliters. This puff volume was chosen because it resembles
more closely the standard puff volume of 35 milliliters inhaled by hu-
man smokers.
It was found that the alterations in human lung cultures — adult or
fetal lung — were very similar after exposure to smoke from mari-
huana cigarettes and after exposure to smoke from Kentucky stand-
ard cigarettes. From the scheme in figure 3 and the data given in fig-
ures 4 and 5, it can be seen that each type of smoke produced abnor-
malities in DNA synthesis, in cell division, and stimulated irregular
growth of the lung cultures.
Furthermore, after exposure to each type of smoke the human lung
cultures disclosed a variability in number and DNA content of
chromosomes.
However, this disturbance of the genetic equilibrium of the cell
population which persisted for prolonged periods after exposure was
more marked after exposure to smoke from marihuana cigarettes
than after exposure to smoke from Kentucky standard tobacco ciga-
rettes— compare statistical significance, p values in figures 4 and 5.
132
F
>9-
cMevr.ic.al CAnanc-jeS iri ot'-ll.s £,-cm c*du.l4-
Af+er Exposure
Inh.tD.-rlon o£ DMA
Syn-Hiesls arvd of- mifosvS.
Enlarge, me v">+ cmd
irr-egubM-i+ies of nuclei ;
hvCjH DNJA C-<Dn+e.ni-
£>-Ky>-.LAlo47ion o-f DMA
.Sv.; n4-hesis j aboofmal
mik>£is ^ I agg i mg £>-£
Hyperplasia ^ abnormal
pr-O^ i-fe^Oi-i-ioo Wig In
rvM+o£.is _, abnorKnal
number- a.nd D NJ A
133
J?ig.4
/
COMPARISON BETWEEN THE DNA CONTENT (FEULGEN MICROFLUO
ROMETRY) IN METAPHASE (M) AND TELOPHASES (T)OF FIBROBLAS-
TIC CELLS (N*= 431) FROM A CONTROL ADULT HUMAN LUNG
EXPLANT AND AFTER EXPOSURE TO FRESH SMOKE FROM MARI-
JUANA AND KENTUCKY CIGARETTES. (N1= 5)
50-
40
20-
10
CONTROL
M
r
50-
40-
20-
10
^~
j£L
Ubcte
\-
Z
UJ
O
CC
UJ
a.
>
o
z
HI
=>
o
UJ
KENTUCKY CIGARETTES
p Co = 0065
pCo.= 05 _
DNA AMOUNT IN BASIC UNITS
N*= Number of cells measured
N1= Number of experiments
134
lig.5
COMPARISON BETWEEN NUMBER OF CHROMOSOMES OF FIBRO-
BLASTIC CELLS (N"=633) FROM A CONTROL ADULT HUMAN LUNG
EXPLANT AND AFTER EXPOSURE TO FRESH SMOKE FROM KEN-
TUCKY AND MARIJUANA CIGARETTES. (N1 = 12)
CONTROL
4N
i i i n i i i H-rn i n m i i rr'T'i mm
46 50 52- 64- 75- 84- 88 -92 96- 105-
KENTUCKY CIGARETTES
P. C - 0005
n m n m n n n i rrn
46 50 -52 -56- 76- 87 89-92 95-100
MARIJUANA CIGARETTES
P« Co< 0005
n i n n r-TT^n
-r*n*r* r~
42 46 50 52- 56-72- 82-86 88 -92 96- 105
NUMBER OF CHROMOSOMES
N*= NUMBER OF METAPHASES COUNTED
N1 = NUMBER OF CULTURES EXAMINED
135
This larger effect of marihuana cigarette smoke on chromosomes
and their genetic material gains special significance if the following
observation is taken into consideration. Cigarettes made of marihuana
smoked and drew less well than cigarettes made of Kentucky tobacco.
The marihuana cigarettes, which contain a sticky resin, have a much
larger side stream — this means much more smoke is lost in the air
than with ordinary tobacco — so that much less marihuana smoke
reached the cultures than after tobacco smoke.
It remains to be seen whether long-term exposure to marihuana
and tobacco smoke produces even greater differences between their
effects on genetic material.
STUDY 3 : EFFECTS OF SHORT- AXD LONG-TERM INHALATION OF MARIHUANA
CIGARETTE SMOKE — ALONE OR IN COMBINATION WITH TOBACCO CIGA-
RETTE SMOKE ON THE RESPIRATORY AND OTHER SYSTEMS OF MICE
The last study which we are carrying out, are inhalation experi-
ments in mice with marihuana cigarette smoke. Here I would like to
stress the fact that these experiments are underway, they are very
incomplete, and the results which I present here today have not been
published and they are preliminary. So far we have found that in-
halation of smoke from marihuana cigarettes produced irregular
growth in the respiratory system of these mice. The interesting obser-
vation is, and this was done by Dr. Rudolf Leuchtenberger, who is
a pathologist, that he noted that the location of the alterations was
different from that after tobacco cigarette smoke. After inhalation
of tobacco cigarette smoke, alterations were found mainly in the
larger bronchi and bronchioles, while after marihuana they were
found in terminal bronchioles.
Furthermore, as seen in figure 6, inhalation of smoke from mari-
huana cigarettes produces a marked variability and increase in DNA
content in these bronchial cells.
136
i''i
.6
AMOUNT OF DNA* AND SIZE OF NUCLEI (N=600) IN BRONCHIOLAR
EPITHELIAL CELLS OF SNELL'S CONTROL MICE AND AFTER INHA-
LATION OF FRESH SMOKE FROM MARIHUANA CIGARETTES.
(-2000 PUFFS)
z
LLI
o
cc
UJ
Q.
o
z
UJ
o
UJ
cc
u_
CONTROL
40-
,1
40-
I
30-
30-
.
20-
20-
10-
I —
~u
10-
-
n
I
6
10 14 18
I I I I
22 26 30 34
4
1 I
6 8 10
MARIHUANA
40-
I Pco«000!
40-
I Pco« 0005
30-
30-
JL
20-
, 20-
m
10-
I 18
10-
22 26 30 34
M^
I
6
I
1(
)
1'
I
4
6 8 10
DNA AMOUNTS IN ARBITRARY UNITS AREAS OF NUCLEI
IN r2jj
* MICROSPECTROPHOTOMETRY
N= NUMBER OF NUCLEI MEASURED
137
Another observation in this inhalation experiment, which is even
more preliminary than this one. concerns the reproductive system of
the male mouse. It was found that after male mice had inhaled for
3 months puffs of smoke from approximately 100 cigarettes made of
marihuana alone, there was a marked disturbance in spermatogenesis
which was not found with the parallel group which had inhaled the
tobacco smoke. After marihuana there were not only less mature
sperms than in the controls or in the mice which had inhaled tobacco
smoke, but many of the spermatids carried a faulty and reduced
amount of DNA.
Mr. Martin. A spermatid is merely a sperm cell?
Dr. Leuchtenrerger. It is a stage just before the mature sperm is
formed. I should like to say that such spermatids should contain ex-
actly half the amount, haploid. of what we call the normal diploid
amount of DNA. If this preliminary observation can be confirmed on
a larger series of experiments, it would indicate that marihuana
smoke interferes also with male fertility;. In our previous extensive
studies concerned with the fertility problem, which had nothing to do
with the marihuana problem, we had found that reduced amounts of
DNA in spermatids are frequently associated with cattle and human
infertility.2
In conclusion. I would like to say that we realize fully that many
more experimental studies are urgently needed before any definite
conclusions can be drawn concerning long- and short-term effects of
marihuana cigarette smoke on tissues, cells and their genetic material,
DXA.
Nevertheless, on the basis of the data obtained so far in our ex-
perimental studies 3 the following statement appears justified.
Marihuana cigarette smoke has a harmful effect on tissues and
cells of humans and of animals. The observation that marihuana
cigarette smoke stimulates irregular growth in the respiratory system
which resembles closely precancerous lesions would indicate that
long-term inhalation of marihuana cigarette smoke may either evoke
directly lung cancer or may at least contribute to the development of
lung cancer. The observation that marihuana cigarette smoke inter-
feres with the DNA stability in cells and in chromosomes, that is, it
disturbs the genetic equilibrium of the cell population, strongly sug-
gests that long-term inhalation may alter the hereditary material
DNA and may also have mutagenic potentialities. Consequently fur-
ther extensive research is urgently needed to explore chronic effects
of marihuana cigarette smoke on cells and tissues. In particular,
studies should be carried out which are concerned with the problem
of possible mutagenic properties of marihuana.
Thank you.
" Leuclitenbcrser C. Weir D. R.. Schrader P., and Leuchtenberger R. "Decreased
Amounts of Desoxvribose Nucleic Acid (DNA) in Male Germ Cells as a Possible Cause
of Human Male Infertility." Acta Genet, fi : 272-278, 19~>fi. The results mentioned here
were published in more detail under the following titles : "Abnormalities of Mitosis.,
DNA Metabolism and Growth in Human Lunc Cultures Exposed to Smoke From
Marihuana Cigarettes, and Their Similarity With Alterations Evoked by Tobacco Cig-
arette Smoke" (Lpuehtehberper C. and 'Leuchtenbergpr R.) In United Nations Bul-
letin. ST/SOA/SER.S/37 November 17. 1972 ; "Effects of Marihuana and Tobacco
Smoke on Human Lung Phvsiolojrv" (Leuchtenberger C. Lpuchtpnberger R., and Schneider
A.) in Nature, vol. 241, No. 53S5* pp. 137-139. 1973; "Effects of Marihuana and Tobacco
Smoke on DNA and Chromosomal Complement in Human Lung Explants" (Leuchtenberger
C, Leuchtenberger R., Ritter U.. Inui N. ) in Nature, vol. 242, No. 5397, pp. 403-404, 1973
3 See summary of main findings in table 1.
138
Table I
Main findings obtained in our experimental studies concerned with effects of
marihuana cigarette smoke on tissues, cells and their DNA metabolism.
(1) Cultures of animal and human lungs — after repeated exposure to smoke
from marihuana cigarettes disclose abnormalities in DNA synthesis, in number
of chromosomes and their DNA content, in cell division and growth (atypical
proliferation).
(2) Mice — after repeated inhalation of smoke from marihuana cigarettes
disclose atypical proliferation in bronchi of lungs accompanied by abnormalities
in DNA synthesis and cell division. There are also disturbances in spermato-
genesis, such as reduction of DNA content in spermatids.
Senator Gurnet. Thank you, Professor. You mentioned in the last
part of your statement that marihuana cigarette smoke may have
mutagenic potentialities. What do you mean by that?
Dr. Leuchtenberger. It means that marihuana cigarette smoke
may alter the hereditary material. We understand under a mutagen
an agent which produces a change in the genetic material which is
hereditary.
Mr. Martin. That would lead or could lead to abnormal births?
Dr. Leuchtenberger. If you disturb the normal equilibrium of the
genetic material the possibilities that you would get abnormal growth
must be considered.
Mr. Martin. Have you found evidence that marihuana or that cig-
arettes laced with marihuana — I just want to understand — either
one is much more likely to harm lung tissues than only cigarettes?
Dr. Leuchtenberger. Yes.
Mr. Martin. Did your experiments produce clearly cancerous for-
mations in either the mice or in the lung tissue which you exposed
to marihuana ?
Dr. Leuchtenberger. No, we have no cancer so far but you must
not forget that we only used relatively short-term inhalation and
short-term exposure. For instance, from our experiments which we
did with tobacco cigarette smoke, we know that the mice had to be
exposed to inhalation for 1 year or longer before we saw enhancement
of the lung carcinogenesis. Such long-term experiments with mari-
huana are urgently needed. I am sorry if I did not express it suffi-
ciently that the results were obtained after relatively short-term
exposure.
Mr. Martin. But there are certain changes in the cell structures
which suggested to you that the lungs were moving, the lung tissue
was moving in a precancerous direction ?
Dr. Leuchtenberger. Yes, as I pointed out, there is such an indi-
cation. After marihuana cigarette smoke there are precancerous
stages similar to those after tobacco cigarette smoke, of which we
know that they precede malignant transformation, or cancer.
Mr. Martin. Do you plan to conduct any experiments on the long-
term effects of cannabis on lung tissues ?
Dr. Leuchtenberger. We have such experiments underway but I
would not like to talk about them because they are too scanty and
unfinished.
Mr. Martin. What was the THC content of the marihuana you
used in your experiments — was it strong marihuana or relatively
weak?
Dr. Leuchtenberger. We got from Dr. Braenden marihuana with
139
0.6 percent, and with 4 percent of THC, and we compared effects on
mouse lung cultures and DNA. Although we did not make a dose
response experiment, we did find that abnormalities in DNA were
larger after larger concentrations of the tetrahydrocannabinol in
marihuana. But I would like to say that before making a definitive
statement, there should be experiments done where different doses of
THC are used and assessed as to their effects on DNA.
Mr. Martin. I do not know whether you feel qualified to answer
this question, Professor Leuchtenberger, but it has been suggested by
some sociologists and educators in the United States that drug educa-
tion is counterproductive, that it does not scare young people away
from drugs while it frequently excites their curiosity. Would you
have any comments on this?
Dr. Leuchtenberger. I feel that this statement is not a correct
statement. We must not underestimate the intelligence and the open-
ness of young people. I can say from my own experience that the
young people would like very much to have the scientific facts in-
stead of emotions. The few young Swiss people with whom I have
discussed the problem of marihuana in Switzerland, and actually
other young Americans who work over there, when they see the data,
that is when they see that marihuana smoke does damage to the cells
of the respiratory system, and to the DNA, I think they give smok-
ing of marihuana a second and third thought. I therefore feel very
strongly that education of children in schools concerning health-
damaging properties of marihuana should start as soon as possible.
They should be informed on the scientific facts as they become
available.
Mr. Martin. Do you think the kind of scientific evidence that has
been presented at this hearing today might be effective in persuading
some young people who are being — are leaning toward marihuana
to consider it?
Dr. Leuchtenberger. I am convinced of that.
Mr. Martin. Thank you for that statement, Professor Leuchten-
berger.
A final question I would like to ask for you comment on two pas-
sages from a book by Dr. Lester Grinspoon of Harvard University,
a Harvard psychiatrist, "Marihuana Reconsidered." It is a best sell-
ing book, probably the most popular of all the promarihuana books —
and there have been quite a few of them. These are two passages that
appear on different pages. On one page he says :
It is quite true that among the hundreds and hundreds of papers dealing
with cannabis, there is relatively little methodologically sound research. Yet,
out of this vast collection of largely unsystematic recordings emerges a very
strong impression that no amount of research is likely to prove that cannabis
is as dangerous as alcohol and tobacco.
That was written in 1971.
And on page 371, there appeared the following passage :
Indeed, the greatest potential for social harm lies in the scarring of so many
young people and the reactive, institutional damages that are direct products
of present marihuana laws. If we are to avoid having this harm reach the
proportions of a real national disaster within the next decade, we must move
to make the social use of marihuana legal.
I ask for your comment on these two statements.
140
Dr. Leuchtenberger. Well, on the first statement I would say no
serious scientist at this time really could say that marihuana is harm-
less if you have no facts. And the second, I think in view of the evi-
dence which was brought here today, and I believe there will be more,
I think you cannot make such a statement. To me as a scientist, such
statements as you read are absolutely incomprehensible, to say it in
the most charitable way.
Mr. Martin. Thank you very much, Professor Leuchtenberger, for
a very cogent presentation. I have no further questions.
Senator Gurnet. Mr. Sourwine.
Mr. Sourwine. Mr. Chairman, I should like to ask that the four
publications which the professor told us about in discussing her ex-
periments be submitted for the subcommittee files and that they be
inserted in this record as part of the appendix if space permits.
Senator Gurnet. They will be accepted.
Mr. Sourwine. I would have this question in discussing your study
No. 1, Professor, you spoke of the addition of marihuana to tobacco
cigarettes. Did this mean that you used cigarettes composed of part
marihuana and part tobacco?
Dr. Leuchtenberger. Yes.
Mr. Sourwine. Now, in discussing your results obtained in study 3,
and I quote from your statement : "Furthermore, as seen in figure 6,
inhalation of smoke from marihuana cigarettes produced a marked
variability, an increase in DNA content in these bronchial cells." I
am looking at figure 6 and I have a little difficulty understanding
your statement. What is the control — is that the result with smoking
tobacco cigarettes?
Dr. Leuchtenberger. We have actually two controls. One which we
call a negative control, which is nonexposed, and the second control
is when you expose it to tobacco smoke.
Mr. Sourwine. Well, your chart appears to show only one control,
if I read it correctly.
Dr. Leuchtenberger. "Which figure?
Mr. Sourwine. Figure 6, amount of DNA and size of nuclei in
bronchiolar epithelial cells of Snell's controlled mice and after in-
halation of fresh smoke from marihuana cigarettes.
Now, your control seems to be the amount of DNA and the size of
the nuclei in the epithelial cells of Snell's controlled mice, is that
correct ?
Dr. Leuchtenberger. Yes.
Mr. Sourwine. Now, you say you have two controls. Is the other
one reflected in any study?
Dr. Leuchtenberger. We did not place it in this chart but after
tobacco cigarette smoke we did not find any differences from the
control in the bronchiolar tissue.
Mr. Sourwine. I am trying to find out what figure 6 is. I know
what it says at the top but you say that figure 6 shows that the in-
halation of smoke from marihuana cigarettes produces a marked in-
crease in DNA content.
Dr. Leuchtenberger. Yes.
Mr. Sourwine. A marked increase over what? Over the control?
That is the area, the amount of DNA and the size of the nuclei in
control mice?
141
Dr. Leuchtexberger. It is DNA in content in the cells of mice
which have not been exposed to marihuana cigarettes. This upper
thing, this is the normal distribution which you will find in the DNA
content in the bronchiolar cells.
Mr. Sourwixe. In other words, you used the same mice in one case,
but in one test the mice had not been subjected to any smoke at all?
Dr. Leuchtexberger. Yes.
Mr. Sourwixe. At the bottom, the mice had been subjected to
marihuana ?
Dr. Lettchtexberger. Right.
Mr. Sourwixe. So that there is no comparison with cigarette smoke
involved in figure 6 at all?
Dr. Lettchtexberger. No.
Mr. Sourwixe. "Well now, the control appears to range, the amount
of DNA ranges as high as almost 40, and under the marihuana it
never ranges above 20, but you say there was an increase. I cannot
read the chart.
Dr. Leuchtexberger. In the control, about 70 percent of the cells
have an amount of DNA between 10 and 14, in arbitrary units. After
marihuana you have no cells which have this amount of DNA; all
the cells have a larger and variable amount.
Mr. Sourwixe. Well now, let us look at the size of the nuclei on
the same chart, figure 6.
Dr. Leuchtexberger. Yes.
Mr. Sourwixe. Your control ranged to about 38, if I read it cor-
rectly. Your size of the nuclei under the marihuana smoking ranged
to about 32 or not more than 33 ?
Dr. Leuchtexberger. No, this is the frequency in percent which
you read. The main range of size of nuclei is between four and seven
in controls, while after exposure to the marihuana the main range is
from six to nine.
Mr. Sourwixe. All right, your figures, your blocks in black and
your blocks in white, represent really two things, then. You may not
read them as to height, you have to read them both horizontally and
vertically at the same time?
Dr. Leuchtexberger. Yes.
Mr. Sourwixe. And they represent, I see it reads here at the left,
frequency in percent?
Dr. Leuchtenberger. Yes.
Mr. Sourwixe. I must apologize for this line of questioning, but I
dare say that if it confused me it might confuse others similarly un-
scientific who see one higher than the other when it says lower. I
think I now understand it.
You are showing by this chart the total proportion of all your test
cells that showed results in a certain range.
Dr. Leuchtexberger. Yes.
Mr. Sourwixe. Is that correct?
Dr. Leuchtexberger. Yes.
Mr. Sourwixe. I understand now. Thank you for explaining it. I
have no further questions, Mr. Chairman.
Senator Gurxey. AVell, I want to thank all of the members of the
panel for coming here today and testifying on this very important
subject of marihuana and its effect upon human beings. It is quite
142
obvious from the testimony today that what the subcommittee
thought when we started the hearings, that is ,we do not know much
about marihuana, is readily apparent. From what we do know about
it, it looks as though we ought to get a lot more knowledge about
it because indeed, the effect of marihuana upon humans may be quite
serious. I am sure that these hearings — and we will have others —
mark an initial and very important efforts in trying to find out the
effect of this drug upon human society.
I do want to thank you so much for contributing to the knowledge
of the subcommittee. Thank you.
The subcommittee hearing is adjourned at the call of the Chair.
[Whereupon, at 5 :20 p.m., the hearing was adjourned, to recon-
vene at 10 a.m., Friday, May 17, 1974.]
[The following testimony was given on Monday, May 20. In ac-
cordance with the instructions of Senator Strom Thurmond, who pre-
sided, it is printed together with the testimony of the panel of medi-
cal researchers who testified on Thursday, May 16.]
TESTIMONY OF DR. JULIUS AXELROD, NATIONAL INSTITUTE OF
MENTAL HEALTH
Senator Thurmond. Dr. Julius Axelrod, I believe, is our first wit-
ness. Doctor, we are honored to have you here and will be pleased to
hear from you at this time.
Dr. Axelrod. I am honored to be here.
Mr. Martin. Dr. Axelrod, would you identify yourself briefly for
the record ?
Dr. Axelrod. I am chief of the section of pharmacology, labora-
tory of clinical science, the National Institute of Mental Health,
United States Public Health Service.
Senator Thurmond. All right. Dr. Axelrod, where did you grad-
uate from medical school?
Dr. Axelrod. I am not a medical doctor, I am a doctor of philos-
ophy ; I graduated from George Washington University.
Senator Thurmond. From George Washington University ?
Dr. Axelrod. Yes.
Senator Thurmond. And you received your doctorate degree where ?
Dr. Axelrod. From George Washington University.
Senator Thurmond. You obtained your bachelor of science degree
at the City College of New York, did you ?
Dr. Axelrod. Yes.
Senator Thurmond. Now, you pursued your scientific studies while
working in various hospitals and institutes as laboratory assistant,
research associate, and chemist, I believe?
Dr. Axelrod. Yes.
Senator Thurmond. Is that right?
Dr. Axelrod. Right.
Senator Thurmond. From 1953 to 1955 you were senior chemist at
the National Heart Institute of the NIH?'
Dr. Axelrod. Yes.
Senator Thurmond. In 1955 you received your Ph. D. from George
Washington University, is that right?
143
Dr. Axelrod. Yes.
Senator Thurmond. Since 1955 you have been chief of the section
on pharmacology, laboratory of clinical science, National Institute of
Mental Health?
Dr. Axelrod. Yes.
Senator Thurmond. Doctor, you are the author or coauthor of
more than 360 scientific papers, is that correct?
Dr. Axelrod. Yes.
Senator Thurmond. And you have been the recipient of numerous
awards for scientific achievement, is that correct?
Dr. Axelrod. That is correct.
Senator Thurmond. And in 1970 you were awarded the Nobel
Prize for physiology or medicine.
Dr. Axelrod. That's correct.
Senator Thurmond. Now, what was the specific accomplishment
that brought you this award?
Dr. Axelrod. The elucidation of the chemistry of the nervous sys-
tem, and studies of the effect of drugs on the brain.
Senator Thurmond. The effect of drugs on the brain?
Dr. Axelrod. Right.
Senator Thurmond. I see. Well, you may proceed with your state-
ment, if you will.
Dr. Axelrod. Senator, I am honored to testify before this com-
mittee.
Senator Thurmond. Now, are you going to follow your statement
strictly ?
Dr. Axelrod. Yes, I am.
Senator Thurmond. Or would you just want to put it in the
record ?
Dr. Axelrod. I would rather read it, if I may.
Senator Thurmond. All right, you may proceed with your state-
ment.
Dr. Axelrod. For many years our laboratory has been involved in
biochemical and pharmacological investigations on drugs affecting
the mind. We have developed very sensitive methods for measuring
LSD and amphetamine in blood, urine, and tissues. These studies
made it possible to establish how long these psychoactive drugs re-
main in the body, how much gets into the brain, and how the body
disposes of them. Several years ago I found enzymes in the liver
that detoxify narcotic drugs such as morphine, methadone, and dem-
erol. More recently my colleagues and I demonstrated that drugs
such as cocaine and amphetamine change the action of noradrena-
line, a nerve chemical important for brain function.
Our interest in marihuana stemmed from the increasing use of the
drug and the lack of knowledge concerning what happened to it in
the body. The discovery that delta-9-tetrahydrocannabinol — THC—
as the most active principal in the marihuana-containing cannabis
plant and the chemical synthesis of this compound by the Israeli
chemist, Mechoulim, made it possible to study its fate in the human
bodv. The NIMH Drug Abuse Center made available to us as well
as other investigators radioactively labeled delta-9-tetrahydrocan-
nabinol. The availability of THC made it possible for the recent
144
rapid advances in our knowledge of the biochemistry, pharmacology,
and behavior effects of this drug.
We developed sensitive methods to measure THC in blood and
urine of man. After injection to human volunteers we drew blood
samples periodically over a period of time and measured the THC
content. After an intravenous injection of THC the amount of this
compound in plasma rapidly declined during the first hour, with a
half-life of 30 minutes. That means, half the drug disappeared with-
in 30 minutes. After 1 hour the THC disappeared from the plasma
and presumably from the body much more slowly, with a half-
life of 60 hours. THC and its biochemically transformed products
continued to be excreted in the urine for more than a week! The
initial rapid decrease in the plasma represents a redistribution of
marihuana active principals from the blood into tissues including
the brain and also chemical transformation. The metabolic alteration
of THC takes place mainly in the liver. In man the psychological
effects of marihuana are greatest in 15 minutes after injection, begin
to diminish after 1 hour and are largely dissipated by 3 hours. This
is consistent with the initial fast disappearance of the drug from
the blood.
The slower disappearance of THC from the body presumably
represented retention in some tissue and slow release. The observa-
tion that THC and its transformation products persist in humans
for long periods of time indicated to us that the drug and its metab-
olities would accumulate in some tissues when taken repeatedly. We
then did a study to find out in what tissues THC is localized and
whether its concentration builds up after repeated administration.
To gather this information, radioactive THC was injected into
rats. After a single dose there was 10 times more of the drug in the
fat than any other tissue examined. After repeated administration
of THC there was a gradual and steady accumulation of the drug
in the fat. After a single injection of THC there was barely detect-
able concentrations of THC in the brain, but after repeated adminis-
tration there was a gradual accumulation of the drug in the brain.
THC when administered to man is almost completely trans-
formed, mainlv in the liver. The major metabolic product was identi-
fied as 11 -hydroxy THC. This metabolite has been found in our
laboratory and that of others to have essentially the same psychic
effects, that is, as anxiety, euphoria, and pleasure. The intravenous
administration of THC to chronic marihuana smokers resulted in a
more rapid disappearance of THC from the blood, and at the same
time there is a more rapid appearance of the physiologically active
metabolite 11-hydroxy THC. This would suggest that repeated use
of THC results in an increased capacity of enzymes in the liver to
form this active metabolite.
After the injection of the active principal of marihuana, THC,
there is a rapid distribution of the drug in tissues especially fat
and metabolic transformation to active and inactive metabolic prod-
ucts. After repeated administration of THC is considerable accumula-
tion and retention of the drug in fat and a smaller accumulation in the
brain. Repeated administration of THC results in an increased capac-
ity to form a psychologically active metabolic product.
145
Until recently there was little reliable information about the
pharmacological, biochemical, and psychological actions of mari-
huana. Through the support of research by the U.S. Government for
this important problem, increased knowledge is now becoming avail-
able. The medical, social, and legal aspects of marihuana are still
highly complex and require continued study at all these levels.
Thank you. I will be happy to answer any questions, if you wish.
Senator Thurmond. Counsel will now propound some questions.
Mr. Martin. Doctor, there is no question in the scientific com-
munity that THC is a toxic substance ?
Dr. Axelrod. No, there is no question.
Mr. Martin. There are, however, differences within the scientific
community as to the degree of toxicity, and how the toxicity affects
the body ?
Dr. Axelrod. Yes.
Mr. Martin. Would it be a reasonable assumption for a scientist
to make that the retention and accumulation in the brain of toxic
substance would probably, over a period of time, lead to damage ?
Dr. Axelrod. Yes, that's a good assumption.
Mr. Martin. But it has still to be demonstrated ?
Dr. Axelrod. It has still to be demonstrated; yes, sir.
Mr. Martin. Is there any similarity between the manner in which
THC accumulates in the tissue and the manner in which DDT
accumulates ?
Dr. Axelrod. Yes, both THC and DDT are fat soluble compounds,
and because of this physical property are retained in fatty tissue.
Mr. Martin. This retention also affects the gonads, does it not ?
Dr. Axelrod. Well, it depends. I have heard recent reports that
marihuana lowers the male gonadal hormone, testosterone.
Mr. Martin. No, I am talking about that — it does accumulate?
Dr. Axelrod. Oh, yes, it would accumulate in gonads, the brain,
and other tissues where there are large concentrations of fat.
Mr. Martin. Now, you had an opportunity, Dr. Axelrod, to ex-
amine briefly the testimony given to the subcommittee last Thursday
by Prof. Kobert Heath, who is chairman of the department of psy-
chiatry at Tulane University. His testimony had to do with persist-
ence of abnormal brain patterns in rhesus monkeys who had been
subjected to marihuana smoke for a period of time. Dr. Heath told
the subcommittee that these persistent alterations in the brain wave
pattern pointed strongly to the conclusion that there had been per-
haps irreversible damage to the brain. If this is the case, couldn't
the accumulation of THC in the brain, which is established by your
research, tie in with the changes referred to by Dr. Heath ?
Dr. Axelrod. Yes; I would like to make a comment about Dr.
Heath's report; may I?
Mr. Martin. By all means.
Dr. Axelrod. Now, one of the fundamental principles in pharma-
cology is the amount of a compound or drug that enters the body.
You could take the most poisonous compound, and if you take too
little, there is no effect, One may take a very supposedly safe com-
pound, and if you give enough of it, it will cause toxic effects. This,
I think, all pharmacologists recognize.
146
I respect Dr. Heath ; he is a fine neurologist ; but the doses he has
given for the acute effect, for example, would be equivalent to smok-
ing a hundred marihuana cigarettes, a very heavy dose of marihuana.
And the amount he has given for the chronic effect represents
smoking 30 marihuana cigarettes 3 times a day for a period of 6
months.*
The results indicate that marihuana causes an irreversible damage
to the brain. But the amounts used are so large that one wonders
whether it's due to the large toxic amounts Dr. Heath has given. I
think it would be a better experiment if he had done what is done
in pharmacology, a dose response; smaller amounts equivalent to
that used by an occasional marihuana smoker and larger amounts
used by a chronic smoker to see what levels would produce these
irreversible effects. I hope that this will be done.
Mr. Martin. Thank you for your comment, Dr. Axelrod. But, I
would like to point out that when Dr. Heath presented his report, he
had to do it in 13 minutes; it was a very brief summary of a much
longer study. I did have the impression from our questions afterward
that the experiment was performed with doses of different calibrations.
Dr. Axelrod. Right.
Mr. Martin. And at different levels, and maybe that is not re-
flected in the paper itself. Evidence has also been given during the
hearing. Dr. Axelrod, by Dr. Nahas of Columbia University, and
recent research indicated that marihuana inhibits human cell im-
mune response mechanism and reproduction. Does this also tie in
with the findings of your research and the findings of Dr. Heath's
research ?
Dr. Axelrod. Yes.
Mr. Martin. Isn't there a pattern relating to permanent damage
of the brain ?
Dr. Axelrod. Yes, perhaps this would be so. Again, I would like
to qualify my statement. Dr. Nahas is a very fine scientist but these
findings need repetition and confirmation.
Mr. Martin. By all means. I might point out that quite a few
of the scientists made the point, although it was clear they were
pretty Avell convinced by the findings, the research had to be con-
sidered preliminary for the time being. Nevertheless, there was
enough evidence from preliminary research to bring it to the atten-
tion of the public.
Dr. Axelrod. I absolutely agree.
Mr. Martin. Do you agree with that?
Dr. Axelrod. I agree that taking marihuana in large doses is
harmful, and the evidence is becoming pretty compelling. But, one
has to remember that one has to distinguish between a small in-
nocuous dose taken by an occasional marihuana smoker and a large
repeated dose.
Mr. Martin. I have no further questions, Mr. Chairman.
Senator Thurmond. Doctor, I want to thank you very much for
your testimony here today; we appreciate your appearance.
♦The question raised by Dr. Axelrod about the dosages employed in the Heath experi-
ment was the subject of a subsequent commentary by Professor Heath, mailed to the sub-
committee on July 9, 1974. The text of this commentary is to be found in the appendix on
page 382.
MARIHUANA-HASHISH EPIDEMIC AND ITS IMPACT ON
UNITED STATES SECURITY
FRIDAY, MAY 17, 1974
U.S. Senate,
Subcommittee To Investigate the
Administration of the Internal Security Act
and Other Internal Security Laws
of the Committee on the Judiciary,
Washington, D.C.
The subcommittee met, pursuant to recess, at 10 a.m., in room
2228, Dirksen Senate Office Building, Senator Edward J. Gurney
presiding.
Also present : J. G. Sourwine, chief counsel ; David Martin, senior
analyst.
Senator Gurney. The subcommittee will come to order, please.
I wish we could come to order because we are wasting time.
Would you gentlemen rise, please?
Will you all raise your right hands?
Do you swear to tell the truth, the whole truth, and nothing but
the truth, so help you God?
[All witnesses replied "I do."]
Senator Gurney. Thank you.
We have a long series of witnesses here today, as we know, and I
have obligations that require me to leave for Florida early in the
afternoon so I would hope we could be as speedy and as brief as we
can, and, in no way underestimating the extreme importance of
this testimony, but, as I say, try to get our facts out as quickly as
we can.
The first witness will be Dr. Hall.
Dr. Hall, will you identify yourself for the record, please? You
don't have to stand up, just state who you are, you know, your name,
where you reside.
TESTIMONY OF DR. JOHN A. S. HALL, JAMAICA
Dr. Hall. I am Chairman of the Department of Medicine at the
Kingston Hospital in Jamaica.
Senator Gurney. And I will ask a few questions, Dr. Hall, to
establish your qualifications here.
As I understand it, you received your medical degree from the
University of London. King's College, in 1951?
Dr. Hall. That is correct.
(147)
148
Senator Gurnet. And you went on to take a diploma in neurology
from the London Medical School in 1958 ?
Dr. Hall. That is correct.
Senator Gurnet. Subsequently you had Observation Fellowships
in Neurology at the Neurological Institute in New York, at the De-
partment of Neurology in Pennsylvania Hospital, and at the Beau-
mont Hospital, University of Lausanne, in Switzerland?
Dr. Hall. That is correct.
Senator Gurnet. And you served as medical officer in the Ministry
of Health in Jamaica from 1952 to 1960?
Dr. Hall. Correct.
Senator Gurnet. And you are currently Associate Lecturer in
Medicine at the University of the West Indies and Visiting As-
sistant Professor of Neurology at Columbia University ?
Dr. Hall. Correct.
Senator Gurnet. And you have been senior physician and elected
Chairman of the Department of Medicine of the Kingston Hospital,
in Kingston, Jamaica, since 1965?
Dr. Hall. Correct.
Senator Gurnet. Would you proceed with your statement, Dr. Hall ?
Mr. Sourwine. Mr. Chairman, may I venture a suggestion ?
Senator Gurnet. Yes, indeed.
Mr. Sourwine. The Chair might wish to order that all of the
prepared statements go into the record as though read at the begin-
ning of each witness' presentation, leaving him free to repeat the
statement or ad lib or make emphasis and instruct integration of the
two when the record is corrected for printing so that nothing will be
lost and time might be saved.
Senator Gurnet. That is a good suggestion, Mr. Counsel, and that
is so ordered.
Dr. Hall.
Dr. Hall. Mr. Chairman, may I thank you and your staff for
giving me this opportunity to appear on this distinguished panel.
In a previous publication I pointed to the fortuitous introduction
of ganja or marihuana into Jamaica in the 18th century as a possible
source of fiber plant, by the English plantation owner, Matthew
Walker at his botanical gardens in Gordon Town, near Kingston.
The Indian connection following the arrival of indentured labor-
ers at the end of the last century is established historical fact.
Senator Gurnet. Doctor, I wonder if you could point that micro-
phone directly into your mouth so that it will pick up your voice
just a little better.
Dr. Hall. Quiet acceptance and public indifference to the use of
ganja continued until 1954 when the village, Pinnacle, in the hills
of St. Catherine some 20 miles from Kingston, was destroyed by
a police raiding party. The village had become notorious as the home
of praedial larceny, a center for the propagation and use of ganja,
and the headquarters of the Rastafari cult.
The resulting dispersal of the Rastafari cultists into the urban
slums of Kingston, and into rural areas, was to have far-reaching
consequences, as has been published in data elsewhere.
149
I became interested in cannabis as a clinical problem because of:
(1) Its ready availability in Jamaica; it grows in any backyard
and in the wooded forests.
(2) Ill-defined and undocumented clinical manifestations;
(3) Lack of a definite laboratory test for identifying it;
(4) Bizarre, sometimes short-lived confusional states seen in
urban and rural practice;
(5) Folklore; and
(6) The impact of American cultural mores on our island com-
munity.
With these factors in mind I have over the years inquired rou-
tinely of all patients at initial interview whether they smoke ganja
or drink ganja tea. The Department of Medicine at Kingston Public
Hospital sees 12,000 outpatients at its clinics annually.
My team sees approximately 5,000 of these patients, who represent
a spectrum ranging from the unemployed ghetto dweller to the
upper middle class.
It has been possible therefore:
(a) To arrive at a relative incidence of ganja usage
(b) To study the motivation for its use
(c) To identify clinical pictures with which its use is associated
more often than coincidence will allow
(d) To do certain laboratory studies
(e) To gain some insight into its psychocultural effects.
Ours is an adult clinic. Males are almost exclusively smokers of
ganja although urbanization and fashion are causing other trends.
These males come from the social spectrum indicated above. The age
range was 15-65 years.
Ganja tea is used about equally among working class men and
women. In the first 4 months of this year, for example, there were
just over 35 self-confessed ganja users among just over 1,000 clinic
patients. This incidence of 3 percent contrasts with other reports of
widespread use, and is in line with the incidence say of Parkin-
sonism which constitutes 2.5 percent of my clinic population, and
is an uncommon condition in Jamaica. It is accepted that the clinic
population is not all embracing ; but if this figure were even tripled,
we arrive at 9 percent.
Motivation for the use of ganja is summarized as follows :
1. Curiosity.
2. Conformity with the group; social, religious, political.
3. Relief of tension.
4. Stimulation of thought and physical activity.
5. Folk medicine.
In our observation, dosage depends on :
1. Manner and frequency of use.
2. Variations in dosage per se.
3. Potency of preparation smoked or brewed.
4. Unreliable retrospective recall of frequency of use.
5. Technique of smoking.
6. Personal and intragroup variations.
7. Limitations of costs.
8. Legal strictures against the possession and use of ganja.
150
It is noteworthy that a joint, or marihuana cigarette costs in our
situation 40 to 50 cents, while a bottle of beer costs 25 cents and a
quart of rum costs $1.80. A chillum pipeful of dried leaves is
equivalent to about five cigarettes. To reach the same "high" using
alcohol or ganja, the cost would be more with ganja. This challenges
a point made by others that ganja is the poor man's substitute for
alcohol.
Significantly none of these patients has been exposed to ampheta-
mines. LSD, heroin, or other hallucinogens. Those interviewed could
do without ganja for long periods of months at a time. Ritual
smokers also knew when they had had enough.
My findings were essentiallv nonclinical and clinical.
The nonclinical findings related mainly to (1) Educational level;
(2) occupational status; (3) marital status; (4) criminal record, on
which I have commented in a previous publication.
The levels that are quoted were quite low but certainly are not
universally applicable as broader observation at the clinic, commu-
nity or national level could indicate. The same observations would
applv to criminal record.
Clinical findings were certainly more significant and were divided
into immediate and long-term findings.
The immediate findings have been fully corroborated by other
people who have found autonomic overactivity as shown by pupil-
lary dilation, conjunctival suffusion, profuse diaphoresis, tachy-
cardia, and mild hypotension. Shortly after these some of my cases
showed hypothalamic overactivity, that is mild euphoria; others
showed medullary stimulation by way of sedation or acute vomiting.
The long-term effects were also quite remarkable. There were :
1. RESPIRATORY COMPLICATIONS
An emphysema-bronchitis syndrome, common among Indian labor-
ers of a past generation, who were well known for their gania smoking
habits, is now a well recognized present day finding among black male
laborers. Indeed, one of our cases died from acute pulmonary embolism
and at autopsy demonstrated spontaneous trombosis of the pulmonary
artery. In the autopsy room in general, the barrel-shaped, emphysema-
tons, chest, is a common finding in Rastafarian cultists. This raises
questions of their smoking habits and the possible action of toxic metab-
olities from ganja acting on the pulmonary parenchyma, a point which
was substantiated by one of yesterday's speakers, Dr. Leuchten-
berger.
2. G-I TRACT INVOLVEMENT
In the small sample series two cases previously published had
radiologically proven duodenal ulcers also raising the question of
toxic metabolites, vagal stimulation, or a parallel to the excretion of
morphine in the stomach.
Further observation suggests a greater association between duo-
denal ulcer and ganja smokers, attending the clinic, than coincidence
would allow. Detailed studies of gastric fluid and gastroscopic
studies are clearly indicated.
151
3. METABOLIC EFFECTS
Among chronic ganja smokers obesity is never seen. The Rasta-
fari cultists fully substantiate this point of the slim body build.
Constant craving for sugar cane, highly sweetened beverages, or
sweets is noted in many habitual smokers and cultists after smoking
ganja. Many smokers also allege an increase of appetite. Persistent
observations on our part of the absence of obesity suggest some in-
terference with the metabolic pathways for depositing body fat.
The PBI studied in a small series to date has not indicated thyroid
hyperactivity and comment was made yesterday by one of the
speakers on this interference with fatty metabolism.
4. CNS CHANGES
Ganja has long been regarded both by the laity and the profession
as a cause of psychosis in Jamaica. The unrivaled, accumulated, ex-
perience of Cooke, Roves, and Williams, who were in recent years
senior medical officers at the Bellevue Hospital, in Kingston, Ja-
maica, fully substantiates this. The observations also of Prince,
Greenfield, and others corroborate this view. There is also the Moroc-
can report of Benabud. It is a common experience in my wards, three to
six cases per year of ganja psychosis being referred to the psychiatry
clinic. This was noted in my preliminary report on ganja smoking
in Jamaica. My experience can be readily duplicated in hospitals
around Jamaica. It is noteworthy that a survey in a village of
relatively well peasant farmers, for instance, might be misleading.
An incidence of 20 percent impotence as a presenting feature
among males who have smoked ganja for 5 or more years, was re-
ported by me earlier. Several colleagues in private practice have
been alerted to this and tend to corroborate my view of this prob-
lem. The difficulties of assessing this symptom are self-evident. The
likely involvement of the autonomic pathways awaits neuropath-
ologies 1 studies.
Personality changes among ganja smokers and members of the
Rastafari cult are a matter of common observation in Jamaica. The
apathy, retreat from reality, the incapacity or unwillingness for sus-
tained concentration, and the lifetime of drifting are best summed
up in the "amotivational syndrome" of McGlothin & West.
Many smokers come to no grief, as it were, after several years of
ganja use. On this basis some workers, and the media make a
fashionable virtue of its use; they recommend it as a panacea for
poverty, or a benevolent alternative to alcohol. This view is, at best,
half truth. Common observation in Jamaica is that ganja smoking
can be a catalyst for cataclysmic change for ill in the life of a ganja
smoker. The Rastafarians to whom I have referred earlier in par-
ticular typify this picture. Those interested can refer to the work
of Smith, Augier and others, and Kitzinger, previously published.
Mr. Chairman, I have documented some laboratory data which I
shall ask to be incorporated in the record, but I draw particular
attention to hypoglycaemia, that is to say, a fall in the normal
blood sugar which was seen in three of eight cases, 1 hour after smoking
25 grams of dried ganja leaf in a standard pipe.
152
Mr. Martin. Is this a major drop in blood sugar level?
Dr. Hall. Below the normal accepted level.
Mr. Martin. But a substantial drop?
Dr. Hall. Yes, of, say, from 120 before smoking to levels of 50
or less within an hour of smoking 25 grams of the dried leaf.
Mr. Martin. Within 1 hour of smoking?
Dr. Hall. Precisely.
May I continue?
Mr. Martin. Please.
Dr. Hall. This raises a question of the relevance of repeated
hypoglycaemia to personality changes and psychoses well docu-
mented by others.
Mr. Chairman, the dilemma facing most societies regarding the
legalized or uninhibited use of ganja is created, in my view, by
vested interests and the media. In my country, Jamaica, many people
do smoke ganja, I repeat, without apparent ill effects. There is,
however, a growing number of young adults especially who are being
pushed over the edge of the abyss, and are hanging in there in a
world of chemically-induced, drug-induced, fantasy and nonpro-
ductivity.
One can visualize at the national level ganja smoking changing
the life style of a society, undermining economic productivity, and
impairing a country's military effectiveness.
One can visualize too, a totalitarian regime promoting it as an
emotional escape valve, rather like institutionalized festivities.
In Jamaica the vast silent majority recognize all these points and
are not confused. They recognize the liaison and involvement with
crime both local and international.
In my view they are determined to preserve the Judeo-Christian
ethic of pleasurable reward for hard work and the competitive,
achievement-oriented value system.
Thank you, Mr. Chairman.
Senator Gurnet. Thank you, Dr. Hall, for your remarks.
Mr. Martin. Dr. Hall, as you know, there is a widespread im-
pression in our country that almost the entire Jamaican population
is caught up in an endemic marihuana binge — that all Jamaicans
are on ganja.
Your statement suggests this is very much exaggerated. If I
understood you correctly, you estimate the percentage of the popula-
tion on ganja to be somewhere between 3 percent and 9 percent,
based on your continuing study of the hospital population.
Dr. Hall. That is correct, sir.
The impression of widespread use is created mainly by the public-
ity given to visitors from North America who have found Jamaica
a "loous classicus" for obtaining and smoking ganja.
Mr. Martin. The tourists have no trouble getting ganja and mari-
huana in Jamaica?
Dr. Hall. None whatever, and frequently get into trouble with the
law.
Mr. Martin. And ganja has no serious trouble getting from
Jamaica into the United States? As you know, there is an increasing
amount coming into our country.
153
Dr. Hall. There is a well-established traffic.
Senator Gurnet. Incidentally, on that question, Dr. Hall, my
State is the State of Florida. One of the principal sources of flow
into Florida is Jamaica, this is a well-known fact. Is your govern-
ment doing anything to interdict this flow of marihuana into
Florida?
Dr. Hall. Yes, I am in a position to speak of that. The Govern-
ment is taking the most stringent measures to intercept international
shipments coming by private aircraft and presently there are some
very serious cases before the courts at this moment.
Senator Gurney. They are making a good effort to try to stop
this?
Dr. Hall. Very much so, Mr. Chairman.
Senator Gurnet. Thank you.
Mr. Martin. Jamaican marihuana is pretty good stuff, as they
say. It is supposed to be substantially stronger than Mexican mari-
huana, is that correct?
Dr. Hall. That has generally been said, but I have myself no
figure as to the quantum of THC in our ganja.
Mr. Martin. The fact that Jamaica has a relatively large popula-
tion of chronic smokers, perhaps not as an overall percentage but
you have a population of chronic smokers going back many years,
this affords certain advantages in studying the long-term impact of
chronic marihuana smoking?
Dr. Hall. Decidedly so.
Mr. Martin. You may be aware, Dr. Hall, of a recent study which
has been reported on in the American press, a study done in Jamaica
funded by the National Institute for Mental Health. This study, as
you know, came up with the nearest thing to a clean bill of health
that has yet been published — no change in functional ability, no
change in respiratory function, no change in chromosomes — the
nonsmokers suffered more chromosome damage than the smokers — no
change in brainwave patterns, nothing at all.
Do you know anything about this study?
Dr. Hall. Yes, I am familiar with it.
Mr. Martin. Do the implications of this study — well, from what
you have said here, the implications certainly do not conform to your
own experience with thousands of marihuana smokers?
Dr. Hall. That is correct.
The study to which you refer does not have the general support
of experienced clinicians and other workers in the field. We believe
that the selection with which the study was done was faulty and that
in regard to the reported absence of any change in the chromosome
pattern that their technique was faulty and that certainly as regards
the statement that there was no respiratory effect, it is unfounded.
Mr. Martin. From your experience and contacts you believe that
the great majority of doctors in Jamaica who have had actual ex-
perience with marihuana smokers — ganja smokers — are convinced
that it has a substantial negative effect?
Dr. Hall. That is correct.
Mr. Martin. Thank you very much.
I have no further questions.
154
Senator Gurnet. Mr. Sourwine.
Mr. Sourwine. I have no questions, Mr. Chairman, but I respect-
fully suggest that the study which was the subject of the last ques-
tion has not been identified for the record. It is not the usual thing,
as the Chair knows, for the committee to shoot arrows into the air.
If the witness credits a study, the record ought to show what the
study is.
Senator Gurnet. Could you identify the study, Dr. Hall?
Dr. Hall. The study about which I was speaking was a study
mounted by Professor Beaubrun, Vera Rubin and Comitas.
I believe they were funded by one of your national agencies.
Senator Gurnet. When was the study made?
Dr. Hall. It was reported in 1972 and serialized in our national
press.
Senator Gurnet. Do you know how long they spent on this study ?
Dr. Hall. Some months in 1971.
Senator Gurnet. Thank you, Dr. Hall.
Dr. Hall. Thank you.
Senator Gurnet. Our next two witnesses are Dr. Harold Kolan-
sky and Dr. William Moore of Philadelphia, who are psychiatrists
who have worked as a team in studying the effects of marihuana
chronic users and they have coauthored a series of articles in the
medical journals on this subject.
As I understand they are going to testify as a team today.
There wasn't time for the committee to receive your biographical
statements, Dr. Kolansky and Dr. Moore, so I wonder if for the
record, you could state your qualifications.
TESTIMONY OP DR. H. KOLANSKY AND DR. WILLIAM MOORE,
PHILADELPHIA, PA.
Dr. Kolanskt. Thank you, Mr. Chairman.
Senator Gurnet. First of all, would you state your name?
Dr. Kolanskt. My name is Harold Kolansky, and I have a doctor
of medicine degree from Georgetown University School of Medicine
in this city, 1948.
I interned at the Walter Reed Army Hospital 1948 to 1949, and
had residency in psychiatry at the Veterans Hospital in the Phila-
delphia area and in several of the medical schools. After the 1949
period I also served in the armed services as a captain, and psy-
chiatrist and chief of psychiatry for the Fourth Field Army
Hospital in Korea during the Korean conflict, and was at that time
also chief psychiatrist to the Eighth Army Surgeon.
Subsequently, I was at the Albert Einstein Medical Center in
Philadelphia while also in private practice from the year 1952 and
continued in the private practice of psychiatry and child psychiatry
and psychoanalysis since that time.
I was director of child psychiatry from 1955 until 1969 at the
Albert Einstein Medical Center and was chairman of the depart-
ment of psychiatry there from 1968 to 1969.
I have been twice president of the Regional Council of Child
Psychiatry, most recently a year ago, and that embraced the Penn-
155
sylvania, southeastern New Jersey and Delaware communities of
child psychiatrists, and currently am chairman of the Continuing
Education Committee and a council member of the American
Academy of Child Psychiatry. I am certified in psychiatry and in
child psychiatry by the American Board of Psychiatry and Neu-
rology and have the equivalent of certification through the American
Psychoanalytic Association in both child and adult psychoanalysis.
I am currently associate professor of psychiatry at the University
of Pennsylvania School of Medicine, and simultaneously chairman
of the Curriculum Committee on Child Analysis of the Institute
of Philadelphia Association for Psychoanalysis where I also teach.
In the last 9 years in the private practice of psychiatry and in
hospital work as well, Dr. Moore and I have been collaborating in
our observations on marihuana in our practices with patients who
have come to us and we will have more on that in our prepared
statement.
If I may suggest. Mr. Chairman, Dr. Moore would give his back-
ground and curriculum, following which Dr. Moore would give the
first half of our prepared statement and then I would give the
second half.
Senator Gurxey. That is fine.
One other question, Doctor, have you been the author or coauthor
of scientific or medical articles in your career?
Dr. Kolaxskt. I didn't hear your last word, Mr. Chairman.
Senator Gurnet. Have you been the author or coauthor of scien-
tific or medical articles or papers?
Dr. Kolanskt. Yes, sir.
I have been the author of some 40 clinical and research papers m
psychiatry, child psychiatry, and psychoanalysis. Of these five have
been coauthored with Dr. Moore on the subject of marihuana.
One is in press, four have already been published, and additionally
Dr. Moore and I have collaborated on other subjects within the
field of psychiatry and psychoanalysis which have been published.
Senator Gurney. Thank you, Doctor.
Dr. Moore, would you give your background and qualifications
and then proceed with your statement.
Dr. Moore. I am William T. Moore, a doctor of medicine, gradu-
ated from the University of Pittsburgh in 1947. I have been a
practicing psychiatrist and psychoanalyst since 1950. I am certified
in both adult* and child psychiatry by the American Board of Neu-
rology and Psychiatry. I am a qualified psychoanalyst, in the
practice and treatment of children and adults as well as study in
clinical research.
I've been on the full faculty of the Institute of Philadelphia As-
sociation of Psychoanalysis since 1960. I have been the director of
training for the past 5 years for the division of child analysis at the
Institute of Philadelphia Association for Psychoanalysis, I have
been associate professor in child psychiatry in the Hahnemann
Medical College for 13 years up until 1972, and presently associate
professor in clinical psychiatry at the University of Pennsylvania
School of Medicine.
156
I have coauthored and authored a number of scientific papers,
some with Dr. Kolansky and some alone. Since 1964, I have been
quite intensely interested in and actively studying as well as treating
adolescents and young adults involved in drug use and particularly
involved in marihuana use and abuse.
I have been particularly interested in the psychological effects of
adolescent involvement, and the mental functioning in young adults
as a result of marihuana use.
Mr. Martin. Dr. Moore, may I suggest that you move the micro-
phone a bit closer and raise your voice a bit so the audience can hear
you?
Dr. Moore. Closer, like that ?
Mr. Martin. Yes.
Dr. Moore. I have been in active clinical study with Dr. Harold
Kolansky for the past 10 years on this marihuana issue.
Mr. Chairman and members of the subcommittee, we are pleased to
present a summary of our psychiatric findings in those who use
marihuana.
You are already familiar with Dr. Olav J. Braenden's work and
statement to this subcommittee on September 18, 1972. Based on his
laboratory, and coordinating work for the United Nations, and on
his direct contact with Drs. Paton, Rafaelson, Miras, and Salamink,
all of whom were doing current research on cannabis, he stated that
among scientists working in the field, the consensus was that can-
nabis is dangerous. He also said that as more scientific data accumu-
lated, the knowledge of the potential dangers increases.
He indicated that contrary to former views, there are at least 50
substances in cannabis — and he implied that many of them could
be toxic. He quoted the work of Dr. Campbell and his colleagues,
who showed rather definitively the result of cerebral atrophy in
young, chronic marihuana smokers. We would add that the skull
X-rays showing the enlarged ventricles — due to atrophy — of these
patients in the Campbell article, are vividly dramatic. We would
also like to add that, the British journal, Lancet — December 4,
1971 — editorialized Campbell's work, and said.
The paper by Dr. Campbell and his colleagues in this issue deserves careful
scrutiny . . . The atrophy is significant, and the difference from the normal air
encephalogram entirely justifies the authors' description and diagnosis.
We concur with Dr. Braenden and the other investigators, and are
convinced that marihuana smoking carries enormous risks of phys-
ical and mental damage. In our four published and a fifth currently
in press clinical papers on marihuana use we have spelled out the
psychiatric findings, and offered an hypothesis on its toxic effects on
the brain.
In an editorial in the Journal of the American Medical Associa-
tion— JAMA, October 2, 1972, volume 222 1 — concerning our work,
the editor said.
Uncertainty about the potential dangers of marihuana usage prevails among
physicians and others. There are some * * * who contend that the drug's
psychotropic effects are no more serious — perhaps less serious — than those of
alcohol, and that, since alcoholic beverages are sold throughout the United
States, sale of marihuana should be legalized.
157
In this issue of the Journal p. 35, Kolansky and Moore report
observations on 13 patients who had smoked marihuana or hashish
intensively for periods from 16 months to 6 years. All manifested
severe symptoms of cerebral toxic reaction that disappeared within 3
to 24 months after cessation of drug use.
Spokesmen who espouse tolerance toward "occasional" or "moder-
ate" use of marihuana should be mindful of the possibility that, for
whatever reasons, occasional may become "frequent" and moderate
may become "intensive," with forbidding; consequences. Moreover,
if sale of marihuana were legalized, would hashish — a much more
potent form of cannabis be far behind ? * * *
If marihuana ever were given the same legal status as alcoholic
beverages, nothing could be said except "Buyer beware."
Exactly 3 years ago today on May 17, 1971, we presented a report
to the National Commission on Marihuana and Drug Abuse. At that
time we presented our findings on a 5-year clinical study of 38
patients, ages 13 to 24 showing that marihuana alone caused serious
psychological and neurological effects. We told the Commission that
marihuana and hashish have a chemical effect that produces a brain
syndrome marked by distortion of perceptions and reality.
This leads to an early impairment of judgment, a diminished at-
tention and concentration span, a slowing of time sense, difficulty
with verbalization, and a loss of thought continuity characterized
by a flow of speech punctuated with non sequiturs, which leaves the
listeners puzzled. In time, the chronic smoker develops a detached
look as decompensation of his ego or character occurs.
In the last 9 years we have seen hundreds of patients who have
suffered psychiatric and neurological symptoms as a result of mari-
huana use, and have described the findings in almost 60 of these
patients, in our publications.
Senator Gurney. You mentioned decompensation of his ego oc-
curs. Would it be better perhaps for a layman like me to say the
disintegration of himself as a human being?
Dr. Moore. A disintegration of his character.
Senator Gurnet. Thank you.
Dr. Moore. Although we described the deleterious effects of can-
nabis use on adolescent personality development in psychological
terms when we spoke to the National Commission, even then we
stressed our clinical hypothesis that psychic changes were a result of
a chemical damage to the cerebral cortical cells.
We further indicated that the symptoms described by us should
not be confused with the usual psychological phenomena, character-
ized as either developmental changes or psychological aberrations.
All the individuals studied showed some uniformity of symptom
response which to us implied that a common toxic agent — cannabis —
was responsible for the observed reaction. We also considered the
possibility that similar reactions might occur in any one who inten-
sively used cannabis for an extended period of time. We said at that
time:
During tlte past six years we have seen a clinical entity different from the
routine syndromes usually seen in adolescents and young adults. Long and
158
careful diagnostic evaluation convinced us that this entity is a toxic reaction
in the central nervous system due to regular use of marihuana and hashish.
Contrary to what is frequently reported, we have found the effect of mari-
huana to be not merely that of a mild intoxicant which causes a slight
exaggeration of usual adolescent behavior, but a specific and separate clinical
syndrome unlike any other variation of the abnormal manifestations of adoles-
cence. We feel there should be no confusion, because regardless of the under-
lying psychological difficulty, mental changes — hallmarked by disturbed aware-
ness of the self, apathy, confusion and poor reality testing — will occur in an
individual who smokes marihuana on a regular basis whether he is a normal
adolescent, an adolescent in conflict, or a severely neurotic individual.
We were very disappointed in the ambivalent report made by the
National Commission, after 2 years of hearings and study, in which
inadequate attention was paid to the clear evidence presented by in-
vestigators to the effect that cannabis is retained in brain and other
tissue, is toxic and may cause irreversible brain damage. We also
believe that the right of the public to be educated to these toxic
effects is long overdue, and that the Commission failed to organize
this effort.
With increasing frequency, we were seeing adults who also smoked
marihuana, and who developed changes in personality believed to be
due to toxicity we described in JAMA on October 2, 1972
Mr. Martin. That is the Journal of the American Medical
Association ?
Dr. Moore. Yes, sir.
We described 13 adults between the ages of 20 and 41 years, all of
whom smoked cannabis products intensively — 3 to 10 times per
week — for a period of 16 months to 6 years. They all demonstrated
symptoms that simultaneously began with cannabis use and disap-
peared within 3 to 24 months after cessation of drug use.
In addition, a correlation of symptoms was observed in relation
to the duration and frequency of smoking. When coupled with the
stereotyped nature of the symptoms regardless of psychological
predisposition, a consideration of biochemical and structural changes
in the central nervous system — possibly cerebral cortex — as a result of
intensive cannabis use seemed to be in order. We said it would appear
that the present medical and public approach to education regarding
the danger of marihuana use should undergo some reassessment.
In that article we tentatively classified our findings as follows :
1. Biochemical change. Those cases in which symptomatology
indicated less chronic or less intensive use of cannabis or both, and
the patients developed total remission of symptoms within a 6-month
period following the termination of drug use.
2. The second group would be those with biochemical change with
suspected structural change. Those cases in which symptomatology
indicated chronic intensive cannabis use; then upon termination of
drug use, only partial remission of symptoms were evident after 6
months but no residual symptoms were found after 9 months.
3. Biochemical change with possible structural change — those cases
in which symptomatology indicated chronic intensive cannabis use;
then upon termination of drug use, partial remission of svmptoms
occurred after 6 months and residual symptoms were still present
after 9 months or more.
159
Dr. Kolansky will take it from there.
Senator Gurney. Dr. Kolansky.
Dr. Kolansky. Thank you, Dr. Moore.
Amon^ the symptoms shown by most of our patients, are those
we described in 1972.
With a history of regular marihuana or hashish use — 3 to 10 or
more times a week — the individual was characteristically apathetic
and sluggish in mental and physical responses. There was usually a
loss of interest in personal appearance and a goallessness.
Considerable flattening of affect — emotion — at first gave an im-
pression of calm and well-being so that the patient seemed to be at
peace with himself and the world. This was usually accompanied
by his own conviction that he had recently developed an emotional
maturity and insight that was aided by or even a result of his
generous use of cannabis. Having found his "true self," he claimed
that his aggression, ambition, and life goals no longer needed to
follow those of the mainstream of society. We considered this to be
a defensive use of denial and reaction formation in order to avoid
an outbreak of aggression due to diminished stability in his person-
ality organization.
His pseudoequanimity was easily disrupted when his personality
change, new philosophies, and drug consumption were questioned by
old acquaintances or by family members. Also if anyone posed a
threat to his supply of cannabis his peaceful facade quickly gave
way to irritability or outbursts of irrational anger frequently ac-
companied by vituperative verbal attack or sullen petulance.
Many of those we examined were physically thin and often ap-
peared so tired that they simulated the weariness and resignation of
some of the aged. All appeared older than their chronological age
by appearance, and an impression that was sometimes reinforced by
slow physical movement. We thought such slow motion resulted from
a combination of an emotional lethargy and a slowing of the sense
of time ; this latter effect had been cited previously by Melges, et al.,
as also contributing to mental confusion in cannabis smokers.
Frequently our patients complained of tiredness, sleeping during
the day, and wakefulness at night which seemed similar to the
reversal of sleep cycle referred to by Dr. Campbell and others as a
symptom of cerebral organicity.
Mr. Martin. By organicity you mean organic damage?
Dr. Kolansky. Organic damage in the brain.
Mr. Martin. Thank you, Doctor.
Dr. Kolansky. The "symptoms of mental confusion, slowed time
sense. Difficulty with recent memory, and the incapability of com-
pleting thoughts during verbal communication that resulted in con-
fused responses, seemed to imply some form of organic change either
of an acute biochemical nature as noted in cases with shorter
histories of cannabis use or, one might hypothesize, structural en-
cephalopathy when found in cases with prolonged heavy marihuana
use.
Mr. Martin. Again encephalopathy means pathological damage to
the brain ?
Dr. Kolansky. That is correct, sir.
160
We are certain that these symptoms cannot be explained simply
on the basis of psychological predisposition. Headaches, also de-
scribed by Campbell and his coworkers were common. In one of our
cases — not reported in this series — the marihuana syndrome masked
a severe obsessional neurosis that was present before marihuana syn-
drome masked a severe obsessional neurosis that was present before
marihuana use, then reappeared after cessation of drug use. During
marihuana toxicity, his obsessional thinking and compulsive be-
havior were minimal and secondary to the stereotyped symptoms
described above.
We said in 1972 in the Journal of the American Medical Associa-
tion:
The intensity of symptoms and the presence of delusional content during use
of the drug seemed directly related to the frequency and length of time that
cannabis had been used. There also seemed to be some relationship between
symptom intensity and the strength of the drug that was used. Those who
smoked hashish seemed to be more symptomatic. The length of time necessary
for the remission of symptoms also appeared to be directly related to the
duration and frequency of smoking.
In addition, the presence of residual symptoms 9 months after the use of
cannabis was stopped showed some relationship of the symptom residual to the
duration and frequency of exposure.
Lemberger and others at the National Institute of Mental Health have shown
that chemical constituent delta-9 tetrahydrocannabinol is maintained in the brain
and other organs of humans for up to 8 days after ingestion. Mclsaac and his
coworkers in 1971 showed with isotope labeled cannabis that concentration of
the drug occurred in the frontal lobes and cortice of monkeys. Campbell and
his coworkers in 1971 have pointed out that findings that indicate the fat
solubility of cannabis derivatives makes it likely that the accumulation of this
drug in nervous tissue would thereby cause a cumulative chemical effect. This
cumulative effect seemed to be demonstrated clinically by those cases in this
report who had relatively brief histories of smoking cannabis.
In these individuals the biochemical effect is less likely to be confused by
later structural change. During the period of time between cessation of drug
use and symptom remission, those symptoms present are probably due to the
effect of accumulated chemical effect rather than structural changes. In addi-
tion, a number of patients, all told of sometimes feeling some of the effects
of cannabis for several days after their last smoke.
Rosenkrantz, et al., indicated that in the brain tissue of rats examined, there
was a consistent severe loss of brain protein and cell component RNA that play
basic roles in brain functioning.
The occurrence of a stereotyped group of symptoms unrelated to psycho-
logical predisposition in a number of individuals following chronic and exten-
sive cannabis use seems to us to at least imply the possibility of a similar
biochemical application in humans. In those cases where symptomatology,
though diminished, was still present 6 months, 9 months, and 1 year after drug
withdrawal raises an important possibility of more permanent structural
changes in the cerebral cortex, such as reported by Campbell, et al., all of whom
smoked 3 or more years and all of whom showed radiologic evidence of cerebral
atrophy.
In the last 2 years, we have seen much additional marihuana
smoking in two particular groups — those in junior high school, and
those in the 20 to 40 year group. In the younger group our concern
for impairment of adolescent development is strong. We said even in
1971 in our acticle in the Journal of the American Medical Associa-
tion, and I quote :
Clearly, there is, in our patients, a demonstration of an interruption of
normal psychological adolescent growth processes following the use of mari-
161
huana ; as a consequence, the adolescent may reach chronological adulthood
without achieving adult mental functioning or emotional responsiveness.
One month ago, April 18, 1974, a paper in the New England
Journal of Medicine, "Depression of Plasma Testosterone Levels
After Chronic Intensive Marihuana Use," by Dr. Kolodny and his
group gave additional cause for concern in the older age group, and by
implication in the adolescent age group as well, when the authors
described 20 heterosexual men 18 to 28 years of age who used mari-
huana at least 4 days weekly for 6 or more months, who showed
decreased testosterone levels that were dose related. Six of 17 men —
35 percent — showed a marked drop of sperm count, with the count
being lowest in those who smoked most.
In addition to temporary sterility, these authors described two
subjects who were also impotent. The authors caution about mari-
huana use in pregnant women, since delta-9 THC can cross the pla-
cental barrier, and so possibly depress fetal testosterone levels during
critical stages of sexual differentiation. They also express concern
about a delay in a completion of puberty in the prepubertal young-
ster who smokes.
In concluding our prepared statement, we would like to para-
phrase and add to a series of recommendations offered to the original
National Commission on Marihuana and Drug Abuse 3 years ago.
In our opinion these recommendations are even more applicable
today.
First, on education : The National Institute of Mental Health, and
other responsible mental health agencies, and medical associations
should coordinate a large-scale educational effort to inform the
public of the serious implications of marihuana use. The press and
the networks can aid immensely in this effort. There is at this time
enough information to bring equivocation to a halt. The public can
learn that marihuana alone causes serious psychological and neu-
rological effects.
In our view, unless the marihuana problem is brought under better
control, it is unlikely that we will be able to influence effectively the
hard-drug problem and the growing number of individuals who
show long lasting and even permanent effects of damage due to mari-
huana smoking. All schools, particularly elementary schools, should
introduce or improve programs of instruction on marihuana to aid
preventive efforts. Measures to control the flow of marihuana must
be increased.
Regarding research: Further research on the neurological effects
of marihuana in humans should be continued, as should psychophar-
macological effects on animals and man. Additional clinical studies
should be reported.
In view of the seriousness of chronic marihuana cough, respiratory
studies should be continued to determine marihuana's effects on other
body systems, including circulatory, renal, and digestive, hormonal
and reproductive.
There is a need for continuing research on all quantitative and
qualitative aspects of the effect of marihuana on the body system.
Psychoanalytic and psychiatric research on the interferences in
mental function, education, and development should continue.
162
Studies on recurrence of marihuana effects should be carried out.
Regarding legalization and issues of public health: We view
marihuana to be a public health hazard. We also believe that tne
Government has a role in protecting public health. Therefore, logic-
ally the Government should not legalize marihuana and should con-
tinue to prevent the importing, manufacturing, advertising, and sale
of all cannabis products.
Many individuals notable in fields other than medicine have ad-
vocated legalization of the sale of cannabis. Their opinions are not
based on the clinical examination of those who use marihuana, but
on hearsay, questionnaires, testimonials, and a misapplication of
knowledge. They do a disservice to our young.
Distinguished members of the subcommittee, this completes our
formal testimony and we will be happy to entertain questions.
Mr. Sourwine. Sir, may I ask one or two questions about what
you two have just read ?
You told of a man with a severe obsessional neurosis who, during
or immediately after smoking, while he had marihuana toxicity,
showed minimal symptoms of obsessional thinking and compulsive
behavior and symptoms which were secondary as to what you called
the stereotyped marihuana symptoms.
I am not clear and I think it would be helpful if the record were
clear. Of the obsessional neurosis in the stereotyped marihuana
symptoms which is preferable if there is any preferable ?
Dr. Kolansky. Mr. Counsel, may I turn that question over to Dr.
Moore since that patient was a patient of Dr. Moore's ?
Dr. Moore. Actually the purpose of mentioning that is that we
have so frequently found individuals who would appear for psy-
chiatric evaluation would have the stereotyped group of symptoms
that we felt had grown to be so typically marihuana syndrome and
after we would encourage the patients to stop smoking and to com-
pletely rid themselves of drug use we found that they would develop
old neurotic patterns.
I would think that of the two, if you press me as to which would
be better, I think it might be better to be neurotic than it would be
to have organic brain damage or structural change as a result of
chronic marihuana use.
Mr. Sourwine. Doctor, I did not understand that you testified
that this man was not neurotic, but simply that his system were
overridden by the marihuana syndrome.
Dr. Moore. Yes.
Mr. Sourwine. He was obsessionally neurotic all the time ?
Dr. Moore. That is right.
Mr. Sourwine. He did have what you might call an apparent
remission because it was overriden by the sysmptoms, but it was not
a true remission, was it?
Dr. Moore. No, it was not a true remission, but because of the
change in his whole method of operation in life duo to the marihuana
use, it was no longer obvious to the world nor to himself.
Mr. Sourwine. Is it fair then to say that marihuana warps and it
will warp even a man who is already warped — it superimposes its
own warp?
163
Dr. Moore. Yes, sir, I would say that. I would say it is an organic
injury on an already psychological insult.
Mr. Sourwine. Mr. Chairman, I have one or two other questions.
Would you prefer that I defer them until
Senator Gurnet. Go right ahead, Mr. Sourwine.
Mr. Sourwine. You told us of slow motion resulting from a com-
bination of an emotional lethargy and slowing of the sense of time.
Am I correct in understanding that is a case when slow seemed fast
to the subject?
Dr. Kolansky. Often times there is a distortion mentally of the
sense of time in the marihuana smoker. Patients, one patient, for
example, told me of an experience of beginning to smoke at 4 o'clock
one afternoon and he knew that because he had just looked at his
watch because a companion had asked him the time, and the next
thing he knew, though he said he was not asleep, his Avatch registered
as 9 o'clock in the evening. He thought only a very short period of
time had elapsed, and he was startled to find that some 5 hours had
elapsed, so that is one aspect of the distortion of time that goes on.
But we were also describing a kind of slow motion movement and
thinking and lack of alertness that has perhaps an additional im-
plication which to us has an organic ring in the sense that the indi-
vidual cannot really, cannot continue to function in a steadily orga-
nized and time-related fashion.
Often that individual is not aware of that slowing of effort, of
time, of thinking.
Mr. Sourwine. I had a question just on that point to follow this,
but to complete this question, did you ever find any instance of a
change in the time sense the other way, where marihuana appeared
to accelerate the time sense so that to the smoker everything seemed
to be very slow or dreamy?
Dr. Moore. I could give a clinical example that would pretty much,
from what I have seen, prove the opposite.
A young individual who was driving down one of the expressways
had to gradually keep over to the right-hand side because he felt that
the traffic was moving faster than he could keep track of mentally. In
other words, he felt that the external world was moving more rapidly
than he could handle. Finally, he became so anxiety-ridden, so ter-
rified that he pulled over to the side of the road and waited for a
period of time until he felt safe enough to pull back out into the flow
of traffic, until he could get off of the expressway.
Mr. Sourwine. That is again a slowing of the time-sense.
Dr. Moore. I feel that in one of the things that contributes to the
slowing of the time-sense is the inability of the individual to coordi-
nate things as rapidly as he might be able to without the chemical
effect.
In other words, as things happen ordinarily, an individual can
connect those things and move right along with it.
I think with the chronic use of cannabis something happens. He
is not able to hold on to all of the observations and perceptions, syn-
thesize them as rapidly and then act upon them. He has to slow down.
Mr. Sourwine. Well, if a man's time-sense slows and he moves in
164
what is to him a habitual rate, he will actually be moving to the ob-
jective viewer much slower than usual, will he not?
Dr. Moore. Yes.
Mr. Sourwine. And this is what you say happens with the mari-
huana smoker?
Dr. Moore. Yes.
Mr. Sourwine. It does not actually speed up their time-sense so
that they have more time to see what goes on. It is exactly the reverse.
Dr. Moore. But they report the opposite.
Mr. Sourwine. But they think that they are seeing movement, is
that right?
Dr. Moore. That is right.
Mr. Sourwine. Now that brings me to the earlier mention that you
made of this.
You spoke of the flattening of affect, giving it first an impression
of calm and well-being and accompanied by the smoker's own con-
viction that he had recently developed an emotional maturity and
insight. And his conclusion is that his drive and ambition and life
goals no longer needed to follow those of the mainstream of society.
Would it be fair to paraphrase that and say that marihuana makes
both dropouts and copouts ?
Dr. Kolanskt. Mr. Counsel, I think that would be correct in many,
not all.
Mr. Sourwine. I have just one more question, Mr. Chairman.
I think by implication of the previous answer it has been answered
but I would like to ask it for the record. Earlier in your statement
you told us of the combination effects of marihuana — that there was
an early impairment of judgment, a diminished. attention in concen-
tration span and a slowing of the time-sense, difficulty with verbaliza-
tion and a loss of thought continuity characterized by a flow of speech
punctuated by non sequiturs which, if I understand correctly, means
punctuated by statements that did not flow one from the other. The
man, in other words, was speaking disconnectedly. He was speaking
nonsense or perhaps as we say in Washington, "gobbledygook."
Would that be correct ?
Dr. Moore. Yes, sir.
Mr. Sourwine. But he did not, if I understand the implications of
your testimony correctly, he did not himself realize that he was
speaking "gobbledygook," that he was failing to communicate. He
thought in his own mind that he was being very fluent and very wise
and perhaps even philosophical in his expressions.
Would this be correct ?
Dr. Moore. Yes, sir.
Dr. Kolansky. Mr. Counsel, to add a point to that, one of the
common things that we hear from patients who have engaged fre-
quently in marihuana parties or in social marihuana smoking is the
impression that communication is vastly increased between the group
who are smoking. Only after the individuals have been some distance
removed from the smoking of marihuana, when they have ceased
smoking, do they later report that they feel that their thinking was
absolutely incorrect, that, in fact, those parties were many times vac-
uous and self-centered exercises in speech at times, but not com-
munication.
165
Mr. Sourwine. Would this be like a man who has a dream in which
he invents something miraculous or makes a world-shaking speech
and may actually rise in his slumber half asleep, make notes on it,
and in the morning the notes are completely unintelligible?
Dr. Kolansky. That is a reasonable analogy.
Mr. Sourwine. These are people who think they are communicat-
ing and think they are achieving a rapport, and the only rapport they
actually achieve is the rapport of common confusion.
Dr. Kolansky. That is correct.
Mr. Sottrwine. I have no more questions, Mr. Chairman.
Senator Gurney. Just a few general questions, Dr. Kolansky and
Dr. Moore.
It is my understanding from your studies and your testimony that
it is your opinion that marihuana is indeed a dangerous drug. Is
that correct?
Dr. Moore. That is correct.
Senator Gurney. And that the use of it — or the prolonged use of
it, certainly — can have dramatic, harmful effects upon an individual,
and there certainly is evidence that much of that effect may be per-
manent damage — is that correct?
Dr. Moore. That is our opinion.
Senator Gurney. Another question: in your studies and observa-
tions of the use of marihuana, is it your feeling that it is becoming
more widespread in its use in our population ?
Dr. Moore. Yes. As a matter of fact, there have been recent com-
ments and reports that are really repeats of things that I heard 3 or
4 years ago and that is that the marihuana epidemic has crested and
that now it is beginning to decline. I have not found that to be so in
my clinical observations. As a matter of fact, what has been happen-
ing in the past year is that there may be, and I say may be, and this
with a large question mark, a decline on the college campus, but I
have a hunch it is not so much a decline as it is an apathy about re-
porting as to whether it (marihuana) is in use as much. There cer-
tainly is no decline in the large suburban high schools and what has
happened most recently or over the past year or 18 months, is that it
is beginning to appear in the 6th and 7th grades ; in other words, the
junior high schools.
Senator Gurney. And that certainly is a new and recent event as
far as you believe ?
Dr. Moore. Well, the last 18 months.
Senator Gurney. Yes.
Dr. Moore. That period.
Senator Gurney. I suppose that is even more dangerous because
among that age group I do not suppose they are able to exercise
the mature judgment perhaps that a college student can exercise.
Dr. Moore. Not only that, but it will take away the very tools they
will need for adolescent development. It diminishes their perceptions
and the ability to utilize those perceptions and to synthesize them
into a whole ; the ability to develop a character, to make new identifi-
cations, is all taken away by the use of marihuana.
In addition to that, he is not getting an education. If he smokes
marihuana in the morning at 9 o'clock in the restroom, he is not likely
166
to be able to absorb very much education the rest of the day, and
that is more common than is generally realized in public and by
parents and teachers as well. A youngster who smokes in the morn- ji
ing can get through all day at school without ever being detected.
Dr. Kolansky. Senator Gurney, on the same point, I would like to \
add for the record it is our view that marihuana use has really, as I
Dr. Moore said, not at all disappeared but it has become more a part |
of the fabric of the school and of society, so that it really is not
talked about very much. I don't think marihuana is being used so j
much in rebellion against society today as it was 6 or 7 years ago, but |
it is simply being used, and I think one of the problems in this use is \
the fact that there has been thoroughly inadequate education on a i
mass public basis. The efforts are really not being made. There are
occasional reports here and there, but now there is another phenom-
enon that should be noted.
There is an increasing mention of alcoholism among our young
people, which indeed is there, and we would take the view, a plague
on both their houses, both alcohol and marihuana: but the current
situation seems to be a pitch toward the drug epidemic is over, mari-
huana is no longer a problem, we only have the problem of alcoholism.
I think this is a tragic error in thinking, and I think the public must
be informed that the epidemic has not crested and that it is an epi-
demic and that here is a vast toxic effect from marihuana in the self.
Senator Gurnet. That really is why I laid the basic premise with
these questions because you touched upon the next point I wanted to
make, and that is : is it not your opinion that the widespread impres-
sion about marihuana, among lay, not medical people or scientists,
is indeed that it is not a dangerous drug? Isn't this the widely ac-
cepted opinion ?
Dr. Kolanskt. That is correct.
Senator Gurnet. Now then going on from there, I wanted to ask
a couple of other questions on that, too, which puzzled me in your
paper here. Taking them in chronological order, you mentioned that
one of your papers was printed in the American Medical Association
Journal and, as I understood it in the very same journal there was
an editorial that, if it did not discount your paper entirely, at least
refused to mention any of the serious points you made. Isn't that
true?
Dr. Moore. No.
Dr. Kolanskt. No.
Dr. Moore. That probably — there were two papers that were pub-
lished in JAMA, that is the Journal of the American Medical Asso-
ciation.
Senator Gurnet. Yes.
Dr. Moore. I read part of the editorial that accompanied the second
paper.
Senator Gurnet. I see.
Dr. Moore. Which laid stress on the organic effects. In the first
paper we geared our attention toward the effects on the developing
adolescent and we were trying to show at that time how it affects
adolescent development adversely.
167
Also, coincident all v, or accidentally — of course, we as psychoana-
lysts do not believe in accidents — in the same journal there was an
article, not by the editors but it was an additional article published
by two, I think they were psychologists or Ph. D.'s in New York, on
the whole matter of scientific investigation in medicine, in which they
stated that you must have in every medical scientific investigation or
any scientific investigation a cover group or a double blind study and
so forth.
We answered that in our second paper under the title of "Meth-
odology", and we pointed out that in medical clinical investigation,
whenever you have a new set of symptoms appearing on the scene
that are unlike any other symptoms, and when you have in those in-
dividuals who have this new set of symptoms some common factor,
element or toxic drug, you then can begin to suspect that perhaps that
drug has some cause on the effect. After a period of time, if you re-
move what you suspect to be the causative factor and the symptoma-
tology disappears and then later on, giving the drug again, the symp-
tomatology reappears, then you can pretty safely assume — and this
is common clinical medical practice that has gone on for centuries —
you can assume that you have a new clinical entity. It remains after
that to be proven in the laboratory and in other specialties of
medicine.
We pointed out at that time that this method did not mean that
our results were any less scientific nor were they any less valid than
the so-called double blind study. As a matter of fact, if we were to
write a paper attacking double blind studies, we could tear them apart
and show them how they can make plenty of mistakes with such a
scientific method. That is probably where the misunderstanding came
from. It was not an editorial, it was a coincidental article and, inci-
dentally, it was the news media that picked it up and made the
connection.
Senator Gurnet. I see.
Dr. Moore. As though they were refuting what we had done, which
was not true.
Senator Gurnet. I see.
Dr. Kolanskt. If I may add, Mr. Chairman, you may also be
referring to our quotation from the editorial itself in the second ar-
ticle in the Journal of the American Medical Association which was
entitled "Buyer Beware."
If the wording sounded ambivalent in the editorial to begin with,
it was anything but ambivalent towards the end of it because the
editor said, and I quote once more, "If marihuana ever were given
the same legal status as alcoholic beverages nothing could be said
except 'Buyer Beware'."
Senator Gurnet. Another question on this business of the country
not taking marihuana seriously was the report of the National Com-
mission that you referred to here on page 4 and page 5. The National
Commission— I forget what the title of it was— on Marihuana, wasn't
it, Marihuana and Drug Abuse? Why do you think that they took so
lightly this problem of smoking of marihuana as they did — and we
all know they did — do you have any idea why ?
Dr. Moore. We are just as puzzled today about it as you are, sir.
168
We do not know why they did it. We were shocked when we saw the
first reports that came out through the news media. Governor Shafer,
before the television audience, and the repeated front page kind of
item that practically gave marihuana sanction — and, of course, on
reading the Marihuana Commission report it does no such thing. It
actually states in the Marihuana Commission report that they dis-
courage its use, and they certainly did not approve of legalization,
and there are parts in the Commission's report that very clearly state
that it affects adolescent development, that it should not be used by
adolescents, and particularly discouraged use by them. But these parts
were hidden. And we felt that where the Commission perhaps lost
the day was that they did not, at least, give enough emphasis to the
warnings, with the result that the report was highly ambivalent and,
in our terms, it means you say one thing out of this side and the op-
posite out of that side.
You should say them both the same way.
Senator Gurnet. Was there ample scientific and medical evidence
presented to the Commission, or available at that time, which showed
that the drug was a dangerous drug?
Dr. Moore. I would hope so.
They had access not only to what we said, but they had access to
a number of other individuals in this country who have done work on
it. They had access to Campbell's report. They even ignored that re-
port, practically, and that was a very important report.
Campbell even raised the question at that time as to whether the
chronic use of hashish might in fact cause an epidemic of Parkin-
sonism, which Dr. Hall referred to in his study this morning, and
Dr. Campbell felt that the effect of cannabis on that area of the
brain was. that, if destroyed, it will in later life develop into Parkin-
sonism. He felt there was a certain correlation between the epidemic
proportions of Parkinsonism in Nepal and the chronic use of hashish.
Senator Gurnet. Is it fair to say — and here I must rely upon you
because I am not familiar with the media treatment of the Commis-
sion's report, I just recall very little about it, but I suspect you prob-
ably paid attention to media reports — but how did they present the
report, generally speaking, to the public?
Dr. Kolanskt. Mr. Chairman, if I may take that, and maybe Dr.
Moore will comment further, I feel it would be difficult for the media
to select out the comments that Dr. Moore just summarized. I noted
that last week in the prepared statement by Dr. Brill — who was a
member of the Commission — in his statement here, that he indicated
that the Commission strongly worded their feeling about the danger
of marihuana. But I must submit that I think it would have been
very difficult for the media to weed those aspects out.
Moreover, we wrote to the Commission after we had testified, in-
dicating that Campbell's report was now available. We sent a copy of
the report to the Commission. We got a rather terse letter back in-
dicating that they were aware of the Campbell work. To our knowl-
edge it was not mentioned. On a Sunday morning
Mr. Martin. May I ask you who sent this report to you, who sent
this letter to you, for the Commission ?
Dr. Kolanskt. I don't recall who it was, but it was sent from the
Commission.
169
I might also add that the news media were aware of Campbell's
report and reported on it, and, in fact, on a — I think it was a Sunday
morning, "Meet the Press' or one of the other major network pro-
grams, in which they had a discussion with a member or members of
the Commission. The reporters there present themselves brought up
the Campbell work, and this was virtually promptly dismissed with
the statement, "These people were all on other drugs and, therefore,
the meaning of the toxicity of marihuana in the Campbell work is not
of significance" — and I am paraphrasing here. But the people in the
Campbell work were not all on other drugs. Some were. The one single
uniform feature in those young patients who had cerebral atrophy
was their smoking of marihuana from 3 to 11 years. So the Commis-
sion, in our opinion, did ignore or play down certain findings, to our
distress.
Senator Gtjrney. Is it fair to say, then, generalizing, of course, that
the Marihuana Commission really misled the media in their presenta-
tion of the dangerous aspects of the use of marihuana ? Is that a fair
statement ?
Dr. Kolansky. More charitably, I would simply indicate that, in
the form in which it was written, it was difficult for the media to
weed out what was significant.
Senator Gtjrney. And as a result of that is it fair to say that the
public — or there was an opportunity missed to inform the public of
the dangerous aspects of the use of marihuana?
Dr. Kolansky. We feel that way.
Dr. Moore. To at least sound the early warning signal.
Senator Gtjrney. And what our problem really is now and, of
course, that is why this subcommittee is intensely interested in this,
in bringing before it just about every eminent authority it can to
present the results of their findings, is because we think the para-
mount issue now is to present to the public the dangers of the use of
marihuana so that they will understand. Perhaps parents and teach-
ers or whoever has charge of influencing and guiding younger people
can bring this to their attention.
Don't you think this is something that we all need to do?
Dr. Moore. Yes, sir, we do.
Senator Gtjrney. Thank you, Doctor.
Mr. Sotjrwine. May I ask one question following out the Chair-
man's thought?
Senator Gtjrney. Yes.
Mr. Sotjrwine. Would you say it is fair to describe what the Com-
mission did as a Solomon-like decision ? They had a certain dichotomy
among their membership, they wanted to go two ways, so they cut
the baby down the middle and gave half to each side.
Dr. Moore. I would say that is a fair statement.
Mr. Sotjrwine. Thank you.
Senator Gtjrney. Well, thank you, Doctors, for your testimony. It
certainly has been helpful.
Our next witness is Dr. Bejerot. Dr. Bejerot, would you identify
yourself for the record?
170
TESTIMONY OF PROF. NILS BEJEROT, STOCKHOLM, SWEDEN
Dr. Bejerot. I am Dr. Nils Bejerot from Karolinska Institute,
Stockholm.
Senator Gurnet. Let me ask, there was one missing when we be-
gan— I believe you were sworn in, Dr. Bejerot.
Let me ask you a few questions, Doctor, about your qualifications.
You took your medical degree from the Karolinska Institute in
Stockholm? '
Dr. Bejerot. Yes, in 1957.
Senator Gurnet. And subsequently you trained as a psychiatrist
at the Southern Hospital, the St. Goran Hospital in Stockholm from
1957 to 1962?
Dr. Bejerot. That is right.
Senator Gurnet. And from 1958 up to the present you have served
as a consultant psychiatrist to the Stockholm Police?
Dr. Bejerot. Yes.
Senator Gurnet. And in 1963 you studied epidemiology and medi-
cal statistics at the London School of Hygiene, on a grant from the
World Health Organization?
Dr. Bejerot. That is right.
Senator Gurnet. You have been involved in an intensive study of
drug dependence for some 8 or 10 years now ?
Dr. Bejerot. Something like that.
Senator Gurnet. You are the author or coauthor of more than 130
scientific papers ?
Dr. Bejerot. Yes.
Senator Gurnet. And you are also the author of several books on
drug addiction ?
Dr. Bejerot. Yes.
Senator Gurnet. Is it correct that your best known is "Addiction —
An Artificially Induced Drive" ?
Dr. Bejerot. I think that book is the most well known.
Senator Gurnet. How many languages has this been translated
into?
Dr. Bejerot. I think four languages — five.
Senator Gurnet. Is it fair to say that another work of yours, "Ad-
diction and Society," is widely regarded as a standard text, or as the
standard text, on the epidemiology of drug abuse ?
Dr. Bejerot. I have been told so.
Senator Gurnet. Well, you are very modest.
Proceed with your statement, Doctor, and if you could make sure
you get that microphone so you are talking directly into it.
Dr. Bejerot. Thank you, Mr. Chairman.
On the request of the Senate Subcommittee on Internal Security,
I am presenting here a summary statement of my views on the social
and psychological effects of cannabis, and on the specific question of
legalizing the sale and use of marihuana.
The most important psychological complication of cannabis abuse-
is addiction. An excellent illustration of this phenomenon was given
by the Egyptian delegate at the Second International Opium Con-
ference (1924), and is reprinted in the committee hearings of Sep-
171
tember 18, 1972: "Notwithstanding the humiliations and penalties
inflicted on addicts in Egypt, they always return to their vice."
It is often declared that cannabis does not give rise to addiction.
This is a misunderstanding which has arisen concerning the nature of
addiction, and here I refer to my first appendix, "A Theory of Ad-
diction as an Artificially Induced Drive," published in the American
Journal of Psychiatry.
The pharmacological and physiological phenomenon of tolerance,
that is, the situation where an individual needs to increase his doses
in order to obtain the same effects of the drug, and the so-called
physical dependence connected with this, has been confused with ad-
diction, which is synonymous with drug dependence or psychological
dependence. Tolerance development only represents a temporary adap-
tation of the body tissues to the drug taken. The distressing vegeta-
tive or "physical" abstinence phenomena are experienced only in con-
nection with drugs with a depressant effect on the central nervous
system : Opiates, barbiturates, other sedatives and hypnotics, alcohol,
solvents, et cetera, but are almost completely absent even in advanced
abuse of drugs with a central stimulant effect — cocaine, ampheta-
mines, phenmetraline, methylphenidate and hallucinogens such as
mescaline, psilocybin, cannabis, LSD, et cetera.
The physiological or "physical" abstinence reactions are easily
handled and cured in a few days or weeks of adequate treatment, and
do not give rise to problems of any medical significance. The main
effect of the tolerance phenomenon is that it makes it extremely dif-
ficult for an addict to break a period of drug taking. To cure drug
tolerance or vegetative abstinence reactions is simple, to cure or even
handle the addiction is extremely difficult.
Thus, physical dependence is only an incidental metabolic compli-
cation of certain kinds of drug taking, and is not included in a strict
concept of addiction. All euphorising drugs, however, may give rise
to psychological dependence or addiction, and this has, as already
mentioned, the character of an artificially induced drive, in many
cases far stronger than sexual drives. This theory has recently been
supported by the experiments of a German team under Professor
Roeder in 1974. They considered that if addiction had the character
of an artificially induced drive, this drive or craving must have a
special center in the brain. They found this center in the hypothala-
mus region, and were able to put it out of action by the destruction
of about 1 cubic millimeter of the tissue by the stereotactic method,
and thereby put an end to the craving for the drug. In human ex-
periments, largely carried out on addicted physician volunteers, sex-
ual potency was affected, and this indirectly also supports the theory
of the drive character of drug addiction.
A serious complication of cannabis abuse seems to be chronic
psychosis, that is, insanity, a condition which has long been recog-
nized in areas where cannabis abuse is endemic. In the West it is
often said that these cases reported as cannabis psychoses are actually
schizophrenias. If the Committee has any doubts about the existence
of chronic cannabis psychoses, it can initiate a simple investigation
to illuminate the question. If the rates of schizophrenia among rela-
tives of verified cases of schizophrenia are compared with those
172
among relatives of persons with chronic cannabis psychoses, there
will be a difference in these two rates if we are dealing with two dif-
ferent conditions. This technique was used by Tatetsu, 1963, in Japan
to prove that chronic amphetamine psychoses are of a different nature
from schizophrenia.
I will not go into details about acute cannabis intoxication, which
is a well-known phenomenon, but a few words should be said on the
amotivational syndrome. This is a massive and chronic passivity
brought about by prolonged and intensive abuse of cannabis. In
these cases there is a basically altered sense of reality, and a tendency
to magical thinking. Intellectual deterioration, which may be irre-
versible, and vagabondism commonly develop.
The amotivational syndrome has been observed very late in the
West. This phenomenon in the Middle and Far East was commonly
interpreted as an expression of general debility, so called "Eastern"
personality, et cetera. If cannabis effects are studied on persons who
are already passive — as was the case in the La Guardia report, where
persons under study were prisoners and unemployed — passivity may
escape notice.
In regard to legal aspects of illicit drugs, I would like to make
some general remarks on drug epidemics before going into the spe-
cial question concerning cannabis.
In Stockholm at the end of the 1940's an epidemic of intravenous
abuse of central stimulants arose in a little group of about a dozen
intellectuals and bohemians. The number of abusers doubled roughly
every 30th month for many years, and in 1965 there were about 4,000
cases in Sweden, but none in the other Scandinavian countries.
At the beginning of 1965 a campaign was waged in the Swedish
mass media in favor of liberalizing drug policy regarding nonmedical
use of narcotic and dangerous drugs. The arguments were on the
same lines as in the present campaign for legalizing cannabis.
Under pressure from this campaign the Swedish Board of Health
permitted "by way of an experiment" the prescribing of dangerous
drugs, both opiates and amphetamines, to a limited number of addicts
for intravenous self -administration.
During the 2 years from spring 1965 to spring 1967, when this
prescribing activity took place in Sweden, the so-called legal addicts
there were together about 200 persons, had a higher crime rate than
they had had during a corresponding period prior to receiving their
drugs legally [Lindberg 1969].
The records show that they were in receipt of health insurance and
social welfare allowances on a larger scale and for longer periods than
before this prescribing began ; they were unemployed more than pre-
viously, although the situation on the labor market had not deterior-
ated ; they even had a higher mortality rate than a comparable group
of addicts who were not receiving drugs legally.
In the summer 1967 every fourth intravenous abuser arrested in
Stockholm said he had received drugs during this 2-year period from
persons he knew to be legal addicts. Six months after the start of the
experiment the addicts were receiving on an average twice the quan-
tities of drugs as at the beginning, and after 2 years they were re-
ceiving three times the initial amounts as calculated from the 10,000
prescriptions we have checked these on.
173
During the 2 years the experiment continued, the rates of abuse
among arrestees in Stockholm rose more rapidly than during any
other period, particularly among the youngest age group, those of 15
to 19 years of age, where the rates rose from 6 percent injecting in
1965 to 28 percent 2 years later.
The rapid fluctuations in Swedish drug policy along a permissive-
restrictive scale during the second half of the 1960's provided some-
thing that may be justly described as an experimental situation. I
have just completed a 400-page report on the covariation between
rates of drug abuse among arrestees in Stockholm during the years
1965-70 and drug policy during this period. Only intravenous drug
abuse was studied, as only this form can be objectively and simply
observed through needle marks on the arms; but there is no reason
to believe that other forms of illicit drug abuse would vary in rela-
tion to drug policy in another way than the intravenous form.
Several investigations, for instance a comparison with a casefinding
study which was one of the most extensive ever carried out anywhere,
showed that the arrestees to a large extent were representative for the
population of intravenous abusers known to the various authorities
in Stockholm.
The study comparing drug abuse and drug policy showed, that
during a liberal and permissive period of drug policy, intravenous
abuse accelerated. On a return to a traditional restrictive policy in
1967 the acceleration was checked, and when an extrarestrictive pol-
icy was introduced with a police offensive on the drug trade in 1969,
the rates of abuse fell in this study.
Even though the Swedish mass media have never admitted their
responsibility for the permissive drug policy they launched and drove
into effect, they have become very cautious on the drug question.
There is no longer any articulate demand for a liberal cannabis
policy in the Swedish mass media, although there is a large number
of cannabis smokers in the country. The Swedish authorities are now
unanimously against any further experiments with legal supplies of
dangerous drugs.
The illicit drug problem should be seen in the perspective of the
dynamics of the spread of the drugtaking behavior. It is generally
agreed nowadays that abuse of the type we are discussing here is a
contagious condition spread from an abuser to a novice by direct
personal contact. This process is called contagion in medicine, and
peer pressure in sociology.
In 1965 I introduced a sociomedical classification of addictions
according to their mode of inception into three main types —
appendix 2.
THERAPEUTIC ADDICTIONS
These are the rather rare cases which have developed as complica-
tions to medical treatment. These cases mainly affect middle aged
people; they occur in all countries and at all periods; thus their dis-
tribution is rather constant in time and place.
EPIDEMIC ADDICTIONS
These are the type we are discussing today. They usually affect
young persons, and vary greatly in time and place. As already men-
33-371 O - 74 - 13
174
tioned they arise through case-to-case spread, and for that reason
they may increase almost exponentially for long periods. This has
been demonstrated concerning injections of central stimulants in
Sweden — Bejerot 1970 — heroin in Britain, where the rates doubled
every 16th month, 1958-68 — Bewley et al. 1968 — and the inception of
cannabis smoking in five Danish towns, 1965-70 — Holstein 1972.
Later the rate of increase falls and levels off, and the curves are
mathematically of the so-called logistic or s-formed type.
ENDEMIC ADDICTIONS
Here the drug has become accepted in society for pleasure and re-
laxation. The whole population is then exposed to risk, and large
groups of ordinary people become addicted to the drug.
Examples of endemic addictions are cocainism among South Amer-
ican Indians, opium smoking in Old China, cannabis smoking in the
Middle East and alcoholism in the Christian part of the world.
In the early stages of a drug epidemic only very deviant persons
use the drugs, particularly if they must be obtained illicitly. As the
epidemic spreads, more and more normal persons are drawn in, until,
eventually, the drugs become socially accepted, and then perfectly
average people use them : In fact it may then be deviant to refuse to
use them. An endemic drug culture is extremely difficult to eradicate.
The cannabis epidemic in America today seems to be perilously near
to becoming endemic. Large sections of the mass media, on the basis
of pharmacological data they were not in a position to judge, have
declared that cannabis is harmless, and a suitable drug for young
people. It requires no more than this to explain the explosive increase
in cannabis abuse in the Western World today.
The demand for legalizing cannabis has been strongest in those
countries which have had the shortest experience and the weakest
forms of the drug. Correspondingly, I consider that as a psychia-
trist, one's attitude to cannabis becomes more negative the more one
sees of its effects.
Those who argue in favor of legalizing cannabis are also bound
to consider whether legalization is also to include hashish and the far
stronger, concentrated product, cannabis oil. Since tetrahydrocan-
nabinol can now be synthesized, the supporters of legislation should
also decide if the synthetic products are to be accepted, or only THC
extracted from natural products. Since the potency of THC is com-
parable to that of LSD, it would be logical to make a decision at the
same time as to whether LSD, psilocybin, mescaline, et cetera, should
be legalized.
Intensive and frequent abuse of hallucinogenic drugs— mescaline,
psilocybin, LSD and cannabis — seems to give rise to profound
changes in the sense of reality, and this phenomenon does not appear
to pass over when the individual is sober or when he stops taking the
drugs. In this way the hallucinogens seem to be more dangerous to
the mental functions than other groups of euphorizing drugs.
If cannabis were legalized in the United States, this would prob-
ably be an irreversible process not only for this country and this
generation, but perhaps for the whole of Western civilization. As far
175
as I can see another result would be a breakdown of the international
control system regarding narcotics and dangerous drugs.
TO SUMMARIZE
There is no doubt that cannabis is an addicting drug, and that
persistent and intensive cannabis smoking frequently gives rise to
profound phenomena with passivity and change in the sense of reality
as the most apparent signs.
Thank you, Mr. Chairman.
Senator Gurnet. Thank you, Doctor.
Mr. Martin. I have a few questions I would like to ask Professor
Bejerot — and, also, I would want to suggest that you answer the
questions as briefly as possible. We are very pressed for time ; we are
going to have to get through with our next three witnesses in roughly
an hour. So to our upcoming witnesses I would like to suggest that
you cut your reading version roughly in half. The entire text will be
inserted in the record as though you read it, in accordance with the
chairman's opening ruling, and that will leave some time for ques-
tions and we will be able to wind up by 1 o'clock approximately.
Professor Bejerot, if I understood your statement, you differ with
the concept that there is an important difference between "addiction"
and what we call "drug dependence" in this country. Do you think
this is a false distinction ?
Dr. Bejerot. You see, at first I differentiate very sharply between
drug abuse and drug dependence, but drug dependence according to
my terminology is synonymous to drug addiction.
I define addiction as an acquired, profound, and persistent fixation
to certain strong and pleasurable sensations commonly produced by
intake of euphorizing drugs. This fixation leads to a behavior of a
compulsive character and much resembling natural drives as sexual-
ity and sometimes replacing them, and I consider also such phenom-
ena as, for instance, gambling and kleptomania are kinds of addic-
tion, so you do not need drugs to produce addiction. And I also mean
that sexual perversions, such as for instance, fetishism, seem to be
more or less conditions of the same nature.
And I would take the opportunity to add here, that drug addictions
occur spontaneously in the animal world under natural conditions.
Mr. Martin. Using your definition, Professor, there is no doubt in
your mind that cannabis use can, and frequently does lead to
addiction ?
Dr. Bejerot. There is no doubt about that.
Mr. Martin. It is widely argued, at least, it has been argued by
some people, that cannabis does not result in psychotic conditions.
But I think it is conceded even by people who have made this state-
ment that where you have borderline cases — people who are weak
psychologically — the use of cannabis can push them over the border,
over the brink?
Dr. Bejerot. I think that just the borderline cases are those in very
great danger. We have an average of 1.5 percent schizophrenics in
every society, and we have a few percent of borderline cases, so in a
country of this size there are some millions of people who are in a
very high risk for psychosis from marihuana or cannabis.
176
Mr. Martin. So you have some millions of people in this country ;
who, in your opinion, might become completely psychotic personal-
ities?
Dr. Bejerot. Yes, who would be very susceptible.
Mr. Martin. If they were exposed to cannabis ?
Mr. Sourwine. May I ask one question for clarification? You i
would not wish to be quoted, would you Doctor, to the effect that an j
individual had no serious danger from the use of cannabis unless he j
was already a borderline psychotic ?
Dr. Bejerot. I would not say so. You see, it is always a question ,
of dose-response relations. But the personal susceptibility differs very j
much in different individuals and for some individuals far less doses :
are needed to result in a psychotic break.
Mr. Sourwine. Is an ordinary person with no special medical edu-
cation or experience competent to decide whether he is in danger from
cannabis use ?
Dr. Bejerot. No, the individual could not do that himself.
Mr. Sourwine. No other questions.
Mr. Martin. If cannabis does as much harm to the individual as
your paper indicates, Professor, if there are hundreds of thousands
or millions of young people in our country who are using it on a
continuing basis, which we know to be a fact, wouldn't this suggest
the possibility that, perhaps a decade or two from now, our society
may find itself encumbered with a large population of partial crip-
ples— of workers who have lost some of their functional ability, al-
though they are functional at a lower level, and of partially crippled
minds that would still operate, but again at a substantially lower
level than they were capable of performing at before they were ex-
posed to cannabis ?
Dr. Bejerot. That is true.
Mr. Martin. And wouldn't the same thing also apply to the physi-
cal effects of cannabis which were described in yesterdays session by
the panel of medical scientists which we brought together from va-
rious parts of the United States and other countries?
Dr. Bejerot. I have been mostly concerned with the psychological
and psychiatric and social effects, and the physical effects I haven't
studied personally. But I was impressed by the testimony given
yesterday.
Mr. Martin. I have no further questions, Mr. Chairman.
Senator Gurnet. Thank you, Doctor.
Professor Soueif, would you stand up, please, and hold up your
right hand. Do you swear the testimony you are about to give this
subcommittee will be the truth, the whole truth, and nothing but the
truth, so help you God ?
Dr. Soueif. I do.
Senator Gurnet. Yours is a fairly short statement, Professor, and
I think if you omitted the things in the parenthesis, we could get
through all of it fairly rapidly.
Let me first ask you some questions here to establish your qualifi-
cations, and I will do this all in one question.
It is my understanding you took your doctor of philosophy from
Cairo University in 1954; you did postdoctoral research at the in-
stitute of psychiatry, London University, 1955 and 1956; you have
177
been on the faculty of Cairo University since 1962, first as an asso-
ciate professor of psychology, and, since 1970, as a full professor;
since October 1973 you have been chairman of the department of
psychiatry and philosophy at Cairo University; at different times,
you have been a guest researcher or guest professor at the institute
of psychiatry, London University, the Max Planck Institute of Psy-
chiatry in Munich, and the Lund University in Lund, Sweden ; from
May 1968 to January 1971 you served in your government as Under
Secretary of State for Culture; you are currently a member of the
World Health Organization's Panel on Drug Dependence, and a
member of the Scientific and Professional Advisory Board of the
International Council on Alcohol and Drug Addictions?
During the 1960's you produced a major study of the impact of
the hashish epidemic on Egyptian society. This study, as I am told,
is recognized as a classic in this field. You are also chairman of the
Committee for the Investigation of Cannabis Consumption in Egypt.
Are these statements I have made accurate to describe your back-
ground ?
TESTIMONY OF PROF. M. I. SOUEIF OF EGYPT
Dr. Soueif. Correct, Mr. Chairman.
If you may allow me for one single remark ; I thought I heard you
saying that I am now the chairman of the department for psychiatry
and philosophy, I think it is psychology and philosophy.
Senator Gurnet. Well, it was philosophy here, yes. But it is psy-
chiatry ?
Dr. Soueif. Psychology and philosophy, not psychiatry.
Senator Gurnet. We will make that correction in the record and
we thank you for calling that to my attention. Proceed with your
statement.
Dr. Soueif. It is an honor to have been invited to give my scientific
opinion before this highly esteemed subcommittee on the subject of
cannabis consumption.
My colleagues and I have been working on the subject from Oc-
tober 1957. Starting from 1967, I got in touch with American and
European scientists who became interested in the field as cannabis
taking was reported to have been gradually spreading in a number
of Western societies. I was invited to participate in a number of meet-
ings which were held at the WHO in Geneva and in various other
places; for example, Rome, Helsinki, and London, where I had the
opportunity to raise and discuss various relevant questions with com-
petent scientists who had done significant work mostly in the area of
cannabis and drug research.
In my statement, I will have to bank most of the time on the work
I did with my colleagues in Egypt. I will refer, however, whenever
possible, to other investigators whose work sheds light on relevant
issues.
i
A few points have to be made clear :
a. I did all my work on regular long-term users. Most of the work
reported in the literature has been carried out on short-term takers
178
and the immediate effects of the drug. Some discrepancies between
the two sets of findings may, therefore, be expected and could be in-
terpreted in various ways.
b. The main part of my work was done on prison inmates; those
may differ in certain respects from ordinary citizens. However, in the
absence of data pointing otherwise, the information we obtained
might be given more weight than mere hunches or impressions, re-
garding generalizability.
c. Cultural differences between Egyptian takers and their Western
counterparts, for whatever this might imply, should be taken into
account.
n
Our findings have been obtained by the use of two methods —
Soueif, 1967; 1971:
a. We carefully interviewed big numbers of takers and comparable
nontakers on a wide variety of points relevant to cannabis use.
b. We also used objective psychological tests to measure a number
of psychological functions considered by various authorities to be of
crucial importance for adequate functioning in work situations. Such
functions are also treated, in the clinical literature, as significant
indices of mental health— R. Payne 1973 ; A. Yates 1973.
In all cases of interviewing and testing, we based our conclusions
on the results of comparisons between users and nonusers.
ni
We found that the majority of cannabis takers — 78.5 percent —
expressed a desire, but inability, to get rid of the habit, and about
one-fourth of this discontented majority had made actual though
unsuccessful attempts to stop the habit completely. According to their
own reports, takers, when deprived of the drug, tend to become
quarrelsome, anxious, impulsive, easily upset, and difficult to please —
see also Haines and Green 1970. Their productivity deteriorates in
quantity and quality. Such changes, combined with what seems to be
an overpowering urge to continue taking the drug, constitutes some
aspects of what the late Dr. Eddy and others called psychic depend-
ence— Eddy and others 1965.
We also found that cannabis takers far exceeded nontakers as
regards attachment to alcohol, coffee, tea, and tobacco — see also
Cohen 1972; Goode 1971; Leonard 1969; McGlothlin and others 1970;
Whitehead and others 1972 — and that they, in fact, did so before
taking to cannabis. However, the longer they go on taking the drug
and/or the heavier they become as habitues, the more liable to adding
opium to their drug menue they turn — Figure 1 — Soueif 1971 ; Nahas
1973. This kind of data, in our opinion, suggests that cannabis taking
may be viewed as part of a broad need or urge for any chemical agent
that would affect the central nervous system, either by arousal or by
inhibition, and that more familiarity with or attachment to cannabis
facilitates — not necessarily on a pharmacological basis but could be
through some psychosocial mechanisms — proceeding towards harder
drugs.
179
However, cannabis takers did not seem to be significantly below
the average for nontakers on certain aspects of moral behavior. When
faced with situations implying various kinds and/or degrees of temp-
tation, takers did not appear to behave as more vulnerable than non-
takers. They, also, did not see any inherent relationship between their
drug habit and criminal tendencies or ways of behavior.
We examined the actual criminal records of a large group of
convicted takers and of an almost equally big group of convicted
nontakers. Both groups were derived from the same prisons. In com-
paring the two samples, we took into account all criminal offenses other
than those having to do with narcotics. More nontakers — 13.5 percent —
than takers — 5.7 percent — were found to have had criminal records
previous to their arrest. We also found that nonusers tended to exceed
users regarding the average number of crimes committed by each of
those having criminal records — Soueif 1971. On the basis of our data,
therefore, cannabis taking is not significantly associated with crim-
inality. This conclusion is in agreement with what several other
investigators reported — Nahas 1973.
rv
On the objective tests, we obtained the following results :
a. Takers were definitely slow on tests used for the assessment of
speed of very simple motor tasks. Those tests were derived from the
world-known battery named USES.
b. They did also poorly on a test measuring speed and accuracy of
visual discrimination. This test requires a good deal of concentration
of attention.
c. Takers were definitely below the average for their comparable
nontakers on tests for hand-eye coordination with and without speed
being explicitly emphasized in the instructions. "Trail Making and
Bender Gestalt Copy" respectively.
d. We also found that on some tests of immediate memory — Bender
Gestalt Recall — especially those requiring some kind of mental reor-
ganization of the test material — "Wechsler's Digit Span Back-
ward"— cannabis takers were very low performers.
e. Cannabis takers tended to overestimate distances of moderate
lengths. However, nontakers tended to underestimate such distances.
f. As to time estimation the results are still equivocal. See also
Hollister and Tinklenberg 1973 ; Tinklenberg and others 1972.
As to the relative magnitude of intellectual and psychomotor im-
pairment associated with cannabis taking we came recently to the
conclusion that such impairment seems to vary in size according to
the general level of predrug proficiency : The higher the initial level
of proficiency, the bigger the amount of impairment. We could, so
far, demonstrate the validity of this conclusion within two contexts
as follows — Soueif 1974 ; 1971 :
a. Those with a higher level of education — and/or intelligence —
show the largest amount of deterioration, illiterates almost no dete-
rioration, and semiliterates in between.
180
b. Urbans — being presumably at a higher level of arousal than
rurals — show much more impairment than rurals, with semirurals in
between.
At present, we are testing the theory along a third dimension,
namely, young — minus 25 years — versus old age — 40 plus years. The
prediction is that young takers would display more impairment than
older users. We would, also, expect the same pattern of findings to
emerge in the area of creative thinking abilities. But this has to await
verification.
Senator Gurnet. Thank you, Doctor.
Mr. Martin.
Mr. Martin. Professor Soueif, at yesterday's hearings which you
attended, Professor Heath of Tulane University presented evidence
of aberrations from the normal brain wave patterns in different seg-
ments of the brain. The subjects in most of his experiments were
rhesus monkeys, but he has also done his experiment with humans.
Among other things, he stated that some portions of the brain appear
to be much more affected by marihuana smoking than other portions.
Could this tie in with your finding that those with the higher level
of education show the largest amount of deterioration, illiterates
almost no deterioration, and semi-illiterates in between?
Dr. Sotjeif. I think it does show some sort of agreement or con-
vergence with my results in the sense that in the clinical literature —
and I am talking here as a clinical psychologist — we know that
patients with brain damage are to be tested on tests of speed of
psychomotor performance, and the expectation is usually that they
show abnormal slowness. This has been shown to be the case during
the last 20 years or more. I can tell offhand some names of the
researchers.
Dr. M. B. Shapiro of the Institute of Psychiatry of London, has
reported on this fact.
Dr. E. Paine from Canada and J. H. G. Hewlett, who were together
at the Institute of Psychiatry, did quite a lot of work in this area,
and this has been published and republished again in 1973 and it
has not been refuted.
Therefore insofar as the slowness of performance goes, this ties up
with the idea of brain damage, which has been described yesterday,
here.
I think one can go on again telling the same story about something
like visual discrimination and that cannabis takers showed some
deterioration or impairment of this function.
The only thing to be pointed out is that I did not mention brain
damage because I always prefer to stick, very much, to my area of
specialization, as a man who studies behavior as it can be observed
from outside, and I leave the rest to my other colleagues in the
scientific arena.
Mr. Martin. I believe you have used the expression "dependence"
or "drug dependence" in describing the attachment of the marihuana
smoker to marihuana. But whether you call it addiction or depend-
ence, what it adds up to in either case is that the victim is attached
to the drug which has enslaved him in an obsessional manner — to the
181
point where he finds it virtually impossible to separate himself from
it even if he wants to ?
Dr. Soueif. Oh, correct, I quite agree. I quite agree, and there is no
point here in raising any type of semantic problem on it.
Mr. Martin. There is one more question I would like to ask. I hope
you can give us a very brief summary, perhaps in 2 or 3 minutes, of
the major findings of your classic study on the total impact of the
hashish epidemic on the Egyptian population, or on that portion of
the Egyptian population that was involved in long-term use of
hashish.
Dr. Soueif. I think you probably know that I have been involved
in this work for the last 16 or 17 years with an interruption, to be
very correct, of one year during 1965-66.
The impression, the general impression, I can just put forward
straightaway, is that, if cannabis taking had not been so endemic in
my country, I think at least a big proportion of my cocitizens could
have been with a higher level of aspiration and sort of more willing-
ness to fight their life through instead of rather leaning towards
something like lethargy. I should think so.
Mr. Martin. Their performance capability as individuals and as
members of society would have been much greater had they not
been
Dr. Soueif. Yes, yes. As a matter of fact, I am basing this impres-
sion on one simple point. I have already made an estimate, and this
was published in 1967, about how many regular takers would be
estimated in Egypt, and taking the estimate into consideration, to-
gether with the fact that the modal age for using cannabis, again at
home, is the age between 20 and 40, which is actually the climax of
productivity in a man's life, I guess it is a big sort of catastrophe for
a nation to have this large number of young men taking cannabis
because it is mainly a male sort of phenomenon at home, not like in
the Western societies, females, the very big majority do not come to
it. So anyway, with the large number of estimated cannabis takers
compared with the number of people at this age group who would be
working productively, I think it is really very serious.
Mr. Martin. It would not be inaccurate to describe them as partial
cripples who had lost a substantial percentage of their ability to
perform, either at the manual level or at the mental level?
Dr. Soueif. To some extent one can put it this way, although I am
here a bit impressionistic I should say.
Mr. Martin. I have no more questions, Mr. Chairman.
Senator Gurnet. Mr. Sourwine.
Mr. Sourwine. No questions, sir.
182
[Chart submitted by Dr. Soueif with his testimony :]
SO'/,
50
■3 *o
i 30
20
10 -
0 5 10 15 20 25 30
Duration of hashish consumption (in ytars).
FIGURE I. THE RELATIONSHIP BETWEEN OPIUM TAKING AND DURATION
OF HASHISH CONSUMPTION.
Senator Gurnet. Thank you, Doctor, very much for your fine
contribution.
Our next witness is Dr. Malcolm. Would you identify yourself, Dr.
Malcolm, for the record?
TESTIMONY OF DR. ANDREW MALCOLM, TORONTO, CANADA
Dr. Malcolm. Yes, my name is Andrew Malcolm. I am from
Toronto, Canada.
Senator Gurnet. I will run through your qualifications in just one
long question, Dr. Malcolm, which you can answer at the end.
As I understand, you graduated in medicine from the University
of Toronto in 1951.
You undertook a psychiatric residency at the New York Hospital
in Westchester County in 1952.
You were registrar at the Bexley Hospital in London, England,
for 2 years from 1954.
You were senior psychiatrist at Rockland State Hospital in New
York for 3 years from 1955.
You have a certificate of the Royal College of Physicians — Canada —
183
and you are a diplomate of the American Board of Psychiatry and
Neurology.
You were with the Ontario Addiction Research Foundation in
Toronto for 9 years, during which time you studied the problems of
alcoholism, narcotics, marihuana and solvent-sniffing.
At present you are a full-time practicing psychiatrist and a mem-
ber of the Drug Advisory Committee of the Ontario College of
Pharmacy.
You are author of three books in the field of drugs which have
received wide recognition — "The Pursuit of Intoxication," "The Case
Against the Drugged Mind," and "The Tyranny of the Group."
You have also authored some 60 papers.
Are those statements an accurate summary of your background?
Dr. Malcolm. Yes, pretty accurate.
Senator Gurnet. Proceed with your statement, Doctor.
Dr. Malcolm. The study of drug affliction of the cannabis type is
exceedingly complex. I will restrict myself, however, to three related
aspects of this study that have been massively ignored in recent
years. I refer to marihuana and suggestibility, marihuana and the
amotivational state, and marihuana and the ideological conflict.
1. ACUTE EFFECTS SUGGESTIBILITY
Concerning the acute effects of THC intoxication much excellent
work has been done in the last few years. Virtually nothing, how-
ever, has been done to determine the relationship between marihuana
and the vulnerability of the intoxicated person to persuasion. But
this drug is an illusionogen. In sufficiently high doses it is capable
of producing what has been called the altered state of consciousness.
Such a state, when it develops, has a number of characteristics which
I have described in some detail in my book "The Pursuit of Intoxi-
cation." (1) These include an impairment of the ability to test external
reality and a tendency to engage in nonlogical thinking. Marked
changes in time sense and of body image occur. Emotional responses
are altered and sensory perception is typically distorted. The result
of these myriad effects is the creation of a person who is funda-
mentally changed from what he is like in a state of normal waking
consciousness. His critical judgment is impaired and his capacity to
effect transactions with reality is markedly reduced. As a result we
may say with some certainty that such a person would be poorly
defended against the influences flowing toward him from the milieu
in which he has consumed the drug.
This, of course, is an hypothesis based on much clinical observa-
tion ; but it is one that should not be lightly dismissed without some
attempt at scientific validation.
This theory was first publicly proposed by me at the American
Orthopsychiatry Association Annual Meeting in San Francisco in
March 1970. In early 1972, when I was still a staff psychiatrist with
the Addiction Research Foundation of Ontario, I was developing a
research study to determine the relationship between THC intoxica-
tion and suggestibility ; but I regret to have to report here that that
institution dismissed both this theory and its principal investigator
184
shortly after I issued a public criticism of the Commission of
Inquiry into the Non-Medical Use of Drugs. This Commission had
advised the Government that the simple possession of marihuana
should no longer be regarded as an offense against the Criminal Code
of Canada.
Of course a very important part of this theory is that three vari-
ables determine the degree to which marihuana can become a factor
in the attitudinal reorientation of any given person. There is the
personality of the user himself. He may be extremely well defended
against the loss of control that is otherwise typical of the altered
state of consciousness. However, not all of the people who are exposed
to marihuana are mentally and physically healthy, psychologically
mature, worldly wise and intelligent. Indeed, many of the people who
are most liable to be exposed to this drug are either very young,
mentally unwell, or both. Such people, who have already been in-
trigued by the celebrated critics of every institution of our society
might, on achieving the marihuana ASC, be caused to accept uncriti-
cally the belief that the society is so irredeemably evil that total with-
drawal from it can only be regarded as both necessary and virtuous.
But apart from the personality of the user there is also the potency
of the material that is actually consumed. Recent studies have estab-
lished beyond any doubt that the marihuana effect is dose-related. A
high dose of THC given to an unstable person who is inclined to be
suggestible in the first place might result in a marked enhancement
of his tendency to be easily persuaded. And this would be particularly
the case if the third variable, the milieu, was especially powerful.
And by the milieu I mean the setting in which the vulnerable person
takes the drug and, particularly, the charismatic person who is a part
of that milieu and who seems to exemplify the ideal member of the
disaffiliated subculture.
It is my opinion that among the many unusual characteristics of
marihuana use one of the most important is that its users may be
rendered suggestible and that what they consider to be their volun-
tary espousal of a new system of values may be due, in fact, to
influences beyond their conscious control. (2)
2. CHROXIC EFFECTS — THE AMOTIVATIONAL STATE
One exposure to marihuana, even by an immature person in a setting
highly conducive to his alienation from the general society, will
probably not result in his immediate conversion to an entirely new
style of living. For this to happen the person must repeat the cycle
many times. He must become a chronic or habitual user of this drug.
As a clinician, I have seen numerous people who presented a most
distressing picture that resembled in varying degrees simple schiz-
ophrenia, the sociopathic personality, and chronic brain syndrome.
That is to say, these people seemed to be lackadaisical, passive,
uninterested in the world around them and demonstrably unreliable.
They would often be verbally quite facile but the range of their
thought and feeling would be very limited, I might even say impover-
ished. Their attention spans would be short and they would seem
interested only in experiencing each moment as it occurred without
185
reference either to the past or the future. Their thinking would be
frequently nonlogical and they would be very fascinated by magical
explanations for natural phenomena. Absurdities and incongruities
seemed only to amuse them in a peculiarly superficial way. They
presented, in short, a nonintoxicated version of what actually happens
when a person consumes a sufficient quantity of marihuana to achieve
a state of disinhibition, mild euphoria, self-centeredness and some
degree of detachment from reality.
Now this clinical picture has been called the amotivational state
and I consider it to be of the greatest importance that it be either
confirmed or disconfirmed that this condition develops in direct
response to the chronic use of marihuana. Most of these patients give
me the impression that they have been repeatedly persuaded that the
values and behaviors that characterize the inclusive society are
entirely lacking in virtue even though they are unable to give an
informed argument to support their own rigidly held beliefs. In fact
they seem to have been converted, through repeated exposure to the
drug and to the milieu in which it is used, to a philosophy of life
that has very little survival value in a technologically advanced and
liberal democratic society.
3. THE IDEOLOGICAL CONFLICT
But therein lies a very difficult problem. A particular scientific
study may report that THC, in sufficient quantity, can bring about
hallucinations and marked distortions of perception; but this infor-
mation will be examined by two groups of people and two entirely
opposite interpretations will be offered regarding the significance of
these findings. The first group will say that the subjects have been
rendered psychotic and that the drug must, accordingly, be called a
psychotomimetic. These people will be strongly opposed to the further
acculturation of this drug in our society. They will say that its wide-
spread use will injure many individuals and reduce the capacity of
the society to maintain itself.
The second group will examine precisely the same findings and
conclude that the drug is a thing of inestimable value. It expands
the mind. It brings about enlightenment. The drug is, therefore, a
mind-manifesting agent, a psychedelic. And if only the whole coun-
try could be turned on there would be peace and joy at last. The
people in this group are the most vociferous apologists for mari-
huana. (3)
At a meeting of the Smithsonian Institution in 1972, I was on a
panel with Dr. Richard Blum and on that occasion my distinguished
American colleague pointed out that his countrymen were seeking
quiescence through the use of such drugs as marihuana. He said they
were escaping from the complex, competitive, high performance cul-
ture which was, in so many ways he said, repulsive. The effect of this
statement was, in my opinion, to promote the use of marihuana. It
would seem that the law was the real problem. The drug was itself
relatively benign and therefore the only humane and civilized thing
to do was to strike down the law and let the people enjoy this sweet
and quieting drug.
186
Those who were inclined to emphasize the benignity of marihuana
were clearly in the ascendant in the early seventies. Those of us who
were inclined to regard the drug as a most deceptive weed, to use
Dr. Gabriel Nahas' excellent phrase, were being systematically
ignored. This tendency clearly continues but there are now some
encouraging indications that the words of caution issued repeatedly
by a rather small number of us may not have been entirely in vain. (5)
From a clinical point of view we had observed that the drug
hindered maturation and retarded recovery from psychiatric illness.
I had most particularly suggested that it appeared to play some part
in the creation and diffusion of the alienated subculture. We felt that
such a drug must ultimately have a profound and deleterious effect
on the complex biochemical processes of the living organism. In very
recent years such studies, well designed, well controlled, and making
use of quantified and active material have served to confirm, again
and again, our earlier clinical impressions. Most recently, the study
by Kolodny and Toro in St. Louis is an important case in point. (4)
These workers reported that among heavy users of marihuana there
was a marked suppression of the production of male hormones. This
finding, to an observer of the amotivational state, might well seem to
be a biochemical factor serving to reinforce the toxic and psycho-
social influences that enhance suggestibility and lead, in time, to the
development of that unfortunate state of mind in which the afflicted
person seems to be dependent, bored and crucially lacking in energy
and motivation.
The ideological conflict will continue, I have no doubt; but
eventually it will become apparent to all but the most thoroughly
habituated users of cannabis that if this drug expands whatever is
contained within the cranium the enlightenment conferred is compa-
rable to what one would expect in a case of hydrocephalus.
That, Mr. Chairman, is my prepared statement. Thank you very
much.*
Mr. Martin. I would like to ask a few questions of Dr. Malcolm.
Yesterday Dr. Kolodny, who testified, mentioned the possibility that
the so-called amotivational syndrome to which you referred might be
the result of a reduction in male hormones caused by the use of
marihuana. Does this make sense to you ?
Dr. Malcolm. Well, I was tremendously interested in the works
of Kolodny and Toro which have been published in the New England
Journal of Medicine because if indeed there is a 44-percent suppres-
sion of testosterone, that would be a biochemical basis for what I have
♦Bibliography : 1. Malcolm. Andrew I. The Pursuit of Intoxication. Simon & Schuster,
New York, Revised Edition, 1972. 388 pp.
2. Malcolm. Andrew I. "The Alienating Influence of Marihuana." Proceedings of the
Eastern Psychiatric Research Assoc. 15th Ann. Meeting, New York, Nov. 7, 1970.
3. Malcolm, Andrew I. The Case Against the Drugged Mind. Clarke, Irwin & Company
Limited, Toronto. 1973. 204 pp.
4. Masters, William H., Kolodny, R. C. and Toro, Gelson. Paper published New England
Journal of Medicine. April IS, 1974.
5. Nahas, Gabriel G. Marihuana — Deceptive Weed. Raven Press, New York, 1973.
334 pp.
187
observed for some time as a psychosocial phenomenon, that is to say,
passivity, withdrawal from interest in general activities.
I would sav that the cause of the amotivational state is multi-
factorial but here is evidence from another quarter supporting that.
Mr. Martin. You spoke about the amotivational syndrome as
though you feel that it is not a hypothesis or an assumption but a
reality which you encounter in the great majority or all of the
marihuana users you come across?
Dr. Malcolm. As a clinician I see it as being extremely important
so I really have little doubt myself of the existence of this phenom-
enon. I have seen it very, very often indeed. It is not really for me
hypothetical anymore.
Mr. Martin. I understand. Dr. Malcolm, that you had designed a
device— I do not know how germane this is to our hearing, but it is
fascinating — which is intended to stop an intoxicated driver, no
matter what causes his intoxication, from getting into his car and
starting it?
Dr. Malcolm. Well. yes. I was concerned that the breathalyzer did
not serve to keep the intoxicated driver from the road today because
we deal with multiple drug use, and alcohol may not have been the
only thing a man consumed so we needed something else to determine
whether it is alcohol, THC or almost anything else, but the fact is he
would be intoxicated.
There have been proposals put up elsewhere of an electronic device
that might prevent him from starting his car, from turning on the
ignition. Well, I invented a very simple
Mr. Martin. This is an electronic device that would require him to
perform certain complex functions ?
Dr. Malcolm. Certain complex functions such as the phystester
which I understand has been developed by General Motors.
Mr. Martin. Presumably he could not perform this while intox-
icated?
Dr. Malcolm. Yes, it is a test of his capacity to show good judg-
ment and good eyesight in that case and coordination and so on.
But I felt what was needed, was actually needed, was a mechanical
device very simple, very inexpensive, but still if it were properly
designed, one which would screen the greatest number of people that
would be so intoxicated as to be dangerous on the road, because 27,000
people are killed every year, in fact, in automobile accidents caused
bv drunk driving.
" This was simply a combination lock, and the man would be required
to turn the dial'to a number of positions. A simple test could be
designed to determine how finely it should be calibrated and how
many numbers he would have to touch and only until he had com-
pleted this test would he be able to in effect start the ignition of his
car. It is a device that is so simple that I think it might indeed
reduce a good deal of the carnage on our roads if it were developed
for use and tested.1
Mr. Martin. I hope your device is finally produced. Dr. Malcolm,
and introduced into automobiles, and that it reduces the carnage on
our roads in the future.
JThis device, the Toxicomb, is described in "The Case Against the Drugged Mind,"
Clarke, Irwin and Co., Toronto.
188
Coming back to marihuana, is there any evidence to support the
assumption that people use marihuana as a social stimulant, and that
if they use marihuana they won't use alcohol ?
Dr. Malcolm. There is absolutely no evidence. It is a myth that
has been set forth over the last few years that marihuana drives out
alcohol wherever its use becomes important. In fact, marihuana is
added to alcohol and the person now can be described as a multiple
drug user, but both drugs continue to be used and I might say in even
greater quantities.
Mr. Martin. What this would mean is that many of the drunken
drivers who are arrested as drunken drivers are probably drunk on
both alcohol and marihuana ?
Dr. Malcolm. There is no doubt in the future we are going to be
able to show this is the case. Eight now the drunk driver is by
definition drunk on alcohol but in fact he may have taken one drink
and many other drugs. The breathalyzer would show it is far under .1
milligram percent but he still would not be able to function inside an
automobile.
Mr. Martin. When you get drunk on alcohol and marihuana, is
there a simple arithmetic effect in which one is added to the other, or
is it a synergistic effect, a compounding effect?
Dr. Malcolm. Well, both drugs obviously have a central nervous
system depressant effect but there are certain things peculiar to
marihuana that would greatly complicate the matter. Judgment is
obviously affected and the interpretation of the meaning of various
symbols that we ordinarily understand is distorted, too. The effect
of adding marihuana to alcohol is not similar to what would happen
if you just took more alcohol. There is a distortion of perception and
a further impairment of judgment of a rather unusual kind.
Mr. Martin. I have a rather big question for which I would like
to have a very brief answer. Not much is known in this country about
the Canadian Le Dain report, but I believe there are some remarkable
similarities between the Le Dain report and the Shafer report in the
United States. Could you comment on these briefly, Dr. Malcolm ?
Dr. Malcolm. As you say, that is a difficult thing to say in a word.
There are many interesting similarities. Both reports contain a great
deal of material that would give the general impression that mari-
huana was a relatively benign intoxicant and not one that would
represent a tremendous public hygiene problem. The Le Dain report
in Canada actually proposed that the simple possession of marihuana
no longer be considered an offense against the criminal code. A
similar recommendation was made by the Americans. That kind of
information certainly gives the impression to the people that they
need not be unduly concerned about the increasing use of that drug.
Nor did they emphasize the fact that there were far more potent
varieties of that drug available now and in the future. There was a
lenient and permissive attitude to marihuana on both sides of the
border. Both Commissions were obviously extremely selective. They
did not ask for testimony from a number of people who might have
said things of a more cautionary nature. I am very familiar with that
activity in Canada. I know of many people who were concerned about
marihuana who were not invited to testify, and I know perfectly
189
well there were manv Americans and other people who were not
asked to testify here. So there was a kind of bias initially in favor of
improving the climate of acceptance of marihuana on the grounds
that it was criminalization that represented the real problem and
not the possibly deleterious effect of the drug itself on the general
population.
I think that would be a brief statement in response.
Mr. Martin. I think you have done remarkably well in the short
span of time.
The final question I would like to ask : In your writings — I have
two of your books at home — you have been critical of the concept
known as "wise personal choice" — that is, leave it to the wisdom of
the individual citizen — as a mechanism for the social control of drugs.
Dr. Malcolm. Yes.
Mr. Martin. Would you elaborate on this study briefly ?
Apparently you don't feel the decision can be left to the individual ?
Dr. Malcolm. No.
The problem here is that a great many people have suggested that
the answer to the problem of drugs is to give the people all of the
information, all of the facts, and then they will make a wise personal
choice on the basis of those facts.
Now this appears to be a most beautiful, civilized, humane, and
progressive and advanced kind of thinking; and the only problem
with it is that it is totally impractical and naive because not all of
the vulnerable people in the general community are able to under-
stand the facts or are inclined to care about all the facts. Indeed
education is important, and I am not opposed to this at all, but it is
very foolish to think that giving the people all the facts will cause
them to make a wise personal choice.
It is necessary to have some external restraint when, indeed, some
of the people are incapable of exercising internal restraint. But those
people who propose wise personal choice usually are unalterably
opposed to any kind of external restraint. It is very foolish because
what we need in fact is both of these elements.
Mr. Martix. A combination of education and the law ?
Dr. Malcolm. Education and the law, and not one or the other. It
is verv naive to think that everyone is equally educable or would
even be guided by these facts, if they knew them. The problem with
alcohol in our society is a perfect example of the disastrous impact
of wise personal choice. Indeed there is lots of evidence that alcohol
is a drug that causes trouble. It is completely available, and no one
is guided by the information received.
Mr. Martin. I have no further questions, Mr. Chairman.
Senator Gurnet. Thank you very much, Dr. Malcolm, for your
contribution to our svmposium here.
Our next and final witness is Dr. Zeidenberg. Would you identify
yourself for the record, Doctor ?
TESTIMONY OF DR. PHILLIP ZEIDENBERG, COLUMBIA UNIVERSITY
Dr. Zeidenberg. Yes. I am Dr. Phillip Zeidenberg, research asso-
ciate in psychiatry at Columbia University. I am senior research
phychiatrist at New York State Psychiatric Institute.
33-371 O - 74 - 14
190
Senator Gurnet. I will make one statement here about your qual-
ifications and if it is correct you can answer yes at the end.
I understand you are a graduate in mathematics magna cum laude
of Harvard University.
You achieved your medical degree from the College of Physicians
and Surgeons, Columbia University, in 1958.
You received your Ph.D. in biochemistry from Columbia Univer-
sity in 1965.
Your special disciplines are clinical psychiatry, research in the
clinical and biochemical psychopharmacology of both depression and
drug abuse and research in electroconvulsive therapy.
At the present time, in addition to being a research associate at
Columbia you are the associate attending psychiatrist at Vanderbilt
Clinic, associate psychiatrist at Presbyterian Hospital, chairman of
the New York State Psychiatric Institute Radiation Safety Commit-
tee, chairman of the Drug Dependence Committee of New York State
Psychiatric Institute, and director of the methadone treatment pro-
gram of this Institute.
You have won several fellowships and awards, including the Amer-
ican Medical Association's Physician Recognition Award in 1969, and
you have published 12 papers including a chapter in the medical
textbook entitled "Medical Aspects of Drug Abuse" published in 1974.
Is that statement of your qualifications accurate?
Dr. Zeidenberg. That book is in print. It is 1974, "Drug Abuse as
a Factor" and "Medical Aspects of Drug Abuse" now in the press.
Senator Gurnet. Thank you, Doctor. Now you can proceed with
your statement.
Dr. Zeidenberg. As I pointed out in my recent article on this
subject * the pressure for legalization of marihuana without even
medical supervision so short a time after the beginnings of under-
standing of its chemistry, pharmacology, and toxicology is unprece-
dented in the history of this country. I interpret this eagerness as
being in part as backlash to excessively punitive measures carried out
against naive and noncriminal individuals, especially young people.
I feel other factors are also at work in this, but the brevity of this
statement precludes going into this complex issue in greater detail. I
will restrict my comments to psychiatric and pharmacological haz-
ards which must be seriously considered before any irreversible
legislative steps are taken.
I use the term "irreversible" deliberately, because I wish to
emphasize that legalization of use of an agent in society creates a
situation in which the agent becomes embedded in the social structure
and is virtually impossible to extirpate. One need only look at the
situation in regard to alcohol and cigarettes to realize this obvious
fact. At the present time, heavy chronic use of marihuana is a
relatively minor problem in this country although large numbers
experiment with the drug briefly and intermittently. There is no
question in my mind that legalization of marihuana will lead to a
large population of chronic heavy marihuana users, numbering in the
1 Psychopharmacological Hazards of Legalizing Marijuana in the U.S. Bulletin, New
York State District Branches, American Psychiatric Association 16 :2, September 1973.
Phillip Zeidenberg, M.D., Ph. D.
191
millions, just as prevails with alcohol and tobacco. Both of these
latter agents exact a terrifying; toll in human life, suffering, and
expense in this country annually. I think it is probable that heavy
marihuana use in our country would create a third at-risk population
overlapping only in part with the two previous groups and further
add to mortality, morbidity, and public cost. Anyone who doubts that
such a population of individuals would develop need only look at the
public health figures from nations where use is indigenous. I myself
have had the opportunity to carefully scrutinize the situation in one
such country.2
What are the possible public health consequences of the develop-
ment of a large population of chronic heavy marihuana smokers in
this country? I can only summarize some of them in the brief time
available.
CHRONIC SOMATO-TOXIC EFFECTS
Although much publicity has been given to studies indicating
marihuana as harmless by certain physiological criteria, it must be
emphasized that the number of physiological variables which must
be studied is enormous before this agent can be established as safe or
at least as safe as other drugs — no drug is perfectly harmless. Recent
reports have indicated that this agent may be more dangerous than
was first realized. A group of workers at the Reproductive Biology
Research Foundation in St. Louis have recently reported depression
of plasma testosterone levels after chronic intensive marihuana use.
Thirty-five percent of these men showed reduced sperm counts.3 This
ties in with an earlier report of gynecomastia in marihuana users.4
Nahas and coworkers at Columbia 5 have demonstrated inhibition
of cellular mediated immunity of 51 young chronic marihuana
smokers. They postulated that this may be due to direct impairment
of DNA synthesis by the agent. On the other hand, the findings of
Nahas may be hormonally mediated and thus related to the findings
of the St. Louis group. I)NA synthesis may be secondarily inhibited
by effect of the drug on hormones via the central nervous system.
Much more work is needed in this area to clarify this matter.
Since time is limited, I will only mention other possible toxic
effects which need consideration.
(a) Chronic marihuana smoking causes bronchitis, diminished lung
capacity, and abnormal microscopic changes in lung tissue. In the
long run, chronic marihuana smoking may have many of the pul-
monary effects of tobacco. Furthermore, in many places where it is
used, marihuana is diluted with tobacco, so that legalization of this
agent will incidentally promote use of a known harmful agent which
the Federal Government is now spending large sums to reduce the
use of.
(b) Recent reports on chromosomal damage by marihuana need to
be considered and reinvestigated seriously. Although they are in con-
flict with earlier reports, they come from highly reliable sources and
*Kif in Morocco by Gabriel G. Nahas, M.D., Ph. D., Phillip Zeidenberg, M.D. Ph. D.,
and Claude LeFebure', M.S., International Journal of the Addictions in press (lH7d).
3Kolodny, R. C, et al. New England Journal of Medicine 290 :872 (1974) MQ_0.
* Harmon. J. and Abapoulios, M. A. New England Journal of Medicine 287 :«db (iy7J).
6 Nahas, G. G., et al. Science 183 :419 (1974).
192
would tend to mesh with the previously mentioned research on hor-
mones and cell-mediated immunity. This area needs to be carefully
investigated before final conclusions are drawn.
(c) The issue of possible associations between heavy cannabis use
and brain damage or permanent behavioral alteration has become
hopelessly confused by a maze of conflicting, poorly controlled, and
difficult to interpret reports. No definite conclusions can be drawn
at this time but this is a priority research issue. No irreversible
legislative steps should be taken until this issue is clarified.
ACUTE AND CHRONIC PSYCHIATRIC AND BEHAVIORAL EFFECTS
There is no doubt that a single dose of tetrahydrocannabinol can
cause an acute psychotic reaction in mentally healthy individuals.
One of our subiects in a small pilot study with oral delta-9 tetrahydro-
cannabinol had an acute paranoid break lasting several hours. This
young man is of unquestionably sound mental health.
Marihuana use is also associated with longer lasting and even
chronic psychoses. Many of these individuals, but not all, are found
to have a previous history of serious mental illness. The remaining
are often loosely dismissed as prepsychotic or latently psychotic indi-
viduals. It must be emphasized that this is an operationally meaning-
less statement making use of facile psychiatric jargon. It is not of
much consolation to an ex prepsychotic, made ex by an hallucinogenic
drug like THC who might have otherwise made it to a ripe old age
still prepsychotic, a condition operationally indistinguishable from
nonpsychotic. It behooves us to investigate this aspect of the drug
more scientifically before it is made widely available.
I wanted to add parenthetically here in knowing some of the
remarks made previously that the capacity of marihuana, generally
acknowledged to exacerbate underlying mental conditions, is some-
thing which tends to be dismissed because of prejudices which we
have in this country against mental illness as an illness.
Now, to take a physical analogy we know that a great percentage
of our population carries within it dormantly the herpes simplex
virus and if anyone were to suggest the introduction of an agent
which would greatly increase the rate of appearance of active herpes
simplex this agent would immediately be stricken from use. But the
idea of introducing an agent which activates mental illness is some-
thing which does not seem to be so reprehensible to individuals, and
this is a part of the general public misunderstanding of the nature
of mental illness, in my opinion.
As far as the effect of marihuana on behavior of normal indi-
viduals is concerned, there is no doubt that it impairs normal func-
tioning. In our work6 we have found it to interfere with memory,
speech, and pain perception. Numerous other studies, more extensive
than ours, and involving other parameters, show that much normal
behavior in our society is not possible under the agent. Driver per-
formance, for example, is significantly impaired. Thus extensive
8 "Effect of Oral Administration of delta-9 THC on Memory, Speech and Perception
of Thermal Stimulation." bv Phillip Zeidenbers:. W. Crawford Clark, Joseph Jafice.
Samuel W. Anderson, Susan Chin, and Sidney Malitz. Comprehensive Psychiatry
14:549 (1973).
193
marihuana use may bring us an entirely new at-risk population
suffering from some of the detriments of both tobacco and alcohol.
In our work, which we did, we verified quantitatively some of the
observations made bv Drs. Kolansky and Moore earlier today about
the flow of speech. We found that marihuana interferes with imme-
diate memorv and thereby directly interferes with the flow of speech
giving the characteristic marihuana speech which is so well known.
Possibly the issue of greatest importance in the area of behavioral
toxicity of marihuana is the question of the amotivational syndrome.
This problem is frequently dismissed by those favoring legalization
as a syndrome that is brought about by coexisting psychiatric diffi-
culties in those individuals who coincidentally use marihuana, or
alternatively, it is written off as something which is brought about
by hopeless socioeconomic conditions in backward third world
nations. Nevertheless, this syndrome is seen consistently in virtually
all studies of chronic users in all countries and there are no reliable
ways of measuring the subtle changes in mental state that might
cause such a syndrome. This type of apathy and alienation may be
brought about by drug-induced changes in capacity for attention,
concentration, and motivation for which we have no adequate meas-
ures. The history of psychiatry is full of unwarranted assumptions
about psychological causation that later proved to be erroneous. If we
are contemplating legitimizing this agent, it behooves us to investi-
gate this phenomenon thoroughly with refined psychophysiological
techniques.
• And let us not deceive ourselves that this phenomena can't happen
here in our socioeconomically advanced society. There have been
clinical reports of this syndrome in chronic younger users here.
Furthermore, the assumption that withdrawal into chronic cannabis
use is a response to socioeconomically deprived conditions not found
in this country is unwarranted and shows more pride and arrogance
than judgment and intelligence. I have seen personally a society in
which de facto legalization of this drug has created a large number
of people with the amotivational syndrome. The majority of people
in this society, although poor, are hard working, intelligent, highly
animated and motivated, and not using marihuana. To regard our-
selves as immune to this syndrome is not only potentially destructive
to our own society but an affront to our foreign neighbors who have
more pragmatic experience with this problem and with whom we
have existing treaties to outlaw this drug. Clinical experience is often
made light of in this era of controlled scientific studies. I do not
wish to minimize the value of scientific work. I merely suggest that
a thousand years of clinical wisdom are not to be dismissed by a few
preliminary scientific studies.
Finally, I wish to discuss my point of view on the social aspect of
this problem. I feel that the President's commission on marihuana
and drug abuse was correct in stating that the problem of marihuana
is only one problem in the spectrum of drug abuse. Alcoholism,
cigarette smoking, and opiate abuse all outrank marihuana in magni-
tude as public health problems. It has been argued that marihuana is
already freely available and that a situation prevails akin to that of
prohibition, in which excessively punitive measures are employed
194
against those using "bootleg" marihuana while others use legal alcohol
and tobacco freely. It has been stated that legal marihuana would
merely continue to be a minor problem in the United States.
I believe there are dangerous psychological errors in these view-
points. Each of us has within him a certain capacity to commit
antisocial acts, varying with the individual and his circumstances. It
will be noted from the Third Report on Marihuana and Health that
the use of cannabis in the United States has not increased dramati-
cally, despite readv availability. I believe this is because of the fact
of its illegality. Illegality is a cutoff point which separates the vast
majority of the population from those with psychopathology suffi-
ciently great to drive them to commit the repeated antisocial acts
necessary to use it regularly. I believe that legalization will turn on
a "green light" which will enormously increase the number of chronic
heavy users, just as it has in every other country where de facto
legalization exists. Once this happens, marihuana will become an
integral part of our social structure and take on complicated social
and symbolic significance as tobacco and alcohol already have. Once
this happens, it will be virtually impossible to remove it, and any
attempts to remove it will indeed be regarded as prohibition, as was
the case with alcohol and, in some instances, tobacco. Before the drug
takes on this social and symbolic significance, laws against it are not
the equivalent of prohibition. Prohibition, as we understand it in this
country, is not prohibition in the literal or restricted sense of the
words, but a complex memory extrapolated from the events of the
1920's. As such, it does not apply to marihuana restrictions.
On the other hand, certain realities about marihuana must be faced.
It is impossible to cut off the supply of this agent. It will always be
readily available and there will always be a subsegment of our popu-
lation willing to take the risk of experimenting with it. Ultrapunitive
measures taken against individuals occasionally using the drug can
only lead to the backlash of pressure for legalization. Offenders
should be given light, but significant sentences, enough to be a
sufficient deterrent to repeated use. Chronic heavy users should be
offered psychiatric treatment, not jail. This alternative should be
reserved for hardened profiteers and sellers. Our job is to prevent
marihuana from becoming an embedded social phenomenon. Eradi-
cation by legal measures is a hopeless fantasy. The job of the law is
to find the appropriate deterrent so that the marihuana problem is
kept as a minor drug-abuse problem without crucifying errant ado-
lescents. On the other hand, legalization will open a Pandora's box
which we may not be able to cope with for centuries, or ever.
Senator Gurnet. Thank you, Doctor.
Mr. Martin.
Mr. Martin. I have just a few questions for Dr. Zeidenberg. You
say on page 8 of your testimony that alcoholism, cigarette smoking,
and opiate abuse all outrank marihuana in magnitude as public health
problems.
Dr. Zeidenberg. Yes, I am talking in terms of numbers and cost.
Mr. Martin. In terms of numbers of people involved ?
Dr. Zeidenberg. Yes, in numbers of people involved.
Mr. Martin. But do they outrank it — marihuana — in terms of the
damage it does to the individual involved ?
195
Dr. Zeidexberg. Well, I think that marihuana is as capable as
alcohol and tobacco of causing damage to the individual.
Mr. Martin. From your observations and from your reading
would you agree with the estimates that have already been offered
that marihuana exposure — regular exposure over a 1- or 2-year
period — is capable of inflicting irreversible brain damage?
Dr. Zeidenberg. I think there is evidence to point in that direction.
However, I think that there is conflicting evidence and I think that
is something which needs more work and needs to be clarified. There
is, however, the distinct possibility that that may occur.
Mr. Martin. If that in fact were established, it would be a sub-
stantially more dangerous drug than alcohol or tobacco?
Dr. Zeidenberg. Well, alcohol causes brain damage if used chronic-
ally.
Mr. Martin. Not over a 2-year period?
Dr. Zeidenberg. Well, it usually takes longer than that and, of
course, tobacco, I wish that somebody would clarify that with regard
to tobacco, but I certainly think it is a dangerous drug and it may
very well prove to cause brain damage.
Mr. Martin. Would it not also be more dangerous— we are talking
about potential as well as about the situation that exists today — be-
cause of its easy accessibility and because of the ease with which it
can be used by very young children? For example, a grade school
kid can't take a quart of alcohol and hide it in his pocket and go
down into the washroom, before school or at the noon break, and
drink it.
Dr. Zeidenberg. Right, very much more dangerous, and also more
dangerous in the sense it cannot be detected, at least not at the present
time, and as was pointed out earlier by one of the previous speakers,
a child who needs an education can go into the washroom and smoke
a couple of marihuana cigarettes in the morning and not learn a
single thing for the rest of the day and nobody is going to know it.
A kid who goes into the bathroom and has a couple of shots of
whiskey in the morning certainly is going to be detected after a
while and receive some kind of treatment.
Mr. Martin. It is one of the "safety factors" built into alcohol
use, if you wish to use the expression?
Dr. Zeidenberg. So it seems.
Mr. Martin. The boy who drinks is intoxicated and staggers and
the staggering gives him away — that does not happen with mari-
huana?
Dr. Zeddenberg. Right.
Dr. Martin. One more question and then I think I will be
through.
You say on page 9 of your testimony that the Third Report on
Marihuana and Health — this is from the Secretary of HEW to Con-
gress-
Dr. Zeidenberg. Yes.
Mr. Martin [continuing]. "Reports that the use of marihuana in
the United States has not increased dramatically." I don't know
whether you have had occasion, Dr. Zeidenberg, to look at the charts
submitted to the subcommittee last week bv the Drug Enforcement
196
Administration, showing a staggering increase over a 5-year basis in
the rate of interdictions of marihuana and hashish coming into the
United States or targeted at the United States. Marihuana interdic-
tions went up tenfold to 780,000 pounds, hashish went up twenty-five
fold over a 5-year period to 55,000 pounds. These were seizures made
by Federal agents only — these figures do not reflect seizures at local
levels. What this means, in effect, is that our law enforcement author-
ities probably seized substantially more than a million pounds of
marihuana and 70,000 pounds of hashish.
If you want to be very conservative, multiply 7 or 8 — some people
say io — and you have an idea of the amount consumed. It comes to
7 or 8 million pounds of marihuana, 600,000 pounds of hashish. These
figures certainly do not suggest, would you agree, that the marihuana
epidemic is receding or diminishing ?
Dr. Zeidenberg. Well, they certainly do not seem to correspond to
the report of HEW on marihuana and health which says that the
increase has not been dramatic. Those figures are certainly very dra-
matic.
Mr. Martin. There was also a graph showing a parallel upward
curve in the rate of arrests by local and Federal authorities for can-
nabis offenses — it just went up at an angle of about 60 degrees — so that
all the indices appear to conform on this point. And the question is,
where do the authors of the Third Report get their estimates ?
Dr. Zeidenberg. I do not know. I think you will have to ask them.
Mr. Martin. It is a good point.
The Shafer Commission actually last year in their final report
said that in 1972 there had been an 8-percent increase in the rate of
cannabis use over 1972. We have no figures for 1973, but if it were
8 percent for 1973 it would still indicate a 16-percent increase over
a 2-year period, lower than the other figures suggested but still very
significant. It does not suggest a tapering off.
Dr. Zeidenberg. No.
Mr. Martin. So on the basis of any available information from
official Government sources, the question arises how could they come
to this conclusion ?
Dr. Zeidenberg. It is a bit surprising. I must say in my own clinical
practice I do not get the subjective feeling that marihuana use is
tapering off. I still hear about it, I hear about it more and more
from my patients. As a matter of fact, it is becoming taken for
granted.
I am afraid that the drug is acculturing, becoming part of the
society in spite of the red light of illegality. I hope, for one, that
that does not happen, but
Mr. Martin. You speak about the red light of illegality. Are
there any red lights on in our academic community or in our media?
Dr. Zeidenberg. Well, generally, I think, the media tends to, in my
own reading of the media I don't think the media tends to empha-
size the negative aspect of marihuana. They tend to emphasize what
has been spoken of as the harmless effects of the drug.
No, I do not think the media have put out a red light.
Mr. Martin. Has the academic community put out a red light?
197
Dr. Zeidexberg. No, generally speaking, I would not say they haye.
Mr. Martin. So we have here — Dr. Malcolm has made the point
that in order to control this you have to have a combination of an
educational program and the law. We have the law, we do not have
the educational program today?
Dr. Zeidexberg. That is true.
Mr. Martin. So our defenses are defective in that sense.
Do you have any further comment you would like to make on the
third report of the" Secretary of HEW on marihuana to the Congress?
Dr. Zeidenberg. Well, I had a number of comments. I don't know
that the time allows to comment on this, on so much. Their statement,
for example, that the typical marihuana dealer is not a street dealer
of such drugs as heroin or cocaine, he is typically himself a user, a
middle class, not otherwise involved in criminal activity and his sell-
ing is closely correlated with his level of use, I really wonder how
they know this, I don't believe it to be true. In my own experience
I have seen many people who are very deeply into the business of
selling marihuana for a profit. I am afraid there is just two much
here for me to comment on in the brief time.
Mr. Marttx. You are aware of the fact that some of the seizures
over the past 18 months have run into the multiton range — 12 tons of
hashish, 3,700 pounds of hashish, 20 tons of marihuana, 43 tons of
marihuana. Someone is operating on a big scale?
Dr. Zeidexberg. Yes, I believe that is true. I am not personally
acquainted with this. I did read an article in Time magazine some
time back about a good deal of criminal activity associated with
marihuana importation across the border from Mexico into Arizona,
taking place between Phoenix and Tucson. That certainly was not the
operation of small-scale operators who were just selling it themselves
for fun.
Mr. Martix. I believe I have gone beyond my time limit, Mr.
Chairman. That concludes my questions.
Senator Gurxey. Gentlemen, I want to thank all of you for com-
ing here today and taking time away from your medical practice and
your profession, your research or teaching or whatever your work
may be and making this contribution in our effort to find out as
much as we can about the effects of marihuana on our population,
especially our youth. Certainly not only is it a domestic problem here
in the United States, which is constantly growing, but it is a world-
wide problem in many other countries as well, and I especially want
to thank our foreign visitors, visitors from other nations abroad, for
coming such long distances to help us out in our quest for informa-
tion, too.
Thank you very much.
The subcommittee is adjourned subject to the call of the Chair.
[Whereupon, at 1 :05 p.m., the subcommittee adjourned subject to
call of the Chair.]
MARIHUANA-HASHISH EPIDEMIC AND ITS IMPACT ON
UNITED STATES SECURITY
MONDAY, MAY 20, 1974
U.S. Senate,
Subcommittee To Investigate the
Administration of the Internal Security Act
and Other Internal Security Laws
of the Committee on the Judiciary,
Washington, D.G.
The subcommittee met, pursuant to notice, at 2:30 p.m., in room
2228, Dirksen Senate Office Building, Senator Strom Thurmond, pre-
siding.
Also present : David Martin, senior analyst.
Senator Thurmond. The subcommittee will come to order. This is
the fourth in a series of hearings by the Senate Subcommittee on
Internal Security dealing with the marihuana -hashish epidemic, and
its impact on the U.S. security.
Last Thursday the subcommittee took testimony from a panel of
seven internationally distinguished medical scientists. On Friday
we took the testimony of a similar panel of scientists assembled from
many parts of the world. Although I could not attend these hearings
because of other pressing Senate duties, except for a few minutes, I
had them monitored by my staff. I have been told that the scientific
evidence presented at these hearings established beyond any question
that marihuana and hashish are very dangerous drugs that do per-
manent damage to the brain ; that there was also evidence presented
that there is serious damage to the reproductive system, and danger
of genetic damage and mutation.
Today we shall be concluding this series of hearings. Our first
witness will be a medical scientist, Dr. Julius Axelrod 1 of NIH,
who won the Nobel Prize in 1970; our second witness will be Dr.
Conrad Schwarz, a distinguished Canadian psychiatrist from Van-
couver; our third witness will be Prof. Hardin Jones of Berkeley,
one of this country's most eminent scientists, who is qualified in
many different disciplines in the general field of medicine and science.
Dr. Jones and Mr. Keith Cowan of Canada, who follows him, will
be dealing with the causes contributing to the spread of the cannabis
epidemic in our country, and internationally, and what can be done
to combat the epidemic.
1 The testimony of Dr. Julius Axelrod was ordered to be printed with the testimony of
other scientists on May 16 and may be found on p. 142.
(199)
200
To save time, will all witnesses rise and be sworn in at the same
time, at one time as a group ? Would you raise your right hands ?
Will the evidence that you give in this hearing be the truth, the
whole truth and nothing but the truth, so help you God?
Dr. Axelrod. Yes.
Dr. Schwarz. Yes.
Professor Jones. Yes.
Mr. Cowan. Yes.
Senator Thurmond. Have a seat.
Dr. Schwarz we would be pleased to hear from you now. If you
would please identify yourself for the record, and state your qualifi-
cations.
TESTIMONY OF DR. CONRAD SCHWARZ
Dr. Schwarz. I am Conrad J. Schwarz, and I am a graduate
in medicine of the University of Glasgow, licensed as a practicing
physician in the Province of British Columbia, Canada. I hold a
fellowship qualification in psychiatry from the Royal College of
Physicians and Surgeons of Canada.
Mr. Martin. Could you raise your voice, Dr. Schwarz, or bring
the microphone closer to you?
Dr. Schwarz. I am a consultant psychiatrist to the Student
Health Service and clinical associate professor in the Department
of Psychiatry, University of British Columbia. I am chairman of the
Drug Habituation Committee of the British Columbia Medical As-
sociation, a member of the Methadone Advisory Committee of the
Canadian Government Department of National Health and Welfare,
and a member of the board of directors of the Narcotic Addiction
Foundation of British Columbia.
Senator Thurmond. You may proceed now with your statement,
Doctor.
Dr. Schwarz. I would like to first of all indicate that as a prac-
ticing physician and psychiatrist, my approach is essentially clinical
rather than scientific. Thus, rather than seeking to demonstrate
isolated cause-and-effeet relationships, the process consists of the
gradual accumulation of observations from which deductions can be
made of value in the diagnosis, treatment, and prevention of illness
in human beings.
In the case of cannabis, over the past 6 years, I have made an
extensive survey of the literature, examined many users, participated
in private, public, and professional lectures and debates, and refined
my thoughts in a series of published papers. From this ongoing
process, I have formed certain clinical opinions which have been
successfully applied in practice and teaching, and which I have
found to be corroborated by many other physicians working in their
own ways. Of particular interest is the fact that many users of
cannabis have agreed with much of this material when it has been
brought to their attention and a number of them have discontinued
use of cannabis with significant improvement in their health.
Most of the details of my thinking on this subject are contained
in the selection of four papers marked (1), (2), (3), and (4), which
I have made available to the subcommittee. In addition I have sub-
201
mitted three appendices marked (A), (B), and (C), which detail
the advice given in 2 successive years by overwhelming majorities
at the annual meetings of the General Council — governing body — of
the Canadian Medical Association when the Canadian public were
clearly advised against the nonmedical use of cannabis.
I will try, briefly, to cover those points which merit emphasis in
relation to cannabis. In the first place, there is a need to correct
some of the prevalent myths about the history of this drug. There
is no evidence that cannabis was used for pleasure before about the
10th century A.D., in the Middle East or in India. Some writers
appear to have used isolated references in ancient manuscripts to
what might, or might not have been cannabis, to give a false sense
of ancient respectability to it.
Ever since its use for intoxication was recognized, persistent cau-
tionary statements have been made by close observers of cannabis. It
should be emphasized that many of the new observations on the
adverse effects of cannabis, which are now beginning to pour into
the medical journals, are but modern terminological refinements of
observations of clinicians and others in the old literature.
For example, the statement of Ali al-Hariri, the 13th century
Moslem religious leader quoted in paper (3), who made the clinical
observation that cannabis was retained in the body, and had con-
tinuing effects, for up to 40 days. Recent scientific measurements —
the work of Dr. Axel rod's group in particular — have so far con-
firmed the presence of THC and its metabolites for at least 8 days
in the human body.
Again, as indicated in paper (3), the major national commission
studies of cannabis all contain a considerable amount of cautionary
clinical material, the significance of which has been lost to the general
public because of media preoccupation with the philosophical, politi-
cal, and legal discussions in these reports. This statement even applies
to the often quoted but apparently seldom read Indian Hemp Drugs
Commission Report of 1893-1894.
From the point of view of this physician, the overwhelming mass
of evidence leads to the conclusion that the use of cannabis consti-
tutes a significant health hazard. The evidence for this conclusion
is detailed in the references in the four papers and in appendix
(A) and can be summarized as follows:
(1) Cannabis is a complex plant with many chemical ingredients,
the nature and action of which are largely, but are not entirely un-
known.
(2) What is known is that pharmacologically, a major active
ingredient, THC. and its metabolites, which probably have continu-
ing activity, persist in the body for long periods of time, and likely
have continuing psychological and physical effects.
(3) The most commonly used derivatives of cannabis, marihuana
and hashish, show varying potency, deterioration with time, and
variable effects on humans.
(4) Probably because of the long duration of active cannabis
ingredients in the body, regular users, that is, once or twice weekly,
show clinical evidence of continuing low-grade intoxication, charac-
202
terized by memory impairment, mood swings, sleep disturbances, and
generally lessened functioning. They also show a variety of physical
disorders. Both the psychological and physical symptoms usually,
though not always, begin to clear up a week or two after discontinua-
tion of cannabis use, suggesting that a long-acting biochemical proc-
ess is involved. This very relief of symptoms offers presumptive
evidence for the "clinical" impression that cannabis is a causative
factor in their production and maintenance.
(5) There is evidence that tolerance and increased dosage need is
occurring with regular cannabis users. This is indicated by a switch
from the use of marihuana to hashish, which is about 8 to 10 times
more potent, and by the huge doses of hashish used, for example, by
some American G.L's in Germany.
(6) Animal experiments have shown that active cannabis prod-
ucts cross the placental barrier and can be passed in breast milk.
There are also animal reports of fetal abnormalities and, more
recently, there are reports of chromosome damage in human light
and heavy users.
(7) In keeping with reports that marihuana contains about 50
percent more tar and nicotine than heavy tar cigarettes, there are
reports of cancerous changes in animals and precancerous changes
in the lungs of young human users.
(8) There are reports of changes in nucleic acid synthesis in
animal brains, which are thought to have some bearing on the
clinical observation of memory impairment in humans, and there is
also a report of cerebral atrophy in heavy human users.
(9) Finally, there is the recent report from Dr. G. G. Nahas, of
Columbia University, of interference with human immune response
mechanisms by cannabis, much in the same way that DDT carries
this danger.
The physician, presented with the above list, for which detailed
references are available in the attached documents, must conclude
cannabis constitutes a significant hazard to the health of the indi-
vidual. It is my contention that there really never has been, and
there is not now, any significant body of medical opinion in favor
of the utilization of cannabis. Like every other group, the medical
profession has been confused about the philosophical and humani-
tarian aspects of drug use, and some individual physicians have ex-
pressed their idiosyncratic opinions as philosophers, lawyers and
politicians on both sides of the drug debate.
I myself have indulged in the same process at times in the past,
but have found that when I make philosophical, legal or political
pronouncements about cannabis, these only detract from what I have
to say as a physician and psychiatrist. Such pronouncements seem
only to allow some individuals to categorize me personally as being
with them or against them and in either case they turn out and
continue comfortably in their own convictions. By exercising my
democratic right to keep mv vote secret, it is my impression that
this encourages people to take a closer look at the evidence rather
than judge the person.
However, I consider it important to state clearly my views on the
203
medical aspect of the marihuana debate. It is my clear opinion,
based on the material presented to the subcommittee, that the use
of cannabis should be discouraged on the grounds of individual and
public health concerns. This is an opinion which is shared by the
governments of many countries which have signed the Single Con-
vention of the United Nations, by the recent British, American, and
Canadian national commissions, and by the Canadian Medical
Association.
Given that goal, which seems to be always still standing there
when the marihuana smoke blows away, it is up to the legislators in
different countries to decide what part their laws should play in
achieving it.
Senator Thurmond. Counsel has some questions.
Mr. Martin. Thank you very much for your presentation, Dr.
Schwarz. Do you find the cannabis problem increasing in Canada,
the way it is here?
Dr. Schwarz. Well, we have the feeling that it may be beginning
to stabilize a bit in Canada; but it certainly has been increasing very
rapidly up until quite recently. It's very difficult to say. Certainly
the number of convictions for trafficking has gone up dramatically
year by year for the past 4 or 5 years.
Mr. Martin. I assume you follow the situation in the United
States closely because of your general interest in the problem in
Canada?
Dr. Schwarz. Yes.
Mr. Martin. From what you know of the situation here, and
from your personal experience in Canada, do you feel that the
Canadian situation is roughly comparable to ours, or are there sig-
nificant differences?
Dr. Schwarz. No, I don't think there are any major differences;
I think they are quite comparable.
Mr. Martin. I would point out in response to your first answer,
Dr. Schwarz, people here are saying it is tapering off, or receding
a little bit, but there is contrary evidence, quite contrary ; the amount
being consumed goes up, and up, and up.
Dr. Schwarz. Yes, I think we are having the same difficulty in
trying to read the month-to-month situation in Canada.
Mr. Martin. Do you feel the press in Canada overstates or ac-
curately describes the dimension of the problem?
Dr. Schwarz. I think it still has to be called an epidemic in terms
of the rapidity of the spread in the use of cannabis over the past
several years.
Mr. Martin. And the total number of people involved ?
Dr. Schwarz. I think so.
Mr. Martin. Are cannabis users generally honest ; have you found
them generally honest in their interviews, informing you of the in-
tensity and duration of their habit, and any symptoms they may
have noticed ; or do vou have any problems getting the truth out of
them?
Dr. Schwarz. I think they are honest, although I think we prob-
ablv have some difficultv getting the facts out of them ; I think that
204
is partly because of some effect of cannabis, it being a long-acting
substance, its duration in the body is continuing and active.
The problem is not so much their honesty; the problem is their
difficulty in remembering. I know in my interview technique, which
is a fairly fine instrument in doing the investigation of cannabis
users — I could give you a brief excerpt. I usually ask them how long
they have been using cannabis : how often they use it. Most of them
answer that question with, "Oh, I only use it on social occasions." I
then say, "Well, when were the last three occasions you used it?" The
answer is usually something like, "Oh, last Saturday night, last
Friday night, and sometime earlier in the week, but I can't quite
remember."
As we go through the process I usually say to the individual, "Is
the use of cannabis affecting you in any way adversely," and the
answer always is, "No, everybody knows cannabis doesn't do any-
thing to you." So, I then say, "Well, how has your memory been
lately," and the most common answer is something like, "Well, that's
a funny thing, Doc, it's not as good as it used to be." And I say,
"How has your mood been lately "
Mr. Martin. Your what?
Dr. Schwarz [continuing]. "Your mood," and the answer, "The
funny thing is, my girlfriend tells me I'm more irritable." "How
has your sleep pattern been lately?" "Well, I have difficulty going
to sleep at night, and I sleep more during the day."
A number of individuals also describe a continuous feeling of
being "spaced out" for 1 day or 2 days after the smoking of mari-
huana. And this again, I think, is related to the duration of the con-
tinuing intoxicant in the body.
Usually by this kind of a process we get an individual to agree
that cannabis may be a causative factor in this; and if we get him
to that point, I usually suggest to him that he discontinue the mari-
huana for a couple of weeks on a trial basis. Quite often they come
back in and say, "You know, I'm thinking a lot more clearly, I
didn't realize I was in that fog before. I'm picking up old interests,
getting in touch with old friends I haven't seen for quite some time."
And that process of improvement can continue to occur if the cannabis
user avoids it.
Mr. Martin. There are certain symptoms you believe may be
caused by certain drugs but are not sure they may be caused by this
drug. You remove this drug, the symptoms disappear. This would
be satisfactory proof in the eyes of most doctors, would it not ?
Dr. Schwarz. Oh, I don't think there is any doubt that there are
clinical findings, that is, adequate justification, for advising people
not to smoke cannabis.
Mr. Martin. You, from your own experience, Dr. Schwarz, feel
that the amotivational syndrome referred to by psychiatrists that
testified previously is a clinical fact, a demonstrable clinical fact; or
is it just a hypothesis which has yet to be demonstrated ?
Dr. Schwarz. No, I think it is a clinically acceptable diagnosis;
not necessarily a personality disorder because the causation of it is
still unknown, but it is fairly clear that a number of regular users
of cannabis are showing a deterioration of functions. Some people
205
interpret it as a change of personality, while I personally tend to
term it more the persistence of a long-acting substance in the body.
But, there is no doubt there is a significant change in regular users
of cannabis.
Mr. Martin. And this is a very frequent syndrome of drug users?
Dr. Schwarz. I think I could elicit symptomatology in any
chronic user.
Mr. Martin. In your statement you made the point you would
rather not express your opinion concerning legalizing marihuana
because you feel such a pronouncement might detract from what
you had to tell your patients as a physician and psychiatrist.
I respect your position on that point, Dr. Schwarz, but I would
like to pose an alternative question on the psychological plane. If
the Government tells the young people on the one hand that mari-
huana is a very damaging drug; and yet on the other hand removes
all penalties, even a simple civil fine for the possession and use of
marihuana, might that not tend to confuse the young people that you
are trying to reach ?
Dr/ Schwarz. Yes, I think it's obviously a double message. You
are saying on the one hand, we don't want you to use this, but on
the other hand, you can have it in your possession. I think that has
certainly caused some confusion among people in Canada because
this sort of neutralizing statement did come out, for example, in the
Le Dain Commission, which presented a massive volume of material
on cannabis which was totally ignored, or largely ignored, by the
media because the Le Dain Commission came out with legal, or philo-
sophical, comments which affected the headlines.
So, I think it's certainly confusing to people to be told we don't
want you to use it but it's ok to have it in your possession.
Mr. Martin. Or it's not so bad that we have to impose a penalty.
Dr. Schwarz. Right.
Mr. Martin. You referred to a resolution of the 1972 general
meeting of the Canadian Medical Association, recommending doctors
to advise their patients of the dangers of marihuana.
Dr. Schwarz. Yes.
Mr. Martin. This was passed by a substantial margin?
Dr. Schwarz. There were 220 delegates at the annual meeting of
the Canadian Medical Association from all over Canada, represent-
ing all physicians in Canada ; out of the 220, only two people voted
against the resolution advising the Canadian public against the use
of cannabis.
Mr. Martin. That's a pretty good accomplishment. You must have
done a pretty good job of preparatory educational work.
Dr. Schwarz. Well, we had not only educational but study work.
We had a committee in British Columbia for 4 years looking at
cannabis, a committee of seven physicians, all of them with a good
deal of experience in the drug field. We were able to present a report
to the British Columbia Medical Association that was approved
unanimously, and at the annual meeting of the Canadian Medical
Association it was passed by an overwhelming vote.
I think not only was the material we prepared, the background,
33-371 O - 74 - 15
206
important in this, but I think it became obvious as the discussion
went on in the meeting that many physicians had seen this kind of
thing clinically in their offices anyway, and that they had seen some-
thing like this happening. We just happened to be able to put it all
together at that time in clinical diagnostic terms much better than
had been done before.
Mr. Martin. Talking about education, Dr. Schwarz, do you believe
the young people that use marihuana have a completely closed mind?
Dr. Schwarz. No, I don't. One of the reasons why we have to get
this kind of information across to the public through the media, it
is only when you sit down with the regular cannabis user and start
questioning him that he becomes aware of, say, the sleep pattern,
his general health ; and a fairly significant number respond by agree-
ing, yes, maybe there is a cause-and-effect relationship here; maybe
I should cut down on cannabis use, or give it up completely for a
while and see if things clear. Once you get to that point, again, you
are much nearer abstention from the drug.
Mr. Martin. Mr. Chairman, that ends my questions. I would like
to ask, if the chairman approves, that the exhibits and papers which
Dr. Schwarz has offered for the record be incorporated in the
appendix.
Senator Thurmond. Without objection, that will be done.
Mr. Martin. I have one more suggestion I would like to make for
the approval of the chairman. Dr. Axelrod's testimony should have
been given last Thursday when we had our panel of medical scien-
tists. Unfortunately Dr. Axelrod was not present on that day. 1
would like to propose that his testimony be printed together with
that of the medical scientists who testified last Thursday.
Senator Thurmond. Without objection, that will be done.
I wish to thank you, Dr. Schwarz, for your appearance here and
your testimony.
Our next witness will be Prof. Hardin B. Jones. Professor Jones,
will you please identify yourself for the record and tell us some of
your qualifications.
TESTIMONY OF HARDIN B. JONES, PH. D., PROFESSOR OF MEDICAL
PHYSICS, PROFESSOR OF PHYSIOLOGY, ASSISTANT DIRECTOR,
DONNER LABORATORY, UNIVERSITY OF CALIFORNIA, BERKELEY
Professor Jones. Mr. Chairman, I am Hardin B. Jones. I am
professor of physiology, professor of medical physics, and assistant
director of the Donner Laboratory of Medical Physics at the Uni-
versity of California, Berkeley. I have been on the staff of the Uni-
versity of California, Berkeley, since 1938. I received my Ph. D. in
physiology in 1944 and in the same year was appointed to the
faculty. I have published approximately 100 significant papers on
such topics as: origins of cancer, longevity, aging, cardiovascular
disease, effects of radiation, effects of smoking and other environ-
mental hazards, physical fitness, nutrition, regional blood flow, in-
fectious disease, and treatment of cancer, and I have recentlv concen-
trated my professional attention on the matter of drug abuse. My
207
fields of scientific specialty include physiology, biochemistry, demog-
raphy, statistics, biophysics, and epidemiology, and I have used many
of these resources in my study of the effects of drugs and the origin
of the drug movement. I have recently written a book, "Coleridge,
on Coleridge and Opium," and, with my wife, another book, "Sen-
sual Drugs: Dehabilitation and Rehabilitation of the Mind." I
tender, as part of my testimony, some of my shorter articles and
reports on the effects" of cannabis.* One of these is a report to the
Army stemming from studies and educational demonstrations I con-
ducted through the arrangements of Maj. Gen. John K. Singlaub,
then Deputy Assistant Secretary of Defense, Drug and Alcohol
Abuse, a position now held by Maj. Gen. Frank B. Clay. I made
three extensive studies of the drug problem in Southeast Asia; the
last was with Mrs. Jones (we collaborate) and included studies of our
soldiers in Germany. General Abrams, then commanding our forces
in Southeast Asia, awarded me a citation for distinguished civilian
service in recognition of this work.
It is pertinent to my testimony that I have personally interviewed
more than 1,600 drug users, most of whom used cannabis, and that
I give a unique course, "Drug Use and Abuse." The course has a cur-
rent enrollment of 390 students. I have given it 10 times in 5 years,
and it provides a clear example of how information, equivalent to
that of these hearings, can stop drug abuse.
Senator Thurmond. Dr. Jones, I have a few more questions about
your qualifications before you testify here today. I believe it is not
an overstatement that you have somewhat of a national reputation
for careful scientific research.
Professor Jones. I believe that is true, sir.
Senator Thurmond. It was because of this reputation that you
were asked to serve as a consultant on the Atomic Energy Commis-
sion on the effects of radiation and protection against radiation; is
that true ?
Professor Jones. I did most of the basic work that led to the new
standard for radiation protection, and guidance to estimate radiation
exposure hazards based on proportionality rather than on a thresh-
old.
Senator Thurmond. And it was your research that established the
basis for the radiation safety standards currently in use.
Professor Jones. I believe that my research and the evidence sub-
mitted played a very large part in that.
Senator Thurmond. These standards are generally accepted by the
scientific community, are they not?
Professor Jones. Yes, they are.
Senator Thurmond. It Was also your reputation as a careful
scientist that led you to the appointment as consultant on the Army
Drug Abuse, did it not?
Professor Jones. Yes, it was.
Senator Thurmond. You may proceed now with your statement,
Dr. Jones.
*A list of the articles referred to mav be found at the end of Professor Jones testimony,
p. 250. The articles are retained in the files of the subcommittee.
208
Professor Jones. Senator Thurmond, I preface my prepared re-
marks to thank you and your colleagues of the Internal Security Sub-
committee for these hearings. They comprise the most extensive and
comprehensive scientific meetings yet held on cannabis abuse. A
number of us have made this observation. We also want to state
clearly that the subject is urgent and needs the most serious atten-
tion. The awful fact is that we are caught up in the most destructive
epidemic of cannabis abuse the world has yet known. But the magni-
tude of the disaster has not been recognized and corrective remedies
have not been applied. These hearings may be the first step toward
corrective action.
Mr. Martin. Before you go further, Professor Jones, I note from
your qualifications that you are also experienced as a medical stat-
istician— perhaps you can throw some light on a matter that has
been troubling some of us on the subcommittee. On the one hand
there are official surveys that tell us that the cannabis epidemic has
either leveled off, or perhaps tapered off ; on the other hand, there is a
massive annual increase in marihuana and hashish seizures, mari-
huana has gone upward in a 5-year period tenfold to 780,000 pounds;
in the case of hashish 25-fold over 5 years to 54,000 pounds — by Fed-
eral agents only. And cannabis arrests over the same period of time
have increased comparably. All of this suggests that there has in
fact been a continuing increase in cannabis abuse, rather than a
tapering off. How do you explain such a conflict?
Professor Jones. Well, it depends, Mr. Martin, on what informa-
tion one uses. In different parts of the country one gets different
examples of the extent of drug use, or drug abuse. In the beginning
of the epidemic the larger cities and college campuses particularly
were the beginning of the infection that led to the epidemic; and
these centers for the most part now have reached saturation as far
as the numbers or fractions that may be involved.
But, our rural areas, that is a different thing. In our rural areas
the epidemic is just now reaching public crisis proportions. And in
most rural areas in the United States, areas that we formerly
thought were immune, if there is such a thing, the problem is about
as bad as it is currently in Berkeley.
But I, myself, believe from all the surveys I have been able to
supervise and personally conduct on the university campus — and the
large number personally available to me from my own samples at
Berkeley amounts to approximately a thousand students a year, a
good size sample — that even today at Berkeley, although drug use
on the campus has remained at a fixed percentage, 55 percent of the
students in the last 2 years
Mr. Martin. 55 percent use what?
Professor Jones. Use cannabis, and some of them of course use
other drugs as well.
Mr. Martin. Just experimental, or on a regular basis?
Professor Jones. They use it on a regular basis so that even though
of the average freshmen coming to the university, only about one in
six or one in eight uses cannabis when they come in, each successive
year they stay the fraction that uses cannabis or other drugs in-
creases, so by the time they graduate, considerably better than 90
percent are experienced cannabis users.
209
So, even in the university atmosphere, where the sampling of
drugs should show a steady volume, there is still an increase in the
students' use of drugs as they pass through the university. This
cetainly portends, taking the United States as a whole, that the young-
est cohort of the youngsters that are approaching adult age is still
being inducted into the drug problem. So, the problem is not going
away. I doubt if it is truly even crested as yet, although I would like to
think that in the future we may see such evidence.
Mr. Martin. One further question, some of the people with whom
we discussed the matter tells us that the statistics for seizures or con-
victions of marihuana and hashish, and the statistics for arrests, year
by year, of cannabis offenders, are no reliable indications of the
amount of cannabis actually being consumed. Do you feel that these
statistics are in fact worthless as indicators of a trend; or do you
think that they have serious validity?
Professor Jones. Mr. Martin, I believe the numbers have very
significant validity. They are not the only answer, and I think it is
always important to go by as many sources of information and
points of view as are available. But, in 1968 I wrote a very serious
analysis of the trend in the drug problem, and I used arrests of drug
users and also seizures of drugs as the basic quantitative informa-
tion on which to make my projection.
My projection has been accurate within 10 percent in estimating
the drug traffic today; and in fact drug traffic today has increased
nearly a factor of 10 above the level of that time. So, I think the
seizures are very important data. We have always been able to use
seizures as some real indication of traffic. In fact, in a country as
big as this, with 200 million people involved and the many tons
of illicit drugs being seized per year, the statistical stability of these
numbers is very great indeed, and you can tell that from the re-
markable smoothness of the trend and the uniform rate of increase
over the past decade.
Mr. Martin. Thank you. Will you proceed with your statement,
Professor Jones. And, I want to point out for the information of the
two remaining witnesses, you and Mr. Keith Cowan, that we are
going to be short of time this afternoon because of the schedule of
rollcall votes that are scheduled for after 4 o'clock. So, I would ask
you to edit your text as you read it, judiciously, with a view to ab-
breviating your reading time as much as possible.
Professor Jones. Could the statement be inserted?
Senator Thurmond. Without objection the entire text will be in-
serted in the record, and you can comment on the main issues if you
wish.
Professor Jones. Very well, I will only read those portions that I
believe important for us to consider in detail at this time ; and I will
paraphrase and condense the rest, and try not to go over 20 minutes.
I was talking about the magnitude of the current disaster.
I do want to say that, typical of disasters, the reason they become
disasters is that the remedies are a part of the problem and make the
disaster worse than otherwise it would be. I feel that most of the
public effort that we have applied to the drug problem, in the at-
tempt to convince ourselves that a drug can be kept at a moderate
210
level, specifically in regard to the cannabis family of drugs, led us
to expend most of our energy debating questions as to whether drugs
in general, or cannabis in particular, might be legalized or de-
criminalized; all of this has not only dissipated our energies, but
also has kept us from directing our attention to the central problem.
As an expert in human radiation effects, I point out that the
chromosome damage found by Professor Stenchever, even in those
who use cannabis moderately, is roughly the same type and degree
of damage as in persons surviving atom bombing with a heavy level
of radiation exposure — approximately 150 roentgens. The implica-
tions are the same.
Dr. Heath has presented direct observations in humans that use
of cannabis results in persistent poisoning of the deep centers of the
brain necessary for the awareness of pleasure. This fits the observations
by many of us that marihuana users have severe sensory deprivation,
and that this symptom of marihuana intoxication is the slowest and
least likely to recover. Dr. Heath has, in a sense, shown by direct
measurement that cannabis poisons the very part of the brain that
allows full awareness of being alive.
There is perhaps no greater hell, even with pain, than not to be
able to feel alive. Those who are not able to feel alive will even
seek pain to get relief from their remorse. And that is the hell that
is projected for those who use cannabis.
I must say that, with regard to my 1,600 cannabis users, it is rare
to find someone that does not show symptoms of this very tragic
change. Hopefully those symptoms will be reversible.
Now, in presenting my argument, let me also ask, for the record,
that two highly integrated papers of mine will be carried in the
record along with this testimony because they have to do with a
view of cannabis that is not available elsewhere; and it's highly
integrated and coordinated with all the testimony that occurs. These
papers, however, are not recent, they were prepared over the last 2
years.
Mr. Martin. May I suggest that this material be accepted for the
files of the subcommittee, Mr. Chairman.
Senator Thurmond. Without objection, that will be done.
Professor Jones. Also, for the educative instruction of what we
have brought together here, I have three small letters to the public,
some of which have been widely distributed already, but they ought
to be a part of the record, too, because they will easily allow anyone
reading the text to realize the significance of the findings.
Mr. Martin. Do you have any other documents you wish to offer
at this time?
Professor Jones. No, I will proceed now to look at the exhibits.
Mr. Martin. May the letters be incorporated as appendices?
Senator Thurmond. Without objection, that will be done.
Professor Jones. The findings of Stenchever and Heath put the
effects of cannabis in a very serious category. Not only do we hope
that there will be appropriate action by Congress and the executive
branch of the Government but we also hope for an end to foolish
statements encouraging the use of marihuana.
In my presentation this afternoon, I plan to deal with the sources
211
of the current marihuana-hashish epidemic, because only when we
have identified the sources will we be able to attack and push back
the epidemic. A classic source is the influence of the literary-intel-
lectual tradition involving some much admired names in English and
French literature. But this by itself would not have been enough
to launch the epidemic. Nor did the epidemic arise spontaneously. I
believe that the rapidity with which the use of marihuana has spread
across our Nation in less than 10 years is the result of a massive
and sustained promarihuana propaganda campaign, involving a
small but influential number of academic propagandists, the media,
the entertainment industry, and the new left.
In my presentation, I plan to deal separately with each of these
sources of promarihuana propaganda.
Origins of the Drug Movement
involvement of literary intellectuals with drugs
Some writers of the late 18th and early 19th century began to
make use of mind-altering drugs when the large-scale importation of
opium to the Western countries by the East India Co., beginning
in 1776, made opium and morphine readily available. The effects of
these drugs fitted well with the mood of the Komantic Movement.
Under the influence of opiates, writers fantasized and were attact-
ively mystic and incomprehensible. They had much to do with the
dreamy* impracticality and the sympathy-generating anguish of the
Romantic Movement. One cause of the dreaminess was the non-
specific euphoria induced by opium. The anguish, depression, and
misery were derived from the special problems of the opium-eater:
addiction, tolerance, withdrawal illness, sensory deprivation, and
depression. Samuel Taylor Coleridge and Thomas de Quincey were
the first prominent writers in this movement; other prominent
intellectuals, over the intervening century, were Charles Baudelaire,
Edgar Allen Poe, and, in recent times, Aldous Huxley. Huxley
wrote an essay, "Heaven and Hell," revealing his drug-induced
manic depressive disease. He also wrote, in 1954, the essay that be-
came the touchstone of the current drug movement : "Doors of Per-
ception." Here he witnessed to the mental wonders of "mind ex-
pansion" through use of the hallucinogenic drug, peyote or
mescaline. Millions have read this romantic and misleading account
of mental "trips" on a drug. That hallucinations do, occur and are
fascinating is not incorrectly reported; what is in error is the as-
sertion that this is "mind expansion" or in any way an enhancement
of the powers of perception. The mind simply limps along with
portions of the brain not working. Novel? Yes, for normally we do
not deliberately generate sensory confusion and impairment of
perception. But the romantic notion of "mind expansion" took hold
and was combined with supposedly "scientific" studies in the same
vein by Dr. Timothy Leary — then assistant professor of psychology
at Harvard University. Leary used and studied the drug, psilocybin,
which is similar to mescaline but more powerful. The still more
powerful lysergic acid diethylamide, LSD, was rediscovered and
212
used by the drug romanticists in the mid-1960's. In the meantime,
through the efforts of Herbert Marcuse, "Eros and Civilization,"
Timothy Leary, Allen Ginsberg, and others, a political movement
based on the use of drugs was conceived and launched.
The political goals of some of the drug cult leaders can be per-
ceived in the almost incoherent ramblings of Leary in his 1968
book, "High Priest." On pages 111-128, he describes a group drug
session using the "sacred mushroom" drug, psilocybin, that took
place in December 1960.
There were the detached philosophers * * * who knew that the new drugs
were reintroducing the platonic-gnostic vision * * * here was Allen Ginsberg,
secretary-general of the world's poets, beatniks, anarchists, socialists, free sex
love cultists * * *. He was lying on the top of the blanket. His glasses were off
and his black eyes, pupils completely dilated — from psilocybin — looked up at
me * * *. A little later, in the study. In front of the desk looking like medieval
hermits were Allen and Peter both stark naked.
[Ginsberg's words, as cited by Leary, in capitals.]
I WENT IN AMONG THE PSYCHOLOGISTS IN STUDY AND SAW THEY
TOO WERE WAITING FOR SOMETHING VAST TO HAPPEN, ONLY IT
REQUIRED SOMEONE AND THE MOMENT TO MAKE IT HAPPEN— AC-
TION, REVOLUTION * * * Allen says he is the Messiah and he's calling
Kerouac to start a peace and love movement * * * I also hear Paul Goodman and
N. Podhoretz are forming some kind of committee for intelligent action which
has as program various things such as sex freedom and drug freedom.
♦ * * I SAW THE BEST MINDS OF MY GENERATION * * * Allen talked
nearsighted Marx-Trotsky-Paine poetry * * * WHO DISTRIBUTED SUPER-
COMMUNIST PAMPHLETS IN UNION SQUARE WEEPING AND UN-
DRESSING * * *. Allen Ginsberg the social-worker politician explaining the
sex-drug-freedom-ecstasy movement * * * And so Allen spun out the cosmic
campaign. He was to line up influentials and each weekend I would come down
to New York and we'd run mushroom — psilocybin — sessions.
In the early 1960's, I was occasionally aware, from student con-
tacts, that the Telegraph Avenue area of Berkeley was experiment-
ing with LSD and free sex — Leary style. But prior to 1965, this
must have been confined to a small and isolated segment of the
university community.
Chance opportunity to launch the drug movement came to
Berkeley in January 1965. The Free Speech Movement won an en-
dorsement from the Berkeley faculty of their contention that free
speech includes freedom to engage in illegal advocacies and acts.
This sad event occurred on December 8, 1964. When the campus
reopened in January 1965, the first such illegal act was open ad-
vocacy of drug use — in particular, marihuana and LSD. Pro-mari-
huana handouts flooded the campus for months, and speakers end-
lessly sought to promote these drugs in the "free speech area", using
university public address equipment, and in classrooms. A student,
Charles Artman — "Charlie Brown" — who was much involved in use
of LSD and marihuana, became the initiator of the Filthy Speech
Movement. When I first met and interviewed him, he was a clean
and bright-appearing young man. In a relatively short time, he
changed to an aged, sagging, and dull-witted person. As for the few
prominent in the Free Speech Movement who have remained active
and vigorous, it appears that they were not drug users. On the other
hand, there were multiple tragedies among those who used drugs,
though no one can prove a causative link to cannabis and LSD.
213
During this time, we had a son and a daughter on campus. Among
their circle of friends, even though our children did not use drugs
and the majority of their friends did not, there were nevertheless
some who were seriously affected by drug abuse :
1. An A student in engineering became heavily involved with
marihuana and LSD and failed in his courses. He partially recovered
and changed his major to sociology, but then dropped out into the
Haight-Ashbury drug culture and is reported to have died. When
last seen, he was unrecognizable physically and with no trace of his
former high intelligence.
2. A strong B+ student with aptitude in literature became a
"speed-freak" — heavy user of amphetamines. She was also involved
with marihuana and other drugs. She has partially recovered —
enough to work and support an inactive, pot-using "husband" — but
she lost her way.
3. An A student did surprisingly well in spite of his use of can-
nabis, a few LSD trips, and heroin addiction. But he was able to
sustain himself for only a year. Drug use then became his entire
life pattern. He left Berkeley, so I do not know what has happened
to him since.
4. An A student, son of a professor, became a multiple drug user
and a dealer in drugs. He was "busted" early in his drug-peddling
career and gained rehabilitation, but only after considerable effort.
He is reportedly doing well and free of drug use.
5. An athlete who sometimes dated our daughter had an athletic
scholarship, was a strong student academically, and was recognized
as an outstanding person. His subsequent involvement with cannabis
and LSD produced a permanent personality change. He became
homosexual and a dangerous manic depressive. Shortly afterward,
iij an LSD flashback, he killed a relative. He is now institutionalized.
6. A young man, the son of schoolteachers, very able mentally and
with exceptionally fine home training, began using drugs on campus.
One day he went home while "high" on amphetamines, beat his
father to unconsciousness, and killed his mother by mashing her
head with a flowerpot. He never offered any explanation for his
"madness."
7. A young man who was both an outstanding athlete and a strong
student was accepted into medical school. He was a moderate canna-
bis user. During his sophomore year in medical school, he died of an
overdose of barbiturate self -injected intravenously.
8. An additional six individuals have undergone personality
changes due to cannabis and LSD, to a degree requiring psychiatric
care. It can be said that, while these six have "recovered", they have
certainly blunted their potential and cannot make up for the loss of
time in the most formative period of their education and develop-
ment.
I cite the above cases because they all occurred within the limited
circle of friends and acquaintances of my son and daughter. The
number of cases is high, in view of the small fraction of that circle
that was involved with drugs. No equivalent tragedies occurred
among the acquaintances of another daughter, who was at Berkeley
in 1960-64, or of our son who is there now, 1970-74, but not in touch
214
with the drug-using segments of the campus. From questioning
parents on this subject, as I often do, I conclude that it is rare today
to find adults without some close relative — often their own children —
affected by drug abuse; dropping out, indolence, lowering of goals,
alienation, and mental dullness are common. Although death from
overdose of drugs — heroin, methadone, and barbiturates — has be-
come the leading cause of death of young adults, and although drug
use is common, the vast majority of those severely affected remain
out of sight, supported by relatives, friends, or state welfare agencies.
Superficially, there are few signs that we are suffering such a cata-
strophic loss. All samplings I have made in ghetto, middle-class, and
upper-class communities show extensive harm from cannabis, heroin,
amphetamines, LSD, and now cocaine. Yet the magnitude of the
problem remains hidden. Families affected bear their anguish in
silence, and the agencies that evaluate vital statistics have collected
little information on this problem other than numbers of deaths
from overdose.
Drug abuse patterns of each type of drug and the techniques of
taking the drug spread from person to person. Each user draws in
others. This is the explanation of the fact that numbers of drug users
increase multiplicatively with time. Prior to 1965, signs of drug use
had been increasing at the rate of approximately 6 percent per year.
But after drug use was openly advocated, as at Berkeley from Jan-
uary 1965 on, drug use of each type increased at 7 percent per month,
resulting in an annual increase 20 times as great as before 1965.
Young people became more easily convinced that the invitations of-
fered by drug-using friends were worth accepting. Whereas prior to
1965 it took a decade, on the average, for each user to convert a
friend, after 1965 it took only 9 months. The greater susceptibility is,
in my opinion, the result of widespread advocacy of drug use by
persons in influential positions. Professors — not all, but a few — were
involved. Magazines did their part, too, by romanticizing the use of
hallucinatory drugs. Life ran feature stories in 1965 of the expedi-
tions to Central America to try the "sacred mushroom", psilocybin.
For the first time, the drug abuse disease of a few intellectuals broke
into the educational system, literally without opposition and with
"distinguished" support for the "mind expansion" hypothesis.
WHAT ARE THE MOTIVES OF THOSE WHO ADVOCATE DRUGS ?
I have had discussions with many drug-user advocates. Relying
principally on personal experience, they believe that cannabis and
whatever else they use is harmless because they perceive no diffi-
culties. That is one of the subtle dangers of most of these drugs:
That the user is rendered incapable of detecting the changes in him-
self.
Some advocates equate drug use with civil rights and with the anti-
war movement. After my first lectures about marihuana in 1969, in
which I pointed out the adverse effects, a delegation of students
called at my office to complain that my lectures were "against their
constitutional rights."
From a few of the more sophisticated students involved in the
215
effort to legalize drugs, I have learned that they expect to start a
political movement of the magnitude of the antiprohibition move-
ment of the depression period. An important book in this vein is by
John Kaplan, a Stanford law professor : "Marihuana — the New Pro-
hibition."
At Berkeley, where these events began, the Free Speech Move-
ment came first, followed by the drug movement, followed by the
Filthy Speech — free sex — Movement, and later by the antiwar move-
ment. There has been a commingling of the same persons in these
movements. I have already noted the involvement of the FSM lead-
ers with drugs.
THE DRUG PROPAGANDISTS
Dr. Timothy Leary : I knew him in the 1950's and, in my opinion —
reinforced by others who knew him in Berkeley — he has signs of
mental deterioration, coincident with his drug use. Typical of the
persistent delusions of heavy drug users are his lapses into belief in
his personal divinity — note the title of one of his books : "The High
Priest." He talked on the Berkeley campus frequently, advocating
that students "blow their minds" on drugs. Another Leary phrase
was : "Tune in, turn on, and drop out." By chance, I was one of the
last to challenge him in public discussion before he was arrested. We
debated in San Francisco on Friday, November 7, 1969. Leary asked
the audience of some 500 high school journalism students to use
drugs to protest the war in Vietnam. "Blow your minds." I replied
that many young people had already taken Dr. Leary's advice, and
this had led, through LSD use, to the death, or mental or physical
maiming, of more people than had been killed or maimed in the
war in Vietnam in the same time period. Leary exclaimed, with a
waving of his arms : "I've been shot." Then, after a pause, he said :
"You are wrong; I know of only 250 who died from taking LSD."
I replied: "These were the ones you knew about personally, Dr.
Leary." He remained after that in a trancelike state, making no
further comment. Interestingly, the newspaper report of the incident
cited the "verbal scuffle," but did not give the significant details.
Leary's viewpoint is well summed up by his statement, cited by the
press on February 7, 1969 : "Psychedelic drugs are the most revolu-
tionary agents discovered by man. The Establishment should be
having nightmares about them."
Now, the Leary matter is relatively extensive, even in this conden-
sation of my files on Leary ; I offer this in its entirety to the committee,
but I have also marked certain exhibits that you may find par-
ticularly handy. There is no doubt that, in Leary's own words, he
and Allen Ginsberg and others were trying to get a drug-sex-ecstasy
movement started.
Mr. Martin. Mr. Chairman, may these exhibits be accepted with
the understanding that the subcommittee will exercise its judgment
in deciding which if any of the items should be included in the
appendix ?
Senator Thurmond. Without objection, that will be done.
Professor Jones. Andrew T. Weil: Then a student at Harvard
Medical School, he published [Science 162: 1234, December 1968],
216
with Norman Zinberg and Judith Nelsen, a study entitled : "Clinical
and Psychological Effects of Marihuana in Man." The authors postu-
lated that there may be a "reverse tolerance" with marihuana use
since "people do not become high on their first exposure to mari-
huana even if they smoke it correctly * * * as use becomes more
frequent, the amount of drug required to produce intoxication de-
creases— a unique example of 'reverse tolerance.' " Although the
authors acknowledged the possibility of other explanations for the
effect, the colorful phrase, "reverse tolerance," was seized upon by
Time in its report on this study.
I replied at once to that extravagant claim :
Time speculates about a "reverse tolerance" to marihuana (Dec. 20). No
claims for reverse tolerance have been made by responsible persons, even
though the lack of response to marihuana in initial trials is well known. I
prefer the statement of a pot user, published by the columnist, Helen Bottel,
in April : "Marihuana, contrary to narcotic drugs, has a cumulative effect,
and each time it is smoked it will take less and less to feel high, but it may
take as many as four or five tries before you get off the ground."
My search into the matter has convinced me that the explanation is not
that kids are too scared to let the drug take effect at first or that the pot
reaction is the result of suggestion and conditioning or a reverse tolerance.
There is no precedent for a reverse tolerance. There is much precedent for
accumulation of chemical burdens, and it seems to me that this is the most
likely explanation — a lasting and accumulative effect of marihuana on the
brain.
I have here as an exhibit my immediate reply to this, which was
also published in Time Magazine 2 weeks later, in which I showed
what has been borne out today, that this evidence shows that mari-
huana has a cumulative effect, not a reverse tolerance.
Mr. Martin. Is ask that this be received for the files of the subcom-
mittee, Mr. Chairman.
Senator Thurmond. Without objection, this will be done.
Professor Jones. Nonetheless, the world of literary intellectuals
has clung to the term "reverse tolerance", and one can use the pres-
ence of this phrase at the present time as a device to tell the difference
between papers that are scientifically and professionally sound, and
papers and articles on the cannabis problem that are propaganda
and fiction; they divide very equally on this point. And none of the
propaganda for marihuana that I have ever known since the formu-
lation of this term has left out the term "reverse tolerance", which
is unfortunately also included in the Shafer Report, which I con-
sider more a political and sociological document, and mistaken
ideology
Mr. Martin. Let me interrupt you at this point, Dr. Jones.
Professor Jones. Yes.
Mr. Martin. You used the word "propaganda"; are you using
propaganda in a derogatory sense ? After all, if you believe in some-
thing that you believe is good, is there something wrong in making
propaganda for it, making the facts known to other people, per-
suading them?
Professor Jones. That is a point that well can stand clarification.
All of us who are here are propagandists because that is the primary
explanation given in the dictionary. I have many causes and be-
liefs that I adhere to and I express myself clearly on them.
217
However, I am using propaganda in the sense of persons' using an
incomplete rendition of the information available and known to
them, and probably being intentionally deceptive in their presentation ;
the dictionary also covers that possibility.
Mr. Martin. What you are saying in effect, you don't object to
propaganda, you object to propaganda in a bad cause.
Professor Jones. Well, I object to propaganda
Mr. Martin. You object to it in a bad cause.
Professor Jones. I object to a bad cause, certainly.
Mr. Martin. And dishonest methods.
Professor Jones. I also object, as a scientist, to dishonest methods.
T object as a scientist in a field that has been defined as a problem,
and when we are going about deciding the nature of the problem,
and its possible resolution, I would fault myself if I didn't give all
the possible points of view that need consideration. I would con-
sider as scientific propagandists, rather than scientists, those who
simply give a single point of view and eliminate the alternate possi-
bilities that are strictly within the realm of reason.
And I believe that has been done repeatedly with the term "re-
verse tolerance", and I think its inclusion in the Shafer Commission
report along with a lot of other material that was incorporated in
a highly uncritical and unfounded fashion places the report, at
least partly, in that category. There are other aspects of the report
that are not in discussion.
I come now to the case of Dr. Lester Grinspoon of Harvard Uni-
versity. Dr. Grinspoon cleverly omits references to any evidence that
marihuana may have more than a transitory effect lasting a few
hours. He spoofs selected examples of dramatic adverse effect so as
to equate them with error, in order to eliminate adverse evidence.
His book, "Marihuana Keconsidered," Harvard University Press,
1971, has been heralded in the New York Times Book Review as
"The Best Dope on Pot So Far." The Washington Post, May 30,
1971, in its review by Edward Edelson of Grinspoon's book, had this
to say:
"[Grinspoon] is convinced that future experiments will confirm the belief that
marihuana is an extraordinarily harmless drug. Here he may be optimistic * * *
use of marihuana is increasing. Time and numbers are on the side of legaliza-
tion. Dr. Grinspoon's book is part of this movement." The book followed his
article, "Marihuana," in Scientific American, December 1969. The content of
the article led the editor to summarize : "There is considerable evidence that the
drug is a comparatively mild intoxicant. Its current notoriety raises interesting
questions about the motivation of those who use it and those who seek to
punish them." Both works show the same bias. I notice in reviewing my files that
I marked his Scientific American publication : "This article is nothing more
than promarihuana propaganda." That was in 1969. The intervening years
have shown that judgment to be correct. Any competent scientist reviewing
the medical literature on effects of cannabis would have raised a number of
serious questions pointing strongly against the conclusion that this is an in-
nocuous weed. To paraphrase the Scientific American Summary : "The current
notoriety of adverse findings about the use of marihuana, being consistent with
the older medical literature, raises interesting questions about the motivation
of professors at distinguished universities (Harvard, Stanford, and Berkeley)
who claim safety in its use. Do they use it?"
But the propaganda is not entirely the work of these mistaken
persons. I accepted an invitation for a television debate with Lester
218
Grinspoon to be held in Dallas in May 1971. We were to argue the
issues for 3 hours; then the station would edit the tapes so as to
produce a punchy hour-long program to be used nationally. I was
familiar with Grinspoon's arguments, and I was certain that I
bested him on each of them. Fortunately, I took the trouble to re-
turn to Dallas about a week later for the first televised showing of
the edited tape in Texas. There I appeared, apparently agreeing with
every outrageous point Grinspoon made! I quickly reached the local
station manager and voiced my complaint. The manager reviewed
the original tape and gave me an equal hour of prime time the fol-
lowing evening. The edited tape was never again used-— at least to
my knowledge. Obviously, the editor had liked what Grinspoon said.
Now I come to the case of Dr. Norman E. Zinberg : He is an assist-
ant clinical professor of psychiatry at Harvard University. On my
arrival in Boston on April 15, 1970, I read a front-page story in the
Globe : "Study Shows Pot Non-Progressive." It reported on a press
conference called by Dr. Zinberg to publicize a study by him and
Andrew Weil just published in the British scientific journal, "Na-
ture," under the title : "A Comparison of Marihuana Users and Non-
Users." It was reported that they had completed a 2-year follow-up
of 61 marihuana users, ranging from chronic to brand-new users, and
had found absolutely no progression to harder drugs during that
interval.
The facts revealed in his paper, however, are as follows: He had
interviewed 62 prospective subjects regarding their personal histories
and attitudes and accepted 61 of them. The 24 in the category of
marihuana-naive were selected as "inhalers" of tobacco cigarettes.
The remaining 37 were marihuana users : 9 "chronic" daily users, 28
less than daily use. The study was an experiment with respect to
those who had never used marihuana before; but all of the "com-
parison" on which the report focuses was a retrospective study based
on interviews with the subjects, rather than a followup. The naive
subjects used marihuana only under Dr. Zinberg's supervision and
had not previously tried marihuana or any of the harder drugs,
except that two had used amphetamines occasionally to prevent
sleepiness. The text states:
Of the NN subjects [non-naive marihuana users], one had tried marihuana
once, seven had taken it "a few times" ; the rest used it regularly — weekly or
even daily. Fifteen . . . had tried hashish, and four had used LSD (2 once, 1
twice, and one 6 times). All the C group [chronic users] had tried hashish;
four of them had taken LSD. One subject had taken LSD twice, mescaline twice,
and methedrine, cocaine, and heroin once each. Another had taken LSD three
times and heroin once. Both of these had been overseas in unusual circum-
stances when they had tried heroin several years before the interview, and
neither had tried it again. All regular users [of marihuana] . . . said they had
ready access to a variety of psychoactive drugs.
In a letter to the Globe, I pointed out that Zinberg's data con-
firmed my own findings that use of marihuana led young people to
try harder drugs. I also commented on the fact that this was not a
2-year follow-up. Zinberg's letter of reply glosses over these im-
portant points and insists:
One of the conclusions of this in-depth study of 63 subjects was that there
was remarkably little use of drugs other than marihuana by the participants
despite heavy marihuana use by many of them.
219
The key point, however, is that 24 of the 29 regular users of mari-
huana had tried hashish, eight of the 29 had tried LSD, two had
tried heroin, and one had tried several other drugs, whereas none of
the 24 nonusers had tried any of these drugs. Only marihuana users
learn to experiment with harder drugs, and some of them become
addicted to them.
I have the letter here, in the Boston Globe. There was no doubt in
my mind, and there can be no doubt, the evidence is here, I submit
it for the record as well as my text of what this report, this man's
study shows.
Mr. Martin. May they be accepted as exhibits and printed in the
appendix, Mr. Chairman?
Senator Thurmond. Without objection, that will be done.
Professor Jones. There are various deficiencies in the Zinberg
study, such as the fact that the method of selecting subjects pre-
cluded the possibility of having addicts in the study population ; but
it would be inappropriate to expand the analysis here. The myth of
nonprogression from marihuana to more powerful drugs, as generated
in this article and the accompanying press conference, has stayed in
the promarihuana literature. Like "reverse tolerance", citation of
this study in defense of marihuana is an indicator of pseudoscientific
treatment of the topic of drug abuse.
In spite of my public disclosure of the falsity of Professor Zin-
berg's conclusion, he appeared a few weeks later as a guest on a
nationwide TV program and gave the same presentation, claiming
proof that marihuana users do not progress to other drugs. I com-
plained to the network by telephone and letter, but there was no
correction of this propaganda.
Then there is John Kaplan. His book, "Marihuana—The New
Prohibition," is a persuasive argument that those wishing to use
cannabis should be allowed to use it as they wish, as is the case with
alcohol. It is a libertarian and legal argument without scientific
competence. The author selects evidence on only one side of the issue,
citing a variety of writings that marihuana is a mild drug, essen-
tially harmless. Although the legal argument is well put, it cannot
overcome the real evidence that cannabis users are mentally dulled
persistently and without capacity for knowing the difference. A
legal scholar such as a Stanford University professor of law should
have made a more thorough search for competent sources. He is
shown to be a propagandist by the bias of his book.
In a special class is Edward M. Brecher, principal author of
"Licit and Illicit Drugs," the Consumers Union report on narcotics,
stimulants, depressants, inhalants, hallucinogens, and marihuana —
including caffeine, nicotine, and alcohol.
Brecher has assembled much interesting material, and it is a com-
pendium worth having, but only if one sets aside most of his argu-
ments and conclusions. They simply reflect the marihuana-is-harm-
less view. In substantiating this point, Brecher has simply used the
promarihuana ' literature and omitted reference to authorities show-
ing adverse effects. The hasty publication of the Consumers Union
report without inclusion of major scientific works on the subject
and without critical review by competent authorities has yet to be
220
explained by the Consumers Union. Its publication has helped in
the movement to legalize marihuana.
Dr. Joel Fort of San Francisco has been another tireless worker
for the legalization of marihuana. He states that he is against drugs
and that marihuana should not be used. Yet, other acts and argu-
ments presented by him have the opposite impact. I have opposed
him in debate many times. Occasionally, depending on the kind of
audience, he has stated that marihuana is harmless. Mostly, he draws
a picture of a world so bad that use of marihuana is a welcome re-
lief, as the lesser of two evils. In his teaching on the Berkeley
campus — lecturer, School of Criminology — students report that he
asserts that marihuana is less harmful than alcohol and cigarettes.
Followers of Dr. Fort, on more than one occasion, have tried to dis-
rupt my class on drugs, as illustrated in the attached articles from
the Daily Californian, the daily paper of the Berkeley campus, and
from the Berkeley Daily Gazette.
Persons associated with the campaign to legalize marihuana have
continued to harass my teaching activities. On the opening day of
this quarter — April 1, 1974 — in my course on drug use and abuse,
offensive leaflets attacking me as a person were distributed to the
class of approximately 400 students. The source of the leaflet is not
identified but it was rumored to be from the California Marihuana
initiative group. Apparently this was part of a plan in which my
class had been chosen as a target in order to gain public attention
in the campaign for an initiative to legalize marihuana ; but the ini-
tiative had just then failed to get enough petition signatures to be
on the June ballot. The supporters nevertheless "gave me the treat-
ment."
Samuel Irwin is a professor of psychopharmacology at the Uni-
versity of Oregon Medical School. An example of his marked bias
toward the belief that the use of marihuana is safe is contained in a
pamphlet : "Drugs of Abuse : An Introduction to Their Actions and
Potential Hazards". The bulk of this pamphlet is a flawless discus-
sion of effects and hazards of drugs. Irwin fails, however, to give
any significant warning about the considerable hazard from use of
USD-25 or cannabis. The remarks in the section, "A Look to the
Future", are especially disturbing:
Drugs have positive short-term uses for recreation, for an unique experience,
to enhance performance, to produce a change to some desired state, for con-
trolling feelings of anger or distress (to promote well-being), or as important
tools in learning some of what it is humanly possible to achieve in awareness,
relationships and spiritual growth (more-being, as with LSD and marihuana).
But the real challenge of personal development is to learn to go it alone with-
out drugs to achieve a higher, lasting level of spiritual growth, self-actualization
and control; it is possible in no other way. This is certainly an encouragement
to experiment with drugs, in spite of the exhortation to "learn to go it alone
without drugs".
PROPAGANDA FOR MARIHUANA FROM THE "RIGHT"
On many occasions of debate with those advocating the legaliza-
tion of marihuana, I have listened to such statements as "even the
conservative experts appointed by President Nixon on the Mari-
huana [Shafer] Commission agree that it is a mild drug and should
221
be legalized." Fortunately, the foolish portions of the Shafer Com-
mission's report were too ambiguous to be convincing.
The turnabout of William F. Buckley, Jr. in reporting (Decem-
ber 1$72) that he had used marihuana, found it harmless, and ad-
vises decriminalization, is a different matter. His unambiguous state-
ment, his stature as a leader, and the reversal of his former position
had a widespread impact, I contacted Mr. Buckley by telephone and
letter and was led to believe that he had invited me to reply in a
statement to his paper, the National Review. My essay was sent at
once (December 14, 1972) but was never published, nor did Mr.
Buckley provide an explanation for withdrawal of his invitation.
OTHER PROPAGANDISTS
The above listing of propagandists is by no means complete, even
with regard to the major figures. There are prestigious persons other
than Bill Buckley who have given occasional aid to the marihuana
movement; the list includes Dr. Margaret Mead and Dr. Roger O.
Egeberg. They have been silent recently ; perhaps the growing body
of evidence against the safe use of cannabis has caused them to sense
their error. If that is so, I urge them to speak up and redirect those
who were misled by their earlier statements. I cannot attempt to
provide a list of such persons; it would be very long. But the situa-
tion is clear; many have spoken in defense of marihuana without
valid justification.
PROPAGANDA FOR MARIHUANA IN THE EDUCATIONAL SYSTEM
All about me in the educational world I observe examples of bias
in favor of drugs. My many public letters on the subject of effects
of marihuana have drawn answers from a few members of university
faculties who hold that the use of marihuana is beneficial. Since these
persons claim that they teach about drugs, I presume that they advo-
cate the use of marihuana. In one instance I can be certain that this
was the case. The facts cited pertain to a large course, Sociology 1,
given in the Winter Quarter, 1973, at Berkeley. I have the statement
of a student who gave me the study assignment sheet and the text
of the assignment. The text is Targets for Change: Perspectives on
an Active Sociology, edited by Bateman and Petersen, Xerox Col-
lege Publishing, Lexington, Mass./Toronto, 1971. All of the chapters
in this book reflect the New-Left varieties of social change, but the
example of assigned reading is Chapter 5. Becoming a Marihuana
User, by Howard S. Becker. Of all the promarihuana articles I have
read, this is the most likely to induce the naive person to try the ex-
perience and to convince the occasional user that he has set himself on
a path toward ever-unfolding pleasure. The chapter contained no
information of any other point of view.
The point I wish to make is that all the students in the class were
required to read the most persuasive argument that I have ever
known for the use of marihuana. I think that reading it would be the
biggest bait that a person who had not yet used marihuana might
have, as his required reading. And anybody who is already a mari-
222
huana user would read it and be certain that he has been lucky
enough to start out on the new road to the future.
This kind of instruction does not occur in all college classes in
sociology, but it is a very common thing, taking the larger univer-
sities in the United States, and many other college campuses.
Mr. Martin. May these documents be accepted, Mr. Chairman,
for the record, with the understanding that the subcommittee will
exercise its discretion in deciding which of these documents if any
to incorporate in the appendix as exhibits?
Senator Thurmond. Without objection, that will be done.
Professor Jones. Also, at Berkeley, several other courses consider
drug use. Dr. Joel Fort gives such a course, and the others are also
in the hands of persons who believe in the moderate use of drugs to
enrich life or for recreation. Perhaps most students are not fooled,
however, since my class on drug abuse draws many more students.
The more subtle propaganda for drugs is that which appears as an
element of courses in psychology or sociology or anthropology in
which the advocacy of the marihuana experience is a secondary part
of instruction. Such examples appear to be common.
MISINFORMATION STEMMING FROM OFFICIAL GOVERNMENT REPORTS
The Federal Government, through its official commissions and
agencies, has been one of the worst offenders in spreading the im-
pression that cannabis is a relatively harmless drug.
I would like to offer for the record a copy of my own prepared
testimony before the Shafer Commission. I appeared before the
Shafer Commission, and I have no evidence whatsoever that any of
the significant and important things I was able to tell them had any
impact, or got to any use by the committee. Also, when I appeared
before the Shafer Commission, I was humiliated and attacked in a
most unbelievable way, not only by one of the promarihuana com-
missioners, but also treated rudely and badly by Governor Shafer
himself.
Mr. Martin. Would you be prepared to name the promarihuana
commissioner?
Professor Jones. Professor Ungerleider, a colleague from the Uni-
versity of California at Los Angeles.
Mr. Martin. You are positive in your own mind that he is actually
promarihuana ?
Professor Jones. I have no doubt from the things that he has
written, and I have a letter from him and an exchange back from me
on this very subject in the folder.
Mr. Martin. Would you continue?
Professor Jones. Reports of the Department of Health, Educa-
tion, and Welfare, are inadequate scientifically, do not treat ac-
curately the principal matters needing clarification and, in many
instances, are likely to lead the public to believe that science has
proven marihuana harmless. Upon the release of the HEW report
on marihuana, 1973, the Detroit Free Press carried this story :
Study Finds Marihuana Not Harmful * * * The definitive answer probably
is years away, but the Federal Government, particularly the Department of
Health, Education, and Welfare, is commissioning many projects to find out —
223
(Remember, it was HEW's surgeon general that issued the now famous ciga-
rette warning that appears on every pack.) But one of the first HEW studies
to be completed comes to an astonishing conclusion : Chronic use of marihuana
has no apparent harmful effects.
The above listing of propaganda, propagandists and invalid re-
ports does not by any means cover all the sources of these harmful
activities. As of May 1974, several State legislatures are considering
bills that, if passed, will for all practical purposes, legalize mari-
huana. In Washington, D.C., the Mayor's Advisory Committee on
Narcotics Addiction recommended the "legal growth, manufacture,
and supply of marihuana." The first point of the chairman, Mr.
Frank H. Rich, was, "No demonstrable evidence is available to sup-
port the assertion that marihuana use is hazardous or detrimental to
the physical or mental health of the user." He acknowledged credit
to the Shafer Report and to Professor Kaplan's book, "Marihuana —
the New Prohibition". The sources of propaganda are cited as ref-
erences again and again, as though they were valid, and when the
work depends on these sources, it makes no use of the available sci-
entific information.
THE MEDIA AND PROMARIHUANA PROPAGANDA
For a decade now, newspapers, journals, radio, and television have
repeatedly featured promarihuana spokesmen like Timothy Leary,
Joel Fort, Lester Grinspoon, and Norman Zinberg. If the principle
of equal time were invoked, the networks would by now owe some
hundreds of hours, at least, to scientists whose work on marihuana
had led them to the opposite conclusion. In placing their facilities at
the disposal of this onesided propaganda campaign, the news media
may have succeeded in brainwashing themselves, in addition to the
brainwashing of a substantial portion of the American public. At
least, one cannot escape the impression that many people in the media
now seem to have convinced themselves that marihuana is perfectly
safe and that the public interest demands its legalization.
The Shafer Commission Report, paraphrased, said: "Marihuana
is harmful; however, let us decriminalize it." The propagandists in
the media are, perhaps, somewhat more consistent. Though they
quote the Sha»fer Report and the Consumers Union Report, they
are likely to put the argument in these terms: "Marihuana is safe;
let us legalize it." In the form of arguments most commonly propa-
gated by the media, the call for legalization is almost invariably
preceded by some kind of assurance that marihuana is safe, or at
least relatively harmless : you use it and live without any apparent
difference.
The form of presentation that started in the underground media
moved upward into the "respectable" journals. I choose these ex-
amples as flagrant propaganda :
Esquire, July 1968, published an article by Timothy Leary, "In
the Beginning, Leary Turned on Ginsberg and Saw that it was Good
. . . And then Leary and Ginsberg Decided to Turn on the Whole
World." This is a personal testimonial by Leary of the solace and
comforting strength he claims to have found in his cult of free sex
and drugs.
224
Playboy, October 1969, carried a lead article by Joel Fort, M.D. :
"Pot : A Rational Approach." This article is an uncritical review of
Grinspoon, Zinberg, Weil, Mikuriya and other sources commonly
used to give the impression that scientific findings confirm the safety
of marihuana or at least the lack of significant adverse effects. I
quote an excerpt:
And marihuana, decidedly, is not a narcotic, although just what it should be
called is something of a mystery. The tendency these days is to call it a "mild
psychedelic," with emphasis on mild ; this is encouraged by the Tim Leary
crowd . . . and by those to whom psychedelic is a monster word denoting hal-
lucinations, insanity, suicide, and chaos.
The text goes diffusely on to scramble pharmacological terms. The
point is, Dr. Fort claims marihuana is a very mild something. The
same Dr. Fort was quoted by the Oakland Tribune, May 26, 1966 :
LSD THREAT LESS THAN ALCOHOLISM— LSD is dangerous enough, but
it poses a far lesser threat to the populace than alcohol, sedatives, stimulants
and tranquilizers, or even the use of tobacco, according to Dr. Fort.
He was asking clergymen to help maintain an unbiased attitude
toward this powerful new drug. Even readers of Playboy are en-
titled to a reasonable degree of competence in a supposedly scientific
evaluation.
Psychology Today, January 1973, carried an article by Timothy
Leary: "The Principles and Practice of Hedonic Psychology and
an Explication of the Seven Levels of Consciousness (Pleasure)."
It is fair to say that this is an unrestrained effort to recruit the
reader into the Leary world of marihuana and beyond.
Surely the media have an obligation to end the one-sided exposure
of readers and viewers to this kind of propaganda. It is, of course,
interesting to have essays in science fiction, but is this not too much ?
And can it qualify as science at all ? True science fiction has always
been an extrapolation from scientific observation; these stories are
based on illusion.
THE ENTERTAINMENT INDUSTRY AND PROMARIHUANA PROPAGANDA
Another important element in the barrage of promarihuana and
prodrug propaganda is the output of our entertainment industry.
There have been prodrug films such as "Easy Rider", which sym-
pathetically portrayed the life of young people caught up in the
drug culture, including the use and sale of marihuana.
And then there was the brilliantly made but criminally damaging
film, "Superfly," which glamorized the lives of two black cocaine
wholesalers, in a manner which brought protests from black com-
munity leaders in Washington. D.C., and in other cities. I quote what
the New York Times film reviewer said about "Superfly," because I
consider this statement to be illustrative of the blindness and toler-
ance— yes, and the perversity — that has reduced our media in too
many instances to handmaidens of the prodrug propagandists. Here
is the quote:
That the film — Superfly — does not also belong with those movies portraying
the evils of drugs must be the result of very intelligent calculation ; for there
is no moralizing, not even the subtle silent kind, and the film's most eloquent
spoken passage is given to Priest's partner — Priest is "Superfly"— when he de-
fends dealing as a way of life.
225
In March 1971, Edith Efron wrote an article for TV Guide ana-
lyzing 24 "drug dramas" that had appeared on 14 dramatic series
over the previous year. Heroin was given uniform and negative
treatment in the plays. Five of these plays portrayed the hazards of
pep pills and barbiturates. But only one play dramatized the hazards
of marihuana. Summing up, Ms. Efron said :
What does all this add up to? It adds up to this: a flood of plays allegedly
reflecting the contemporary white "drug culture," which soft-pedal or omit every
major aspect of that culture, * * * which strongly intimate that the guilt for
the drug epidemic lies with white middle-class America and its traditional
values * * * which morally whitewash the drug takers * * * and which por-
tray— in the case of the heroin addicts — their intense medically documented
suffering.
The recording industry has played a major role as a vehicle for
prodrug — primarily promarihuana — propaganda. Scores of such
songs have been recorded by folk singers and rock groups and be-
came best sellers and top favorites of disc jockeys across the country.
Some of the better known ones are : "White Rabbit", "Magic Carpet
Ride", and "Comin' Into Los Angeles."
In early 1971, the FCC issued a warning about broadcasting song
lyrics that might encourage young people to use or experiment with
drugs. Some of the stations reacted affirmatively to this warning. But
some resisted. The Recording Industry Association of America peti-
tioned the FCC to rescind its warning because, it said, the warning
has become a "rallying cry for arbitrary action by censors and vigi-
lantes." James Caroll, program director of WKCR-FM at Columbia
University, told the New York Times: "For them to try to suppress
drug songs is a tendency to stomp all 'over the First Amendment."
I'm all for the First Amendment. I believe it was Justice Holmes,
however, who pointed out that the First Amendment does not cover
the right to shout "Fire" in a crowded theatre. Although I am not a
lawyer, I feel strongly that it also does not cover the right to carry
on a false and insidious propaganda campaign in favor of drugs
which have already destroyed the lives of hundreds of thousands
of young people — a campaign which will, if it goes unchecked,
seriously undermine the health and morale of our people and the
security of our Nation.
The above observations do not reveal the full extent to which the
broadcast media or the media of print push marihuana. Leary fol-
lowers are abundant in the world of the media and remarks about
pot are common, as common today as remarks about tobacco or al-
cohol. In California during the public debate in 1972 over the initia-
tive measure to legalize marihuana, the media were careful to try
to obtain competent persons to present the opposing side. Making
such presentations fatigued the few experts who could give the ac-
curate information needed. On the promarihuana side, no expertise
was necessary to give the argument centering on keeping the mari-
huana user out of jail — a misleading argument, but one with appeal.
Dr. Fort and a large number of lay persons took advantage of every
opportunity they could to speak for the proposition. In almost every
instance, their real argument was "It's safe." The authority quoted
was always the Shafer Report, used in a way to obscure all the
cautionary passages.
226
The media need to do some searching; of conscience to find the
means of achieving balance when qualified professionals are not
available.
THE ROLE OF RADICAL PROPAGANDA
Radical propaganda has also played a major role in the spread of
the drug epidemic and, in particular, of the marihuana-hashish
epidemic.
When I say "radical", I mean primarily the New Left rather
than the Old Left. The New Left has today lost much of its strength,
but just a few years back it was a potent force, on and off the cam-
pus. It was a broad and variegated phenomenon. Although some of
the organizations and leaders and publications involved in the New
Left appeared to be "far out," or even entertaining, virtually all of
them had to be considered revolutionary in the sense that they were
militantly opposed to the capitalist system and the established order
and favored the use of violent means to bring about its overthrow.
Perhaps the principal vehicle of the New Left movement was the
underground press. The underground press has undergone consider-
able attrition in recent years, but not so long ago every major Amer-
ican city had one or several underground papers, and even relatively
small cities had their own local underground press. The small papers
circulated no more than a few thousand copies per week; the larger
papers had weekly circulations that ran as high as 200,000. It has
been reported that, at the height of the phenomenon!, there were
some 800 underground papers in the country, with a total readership
of roughly 20,000,000 young people.
I have yet to see an underground newspaper that was not actively
engaged in the promarihuana propaganda campaign. Let me give you
a few examples of their propaganda.
Timothy Leary, the guru of the New Left drug cultists, was carried
almost on a syndicated basis by just about the entire underground
press. Let me quote a few of Chairman Leary's words of wisdom.
On January 2, 1969, Leary told the Berkeley Gazette : "Drugs are
the most efficient way to revolution * * * I'm for anything that dis-
rupts the university. The only way a university can serve any useful
purpose is in turning people on and making them feel good."
On October 25, 1969, Leary wrote an article for the Los Angeles
Free Press, an underground paper, in which he said :
I think dealing is the noblest of all human professions, and urge any crea-
tive young person to consider it * * * I remember talking recently to a group
of clear-eyed, smiling, beautiful dealers. They were young men in their
twenties, as all dealers have to be young. At that time their life situation
was close to perfect.
In a tape recording brought back by Jennifer Dohrn after visiting
Leary in Algeria in October 1971, Leary said : "Blow your minds,
and blow up the prisons and the controlling centers of the genocidal
culture * * * The political revolutionary must be turned on to seek
and tap his internal energy."
I offer copies of these items for the record.
I have here another item, from The Rat, a Bay Area underground
paper, dated October 8, 1969. Here is a brief excerpt: "* * * when
the youth in large numbers embraces pot, it signifies a very funda-
227
mental rejection of Amerikan bourgeois society." American is spelled
with a "k".
The Berkeley campus had an official publication called "Orienta-
tion." I have here an item taken from an underground counterpubli-
cation called "Disorientation : notes from the underdog." Let me
quote one brief paragraph: "Society hates drugs because they can
giye people ideas and visions of beauty and love and make them
realize that this current society has to be brought down and totally
rebuilt."
Mr. Martin. Do you believe the underground press exercised any
significant influence on our young people in promoting the cannabis
epidemic ?
Professor Jones. I think there is no doubt whatsoever it had a
tremendous impact. Here are other things, here is a thing related
to the underground press which is actually a book — this is a photo
copy part of the book — it is in the same vein, it is incredible.
Mr. Martin. Why, if it is a New Left booklet, do you consider it
promarihuana ?
Professor Jones. Because from the beginning there was an inter-
twining of the New Left with the drug movement.
Mr. Martin. And this is representative of the book itself?
Professor Jones. It is representative of the book itself, and there
are many other statements, especially in the White Panther Society —
I have a copy of their text here, too. The platform of the White
Panthers is under point 3, and it says, "Total assault on the culture
by any means necessary, including rock-and-roll, dope, and" — excuse
me — " in the streets."
I'm afraid I'm a little callous on some of these four-letter words,
coming from a community
Mr. Martin. It will have to be edited when the record is printed,
Professor Jones.
Professor — ones. This is the flag of the White Panther Society.
You can see that over the red star there is a marihuana leaf; it is
not a fig leaf, it is a leaf of the cannabis plant. The White Panther
Movement may by this time have gone out of existence, but it was at
one time a very active group. I have here as another exhibit a photo-
graph taken at the White Panther booth at a Michigan rock festival.
A typical example of New Left drug propaganda is a formal pub-
lication by Lyle Stuart, Inc., New York, "The Anarchist Cook
Book" — which I show you here. In addition to recipes for bombs to
be made "in the kitchen," methods for the preparation of many
drugs are given. Ordinary recipes include instructions for making
marihuana salad, hashish soup and hashish cookies. The introductory
chapter on drugs states : "The use of drugs comes under the birth of
a new culture * * * The use of drugs in this new culture will be
free * * * for there will be no more jails." And the author quotes
Jerry Rubin : "Pot is central to the revolution. It weakens social con-
ditioning and helps create a whole new state of mind. The slogans
of the revolution are going to be pot, freedom, license, the bolsheviks
of the revolution will be longhaired pot smokers." x
1 The original quotation is from Avant-Garde. N.Y., March 1969, p. 33. Article by Peter
Sehieldahl, "Thoughts of Chairman Jerry."
228
jps
FLAG OF THE WHITE PANTHER PARTY
(The body of the flag is black; the center star is red; the superimposed mari-
juana sprig is green)
I have in the files that I have brought here today and in my files
at Berkeley literally thousands of such items, culled from the under-
ground press and leftist publications. There is absolutely no doubt
my mind 'that the total impact of this propaganda, endlessly re-
peated in hundreds of underground papers across the country and in
thousands of tracts, played a major role in the spread of the drug
epidemic.
The underground newspapers were generally not identified with
any specific New Left organization, although they shared the New
229
Left ideology. The formal organizations in the New Left movement
were divided on the issue of marihuana. SDS — Students for a Demo-
cratic Society— to the best of my knowledge, did not encourage the
use of marihuana, although its members were far from being drug
teetotalers. Marihuana has been regarded with favor, however, by
the Weathermen, the Black Panthers, the White Panthers, Leary's
Brotherhood of Eternal Love, and, currently, by the Symbionese
Liberation Army. In the case of the last-named organization, I have
a document which shows that marihuana is used in a ritualistic
manner by the SLA.
It must not be imagined that these New Left revolutionaries were
ineffective because they were so strange — even kooky. The thing that
made the New Left revolutionaries effective despite their strange
ways was that they were always sensational news ; and they were, in
consequence, frequently able to exploit the curiosity of the press in
order to promote their promarihuana propaganda. In his book,
"Future Shock," author Allen Tomer quoted this passage from a
letter written by New Left poet Allen Ginsberg to Timothy Leary :
Yesterday I got on TV with N. Mailer and with Ashley Montagu and gave
big speech * * * recommending everybody get high * * * Got in touch with all
the liberal prodope people I know to have [a certain prodrug report] publi-
cized and circulated. I wrote a five-page summary of the situation to this friend
Kenny Love on The New York Times and he said he'd perhaps do a story (news-
wise) * * * which could then be picked up by U.P. friend on national wire. Also
gave copy to Al Aronowitz on New York Post and Rosalind Constable at Time
and Bob Silvers on Harper's * * *.
It is to be regretted that our media — including reputable news-
papers and TV personalities and publishers — permitted themselves
to be used bv the New Left propagandists. As an illustration of what
I mean bv "permitted themselves to be used," I have here a copy of
"The Little Red School Book," which was published by the Pocket
Book Division of Simon & Schuster. "The Little Red School Book"
is a militant New Left sensualist manual, written at a junior high
school level. It gives explicit instructions on how to take over the
classroom, intimidate the teacher, engage in sexual intercourse, mas-
turbate, take the pill, on how to become involved in expanded sexual
experiences, and on how to use drugs. On page 183, it reads :
"Remember, being high can be fun. But don't count on working
or learning anything while the sensation lasts."
The Communist Party itself has not participated in the promari-
huana propaganda campaign or in the campaign to legalize mari-
huana. I think it is important to note, however, that Bettina
Aptheker, one of the top leaders of the Berkeley uprising and an
identified Communist, never dissociated herself from the militant pro-
pot propaganda which characterized the uprising and which, over a
period of several months, raised the use of pot on the Berkeley
campus to epidemic proportions. This, as I have pointed out, was the
beginning of the national epidemic: from Berkeley the epidemic
spread out to other campuses, then down into the high schools and
the junior high schools, and now down into the grade schools and up
into the adult ranks of both the blue collar workers and the middle
class.
The Communist Party says that it is against the use of marihuana.
However, when Bettina Aptheker had an opportunity to use her
230
immense prestige with the Berkeley students to speak out strongly
against marihuana and to oppose it at the inception of the national
epidemic — she failed to do so.
The Trotskyists and Maoists have also not participated in the pro-
marihuana propaganda, and, at least in the case of the Trotskyists—
I do not know about the Maoists — are on record as opposing the use
of the drug.
It is interesting to note, however, that when the Communists,
Trotskyists, and Maoists, cooperating despite their differences,
brought hundreds of thousands of young people to Washington to
protest against the Vietnam war, the air of the greater Washington
area was heavy with pot smoke for the duration of the demonstra-
tion. There is no record of any spokesman for the major Old Left
organizations using his command position in the demonstration to
discourage the use of pot. And one is compelled to ask : Why ?
In his testimony last Friday, Dr. Andrew Malcolm, a Toronto
psychiatrist, told the subcommittee that marihuana makes people far
more suggestible and therefore far more open to manipulation. This
coincides with my own experience with some 1,600 marihuana smokers
over an 11 -year period. I am convinced that people under the per-
sisting influence of marihuana can be easily manipulated by dema-
gogs of the extreme left or of the extreme right. Marihuana smokers,
in short, would be grist for the mill of any future totalitarian move-
ment. Dangerous political consequences may flow from the fact that
we already have in our society a body of some millions of chronic
users that continues to grow in an exponential manner.
Perhaps the role played by pot in enhancing suggestibility is the
reason why the Old Left leaders of the anti- Vietnam demonstrations
did nothing to discourage the use of pot among the demonstrators —
despite programmatic statements which appear to oppose the use
of pot.
THE SCOPE AND DISTRIBUTION OF THE EPIDEMIC
My extensive interviews with drug users and with persons who
do not use drugs permit some deductions about the variations in the
population by subgroups' tendencies to use cannabis. Economic
status has little to do with these variations. Strong religious faith,
whether Christian, Jewish, or other, appears to give resistance to
the drug. Strong family ties, more frequently found in connection
with strong faith, also appear to reduce involvement. In my work
with the black community, a scourge of multiple drug use is already
evident as an endemic situation; special efforts may be necessary,
but such efforts are likely to get community support. The situation
calls for urgent action ; the longer we wait, the more difficult it will
be to reverse the trend.
With regard to the United States as a whole, there is no com-
munity free of the problem ; it is now as widespread in the rural as
in the urban communities. In some respects the rural youth are worse
off because no counterdrug activities were organized there since it
was felt that these youngsters were not susceptible to the epidemic;
but it has simply reached these parts of the country later. As a
result, the harm from cannabis might be kept low in rural areas
through prompt action because the average length of use of cannabis
231
is less. This is how I stated the problem in 1968 in a booklet that
had more than 1 million copies distributed : "Social pressures among
the young to use the dangerous drugs are widespread and, unless the
trend is reversed, as much as half of this generation of young people
may acquire crippling drug addiction or habituation." To that state-
ment we need only add the genetic hazard.
RECOMMENDATIONS
Now, Senator, I have taken more time than I should have, but I
wish to bring to your attention and the attention of the subcommittee
four points that I think are very important for you to consider.
1. The first step toward correction has been attained with these
hearings— the defining of the problem. The summary papers, rep-
resenting nearly the full array of scientific information on the sub-
ject of cannabis abuse in the world, will soon be in print. It is im-
pressive in the extent to which all sources are in agreement.
There are several examples of the effectiveness of accurate infor-
mation alone in reducing the abuse of drugs. Therefore, the first
recommendation is to make the findings of these hearings available
throughout the country without delay. Congress as a whole or the
Senate should distribute the hearings at once to local and State
governments and to schools, colleges, and public libraries.
2. It is recommended that a special task force on drug education
should be appointed by the President, with its members selected from
the ranks of those scientists who have sought to face up to the prob-
lem rather than to pretend that there is no problem.
3. A working group of experts should immediately plan and formu-
late methods for rehabilitating the large numbers of drug-using per-
sons who may seek rehabilitation in response to an intensive educa-
tional campaign. Heavy cannabis users need approximately the same
degree of care in becoming rehabilitated as do narcotic addicts.
4. Somehow, the legal and organizational means must be found to
counter the massive, unopposed promarihuana propaganda cam-
paign that is still going on in our country. I suggest the Presidential
appointment of a second task force of leaders in science, medicine,
communications, and other appropriate fields, to study the prob-
lem and to maintain a watchful view over published materials and
broadcasts so as to detect propaganda supporting drug use and to
respond promptly, factually, and forcefully in such instances.
I will close with that, sir.
Mr. Martin. That concludes your statement?
Professor Jones. Yes.
Mr. Martin. Mr. Chairman, I have some questions.
Senator Thurmond. You may go ahead and ask your questions.
Mr. Martin. As an expert on radiation, Professor Jones, is there
any observation you would like to make in connection with Dr.
Axelrod's work on the retention of THC in the brain and other fatty
tissue ? I ask this question because Dr. Axelrod's research was, as you
know, conducted with radioactively tagged THC.
Professor Jones. I was hoping that I would have a chance to dis-
cuss that privately with Dr. Axelrod, but I suppose I might just as
well engage in this forum.
232
I followed all the radioactive work, including Dr. Axelrod's and
his colleagues'; and I do know, however, that the ease with which
radiation labels can be detected is in part in these techniques related
to how rapidly it moves into and out of the body tissues.
I notice in Dr. Axelrod's study and those of others that there is
still in the order of 20 to 10 percent of THC labeled that is unac-
counted for either as THC, or some of the immediate metabolites
which still retains impactment in the body well beyond a week. And,
although I can't prove it, I can fit very good models to this which
suggest that this residue which is retained in the body, in the order
of 10 to 20 percent, may persist in the body for a very, very long time,
constant indeed, such as would be removed from tissues probably at
a rate of about 10 percent a month. And this of course, the 10 per-
cent a month, would match the loss of toxic symptoms that we see in
individuals that are poisoned by cannabis.
Mr. Martin. From your experience with marihuana users, Profes-
sor Jones, I want to ask you a question I asked all the other psy-
chiatrists.
Do you regard the so-called amotivational syndrome as a hypoth-
esis that has yet to be proven, or as a scientifically established fact?
Professor Jones. I regard it as a scientific established fact because
I have yet to see a qualified observer that didn't see it in marihuana
users. I have interviewed 1,600 of them, and I did see some degree of
amotivational syndrome in all of them, including some of the bright-
est university students that I have had. The level of dosage that may
be concerned in amotivational syndrome tends to be in heavier doses,
but I still have a number of individuals in whom I can be relatively
certain from a clinical point of view that their use of marihuana has
been confined to a few times per month, and that they can still have
the amotivational symptoms. Now, it's difficult to know, because
behavior and brain function is so complicated, as to what particular
change, or changes, the amotivational symptom produces.
I would prefer to say that I monitor probably in the order of 20
separate characteristics of brain functions in my interviews from a
clinical assessment point of view, and that nearly all of them show
some degree of change ; and that there is a difference in the pattern
from user to user, depending upon dose. So, the great observation
that we have from these hearings is reinforcement of that, that all
of us who see and carefully evaluate cannabis users detect in them,
even when it's over, even up to months beyond their use of cannabis,
residual effects on brain and behavioral functions.
Mr. Martin. Is this damage to the brain reversible, in your opinion?
Professor Jones. Within my own experience I cannot answer that
question. But, I have had individuals, students, whom I have been
able to follow for several years that, although they have made remark-
able progress back towards being normal functional human beings,
they still have some "kookiness" about them which would best be
described as effects of cannabis. But, unfortunately I didn't know
them before.
Mr. Martin. How long do you have to smoke marihuana, and how
much do you have to smoke a week to bring about that kind of
brain damage?
Professor Jones. There is some disagreement among us here. I
point out Dr. Campbell's analysis in England, who did the first study,
233
undoubtedly was measuring individuals that had very great sensi-
tivity to cannabis, that there was brain atrophy and I believe the
data that we have because in many ways the findings have been
amply confirmed, and confirmed in these hearings, that these indi-
viduals did get brain atrophy of a significant kind in the very areas
of the brain that were predicted to be subject to atrophying from the
effects of cannabis.
But we still don't know whether the average cannabis user, espe-
cially those that seem to use cannabis with more impunity, might get
these effects. But, I would prefer to think, at least from the stand-
point of cautioning individuals that anyone using cannabis may be
inducing in the brain some of these things.
Mr. Martin. I would ask you to keep your answers as brief as
possible, Professor Jones, because we are running out of time.
Which do you consider the most dangerous — the more dangerous —
cannabis or alcohol ?
Professor Jones. There is no doubt that cannabis is many times
more dangerous. I have often commented on that by saying, 30 times
more dangerous.
Mr. Martin. Could you in 1 minute, or 2 minutes, tell us why?
Professor Jones. You are asking me to be brief. Well, the changes
to dependency occur in those that become dependent 30 times faster
with cannabis than they do with alcohol. The brain damage that we
see in an alcoholic, and its equivalent to cannabis use, too; but you
won't find among teenagers, or those in their 20's, even though they
are alcoholics, the kind of brain damage you see in cannabis users
who are daily, heavy cannabis users ; and they already have all the
signs of advanced Parkinson's degeneration of the brain, and other
brain changes, too, of a totally irreversible nature, and are only 18
or 19 years of age.
Mr. Martin. A question that has been raised is why we don't have
widespread noticeable effects of the cannabis epidemic. The epidemic
is a big one ; cannabis, as you say, is very dangerous and destructive
to the body and mind. Wny is it so difficult to perceive the conse-
quences, or why do most people have difficulty in perceiving the
consequences ?
Professor Jones. Well, the cannabis user changes gradually; he
drifts into whatever society will support him. He will remain at
home, supported by parents; mooching off relatives, mooching off
friends ; living off charity, living off grants in a college community,
or just being a bum, or whatever, if he is badly affected. So, we don't
see the individuals listed and categorized in our tabulation of diseases.
And because they have also, at least not as yet, not started dying with
a tremendously high death rate, although I think that will change
very rapidly. But, there has been little public awareness. The drug
user tends to remain hidden within the population, that is also true
of heroin, they are largely being cared for at the expense of middle-
class society, a terrible burden on those who are still working in the
parental class. But, the situation will change markedly as the family
resources become exhausted and the individuals who are now sup-
porting them approach retirement age.
Mr. Martin. What you are saying, I think, is that this is a very
insidious drug, which permits the user to look relatively normal, at
least to the untrained observer that has no way of knowing that he
234
is a cannabis user. But he is nevertheless seriously maimed, it has
reduced his ability to perform either as a brain worker, or as a
mechanical, let's say, blue collar worker.
Professor Jones. Well, I don't think there will be many individuals
who are high class and use cannabis. And all of us should be worried
right now about the fact that so many medical students and young
physicians are using cannabis. I personally don't think a cannabis
user can take responsibility for another person because this part of
his brain is missing, it's not connected, it's not working. He is highly
prone to make errors in a situation which is new. He can carry out
routine things, but his ability to function becomes worse and not
better. The average person, especially in their young, pre-middle age
period, grows and mature noticeably in every passing year. The
cannabis user either remains stationary or regresses in mental powers
back to childhood.
Mr. Martin. You feel that abandoning the prohibition would have
a more serious result than abandoning the prohibition on the use of
alcohol ?
Professor Jones. I believe every time drugs are made freely and j
legally available that use increases. I have never talked with anyone, ]
including drug users, who didn't believe that cannabis use would ]
increase if it was legalized. Most young people who do not now use j
drugs tell me the reason they do not use drugs is because it's illegal. ]
And I think many of them now in the near absence of good, cau- j
tionary information, would be tempted to use cannabis if it was ,
legalized, and it is more likely that they would be trapped in that j
decision than getting enough wisdom and making an independent j
judgment.
Mr. Martin. Thank you very much, Professor Jones; there are j
many more questions I would like to ask you, but our time is running j
out rapidly. We still have Mr. Cowan to testify, and I will have to <
terminate my questions.
Professor Jones. I am sorry to have cut into Mr. Cowan's time
because I know he has many things to tell us.
Mr. Martin. You cut into your own time, too. Thank you very
much.
Mr. Chairman, may the additional documents which Professor Jones
offered for the record be incorporated at the discretion of the sub-
committee in the appendix material ?
Senator Thurmond. Without objection, that will be done.
If counsel has any further questions he wishes to prepare, and have
these witnesses respond to, if they would kindly do that, those could
be included in the record.
Mr. Martin. Thank you very much, Mr. Chairman.
Senator Thurmond. They could be done in writing and included
as part of the record ; they have already been sworn.
Mr. Martin. That would simplify the matter greatly, Mr. Chair-
man.
[The following questions and answei'9 were subsequently supplied
for the record :]
Question. Dr. Jones, Dr. Malcolm made the point that marihuana users have
impaired judgment under the acute effects of marihuana. Would you comment
235
on this point, particularly in regard to your statement that your observations,
largely of students, were made while they were not acutely affected?
Answer. I have found that cannabis users, while not acutely intoxicated, per-
sistently show a pattern of undesirably altered mental functions:
(1) They use non sequitur in speech — that is, their conclusions do not follow
from their premises — and they preferentially accept non sequitur from others.
(2) They are easily induced into risky, impetuous, and foolish behavior, such
as acceptance of heroin, LSD, other dangerous drugs, and homosexual expe-
riences, which are afterwards regretted.
(3) There is a narrowing of the usually wide range of facial expressions that
reflect the complexity of thought formation; the habitual facial expression
tends to become a mask.
(4) There are gaps and abrupt transitions in expressing their thoughts.
(5) There is usually pallor of the face and almost no changes of color with
the emotions of social discourse ; blushing is reduced or absent altogether.
(6) Weakening of short-term memory often appears in conversations; sig-
nificant points comprehended early in the conversation escape a few minutes
later.
These effects are probably less marked in university students than in other
cannabis-using persons of the same age. University students are probably not
as indolent as the average cannabis user because those most heavily affected
undoubtedly drop out of college. Among the cannabis-using students I have
known, those with the most severely depressed mental activity have indeed quit
college. There are also many testimonials of such dropouts who quit cannabis
and were able, after several months, to return to their former activities, in-
cluding their studies.
I also have seen a few relatively heavy cannabis users who are impetuous
rather than repressed into inactivity. From my partially formed opinion about
them, they probably continue to function because of superior intellect. But they
are still affected, showing the non sequitur, the masked face, pallor, and rash
behavior.
I am concerned about cannabis-using physicians I have seen among the re-
cent graduates of our medical schools. There are reports that as many as half
the medical students of the last 5 years have been using cannabis. Some of them
unquestionably drop the habit before they become practicing physicians — but
many do not. I have talked briefly with approximately 40 young physicians who
report using cannabis. At least a quarter of them show the physiological
changes I have described. They defend cannabis use by quoting the medical
pseudoscience — but they have never examined the scientific studies.
In view of the life-and-death responsibilities of physicians, impairment of
their judgment by cannabis use must be regarded as a major threat to the
public welfare.
Question. Dr. Jones, in your testimony you state that the number of drug
users of each kind has been increasing by approximately 7 percent per month
in recent years. Is this intended as a firm estimate — or are you offering this
figure as the median of a range of estimates? I ask this question because from
my own reading of the literature, it doesn't appear that we have sufficient in-
formation to make a precise estimate possible.
Answer. Yes ; I should clarify my calculations. I have used various rough
methods to measure the rate of increase in drug users. The range is 5 to 10
percent increase per month since 1965. The median, or average of all of them
is 7 percent per month. The rate is similar if we consider separately the users
of marihuana, hashish, or opiates, the extent of barbiturate or heroin addiction,
the records of drug arrests, or the quantities of drugs seized in illicit drug
traffic. In May 1974, my statistics on University of California men show that
15% of freshmen, 35% of sophomores, 58% of juniors, and 90% of seniors use
cannabis. The year-to-year increase turns out to be exponential — like compound
interest — but the rate depends on whether we assume that the compounding
goes on only during the nine months of the school year or throughout the
twelve months of the calendar year. The rate of increase in percentage of can-
nabis users during a 4-year university education is then 6% per month (as-
suming 12 months of exposure) or 8% per month (assuming 9 months of
exposure).
Question. When you say that the epidemic has been spreading at an average
236
rate of 7 percent per month and that this rate is exponential — wouldn't such a I
rate of increase completely saturate our society in just a few years time? '
Wouldn't there have to be a leveling off somewhere along the line?
Answer. You are quite right. The 7 percent figure is characteristic of an epi- i
demic at the height of its spread, when there is still a large susceptible popula- j
tion. This is where we stand with the marihuana epidemic today. Obviously, it
can't go on at this rate indefinitely. Even if nothing is done, somewhere along
the line it has to level off, because the susceptible population categories have
been saturated. If nothing is done to bring it under control, however, the epi-
demic is going to level off at very high point. With a concerted campaign, we can
get the curve to level off sooner, and then, hopefully, turn it downwards.
Question. The subcommittee has received testimony suggesting that marihuana
must be regarded as a kind of universal threshold drug which frequently leads
to the use of other drugs, including the opiates. On the other hand, it has been
stated in the Shafer report and elsewhere that there is no evidence that the use
of marihuana leads to heroin addiction. Does your own experience throw any
light on this aspect of the problem?
Answer. That marihuana does lead to the use of other drugs has been estab-
lished by many studies. For example, the Annals of Internal Medicine for 1970
carried a survey of college students by Crompton and Brill which reported that
100 percent of heavy marihuana smokers used other drugs ; 22 percent of those
who smoked marihuana monthly used other drugs ; while no other drugs had
been used by those who never smoked marihuana.
The assumption that cannabis use does not lead to heroin comes from mis-
leading statements such as, "marihuana does not necessarily lead to the use of
heroin." As so stated, it is true, for most cannabis users in the United States
have not taken up the use of heroin, even occasionally. It is also true that some
cannabis users will never use heroin ; however, at least half the cannabis users
are susceptible to the temptations and invitations to try heroin.
The association between marihuana and subsequent heroin use is indeed re-
markably high. In my recent drug history sampling of 400 college men, 280 took
up use of cannabis in some regular pattern, and after that 40 percent of them
(118 cases) used heroin or other opiates one or more times. One hundred twenty
had not used cannabis ; none had tried heroin. From interviews of soldiers in
Vietnam in 1972, I found the soldiers who smoked tobacco cigarettes were often
offered cigarettes laced with heroin. The tobacco smokers declined the offer if
they did not also use cannabis. Not all cannabis smokers accepted heroin-laced
cigarettes, but the majority did over a period of prolonged contact. In the United
States over the past 2 to 6 years, 0.5 to 1 million heroin addicts have come from
the cannabis-using subpopulation. This has been estimated at 30 to 35 million, of
which several million use cannabis daily ) . The transfer from cannabis to heroin
addiction is approximately 3 percent per year, and the transfer from cannabis
use to some heroin use is about 7 percent per year (Use of opiates infrequently
enough to avoid frank addiction is, at this time, more widespread than addictive
use).
In a study of 850 hashish users in Cairo done by Professor Soueif at the re-
quest of the Egyption Government (Soueif, Bulletin on Narcotics 23: No. 4,
Oct.-Dec. 1971), it was found that the transfer to opium use from hashish use
was 3 percent per year, exactly in agreement with my findings in the United
States. The graph submitted by Professor Soueif when he testified clearly estab-
lishes that the incidence of opiate use is directly related to the number of years
of hashish exposure.
When I stated to my drug abuse class in April 1973 my statistical computation
that about 10 percent (approximately 3 percent per year) of daily marihuana
users in the United States have become heroin addicts in the 3-year period 1969-
1972, I was challenged. A group of procannabis students conducted a poll which
they proclaimed, both in advance and on completion of their findings, to show
that I was wrong. Based upon 50 percent returns from 700 mailed questionnaires,
they showed 2 percent of students to be heroin addicts. What they did not reveal
in their press release was that 5 percent of the marihuana users or about 10 per-
cent of daily users were heroin addicts. Allowing for statistical fluctuations in
samplings of this size, and for the fact that heroin addicts are likely to drop out
of college, this survey is a good confirmation of my statement that about 10 per-
cent of daily marihuana users in the United States as a whole have become ad-
dicted to heroin.
237
When we look at the problem from the other direction, the association between
heroin and prior cannabis use is even more startling. Most surveys of heroin users
show that the prior use of cannabis is in the range of 85 percent to 100 percent.
In my own studies of drug users, where I employ the interview technique (which
I find more reliable than the survey technique to obtain such mformation), the
percentage is close to 100 percent. In 102 consecutive cases of heroin-using
soldiers, all had used cannabis regularly prior to taking up the use of heroin In
367 additional heroin addicts interviewed by me in the United States, only 4 had
not used cannabis prior to heroin use. .. «
Another misleading statement often made by the advocates for the legalization
of marihuana, namely, that "all heroin users drank milk as infants" is foolish,
the assumption being that marihuana is no more a stepping stone to heroin use
than is milk. We could equally say "all heroin users were born." It is true that
the majority of heroin users undoubtedly drank milk as infants. About 100 per-
cent drank milk, and about 100 percent have used marihuana. But from the other
direction, of those born, or who drank milk, only 1 percent use heron, while
the marihuana users, 30 to 40 percent have tried heroin— too high to dispute the
cause and effect relationship.
Although the nature of the transfer from cannabis to heroin (or to other
drugs) is not completely known, there are some explainable reasons :
a. Peer pressure and depressed good judgment ;
b. Desire for increased senusual effects ;
c. Suppression of judgment brought about by chronic use of cannabis ;
d. Crosstolerance.
Although medical texts cite there is no evidence of crosstolerance between can-
nabis and opiates in humans, there are animal behavioral studies that show cross-
tolerance. Some degree of similar chemical action would be expected because of
the marked similarity in chemical structure between opiates and cannabinols. In
my studies, daily users who have transferred to heroin use do not show cannabis
withdrawal symptoms (restlessness, sleeplessness, etc.) — indeed an indication of
crosstolerance. Crosstolerance, then, enables the cannabis user to have increased
sensual effects from heroin without the unpleasant withdrawal symptoms of
cannabis.
From the fact that some observers of heroin-using soldiers reported, in 1971,
a small fraction who began heroin use without first using cannabis, I postulated
that as a larger fraction of soldiers or civilians became heroin addicts and heroin
advocates, there would be more direct assumption of heroin taking without prior
use of cannabis. This has not turned out to be the case. In 1971 essentially all
heroin users first used cannabis ; they do now also.
Question. I have another question to ask with regard to your estimate that
the number of drug users of each kind has been increasing by approximately
7 percent per month in recent years. There does appear to have been some re-
duction in the use of heroin and LSD over the last two years, does there not?
Answer. That is correct. There has been an improvement because there has
been an all-out campaign of public education by various government agencies,
which has been completely supported by the media. But there has been no
comparable campaign directed against marihuana, hashish, amphetamines or
other drugs — and in the case of these drugs, we are still afflicted by a continu-
ing monthly increase in their consumption. Marihuana is perhaps the worst of
all because', as I have pointed out in my previous testimony, there has over the
past decade been a massive campaign of deceptive propaganda designed to make
potential users believe that it is relatively innocuous and that it affords
pleasures that cannot be found with any other drug or in any other way.
Question. In observations on effects of cannabis, can you make a further dis-
tinction for us between scientific evidence and clinical evidence that marihuana
is perhaps without harm at some level of use? Do any scientists actually say
that, it is safe?
Answer. Clinical evidence is derived from an experienced person's subjective
interpretation of symptoms of health and disease, such as subtle irregularities
in the sound of the heartbeat or the sounds produced by thumping the chest.
Diagnoses made scientifically by using the physical record produced by the elec-
trocardiogram or the chest X ray are more objective. A group of physicians
may examine and discuss such a record and come to a consensus on the most
probable interpretation. Thus, the scientific measurement results In a smaller
238
range of difference of opinion. In practice, both kinds of observations are
needed because they do not necessarily measure the same functions.
In estimating the effects of drugs, behavior Lnd mental functions are ex-
tremely important; they are not (except in rare instances) correlated with
electroencephalograms, X rays, or chemical measurements of blood or cerebro-
spinal fluid. Consequently, we have to rely chiefly on clinical evidence or soft
data, in contrast to hard data from chemical or physical measurements. In a
few cases, hard data have confirmed some of our clinical observations. For
example, many of us had concluded that there are pleasure centers in the brain
that are somewhat selectively affected by sensual drugs. In my published pa-
pers I had come to the clinical conclusion that cannabis first stimulates and
then depresses the appreciation of pleasure, and so have Drs. Kolansky and
Moore and others. We have used the terms, "sensory deprivation" and "de-
personalization," in describing this toxic effect deduced from our clinical
studies. Now, Dr. Heath has physically located the pleasure centers in humans
so that there can be no doubt about their existence ; his observations are hard
data.
Most toxic substances appear to have a threshold of dose below which the
body can cope with their harmful effects so that no scientific or clinical evi-
dence of damage is apparent. A few substances, such as salts of the heavy
metals — for example, lead or mercury — tend to accumulate in the body, usually
in a specific organ. In that event, the effect of continual exposure to small
doses is long delayed ; the damage may not appear clinically for years, and it
has sometimes been difficult to associate the effect with its cause.
There is hard scientific evidence that THC does accumulate in the brain and
is removed very slowly. This was the subject of Dr. Axelrod's testimony. No
scientist could therefore pronounce marihuana "safe" at any level of continuous
use. The amount of damage may be too small to measure, but the only valid
conclusion from the evidence is that some damage must occur with persistent
use of marihuana. There is no process by which science can prove any sub-
stance completely safe ; it can only report that the known tests to detect cer-
tain kinds of injury have yielded negative results. In this case, the tests for
THC in the brain gave positive rather than negative results, so science cannot
be called upon to endorse marihuana use.
Question. Do you think the significance of Dr. Axelrod's work has been ade-
quately understood?
Answer. Let me add to what I have already said on the subject of Dr. Axel-
rod's work. The work of Dr. Axelrod and his colleagues* establishes the highly
significant point that the active ingredient of cannabis stays long in the body.
In a week's observation of human volunteers who were given aliquots of radio-
actively labeled delta-9 THC, only 65 to 70% of the material had been elim-
inated from the body by the end of one week. Of the residue in the body, as
tested by analysis of blood samples, the major fraction was still in the form of
delta-9 THC or its psychoactive metabolite 11-hydroxy-THC.
There tends to be considerable misconception in the current literature over
the significance of this pattern of retention. I make the following points, based
on analysis of the quantitative data reported by Axelrod et al.
1. Although the blood levels of THC decline during the first few days with a
half-time of 1 to 2 days, the continued appearance of THC residues in the
urine and the feces indicates that the remainder of the THC has moved from
the blood to storage in other body reservoirs, from which it is removed with
half times of one week or longer.
2. In Dr. Axelrod's human studies, there was no analysis of uptake by body
fat or in brain or other organs. Some deductions can be made, however, from
the companion studies he made on rats given radioactive delta-9 THC. The reser-
voir of retention of THC in the rat is body fat, and the THC absorbed by the
fat is given up slowly. This effect can be measured by the uptake of THC in
fat under conditions of repeated administration of labeled THC and by the
disappearance from fat when a single injection of the drug is administered.
The nearly linear accumulation of THC by fat over a 28-day period in which
* Analysis of the Metabolic Fate of delta-9 THC In Findings Reported by Dr. Julius
Axelrod and His Associates: Pharmacological Reviews S3: (4) 371-380. 1971; Science
170: 1320-1322. 1970 and 179: 391-393, 1973; Annals of the N.Y. Acad. Scl.
191: 142-154, 1971 (See Appendix).
239
equal quantities of labeled THC were administered every other day, clearly
indicates that there is long-term retention of the THC in fat. In these obser-
vations in rats, it appears that the fat releases THC with a half-time of sev-
eral weeks. Thus, the daily rate of loss approximates only 1 to 3%.
3. The slow release of THC from fat, as observed in rats, tends to imply
similar retention of THC in humans who smoke marihuana and hashish. We can
expect that the retention of THC in fatty tissues of humans is longer than In
the rat because the rat's metabolic rate is about three times greater than the
human rate. Thus, release of labeled THC from human fat is likely to have a
half-time approximating a few months rather than a few weeks as in the rat.
4. It may be a coincidence that the rate of disappearance of THC from the
human body as measured by appearance in the urine and feces is approximately
the same as the rate of disappearance of THC from the fat of rats.
5. In the THC studies, the metabolic processes most likely to be detected are
those with the fastest rates of turnover, since they produce the highest con-
centrations of the labeled material. Thus, the data obtained by Axelrod on the
elimination of THC probably describe only the more rapid processes, while the
20 to 30% residue of labeled THC is removed remarkably slowly, requiring
weeks for certain, and probably months, to be eliminated. The rate of removal
may, in fact, match the slow regression of mental symptoms on abstinence from
cannabis abuse, which occurs at approximately 10% reduction in symptoms per
month.
6. The retention of THC and its metabolites in brain tissue is an important
consideration. The Axelrod observations show that the rat brain's cumulative
concentration of labeled THC is about 5% that of liver and 1% that of body
fat when THC was administered every other day for 28 days. Apparently, most
of the THC taken into the body goes to body fat (perhaps the uptake in vis-
ceral organs depends on fat content) while the brain gets a small fraction.
Assuming that the distribution of THC derived from smoking cannabis is the
same in humans as that of injected THC in the rat and that the average ex-
posure to THC through marihuana smoking causes 10 milligrams to enter the
body, then less than 1% of it would be deposited in the brain. This would mean
that the amount of THC or its metabolites that affects the brain is indeed
small, since a dosage of 0.1 milligram or 100 micrograms distributed to the
whole brain would induce intoxication. It also suggests that a few hundred
micrograms of the active material held for a long time in the human brain may
be responsible for the persistent effects associated with the behavioral changes
seen in chronic marihuana users.
I wish to make another statement of some importance based upon the same
point, that only a small quantity of the active ingredients of marihuana in-
jures the brain. At least one research project in California sponsored by the
National Institutes of Health is giving to human volunteers injections of sev-
eral hundred milligrams of pure delta-9 THC, also supplied by the National
Institutes of Health. These quantities in single applications, especially within
the blood stream, hazard real damage to brain tissue.
Question. Dr. Axelrod expressed the belief that marihuana may result in
"reverse tolerance," and he offered an explanation for this observation. From
your past writings, I know that you believe the concept of reverse tolerance is
based on erronous observations. Could you tell us why you believe this con-
cept to be in error?
Answer. Dr. Axelrod believes that "reverse tolerance" — that is, the develop-
ment of a given effect with smaller and smaller doses as use of marihuana
continues — is explained y the fact that, with heavy marihuana use, there is
increased enzyme conversion of the delta 9-THC to the more active 11-hydroxy-
THC. I have every confidence in his work and do not doubt that this phenom-
enon plays a part in the effects I have observed in persons during their initia-
tion into marihuana use.
From my studies of cannabis users, I find that the first few smokes of reefers
produce minimal effects ; whether the person consumes 4 to 6 all at once or
over a period of several weeks, he does not "turn on" until about the 4th to the
6th "joint." He has now reached his most sensitive level because of the accu-
mulation of THC in his system, perhaps augmented by the conversion noted by
Dr. Axelrod ; and, for the next few times, he may renew the high by smoking
just part of a reefer. He is likely to remain at that level of tolerance for a
240
time; but later on, he finds it necessary to increase the dosage, and usually
the frequency also, in order to get the same effect. I interpret these observations
to mean that THC accumulation is the chief cause of the seeming "reverse
tolerance" that brand new users display, but that the habitual user eventually
experiences true tolerance— the need for larger amounts of the drug to produce
the desired, effect.
Qustion. Dr. Jones, you were also present when Dr. Kolodny testified last
Thursday on research conducted by a group of Masters & Johnson scientists
under his direction, which revealed lowered male hormone levels in marihuana
smokers? As a scientist who has studied the physiological effects of cannabis,
do you have any reservations about this finding?
Answer. Dr. Kolodny's discovery is, in my opinion, of the greatest signifi-
cance. I found his research methodology impeccable, and, although he was
properly modest about the finality of his findings, I personally believe that they
already have the quality of hard scientific evidence. I might point out that four
years ago, I hypothesized that marihuana users had less than usual male hor-
mone because they appeared less virile and had less sexual activity. I applied
for an NIH grant to test the hormone profiles in persons at various stages of
involvement with cannabis or other drugs, or abstinence from them. The NIH
study section disapproved the application. Dr. Kolodny now shows unequivocal
evidence for the suppression of male hormone in men who smoke marihuana.
Despite this, I anticipate that his findings will be misunderstood by some and
denied or misrepresented by others.
Question. Could you tell me why you believe that these findings can be mis-
understood or misrepresented or denied, when you yourself consider the evi-
dence to have a hard scientific quality?
Answer. This wouldn't be the first time that hard scientific evidence has been
misunderstood or denied. In this specific case, there are a number of reasons
that make misunderstandings understandable.
First of all, based on my observations of some 1600 cannabis smokers, I have
found that feminization in appearance and behavior is only evident in about
half of male cannabis users.
Second, in my opinion, signs of suppressed masculinity are most marked in
those who are physically inactive. I find, obversely, much less behavioral basis
for suspecting depressed virility in athletes using cannabis, even though they
may have other signs of functional brain changes.
Third, Dr. Kolodny has matched sexual impairment with suppression of male
hormones in cannabis users. In my opinion, it will be equally possible to show
in marihuana-smoking males, selected as fully masculine types having normal
sexual inclinations, that testosterone levels are in the normal range. I believe,
therefore, that we will observe a false dispute of the highly important Kolodny
findings simply because it will be easy to pre-select subjects not yet sexually
debilitated by their use of cannabis. But the fact that you can find X number of
marihuana-smoking males who have not yet been sexually debilitated does not
disprove the finding that an equal, or substantially larger, percentage have
suffered sexual impairment in varying degrees.
I personally confirm the Kolodny observation and caution those who would
dispute it that we are evaluating a drug with a very wide range of patterns
of debilitating effects.
Question. Some of the psychiatrists who testified said that cannabis makes
people suggestible, that it has an almost hypnotic effect. Does this coincide
with your own experience?
Answer. Cannabis does have hypnotic effects. A symptom of this action is
the "stoned thinking" of the marihuana smoker. What is not fully realized is
that this condition persists, though at a reduced level, between uses of the drug.
Stoned thinking is described as use of the non sequitur, thoughts and deductions
not fully logical but accepted as logical by the cannabis users. One such person
is pleased to note the non sequiturs in the speech of another ; it is what the
"pot" user calls good "vibes" and the like. The reinforcement of the foolish
notions offered by one cannabis user, reflected upon and echoed by his peers who
share the same vibes, is similar to the impetuous acts of gangs of juvenile
persons — act now ; don't worry about the consequences. Examples include the
minor rip-offs (which is to say, stealing) of what is wanted at the moment,
without restraint, or the breaking of faucets and plumbing in public lavatories
or the urinating on the floor. Why? The answer is: Why not?
241
The cannabis user, as a soldier in Vietnam, would accept heroin-laced ciga-
rettes ; whereas, the other cigarette-smoking soldiers would not. This can hap-
pen during a cannabis high, but it is more likely to occur when the cannabis
user is sober. Tragic episodes of foolish criminal behavior of U.S. soldiers in
Vietnam should be investigated in light of possible ties to cannabis toxicity.
Marihuana users are likely to make impetuous sexual decisons. I first thought
that these were confined to the period of cannabis intoxication, but my inter-
views produced evidence that this generally occurs when the cannabis user is
between highs. I have talked to many cannabis users who consented to the
propositions of homosexuals who had picked them up from the roadside as
hitch-hikers. These young men are likely to be troubled by these experiences.
Three such men, after having abstained from cannabis for several months,
stated that they were then able to see that they had acted under the spell of
cannabis and they would not have been vulnerable had it not been for the
suppression of mental powers that they now could relate to cannabis use.
The hypnotic spell of cannabis facilitates and probably induces appeal of the
absurd. A century ago, the French scientist, Moreau, recognized this tendency
in hashish users and called it "alienation," a term appropriately used today to
describe persons altered by "cannabis.
Question. Have you read the Third Annual Report to the U.S. Congress from
the Secretary of Health, Education, and Welfare for 1973 on the subject of
"Marihuana and Health"?
Answer. Yes, I have read the report and studied the findings.
Question. Some people associated with the marihuana legalization lobby have
made the point that the 1973 HEW report on marihuana roughly parallels,
and therefore appears to bear out, the findings made by the Shafer Commission
in its own report. Would you consider this an accurate assessment of the HEW
1973 report on "Marihuana and Health"? Or are there, in your opinion, im-
portant differences between the two documents?
Answer. Regrettably, thhe differences are minor and the similarities great.
Question. Would you be prepared to offer your assessment of the HEW re-
port, based on your study of it to date?
Answer. Let me begin by saying I consider it a very biased document. It ig-
nores much of the scientific evidence against marihuana and distorts the mean-
ing of some of the studies that it cites. These were faults of the First and Sec-
ond Annual Reports, also. All three compare very unfavorably with the com-
prehensive and accurate report on Smoking and Health published by the De-
partment in 1964 ; these are neither comprehensive nor accurate.
Though the Report is supposedly directed "to the basic question : What are
the health implications of marihuana use for the American people?", it is ac-
tually oriented primarily to matters of social acceptability and the relationships
of social class to marihuana use. The one-page "Summary", having stated "the
basic question", does not mention health again. It speaks of "social patterns
of typical use", "the user's self concept", "the cultural context" of use, and the
"personal values" of the user, and states that "ascribed characteristics of
users [may] represent . . . the institutionalized prejudices of those of higher
social status." There is no mention in the Summary of the scientific evidence
of organic and functional damage to the brain, or of damage to the hormonal
system or to chromosomes. A reader of this abbreviated "Summary" would
conclude that marihuana has no effect on health. The rest of the Summary
section does treat issues of health but from a biased viewpoint.
Parts of the Report seem like a sharp lawyer's defense of marihuana. In
playing down the seriousness of the problem, for example, the Report states
(p. 5) : "The rate of increase [of cannabis use] in some segments of the pop-
ulation may have diminished." Many readers would gain the impression that
use has diminished rather than that the increase in use may be somewhat
slower than formerly — that the use of marihuana is definitely increasing.
With regard to the linkage between cannabis and LSD or heroin, the Report
is incorrect. I disagree with the statement, "Heroin use in this group [college
students] is extremely uncommon." My studies have found that 20% of the
cannabis users in the university population that I have studied have tried
heroin. Very few of them have become addicts and, as I pointed out in answer
to a previous question, those who become addicted drop out of college ; but I
believe that the statement in the Report is misleading, since I regard even one
242
or two trials as dangerous "heroin use". It is that process by which a fraction
of marihuana users become heroin addicts.
With regard to the use of cannabis by physicians and medical students, the
Report complacently states : "Only seven percent [of physicians] reported cur-
rent use [of cannabis] and, as expected, younger physicians and those living in
New York City and San Francisco were more frequent users than those in the
other areas." This is, in fact, alarming ; for the effects of cannabis in persist-
ently depressing memory and other mental functions can be expected to dimin-
ish the quality of performance of physicians. If seven percent of all physicians
now use cannabis, while the use is "more frequent" among the younger ones,
then the fraction of young physicians using the drug is large. Some surveys
suggest that 50% of medical students smoke marihuana. The Report cites a
study with only 50% response that showed one third of a group of physicians
had tried marihuana, and one might suspect a higher fraction among the non-
respondents. The report minimizes the importance of this aspect of the problem.
The Report dismisses the studies conducted by Professor Soueif for the
Egyptian Government in two short paragraphs. It fails to recognize the great
significance of this work. These studies were carefully controlled ; they focused
on the persistent effects of cannabis and compared a wide range of social and
achievement levels ; they were conducted when the persons in the study were
not acutely affected by cannabis ; and they found a striking result : the higher
the individual's original mental test scores, the more they were depressed by
cannabis use. None of this is mentioned in the body of the Report. There seems
to be an indirect reference to Soueif's study in the "Introduction," but only
for the purpose of belittling its importance : "There is significant new evidence
regarding the implications of long-term cannabis use. However, much of it is
based on overseas populations quite different from an American user popula-
tion both in their patterns of drug use and in the demands their society makes
upon them. Moreover, ours is a society that makes simultaneous use of many
drugs. They are used recreationally, as self medication and by prescription."
It would have been wise to point out that America probably demands higher
average levels of mental performance than does the Egyptian society and
hence that the damaging effects of cannabis use in American life must be
greater. And the Report should not have lightly accepted the propagandists'
cliche, "recreational use of drugs," and mentioned it so casually as a socially
accepted practice. It tends to make drug use seem as "American" as going to a
baseball game or eating apple pie.
Although a 4-page summary of the Soueif study is finally presented in the
section on "Marihuana Use in Other Countries," I find it does not convey the
sense of the paper or its significance. The text is merely full of technical details
of methodology. It does not even mention Soueif's finding that the probability
of hashish users becoming opium users was a function of the duration of their
exposure to hashish.
The section on "Future Research Directions" is strong on sociological studies
but weak on the biomedical side. It fails to emphasize the importance of inves-
tigating the extent of persistent effects of marihuana on mental function and
possible brain damage. The decreased educability of chronic marijuana users
has been observed, but further research into its causes and cure is essential.
The Report seems to regard the genetic and embryonic effects of marihuana as
a closed book, since no recommendation for future research on that aspect is
offered. I believe there is enough evidence to call for a more extensive investi-
gation of that effect.
Like the Shafer report, HEW's 1973 report on "Marihuana and Health" con-
tains some impressive cautionary material in the larger text — which is some-
how completely ignored in the summary of findings. For example, the HEW
report, under metabolic effects, makes this statement:
"By using whole-body autoradiography and measurement of radiolabeled
drugs in isolated tissues, it has been unequivocally shown that THC penetrates
the placental barrier and accumulates in the fetus. ... At high doses, the fetal
levels become high enough, however, to cause embryonic and fetal deaths."
This sounds pretty impressive — however, none of this is reflected in either
the two-page introduction or the six-page summary, which is what most people
read and credit.
In other cases, the report glosses over recent research conducted by respon-
sible scientists in the United States and abroad — or seeks to refute this re-
243
search by repeated references to the utterly worthless study conducted, under
an NIMH grant, by a few Jamaican scientists of limited credentials.
While the report does make a brief reference to the research conducted by
Dr. Stenchever and his colleagues at the University of Utah, which established
that marihuana smokers, even at the rate of one cigarette a week, displayed
three times as many chromosome abnormalities as non-smokers, it dismisses
this extremely well-controlled study with the following words :
"There is no convincing evidence that chromosomal abnormalities arise from
marihuana use. The Jamaican study of chronic users as well as other studies
of the effects of THC on chromosomes in human lymphocytes (a type of white
blood cell) indicate no changes related to cannabis use."
The report also completely ignored the most impressive neurophysiological
studies yet conducted on the human brain and the brains of monkeys which
produced electroencephalographic recordings demonstrating massive abnormal-
ities in the brains of cannabis smokers, and persisting abnormalities after rel-
atively brief periods of chronic use. This testimony was presented to your
Subcommittee last Thursday by Dr. Robert Heath, Chairman of the Depart-
ment of Psychiatry and Neurology at Tulane University. Again, the worthless
Jamaican study is invoked as the supreme authority. This is what the report
says :
"Systematic study of brain electrical activity (EEG records) in matched
user-nonuser populations in both Jamaica and Greece have not disclosed ab-
normalities associated with cannabis use."
Perhaps not very surprisingly, the report fails to conclude that we are con-
fronted with a national cannabis epidemic of a gravity that calls for an all-out
effort of public education by the various federal, state and local agencies con-
cerned with the problem of drug abuse. Without such a campaign, needless to
say, it's going to be impossible to turn the situation around.
Despite the fact that it contains much solid scientific information, therefore,
I would have to state, bluntly, that in my opinion those who compiled the re-
port for the Secretary of HEW have been guilty not only of professional in-
competence but of a major disservice to the people of the United States.
Question. You have spoken in a highly critical — I might say bitterly criti-
cal— manner about the Jamaican study which was quoted by the HEW report.
Do you really think this study has had any serious impact on public under-
standing in this country of the dangers of cannabis use?
Answer. Let me first quote from an official paper on this research :
"Twenty-seven cultures from 12 users and 15 controls failed to produce ade-
quate results for analysis. Either there was complete failure of mitotic activ-
ity or the quality of the cells was inadequate for examination. Part of this
high failure rate was clue to a bad batch of calf serum used in our culture
medium. It is not known without repeating the examinations whether this was
the only factor."
The above difficulties, acknowledged by the Jamaican study, invalidates the
observations. For one thing, 12 users and 15 controls amounts to a large frac-
tion of the study ; for another, the admitted difficulty suggests that cell cultures
in the defective medium appearing to have some degree of mitotic activity or
"reasonably normal" cell appearance were accepted as part of the study. This
kind of research difficulty would not be acceptable by experts in the field of
chromosome studies ; indeed, they would not have conducted any such study
without being certain of the culture media and all other aspects of the test
conditions determining the validity and the reproducibility of the results.
I believe tbat the Jamacian study — precisely because it was funded by NIMH
and has now been given the apparent blessing of HEW — has already had a
tremendous negative impact in the United States. It is being quoted over and
over again by all those who are lobbying for the legalizatoin of marihuana. This
would be bad enough. But the damage was compounded by an article in the
popular medical weekly, Medical Tribune, in October of last year. I have brought
a copy of it here with me.
The heading of the article reads, "Study of Chronic Use of Marihuana Dem-
onstrates No Chromosome Breaks, Brain Damage, or Untoward Effects." Then
the article says, I quote :
"A double-blind clinical study of the effects of marihuana in a sample of a
population long habituated to its use has yielded no evidence of significant
2M
physiologic or psychoneurotic differences between smokers and a control
group of nonsmokers. . . .
"The results of this investigation appear to lay at rest many common beliefs
about the deleterious effects of marihuana — beliefs based on laboratory obser-
vations (or anecdotes) of acute effects in haphazardly collected groups of
study subjects, without regard for idiosyncratic physiologic differences or be-
havioral or sociologic background. . . .
"Abnormalities found in chromosome studies of peripheral blood cultures
were slightly more frequent in the nonsmoker controls."
The article in Medical Tribune, not very surprisingly, was widely picked up
around the country. An article in the Detroit Free Press, for example, carried
a five-column head : "Study Finds Marihuana Not Harmful." Since I have al-
ready quoted from this article, I shall not repeat myself — apart from empha-
sizing that the article was not speaking of the occasional use of marihuana but
of the chronic use of marihuana having no apparent harmful effects.
For these reasons, I believe that the Jamaican study has done tremendous
damage to the cause of public education, and that the emphasis placed on this
document by the recent HEW report has given major support to the pro-
marihuana lobby in this country.
Question. Dr. Jones, how is your scientific research on drug abuse supported?
Answer. At present, not at all. When I first became involved, in 1965, I con-
sidered this research a side line. I read and analyzed the literature on the
subject and began, in my spare time, to interview and study the characteristics
and experiences of persons taking the psychoactive drugs. In 1967, I received
a grant from the Carthage Foundation for a special study of Controversy in
Science, and they allowed me to use a portion of it for my study of drug-
affected persons. From the beginning, my research was directed toward deter-
mining long-term consequences of drug abuse and methods applicable to edu-
cation in drug abuse prevention and in rehabilitation of drug-dependent per-
sons. Almost immediately, I found significant leads in these areas, warranting
expansion of my work into supportive laboratory research and clinical trials.
Question. Then you did obtain funding to enlarge your studies?
Answer. No, I did not. I have tried repeatedly to get such funds, both by
formal application and informally, but I was always turned down.
Question. Can you tell us more fully about this situation and whether you
have grant applications that are now pending?
Answer. Before answering your question, allow me to state that my appear-
ance here as a witness has nothing to do with my disappointment in seeking
Federal support and the handicap it has been to my work. I have no grant
applications pending at this time and I have no plan to submit an application,
as I will explain.
The funds from the Carthage Foundation were limited. From the beginning
until they expired last year, we had agreed that I should apply for Federal
funds, since very large sums were known to be available for drug abuse re-
search and my studies were so promising of early practical results. When I did
apply, however, I found the reviewers of my proposal were very antagonistic,
and it was no surprise to me that my application was rejected. I know that my
vocal and long-standing opposition to the "soft line" on marijuana and to the
methadone program for heroin addicts has not helped to make me popular in
some circles.
Question. Dr. Jones, from your continuing research, have you been able to
make an estimate of the extent of cannabis use in the United States, and the
trend? Could you offer an opinion about the information on cannabis seizures
supplied by Mr. Andrew C. Tartagiino of the Drug Enforcement Administration?
Answer. Most of the data I have been able to collect indicate that the use of
cannabis is increasing at an exponential rate — like compound interest — and
that the outlook for the immediate future is further increase in cannabis use.
In my opinion, it will continue to increase until the public understanding of the
hazards involved is sufficient to discourage the use of marihuana.
Each year of the past decade, some authorities have stated that the use of
drugs is declining ; but overall, the use of both marihuana and hashish has been
steadily on the increase. In the first analysis I made of this trend, in 1968, I
used as the quantitative measure both the number of California juvenile drug
offense arrests and the quantities of drugs seized. I believe the data supplied
by Mr. Tartagiino are consistent with the present trend of increase in numbers
245
of cannabis users and increase in quantity of cannabis consumed by each in-
dividual— both in dosage per use and frequency of dosage.
The regularity of the tendency for the quantities of cannabis to increase
with passage of time, from 1969 to 1974, is impressive. This is what would be
expected in a country as large as ours, with many agents working on illicit
drugs and with the separate seizures being relatively small in comparison with
the aggregate totals for the year. I must emphasize the seriousness of the fact
that all data I have examined on the frequency of use of cannabis by grade-
school and college students indicate a steady increase in percentage using the
drug, both by age and by grade. The Tartaglino data are in accord with these
observations and should alert us to the increasing use of cannabis.
1 have made a continuing survey of marihuana use among UC students since
1968. On the basis of my own data, I have made a graphic analysis of the trend
of the Tartaglino data, as shown in the graphs which I am submitting for the
record at this point.
TABLE I.
-ESTIMATIONS OF NUMBERS OF CANNABIS USERS AND QUANTITIES OF THE DRUG CONSUMED (TABLE OF
QUANTITIES OF THC CONSUMED BASED ON 200 U.C. MALE UNDERGRADUATES, 1973)
Frequency of use per week
mg THC, estimated
smoked per 100 users
percent smoked absorbed per week per year
Assumed dose
THC:mg/dose
Estimated
mgTHC
smoked per
year per
person
7 or more 4 40 20 1,200 62,400
6 to 7 6 30 15 1,117 60,840
4 to 6 .. .... 20 26 13 2,600 135,200
2 to 4 54 20 10 3,230 166,400
1 to 2* 10 16 8 240 12,480
Less than 1 6 10 5 30 1,560
Total U38.880
15,600
10, 140
6,760
3,081
1,248
260
1 THC equals 4.39 g smoked per year per male cannabis user.
1 Seizures are estimated to be between 8 to 12 percent of the contraband. A conservative figure, therefore, estimating
the total cannabis smuggled is to multiply Federal seizures by a factor of 8 (assumes 12 percent seizure).
> This is based on my interview data; approximately half of cannabis using persons grow their own or get their supply
from someone who grows it.
Note: Estimated supplies of cannabis, United States 1973: Marijuana seized by Federal agents, 782,033 lb at 1.5 percen
THC equals 11,730 lb THC times 8 ' equals 93,840 lb; estimating domestic production ' equals illegal importation of 93 840
lb; hashish seized by Federal agents, 52,333 lb at 10 percent THC equals 5,233 lb THC times 8 equals 41,864 lb; total THC
consumed in 1973 equals 229,544 lb; or total THC consumed in 1973 equals 104,300 kg.
Total users in United States if pattern of use is like Berkeley, the average male user consumes 4.39 g THC per yea r.
The average female user consumes 3.6 g THC per year.
Ratio, male to female users is 2 to 1; average user, male plus female, estimated to consume 4.13 g/yr.
Therefore 104,300,000 g THC available in United States in 1973 divided by 4.13 g THC consumed per average user is
25,000,000 users. Of these, 10 percent or 2,500,000 use cannabis more than 6 times per week.
TABLE II.— DURATION OF MARIHUANA USE, 1973, U. C. MALE STUDENTS 18-24 YEARS OLD
Percent
Percent
0
6 months or longer.
1 year or longer
2 years or longer...
3 years or longer...
42 4 years or longer.
57 5 years or longer.
54 6 years or longer.
44 7 years or longer.
33 8 years or longer.
Note: Estimated year of onset of marihuana epidemic in these users— January 1966; average age then 14 years 9th
grade. This estimate is based on a larger compilation of the data.
TABLE III.— FRACTION OF MALE STUDENTS REPORTING RECURRENT USE OF MARIHUANA, U.C. 1973
Percent
Percent
Freshmen
58
90
246
1000
MARIJUANA AND HASHISH
REMOVED FROM ILLICIT MARKET BY FEDERAL AGENTS
100
CO
T3
C
D
o
Q.
CO
c
CO
CO
o
800-
600
200
400 -
69 70 71 72 73 74
Year
69 70 71 72
Year
73 74
Fig. 1
Fig. 1. — Pounds of cannabis (marihuana, A; hashish, B) removed from the
illicit market of the United States by Federal agents. The information is from
the statement before the subcommittee by Andrew C. Tartaglino. Note the ex-
ponential increase from 1969 to 1974.
247
10,000
_ Doubling time -
-1.54 yr = 46%/yr
FEDERAL
SEIZURES
Marijuana THC
Hashish THC
Millions of plants
seized in California
69 70 71 72 73 74
Year
:ig. 2
Fig. 2. — Kilograms of THC in the cannabis seizures. Marihuana is assumed to
contain 1.5% THC and hashish, 10% THC. The quantity of THC is on a loga-
rithmic scale, and a line matching the most recent increase in THC is drawn for
reference. Its slope indicates a doubling time of 1.5 years, or a rate of increase
of 46% per year.
248
0
Fig. 3
I i^— — r-H 1 —
20
£ 40
0
o
CD
Q- 60
—
— 1
J Frequency of cannabis use
80
- / UC
ma
le students, 1973 "
- / 18
22
yrs -
100
x\ I I
I I I I I I
0
2 4 6 8 10
No. of uses per week
12
Fig. 3. — The frequency of cannabis use in 200 marihuana-smoking under-
graduates, 1973.
249
100,000
co
_CD
'E
CD
>
D
'c
i_
o
<■£
"(0
o
CO
CO
CD
i_
k_
CD
CD
CO
c
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10,000 -
1000
100 -
HEROIN
10
1960 1962 1964 1966 1968 1970 1972
* Drugs requiring prescription but not including narcotics.
Fig. 4
Fig. 4.— Analysis of drug abuse trend (Jones, H.B., 1968). Based on Califor-
nia juvenile arrests for drug offenses.
250
List of Research Papers on Drugs Offered for the Record by Professor Hardin
Jones.
1. "The Deception of Drugs" by Hardin B. Jones, Ph. D., Clinical Toxicology,
4(1), pp. 129-36, March, 1971.
2. "A Report on Drug Abuse in the Armed Forces in Vietnam" by Hardin B.
Jones, Ph. D., Medical Service Digest, August, 1972.
3. "A Study of Drug Abuse and Its Prevention for the Armed Forces of the
United States" by Hardin B. Jones, Ph. D., and Helen C. Jones. (A report on a
worldwide study of drug abuse in the U.S. Armed Forces, conducted under con-
tract for the Department of Defense. )
4. "The Effects of Sensual Drugs on Behavior : Clues to the Function of the
Brain" by Hardin B. Jones. (Chapter 8 of PSYCHOBIOLOGY, Newton and
Riesen, John Wiley and Sons, Inc., 1974.)
Mr. Martin. Our next witness is Mr. Keith Cowan from Canada.
Senator Thurmond. Mr. Cowan, it is good to have you with us.
Will you identify yourself for the record and state your qualifica-
tions ?
TESTIMONY OF KEITH COWAN, PRINCE EDWARD ISLAND, CANADA
Mr. Cowan. Yes, sir; I am an adviser to the government of the
Canadian province of Prince Edward Island, director of an institute
associated with the University of Prince Edward Island, and a mem-
ber of the public drug education committee of the department of
education. My presentation today is made as an individual.
My special interest lies in the field of communications which is
applied in my work to the problems of drug education and labor
relations.
My background includes a honor's premedical science degree from
McGill University in 1940, and several additional years of night and
day university work in the humanities, labor relations and commu-
nications.
Twenty-five years of work has been spent in industry, the informa-
tion media and government, including 8 years with the Economic
Council of Canada and the national productivity council, during
which time I prepared a 2-year study on the "Role of Communica-
tions and Behavioral Knowledge" for our National Commission on
Labor Relations.
Mr. Martin. Mr. Chairman, I believe Mr. Cowan will have to ab-
breviate his statement considerably in order to get through in the time
remaining to us. May I suggest that the entire text of his statement
be incorporated into the record as though read.
Senator Thurmond. Without objection, that will be done. Mr.
Cowan, your entire statement will appear in the record as you have it
prepared.
Mr. Cowan. Thank you.
Senator Thurmond. And then counsel will propound questions to
you to bring out certain points, and anything that you feel in addi-
tion, if you could do it.
When I have to leave to vote I will ask counsel just to continue the
hearing in my absence.
Mr. Cowan. General interest in drug abuse issues began with our
children's university years both in the United States and Canada in
the 1960's when drugs on the campus became a public issue and a
natural concern of parents.
251
A special interest in cannabis started 4 years ago when my cabinet
minister, the late Hon. Elmer Blanchard, our Province's Minister of
both Labor and Justice, asked if I could help him prepare a statement
to be presented to our National Commission on the Non-Medical Use
of Drugs, which is popularly known as the Le Dain Commission. The
Ottawa government had invited each provincial government to give
its views at the open hearings of the traveling commission. Prince
Edward Island was the only province which responded.
What began as a request for a "little" time has instead become a
continuous part of my work and concern to this day, touching per-
sons and organizations in several countries. My various responsibil-
ities over several years have permitted numerous visits to the United
States which made direct personal contacts possible with administra-
tors, deans and students at many American universities and research
centers investigating cannabis problems. This added greatly to phone
and mail exchanges and information from literature, providing data
for my presentation today on "Cannabis and the Communications
Gap."
When the poet suggested that "ignorance is bliss" he could not have
been aware of today's vast and, I believe, dangerous communications
gap on the subject of the harmful effects of marihuana and hashish.
Evidence is mounting in Canada and the United States that huge
numbers of youth at increasingly lower age levels in schools and
neighborhoods, many young professionals and important press and
other media accept cannabis as a basically harmless recreational drug
which should be as available as alcohol or tobacco. The evidence of
these hearings warns us to the contrary.
It is clear from my work that this "benign" image is one of the
major causes of the drug's wide acceptance and use. Therefore, Mr.
Chairman, your subcommittee of the U.S. Senate deserves high com-
mendation from within and without the United States for bringing
together thoroughly qualified medical researchers from around the
world to testify in public hearings in order that carefully prepared
evidence might help to close such a serious gap in public knowledge.
You have heard from recognized authorities at these hearings of
specific and serious problems which arise from the steady use of
marihuana and hashish, such as long-term retention and accumula-
tion of cell-interfering chemicals in the fat cells of the brain and
reproductive organs, significant chromosome breakage and DNA
damage, serious immunity and hormone interference, traffic dangers,
reduction in the abilities of the higher levels of the mind such as
memory, intellectual capacity, coordination, potential irreversible
brain damage and so on. Some of the evidence has only become known
in the last 2 years, but strong warnings have been available for many
years as clinicians had observed harmful effects without knowing the
how or why.
In spite of such evidence, pressures are being exerted on Western
World governments to take irretrievable steps towards the legaliza-
tion of cannabis products, perhaps more fiercely in the United States
than anywhere else. While the governments of Great Britain, France,
and Canada have made firm decisions to hold the line on any spread
of the drug through heavy legal penalties for trafficking and con-
252
tinued but reduced penalties for possession, public evidence of pres-
sures on American State, civic, and Federal governments has given
Canadians concerned with the problem, considerable anxiety due to
the lengthy common and friendly frontiers. Drug traffickers recog-
nize no custom barriers.
What gives these political pressures credence, is the general com-
munications gap particularly among the youth.
A few illustrations of this gap may suffice.
The most recent have come to my attention since arriving in Wash-
ington to attend these hearings. Two young men visiting from De-
troit, Mich., dropped in on the first hearing. Afterward, one of
them, a teaching assistant, wanted more information since he seriously
questioned the evidence of harmful effects which he had heard for the
first time. He announced that he enthusiastically supported the drive
to "decriminalize" marihuana. He said that he had read the National
Commission report, the books of Dr. Grinspoon of Harvard and knew
of the work of the organization called NORML — National Organiza-
tion for the Reform of Marihuana Laws.
"What evidence have you read of the harmful effects of the drug?"
I asked. "Well," he said with a puzzled look, "I haven't read of any
serious problems." The other youth did recall having seen one item
about hormone damage in a recent Detroit newspaper.
The almost closed mind of the first youth, a teacher who had done
some reading and research, and his apparent missionary enthusiasm
to liberalize the use of cannabis as a harmless drug is a common
phenomenon.
In the last few days I also met a well-educated, highly intelligent
Washington couple from the business community, with children in the
young teenage bracket. When I told them of the evidence presented
to this hearing, they were greatly incensed because they had not heard
of it before. "We have been trying to find out something authentic
about this drug without success," said the mother. She knew that the
drug was being used in the neighborhood and wanted to discuss the
question intelligently with her children.
A local university dean told me last week that, with virtually no
evidence to place against his children's reading and the accepted belief
among their friends, he had very great difficulty making a case to
discourage them from using it.
A responsible Washington public official informed me that he finds
the young college person coming onto his staff generally favorable
to the open use of marihuana and disdainful of any harmful effects.
A relative of mine from the State of Washington reports that her
son's high school teacher told the clas during a drug education pro-
gram that marihuana was the only drug for which she had no ade-
quate information.
A quiz conducted in a Texas high school showed that out of a class
of 25, only two students believed that any harm could come from us-
ing marihuana, and neither of the two could describe any specific
difficulties.
Last year, a University of Michigan team conducted a high school,
classroom drug education program, in which the pro's and con's of
marihuana, tobacco, alcohol and one or two other drugs were listed
253
on the board, side by side — without any judgment or evaluation. It
was found, however, that the use of marihuana increased significantly
following these presentations. I phoned the professor in charge, and
asked if certain of the information which has been presented in this
hearing and was then available had been listed among the harmful
effects of marihuana. "No," was the reply. From the manner of pre-
sentation, in my analysis students could see no basic difference be-
tween tobacco, marihuana and alcohol. And since they themselves
had tried or were using alcohol and tobacco, along with most of their
parents, it seemed reasonable to use pot as well.
Discussions with a cross-section of people from many parts of
Canada and the United States over the past 3 years, including meet-
ings with groups of students, confirm the impression that a belief in
the essential harmlessness of marihuana is a widespread viewpoint,
especially at school and university levels.
Last month, I sat in a gathering of Canadian high school students
from a fairly large area. They were frank about the growing use of
cannabis in 'lower grades and the fact that general opinion in the
schools favored the legalization of marihuana because it was harm-
less.
Knowledge about this communications sickness was sharpened when
I recently met with educational officers from Canadian drug addiction
organizations. When I presented a summary of the evidence you have
been hearing, the majority of those present were either startled that
such information existed or attacked the information as inaccurate,
as yet unproven, or highly biased. A representative of Canada's
largest drug addiction organization reported categorically that his
group were "less concerned" about marihuana and its effects than they
had been 5 years ago. The second largest organization suggested that
they had never been given any evidence to be concerned about by the
universities upon whom they depended for information.
Even more disturbing is the report from Canada's Toronto Globe
and Mail of December 21, 1973, on a new study conducted by the
Ontario Addiction Research Foundation which shows that high
school teachers tend to be more favorable to the legalization of mari-
huana than students. The more the person knows about the drug,
according to this research, the more permissive he or she becomes
and, of course, teachers had read more than their students. Assum-
ing some accuracy in this study, the question we must ask — as I did
of the youth from Detroit— is, "What has been read by the teachers
of this continent and all the others to produce such a favorable atti-
tude to legalization?"
During the last 3 years, the national press of Canada and, as sev-
eral witnesses have reported, the U.S. press as well, has almost totally
emphasized the harmlessness of cannabis. Some encouraging changes
have begun, however, in the past 6 months, I am pleased to report.
To illustrate the problem, last September 25, Canada's largest
newspaper, the Toronto Globe and Mail, ran a lead editorial on the
excuse of the announcement by a Toronto dentist who claimed that
regular marihuana smoking seems to keep teeth clean — so might ni-
tric acid. The editorial totally exonerated the drug from causing any
medical problems. The real and only harm came to youth because of
33-371 O - 74 - 18
254
breaking the law. And in any case, the editors suggest, doctors, law-
yers, university professors, et al., are now using the drug. By infer-
ence, "let's get on with it," and smoke up.
One month earlier, the same paper carried a full-page review of
the U.S. Consumers Union volume "Licit and Illicit Drugs" accom-
panied by color drawings and a headline entitled, "Are Laws More
Damaging Than Drugs?" emphasizing, with faint criticism, the
book's theme and the policy position of the Consumers Union, namely,
that penalizing laws for all drugs, including heroin, rather than the
drugs themselves, had caused the most damage to society and indi-
viduals. To the layman, says the paper, this book is "most convincing"
and from a "long respected source," adding that the Consumers
Union expects that the book "will have a great impact on public
policy."
Again, on February 12, 1974, a three column story on cannabis
research in Ottawa Laboratories plays up a "research student's"
comments — made while rolling a joint for himself — that he had be-
come convinced marihuana was "less harmful than alcohol or ciga-
rettes" and should be legalized. More cautionary comments from the
professional researchers themselves were buried in following para-
graphs.
A similar pattern is evident in the American press. The New York
Times, which has an important Canadian readership, used to give
good space to news critical about marihuana. This has almost stopped
dead for the past few years. Not one word on these hearings, for
instance. While the Washington Star-News carried an excellent story
critical of cannabis following the opening day of these hearings,
nothing appeared in the Washington Post until 2 days afterward
when a four column, well-displayed story written by Tom Braden
appeared on the editorial page of May 11. Its title, "Slow Progress
on the Marihuana Front" was set off by a sizable picture of police
officers in a marihuana patch. In telling of changes in States laws to
reduce penalties for marihuana use, the article claimed that "no re-
spected bod}^ of opinion any longer holds that moderate consumption
is any more dangerous to the human body than consumption of to-
bacco or alcohol" — a fallacy that is contradicted by the evidence pre-
sented at these hearings.
Nothing appeared about the evidence from the hearings during the
next few days in the Post, even though one of its writers had tried
to contact one of the witnesses by long distance phone before he came
to Washington. The Post of May 17, which came immediately after
the revelation before this committee of the high probability of brain
damage and cancer resulting from pot use, not only carried no story,
but carried six other well-displayed items on health and drugs, cov-
ering about 140 column inches.
The Washington Post has a great impact outside your country
because it is quoted extensively in other papers. Intelligent readers
in other countries rely heavily on quotes from the Post for informa-
tion about the United States. The Post also commands special interest
because of its reputation as a paper which is continually attacking
coverups, or what it believes to be coverups. The Post has the right,
of course, to publish Mr. Braden's profoundly mistaken column on
255
marihuana — even though columns like this encourage young people
to experiment with pot and then go on to become regular users. But
was the Post not guilty of the kind of coverup it denounces so reg-
ularly when it decided — and it could only have been a deliberate de-
cision— not to report on these hearings? Their decision to ignore the
hearings was all the more difficult to understand because of the inter-
national eminence of the scientists who testified, because of the news-
worthiness and public importance of the research on which they re-
ported, and because of widespread public and family concern over
the issue.
Hopefully, the publishers and editors of the Post will reconsider
their attitude, and will take the time to examine the scientific findings
on cannabis presented to the subcommitee and then make this infor-
mation available to their readers. This is something that their read-
ers have the right to know.
The sad truth is that highly important and cautionary evidence
has been available for years in the literature and in the experience
of prominent medical men who have treated cannabis habitues. But
it has not reached our youth and the public in any effective way as
yet. Neither the United States nor the Canadian national commis-
sions have succeeded in this vital educational job. In the United
States, the report of the National Commission on Marihuana has
been interpreted as providing a green light to the eventual legaliza-
tion of the drug. In Canada, the Le Dain Commission's final cannabis
report contains important cautionary material, but, perhaps due to
the Commission's split decision, it has not deterred large numbers of
Canadians from believing otherwise.
On a recent trip to England I searched bookstores associated with
the University of London and the University of Oxford. Excepting
one book, the only books openly available gave cannabis a basically
clean bill of health. One document stated succinctly that science had
not established that marihuana was as harmful as tobacco. Another
book, prominently displayed at London hotels and tourist bookstalls
for the more adventurous youth who were seeking "underground
London," gave a full chapter to disproving any harmful effects and
suggested that a secret British commission had cleared the drug for
legal use, but the Government was afraid to make it public for polit-
ical reasons. I learned, officially, that such is not the case.
Visits to five other universities on the U.S. eastern seaboard brought
the communication gap home even more seriously. In one major
university, I thoroughly investigated the literature in the bookstores,
and every single drug study was favorable to cannabis. The dean of
students told me that while they were observing ill effects on students
using the drug in increasing numbers, they had no confirmation in the
general literature to support their observation, and were therefore
silent. Comments from several knowledgeable observers of campus
life suggest that students on this continent will find almost all readily
available books lacking in suitable cautionary material at their cam-
pus book shops.
Time has permitted a visit to only one Washington bookstore. A
careful look at all books on display for sale on drug problems re-
vealed that only one book detailing effects of popular illicit drugs
256
was available — a Ford Foundation sponsored study dated 1972 in
which a Dr. A. T. Weil categorically states that cannabis was the
only common drug which has no significant physical or mental harm-
ful effects. Technical books have also been at fault.
In the summer of 1973 a scholarly article appeared in the U.S.
"Journal of Drug Issues," written by three up-and-coming minds in
the legal profession, all holding significant posts, one a Canadian. It
proposed that cannabis be removed from international restrictive
legal controls. Why? Because, and I quote, "The assumption that
cannabis has significant inimical effects on the user and the society
in which he lives was the reason why cannabis was subjected to the
controls of the United Nations 1966 Single Convention. Inasmuch as
this assumption has been contraverted by a number of comprehensive
empirical studies, and because no evidence has offered to substantiate
such assumptions, it appears the raison d'etre for subjecting cannabis
to international controls is lacking."
The findings of four major national commissions were used as
prime supporting evidence — the British, United States, Canadian,
and Dutch Commission.
The study seriously erred in failing to mention the cautionary
warnings from the United Kingdom, United States, and Canadian
Commisison reports. It has been parlayed around government justice
departments for serious study I am informed.
Last week, the executive committee of the Illinois Bar Association
voted to recommend the removal of all penalties for possession and
use of marihuana. On inquiry, Malcolm S. Kamin, chairman of their
Individual Rights Committee reported that the organization NORML
had encouraged this move by informing his committee both in person
and by literature that marihuana was no more and probably less
harmful than tobacco or alcohol and on this evidence, with none other
available, the decision was made.
Mr. Martin. Could you define NORML for the subcommittee?
Mr. Cowan. Yes, it's the National Organization — I get confused
with all these various long names
Mr. Martin. National Organization for the Removal of Marihuana
Laws?
Mr. Cowan. It's the Repeal of Marihuana Laws ; it's the word "re-
peal" that I was trying to recall. I am so used to using the short form.
Mr. Kamin said it was a personal presentation and the evidence
which they provided which gave the Illinois Bar Association the
position which they accepted, that this was a basically benign drug,
probably less harmful than alcohol or tobacco, in the words, "In the
lack of evidence to the contrary" they of course accepted that posi-
tion. He has asked me for material. I followed it up because it seemed
to fit in with this material.
(Regarding the United Kingdom, United States, and Canadian
Commissions, all were agreed in cautioning against the nonmedical
use of the drug.)
A slick paper medical handout supplied free of charge through the
mails to American doctors called "Medical Economics," carried a
19-page special feature entitled "Learning to Live with Drug Abuse"
on May 28, 1973. It suggests the Shafer Commission has said what
257
everybody has known for years — namely, and I quote, "for most
people, based on what we know, marihuana is a relatively safe drug."
In a headline it also says "Decriminalization laws are giving young
people assurance that marihuana isn't so bad after all." Decriminali-
zation— with eventual controlled legalization like alcohol — comes
through as the recommended way of the future. No mention is made
of any of the serious effects being considered here.
The promotion and massive distribution of books favorable to mar-
ihuana by the organization NORML and other similar groups, as
well as the Consumers Union, adds to the availability of pot permis-
sive literature everywhere.
Evidence has also been given previously before the commission on
the disproportionate amount of time TV has given to promarihuana
sympathizers.
A brief look at the Theory of Communications may help to under-
stand the communications gap phenomenon.
Communications Theory suggests that each person in the process
of either sending or receiving messages from or to another person
tends to either block or alter these messages through a variety of
filters or altering devices built into the human system. Years ago,
Walter Lippman. brilliant American journalist and philosopher, de-
scribed the No. 1 human filtering device in these words : "The images
in our head and the reality in the world around us."
The "image' of cannabis which we hold in our heads becomes criti-
cal, for we will normally view facts about cannabis according to that
image. It is easy to visualize how our Detroit teacher had read cer-
tain books, reinforced by newspaper stories, the comments of friends
and peers and because of the slowness of the drug to cause visible
harm found it easy to develop a benign image of Cannabis — which
tended to filter out negative information about cannabis.
Until the late 1950's. marihuana was little used in North America,
feared as a drug of immediate and terrible consequences to human
health and sanity and was placed under the heaviest penalties of our
narcotics laws. The Dr. Tim Leary's. some early research, and other
writings destroyed the validity of the "terror" image. "Scare tactics"
were condemned. The removal of fear was unquestionably a prime
cause of the drug's immense immediate spread. We had to ask our-
selves in our pre-Le Dain analysis on Prince Edward Island, how-
ever, "did it follow that a proper removal of the terror image neces-
sarily permitted the substitution of a benign image implying full le-
galization and open public availability?"
The filter of Values and Concepts is also important :
Four years ago our Minister of Justice and our Cabinet had to face
the values to be used in making a decision about cannabis before the
presentation to the Le Dain Commision.
It was ascertained from reliable medical authorities that clinical
observations over a long period of time had shown up, certain possi-
bly, serious harmful aspects of cannabis use which modern research
had not yet verified. From his value system, the Minister reasoned,
the role of a government is to take responsibility for the overall social
health and well-being of the community — concerns regarding pollu-
tion and thalidomide, are examples. Looking back over the contro-
258
versy, it is pleasant to read the final Le Dain "cannabis" statement 3
vears later, in which four of the Commissioners agreed on the con-
cept that "harm is the most useful criterion for social policy" (p.
265), either to self or to society.
These clinical observations would have to be taken seriously until
such time as medical research had clarified their seriousness. Clinical
observation, we were instructed by our medical advisers, is an im-
portant tool of medicine.
Therefore, said the Minister in his presentation, "We strongly
condemn any move by this Commission to recommend, or any move
by the Federal Ministers of Health or Justice, to legalize or liberalize
the use of marihuana at this time, as a betrayal of the trust which
the people of Canada have placed in you, and a betrayal of the so-
cial, medical principles under which other drugs are abruptly re-
moved from the market, when only preliminary research has indi-
cated possible human danger" . . . "far more research is needed before
any liberalization could possibly be considered," he added. In short,
when warning flags are up, "A drug must be considered guilty until
proven innocent," the title of our second brief to the Le Dain Com-
mission given by the suceeding Justice Minister of P.E.I., the Hon-
orable Gordon Bennett.
Concepts and values also played a role in the legal problem. Society
is always endeavoring to solve the equation between total personal
freedom and the need for order. I can only be free to the point where
what I do unduly interferes with another person's freedom and vice
versa. We legislate both protection against undue interference from
each other and human rights together.
Therefore, the Minister, backed by the Cabinet, not only called for
continued restrictions but also for a reduction of penalties for mere
possession — no jail sentences for first and possibly second youthful
offenders, with the removal of a criminal record after 2 years of good
behavior. In operating the law, he added, youth should nevertheless
come to understand that this is a "no-nonsense matter."
It was a plea for time to establish the validity of the warning
signs. We have some evidence that P.E.I.'s plea was heeded in high
places, even if only dimly in the Commission's Interim Report.
All of the above, of course, places a high value on the worth of the
individual.
The second filter is emotion. If I dislike or fear someone or some-
thing I tend to pass along selected information which supports my
fear. And worse, I filter out facts which don't support my dislikes.
The opposite follows. A young adult who has developed a desire for
the pleasure of the marihuana or hashish high, whether it be physical
or psychological, will filter out information which threatens his
pleasure and probably let it influence his judgment, say, if he is in
the news media. England's Dr. Fairbairn told me of a recent visit to
Greece, where he observed incapacitated "hashaholics" who became
quite violent if any move was made or threatened to cut off their
supply of hashish.
The third filter of importance is that of objectives or goals. If you
have committed yourself to an evening out with the boys, or a day
off on the golf course, you will find how readily you produce sup-
porting evidence and reject facts threatening your goal.
259
Considerable numbers of determined individuals, some profession-
als, and a few well-organized, seemingly well-financed groups, es-
pecially in the United States, are bent on an all-out campaign to
achieve the goal of legalizing cannabis, either through full-scale,
alcohol-type distribution systems or by a process of de facto legaliza-
tion by removal of all le<zal penalties for use and minor distribution.
Journalist Edward M. Brecher appears to reveal the true goal or
expectation of full legalization while promoting a de facto program
in his report "Licit and Illicit Drugs," of the Consumers Union in
these words, "One step short of legalizing marihuana would be the
abolition of all penalties for possession * * *." When there is a de-
termination to legalize or decriminalize marihuana, writers, leaders
and followers put this communication filter to work. An organization
based in Washington, B.C., called the National Organization for the
Reform of Marihuana Laws better known as NORML, seems to be
the most powerful. It puts out full page ads in magazines soliciting
support. The ad is clever, misleading selection of data from the U.S.
National, or "President's" Commission Report on Marihuana de-
signed, of course, to support their goal. Four so-called myths are
listed, and then denied in selective quotes from the Commission doc-
ument under the title "Fact." For example :
The myths are 1. "Marihuana leads to heroin," 2. "Marihuana use
causes crime and aggressive behavior," 3. "Marihuana is addictive,"
4. "Marihuana users are societal dropouts."
In each case the answers leave out important qualifications which
are contained in the Shafer Report.
Shafer said, for example —
The fact is apparent that the chronic, heavy use of marihuana (1) may
jeopardize social and economic judgments of the adolescent and (2) on the
basis of past studies . . . seems to constitute a high-risk behavior, particularly
among predisposed adolescents.
In conclusion it reads, "The incidence (of this behavioral pattern
in the U.S.A.) is too frequent to ignore." The Report also calls for
discouragement of the drug's use in strong words and for more effec-
tive measures to prevent its growth and all trafficking — both omitted
from NORML's ad.
Unfortunately, the manner in which the staff of the Shafer Com-
mission has placed the words and paragraphs together in their first
report is either a communications stupidity or it is a calculated effort
to distract attention from the report's strong cautionary language
which Dr. Henry Brill of the Commission has reported here was the
true intention of the members of that body.
Since the goal of the NORML group isWowedly to lobby against
criminal penalties for marihuana use, and to work for the same kind
of Government controls that are used on alcohol — Medical Economics,
May 28, 1973 — it would be natural to expect them to filter out infor-
mation which would interfere with their goal achievement — such as
harmful effects from marihuana use — and to promote favorable
information.
Part of the funding which NORML achieves from the sale of its
promotional literature, as well as from the Playboy Foundation, was
used to buy the rights to the old 1936 antimarihuana movie "Reefer
260
Madness" which is now being shown up and down the campuses and
schools in Canada and the United States.
The film is a horror-type documentary suggesting instant madness
from the use of one joint of marihuana. The kids come and laugh
themselves hoarse because the reality of smoking the drug, at least in
the early stages, seems to them to have no bad effects — only pleasure.
In a subtle way, however, the film reinforces the benign image
filtering mechanims, so that a person becomes more and more im-
mune to believing negative facts about the drug. "Scare stuff" say
the kids — if you don't put your truth effectively.
NORML also supplies a regular team of spokesmen for seemingly
every state or civic hearing on legal changes or court trials.
One would also have to ask what were the objectives, or communi-
cation filters, of the National Coordinating Council on Drug Edu-
cation in Washington, D.C., when a recent issue of its National Drug
Reporter lists available study material and includes all of the fav-
orable marihuana texts but makes no mention of cautionary writings
such as the works of Drs. Nahas, Bloomquist, Louria, Paton, Mechou-
lam, et cetera.
Possibly the most serious distortion has been committed in Brecher's
"Licit and Illicit Drugs." On what can be demonstrated as erroneous
and incomplete information, the highly respected Consumers Union
executive which sponsored the study, recommends "immediate re-
peal of all Federal and State laws governing the growing, process-
ing, transportation, sale, possession, and use of marihuana," in an
accompanying commentary.
Brecher used as his chief source quoted references from Le Dain's
first "Interim Report." He draws vital conclusions, suggesting that
they are implied in the "Interim Report." The final Le Dain report
"Cannabis," however, directly contradicts Brecher.
For example, "Licit and Illicit Drugs," drawing from the Le Dain
"Interim Report," claims for marihuana that
1. it is not addicting; 2. it is tolerance-free; 3. its physical depend-
ency reports are suspect; 4. its short-term psychological effects are
slight, and have little clinical significance; 5. it has little toxicity
with overdoses; 6. its stepping-stone-to-other-drugs theory is errone-
ous; 7. there is no evidence of lung cancer.
And summing up, "with respect to psychoses and other adverse
psychological effects . . . the Le Dain report is on the whole quite
reassuring."
Le Dain's final report contradicts or heavily qualifies each of these
statements, for example :
The effect of cannabis in the mind is a potent one.
It is not unreasonable to assume that persistent resort to cannabis intoxica-
tion may produce changes and impairment of will and mental capacity . . . (the)
result of some biochemical effect. . . .
We believe that by stimulating a taste for drug experience . . . cannabis must
be reckoned as a potent factor contributing to the growth of multi-use drugs.
What has come to our attention with respect to long-term effects since the
Interim Report is a matter for cautious concern rather than optimism.
On lung cancer, Le Dain suggests that it is "not an unreasonable
possibility" while also admitting the "possible effect on chromosomes
and human foetus."
261
"Licit and Illicit Drugs" also puts forward the claim that :
Marijuana is here to stay. No conceivable law enforcement program can curb
its availability.
Prohibition does not work.
A law enforcement policy that converts marihuana-smokers into LSD or
heroin users should be abandoned.
While Le Dam's majority finding in contrast agrees that:
In our opinion, these concerns justify a social policy designed to discourage
the use of cannabis as much as possible.
The state has a responsibility to restrict availability of harmful substances
. . . and that such restriction is a proper subject of criminal law.
A policy of making cannabis legally available under government controls
would increase, rather than reduce availability. . . .
And finally, there is "no doubt that criminal law creates risks for
the trafficker."
No possible excuse can be made for Brecher's failure to notify the
Consumers Union of the contradicting evidence provided in the final
Le Dain report, when he used the Le Dain Interim Report for his
source of knowledge.
Nor can the Consumers Union be excused for failure to draw atten-
tion to the Le Dain conclusions and to the new, completely contra-
dicting, evidence in ensuing monthly issues of their Consumer Re-
ports which carry large advertisements for "Licit and Illicit Drugs"
and are available on most Canadian newsstands. A request to the
Consumers Union by last year's president of the Canadian Medical
Association, Dr. Gustav Gingras, for such printed corrections in
order to undo the harm caused to readers of this misleading book,
was flatly refused.
OTHER GOALS
Evidence is accumulating on what I believe to be a relatively small
number of people whose goals are not based on misconceptions about
the harmful side of marihuana. How much influence they have, no
one can say, but their efforts cannot be entirely neglected. One ele-
ment openly seeks an overthrow of present society, and announce that
pushing drugs is an integral part of the program. The Le Dain
hearings produced evidence from one young witness that he and
others intended to use drugs to destroy society, but it would probably
be necessary to correct the drug program and its damages after they
had succeeded.
The "Weatherman" group in the United States has issued bulletins
suggesting that "grass and the revolution are inseparable." And "The
Brotherhood of Eternal Love" established by Dr. Tim Leary for the
avowed purpose of societal change are thought by international po-
lice forces to have been the world's largest manufacturers of illicit
LSD. A number of people identified with their organization have
been apprehended by police in the past several months with large
quantities of hashish in their possession.
Cash profit can also be a motive for information distortion. One
prominent doctor told me that a cigarette manufacturing company
had approached him to ascertain exact knowledge about marihuana.
That company became convinced of its harm. . . . What about others,
or less reputable groups attracted by the rewards from big time
262
trafficking. Many youth have also found the sale of marihuana in
small lots financially rewarding.
It may be of interest to note that in Canada, a Commission on
Youth under the Secretary of State turned out a document in 1971
for national distribution calling on the government to legalize mari-
huana for everyone over 18 on the grounds that "soft drugs are rela-
tively harmless, or at least, so they seem in the absence of any con-
clusive medical evidence to the contrary." Fortunately, prominent
Canadian medical men and the Canadian Medical Association had
strong words to say to the government about this misleading claim.
Strangely, a committee at the National Y.M.C.A. headquarters
turned out a newspaper for distribution to youth from each "Y"
across Canada calling on young people to study the Commission re-
port, referring specially to the marihuana recommendations. They
asked youth to make their voices heard in parliament on the issue.
Fortunately, wiser heads prevailed.
The methods of the pressure groups sometimes raise serious ques-
tions :
SANE, short for "Committee for a Sane Drug Policy" of Boston,
Mass., joins NORML in reaching out to knock down any opposition.
When Dr. Nahas appeared before a committee of the Massachusetts
legislature considering the reform of marihuana laws last year, this
organization rilled the hall with supporters and presentations. Dr.
Nahas, almost alone, presented the other side, based on research evi-
dence. He was publicly attacked as "irresponsible," by NORML
adherent and SANE cooperator Dr. Grinspoon.
Recently, while in England, I was shown the June 1973 issue of a
monthly English bulletin called Drugs in Society, which carried a
brief account of Dr. Morton Stenchever's discovery of chromosome
breakage at the University of Utah. In the issue for the following
August, I was shown a written personal attack on the integrity of
this highly qualified scientist written by a Marsha Semuels of Bos-
ton, who signed herself as "coordinator" of SANE. Dr. Stenchever
was charged in her letter with not being a pharmacologist, nor a
medical researcher, but a teacher of gynecology "whose study had not
been published," and in the writer's own words "probably never will
be." "What has been reported as scientific evidence," she adds, "is
merely a speech the doctor made at a conference. It cannot, therefore,
be taken seriously."
I, too, had talked and corresponded with Dr. Stenchever, and as
you heard last week, he has conducted extensive research for years,
advanced genetics is his scientific discipline and his study did appear
in The American Journal of Obstetrics and Gynecology of January
1974.
Under severe attack for his work, however, the doctor briefly con-
sidered giving up the project rather than become involved in "polit-
ical" issues. Vicious letters and phone calls, questions from those fi-
nancing his research, a bitter attack in the college newspaper by its
editor, came close to stopping this important research, which others,
once tipped off, have now confirmed.
The attacks on Dr. Nahas have been equally vicious. Following the
publication and press release of his immunity damage studies on
263
January 25, 1974, K. Keith Stroup, director of NORML, wrote a
letter on February 2 to the Columbia University student newspaper,
the Columbia Daily Spectator which was published February 22.
After quoting a review criticizing the methodology of Dr. Nahas'
book "Marihuana — Deceptive Weed" by a pharmacologist in the
Journal of the American Medical Association, Stroup quotes from a
review in the New England Journal of Medicine which calls the book
filled with "half truths, innuendo and unverifiable assertions." Stroup
neglects to mention that the author is Dr. Lester Grinspoon, promi-
nent member of NORML's advisory board, who is then quoted di-
rectly when he calls Nahas' work "psychopharmacological McCarthy-
ism."
Stroup includes, as well, a quote from Dr. Norman Zinberg, also a
NORML board member, which calls Nahas' work "meretricious
trash," and done by a man who is "solely and cynically interested in
picking up a few bucks by playing on the public's enormous concern
about drug use."
Since none of the national commissions reported similar finds,
states Stroup, nor is it seen in clinical evidence he claims, Nahas must
be dismissed as a man who "favors treating marihuana users as crim-
inals" and whose attitude as well as his study is based on "self-
righteous fanaticism."
Stroup has erred in failing to mention that Canada's Le Dain
Commission did foresee the possibility of future chromosome damage
and it must be noted that the attack is based on the Nahas book, not
the research paper. On a much more serious point, we must ask why
a "responsible" body concerned about the well-being of humanity
should not first seriously examine the actual full detailed facts of the
Nahas research, its procedures, et cetera, in the light of the harmful
implications to health and future generations should his findings be
accurate — instead of attempting the character assassination of the
man.
No full detailed criticism of the extremely careful research done by
this brilliant team from Columbia, which includes Dr. Morishima
who testified here last week, has been done by NORML or the medical
reviewers mentioned.
Stroup sent an additional, even stronger letter to the dean of Dr.
Nahas' department at Columbia, in a further attempt to discredit
him. It was, of course, ignored, I am informed.
Attacking the man personally and not his actual work raises ques-
tions about the attacker and has no role in science.
I would also like to mention that the Science Editor of the Asso-
ciated Press in New York received an anonymous phone call on Jan-
uary 24, 1974, just before publication of the Nahas study suggesting
that the press story should not go out the next day since the work was
garbage and at least one of Dr. Nahas' team intended to publicly
break with the work because of his disgust with its inadequacy. The
caller was ignored. His facts were wrong.
I have presented evidence on certain American books, organizations
and newspapers since many American journals and other printings
are widely distributed and read in Canada and influence Canadians
as well as Americans.
264
Therefore, I hope very much that authors Grinspoon, Zinberg,
Goode, and NORML and the Consumers' Union, will examine this
new scientific evidence without delay. I am confident that they will
find it convincing. When they do, I hope they will move immediately
to give this information the wide public recognition it deserves — so
that hundreds of thousands of young people on this continent who
had believed their earlier statements about marihuana — statements
which were based on now-outdated research — can obtain the informa-
tion they need to help themselves to stop the use of the drug.
Time does not permit proper attention to the educational problem.
In Canada, reference is frequently made to the failure of all past
antidrug educational methods based on recent reports by some Amer-
ican drug education authorities, and their call for a moratorium on
all drug education until better methods are devised.
Such a delay in getting this new, clearcut knowledge about can-
nabis into the hands of teachers, parents, youth, TV, the press and
the public could only serve to continue the current escalation in the
use of this drug. The benign image af cannabis must quickly be re-
placed by the image of a drug with potential for serious personal
and social harm. A massive educational job is needed immediately.
While touring Capitol Hill last Friday, a group of the doctors who
had been testifying here were approached by a boy of about 10 years
of age who asked if they were Senators. On being informed that
these men were world experts on marihuana, he simply asked "Will
it hurt you?" He really wanted to know. So, I believe, do the vast
bulk of Canadian and American youth.
That is the end of my statement, sir; I will be glad to answer any
questions.
Mr. Martin. Thank you very much for a very illuminating presen-
tation. I must say that you have more or less answered all the questions
I was thinking of asking. Because of this, and because of the lateness of
the hour, therefore I believe we can safely let the record stand as is.
On the order of the Chairman, the hearing is adjourned.
[Whereupon, at 4:45 p.m., the hearing was adjourned subject to
the call of the Chair. 1
MARIHUANA-HASHISH EPIDEMIC AND ITS IMPACT ON
UNITED STATES SECURITY
TUESDAY, MAY 21, 1974
U.S. Senate,
Subcommittee To Investigate the
Administration of the Internal Sectjritt Act
and Other Internal Security Laws
of the Committee on the Judiciary,
Washington, D.C.
The subcommittee met, pursuant to notice, at 10:45 a.m., in room
2300, Dirksen Senate Office Building, Senator Strom Thurmond, pre-
siding.
Also present : David Martin, senior analyst, and A. L. Tarabochia,
chief investigator.
Senator Thurmond. The subcommittee will come to order. Since
this hearing today is a continuation of the one yesterday, it will be
unnecessary to swear the same witnesses.
Professor Jones, you were sworn yesterday?
Professor Jones. Yes, I was.
Senator Thurmond. And you will just continue with your testi-
mony today. Now since this portion of your testimony will deal with
security in the armed services, we have decided to take this part of
your testimony in an executive session.
Mr. Martin, you may proceed now with your questions.
Mr. Martin. Thank you, Mr. Chairman.
Professor Jones, in yesterday's testimony you gave evidence of a
general nature about the scale of the current marihuana-hashish
epidemic in the United States. Is there anything further you would
like to say for the purpose perhaps of affirming your estimate of
just how big this thing has become?
Professor Jones. In every locality of young people on the college
campus, the university campus, or in the high schools that I am able
to reach — and I have pretty well been into a sampling across the
whole United States — the involvement is of the order of 50 percent
of our young people. This means, of course, that we have tens of
millions of young people using marihuana, and some of them, of
course, use more dangerous drugs.
Probably at least 1 million people are dangerously involved at the
present time with use of cannabis and another 5 to 10 million of them
will progress to this level over the next few years unless somthing is
done to reverse the trend.
So the problem of marihuana probably is a good deal more serious
than that of heroin, although the heroin problem is also great. I
(265)
266
think that the heroin problem has been held in check more these last
2 years than I would have thought, considering its runaway nature
6 years ago.
Mr. Martin. Primarily this was due to
Professor Jones. The' law enforcement action in choosing the sup-
pression of heroin— the current lack of use of heroin is only because
it is not available, in my opinion.
Mr. Martin. May I get your reaction to an assumption that I have
been considering for the past few weeks. In the case of heroin, we had
the law enforcement agencies working against the epidemic in a very
concentrated way, throwing in larger numbers of men and operating
with larger funds and improved technologies. We also had the en-
tire school system basically on our side. No one thought that heroin
was good and no one defended the right to use it.
We also had the entire press on our side, so that you had a united
front between Government law enforcement, the academic commu-
nity, and the press. And this is why — the existence of the united front
is why we have had so much success in reversing the trend in heroin
use. Would you say that is a reasonable assumption ?
Professor Jones. Without contradicting myself, I can modify my
statement in that direction. What I meant to imply was that the
average marihuana user is relatively unrestrained about the drug use,
and if he is in a community of individuals who have heroin available,
he is likely to use it.
Now, I do think that the educational program against heroin has
brought about an attitude even in the drug movement sector in so-
ciety in which they are less likely to use heroin than in the past. And,
as a matter of fact, I think I have found in my own sampling of
students on the University of California campus this year, that the
marihuana users are somewhat less inclined to use heroin than the
last 2 years.
But you see, last year and the year before that, 40 percent of those
who were using marihuana more than three times a week had been
experienced users of heroin.
Mr. Martin. When you say experienced, you don't mean that they
were addicts?
Professor Jones. I don't mean that they were addicts, but they
were using heroin every now and then, whenever it was available.
And that number now has dropped to a little less than 30 percent;
and it is the drop in the numbers of people that I have, that makes
it a significant reduction statistically.
Mr. Martin. Are these percentages that you give us based on
your personal experiences with the 1,600 marihuana users that you
have interviewed?
Professor Jones. Yes, but the sample is larger because in my classes
I give out questionnaires in which I coach the students as to what
kind of information I am trying to get from them and why. And I
believe that my questionnaires are fairly reliably answered, and I
have a sampling that runs around 500 questionnaires filled out per
year, and have kept such records over the last 5 years. So you see,
that is 2,500 cases by itself. This does not represent those that I have
267
interviewed, so putting them all together, I have records of a sort that
would amount to a sampling of at least 4,000 individuals.
Mr. Martin. I would like to pursue the question that I asked pre-
viously. Professor Jones, in the case of the heroin epidemic. It now
appears to be accepted by most people who have knowledge of the
situation that we have succeeded over the past few years in reducing
the problem significantly ?
Professor Jones. We must have reduced the problem significantly,
because otherwise we would have been in a disaster right now with
regard to heroin, because heroin use from 1966 until at least 1972 was
doubling every 9 months — an exponential rate of increase. And I had
calculated and wrote one significant letter to the President — I don't
write to the President of the United States very often — but I wrote
a letter that was well conceived, and I believe accurate, pointing out
that as of that time there probably were about 1 million heroin users
in the United States ; most of whom should have been at a level in-
volving dependency on the drug.
Now I don't think we have increased very much since that time.
I think the reason for it has been that the supplies of heroin simply
have not been enough to keep up with the demand. The demand is
not urgent; the demand is just this foolish demand on the part of
cannabis users to take any kind of drug that is available.
Mr. Martin. I want to come back again to the question I tried to
make. In your opinion, is the fact that we succeeded in controlling,
or perhaps even pushing back, the level of heroin used in this country
due to the fact that we had not only the forces of the law
Professor Jones. Always in successfully dealing with the drug use
problems you have to use the coercive aspect of the law, the seizure
of contraband, and the educative force of every agency in society to
try and persuade people not to do these foolish things.
Mr. Martin. Including primarily the academic community and the
media ?
Professor Jones. Yes. And everyone has been in concurrence with
regard to the foolishness of using heroin.
Mr. Martin. Heroin — but when it comes to the question of mari-
huana we don't have this united front on the part of Government and
the media and the academic community? From your testimony yes-
terday, it appears — and correct me if this is not an accurate reading —
that the academic community and the media by and large have been
pushing in the opposite direction ?
Professor Jones. The academic community is the main source of
the problem with regard to propaganda to the use of marihuana;
propaganda unfounded in scientific evidence. Nontheless, almost
every campus has it
Mr. Martin. You also have some critical words to say about the
tolerant attitude of the media in your testimony ?
Professor Jones. Yes. They have done their bit because of the sensa-
tional aspect of the news in the academic world that the academic world
recommends cannabis; or that is to say, marihuana and hashish. The
media has been anxious to pick this up because it is sensational.
Mr. Martin. And where the forces of education in the academic
community and the media are operating, in effect, against the forces
268
of law enforcement, it becomes very difficult for the law enforcement
forces to do their job properly?
Professor Jones. It certainly does. And on top of that, you have a
significant segment of the social institutions of this country and their
related components in the educational system urging the acceptance
of a libertarian view to let everyone do what they want with regard
to any life choice, including the use of drugs. And these individuals
go well beyond even the libertarian point of view because they also,
among their ranks, have those who positively extoll the pleasures and
the desirable consequences of drug experimentation.
Mr. Martin. Let's come back to the actual scale of the current
marihuana-hashish epidemic.
Professor Jones. Yes.
Mr. Martin. You were presented yesterday with certain figures
compiled by the Drug Enforcement Administration at the request
of the Senate Subcommittee on Internal Security, showing the up-
ward trend in marihuana and hashish seizures by Federal agents
over the past 5 years. The question was posed in yesterday's hearing :
Do you feel that this has serious statistical significance in attempting
to assess the scale of the current epidemic ? I was wondering whether
you had an opportunity to consider this matter further, and whether
you might perhaps have used your statistical experience to make
some computations that would throw some light on the matter ?
Professor Jones. I have taken the raw information that was available
in the report and plotted it off on graph paper that I have already
submitted for the record. But that is good enough to say that the
points show a smooth orderly progression from year to year from
1969 through 1973.
There is no doubt that the rate is increasing, and also there is
no doubt that one can say flatly, that the rate of increase for the
last 2 years is surely exponential with an increase rate per year in
the rate of seizure of 33 percent. This is not a steady state; it is an
exponentially increasing rate, and one that will approximately
double every 3 years in the level of marihuana and hashish con-
sumed.
It is also interesting that marihuana and hashish turn out to be
increasing both at about the same rate, and the present number also
indicate that the THC load, which is the active ingredient in both
marihuana and hashish, turns out to be about equal for marihuana
and hashish for the country at large.
Mr. Martin. This is for the last year, 1973 ?
Professor Jones. For the whole period— well, for the last 2 years, let's
say. For the last 2 years, about the same.
Mr. Martin. When you say it is moving upward at an exponential
rate, what you mean is that on your graph paper it is not moving
up in a straight line, it is moving in an upward sweeping curve?
Professor Jones. In an upward sweeping curve. The curve is more
parabolic shaped. It is precisely exponential.
Mr. Martin. Would this rate of increase be more or less uniform
for all segments of the population, or would it vary significantly
from one section of the population to the other?
269
Professor Jones. It varies significantly from one segment of the pop-
ulation to another, but we can also say with regard to each subsection
of the population, for the fraction of that subpopulation that is very
susceptible to the use of drugs, that the rate of increase in use of
marihuana and hashish and other drugs is the same.
In certain groups in the country, though, the young people are
fairly resistant to drugs, whereas in other segments the individuals
are quite susceptible.
Mr. Martin. Which segments of the population, in your opinion,
are the most susceptible ? Which segments are most resistant ?
Professor Jones. In the many hundreds of drug users I have inter-
viewed I always get an idea about their origins, their family back-
ground. The drug users run a little bit more than 2 to 1 from broken
homes and from backgrounds in which the home environment is not
particularly stable. If the home is not broken, you also have to take
into account that either the mother or the father or both are alco-
holics. That is a pattern that is very much involved with whether
the youngster is going to be susceptible to drugs.
I don't think there is a genetic factor, it is a part of the home
environment.
Mr. Martin. You find higher incidence among the lower economic
strata?
Professor Jones. Yes, the lower economic strata of the types of indi-
viduals that would be involved in what would be called the ghetto
structures. It is not a question of the blacks, because whites live in
ghettos too. The Puerto Ricans, the whites at low economic levels,
and the blacks have undoubtedly the worst drug abuse problem in
any segment of the United States, being at least three times as bad
as the middle-class population at large.
Mr. Tarabochia. May I ask a question along those lines ? The fact
that the Army, since it has eliminated the draft system, is forced
to recruit personnel from the lower social strata — do you think that
this would account for a higher incidence of drug abuse in the
Armed Forces, and especially the Army, which may have lower
standards than the Air Force or the Navy?
Professor Jones. I think that this is exactly what one would have
predicted on a theoretical basis since the habits that individuals have
would follow from civilian life to the Army. Whether they use alco-
hol or tobacco or marihuana, or whatever, they would keep those
habits in going into the Army. The Volunteer Army, whose main
attraction is that individuals could be higher paid than anything
else they could do at home ; this works on a straight economic basis —
that there would be more individuals going into the Army from the
lower socioeconomic groups which are already contaminated by drug
use, at least a factor of two and perhaps a factor of three more than
the population at large. Then you will get new soldiers who start
out at a level of drug use that is markedly above what has been the
Army experience in the immediate past.
Furthermore, you have to allow for the fact that drug use has been
going up throughout the entire population. So these two combined
means that the military experience, for the moment at least, form
33-371 O - 74 - 19
270
the seeds of individuals who can become very heavily involved with
drugs. And the problem has worsened steeply over the last 5 years.
Mr. Tarabochia. So that you have two elements that contrive to
make the problem more accute: the lower strata of the population
which is inured to drug abuse, plus the intellectuals who are propa-
gandizing the use of drugs for reasons of their own?
Professor Jones. Yes. The military was fortunate during the Viet-
nam war in that they had few individuals of the college class who
were heavily involved with drugs.
But it is perfectly clear from the statistical records that I person-
ally gathered while I was in Vietnam that the soldiers who were
using drugs and got into trouble with heroin and heroin addiction
were very much more likely to be the ones who were using mari-
huana at home before they went into the Army. And the fraction
of soldiers using drugs at the time they arrived in Southeast Asia
matched the use of drugs in the population of the same age for that
calendar year that we knew in the home population.
Mr. Martin. I want to backtrack just a little bit to make sure
that the record is clear. Now you say that the rate of use in the
lower socioeconomic strata is greater than the average for the general
population by a factor of two or three?
Professor Jones. Yes.
Mr. Martin. Do you have a rough idea of what percentage of the
present volunteer Army is recruited from the lower socioeconomic
strata ?
Professor Jones. No, I don't have that information, but we could
get that.
Mr. Martin. It would be the bulk of the Army
Professor Jones. It would probably be the bulk of the Army at
the moment, since it has gone over to the volunteer basis. But the
point I was making was the fact that during this time when the
military has had such an obviously difficult time with drug users,
which was the war in Southeast Asia, the bulk of the soldiers who
were being inducted into the Armed Forces were outside of the
college class. If they had had even a third of their soldiers drawn
from the college class, they undoubtedly would have picked up more
drug users, because at the time it was the college class that was
heavily contaminated with drugs.
Now that contamination has spread more uniformly through the
population as a whole, but there is still a differential, especially with
regard to the level of drug use per person involved in which the
lower socioeconomic groups are two to three times more involved
with drugs than the middle class American.
Mr. Martin. So, as a rough estimate, do you think that there may
be twice as much drug use per capita in the Armed Forces ?
Professor Jones. The potential for having difficulties of the types
seen in Germany and Southeast Asia during the last 5 years has gone
up, probably at least a factor of two with regard to the military
because they are now taking in soldiers who are much more con-
taminated to begin with in terms of habits to use drugs and mari-
huana and beyond from the very beginning.
271
Mr. Martin. Could you tell us something about your specific find-
ings in the course of your investigations for the Department of
Defense in Vietnam and in Thailand and in Germany and in the
United States?
Professor Jones. I made two trips. First of all, the one was I
believe in 1970 and the other in 1972, to Vietnam, arriving in Saigon
and going through a selection of bases by helicopter in South Viet-
nam for the purpose of looking at the cause of heroin use and dem-
onstrating to the Army what could be done about rehabilitation of
heroin users.
In my first visit, I interviewed approximately 28 heroin users in
.'a 2-week period. I spent a lot of time in the interviews, so that
represents quite a bit of work. I was able to show, and I knew before
I went, that heroin users are sexually incapacitated. And we were
able to use this information of a very significant type in drug
prevention education.
We worked out the usefulness of the system, and also it's a major
factor of persuasion in getting the heroin addict to want to be re-
habilitated ; to remind him of the fact that the sexual functions can
come back.
Mr. Martin. During this trip you also made some observations
relating to the use of Vietnamese marihuana which was very wide-
spread among our Armed Forces?
Professor Jones. Yes, I looked into the matter of cannabis inten-
sively. I did much more than just interview heroin addicts. I was
interviewing and talking to every soldier and officer I came in con-
tact with with regard to a large number of questions that I had
in mind about the drug problem in the Armed Forces.
Mr. Martin. These interviews were over and above the interviews
with the 28 heroin addicts?
Professor Jones. Yes, indeed. Altogether I would say in the three
trips to Southeast Asia that I interviewed 88 heroin addicts, but I
probably interviewed on the order of 300 individuals who were not
involved with the use of drugs, because I considered every person
that I would talk to, that I could get a chance to ask some questions,
a source of such information.
Mr. Martin. We are interested in the information you gathered
specifically with relation to cannabis rather than heroin, because we
are not concerned with heroin as such in these hearings.
Professor Jones. The primary problem in Southeast Asia was can-
nabis. Heroin was a problem too, but the cannabis was also a very grave
problem.
Mr. Martin. How did it affect the security of our Armed Forces,
or are you in a position to offer any enlightenment on that?
Professor Jones. Well, the use of cannabis was a good deal more
prevalent than the use of heroin. And also, it has such a persistent
effect in making soldiers sloppy in their thinking, susceptible to all
sorts of suggestions of an absurd nature, and careless in all matters.
Mr. Martin. Is this based on your personal observations or is this
based on conversations with the commanding officers?
Professor Jones. I did not find a commanding officer who knew
272
that much about the cannabis problem, but they were worried about
the use of cannabis. This was my own information, largely based
on the total interviews that I have made of cannabis users. They are
all persistently affected in a number of separate ways that can be
documented, in mental functions, all in the direction of being less
acute in their thinking, less organized in their thinking, less memory,
and able to take less responsibility.
Mr. Martin. Did any of the officers you spoke to express concern
that the breakdown of discipline or the weakening of discipline in
the American Armed Forces in Vietnam might somehow be related
to the widespread use of cannabis ?
Professor Jones. The officers I talked to in Vietnam were worried
about cannabis because they suspected that this may have been a
part of some of the terrible events such as the murdering of officers.
Mr. Martin. The so-called fragging?
Professor Jones. The fragging of officers, yes. And believe me, all
of the officers were uptight about this situation because they didn't
know when it might be their turn. The incidence wasn't so great
that it would be likely to induce a neurosis in the officers, but it was
great enough to worry about, and they knew that this kind of event
was not associated with the heroin user, but rather with the can-
nabis user, and also the amphetamine user. But the amphetamine
user also had to be a cannabis user, and the tie between these two
is very, very great.
Mr. Martin. There were a number of officers who expressed con-
cern to you that the incidence of fragging, which reportedly was
very high, might be directly related to the widespread use of cannabis ?
Professor Jones. Yes. They also believe that.it might be due to
the amphetamines that were used there. I am not able to tell you at
this time, I will have to go back to my notes, what the amphetamine
was that was being used, but it was an amphetamine that produced
a psychotic state. It is not available in the United States.
Mr. Tarabochia. Was it speed?
Professor Jones. No. Speed is methedrine, and this was a German-
made amphetamine which has not been available in the United
States.
Mr. Tarabochia. This was available in Vietnam?
Professor Jones. Yes, it was available in Vietnam. The one thing
that was fortunate in Vietnam was that they did not, during the
years of the war at least, up to 1973, have to face the special prob-
lems of cocaine users. But the Armed Forces were rightfully worried
that at some point in time cocaine might be introduced. The drug
that was mostly available in Vietnam, or the two drugs, were the
home grown varieties of hemp, the cannabis drug, and also the pure
heroin which was available in large quantities below the world
market price.
Mr. Tarabochia. Am I correct in assuming that the potency of
native cannabis in Vietnam is higher than the ones found here,
Mexico, and Jamaica?
Professor Jones. Practically all of the users that I interviewed
were convinced it was 10 times higher than at home. I think the fact
273
is that it would probably be about rive times higher now, because
the quality of marihuana at home has gone up recently quite signifi-
cantly. But in the period of 1971 to 1973 when I was getting this
data in Southeast Asia, those who were using marihuana freely said
that it was 10 times more potent than at home. It would certainly
be 10 times more potent than, say, varieties grown in California,
and maybe 50 times more potent than the weak little marihuana
grown in flowerpots on window sills.
Mr. Tarabochia. And T presume that because of the fact that it
was locally grown and easily available it was even more pure than
the type of marihuana that can be found in the local market ?
Professor Jones. It Avas just stronger. Southeast Asia is a tropical
zone. It has good soil. And the marihuana plants grow high with
rank foliage, and the foliage is glistening with the resin that is the
active ingredient in marihuana.
Mr. Martin. To come back to the question of the problem of
security and the use of cannabis. Apart from the fact that many
officers expressed concern to you that there might be a connection
between fragging and the widespread use of cannabis, do you have
personal knowledge of any specific instances where there were viola-
tions of security or breakdowns in performance — in combat perform-
ance— or in the use of vehicles or aircraft, as a result of the use of
cannabis ?
Professor Jones. No, I was not in a position to get that kind of
information. The only infraction of military rules that I actually
saw while I was there was that a sergeant and an enlisted man were
driving into a camp enclosure in a military truck, and a sentry
searched the truck and found prostitutes in it. But that was the only
thing. And then, of course, the women were shooed out.
Mr. Martin. But you have no information that this was specific-
ally related to the use of marihuana?
Professor Jones. No, it was not related to the use of marihuana.
But it is interesting that the segment of the soldiers who were
very much interested in prostitutes is very likely to be the segment
of soldiers that are interested in the use of the drugs, especially
marihuana. And I never saw a heroin user in the army who had not
been active in the use of prostitutes, whereas in soldiers in general I
doubt if the use of prostitutes is as high as 50 percent, because the
more restrained individual is not so crude in his behavior.
Mr. Martin. But were you not saying a while ago, Professor
Jones, that heroin inevitably results in a loss of sexual potency ?
Professor Jones. Yes. But these were the individuals earlier in
the stage of their career as soldiers who had not yet taken heroin,
who then became heroin addicts. In the beginning they were using
marihuana and using prostitutes, too.
Mr. Tarabochia. Also, the use of prostitutes as a means to obtain
the money to pursue the habit of drugs. You have females who
prostitute themselves.
Professor Jones. Well, it was different in Southeast Asia. The
prostitutes there were not interested in getting money for drugs,
whereas in New York City, where I have interviewed prostitutes,
274
they turn out to run very heavily into heroin addiction. And it
works out in two ways; one, they have essentially sexual impotence
as far as the emotional side of sex is concerned, so it makes their
business just a mechanical one; and they are also interested in being
prostitites because they can get enough money to buy the drugs that
they need. So it is a feedback circle.
In Southeast Asia the prostitutes are not drug addicts, and the
only source of effective education is that the prostitutes knew that
those who were using heroin would not function sexually. So they
were spreading the word and were the only source of precautionary
information that I encountered.
Mr. Martin. I want to come back to the question again of the
general impact on our Armed Forces and how, specifically, the use
of cannabis on an epidemic scale may relate to the question of
security in the Armed Forces. It has been testified at the hearings
held over the past several days by a number of psychiatrists that
people under the influence of cannabis tend to be suggestible; they
can be more easily manipulated by agitators.
Professor Jones. Yes.
Mr. Martin. Would that jibe with your own experience with
cannabis users ?
Professor Jones. Yes. I have been pulling my notes together along
this line. But there is no doubt that the marihuana user is more
susceptible. We classify marihuana as a hypnotic drug. I think it is
fair to say that one of the persistent effects of marihuana is this
hypnotizing depression of the will and the ability to use reason in a
precautionary fashion. They are very much more likely than anyone
else to be drawn into impetuous and foolish activities. And I have
two examples that I think are quite secure in the support of this
statement.
Many of the young men that I have interviewed on the college
campus who are marihuana users have been induced into homosexual
activities. But if they confide this to me, it is usually on a basis that
they have been very worried about it and they have been anxious
to talk to someone who is professionally qualified along these lines,
because they felt that these experiences had been very hurtful to
them.
I have also had three in this category who have sobered up by
going off of the use of marihuana and hashish totally for a period
of several months, and these three have said without any doubt on a
reinterviewing that their foolishness in taking on a homosexual
experience was due to the fact that their will was so depressed that
they just were not able to say no.
Mr. Martin. Let me come back to the question of manipulation
by agitators.
Professor Jones. I did not finish my examples, though.
Mr. Martin. Go ahead.
Professor Jones. The other big evidence for this is the relationship
between marihuana and heroin. If a marihuana user has not yet
used heroin, he will be vociferous in saying, "I would certainly not
use heroin under any circumstance. People could stand there and
even offer me money to use it and I would not use it because I would
275
only use marihuana." Yet, I never saw in my own interviews of
heroin users, which is now up about 600 individuals, I never
saw a one that did not use marihuana to begin with.
Mr. Martin. You did not see a one in all 600 interviews?
Professor Jones. All 600 interviewed were marihuana or hashish
users before they became heroin addicts.
In Southeast Asia I interviewed a number of individuals who were
obvious smokers, so I asked every smoker, "Have you ever been
offered a skag cigarette?" And they would say, "Sure, it would be
impossible not to be in Southeast Asia as a smoker and not have
someone offer you within a year's time or so a skag cigarette." But the
smokers would not accept a skag cigarette. But if this person were
a marihuana user, surely the chance must be high that he would
accept the skag cigarette, because this is where the heroin users
came from.
I never saw a heroin user in Southeast Asia who had not been a
marihuana user. Now, the only difference between my records in this
regard and the Army questionnaires that have been filled out — the
Army kept track — Well, I saw a tabulation of 2,500 heroin users in
Vietnam, and I am sure the Army record by this time has gotten into
much higher numbers. But 2,500 is a lot.
The Army showed that approximately 10 percent of the question-
naires filled out by the heroin users indicated they had never used
marihuana. But I think that is because, if you just hand a person
a sheet and do not explain enough, you may get a little bit of misin-
formation.
Two of the individuals out of 88 that used heroin that I inter-
viewed put down or tried to tell me at the beginning of the interview
that they had never used marihuana before they used heroin. And
in the course of the interview I found out that they had used mari-
huana before thev had used heroin. I said, "Well, why did you lie to
me?" And they said, "We did not lie. We were not addicted to mari-
huana, and therefore it did not count." And this is the reason why
the Army, with regard to questionnaires, finds that only 90 percent
of heroin users have used marihuana before when the real thing
is close to 100 percent.
Mr. Martin. You think the questionnaire method, then, is defec-
tive in trying to elicit a clear picture of the drug situation ?
Professor Jones. The Army has not done this intentionally, of
course. It is just the nature of questionnaires. You never get quite
as accurate information from questionnaires because the questions
are not asked free of some of the ambiguities that people can read
into the question. And these two individuals were probably correct
in their own mind in saying, "Well, they were looking for addictive
drugs and I was not addicted to marijuana. I just used it occasionally.
It did not count."
Mr. Martin. This points to another question dealing with our
general situation in the country. Most of the information we have
about the prevalence of cannabis use is based on questionnaires?
Professor Jones. Yes, it is.
Mr. Martin. Obviously, they do not go in for personal interview-
ing on a large scale ?
276
Could this be part of the explanation for the great discrepancy
between official estimates of the extent of cannabis use and the
calculations you have made, based on the amount we know was
seized or intercepted by Federal agents over the past 5 years?
Professor Jones. I think it explains the secondary discrepancies
in information and explanation. I do not think there are any major
discrepancies in information, because everyone has agreed that we
have a problem, not only with cannabis, but with LSD and ampheta-
mines and heroin. The question is trying to decide precisely what
fraction of each subsector of the population is involved, and that
is why I say it is a secondary variation. But I do believe that you get
more accurate information from a one-to-one interview, especially
when the person is experienced in conducting the interview.
Mr. Martin. Coming back to the question again of manipulation,
there is one specific aspect of this that the subcommittee would be
particularly interested in. It is common knowledge by this time that
there are organized subversive groups within the Armed Forces.
There has been a good deal of organized agitation and the distribu-
tion of literature and the formation of underground groups within
the Armed Forces, and so on.
Have you heard about this phenomenon in the course of your
travels around Asia and Germany?
Professor Jones. Well, I certainly am fairly sophisticated with
regard to the existence of revolutionary groups and the mischief that
they do, and I did pick up in my studies for the Army individuals that
must have been affected by this. This was not in Southeast Asia.
I think in Southeast Asia, under the conditions of actual warfare,
that there would have been likely less of this. But in Germany, where
the troops were idle and the commanding officers perhaps not so
pressed to take care of this, it would be more likely. At least in
Germany I encountered two individuals that I would say were ex-
tremely alienated from our society and considered themselves revolu-
tionaries. And they both said, as a measure of their alienation, that
as soon as they came back home they were going to get guns and start
killing whites at random.
One of these happened in the presence of an Army captain, who
was a trained psychologist, and afterwards I said to him, "Are you
not going to report this? Here is this man who is obviously so
agitated that you can consider him beyond the range of just an
ordinary person with a behavioral disturbance. He is a dangerous
individual."
And he sort of shrugged his shoulders about it. But the fact is that
I take this man very seriously. I think that he and the other one who
was saying the same thing
Mr. Martin. Both of these men were on cannabis ?
Professor Jones. Both of these men were cannabis users. I think they
were suffering from cannabis toxicity, and I think they were also
suffering from being worked on by revolutionaries in the Armed
Forces.
Mr. Martin. Is this an assumption on your part?
Professor Jones. It has to be an assumption because I do not know
more than that. I would have liked to have explored this in more
277
detailed conversations with the man, but it is — this kind of sophisti-
cated emotional planning to go home and start shooting people is
not likely to occur just spontaneously with hashish use or marihuana
use. You have to have someone to put the bee in the bonnet, so to
speak. The propagandists must have been working on these indi-
viduals.
Mr. Tarabochia. Professor Jones, with regard to your statement,
were you aware of the presence of civilian legal counsel whose purpose
was to assist military personnel under court-martial proceedings for
violations of drug abuse, who were also members of radical leftist
organizations such as the National Lawyers Guild or other related
organizations ?
Professor Jones. No, that did not come up during my visit. But I
was not involved in any of the court-martial proceedings or any of the
legal proceedings against these drug addicts. I was at the drug
treatment centers, and the climate there would be to soft-pedal any
information of this sort, because my attitude and the attitude of the
medical personnel would be to get as much cooperation from these
men as possible.
I do not remember any discussion of possible court-martial
proceedings.
Mr. Tarabochia. Are you aware that a group of these organiza-
tions has brought suit against General Davidson because of the alleged
harassment of the soldiers who are suspected drug users ?
In other words, removing the doors from the rooms of known
drug abusers ?
Professor Jones. I did hear this or read it. I think I read it in the
newspapers. But I do not know any more about it than that.
Mr. Tarabochia. How would you construe such an action, in view
of — in the light of your past experience and studies ?
Do you think that this is an attempt to camouflage the drug abuse
epidemic, under constitutional rights of a soldier?
Professor Jones. Well, I do not know, of course. But I would guess
that that would be a part of the motivations of these individuals. The
antiwar groups and the legalization-of-drug groups are overlapping
movements, and have some of the same people involved. Almost all
of the individuals in these present movements are highly alienated
from society. You find all sorts of weird notions characterizing them.
It would be very easy if someone wanted to measure the degree of
alienation, to construct a questionnaire or a word choice or some-
thing of this sort and get a profile on such persons. But I have not
done that.
Mr. Martin. A few more questions by way of clarifying some of
our discussion. In speaking about the increase in the drag epidemic,
you make the point that not merely are there more people involved
in many strata of society, but that there has been a rate of progres-
sion in the use of marihuana and hashish affecting every individual
user. That is, if they started a year or two ago, they are probably
using substantially more today.
Professor Jones. Every marihuana user tends to progress in use, not
only in frequency of use but in dose. And the more that they do pro-
gress, the more exhilarating it becomes. We find this in all sorts of
users.
278
In tobacco users, a cigarette smoker may start and smoke maybe
one cigarete a day. But the average person quickly gets up to a pack
a day and would go beyond that except the cigarette smoker has too
much time wasted if they smoke more than a pack a day. It becomes
mechanically difficult.
Mr. Martin. This progression in the amount used by the average
user — would not that, perhaps, be reflected in the answers they get to
questionnaires ?
Professor Jones. Yes, it would be reflected.
Mr. Martin. It would be reflected ?
Professor Jones. Yes. Well, I have no difficulty in my questionnaires
of getting information about rate of drug use and showing in my
records of several thousand cases that the average amount of drug use,
such as cannabis, progresses with duration of time of use of cannabis.
The person who is using cannabis daily, for example, takes about
&V2 years to get to that point from beginning, say, in occasional use.
The alcoholic who is using alcohol to the same equivalent status in
terms of intoxicating effect has taken 20 to 25 years to come to this
point from the beginning, in which he was using alcohol occasionally.
Mr. Martin. So if a beginning cannabis user comes into the Armed
Forces and nothing is done in the form of education to discourage
the habit, the chances are that he will continue to use more and more
and more while serving in the Armed Forces?
Professor Jones. He will accelerate more rapidly than at home, be-
cause he has more time on his hands. He tends to be bored, and also, the
drug is more readily available and the climate in both Germany and
Southeast Asia for the social life of the soldiers has been one of peer
reinforcement of the drug use. So that all three of these combine
to make the progression into drug use much more rapid than at home.
Mr. Martin. What do you think could be done by the Armed
Forces to cope with this problem ? What prophylactic measures could
they take ?
Professor Jones. Here I would like to talk about an hour.
Mr. Martin. We will not be able to give you quite an hour. But
suppose you do your best in 20 minutes or half an hour.
Professor Jones. Well, I think this is the No. 1 problem, what can
the military do. At the present time the drug preventive education in
the military services is about the same as it is in the college campuses —
essentially nil. It would be possible to turn this around.
Mr. Martin. Is it nil on the question of heroin ?
Professor Jones. Not now. During the time when the heroin problem
was not recognized, there was no campaign against it.
Mr. Martin. But today there is an effective antiheroin educational
campaign ?
Professor Jones. There is an effective antiheroin campaign in the
military.
Mr. Martin. Is there an effective — at least effective in some degree —
anti-cannabis education program ?
Professor Jones. No, there is not. Fourteen months ago in my last
visit to Southeast Asia, part of the arrangements for my trip through
the Department of Defense was that I would be one of the speakers in
an all-military conference on drug abuse being held in Bangkok, and
279
when I arrived the commanding officer was really in quite a state,
because the conference had been taken over by some of the psychia-
trists and physicians who were recommending the legalization of
cannabis and they were holding that cannabis is okay.
Well, they had had a day of this, and I was the lead speaker in
the morning, and in the middle of my talk several of these people
began to challenge me. And of course, I just backed them right into
a corner, and each time I would show the foolishness of their state-
ments I would get loud cheers from the people present. In other
words, the majority of the professionals in the Army who were part
of this conference agreed with me, but they did not know how to
formulate the answers to these promarihuana people.
Well, that conference then did not get beyond this point, because
they kept me on the platform for the rest of the day and into the
night. We just were discussing this problem. But I can tell you that
the same situation also exists in Germany, but I did not get tested
in the same way. But I certainly ran into many individuals in the
Army in Germany who believed that cannabis is okay.
The majority of Army professionals did not feel that way.
Mr. Martin. Who were the individuals — soldiers, officers ?
Professor Jones. It was likely to be individuals entrusted with the
drug abuse problem. They would say, in effect, cocaine is bad and
heroin is bad, but marihuana is okay.
Mr. IMartin. These were individuals that were entrusted with the
drug education program or the drug rehabilitation program or other
aspects of the drug problem ?
Professor Jones. They tend to be the same. The drug rehabilitation
program tends to be coextensive with the drug education program. So
this kind of confusion which comes from the effort to legalize mari-
huana at home that has spilled over into the Armed Forces, and it
makes it very difficult to come to grips with the central problem in
drug abuse in the military, which is cannabis, because it is from
cannabis that drug abuse of all other kinds stems. And also, cannabis
by itself is perhaps more of a threat to members of the Armed Forces
than the other drugs.
Heroin users, at least as long as they are supplied with heroin,
might be able to do their job in the military and not make quite such
blunders as the cannabis users. The cannabis users are never sober
and never out of the umbrella of the hypnotic effects of the stuff.
They are just patsies to make foolish, impetuous decisions.
Mr. Martin. When you say they are never sober, does this also
apply to the occasional cannabis user who smokes a cigarette or two
a week?
Professor Jones. Yes.
Mr. Martin. They are never completely sober?
Professor Jones. They are never sober.
Mr. Martin. Why is that?
Professor Jones. Because there is a residual effect on the brain that
can be tested for, with regard to clinical approaches to the problem or
clinical approaches to assessing that effect. And also, everything we
know about cannabis in terms of the measurement of how much goes
280
into the body and into the brain and stays there, a part of the burden
is still there days, weeks, months later.
Mr. Martin. This bears on the testimony given by Dr. Axelrod at
yesterday's hearing?
Professor Jones. Yes, it does, and the subsequent discussion we had
between him and me.
Mr. Martin. Would you continue ?
Professor Jones. Yes.
Now, I think the drug preventive education in the military could
be made just as effective as I have been able to demonstrate on the
college campus. As I have mentioned before at these hearings, I have
given a course for 5 years. Every 6 months I give a course lasting
3 months, offered to anyone who wishes to attend. It started with
approximately 130 students taking it for credit. At present I have
390 taking it for credit. There has been a steady increase in enroll-
ment.
Most of the students who come into the course are drug users, at
least measured by the fact that they use cannabis on some kind of a
recurrent basis. There is also no doubt but what the students in a
relatively short period of time will change their attitude about
cannabis and stop use of cannabis. I do not get everyone in the
class off cannabis and other drugs, but the majority of the class will
be off drugs, usually in about 2 months of the course. Some indi-
viduals that have been holdouts may not get off of cannabis for
another month or two beyond the course. But I do have information
that they get off.
Interestingly, in each class there has always been the person that
defends cannabis, the student who is very bright and also aggressive
enough so that he can stand up in class and argue with me. In each
class, that is always the person that I can count on for sure coming
over to our side and quitting cannabis use.
Mr. Martin. Because he is bright?
Professor Jones. Because he is bright, and because he has put out
the arguments that have to be put out from his standpoint, and they
have been answered. All of the arguments about the safety of cannabis
or the desirability of using it as a worthwhile experience can be
completely put to rest as far as the young people are concerned, and
also today the hazards that they face such as to the possible damage
to their offspring, the fact that they may not progress in the develop-
ment of minds and bodies such as they hope to have — these are
enough to deter them. And finally, if individuals are not able to see
the advantages of keeping their minds going, there is the fact that
every person I have ever talked to about drugs can visualize what
is happening to the lungs. The problem in the lungs from cannabis
use is of itself enough to deter cannabis use.
And then there is the matter at the end about sexuality. Sexuality
simply goes with cannabis use, as with heroin, except it fades more
slowly than with heroin, but just as surely. And as you know now,
there is not only the evidence of impotency and lack of sexual vigor
in all forms, but there is the direct measurements as presented here
by Dr. Kolodny and coming from the Masters group, which is the
281
most eminent group in the sexual sciences, showing the depression of
male sex hormones to an alarming degree.
These things are all one needs in fully effective drug prevention
education.
Mr. Martin. And you feel the things you have mentioned as
ingredients of an effective drug education program go over just
as well with GI's as they would with college students ?
Professor Jones. Yes, I do. And I can say this not idly, but when
I was in Germany I talked to soldiers brought together for this
purpose, and in each of my visits in Southeast Asia I did the same
thing. There is no doubt that I am just as effective with soldiers as
I am in the classroom.
What I have been urging the military to do for at least 2 years
is to set up drug educative programs in which I can have a major
input, because I know how to do this. And I can train people so they
can be almost as effective as I can be with regard to handling of this
information.
I have also offered to make for the military — and this is currently
being arranged, but we have not made them yet — a series of video
tapings of lectures in the style and using examples that I think would
be most effective to the military. They have video tape playing
machines everywhere that they could use these. Using me canned
would be a lot better than letting the average sergeant discuss the
problem, or the average captain, who is not informed about what
should or could be said. But it does mean that with such information,
the average drug prevention officer in the military would be on a
very secure basis to follow it up, then, with what he can say to those
soldiers that are involved.
Mr. Martin. That leads to a rather basic question, Professor Jones.
Before you can have the military accept the essential fact that we
are confronted with a major cannabis epidemic, and before the
military, accepting this fact, can embark on an educational program
adequate to cope with the situation, would it not be necessary for the
Government of the United States or for those segments of the Govern-
ment of the United States that are concerned with drug abuse and
drug prevention, or drug abuse prevention, to be more correct — would
not the Government have to initiate such a crash program of educa-
tion directed to the people as a whole? I mean, you cannot isolate
the military from the Nation as a whole?
Professor Jones. I think you put your finger on the real problem.
The military has tried, of course, many times to inhibit drug use.
But in the conference that I attended in Southeast Asia, it was an
obvious example of how a good intention on the part of the army to
get everyone educated and cooperating with regard to a real problem
in presenting drug education, that this was being torpedoed by those
who felt that marihuana is a tolerable drug. These individuals voci-
ferously attacked anyone present who was against the use of mari-
huana/largely by calling them a bunch of "juicers," referring to
alcohol use, and they were willing to tolerate alcohol but intolerant
of cannabis, whereas cannabis users knew that cannabis was less
harmful than alcohol, and actually the use of marihuana is a step
282
ahead. "As long as you have to have one drug or another, you might
as well have cannabis." This was the argument.
Mr. Martin. Were the people who made these statements actually
involved in the Armed Forces drug program ?
Professor Jones. These people were involved in the Armed Forces
drug conference in Southeast Asia in March of 1973, which I
attended.
Mr. Martin. Does this not strongly suggest that there is a serious
lack of education on the subject of cannabis in the Armed Forces?
Professor Jones. There has been a very serious lack of education
on the subject of cannabis in the Armed Forces. And a step of the
same sort is the fact that the military has always been undecided
as to what it is going to do about the use of alcohol in the military
forces. There has never been a clear-cut decision that it either should
be tolerated in terms of ad lib use or that anything should be done
about it.
I think the same kind of schizophrenic debate with alcohol abuse
has been passed over into cannabis because it is so easy to prove, with
the information afoot, that cannabis is the same sort of drug.
Mr. Martin. The information available?
Professor Jones. The present information that is available to most
individuals will lead them to believe that alcohol and cannabis are
very similar types of drugs.
Mr. Martin. Whereas you testified yesterday that cannabis is a
much more dangerous type of drug?
Professor Jones. At least by a factor of 10 and probably 30 or
more times more harmful.
Mr. Martin. And, as you pointed out before, smoking cannabis
two or three times a week is enough to leave a person in a permanent
state of intoxication or partial intoxication ?
Professor Jones. We never see this in alcohol. A person getting
over it, they may have a hangover the next day, but within a week he
surely is completely sober, with no detectable traces.
Mr. Martin. Within a week?
Professor Jones. Within a week for sure.
Mr. Martin. It takes that long to get over alcohol intoxication?
Professor Jones. I dare say from a state of drunkenness, in which
case we know that the hangover lasts the next day, that we would be
on safe grounds if we said that a week later that that person would
have no detectable traces by even the most advanced techniques of
measuring mental function. The effects of alcohol wear off within
that time — whereas, with marihuana, a person using marihuana heavily
would easily have detectable traces of it over a period of perhaps a
full week from that single use. And as a chroriic user, he may still have
accumulated effects from all of the uses that he has had. It is quite
different.
Mr. Martin. Let me pursue this question. If we are going to have
an effective program of education on cannabis in the Armed Forces,
this would have to be part of a larger national program of education
on cannabis ?
Professor Jones. It would be a lot easier for the military to do it
as a part of a national program against the use of cannabis.
283
Mr. Martin. Reflecting a commitment by the Government?
Professor Jones. Reflecting a commitment by the Government, so
that the military does not have to do it alone, and so that the indi-
viduals who are so outspoken and not hesitant at all about attacking
individuals — after all, most of the people that were from this country
who were witnesses during these hearings testified to the extent of
personal attack on them. Surely, I can add to this from my own
records as to how many times I have been attacked by those who are
either using marihuana or trying to legalize marihuana.
This is an unpleasant thing to have to face by any person. And in
the Armed Forces, our generals and lesser commanders are not used
to being singled out for this kind of semiprofessional debate in which
there is personal vituperation involved, as well as discussion of some
of the professional issues. People tend to shy away from this. It
becomes a nasty, unpleasant situation.
Mr. Martin. Would that not also be true for some of the people in
Government ?
Professor Jones. Yes, I think so. But then we also have within
Government, as we had evidence in the Armed Forces, individuals
who feel that marihuana is tolerable, and who, for varying reasons,
are on the side of the forces who are trying to legalize drugs at the
present time. So the Government does not have a monolith of unity
of thought on the subject of marihuana, and there is divisiveness
afoot. It is hard to move Government when there is a division, even
though the division may involve the minority.
Mr. Martin. Is this division reflected in any way in the publica-
tions put out by the Government, the various Government drug
offices ?
Professor Jones. Yes. It is easily seen in the official reports of
Government. I think that the individuals who are involved are,
perhaps, a real minority, not more than 10 percent of those who are
professionally involved. But they are so emotionally bent on doing
what they can that they almost ruin the whole report, because they
manage to get their influence in in every single channel that they can
exercise it. You can see this.
The Shafer Commission report was completely distorted by just
a few individuals. I think that the report of the Secretary of Health,
Education, and Welfare, the three separate reports, were also dis-
torted for the same reason. The current one, which counts as an
enormous improvement over the other two, is still a report that is
inadequate scientifically and not at all of the level that one expects.
Mr. Martin. When you say it is inadequate scientifically, it does
not reflect the new scientific information available ? Or what is the
nature of this inadequacy ?
Professor Jones. When it discusses the new scientific information,
it does not manage to focus on the significance of it. For example, in
reviewing the work of Soueif in Egypt, they never once mentioned
the fact that this is important because it identifies in large-scale
observation the persistence of cannabis effects, nor does it even
bother to quote the underscored conclusions of Soueif, who was very
definite about noting that the effects of cannabis occurred in hashish
users in every stratum of society, except the greater the intellectual
284
achievement of tho individuals the more seriously they were affected
by hashish.
Furthermore, the report went on to say — that is, the report from
Health, Education, and Welfare — they went on to suggest that the
information by Soueif might be put aside, since there was not this
level of hashish use in the United States, inferring that marihuana is
still at a low level of usage and at a low level of strength of prepara-
tions used, which we know not to be the case. Especially during the
last 2 years, when hashish has come into very common use, approxi-
mately half of the marihuana users are getting their cannabis in the
form of hashish at the present time.
I know from my interviews of cannabis users that they are using
potent varieties of hashish commonly. So we have a situation — we
can say confidently that the United States has more hashish users
than Egypt.
Now
Mr. Martin. Are you talking about more hashish users in absolute
numbers or per capita ?
Professor Jones. In absolute numbers, I think we have more
hashish users in the United States than Egypt.
Mr. Martin. Then not on a per capita basis ?
Professor Jones. Perhaps even on a per capita basis. I may be
wrong on that. It is an off-the-top-of-my-head comparison, but all the
Egyptians that I have known assured me that the vast majority of
Egyptians do not use hashish or cannabis, and it is a much smaller
population than ours. And we have a much larger fraction of our
population, at least for youth, involved in the cannabis drugs. So I
think we would come out as having more hashish users in the United
States than in Egypt.
Mr. Martin. If I may, I would like to try to summarize your
recommendations, as I understood them.
You feel that the problem of drug education, especially with
reference to cannabis, can only be handled effectively in the Armed
Forces if it is a part of a larger national program.
Step number 1 in this program would be a recognition by the
Government that we are confronted with a very serious situation.
This would have to be preceded by a recognition and acceptance of
the now-massive evidence about the harmful effects of cannabis, a
recognition of the fact that there is an epidemic, and an acceptance
of the need for a crash program to roll back the epidemic and edu-
cate the people and present them with the facts about cannabis. And
against that background and within that framework, it would become
feasible to conduct an effective program of education specifically
tailored for our Armed Forces.
Professor Jones. I believe everything that you have stated. The
only thing is that I would hope — and I think it might come about,
because the problem is so urgent within the military— that even if the
Government as a whole is not willing to take action, that the military
will and can go ahead and do it on their own. But it would be ever
so much more easily done and more effective if it were a total
Government effort.
285
There is need for a total Government effort because the civilian
population really needs the Government's help. And the Armed
Forces, in my opinion, are going to have very grave difficulties in
maintaining an army that is really reliable and that can function in
the face of the possible hazards for drugs that lie ahead unless
something is done about it.
Mr. Martin. And these hazards will grow as the epidemic con-
tinues to spread in the population as a whole?
Professor Jones. Yes. The army will not be able to get any seg-
ment of the population inducted into the military force that is free
from drugs so they can start with an uncontaminated group. I believe
that the army and the other military forces can start with individuals
who are contaminated with drug use and recondition them, in terms
of their mental attitudes, strengthen their ability to deal with all
sorts of problems, which is a matter of education, and rebuild them
mentally as well as physically so they can be effective members of
the Armed Forces.
These methods are available. It is just a question of trying to
organize them and put them into effect.
Mr. Martin. There is a question I meant to ask sometime back.
Does the rate of cannabis use vary from one armed service to another?
Professor Jones. Yes.
Mr. Martin. Or is it pretty well uniform ?
Professor Jones. No. The rate of cannabis and other drugs varies
from one division of the armed services to another, in the first place.
There is also a very great variation depending upon what company
one might be in. There were a few companies in Southeast Asia
where the whole company was just in hopeless confusion because of
heavy drug involvement, with cannabis being the principal one.
I would say that this was where the commanding officer had been
particularly lax with regard to taking any precautionary measures.
I think that the kind of cavalier attitudes that have prevailed might
have been all right under ordinary circumstances, and perhaps the
men under ordinary circumstances would have felt that the com-
mander was a whale of a good guy because he gave so much latitude
and permission. But in facing the drug epidemic, you had to have a
commander that really pulled the reins up tight. And where the reins
were pulled up tight, you could see the difference in the drug prob-
lem. The army has been able to demonstrate over and over again in
Southeast Asia that when they took firm action, the drug abuse went
down, just as vou can show that in civilian life.
Now, the difference between the Army and the Navy and the Air
Force are in that order. The Army has had a greater use of drugs ;
the Navy, the next greatest level of use ; and the Air Force least.
Now, it is not entirely that the Army has had more land-based
connections to the supplies of drugs, although this is one of the fac-
tors. I think it is sort of the esprit de corps, the training that goes
into individuals, the training that makes individuals take more
responsibility. This has been necessarily at a higher order for the
Navy and at a higher order yet for the Air Force. So it shows it can
be done.
33-371 O - 74 - 20
286
And, to some extent, too, they have been more selective with regard
to the origins of their personnel. But today you cannot be sure with
regard to any segment of society that you have eliminated the possi-
bility of drug use by taking a person of good apparent qualifications,
because that person may be contaminated. So the military would be
well advised to use corrective methods in preparing, from boot camp,
or whatever officers training procedures will be involved, to incor-
porate within that antidrug abuse education of the most effective sort
where it is meaningful and convincing to the persons involved.
Again, it can be done. But you cannot do this with individuals that
say marihuana is tolerable.
Senator Thurmond. I want to thank you very much for coming
here today and for presenting us with this very important informa-
tion, Professor Jones.
The hearing is now adjourned, subject to further call of the Chair.
[Whereupon, at 12 :20 o'clock p.m., the subcommittee was adjourned
subject to the call of the Chair.]
MARIHUANA-HASHISH EPIDEMIC AND ITS IMPACT ON
UNITED STATES SECURITY
THURSDAY, JUNE 13, 1974
U.S. Senate,
Subcommittee To Investigate the
Administration of the Internal Security Act
and Other Internal Security Laws
or the Committee on the Judiciary,
Washington, D.C.
The subcommittee met, pursuant to notice, at 2:20 p.m., in room
224, Kussell Senate Office Building, Senator Strom Thurmond,
presiding.
Also present: David Martin, senior analyst; A. L. Tarabochia,
chief investigator; and Robert Short, senior investigator.
Senator Thurmond. The subcommittee will come to order.
Over the past month the Senate Subcommittee on Internal Se-
curity has held a series of hearings on the marihuana-hashish epi-
demic and its implications for U.S. security. Todays hearing is part
of this series. It will deal specifically with the question of cannabis
abuse in the U.S. Armed Services.
To deal with this problem we have here as witnesses Dr. Forest
S. Tennant, Jr., former Chief of the Special Action Office for Drug
Abuse of the U.S. Army in Europe, the 7th Army, and Mr. David
O. Cooke, Deputy Assistant Secretary of Defense, who is now in
charge of the problem of drug abuse of the Department of Defense.
Mr. Cooke is accompanied by a distinguished panel of support-
ing witnesses who have expertise on different aspects of the prob-
lem. The supporting witnesses are as follows: Dr. John F. Maz-
zuchi; Brig. Gen. W. A. Temple; Col. Frank W. Zimmerman, Mr.
David N. Planton; Comdr. S. J. Kreider; Col. Harry H. Tufts;
Wayne B. Sargent; and Col. John J. Castellot.
Gentlemen, to save time, I would suggest that you all rise and
be sworn at one time, if you will.
Will you raise your right hand ?
Do you solemnly swear that the evidence you give in this hear-
ing shall be the truth, the whole truth, and nothing but the truth,
so help you God?
All Witnesses. I do.
Senator Thurmond. Let us have a seat.
Our first witness will be Dr. Forest S. Tennant, Jr.
Since I notice that you have stated your qualifications in the
opening paragraph of your testimony, Dr. Tennant, I think we
(287)
288
will try to expedite it by asking you to proceed with your statement
at this point. You may proceed, now.
TESTIMONY OF DR. FOREST S. TENNANT, JR., M.D.
Dr. Tennant. Thank you very very much, Mr. Chairman. I am
delighted to be here. My name is Dr. Forest S. Tennant, Jr. Be-
tween October 1968 and January 1972, I served as a medical corps
officer in the U.S. Army, Europe. The majority of my service was
spent with the 3d Infantry Division where I helped initiate some of
the first drug and alcohol rehabilitation efforts developed in the
Armed Forces. During the last 4 months of my tour of auty, I was
assigned to the general staff of Gen. Michael Davison, USAREUR
Commander in Chief, and it was my job to assist in development
of drug and alcohol rehabilitation and prevention programs through-
out the command. Since 1972 I have intermittently consulted with
U.S. Army, Europe, concerning drug dependence matters, and I
returned to West Germany for 6 weeks of Active Reserve duty in
late 1972. I am currently a postdoctoral fellow in public health at
UCLA. As part of my duties, I conduct research in drug and
alcohol dependence, and I currently direct three drug treatment
programs and consult with a variety of others in the Greater Los
Angeles area.
Throughout my tour of Army duty I conducted a number of
studies on the drug problem and much of this research involved
hashish, which was the only form of cannabis normally available
in the U.S. Army, Europe. I and my colleagues have published
several papers on hashish which most have been, or will be, made
available to you. Stimuli for our research on hashish was the re-
curring observation that hashish abuse adversely affected the phys-
ical and mental health of soldiers; it impaired combat readiness
and capability of our units; and impacted upon military security.
These undesirable results of hashish abuse occurred in a variety of
ways which I will elucidate during the remainder of my testimony.
Senator Thurmond. Dr. Tennant, when you first went to Europe
did you have any preformed opinions, one way or the other, on
the potential effects of cannabis use ?
Dr. Tennant. I went there in 1968, and at that time the drug
abuse epidemic had not hit its peak, and I knew very little about
cannabis, frankly. The only thing I did know was that it was
thought to be a rather innocuous drug and a rather harmless drug.
And that was the basis of starting my investigations.
Senator Thurmond. Thank you.
You may proceed.
Dr. Tennant. Before discussing the complications of hashish, it
is necessary to establish the difference between the hashish smoked
by U.S. Army soldiers and the usual marihuana marketed in the
United States. Hashish is the resin of the cannabis plant and
marihuana is the whole plant. Hashish normally contains about
8 to 10 percent THC compared to marihuana which contains only
about 1 percent THC. A major difference between hashish and
marihuana from the medical point of view is the irritating effect
289
of hashish on the respiratory tract.1-3 While marihuana smoke is
not particularly irritating, hashish smoke is extremely irritating to
the nose, throat, and lungs. In West Germany, hashish was very
inexpensive, costing only about $1 to $1.50 per gram compared to
several dollars per gram in the United States. It was not uncommon
for soldiers to smoke 50 to 100 grams of hashish per month. It would
require a monthly consumption of 500 to 2,000 stateside marihuana
cigarettes to take in the same amount of active ingredient (THC).
I was, therefore, in the unusual position to observe some American
young men consume massive amounts of hashish, since it was readily
available and inexpensive. It was surprising and of great concern
that some young men would consume and develop tolerance to
enormous doses of hashish that are as yet rarely observed in this
country.
I have not been in a good position to observe the long-term toxic
effects of normal, street marihuana on young Americans in the
United States. During the past 2 years I have enjoyed being the
medical director of a free medical clinic in Los Angeles which
treats the medical problems of approximately 500 young adults per
month. While I frequently observed certain medical and psychiatric
problems related to chronic hashish abuse among American soldiers
in West Germany, I have observed few complications of cannibis
smoking in my clinic in Los Angeles. It is my opinion that, in
contrast to soldiers in West Germany, this has been due to the
low quality of street marihuana found in the United States and
short-term consumption of most young people. Based on my clinical
experience and many reports in the literature, however, I would not
expect us to see an epidemic of complications of street marihuana
for a few years. Given the reports presented before this subcom-
mittee and the fact that chronic use of cannabis is spreading in
this country, it would be reasonable to expect an epidemic of can-
nabis complications within a few years similar to what has been
observed among our soldiers in West Germany.
My own clinical observations indicate that complications of can-
nabis follow a dose-response curve ; that is, higher doses taken over
a given period of time may elicit a more significant biologic re-
sponse. I suspect that much of the controversy involving cannabis,
particularly among the laiety, is due to failure to understand a
dose-response curve. An understanding of a dose-response curve
for cannabis, as with any other drug, allows a scientific understand-
ing of most of the reports in lay and scientific literature that ini-
tially may appear at variance with one another. As I progress through
my presentation, I will frequently refer to dose-response principles.
Between 1970 and 1972 I surveyed U.S. Army soldiers three times
by anonymous questionnaire to determine the prevalence of drug use
and predict trends. Table 1 shows the drug prevalence of hashish,
amphetamines, and opiate drugs among 5,044 subjects. This survey
1 Tennant, F.S., Jr.. et al. : "Medical Manifestations Associated With Hashish." Jour-
nal. American Medical Association 216 :1965-1969, 1971.
1 Henderson, R. L. and Tennant, F. S., Jr. : "Respiratory Manifestations of Hashish
Smoking." Archives Otolaryngology 95 :248-251, 1972.
3 Tennant. F. S., Jr., et al. : "Hashish Bronchitis." Journal, American Medical Associa-
tion 217:1706-1707, 1972.
290
was conducted in the last half of 1971. The survey was conducted
by assembling 26 battalion-size units from 11 U.S. Army kasernes
in the post theater-auditorium and letting each subject fill out
the questionnaire anonymously. On this basis, 35.4 percent reported
they had used hashish in West Germany at least one time. A total
of 14.8 percent reported they used hashish one or more times per
week. I believe this questionnaire study to be fairly accurate since
random spot urine tests of 27,000 USAREUR soldiers during this
same time period showed the prevalence of abuse of amphetamines,
barbiturates, and opiates to be the same as did the questionnaire
study: 1.04 percent by urine test compared to 1.3 percent by ques-
tionnaire— P = NS.4
One of the factors that has made it difficult to evaluate effects
of cannabis is that it is simultaneously consumed with alcohol, to-
bacco, and/or other illegal drugs.5 6 In the study of 5,044 subjects,
about 25 percent reported use of two or more illegal drugs while
about 10 percent reported use of three or more illegal drugs —
figure l.7 Multiple drug use was apparently quite prevalent in this
population before Army induction — figure 2. Approximately 50
percent of the total population reported use of at least one drug —
including alcohol — while about 20 percent reported use of two or more
drugs — including alcohol — before Army induction.
4P = N8 signifies in statistical language that this is not a significant difference.
5P = NS signifies in statistical language that this is not a significant difference.
"Pendergast, T. J., Jr., Tennant, F. S., Jr., et al. : "Drug Use and Its Relations to
Alcohol and Cigarette Consumption in the U.S. Military Community of West Germany."
International Journal of Addiction 8, Fall, 1973.
7 Tennant, F. S., Jr., et al. : "Psychiatric Effects of Hashish." Archives, General Psy-
chiatry 27 :133-136, 1972.
291
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The simultaneous use of other drugs, including alcohol and to-
bacco, with cannabis, is a critical issue in my opinion, and one that
must be directly reckoned with in arriving at decisions regarding
cannabis.
There are many other studies that report that multiple drug use
is very prominent among the drug culture in the United States.
Mr. Martin. These facts are covered in figure 1 which you have
appended to your prepared statement?
l)r. Tennant. Yes. And I have also attached to my statement
something about the frequency of drug use before Army induction.
About 50 percent of all the USAREUR soldiers that we surveyed
reported they used at least one drug, including alcohol, before Army
induction, while about 20 percent reported the use of two or more
drugs before Army induction. Approximately 10 to 15 percent used
two or three or more drugs prior to Army induction.
So, therefore, the drug taking habits of the soldiers began long
before Army induction.
One of the things that I would like to make a special point of
and one that I will cover later in my testimony is that cannabis
products are commonly used with alcohol, tobacco, and other drugs,
and it is my opinion that this is one issue that has not been directly
reckoned with, and one that has not been discussed enough. And
I will come back to it.
One of the things that has seldom been done in the cannabis con-
troversy is to ask a large number of cannabis users if the drug
adversely affects them. Usually a few cannabis advocates attempt
to speak for all smokers. In early 1971 we surveyed 1,018 U.S.
Army soldiers by anonymous questionnaires: 492, 48 percent, had
used hashish in West Germany. This group of hashish smokers stated
that the drug caused the following problems:
1. Bronchitis, 30 out of 492 smokers, 6.1 percent.
2. Sore throat, 122 out of 492 smokers, 24.8 percent.
3. Running nose, 43 out of 492 smokers, 8.7 percent.
4. Diarrhea, 23 out of 492 smokers, 4.7 percent.
5. Headache, 70 out of 492 smokers, 14.2 percent.
6. Emotional problems, 42 out of 492 smokers, 8.5 percent.
7. No bad effects, 205 out of 492 smokers, 41.7 percent.
In addition, 13.9 percent of these hashish smokers stated they had
had to visit an Army physician for an ailment caused by hashish.
Three percent — 3.2 percent — stated they were forced to visit an Army
physician five or more times for an hashish-caused ailment.
Visits to U.S. Army medical facilities by hashish smokers for
hashish-related complaints became a problem in 1969. Over a 3-year
period Groesbeck and I studied the psychiatric manifestations of
720 hashish smokers who sought medical attention at the U.S.
Army Hospital in Wurzburg, West Germany which served a pop-
ulation of about 36,000 over this time period, (table 2) A detailed
analysis of these cases has been published elsewhere so I will only
294
relate certain aspects of these cases that particularly relate to job
performance and military security.8
TABLE 2.— CLASSIFICATION OF 710 HASHISH USERS
Dose per
No. month grams Frequency use Reason for medical consultation
392 0-12 1-3 times per week Respiratory ailment or drug information.
18 ^. 0-25 Experimental or occasional Acute panic reaction or toxic psychosis.
3 10-50 3-7 times weekly Schizophrenic reaction.
110 50-600 Several times daily .. Chronic intoxicated state.
85 10-50 3-7 times weekly Acute toxic reaction (multiple drug use).
HI 25-200 Several times daily... Schizophrenic reaction (multiple drug use).
720 Total
Source: Doses, frequencies, and reasons for medical consultation cf 720 hashish smokers.
Over one-half — 392 — of these individuals smoked small quantities
of hashish and came to us for minor respiratory complaints — sore
throat, sinusitis — or for information about the adverse effects of
hashish. The other subjects exhibited findings of significant psychi-
atric disease. One hundred and ten of these patients severely abused
hashish by smoking 50 to 600 grams monthly for 3 to 12 months.
These men smoked hashish several times per day. Other illegal
drug usage was reported as rare or nonexistent in these soldiers. All
110 patients exhibited a personality disturbance which prompted
psychiatric consultation at some point during their period of high-
dose hashish consumption. Despite variation in overall symptoma-
tology, all displayed symptoms of chronic intoxication similar to
those found in individuals dependent on depressant-hypnotic drugs.
Major manifestations were apathy, dullness, and lethargy with mild-
to-severe impairment of judgment, concentration, and memory. In-
termittent episodes of confusion and inability to calculate occurred
with high levels of chronic intoxication. Physical appearance was
stereotyped in that all patients appeared dull, exhibited poor hy-
giene, and had slightly slowed speech. So apathetic were many pa-
tients that they lost interest in cosmetic appearance, proper diet, and
personal affairs such as paying debts, job performance, et cetera.
Although violence or overt acts of crime were rare in these patients,
they were frequently in social and legal difficulties due to failure to
care for their personal affairs.
Also of serious but lesser concern were 21 of these patients who
developed acute psychotic reactions which required hospitalization.
These types of reactions were common. Table 3 lists the causes of
drug hospitalizations to the 10 USAREUR hospitals between Janu-
ary 1971 and June 1972 and many were for adverse hashish reactions.
8Guerry, R. L., Henderson, R. L., Tennant, F. S., Jr., et al. : Abnormalities of the
Respiratory System In Hashish Smokers. (In press.)
295
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296
This group of patients points out very vividly the problem of
simultaneous use of hashish and other drugs. One hundred and
twelve of the 720 patients developed psychotic reactions resembling
schizophrenic reactions. They followed consumption of hashish with
hallucinogens, amphetamines, or alcoholic beverages. These patients
were, for some, long-term hashish abusers who, for 3 to 6 months
prior to hospitalization, consumed 25 to 200 grams monthly. Schizo-
phrenic reactions occurred abruptly during their period of drug
abuse and all patients at the time of admission to the hospital were
psychotic enough to require restraint and observation. Premorbid
histories obtained from the commanders of these patients indicated
in each instance the presence of progressive psychiatric illness and
deterioration of job performance prior to the onset of acute symp-
toms. All required eventual evacuation to the United States for long-
term psychiatric confinement.
Mr. Martin. While we are on that point, I think it might be
interesting to ask a few questions for the purpose of establishing
just how enormous this quantity really is.
According to Professor Paton, when he was here and testified
before our subcommittee, 5 to 10 milligrams of THC is enough for
the average smoker to get himself a case of cannabis intoxication.
And allowing for wastage in smoking, it would work out to about
25 milligrams of THC. Since hashish is one-tenth THC, this would
make 250 milligrams of hashish. So that 1 gram of hashish would be
enough for four cannabis intoxications.
Does that sound about right for the average smoker?
Dr. Tennant. I think that is about correct, yes, sir.
Mr. Martin. When you get up to the level of 600 grams of hashish
a month, you are talking about 20 grams a day, or approximately
2 grams of pure THC?
Dr. Tennant. That is correct.
Mr. Martin. Which is the equivalent of 80 times the amount
necessary to produce cannabis intoxication in the average smoker.
Now, this is a rate of acceleration that far exceeds any acceleration
that I have ever heard of in the case of alcoholics. They may start
out as relatively heavy drinkers, taking a third of a bottle a day,
let us say, half a bottle a day, and over a period of many years they
will slowly move toward a bottle a day, a bottle and a half a day.
But they do not go much higher than that. They may increase their
intake about fourfold, sixfold, from the time they first begin drink-
ing heavily on a regular basis.
But in the case of these hashaholics you were talking about, they
were able to increase their intake of cannabis — apparently over a
relatively short period of time — eightyfold or a hundredfold?
Dr. Tennant. That is absolutely correct. And it was rather
astounding for us to find this out.
Let me just say that smoking 600 grams a month was^a rare sit-
uation. It was very common for someone to smoke 50 or a hundred
grams of hashish a month. And initially the soldiers would explain
to us that when they first started smoking hashish in Germany they
would smoke no more than one or two puffs of hashish. But over a
297
period of just a few weeks they could build a very rapid tolerance
to the drug.
Mr. Martin. Would it be accurate that some of those that became
hashaholics had not even smoked marihuana before they came to
Germany? Or had most of these done some smoking before they
came to Germany?
Dr. Tennant. Based on our surveys, the majority of them had
smoked some marihuana before they smoked hashish in Germany.
Mr. Martin. Were they chronic marihuana smokers before they
came to Germany? Were they at the once a day level or the once a
week level?
Dr. Tennant. I do not have that precise information. Many of
them were, and some were not.
Mr. Martin. Presumably, some of them were only casual smokers
who took one joint a week or several joints a week?
Dr. Tennant. Yes.
Mr. Martin. And they progressed from this level in a period of
what time?
Dr. Tennant. According to what they would tell us, they could
go from a level of smoking one or two stateside marihuana joints
up to a level of 25 or 50 grams of hashish within a period of 3
months. They obviously developed a tolerance to the drug very
rapidly.
Mr. Martin. Now, when you get up to the level of a hundred or
200 grams a month, even allowing for the much cheaper price of
hashish in Germany, you have reached a point where the ordinary
GI cannot afford that much without some special source of income.
Where does he get the money ?
Dr. Tennant. Of course, different people would get it from vari-
ous places. But we had many cases — and I would like to relate some
anecdotes later in my testimony — who would get into illegal behavior
to support this habit. And, of course, many soldiers went into
the hashish-dealing business. This was quite common. Other soldiers
would say that it would be possible to smoke 25 or 50 grams a month
simply by borrowing from other soldiers. But without question,
many of them did get into illegal activities in order to support this
type of consumption.
Mr. Martin. The requirement for this kind of money would ob-
viously make them security risks?
Dr. Tennant. Very much so.
Mr. Martin. Again you talk about overt acts of crime, are you
talking about violent crime?
Dr. Tennant. Yes, sir. But not directly caused by pharmacologic
effects of the drug.
Mr. Martin. For example, you just said a while ago that many
of them went into selling hashish and other criminal activities?
Dr. Tennant. Let me qualify "other criminal activities" a bit.
Rarely in our experience did we see these people who were chron-
ically intoxicated commit violent crime. In other words, they were
very seldom involved in assaults or beatinsrs or anything like this.
But they were always in other kinds of difficulties.
298
Mr. Martix. Nonviolent crimes ?
Dr. Tenxant. Nonviolent type activities, or illegal activities, let
us say. It was very frequent.
Attached I have a list of hospitalizations of people who required
treatment while I was in the USAREUR Command between 1971
and up through June of 1972. Many people — and I pointed this out —
many people state that if you smoke hashish or marihuana, it will
never result in hospitalization because the drug is harmless. But our
data in USAREUR does not support this belief. We had many
admissions each month to our ten hospitals, which showed that there
were a number of hashish-caused hospitalizations.
And to go right along with this, the recent DAWN (Drug Abuse
Warning Network) data — which is the information system established
here in the United States, of which I have been one of the major con-
sultants during the past year — shows that out of the 800 reporting
hospitals that report to the IMS Company in Philadelphia each
month, there are a number of hospital admissions and emergency treat-
ments that are required in the United States for marihuana and hashish
abuse. So, apparently, the same thing that we saw in the U.S. Army,
Europe is beginning to occur in the United States. This informa-
tion, of course, is not publicly known, because generally the lay
press only reports information that generally states that nobody gets
sick if they use marihuana. However, there is quite a body of data
accumulating in the DAWN system which shows that that is not
the case in the United States at this time.
To perhaps better emphasize the problems that we saw with
hashish and job performance and military security, I would like to
pass on a few anecdotal reports from my own files. And I emphasize
that these are cases out of my own records, and they are not hear-
say. I did not take them from someone else ; they were my own cases.
They point out a lot of problems that we observed with hashish abuse.
Number 1, AJ, a 19-year-old soldier, according to his roommate
sniffed two bottles of cleaning fluid ; drank a fifth of bourbon ; smoked
four bowls of hashish and expired.
2. JM, under the influence of unknown quantities of alcohol and
hashish, took an axe and killed his German girlfriend by literally
chopping her into several pieces. The following morning he claimed
he did not remember the incident.
3. Three soldiers, under the influence of hashish, raped a 15-year-
old dependent girl. All three soldiers blamed the incident on
hashish.
4. SG, under the influence of hashish and strawberry wine, one
evening stole several soldiers' belongings such as stereos and wrist-
watches. The following morning he did not remember the inci-
dent. Furthermore, he claimed he had never stolen before and he
was recognized as a model soldier bv his superiors. He had no use
for the items and returned them to their owners.
5. A frequent occurrence is illustrated by CN who, under the in-
fluence of hashish and alcohol, sliced his wrists in a suicidal gesture.
6. This report points out some of the implications of crime and
violence that are indirectly related to the consumption of hashish —
299
one barracks in my division became known as "Smoky Barracks"
because it was a well-known supplier of hashish. Many violent acts
occurred in these barracks which were related to hashish dealing.
To the best of my knowledge, five to six soldiers commandeered the
hashish dealing. Failure to pay a drug bill for as little as $10 or
$20 resulted in violence. Since I was the surgeon who had to care
for the victims of the violence, I became involved and knowledge-
able. The usual violent act was a "blanket party" which occurred
when the attackers would find the victim asleep. They rolled him up
in his blanket like a hot dog and physically assaulted him with fists
and clubs. On two occasions soldiers were thrown from a two-story
window because they failed to pay a hashish bill and in one in-
stance, a soldier's wife was beaten for a deficit of $60.
7. Some of the fights and incidents between blacks and whites
which occurred in U.S. Army, Europe, in 1970 and 1971 and were
labeled "racial incidents" were, in reality, fights over who would
control the local hashish franchise.
Let me emphasize that the above anecdotal reports do not prove
that hashish caused them. They do, however, dramatically point out
some issues and call for a note of caution concerning cannabis. First,
they emphasize potential problems related to security for the U.S.
Army.
Second, these cases illustrate how cannabis is commonly used in
real life. It is a drug that is seldom taken in isolation. It is usually
simultaneously consumed with other drugs, particularly alcohol.
Even in the United States, marihuana is usually passed around at
parties after alcohol has been consumed. As illustrated by the above
anecdotal reports, it is impossible to tell whether the" tragic events
occurred as a result of a disturbed personality, alcohol, hashish, or
a combination. One thing is certain, however, cannabis effects must
be considered in light of its simultaneous use with alcohol. Most
experiments and research conducted on cannabis in recent years
have not taken into consideration that cannabis is usually not
consumed in isolation from other drugs. At present it appears to
me that we need considerable research on the effects of simultaneous
use of cannabis and other drugs, particularly alcohol.
Mr. Martin. A question at this point, Dr. Tennant. Is it your
impression that when someone takes cannabis and alcohol, the total
effect is a kind of arithmetical sum of the effects of the two drugs —
or do they have a synergistic, or compounding, effect, so that you
get an aggravated reaction by taking the two of them?
Dr. Tennant. From purely clinical observations, there is usually a
compounding effect, or potentiating effect, as it is referred to in
toxicology. In other words, not two and two equals four, but two
and two equals six; this type of effect. At least this is what you see
clinically when these two drugs are consumed. I have frankly not
seen good basic research to really clarify these points. If the research
exists. I do not know about it.
I would also like to mention a little bit about the impairment of
driving by cannabis intoxication. There have been many studies
which point out that cannabis can impair driving.
300
I saw many accidents that appeared to be related to hashish
consumption. Although most were minor and did not take a life, the
following two reports from my own files were tragic:
1. KS, under the influence of hashish, drove his motorbike under
a truck and decapitated himself. His roommate said he made a
usual practice of smoking hashish while riding his motorbike.
2. A 21/4 -ton truck carrying several soldiers drove over a cliff,
while attempting to make a turn. Eight soldiers were killed. My
investigation revealed, via information from soldiers who were not
killed, that the driver smoked two pipebowls of hashish about 1
hour before driving.
The above two incidents point out the potential problem of U.S.
Army soldiers operating equipment, flying, etc. under the influence
of cannabis. To complicate matters there is little way to detect an
individual when under the influence of the drug and there is as
yet no reliable, routine laboratory test to detect THC in the urine,
breath, blood, or saliva.
Mr. Martin. A question at this point, Dr. Tennant, rather than
coming back to the point later on.
Have you heard a tape recording, a very dramatic tape recording,
prepared by Dr. Joseph Davis of the University of Miami Medical
School? It involves a young cannabis driver who had smoked 2i/£
joints, and a student — a friend — who acted as a control, and has
the tape recorder beside him in the car.
Dr. Tennant. I have not heard the tapes. I have read a transcript
of these recordings. And they are quite dramatic. I think they are
probably more dramatic than you would normally see in the case of
an individual who was intoxicated with any drug. But I think his
particular reports certainly points out that people who are intoxi-
cated with cannabis or any other drug are not going to be able to
drive properly.
Mr. Martin. I have here a few excerpts from the transcript which
suggests to me that the net impact is probably qualitatively different
from the impact we get from a simple alcoholic drunk. I would
like to read these few excerpts to you.
The driver said:
I now feel my head vibrating in between two and three different people. I
have forgot to look one way when I rounded that corner. I went into third
gear very, very poorly, possibly the worse that I have done in my entire life.
I am coming to a stop sign. For some reason I feel maybe I won't be able to
stop. It is difficult to force my foot down to the floor on the brakes. It seems
as though both of my feet are riding on cushions, the cushions between my feet
and the brake pedal.
And then after a while he says :
I am very frightened of cars passing me. I .iust did a totally mechanical
action. I don't know why I did it. I just feel that if I could lift my foot off
the brake I would just go zooming around the world.
And then a bit later:
I just can't handle this thing any longer, because I feel like I am going
around the end of the world.
And then a little later:
Let me explain something. I was upside down driving and it is happening
again. And I have got to say something. I can't possibly drive now, no matter
301
what anyone does to me, because I am driving on my head. You know, driving
isn't good when you are upside down.
I have to get off the road. My God, what is happening?
I don't know, I have driven cars a few times, I will confess,
when I have had one or two too many drinks. I have been with
some people who have been driving who have had a few too many
drinks. But I can recall, quantitatively, no reaction quite comparable
to this. This guy was hallucinating ; his mind was not simply fuzzed
up.
Dr. Tennant. I think perhaps that incident may point out that
alcohol is primarily a depressant, but with cannabis you essentially
get psychotic symptoms with a toxic dose, in which case you may
have delusions, or you may be confused, or you may hallucinate. This
is well documented in many reports. It sounds like this is what
happened in this particular incident.
Mr. Martin. The clincher here, which comes at the end of Dr.
Davis' commentary, is that when the car was stopped by a traffic
policeman, the control and the cannabis-intoxicated student simply
changed positions. And the traffic policeman was not aware, he
simply had no knowledge, that this car which has been behaving
so strangely had been driven by a student who was intoxicated with
cannabis.
Dr. Tennant. I would certainly like to add to this that I think
one of the biggest problems from a public health point is the driving
problem with cannabis. One of the big dilemmas that we are in is
that we have no reliable, inexpensive routine test to detect THC or
cannabis products in the urine, breath, blood, et cetera. And, there-
fore, there is no way to accurately detect, for example, for the rou-
tine community or Army post, whether someone is intoxicated with
cannabis, because we just do not have a laboratory test that is
readily adaptable at this time. It is strictly a research procedure at
the moment.
Mr. Martin. One more question. Would not the same considera-
tions apply in even greater degree to soldiers who are operating
expensive or complicated equipment of any kind?
Dr. Tennant. Most definitely.
Mr. Martin. Trucks, artillery equipment, nuclear weapons, guid-
ance svstems — everything?
Dr. Tennant. There is no question about it. And I think this is
a prime danger that we have with cannabis products in the military.
Almost everyone in the military services must operate a mechanical
tool or mechanical vehicle of some type. And, therefore, you simply
cannot afford to have, with our advanced technological vehicles and
equipment, people that are intoxicated on any drug and who operate
equipment.
Mr. Martin. And from your experience, is it not logistically a
much simpler thing for a GI to hide a few marihuana joints in his
pocket, or a little bit of hash in his pocket, and sneak off for 15
minutes and get himself a cannabis high, and then come back to his
job, than it is for him to hide a bottle of whiskey and then sneak
away long enough to get himself really stoned?
Dr. Tennant. Absolutely. In fact, this was, when I was on active
duty, one of our biggest problems, because the sergeant or the com-
33-371 O - 74 - 21
302
pany commander would walk down to the motor pool in a field
operation and find people intoxicated because they had been able
to bring hashish into the working area.
Mr. Martin. Which they would not have been able to do with
whiskey ?
Dr. Tennant. No, soldiers cannot bring a six pack into the area
as easily as hashish. And they would get noticeably intoxicated.
Mr. Martin. Proceed.
Dr. Tennant. One of the other things that came to our attention
from a medical point of view in 1969 and 1970 were respiratory
problems that were related to hashish consumption. We have reported
these findings in several reports. And I will not belabor them, except
to say that we found that sinusitis, pharyngitis, and bronchitis were
extremely common among these heavy hashish smokers. And this is
rather surprising, because even though you can get bronchitis and
emphysema and these sort of problems from cigarette smoking one
usually must smoke cigarettes for 10-20 years to get these compli-
cations. We became alarmed about this because we began seeing
these complications in 18, 19 or 20-year-old men.
One of our major concerns whether hashish may also lead to
cancer as does cigarette smoking. To this end I and two other U.S.
Army physicians began a study in 1971 which involved bronchial
biopsies of 36 male, U.S. soldiers age 17 to 36— mean age 21 years.
My colleagues in this effort were Maj. Roderick Guerry, MC who
is now a pathologist at the University of South Carolina and Lt.
Col. Robert Henderson MC who is an otolaryngologist and still sta-
tioned at the Wurzburg, West Germany, U.S. Army Hospital where
this work was done. Much of the work was done after I left, but
the three of us have coordinated the effort since 1971. A paper has
been written, and I am making it available to you.9
The subjects were as follows:
Hashish and Cigarette Smokers 23
Hashish (No Cigarettes) 7
Cigarettes (No Hashish) 3
No Cigarettes orHashish 3
All 30 hashish smokers smoked over 25-50 grams per month and all
had clinical findings of chronic bronchitis. Twenty-four of the 30
had abnormal bronchial biopsies.
Among the six nonsmokers of hashish only one had an abnormal
bronchial biopsy — was 32-year old cigarette smoker.
The abnormalities found in the bronchial biopsies were the same
that are associated with heavy cigarette smoking and cancer of the
lung.
Our data suggests that the abnormal lesions found in these sub-
jects and which are associated with cancer of the lung are more
likely to occur in people who smoke both cigarettes and hashish than
with either smoked alone.
Mr. Martin. And how long, again, had these men been chronic
cannabis smokers?
Dr. Tennant. Just a few months.
9 Tennant, F. S., Jr., et al. : Effectiveness of Drug Education Classes. American Journal
Public Health, 64 :422-426, 1974.
303
Mr. Martin. When you say long-term cigarette smokers, what pe-
riod of years are you talking about?
Dr. Tenant. Generally speaking, it takes, from the studies that
have been done, about 5 to 20 years to develop precancerous lesions
in the lungs from cigarette smoking alone.
Senator Thurmond. You are talking here about chronic cigarette
smokers, who smoke a pack a day or more?
Dr. Tennant. Yes, sir.
Senator Thurmond. And with the chronic hashish smokers, as
much change took place in 3 months as you would normally find
in chronic smokers who have been smoking a pack or more a day
for many years?
Dr. Tennant. That is right.
Senator Thurmond. Those are very impressive figures.
Dr. Tennant. Now, the interesting thing about this is that we
had 7 of these 30 smokers that did not smoke cigarettes, they only
smoked hashish. And two of these seven had these precancerous
lesions. You might say only two out of seven is not very many. But
you have got to realize that you do not normally find this particular
lesion unless you have smoked for a long time.
Now, the other thing about this study, we had 23 people who
smoked both hashish and cigarettes. And all of these people had
abnormal lesions in the biopsies. And, therefore, our conclusion, at
least based on our evidence, is that it would appear that people
who smoke both hashish and cigarettes develop these precancerous
lesions at an amazingly early age, and that smoking hashish alone
may cause this also.
These findings, I think, would lend some credence to one of the
reports that has come before this hearing, the study of Leuchten-
berger of Switzerland. This would certainly go along with her data.
Mr. Martin. Presumably, Dr. Tennant, you are making copies of
these studies which you are going to make available to the sub-
committee for publication as appendices to the record?
Dr. Tennant. Yes, sir.
Mr. Martin. If that should be the decision of the subcommittee.
Dr. Tennant. Yes, sir.
Mr. Martin. Thank you very much.
Dr. Tennant. I would now like to move to another subject. And
that is the benefit of education about cannabis. And some of Our
efforts in U.S. Army, Europe to attempt to deal with the problem in
this area.
I must say that beginning in 1969-70 various commands within
the USAREUR Command began to attempt to use all types of
education efforts to stem the tide of cannabis and other drug abuse.
And beginning in 1971 the USAREUR Command started making
a tremendous effort in this area. And many things were tried. In
fact, everything imaginable was tried, from the traditional films
and sermons from the pulpit to actually publishing literature that
essentially took the attitude, if you are going to smoke hashish, at
least smoke it right. And we actually officially published material
that actually taught them to smoke it, and to smoke it the safest
way, because we became rather desperate because, we found nothing
else that seemed to be stemming the tide.
304
We conducted one study of 947 soldiers to determine if drug edu-
cation classes given by knowledgeable authorities were effective in
reducing use and abuse of hashish and other drugs. These subjects
were surveyed by anonymous questionnaire to determine drug-use
prevalence at the time of the classes and then again at 3 months
following the classes to see if drug-use prevalence changed follow-
ing the classes. Drug-related hospitalizations among these subjects
were also monitored beginning 1 year before the class to 1 year
afterward. The effect of the classes on hashish use was slight, with
about 80 percent of hashish users maintaining their same hashish
habit following the class. About 15 percent of subjects reported they
decreased or stopped hashish as a result of the class while 5 percent
reported they started or increased hashish use as a result of the
class.
Prior to these hearings, I basically stood on the opinion — based
on our studies — that education efforts to reduce cannabis use had
equivocal and possibly even detrimental value. So much new and
well-done research now indicates to me, however, that we have
enough solid information about the deleterious effects of cannabis
to reconsider education efforts. In the past, all we have been able to
offer in the way of cannabis education has been psychiatric reports.
These have not been impressive to the target population. Considering
that the evidence now strongly suggests that cannabis may lead to
lung disease, brain disturbances, suppression of the immunologic
system, testicular suppression, and possibly even cancer, I feel we
have a responsibility to inform members of the armed forces about
the possible consequences of cannabis. This information may have a
significant effect just as did information about the possible compli-
cations of LSD.
Mr. Martin. You are talking about the series of hearings that the
Subcommittee on Internal Security has just conducted?
Dr. Tennant. Yes.
From reading the testimony that has been presented here, there
appears to be so much new arid well-done research that my opinion
has perhaps been altered. I think that we perhaps now have enough
good research data about the deleterious effects of cannabis to per-
haps reconsider our education efforts in the cannabis area.
In the past all we have really been able to offer in the way of
cannabis education has been to relate some psychiatric reports and
to tell them that it is illegal and that we do not like it. Short of that
we reallv have not had much to say. And this type of education
has not been very impressive to the target population, which is the
young military man.
I would throw up a note of caution, here, however, in that per-
haps we should attempt to give the facts as they were reported here.
I would like to cover one other area now that I think is very
important. And it is a study that I have spent almost 3^ years on,
and which has just recentlv been completed at UCLA.11 In the last
half of 1971 I mentioned that we surveyed slightly over 5,000 Army
soldiers in U.S. Army, Europe. The reason why we conducted this
"Tennant, F. S., Jr., Childhood Antecedents of Alcohol and Drug Abuse. Doctoral
Dissertation, UCLA School of Public Health, 1974.
305
survey at that time was not to really determine how many people
were taking drugs — that was only a secondary goal — our primary
goal was really directed toward prevention. It became obvious to
me in 1971 that education was not working, prevention was not
really working, and treatment was not working very well. And law
enforcement efforts were not working very well. Therefore, I felt
we had to explore a new area. And that was to perhaps attempt to
find out something about the childhood backgrounds of drug abusers,
and perhaps come up with some events or behavior in early child-
hood that lead to adult drug taking.
Now, these types of studies have some problems as far as inter-
pretation. But we felt that we had to make an attempt to find out
why do some kids become users and some do not.
There is a growing body of evidence that indicates that many
destructive — versus constructive — health behaviors such as drug tak-
ing, overeating, smoking, alcoholism, accident-proneness, et cetera
are primarily developed before age 10 to 12 years.
A childhood antecedent that was striking in this study and the
only one that proved to be associated with adult hashish abuse was
an early age of initiation of alcohol use. Among these 5,044 subjects
about 20 percent reported they began alcohol use before age 9 years.
In this study, childhood antecedents of drug and alcohol abusers
were compared with nonusers. Included among antecedents were
childhood hobbies, games, outdoor activities, membership in Scouts,
school athletics and nonathletie activities, time parents spent in ac-
tivities, television watching, church attendance, household tasks,
monetary allowance, type and frequency of punishment, age of first
alcoholic drink, and drinking habits of parents.
The criterion for a significant association between a childhood
antecedent and nonuse or abuse required used here was at least a
20 percent difference between the percentage of abusers and nonusers
who experienced a childhood antecedent. This criterion was estab-
lished because a study sample of this size [N=5044] allowed for a
difference of a few percentage points between groups to be statis-
tically significant at the P<.001 level. Using this criterion, there
were no significant associations between anv childhood antecedent
and frequency of alcohol use. A report of beginning: alcohol con-
sumption before age 9 years was associated with hashish abuse while
the start of alcohol consumption at age 15 years or older was asso-
ciated with nonuse of hashish. Spanking by parents and church
attendance of over 50 times before age 15 years were the only ante-
cedents associated with nonuse of amphetamines and opiates. Pun-
ishment of over three times per week was associatd with abuse of
amphetamines and opiates. These associations were found within
white and nonwhite groups and among subjects with divorced or
separated parents.
Mr. Marttx. In talking about drinking:, do you know whether they
were drinking beer or whiskey or what?
Dr. Tennant. Again, let me emphasize, this was a pilot study,
the onlv one I know that has ever been done like this. And it was
a verv long study. All we could ask was at what age did you begin
drinking ?
306
Much to our surprise, 20 percent of these 5,000 soldiers reported
that they began drinking before age 9.
Now to go along with this — it is very interesting — the soldiers
who reported they began drinking alcohol at age 15 or older were
statistically associated with nonuse of hashish in their adult life.
Now this was the only thing that was associated pro and con with
hashish abuse and nonuse.
I would like now perhaps to wrap up my testimony by bringing
out a couple of issues and perhaps making some recommendations.
First off, I would like to say that as far as attempting to reduce
the use and abuse of hashish in the U.S. Army, Europe, I believe
that the efforts there have far exceeded on many fronts the effort
that the civilian sector has put out. And I particularly want to make
a point of this, since I am one of the few people in the United
States who has had an opportunity to see what the military has
attempted to do to deal with the drug problem, and what the civilian
sector in a very large community has attempted to do with the drug
problem. And judging by the malignment that the press has given
to the military, I must say, compared to what the civilian sector
has done, that that criticism is totally unjustified.
Let me just put it very pointedly. The efforts being made in my
county, which is Los Angeles, does not even begin to compare with
the efforts that the Army community has attempted to make in
Europe.
Mr. Martin. Are we not spending a lot of money, that is, isn't
the Federal Government spending a lot of money on drug education,
on programs around the country — civilian drug education programs,
that is?
Dr. Tennant. Let me say that you are spending a lot of money.
And this is one of my — I am glad you brought this out — a very
important point with me is that we have several Federal agencies
in particular that are giving grants supposedly for drug treatment
and for drug education and for drug training programs. I think
this money has been misused in many cases, if not the majority of
cases. I think that a close scrutiny of where grants have gone would
reveal a spectrum that is almost amazing. This spectrum would run
from people doing a very excellent job of drug treatment and drug
education and drug training, to the other end of the spectrum in
which the money is used for totally unrelated purposes — everything
from running political campaigns to providing salaries and simply
putting it in people's pockets and appropriating it for their own
personal use. And you have got a variety in between.
Mr. Martin. You are involved, I believe you stated, with three
drug educational programs in the Greater Los Angeles area?
Dr. Tennant. My programs are primarily treatment programs.
Mr. Martin. Treatment programs. But you have had contact with
the drug educational programs that are operating in the Greater
Los Angeles area?
Dr. Tennant. Very much so. I consult with many. And I think
I am somewhat familiar with their operations.
Mr. Martin. Those operations do receive funds from Federal
sources ?
Dr. Tennant. Yes, some do.
307
Mr. Martin. Do any of them conduct what you would consider
to be an effective campaign against cannabis abuse, or do they per-
haps tend to take a tolerant attitude?
Dr. Tennant. Let me put it this way. I do not know of anybody
who has been waging a good campaign against cannabis. I do know
of a lot of federally funded drug education programs that are doing
an awfully good job of encouraging cannabis use.
Mr. Martin. That is not what they got this money for, Dr. Ten-
nant.
Dr. Tennant. That is not what they said they got the money for.
They have even been led to believe in some cases that that is what
the Federal Government wants.
Mr. Martin. You are talking about drug educational programs
with which you have had personal contact?
Dr. Tennant. Yes, sir.
Mr. Martin. And this is based on your personal experience?
Dr. Tennant. Right. And without mentioning names or attempt-
ing to slander anybody, let me just say that I think the time has
come that we need a very close scrutiny of drug grants. I think that
someone somewhere needs to take a very serious look at drug grants
given out of the Office of Education and out of NIDA, as to what
that money has been spent for; who those grants went to; to what
kind of people received the grants and to what really was being
done with the money. I can make one statement, I think, without a
lot of reservation: most Federal grants for drug money in the last
3 or 4 years have been given with essentially no requirement of
accountability.
And I do know, incidentally, that Dr. Dupont and his people are
making some efforts in this direction. But I think there is a lot
more that has to be done.
Mr. Martin. Dr. Tennant, I do not know whether you are in a
position to provide for the record some of the names of the drug
education organizations, or setups, that in your opinion are actually
encouraging marihuana use rather than conducting a campaign of
education against cannabis abuse. If for some reason you cannot
provide them for the public record, would you be prepared to pro-
vide the names of these organizations or committees for the infor-
mation of the subcommittee?
Dr. Tennant. I would not be prepared to present them in this
room. But I would be glad to privately.
Mr. Martin. You can give them to us after the hearing, Dr. Ten-
nant?
Dr. Tennant. That would be my preference, yes.
Mr. Martin. Thank you.
Dr. Tennant. I would like to mention a couple of other issues.
I would like to mention very briefly something about security clear-
ances and cannabis. That has been a very difficult problem for the
Armed Forces. And I would basically like to relate what I did as a
medical officer who had to review security clearances and what I
recommended to my commanders.
The use of cannabis was so widespread, as were drinking prob-
lems, that we had to reckon with both of these things in granting
security clearances. And here was our policy — whether it was a
308
right or wrong policy I do not know, but we had to come up with
one at our level that was a workable policy. And I offer it only
for information's sake, and not necessarily as a recommendation,
even.
Our policy was that if someone had a drinking problem or was a
known cannabis user, that on occasion they would be granted a
confidential security clearance. It was our policy that anyone with
a drinking problem or that was a known cannabis user would not
be given a secret or top secret clearance, and certainly no one was
given a nuclear clearance in my unit who was identified in either
one of these categories.
Mr. Martin. Did you ever have to deal with the problem of an
officer or enlisted man who perhaps had been given a secret or top
secret clearance, or a nuclear weapons clearance, and who was sub-
sequently found to be constantly intoxicated on hash, so that his
clearance had to be withdrawn?
Dr. Tennant. On rare occasion; yes, sir. This came about — I can
think of a half a dozen times over a 3-year period within my divi-
sion. But it was not a common occurrence. Frankly, most of these
people who really smoked cannabis heavily became identified rather
soon, because their job performance deteriorated so rapidly.
I would like to cover one other area. Perhaps I as an ex-officer,
can talk about programs easier than can some people who are active
officers. And this is the problem — and I emphasize the problem — of
discharges for drug abuse from the Armed Forces.
Discharges for drug abuse from the military should, in my
opinion, be changed. In simple context, we basically have two types
of discharges: 1. those who receive veterans' benefits; 2. those that
do not provide benefits.
These two categories exist whether the discharge is labeled as
honorable, dishonorable, general, undesirable, unsuitable, et cetera.
When it comes to discharges for drug abuse, the two basic categories —
veterans' benefits versus nonbenefits — have been a demoralizing
factor on the U.S. Army — and I assume other branches of the mili-
tary— unit because it rewards the drug user with the same veterans'
benefits as it does the dedicated, nondrug using soldier. As you are
aware, a discharge for drug abuse now warrants full veterans' bene-
fits including hospital care, home loans, and education supplements.
Our current discharge policy violates a basic tenet which has been
known by social scientists for centuries: "If you reward or ignore
maladjusted behavior, the behavior gets worse."
Those of us who treat drug-dependent individuals as an avocation
base our treatment on confronting maladjusted behavior and re-
warding positive behavior. Our current discharge policy for drug-
abuse not only does not deter drug use, it mav actually encourage it.
My files contain literally dozens of cases of U.S. Army soldiers who
requested A.R. 632-212 discharges for unsuitability for drug de-
pendence for the main purpose of leaving the Army and attending
school with veterans' benefits. I do not think I exaggerate when I
say that I think our discharge policy for drug abusers did as much
to undermine the combat readiness and interfere with security of
my units as did any other single factor.
309
I recommend a discharge regulation for drug-dependent persons
to contain the following points: 1. Discharge termed neither hon-
orable nor dishonorable; 2. No way to identify the individual as a
drug abuser ; 3. The only veteran benefit is treatment for drug abuse —
no other medical care ; education benefits, etc.
If we had such a discharge policy, I believe it would be fair to
the individual; it would not encourage drug use; and it would not
hinder combat readiness and interfere with security.
Two areas have emerged from my work which require progressive
and concentrated research. One is the effects of cannabis when con-
sumed with alcohol, tobacco, and other drugs. The second is the
effect of consumption of legal drugs — alcohol, tobacco — by preado-
lescent individuals on their drug-taking patterns in later life, Present
evidence, although inconclusive, indicates that the consumption of
these substances by preadolescents is_ directly or indirectly related
to abuse of hashish and other drugs in adulthood.
The time may be fast approaching to seriously consider how to
revamp the system to deliver alcohol and cigarettes to the public in
such a manner to effectively keep these substances from preadoles-
cents— to say nothing of keeping them away from under-the-legal
age — is — adolescents. It appears somewhat incomprehensible to con-
sider legalization of cannabis when we cannot deliver our present
legal drugs — alcohol, cigarettes — so that children under age 10 can-
not consume them to the extent they currently do. Although the
withholding of alcohol and cigarettes from children may not prevent
adult drug abuse, current evidence suggests we must eventually make
an effort to educate the public about possible hazards of early age
drinking and smoking.
Mr. Chairman, this concludes my rather lengthy and involved
report. And I appreciate the opportunity to deliver it. I would be
delighted to answer any questions.
Mr. Martin. I have a few questions that I would like to ask Dr.
Tennant, Mr. Chairman.
In your testimony, Dr. Tennant, you referred to a number of
questionnaire surveys on cannabis abuse which were conducted at
different times with different results. In conducting such surveys.
would not the results vary considerably, depending on the phrasing
of the questions, whether or not the questionnaires were distributed
by mail or distributed live to an assembly of servicemen ?
And finally, would they not also depend on the skill of the officer
in charge of the questionnaire survey?
Dr. Tennant. Very much so. When we started out doing ques-
tionnaire studies in 1969, there was essentially no one around that
knew how to do it. And we did some preliminary studies in which
we completely boggled the whole thing. They just gave us mean-
ingless data because we did not know how to ask the questions, and
we did not know how to do it, and there were a lot of problems.
And there was nothinsr in the scientific literature to give us a lot
of guidance. Epidemiologists really had not gotten into this area.
We learned that there were certain ways that you had to ask
questions and a certain methodology that seemed to work. And it
has been very interesting that the methodology that I, and prm-
310
cipally Dr. Tom Pendergast, who is now an epidemiologist at the
University of Missouri, used. He and I over a year and a half's
time developed a method by which we thought we got some fairly
accurate responses. And it has been interesting that these techniques
have been essentially the same techniques that people have had good
success with in school systems. And so, therefore, it is generally
thought, I believe, in the epidemiologic field that there are special
ways and methods that have to be used if you are going to conduct
studies on drug dependence or alcohol dependence.
Mr. Martin. Were all of your questionnaire surveys conducted
live, or were any of them conducted by mail, or do you know of
any that have been conducted by mail in the armed services?
Dr. Tennant. When I was just about to leave active duty there
was a large mail survey I know that was on the drawing board,
and I frankly do not know what happened to it. Based on what we
know, that will not get an accurate response.
Mr. Martin. Why will it not get an accurate response?
Dr. Tennant. For a variety of reasons. We know that, for exam-
ple, if you mail questionnaires to, say, physicians, you only get a
55-percent return. And this is a fairly intelligent group who usually
are fairly well motivated. So you get a very poor return, number 1.
Second, I think it takes a lot of ability to fill out a questionnaire
and put in the mail and then mail it back. It is much more difficult
than it is to just give it to someone and supervise them when they
are sitting there filling it out.
So I cannot imagine that you would get very good responses
out of a mail type questionnaire. And I know of no one who has
done such a study in the United States who felt good enough about
his data to publish it.
Mr. Martin. Your surveys suggest that toward the end of 1971
you noticed what appeared to be a marked improvement in the
situation, as far as cannabis consumption was concerned. Now, you
went back to Germany, I believe, in late 1972 on reserve duty. Did
you see anything at that time which appeared to suggest that the
trend was still continuing, or that we were making some progress
in curbing the cannabis epidemic?
Dr. Tennant. I was very intrigued by finding that between our
surveys done in late 1970 and early 1971 that they showed that
something like 16 percent were using hashish over -3 times a week —
that this had dropped to about 10 percent, according to surveys
right at the end of 1971, over about a year and a half time. And
I have seen some survey data — I do not know how the survey was
conducted — that shows that perhaps this may have dropped off a
little bit even since.
Mr. Martin. When you say "since," do you mean 1974 or 1972?
Dr. Tennant. 1972, 1973 and 1974, after I left active duty and
was no longer doing the surveys.
When I returned in late 1972 I did not do any epidemiologic
surveys. And I talked to a few soldiers, but that is not a very
good way to assess what is going on. You can only talk to a few
people, and that gives you a very small sample; a very biased
sample. And that is not a very good way to do it. You really have
311
to sample a lot of people using a known method in order to get
an idea of the prevalence of drug use.
Mr. Martin. Since you visited Germany there has been a rather
important change in the composition of our armed services. They
have gone over to a volunteer basis. And the volunteer Army, of
necessity, is unavoidably recruited — heavily recruited — from the
lower economic strata of the population. Would that not create an
entirely new situation, a situation which calls for a careful study to
find out in what manner the volunteer composition of our Armed
Forces has affected the problem of drug abuse?
Dr. Tennant. I do not think there is any question about that.
I could name about four or five different factors or variables right
now that might make differences in the prevalence of drug use. And
one of them is, what has the volunteer Army done?
Let us take U.S. Army, Europe, for example. You have also got
to consider the fact that they have quite a good drug treatment
program. They have good police efforts. They have a very positive
attitude toward controlling the problem. I do not know exactly
what has happened to availability of the drug. I see all those factors
possibly contributing to the drop in prevalence. And it was my
contention that soldiers are starting to become very leery of very
heavy use of cannabis, and that this has also been a factor.
The point I am making is that the only way I would know what
is going on now would be to see good epidemiological data from
surveys that were conducted in an appropriate way at this time.
Otherwise, I really do not know what is going on. And I would like
to see that kind of data before I could make an assessment.
Mr. Martin. Professor Hardin Jones, in the testimony which he
gave our subcommittee in executive session, made the point that when
people are inducted into the Armed Forces, or when they join the
Armed Forces as volunteers, they do not change — by and large, they
bring with them into the services both the strong points and the
weaknesses which characterized them as individuals in their civilian
life. Would you agree with that hypothesis?
Dr. Tennant. Absolutely. In fact, I would even go one step fur-
ther. The growing body of evidence — and I alluded to this earlier —
would indicate that to a great extent deviant behavior, deviant psy-
chiatric behavior or destructive health behavior, are pretty well
formed in an individual by age 10 or 12. And, therefore, the military
gets an individual long after his basic patterns and his basic be-
havior has developed. And the military can do very little to change
these patterns.
Mr. Martin. Are you talking about actual behavior patterns, or
certain predispositions which may affect behavior patterns?
Dr. Tennant. I am talking about both. We know that drug taking
starts at a very young age, and that people who become very se-
verely drug dependent in adult life, as a general rule start their
drug taking at age 8, 9, 10, or 12.
Mr. Martin. And you also made the point in your testimony that
in Italy, where they clamp down hard on drug pushers and drug
abusers with very heavy penalties for being caught in the possession
of hashish, that there aire no serious problems with American service-
312
men. So the question of availability appears to exercise a consider-
able influence, even where you may have a widespread predisposi-
tion to get involved in drugs?
Dr. Tennant. That is not a contradiction to my other statement.
And that certainly is true. We know that basic behavior patterns are
formed at a young age, and you basically, frankly, have to have
some laws and controls to make sure that behavior does not become
destructive for society and to the individual later on. And I think
the Italian laws are a dramatic example. We do not have hashish
abuse in Italy among our soldiers. The number of European urine
tests that are positive there in our urine screening program is very,
very small, because they have very stiff penalties. However, in
West Germany, of course, they are very lax. And it is ignored by
the German Government, so, therefore, it is severely abused. And
maybe you cannot legislate morality, but drug taking is not exactly
morality. It can be reduced by control.
Mr. Martin. You can legislate the scale of drug abuse, or at least
within certain degrees you can reduce it by having laws that are
toughly enforced, or you can increase the scale of drug abuse in the
same population bv having lax laws that are weakly enforced?
Dr. Tennant. That is very true.
Mr. Tarabochia. Dr. Tennant, do you think that the attitude
of the local population in Italy and Germany affects the abuse of
hashish and marihuana? Because I know that the Italians, for
instance, looked down on the drunkards, they consider it disgraceful,
and they do not have anything to do with a person who abuses
alcohol, despite the fact that the Italians produce some of the best
wine. Do you find any relation to that?
Dr. Tennant. I cannot give you any scientific data, but my own
opinion is that, yes, it does make a difference.
Mr. Tarabochia. I see. Thank you.
Mr. Martin. Dr. Jones also made the point that the rate of drug
abuse among our economically deprived strata, especially the urban
strata, is much higher than the rate of drug abuse for the popula-
tion as a whole, perhaps by a ratio of two to one. From your own
knowledge of the problem in this country, would you concur with
this estimate?
Dr. Tennant. Again, generally speaking, this has been very true
in the past. However, in the last 5 years it has become less true,
since we have seen severe heroin addiction in the upper strata of
society and even in rural areas. But generally speaking you still, I
think, probably do see more severe drug abuse in your lower socio-
economic groups.
Mr. Martin. And accepting this, would it be reasonable to antici-
pate that the shift to a volunteer Army, at least initially, might in-
crease the problem of drug abuse, because the armed services would
be getting more people who are involved as drug abusers at the
point of admission — unless, of course, energetic measures were taken
from the outset to cope with the problem of occasional drug users
who might become very heavy drug users if something were not
done to discourage them ?
313
Dr. Tennant. My first inclination is that with the all-volunteer
force, drug abuse will go up. But again, there are some factors that
I do not know about. And that would be, for example, have our
recruiting stations and have our induction people gotten more skilled
at detecting drug dependent people at the time of induction? And
so you see, we could actually, just based on the competency of the
induction center to screen out people, have less drug abuse in the
Armed Forces now than we did, say, 3 years ago. I do not know,
however, whether this is the case.
Mr. Martin. There is a problem, Dr. Tennant, of the pressure
to fill the volunteer quota, because volunteers have not always been
easy to come by.
Dr. Tennant. I have heard that, sir.
Mr. Martin. I have only asked one question about why the armed
services, in your opinion, have had some success in coping with the
cannabis epidemic, whereas in the United States all of the evidence
presented to the subcommittee so far indicates that the epidemic is
growing at an incredible rate, and it has now spread through all strata
of the population. Conservative businessmen are taking it, and high
school juniors are taking it, and grade school children are taking it,
blue collar workers are taking it, everyone is using it. Are there
any other reasons you can think of that it would help to explain the
contrast between the relative success that the armed services have
had — the partial success — and the apparent lack of success, the
total lack of success, here on the homef ront ?
Dr. Tennant. The only place in the Armed Forces, of course,
that I can speak of with much knowledge is U.S. Army, Europe. And
if indeed we have had some success there — and I emphasize that
I would need to see some recent epidemiological surveys to know
if we have — but let us say that we have. If indeed we have, I would
have to at least partially attribute that to the efforts that have been
made there by the command. I think the one overriding thing that
has been apparent there, particularly since General Davison took
command — and I do not mean to give accolades to my old com-
mander, but I think he has done a very fine job. And I think our suc-
cess has been due largely to attitude. And that has been reflected, I
know, from DOD level down, that we are not going to take a neutral
or advocacy position regarding drug use within the military services.
Mr. Martin. In short, it has been a command decision that this
is a bad thing, and we have got to do something about it, and there
has been an effort, involving an educational program, involving a
beefed up law enforcement program, and a treatment and hospitali-
zation program?
Dr. Tennant. Absolutely. In 1969 my commanding general was
Major General Tabor. And even as far back as then our entire
division took the attitude that we would approach the problem on
two fronts: We would step up law enforcement efforts and preven-
tion efforts, and we would also start developing treatment pro-
grams, and education programs. And, of course, we do not know
what would work, but we would try. And I think that attitude has
persisted. I think that in the military forces — at least in the U.S.
314
Army, Europe, and throughout the rest of the Army — this has been
a prevailing attitude.
Mr. Martin. And you do not feel that we have a comparable over-
all effort on the homefront in the United States — that is, an effort
which would combine the energies and the devices open to govern-
ment and the energies of the press and the academic communities,
in short, an across-the-board united front?
Dr. Tennant. Again, I do not have any scientific evidence. But it
makes very good commonsense that if you are going to have academic
institutions, advocating drug use ; Federal agencies giving grants to
agencies that advocate the use of marihuana and other drugs; and
a press that is actively calling for legalization of marihuana and
the use of other drugs; I do not see how with this type of neutral
or advocacy stand that we can have reduced drug consumption. It
makes just good commonsense to me.
Mr. Martin. I think that completes my questions, Dr. Tennant.
I want to thank you very much for your patience. And we will go
on to our next witness, Mr. Cooke.
I am sorry we kept you waiting so long. You have already been
sworn. So we will proceed with your statement. And then I have
some questions I would like to ask.
TESTIMONY OF DAVID 0. COOKE, DEPUTY ASSISTANT SECRETARY
OF DEFENSE, OFFICE OF THE ASSISTANT SECRETARY OF
DEFENSE (COMPTROLLER), ACCOMPANIED BY DR. JOHN F.
MAZZUCHI (PHD), ASSISTANT FOR EDUCATION AND INFORMA-
TION, DRUG AND ALCOHOL ABUSE, ASSISTANT SECRETARY OF
DEFENSE (HEALTH AND ENVIRONMENT); BRIG. GEN. W. A.
TEMPLE, USAF, COMMANDER, OFFICE OF SPECIAL INVESTIGA-
TIONS, U.S. AIR FORCE; COL. FRANK W. ZIMMERMAN, USAF (MC)
OFFICE OF THE SURGEON GENERAL, USAF; DAVID N. PLANTON,
HEAD, CRIMINAL DIVISION, NAVAL INVESTIGATIVE SERVICE;
COMDR. S. J. KREIDER (MC) USN, PSYCHIATRY DIVISION, BU-
REAU OF MEDICINE AND SURGERY ; COL. HENRY H. TUFTS, U.S.A.,
COMMANDER, U.S. ARMY CRIMINAL INVESTIGATION COMMAND ;
COL. WAYNE B. SARGENT, U.S.A., CHIEF, ALCOHOL AND DRUG
POLICY DIVISION, OFFICE OF THE DEPUTY CHIEF OF STAFF,
PERSONNEL, U.S.A.; AND COL. JOHN J. CASTELLOT, U.S.A. (MC)
CHIEF, DRUG AND ALCOHOL, OFFICE OF THE SURGEON GENERAL,
U.S.A.
Mr. Cooke. May I get the rest of the members of my team up
here so that it will be a little easier?
Mr. Chairman, I am pleased to be here today to present informa-
tion on investigative and other efforts of the Department of De-
fense pertaining to the control and ultimate elimination of the use
of dangerous drugs, including cannabis, by military personnel.
Maj. Gen. Frank B. Clay, Deputy Assistant Secretary of Defense
for Drug and Alcohol Abuse, supported by other witnesses, has pre-
viously appeared before this committee and provided information
315
on his responsibility. If you will recall, his testimony concerned
the prevention of drug abuse in the armed services through education
programs, the identification of service members who abuse dangerous
drugs and alcohol and the short-term rehabilitation efforts of those
military drug abusers who cooperate with their own treatment. Ac-
cordingly, my statement will be concerned with the investigative
and security aspects.
Accompanying me today are representatives of the three military
department investigative organizations, a medical officer from each
of the military departments and a representative from the Office of
the Assistant Secretary of Defense for Health and Environment.
These gentlemen are the experts in their specific areas and are avail-
able to answer any questions you may have upon the conclusion of
my statement.
The use of so-called mind-expanding drugs, including marihuana
and hashish, has been and continues to be a major concern to the
Department of Defense. This is not only because of the sensitive and
exacting nature of military duties, but also because the use of these
drugs impacts upon the morale, discipline, and security required
for a well-trained and efficient Military Force.
Prior to the mid-1950's, the Armed Forces experienced little crim-
inal activity associated with the sale and use of marihuana and
narcotic substances or the illegal use and abuse of prescription-type
drugs. We have reason to believe that when the "drug culture"
surfaced within American society, subcultures also surfaced within
the Military Services.
The buildup of American Forces in South Vietnam during the
mid-1960's resulted in an upsurge in the use of opiates, principally
heroin, and marihuana. Inasmuch as the conflict waging in Southeast
Asia was of vital national concern and heroin was so readily available
to our Military Forces, our main thrust in combatting drug abuse
was focused in this area and was almost totally concentrated on the
elimination of hard drug usage by our military personnel stationed
there.
One such thrust was the use of our customs program. New policies,
procedures, and processes were developed to eradicate Military chan-
nels as a means for the distribution of narcotics and drugs both to
our troops in Southeast Asia and worldwide.
Historically, the U.S. Customs Service has depended upon the
efficiency and integrity of the military departments to perform cus-
toms inspection of Department of Defense personnel, mail, cargo,
and household goods in overseas areas.
In April 1971, representatives of the House Committee on Foreign
Affairs visited Southeast Asia to review the drug problem in that
area of the world. As a result of this visit, the Commissioner of
Customs initiated an intensified customs inspection program to re-
duce the entrv of drugs and other contraband items into the United
States. In May 1971, instructions were issued to all regional cus-
toms commissioners to immediately implement a 100-percent inspec-
tion of all Department of Defense personnel, their personal prop-
erty, mail, Department of Defense-sponsored cargo, ships, and air-
craft— including crews — arriving in the continental United States
and Hawaii from Vietnam and Thailand.
316
These expanded procedures initially created problems and delays
in processing passengers and the movement of cargo and mail. Pre-
viously, customs inspection performed by military customs represent-
atives at the point of origin were acceptable to U.S. customs officials,
with U.S. customs representatives performing only spot checks in
the continental United States. The military services were concerned
about the impact and magnitude of the problems that would result
once the 100-percent inspection of personal property shipments
became fully operational.
To assist the U.S. Customs Service and to reduce the delay in the
movement of passengers, baggage, and cargo at ports of entry in
the United States, 92 personnel were provided by the DOD to
assist U.S. Customs Service. In addition, the Air Force provided
15 ground security personnel to assist U.S. Customs personnel at
air terminals in the United States and Alaska.
As a result of this 100-percent inspection, seizure or "hit" sta-
tistics compiled by the U.S. Customs Service showed that their
suspicion that military channels were being used to smuggle large
quantities of narcotics and other contraband materials into the
United States were unfounded. Subsequently, the 100-percent re-
quirement was lifted and the 92 DOD personnel augmentation was
withdrawn.
On June 9, 1971, the Department of Defense announced support
of the intensified customs inspection program. The Army, in co-
ordination with the Navy and Air Force, was directed to prepare
a coordinated action plan. Subsequently, the Army was designated
the executive agent, under my supervision, for customs matters in
the Department of Defense.
Concurrently with this intensification of customs inspection the
Department of Defense implemented an aggressive program to re-
duce and ultimately eliminate the use of military channels as a
means of transporting illegal narcotics, contraband, and other con-
trolled substances into the United States. The U.S. Customs Service
has assisted the Department of Defense in this effort by providing
training to designated military customs inspectors, and by on-site
monitoring in order to evaluate and improve the operations.
To properly coordinate the program with other appropriate Fed-
eral departments and agencies, and to monitor the DOD-wide op-
eration, the following assignments of responsibility have been estab-
lished: Deputy Assistant Secretary of Defense, Administration, is
the single DOD point of contact for customs inspection matters and
exercises staff supervision over all customs inspection matters within
DOD ; Department of the Army is assigned executive agent respon-
sibility for customs inspection activities in DOD ; Secretaries of the
military departments are responsible for implementation of pro-
grams within their respective services; area CINC's are responsible
for programs within their respective commands.
Subsequent to the assignment of responsibilities, a long-range
planning program was developed, in coniunction with the U.S.
Customs Service, by the Department of Defense. This program
covers all aspects of customs inspections for personnel, baggage,
mail, and cargo processing through DOD transportation channels.
317
The objective of the program was to establish a DOD customs in-
spection program which was acceptable to the U.S. Customs Service
and eliminated need for reinspections by the U.S. Customs Service,
except for integrity checks.
A DOD directive and regulation were published and have been
distributed to DOD activities worldwide. These publications, along
with implementing publications issued by the respective area
CINC's, establish detailed procedures for conducting all types of
customs inspections. They also establish program responsibility at all
organizational levels and provide a working document which can
be used for determining training needs and requirements.
The Pacific Command had several on-going programs to suppress
drug abuse and drug trafficking prior to the intensified program in
1971. With the inception of the DOD customs program, the Pacific
Command was in a position to implement various aspects of the
program immediately to prevent the flow of narcotics, drugs, and
other contraband within the command and into the United States.
Vietnam had the greatest troop concentration and since drugs and
narcotics were easily obtainable, troops stationed there were partic-
ularly vulnerable to drug trafficking. In view of this, most of the
early efforts in the PACOM area to eliminate drug use and shipment
to the United States were directed toward Vietnam. To supplement
DOD efforts, the U.S. Customs Service was requested to provide
training assistance. The U.S. Customs Service responded by sending
personnel to PACOM to provide training in customs inspection tech-
niques to DOD military personnel. As a result of this training, a
Joint Military Customs Group was formed in Vietnam and this
group eventually reached a peak of 450 assigned personnel. The
group performed predeparture inspections and examination of all
personnel, personal property, mail, and some military cargo depart-
ing Vietnam for the United States.
The effectiveness of the Joint Customs Group was reflected in
statistical seizure reports which showed an overall reduction in
contraband and narcotic seizures made from personnel, accompanied
baggage and mail, exiting Vietnam. Since the Joint Customs Group
proved to be quite successful, it was decided to apply this concept
to other countries in the Pacific area. Although no additional formal
groups were formed, military country commanders in other South-
east Asian countries organized their efforts along the joint-group
concept.
As the DOD customs inspection program was implemented
throughout the PACOM area, U.S. Customs officials provided ap-
propriate training to designated militarv customs inspectors in Thai-
land, Japan, Korea, Philippines, and Okinawa. With the drawdown
of military forces in Vietnam, the need for the Joint Customs Group
was accordingly reduced. It was subsequently dissolved as a formal
unit and the functions were assumed by area commanders utiliz-
ing those personnel trained by the Customs personnel, or who had
received on-the-job training from qualified personnel.
In November 1971, a test project to inspect all mail not previously
inspected by the Joint Customs Group or military postal personnel
was instituted at San Francisco by the U.S. Customs Service. It was
33-371 O - 74 - 22
318
the opinion of the U.S. Customs officials that this channel provided
an excellent means for smuggling contraband into the United States.
The U.S. Customs Service requested DOD to provide 25 military
personnel to work directly under U.S. Customs supervision at the
San Francisco and Oakland mail terminals. These individuals were
to assist customs inspectors in the physical examination of all mili-
tary mail from the Pacific Command. DOD assigned 25 personnel
in early December 1971. During the period from December 1971 to
November 1972, 460,000 parcels were examined, and these examina-
tions resulted in only 14 narcotic seizures. In December 1972, the
DOD discontinued this support and the personnel were released for
other assignment.
The rapid turnover of military custom inspection personnel with-
in the Pacific Command has resulted in a continuous need for train-
ing of replacement personnel. To alleviate this problem, the U.S.
Customs Service has provided agents who are now serving in the
Pacific Command as advisers and trainers to the area commanders.
As a result of the training and assistance given by the U.S. Customs
Service, an effective inspection program has been developed. Pres-
ently, the predeparture inspection by military inspectors in most
countries within the PACOM area is again accepted by U.S. Cus-
toms with only a spot check of a few items made on arrival in the
United States.
The DOD implementation of the customs program in Europe fol-
lows much of the pattern of implementation of the program in the
Pacific Command. CINCEUR has devoted most of his efforts to
developing an operational program for Germany due to the large
troop concentrations in that country. There is an established military
police organization that has been assigned responsibility for the
customs inspection of all DOD passengers, their accompanying bag-
gage, and other personal property shipments prior to the departure
from Germany for the United States. Inspection requirements in
other European countries are accomplished by military customs
inspectors assigned on an area basis and by postal personnel for
military mail.
DOD and the U.S. Customs Service are jointly cooperating in
training of military customs inspectors and are currently coordinat-
ing a phase of the predeparture inspection program at Rhein Main
Air Base, Germany. This has resulted in modification of the physi-
cal arrangements of the air terminal and changes to agreements with
commercial contract air carriers.
The military inspectors at Rhein Main Air Base are presently
being trained by U.S. Customs Service personnel on personnel and
baggage inspection and examination procedures. In addition, the
U.S. Customs Service personnel are observing the performance of
the predeparture inspections to insure that U.S. Customs Service
standards are met. It is intended that a U.S. Customs Service
officer will be permanently assigned to Rhein Main to monitor DOD
predeparture inspections. This should substantially reduce the need
for reinspection in the United States by U.S. Customs, thereby re-
sulting in savings for both DOD and U.S. Customs Service.
During the return of DOD units from exercises in Germany, the
U.S. Customs and Department of Agriculture located officials on
319
site in Germany to observe the military customs inspection, and were
thus able to grant predeparture clearance to the returning direct
flights to the United States.
Customs inspection programs for other European countries where
U.S. Forces are stationed have been developed and are operational.
Narcotic seizure reports received from the U.S. Customs Service
which are based on their reinspections of DOD personnel, baggage,
mail, and cargo exiting Europe indicate that DOD channels are not
being used to transport any significant amount of narcotics into the
United States.
In the Southern Command, U.S. Army Forces, South, has respon-
sibility for the DOD customs inspection program. Although pre-
departure inspections are being conducted, U.S. Customs Service
personnel are performing reinspections in the United States. This
is partially due to the lack of trained military inspectors and the
resultant difficulty of fully complying with all DOD customs in-
spection procedures. The Commander of U.S. Army Forces, South,
is presently evaluating program requirements prior to requesting
U.S. Customs Service training assistance. Also, plans are now being
developed to establish a program for predeparture clearance similar
to the Rhein Main program.
On August 1, 1971, President Nixon established the Cabinet Com-
mittee on International Drug Control. In addition to the Cabinet-
level committee, there are a number of subcommittees in the overall
narcotics control structure. DOD is represented on all these com-
mittees and we have found the structure to be available in the
coordination of Federal interdiction program efforts. The DOD has
provided various forms of support to programs that have been
initiated and are controlled by the Cabinet Committee. This support
has been restricted to the provision of materials and equipment and
some minor amount of training. We are well aware of the participa-
tion limitations placed on the DOD, particularly by the Possee Com-
itatus Act, which severely restricts the DOD in taking an active
or operational role in any of these programs. Furthermore, all
support which has been provided has been on a totally reimbursable
basis.
With respect to the investigative programs of the military depart-
ments, the services have initiated programs in those areas where
large troop concentrations and/or the availability of drugs and
narcotics, including marihuana and hashish, are of great concern
to the Department of Defense. The following examples are indicative
of the programs which have been inaugurated by the services.
In addition to their worldwide drug investigative programs, the
most extensive drug suppression efforts by the U.S. Army Criminal
Investigation Command are being concentrated within the Euro-
pean Command. Over 508,000 military personnel. Army dependents,
and Department of the Army civilians are located in a geographical
area about the size of the State of Oregon. This large concentration
of comparatively affluent Americans provides a lucrative market
for the traffickers of heroin, marihuana, and hashish.
To combat this threat and to plan for future operations, the
Army has developed a program which uses informants as well as
320
investigative personnel. The Army's program in Europe is divided
into three operational levels.
Level 1 is the identification of international traffickers who bring
narcotics and dangerous drugs into Germany for consumption by
U.S. Forces personnel and to provide information to the host country
law enforcement agency concerning those indigenous personnel en-
gaged in wholesale trafficking. Results to date have been highly
satisfactory.
Level 2 are investigations designed to develop and report narcotic
and dangerous drug trafficking and use directed toward U.S. mili-
tary personnel in close proximity of military installations.
Level 3 are investigations in the immediate geographical area to
directly support a commander. In addition to investigating reported
drug cases, investigators at this level of operation provide briefings
and presentations to unit commanders and civic organizations con-
cerning the identification and effects of drug abuse.
A specialized activity utilized within USAREUR is the U.S.
Army, Europe, Drug Information Center. Its mission is to collect,
analyze, coordinate, and disseminate information from all levels of
operation and from all participating activities which relates to drug
trafficking, smuggling routes, modus operandi, and geographical
areas experiencing high drug incident rates.
There is an additional coordinated effort being exerted in the
Federal Republic of Germany to combat the GI drug pushers. This
program has as its objective the isolation and elimination of the GI
pusher and to reduce the pusher's mobility and access to drugs.
The Naval Investigative Service responds to all requests for in-
vestigation of drug abuse where it has jurisdiction. In addition to
conducting these investigations, NIS has instituted criminal intelli-
gence operations to develop narcotics information.
' In December 1972, a narcotics intelligence operation was com-
menced at Subic Bay in the Philippines. This operation was de-
signed to identify those individuals in the Philippine community
who were engaged in trafficking drugs to naval personnel. As drug
pushers were identified, operations were mounted to effect their
arrest by Philippine authorities. This operation has been highly
successful and, at the present time, marihuana is scarce and hard
drugs are virtually unobtainable in the area of the Subic Bay Naval
Base.
In early 1973, NIS began to conduct antinarcotics operations in
various ports visited by 7th Fleet ships, such as Hong Kong, Singa-
pore, Bangkok, Manila, and Penang, Malaysia. These operations were
aimed at street-level pushers who were targeting visiting 7th Fleet
sailors. Working with host government authorities, NIS team mem-
bers effected the arrest of many pushers. These arrests reduced the
availability of illegal drugs and drove up the price, making the
drugs less attractive to fleet personnel.
As a result of the Navy operations, a total of 1,197 individuals
have been apprehended.
NIS intends to maintain pressure on drug traffickers throughout
southern Asia by continuing the antinarcotics operations cited above.
In addition, operations of a more limited scope are being initiated
on the Island of Guam and in the port of Naples, Italy.
321
To combat the use of hallucinogenic drugs such as marihuana
and hashish, the Air Force instituted several new investigative con-
cepts. The most effective of these is the Drug Abuse Development
File. This concept groups all suspected drug traffickers on a given
Air Force installation in one investigative file until such time as a
viable case is developed on a specific individual in the file. At this
time a separate case is initiated. This concept has enabled the Air
Force investigative office to more effectively collate all known in-
formation on suspected drug traffickers, minimizing the cost in terms
of money and manpower of pursuing these drug traffickers.
Another effective program is the awards program wherein known
drug offenders are offered a monetary inducement to furnish infor-
mation on drug traffickers. Since its inception, this program has
identified numerous military drug users and has resulted in the
removal of large quantities of illicit drugs from the market.
Other techniques have involved the use of controlled buys of drugs
using technical aids, undercover agents, and marihuana "sniffer"
dogs.
The foregoing examples for the three Military Department in-
vestigative organizations are only a small part of their overall in-
vestigative efforts devoted to the drug and narcotic program. As
stated previously, close attention is being paid to the drug abuse
situation, worldwide, and as problem areas are identified, appropri-
ate action will be directed to eliminate the problem.
Until such time as drug abuse in the Armed Services poses no
threat to the morale and discipline of a well-trained and effective
Military Force, the Department of Defense will remain dedicated
to the mission of total eradication of all illicit drugs and narcotics,
including marihuana and hashish.
This completes the formal portion of my presentation. I am ready
to answer any questions with respect to the Department's customs or
investigative programs that you may have.
Mr. Martin. There were a few questions I intended to ask at the
beginning of your testimony, Mr. Cooke, for the purpose of estab-
lishing your credentials. Aiid I am going to condense the list of
questions, in the interest of economy of time.
You have been involved, I believe, in various positions in defense
management since 1958 when you were a member of Secretary of
Defense McElroy's task force on reorganization, which led to the
DOD Reorganization Act of 1959?
Mr. Cooke. That is correct,
Mr. Martin. In 1959 you developed a policy reference book for
Secretary of Defense Gates ?
Mr. Cooke. Yes.
Mr. ^Martin. In January 1961 you were assigned to the Office of
Organizational and Management JPlanning established by Secretary
McNamara ?
Mr. Cooke. Yes, sir.
Mr. Martin. In 1964 you assumed the position of Director of the
Office of Organizational* and Management Planning?
Mr. Cooke. Correct.
Mr. Martin. In January 1969 you became Deputy Assistant Secre-
tary of Defense for Administration?
Mr. Cooke. Correct.
322
Mr. Martin. And you are now serving as Deputy Assistant Secre-
tary of Defense for Administration in the Office of the Assistant
Secretary of Defense, Comptroller %
Mr. Cooke. Correct.
Mr. Martin. Thank you, Mr. Cooke.
I perhaps should have started out by establishing the fact that
you served in the U.S. Navy, and that you retired with the rank
of Captain.
Mr. Cooke. I am proud of that fact, sir.
Mr. Martin. In the case of your supporting witnesses, if it is
acceptable to you and to them, Mr. Cooke, I would like to suggest
that — again in the interest of the economy of time — we simply
insert into the record the biographical notes that you have given
us.
Mr. Cooke. I have been assured by my associates that that is
entirely acceptable.
[The biographical notes referred to may be found in the Appen-
dix, p. 425.]
Mr. Martin. Thank you.
Then we can proceed with the questions.
My first question has to do with the scale of the problem of
cannabis abuse, especially as it affects our servicemen in Europe.
I believe that some of the DOD witnesses here have had an oppor-
tunity to examine the testimony already taken by the Senate In-
ternal Security Subcommittee. This testimony established that over
the past 5 years there has been a 10-fold increase in the quantity
of marihuana seized by Federal agents, to a figure of 780,000 pounds
in 1973, while hashish seizures over the same period of time have
increased 25-fold to a figure of 53,300 pounds. Allowing for sub-
stantial seizures at local levels, and assuming that roughly 9 or
10 times as much gets in as they succeed in seizing, we come up
with truly astronomical figures for the consumption of marihuana
and hashish in the United States. This has been the subject of
previous testimony. We know that our Armed Forces are recruited
from our population at large — that if we have an epidemic of this
magnitude affecting our general population, it is also bound to
affect our armed services. And the problem, of course, has particular
significance from a security standpoint when it affects servicemen
on whom the ultimate security of our Nation may rest.
First, I would like to try to resolve some apparent conflicts in
the figures we have received from General Clay on May 9th on the
frequency of cannabis use in the armed services, and some further
conflicts, or apparent conflicts, between his figures and those we
received from Dr. Tennant today.
According to table No. 2 [see page 44], which was appended to
General Clay's testimony, a worldwide sample survey of marihuana
use among Army enlisted grades taken in February 1974 reported
that 69.4 percent of the personnel responding claimed that they
had never used marihuana, apparently even experimentally. This
is an extraordinarily high figure, in my opinion, considering the
fact that our armed services are made up for the most part of young
men belonging to the most cannabis prone age, and also considering
323
the fact that a very high percentage of our voluntary forces come
from economically deprived groups where the percentage of canna-
bis use is somewhat higher than it is for the population as a whole.
On the other hand, according to table No. 1 [see page 44] attached
to General Clay's testimony, a commandwide sample survey of
cannabis use by U.S. Army, Europe, also taken in the same month,
February 1974, found 46 percent of the respondents admitting to
having tried cannabis at least once, as against just a shade over
30 percent who admitted to having tried it on the worldwide survey.
General Clay indicated some personal reservations about these
surveys because they were based on voluntary responses. I wonder
if any of our witnesses here could throw any light on the discrep-
ancy— it is a rather marked discrepancy — between the percentage
for Army enlisted grades worldwide and the percentage for U.S.
Army personnel in Europe who admitted to having had any experi-
ence with cannabis in reply to questionnaires apparently circulated
in the month of February 1974?
Mr. Cooke. Of course, obviously one question there was confined
to the Europe theater, and the second was worldwide. There may
be other factors involved in the discrepancy.
I have with me Colonel Sargent, who is the Chief of the Alcohol
and Drug Policy Division in the Office of the Deputy Chief of Staff,
Personnel, U.S.A.
Colonel Sargent, would you care to comment further on the appar-
ent discrepancy in the two surveys ?
Colonel Sargent. Yes, I will, sir.
In the survey conducted in Germany, U.S. Army, Europe, asked
the soldiers had they ever used cannabis — which of course could
extend to use prior to entry into the service.
In the survey that the Army distributed worldwide in February
1974, we wanted to confine our question to a specific period of time.
We believe this provides better data and provides less ambiguity
in the matching of data received now and future surveys. Our ques-
tion addressed specifically the 6 months prior to February. We did
this in the representative sampling of all grades. But, of course,
for the enlisted grade E-l, we got responses based in part on a
time period prior to entry to service. We were interested in the
2- to 3-month period prior to entry into the service. That is the basic
difference.
With reference to the disparity in Europe, the command break-
out subsequently— and we have not yet completed all of the refining
of the survey data — the USAREUR Command figures also corre-
spond to the worldwide data. We believe that the survey technique
is a valuable tool by which we can corroborate other report statistics
that we get within our program. I believe Dr. Tennant's testimony
indicated that there has been some measure of improvement based on
his own survey techniques, and these recent data tend to support
the downward trends, although slight.
Mr. Martin. Dr. Tennant also indicates some serious reservation
about the efficacy of questionnaire surveys conducted by mail. Do
you know whether either of those surveys was conducted by mail?
Colonel Sargent. Either of our surveys?
324
Mr. Martin. Yes, either the worldwide survey or
Colonel Sargent. No, they are not conducted by mail. They are
anonymous submissions, but in a controlled environment.
Mr. Martin. So that they assemble the soldiers, and they get them
to fill out the questionnaires, and they fold them up and have to
drop them in the boxes, as they leave the room?
Colonel Sargent. With complete anonymity, no social security
account number.
Mr. Martin. But you get everybody in the room, there are no
escapees ?
Colonel Sargent. Yes, sir. There will be a representative group
selected by random sampling. These individuals are then directed
to assemble and are administered the test in a controlled environ-
ment.
Mr. Martin. I come back to the point: once they enter the con-
trolled environment there are no escapees?
Colonel Sargent. That is correct, there are no escapees.
Mr. Martin. They must drop the questionnaire in the box before
they leave?
Colonel Sargent. Yes. They have to put a response in the box.
Whether or not we have obtained anything of value can only be
determined later.
Mr. Martin. You indicated that there is a difference in the word-
ing between one questionnaire and the other questionnaire. This
obviously leads to some differences in the results obtained. Would
there not be an advantage to using a uniform questionnaire through-
out the armed services and on a year after year basis ? After all, if
you change the wording in a questionnaire, you might get a signifi-
cantly different reading which will make it impossible to compare
the results for 1974 with the results for 1973 or 1972 when you used
questionnaires that were differently worded.
Colonel Sargent. The single difference here is that one command,
USAKEUK, administered their own survey, designed to respond
to their own requirements. The worldwide survey is one we devel-
oped to be used semiannually, and the questions will bo used repeti-
tively; the same questions will be included in the August survey:
From this we hope to develop trend data.
Mr. Martin. Thank you for that information.
Dr. Tennant, in his testimony made the point that in different
surveys he had found a range of responses that went from 48 per-
cent— this applies to servicemen who admitted to having used can-
nabis one or more times — the range was 48 percent, and 35 percent,
and 35 percent came toward the end of 1971. And for this reason
he felt that there has been a certain improvement, at least during
his period of service, in West Germany. Does that coincide with
your own impression, Colonel Sargent?
Colonel Sargent. I think there has been improvement. I want to
get a repetitive survey, administered by the Department of the
Army worldwide; then we can better assess the trends.
Mr. Martin. If table No. 1 in General Clay's presentation can
be believed, the U.S. Army in Europe has in effect succeeded in
reducing the percentage of daily cannabis users from 10 to 15 per-
325
cent prior to 1973 to 7 percent in 1974. If that is accurate, these
results do demonstrate a quite extraordinary degree of success in
your drug education and control program. And this would be all
the more remarkable in view of the fact that we have shifted over
to a volunteer basis.
Mr. Cooke. Let me make the point, Mr. Martin, that under the
leadership of then Secretary of Defense Laird we adopted world-
wide intensive program of a whole panoply of measures toward
drug control, drug education and rehabilitation, that I believe were
touched on by General Clay. And we think the results of these
measures — and I am not confining my remarks to cannabis solely—
have proved successful. I do not mean to imply that we are satis-
fied, but we are glad that we are headed in the right direction.
And we certainly intend to continue these efforts.
Mr. Martix. We are dealing here with a rather complex situation.
When it comes to heroin, for example, the antiheroin campaign
conducted by our Armed Forces was conducted within the frame-
work of a national antiheroin campaign that involved the total
mobilization of all the Government resources and all available
support from the media. And the academic community also pitched
in, and everybody was working on it. And there has been a signifi-
cant reduction, according to all accounts, of heroin abuse on the
home front. One would expect this to be reflected in the armed
services, even without the intensive campaign that they themselves
have been conducting. I think that, in percentage terms, the armed
services have made more progress than we have made in the home
front.
When it comes to cannabis, however, we have not been making
any progress in the home front, according to all of the evidence
provided to the subcommittee. We have been losing ground badly
on a year-by-year basis. And this, of course, is bound to complicate
the problem for the armed services, because you are going to get
far more young people who have already used marihuana to some
extent before joining up.
It is a tough problem — wouldn't you agree with that?
Mr. Cooke. I think it is. Because'certainly the demographic slice
of the youth of America we take in our Armed Forces reflects the
attitude and habits of the general young Americans of their age.
I would suggest, though, that perhaps we have exerted more efforts
in the area of cannabis than has been done on the home front.
Mr. Martix. I think there is very little doubt about that.
The subcommittee has heard, not only from Dr. Tennant but from
other sources, that there have been quite a number of cases in which
vehicles also have been wrecked by drivers under the influence of
hashish, and expensive equipment have been damaged or destroyed.
And we have heard of one instance in which a B-52 bomber took
off with an air crew stoned on hash. And I would like to ask
General Temple and Mr. Planton— and there may be someone I
have omitted here— whether thev have personal knowledge of such
incidents, and if thev do, whether they could provide some details
for the record, simply for the purpose of establishing that this is
a real problem.
326
Mr. Cooke. May I introduce for the record General Temple, who
is the head of the Office of Special Investigations in the Air Force
on my immediate right; and Colonel Tufts, who is the commander
of the U.S. Army Criminal Investigative Command; and on his
right Mr. David Planton, who is head of the Criminal Division
of the Navy Investigative Services. These are our top investigative
people. And if you would like us to respond very briefly, we will
amplify, if we may, for the record.
General Temple.
General Temple. Very briefly, sir, as you may be aware, we were
aware of the subcommittee's concerns in this area. With reference,
for example, to the story of the B-52 crew stoned, my organization
has the files on all of the marihuana and other narcotic investiga-
tions that were conducted in the Air Force, and we made a special
effort to research our files thoroughly to attempt to confirm any
such case. We were unable to confirm any such happening.
Mr. Cooke. Colonel Tufts.
Colonel Tufts. Again, not in the aircraft, but in the vehicle
area, we have isolated cases where we have had traffic accidents.
And we have had individuals involved in accidents where there
was an indication that they might have been using marihuana or
hashish. And we have had accidents where, when the vehicle was
found, or when the police came on the scene, they were in the
process of transporting, and there was no evidence that the trans-
porter was a user. I think I could sum it up in general by saying,
we might have a number of cases, I would not say they are isolated,
but we do not have a trend, we do not have a pattern, and we do
not identify this as a major problem, i.e., getting involved with
the usage, and then a resultant accident from the usage.
Mr. Martin. You have had quite a number of cases involving
drunken drivers?
Colonel Ttjfts. Yes, sir.
Mr. Martin. You have heard Dr. Tennant's testimony that in
many cases the drivers who appear to be drunken drivers, or
those who appeared to be drunk on alcohol, are not reallv drunk
on alcohol alone, but drunk on alcohol and hash — that is, they may
have had one drink of alcohol, and then smoked a pipe of hash.
And the hash has affected them a lot more than the alcohol — the two
things work together synergistically, they compound the effect,
or potentiate effect. And when the driver has his accident, you can
smell the alcohol on his breath, you cannot smell the hashish — and
it is put down to drunken driving, it is put down to alcohol, when
in fact it may be a combination of the two.
Now, as Dr. Tennant pointed out, we have got to do a lot of
research. We have no way of establishing either in the civilian sector
or in the military sector whether drivers involved in accidents who
appear to be drunk on alcohol are in fact drunk on a combination
of alcohol and cannabis.
That is a question to which you cannot have any answer.
Colonel Tufts. In my area we investigate only when a fatality is
involved. The local police, or the militarv police, would pick up
such an individual without a fatality, and they would investigate.
327
And then, of course, you would get on the medical side of the house,
where you would have a blood alcohol test and — maybe Dr. Tennant
can answer better than I — possibly urinalyses tests. I would not be
personally intimately familiar with this procedure. But I think I
would have heard about it if there were a problem.
Therefore, I do not think I can address it with any certainty
saying that it is a problem. I do not think it is.
Mr. Cooke. Mr. Martin, as a retired Navy captain, I would hate
to ignore Mr. Planton of the Navy.
Mr. Planton. Yes, sir.
First, the Naval Investigative Service, like the Army, does not
investigate traffic accidents per se, unless there is a fatality or some
unusual circumstance. We would have no record of instances where
the cannabis use has been directly related, or that we became in-
volved in the investigation of a traffic accident or a fatality, because
of marihuana use.
Going to the damage incidents on ships, we have had some cases
where there is a possibility that the use of cannabis or marihuana
was a contributing factor/ However, it is very difficult to say that
precisely.
As an example, we had a mattress fire in the barracks of a Navy
hospital. We developed no suspects in the case, but at the scene,
we found marihuana residue. It was rumored among the troops
that it had been used there. I cite this as an example, that while
marihuana may have been a contributing factor, it does not neces-
sarily follow that marihuana use was going on at the time that the
fire started.
Mr. Cooke. I think we would be concerned about this obviously
in the same wav that we often read in the paper that somebody has
had a few drinks and then the mattress caught on fire, because the
effects of intoxication are apparently somewhat similar.
Mr. Martin. This is a problem that is probably much better in
the civilian sector than it is in the military sector, but all the
scientists who testified before our committee were agreed that the
problem of cannabis intoxication and driving is becoming one of
increasing magnitude, and no answer has yet been found to it.
There have been many drunken driving accidents which have been
put down as alcoholic drunken driving accidents that were in fact
due to alcohol plus cannabis.
Mr. Cooke. I think that is a fair statement, and undoubtedly
true. It is true for our drivers in the military driving their cars
on libertv as for anvone else in the community.
Mr. Martin. Do the officers who are with you, Mr. Cooke, have
any knowledge of any instances where secret or top secret security
clearances or nuclear' clearances have had to be withdrawn because
of cannabis abuse? Dr. Tennant said that he had knowledge of a
half dozen such cases.
Mr. Planton. For the Navy, negative.
Colonel Tttfts. The Army is negative, as far as I know.
Mr. Martin. What about the Navy?
Mr. Planton. The Navv is negative.
General Temple. Your question was whether the clearances were
withdrawn ?
328
Mr. Martin. Any clearances that had to be cancelled or with-
drawn because it was subsequently discovered that the subject en-
listed man or officer was involved in cannabis abuse.
Mr. Planton. I beg your pardon. I misunderstood your question.
I thought it was a question about the disclosure or selling of secret
material. I know that there have been cases in the Navy where
individual ratings have been changed because of an individual's
proclivity to use marihuana. I do not have the number.
Mr. Martin. Their clearance rating?
Mr. Planton. Yes. Or, for instance, if they had a radioman's
rating where security clearance was a condition of that rating, the
Navy has changed their rating to some nonsensitive rating.
Mr. Martin. Coming back to the Army, the question may not
have been clear.
Colonel Tufts. I think I misunderstand you, too.
Mr. Martin. Have there been any instances that you know of
where security clearances, secret or top secret, or nuclear clearances,
have had to be withdrawn because it subsequently came to the at-
tention of the Army that the subject officer or enlisted man was
involved in cannabis abuse?
Colonel Tufts. This does not fall within my area. The Army's
military intelligence handles that. I am sure that I can arrange to
get an answer to it. I know of none myself. Again, my answer
remains the same. But I will get an answer on that within a day
or two and give it to Mr. Cooke.
Mr. Cooke. I would think this, that we have for security clear-
ances a whole list of criteria, one of them being habitual use of
drugs, habitual use of alcohol, among others. And I would think
it highly probable — and certainly I would hope so — that in the
event that the man with a clearance and a need to know in these
sensitive areas and he turned up as a drug user, an alcoholic, or
what have you, that clearance will be withdrawn, and he will be,
if not subject to appropriate administrative or disciplinary action,
certainly shifted to a nonsensitive job, where he no longer needs a
clearance.
General Temple. Speaking for the Air Force, and in terms of the
clarified question, it is standard procedure, and we see it reflected
in our narcotics investigation case files, that if substantial allegations
of narcotics use, including marihuana or hash, are made sufficient
to warrant our opening an investigation, it is rather standard
procedure to at least temporarily disqualify the subject of that
investigation from access to his clearance categories and from, in
appropriate cases, nuclear clearances, pending the outcome of the
investigation. If that investigation does in fact lead to a conclusion
that he is a user, the normal procedure would be a permanent
suspension of sensitive clearances.
If I might add a bit, in terms of the question which may have
been the misunderstanding of the initial question, since my agency,
the Air Force, at least does fill the counterintelligence role, I can
say categorically that none of the cases we have conducted have
shown that addiction, or the play on a man's habits, so to speak,
by agents of a hostile foreign power has been, a factor in any of the
329
espionage-type cases that we have investigated. Potentially it could,
but in fact we have had no such cases.
Mr. Martin. Theoretically it is recognized that a man who is
addicted to drugs and who needs, let us say, $300 or $400 or $500
or $600 a month to finance his habit, is a security risk and could
conceivably be exploited by hostile agents ?
General Temple. Yes, sir.
Mr. Cooke. I think it is more than potential, because General
Temple indicated that we will withdraw his clearance at least
temporarily.
Mr. Martin. Because he is a risk, at least temporarily?
Mr. Cooke. Yes, sir. But in any of the actual cases he has in-
vestigated, that has not turned out to be the causal factor.
Mr. Martin. The subcommittee took testimony from a number
of distinguished psychiatrists in the United States and from several
other countries. And they were pretty well agreed on the point
that cannabis has a devastating effect on a man's judgment, and
among other things, it deprives him of his own will, and makes
him highly suggestible and subject to, or open to, manipulation.
Now, I would like to give you a few examples of their testimony.
Dr. Harvey Powelson, who was for many years psychiatric director
of the Student Health Service at Berkeley, told us:
Such people . . . have become will-less — what we call anomic. An irony here
is that they have now achieved the freedom they sought. They need an external
director. They are ripe for a demogogue.
And Dr. Andrew Malcolm, a distinguished Canadian psychiatrist,
similarly, told the subcommittee that there is much research to be
done "to determine the relationship between marihuana and the
vulnerability of the intoxicated person to persuasion." He said that
the "altered state of consciousness" resulting from marihuana in-
toxication includes:
An impairment of the ability to test external reality and a tendency to
engage in nonlogical thinking. Marked changes in time sense and of body
image occur. Emotional responses are altered and sensory perception is typically
distorted. The result of these myriad effects is the creation of a person who
is fundamentally changed from what he is like in a state of normal waking
consciousness. His critical judgment is impaired and his capacity to effect
transactions with reality is markedly reduced. As a result we may say with
some certainty that such a person would be poorly defended against the influ-
ences flowing toward him. ... It is my opinion that, among the many unusual
characteristics of marihuana, one of the most important is that its users may
be rendered suggestible and that what they consider to be their voluntary
espousal of a new system of values may be due, in fact, to influences beyond
their conscious control.
I would like to ask your psychiatric assistants, Mr. Cooke, do
these observations coincide with their own?
Mr. Cooke. I would be very pleased to do that. I think I have
been neglecting the medical component.
Commander Kreider, would you care to comment on that?
Commander Kreider. I think, sir, that on the whole, the conclu-
sions that are drawn by these distinguished psychiatrist are not
in line with my personal professional experience, nor am I aware
of any good controlled scientific studies which would tend to show
330
this, particularly with regard to suggestibility. I am not sure whether
this means that the individuals who may have been more suggestible
also were prone to use marihuana for its suggestibility — facilitating
effects — or whether there was another explanation for it.
Mr. Martin. Is this not an area where it would be exceedingly
difficult, if not impossible, to conduct carefully controlled studies?
Commander Kreider. I think that two things would have to be
controlled. One, particularly the use of other drugs. So many times
when we think we are seeing one drug we are seeing multidrug
effects. Another is that we have to be sure that the individual had
never used marihuana or hashish or any other drug before. There-
fore, it would take human volunteers, since I know of no animal
studies in which this could be carried out. It would require controlled
conditions over a period of weeks or months with volunteers, and
probably a double blind study in which neither the subjects nor the
scientists know which substance each individual was given.
Mr. Martin. A very difficult study to conduct ?
Commander Kreider. Very difficult. But if we were evaluating
penicillin or any other new drug, I think we would insist on this
study being carried out before we drew any scientific conclusions.
Mr. Martin. But when you are talking about penicillin you are
talking basically about medical effects which are measurable in
terms of their effect on the pulse rate and the working of the
respiratory system, and so on?
Commander Kreider. Yes, sir.
Mr. Martin. And this can all be done with electromagnetic de-
vices that give you, in effect, quantitative measurement of what
is happening in the body, or with quantitative measurements of the
effect on the blood cells. You cannot do that with psychiatry. Ac-
tually, is it not true that most of the adverse evidence that existed
until recently on the effects of cannabis consisted, in fact, of psycho-
logical observations that were made over the centuries by people in
many countries where cannabis was abused ? They had no hard, scien-
tific proof that their observations were accurate. But based on their
empirical experience with cannabis, they arrived at some conclusions
which are now being borne out by further scientific research.
Commander Kreider. Yes, sir, that is certainly true.
Mr. Cooke. Mr. Martin, if I may interrupt a moment, I did not
want to leave the impression that in our program to deal with access
to nuclear weapons and other sensitive materials there is any high
incidence at all. We have rather stringent screening procedure be-
fore any individual in terms of human reliability factors is cleared
for action, above and beyond the normal procedure for access to
classified information. We think we do a good job of that. So I do
not want to leave any impression whatsoever that this is rife, en-
demic or what have you. It would be a very rare occurrence.
Mr. Martin. Coming back to the question of the effect of canna-
bis— the psychological effect of cannabis — I do want to point out
that this question was posed to almost every one of the distinguished
psychiatrists we had before us, all of whom had had extensive
clinical experience with the problem. And it was their consensus
that it was there. Now, again, these mav be empirical observations
unsupported by hard scientific research. But I think there is enough
331
empirical observation here by enough men of scientific competence
in their fields to warrant careful attention.
Commander Kreider. Yes, sir, I agree that their views should be
given attention.
Mr. Martin. We have heard among other things that in the
shipboard riots that pretty well inactivated two of our aircraft car-
riers, I believe it was just about a year and a half ago, there was
fairly widespread use of pot among the personnel involved at the
time of the incidents. Do you have any information concerning that ?
Mr. Cooke. I would like to ask Mr. Planton, whose organization
was involved in the investigation of those, what the investigation
showed.
Mr. Planton. The Naval Investigative Service was involved in —
we have had a number of cases where there have been disputes
on the capital ships including some carriers. I do not know the two
that you allude to, but I presume one of them was the Kitty Hawk.
We were there primarily to investigate the assault aspects of the
matter. And during these investigations, there was no evidence that
came to us that marihuana use played a key role in it, or was in-
deed involved. I would add too, that we have an agent on each of
the carriers on a regular basis, so we have a representation there
on a 24-hour-a-day basis.
Mr. Martin. Dr. Hardin Jones in his testimony before the subcom-
mittee, which I believe has been made available to you prior to this
hearing, informed us that when he was in Vietnam as a consultant
to the Army he was told by quite a few officers that they felt that
the fragging incidents were directly related to the use of cannabis.
Vietnamese cannabis, as you know, is pretty potent— it has 5 per-
cent, 6 percent THC, and that is just about the equivalent of low
grade hashish. Do you have any information on that matter?
Mr. Cooke. I turn the floor over to Colonel Tufts, sir.
Colonel Tufts. I think in your fragging incidents during the
1968, 1969, and 1970 timeframe in Vietnam that there was a rela-
tionship between the use of various drugs and the fraggings. How
many I do not think we will ever know. But I think there were a
number of them.
Mr. Martin. Dr. Jones, by the way, did indicate that he had no
hard scientific evidence. It was an impression conveyed to him by
quite a number of officers, an empirical impression, lacking hard
scientific data to back it up. But nevertheless, it was apparently a
fairly widespread impression among the officers he had consulted
at the time.
Colonel Tufts. There was a definite relationship at that time, with-
out question.
Mr. Martin. And again this might suggest, might it not, that
cannabis use does make people suggestible and subject to manipula-
tion—the possibility is there, even though the proof is still lacking?
Colonel Tufts. I cannot dispute your statement. But there were
many other factors probably in that era of time that induced some
of these incidents.
Mr. Cooke. Mr. Martin, I think your position essentially is that
the abusers of any intoxicating agent— what we see associated with
it is some absentee system, declining interest, dedication to mission,
332
increasing antipathy toward discipline, and degradation of tradi-
tional values. And I think this is true of alcohol and its abuse, and
it is certainly true of cannabis when it is abused, or any intoxicant.
So we are concerned with this problem across the board.
Mr. Martin. But intoxicants work on people in different ways?
Mr. Cooke. Indeed, they do.
Mr. Martin. And some are more benign, if you can use that term,
and some less benign and more dangerous? And the evidence pre-
sented to our subcommittee over the past several weeks strongly
suggests — in fact some of the scientists who testified used this ex-
pression— that cannabis is without exception the most dangerous
drug on the market today in terms of the immediate and long-
range damage it perpetrates on the individual user.
Mr. Cooke. Perhaps you saw that in the article in last week's U.S.
News and World Report.
Mr. Martin. That was in our testimony. There was a lot more
said in the course of these hearings.
Mr. Cooke. I know there was.
Mr. Martin. And we come back to the question whether cannabis
does not perhaps possess certain properties that make it, in terms
of the security of the Armed Forces, a considerably greater danger
than alcohol abuse — it may not be abused at the same level, but
nevertheless, where it is abused, it has a greater potential for
damage to the individual and to the service of which he is a part.
Mr. Cooke. I think all of us here would agree with Dr. Malcolm's
statement before the committee that there is much research to be
done to determine the relationship between marihuana and the
proneness to persuasion. And we would welcome research in that
field. But it is a very difficult field for research as distinguished from
empirical conclusions.
Mr. Martin. Mr. Cooke, you have spoken about the complex of
measures designed to deal with drug traffic directed toward the U.S.
military establishment in Vietnam and Southeast Asia. As you
know, there we broke up a number of major traffic rings involving
military personnel and expersonnel. Have there been any similar
rings in the hashish traffic directed toward our military establish-
ment in West Germany?
Mr. Cooke. May I ask Dr. Tufts, or his people, who were on the
ground in West Germany, to respond first, to that question.
Colonel Tufts. Yes, there is a concerted effort. And we have had
some degree of success in exposing and in tracking the nonmilitary
hashish smuggler and trafficker, particularly in the Federal Repub-
lic of Germany, but also from coming through other countries as
suppliers into Germany. Our successes, I think, are good. There is
still a lot of it getting through. We work
Mr. Martin. Have you uncovered any major rings?
Colonel Tufts. Oh, yes, we have seized — to be specific on the ques-
tion, a ring at what level? I would have to address that point, at
what level do you mean a ring? The ring usually comes through
the traditional traffic routes. And then it is broken down in the
countries on the periphery of Germany, and it comes into the Fed-
eral Republic. We might not have the big international distributor,
333
but I think when it comes into the Federal Republic we have broken
the local distribution, and I say a big ring. When you seize over
$1 million in hashish in one time, one seizure — and we only had
one, I might add — you have cracked a big ring. We work with the
German Police, with the other U.S. Federal agencies, with the Ger-
mans, the Dutch, and the Belgian police. We worked both in the
international trafficking, distribution, and then we orient, of course,
in the various areas like Nuremberg, Heidelberg, and Frankfurt,
where we have large concentrations, where again you find rings at
one level lower. And, of course, then we work right down to the
various kaserns.
Mr. Martin. Do any of the rings you have found so far appear
to be targeted specifically at American military personnel rather
than at the general West European population?
Colonel Tufts. Of course, we like to think — and we do say, and
I believe it is true — that those people that we are working against,
or that your effort is directed against, are definitely targeted on the
U.S. troop concentration — unequivocally they are targeted on our
people.
Mr. Martin. Are they targeted against the U.S. troop concentra-
tions primarily because they consider this the most lucrative market
available in Europe, or has there been any evidence of the involve-
ment of a political motivation of some kind?
Colonel Tufts. There has been no evidence of political motivation
that I know of. And I think the answer is that probably in this
country — and the doctor alluded to some of this — there are young
people that are exposed to this a decade ahead of the European
youth, if we are talking in terms of youth. And I think our people
do have money, our people are pretty well paid, and the young
person who is single does have some money available to him, in
comparison to the similar aged European. And I think the market
has been targeted to our people. I do not think there is any doubt
about it, the market now is targeted toward the young of all the
European countries more and more. And I think that probably you
will have testimony here, at least in the newspapers and the maga-
zines, that there is' an apparent growth, I would not say paralleling
the sad experiences we have had, but there is usage development,
I think, throughout Europe, without question.
Mr. Martin. There appears to be no question about that.
Have any of the rings you have so far discovered involved Ameri-
i can servicemen, or have there been any rings consisting of American
servicemen primarily ?
Colonel Tufts. I cannot think offhand where you would have a
ring. Again, I have to pitch to the level. In the international traf-
ficking, or the large-scale dispensing, these groups consist mainly
of Germans, Dutch, French nationals, and other third-country na-
i tionals, and some U.S. civilians, and a number of European outs,
as we used to call them. This is the man that can make a dollar in
Europe, and he decides to take his discharge. I think now the man
has to come back to this country to be discharged. And we have
I evidence that there are a few people who take the trip back, get
their discharge papers, and get mustered out, and they are lm-
334
mediately back in Europe to study the arts or pursue whatever
endeavor they may see fit. So we do have a few of these people
who are beginning to crop up.
Mr. Martin. The ex-servicemen?
Colonel Tufts. The ex-servicemen. T do not want to mislead you on
my answer. When you got down to the local troop concentration
levels, and when you get into the kaserne of the large troop concen-
tration area, or as the doctor brought out, when you get down into
the battalion, then you have got, as I call it, the pusher rather than
the trafficker.
Mr. Martin. There is the military equivalent of the street pusher ?
Colonel Tufts. That is right.
General Temple. If I might echo Colonel Tufts' observations, ours
in the Air Force in the European area are essentially to the same
effect. First of all, we have not seen evidence of a hostile political
motivation in specific targeting against airbases in an attempt to
corrupt the base and disrupt it. We have seen commercial exploita-
tion by the international drug traffic of the fact that American
servicemen with money to spend are there, and that our Nation
has a reputation as being major drug users, and our servicemen
come from our Nation. And we also have had a good deal of experi-
ence with the ring at the level at which Colonel Tufts is talking,
the local serviceman taking advantage of the opportunity to make
some cash and being a local distributor or pusher; obviously, since
most hashish comes from the Mideast, he is the tail end of a chain
which may have been an international ring, but he may not even
know where the substance came from, and typically will not.
Colonel Tufts. Do not let me leave the wrong impression when
I mention rings. As I was listening to General Temple this came
out pretty strongly. We do get down to, like, a division level or, like,
an organizational level, and you do find what you could well cate-
gorize as a ring, some 10, 20, or 30 people, you know, in a group
of 900, 200, or 3,000, sort of banded together, and they have a com-
mon purpose. But in the sense of the ring, generally, when we men-
tion this we are talking about the large-scale manipulating group
that has moved around as a combine. And we do not find the higher-
ups above it.
General Temple. These groups typically do not have a connection
and ability to go to the country of origin and buy large quantities,
and transport it.
Colonel Tufts. And they are loosely organized, too ; they are just a
group of people with a common interest.
Mr. Martin. You are talking now about the existence or non-
existence of rings within the military establishments?
Colonel Tufts. Yes, sir.
Mr. Martin. But you did, I believe, agree that there were some
criminal rings operating outside the military establishment?
Colonel Tufts. Definitely. There are many of them.
Mr. Martin. And you have had some successes in operating against
them?
Colonel Tufts. Yes, sir.
Mr. Martin. When the Drug Enforcement Administration testi-
fied before the subcommittee on May 9 they provided us with a
335
number of case histories — success stories of their operations against
the cannabis rings. Could you provide us with a few of your more
successful case histories — for the record — not at this moment?
Colonel Tufts. Not at this moment. Some of ours, even though
we talk about them as success stories, they are tied into ongoing op-
erators and operations. And anticipating that question, I have a
prepared answer that I would be happy to give you some of the
success stories, even to the point of including the identity of in-
dividuals later on; I will make them available to you.
Mr. Martin. And if for any reason they cannot be printed in the
form in which you give them to us, it will be your privilege, of
course, to indicate what names or what portions of the reports will
have to be deleted.
Colonel Tufts. I think with the exception of names we can break
them out where they are pretty much printable.
Mr. Martin. Thank you very much, Colonel.
General Temple. We too would be able — subject to the problem
of not interfering with a case still pending or a trial yet to come,
whether of our own people or of the civilian suppliers — we would
be happy to supply you with specific instances.
[The material referred to follows:]
Operations of the U.S. Army Criminal Investigation Command Against
Organized Non-Military Drug Trafficking Groups Who Direct Their
Activities Against U.S. Forces in Europe
The following examples reflect successful operations to interdict the flow of
marihuana and hashish destined for U.S. Forces in Europe. In each case, infor-
mation was developed by Army Criminal Investigators and coordinated with
host-country law enforcement officials who took the necessary apprehension
action. Specific dates and identities have been omitted. To assist in measuring
the illicit income to be derived from selling hashish and marihuana to U.S.
Forces, 1 gram of hashish has a street value of $2. A kilogram of hashish has a
street value of $2,000. A liter of hashish oil has a street value of $9,000.
SUMMER 1972
German police apprehended six German nationals and two Iranian nationals
in possession of 1,293 kilograms of hashish and $134,000 in German and United
States currency believed to be the fruits of illicit drug sales.
WINTER 1972-7 3
German police apprehended two Ghanian nationals in possession of 20 kilo-
grams of hashish which they were attempting to deliver to CID Special
Agents.
German police apprehended two Turkish nationals and two Lebanese nation-
als in possession of 25 kilograms of hashish which they were attempting to sell
to CID Special Agents.
German poMce apprehended four Iranian nationals in two separate investi-
gations while attempting to sell a total of 1,000 kilograms of hashish to CID
Special Agents.
SPRING 1973
Amsterdam city police apprehended three Belgium nationals in possession of
7% liters of hashish oil which they were attempting to sell to CID Special
Agents.
German police apprehended four German nationals in possession of approxi-
mately 50 kilograms of hashish which they were attempting to deliver to CID
Special Agents.
Amsterdam city police apprehended one Dutch national in possession of 40
kilograms of hashish.
336
SUMMER 1973
German police apprehended three Turkish nationals in possession of 5 kilo-
grams of hashish which they were attempting to sell to CID Special Agents.
Searches of the suspects' residence and business establishment resulted in the
apprehension of five more Turkish nationals and the seizure of an additional
15% kilograms of hashish.
FALL 1973
German police apprehended one Iranian national in possession of 86% kilo-
grams of hashish which he was attempting to sell to CID and DEA Special
Agents.
German and Dutch police apprehended one Dutch national and one British
national in possession of 117% kilograms of hashish which they were attempting
to sell to CID Special Agents.
WINTER 1973-74
German customs police apprehended one Egyptian national and one German
national in possession of 40 kilograms of hashish which they were attempting
to sell to a CID Special Agent.
German police apprehended one Turkish national in possession of 15 kilo-
grams of hashish which he attempted to sell to a CID confidential informant.
A search of the individual's vehicle resulted in the seizure of an additional
9 kilograms of hashish.
German customs police apprehended three Turkish nationals, one Tunisian
national, and one German national while attempting to sell 15 kilograms of
hashish to a CID Special Agent.
Dutch police apprehended one Indian national and one Dutch national in
possession of 50 kilograms of hashish, secreted in cans of fish, which they were
attempting to sell to a CID Special Agent. Subsequent investigation resulted in
the seizure of 10 kilograms of hashish in a cafe in The Hague, The Nether-
lands, and 171 kilograms of hashish secreted in compressor parts in Antwerp,
Belgium.
German police apprehended two French nationals in possession of 200 kilo-
grams of hashish which they were attempting to sell to CID Special Agents.
SPRING 1974
German police apprehended one German national and one Austrian national
in possession of 3 liters of hashish oil which they were attempting to sell to a
CID Special Agent.
Spanish police apprehended one Iranian national and one German national
in possession of 148 kilograms of hashish concealed in a camper-type trailer
which they were attempting to transport into Germany for resale. Undercover
operations by CID Special Agents provided the information on which host-
country law enforcement officials acted.
U.S. Army Criminal Investigation Command additionally has one Special
Agent assigned to the Military Assistance and Advisory Group in Iran who is
instrumental in coordinating Iranian and European efforts to stem the flow of
hashish smuggling from Afghanistan, through Iran, to Germany. Prior to the
increased emphasis placed by host-country customs official in searching trucks
engaged in international commerce, Iranian Customs Police and the CID Special
Agent Adviser seized over 1,500 kilograms of hashish within false truck com-
partments that was destined for resale in Germany.
Mr. Martin. What about the Navy?
Mr. Cooke. The Navy experience, I suppose, would be primarily
on the other side of the world, and in particular the Philippines and
Southeast Asia.
Mr. Martin. This would have the advantage of establishing the
fact that it is an international problem, if you could provide us
with a number of such case histories.
Mr. Planton. Our tack in the Navv is a little bit different from
that of the Army and Air Force. What we attempted to do in the
337
Philippines, rather than trying to dry up all the narcotics, was to
develop a climate so that the traffickers there would not sell to our
sailors, 7th Fleet sailors. Our program was aimed specifically at
the street-level vendors. With the winddown of the Vietnam war,
our 7th Fleet ships are now showing our flag in Hong Kong, Singa-
pore, and other ports in the Far East. We have expanded our pro-
gram to those areas in concert with the governments there, working
close at hand with DEA representatives where they exist. Our suc-
cesses since we developed this program in December 1972 through
March 1974, are that our operations have resulted in the appre-
hension of over a thousand individuals. And in the case of Singa-
pore, there, the Singapore Police, based on information which our
team developed in concert with them, confiscated in addition to
drugs, 11 taxis which were worth $86,000. And so as a consequence,
when American ships, Navy ships, go in there, now, taxicab drivers
who used to be in the forefront of the trafficking just will not have
anything to do with "Yankee sailors."
Mr. Martin. That might create some difficulties.
Is it accurate, Mr. Cooke, that our drug educational program, that
is, the drug educational program, in our armed services, are gov-
erned by guidelines promulgated by the National Institute for Drug
Abuse, or do you set up your own guidelines?
Mr. Cooke. I think we are aware of the standards. But we tailor
our guidelines to meet our needs. And I would like to call upon
Dr. Mazzuchi, who is the assistant for Education and Information,
Drug and Alcohol Abuse, for the Assistant Secretary of Defense
(Health and Environment).
Dr. Mazzuchi. We are not bound by the media guidelines. How-
ever, we cooperated with them. When Dr. Dupont called the mora-
torium for the production of specific drug abuse and educational
materials, he requested cooperation from the Secretary of Defense.
And through the Assistant Secretary of Defense, Dr. Wilber, and
now Dr. Cowan, Ave have cooperated with him in this effort when
the preliminary guidelines were developed and they were sent to
our office for comment. And we did comment rather intensively on
these guidelines. And we sent them back to Dr. Dupont through
Dr. Cowan's office. Subsequent to receiving these guidelines, the
committee for media support, which is composed of the Department
of Defense— and I am the representative— Lt. Col. Maine from the
Office of Information of the armed services, and then information
officers as well as drug education officers from the other service
branches, met as a committee, and adopted similar guidelines, very
similar to the guidelines for the screening of media support, especially
film, but also pamphlets, so that outside companies as well as internal
development of films meet these guidelines to the best of our ability to
do so. And then we then recommend or fail to recommend films or
pamphlets that are given to us for screening.
Mr. Martin. You referred to preliminary guidelines. The sub-
committee has heard of a document entitled "New Information
Guidelines," from which I would like to quote a few sentences, and
then you can tell me whether this is the same document as the
preliminary guidelines to which you referred. The document started
338
out: "The following kind of messages have been found to be gen-
erally counterproductive, and as such should be excluded from use
in general informational terms." It then listed ten no-no's, ten ap-
proaches that should not be used in attempting to educate military
personnel against drug abuse. And point number 1 was that "the
use of drug X always causes condition Y." And point number 2
was that "any messages couched in terms which tend to scare the
subject and make fear the main deterrent to future use also should
not be used."
The other eight directives listed made pretty good sense. One of
them said that you were never supposed to say that drug abuse
is exclusively a youth problem, or that the use of drug X never
causes conditions Y — I do not know who would want to say that.
But is this the document in question?
Dr. Mazzuchi. Yes, these were contained in the preliminary guide-
lines. And we then received a final copy of these guidelines, and
it was from this final copy that the Media Support Committee drew
up its own guidelines which have embraced all of the guidelines from
the special action office. I think these guidelines are subject to
interpretation.
And I would like to comment for a moment on this scare tactic
type film. What we interpret, the Military Media Committee inter-
prets as the scare tactic types are those films or pamphlets that try
to rely on exaggerated claims or very frightening tactics, such as,
there have been films out in the past which are really very poor,
especially films dealing with heroin abuse where they showed people
who had overdosed with the heroin being treated in the hospital,
and in a rather bloody fashion, with the obvious intent of the film
to frighten the audience rather than to give them factual informa-
tion. We do not consider it a scare tactic to give factual information.
Some of the factual information itself might be frightening, such
as calling to mind a recent change in the material on methapalone,
which is a depressant type nonbarbiturate which was originally
thought to be safe and is now considered to be not safe. Some of
the material on methapalone would, I suppose, tend to frighten
somebody who has not used it and who might have thought of using
it; reading some of the material he might decide that he does not
want some of these possibilities to happen to him, the possibility
of addiction and of a rather serious type of overdose potential. So
that by scare tactics we in the committee basically use the criteria
of, is the information being presented factually, and is it being pre-
sented in a factual way, or is it being exaggerated and sensational-
ized in such a way as to frighten the person ?
Mr. Martin. Have you had an opportunity to read any of the
testimony presented before the Senate subcommittee in its recent
hearing ?
Dr. Mazzuchi. I was present for all of it and have also read
all of it. And that type of testimony we would not consider — to
me it is very frightening, so the possibility of cannabis use, es-
pecially if some of the preliminary findings are borne out by other
studies, it would be indeed frightening. But this would not consti-
tute a scare tactic, this is factual information.
339
Mr. Martin. So that this kind of information would be usable
within the framework of the current guideline ?
Dr. Mazzuchi. Yes, it would be.
Mr. Cooke. Let me say, I am sure, speaking for all of us, we
intend to take the material developed by the subcommittee and use
it in furtherance of our educational program. And we would welcome
such material.
Mr. Martin. I am sure the Members of the subcommittee will be
very pleased to know that the armed services find the information
of some validity and some use.
I have one final question. Mr. Cooke, do you feel it would simplify
the problem the armed services confront in dealing with the prob-
lem of cannabis abuse if the Government were to decide, as it did
in the case of the heroin epidemic, that we are confronted as a Na-
tion with a very serious situation that calls for an all-out national
effort, and if it then launched the kind of all-out campaign against
cannabis that we launched several years ago against the heroin
epidemic — with considerable success. Would that simplify your prob-
lems?
Mr. Cooke. I think the answer is, of course, yes, because as we
pointed out, our people come from the American society, and to the
extent to which that society reduces the use of cannabis, why our
problems will be immeasurably simpler.
Mr. Martin. Are there any other statements?
Mr. Cooke. I would like to add one observation, that at times
there seems to be a thread running through your questioning that,
because there is at least strong empirical evidence that cannabis
creates a climate and aura of susceptibility in the user, it is not pos-
sible that this is a security problem, because then it is conceivable
that hostile intelligence agents would target it. It seems to me that
if I were a representative of a hostile intelligence agency I would
be looking for rather reliable informants, and the very factors which
would enhance susceptibility of suggestion would also markedly
decrease his value as a possible target. That is a thing I have
sort of been thinking about. And I would like to hear from General
Temple, who, among the investigative agencies present here, and
also Mr. Planton, are responsible for counterintelligence.
Mr. Martin. Let me throw in a thought that they might consider
in responding to you. From the little knowledge that I have of how
intelligence agencies operate, I have the impression that they try
to recruit people at many different levels, from a very low level to
a very high level.
General Temple. That is true, sir. But in our experience — and
perhaps it would tend to explain the point I made in the Air Force
investigations — we have not come across a case in which a hostile
agent played on a man's addiction, for example, to recruit him. It
is rather dear that hostile agents who have any intelligence of our
operations are looking. No. 1, for a person who can be had, but
at the same time, a person who occupies a responsible position where
he has access to the sort of information that the hostile agency is
concerned with, and who is reliable and able to carry out very pre-
cise and detailed instructions. And assuming the psychiatric char-
340
acteristics of the cannabis users, for example, if I were a hostile
intelligence agent, the last man I would waste much effort attempt-
ing to recruit is the pothead in the particular service who, No.
1, is likely to get busted by his own service at any time, wasting my
effort, and No. 2, may be a very poor risk in carrying out any
instructions.
All of this goes to say that we are concerned with the job di-
minishment, if that is the security sense in which you use the word
security, of any member of the Armed Forces who is intoxicated on
duty due to any cause whatsoever.
Mr. Martin. Are there any other observations, Mr. Cooke?
Mr. Cooke. No, as I said at the outset, we welcome the oppor-
tunity to appear before you. We will be glad to supply the infor-
mation you requested for the record, and we think we have a strong
ongoing program across the whole spectrum of efforts, and we in-
tend to keep up with it.
And I can also say that I believe in our judgment, these hearings
of the subcommittee will prove of value not only to the Armed
Forces but certainly to the Nation at large.
Mr. Martin. I want to thank you and your colleagues for your
testimony today, Mr. Cooke.
I have no further questions to ask you.
Mr. Chairman, I hope that we will have the completed testimony
available for distribution in about 4 to 6 weeks.
Mr. Cooke. Thank you very much.
[Whereupon, at 5 :10 o'clock p.m., the hearing was adjourned
subject to the call of the Chair.]
APPENDIX
This portion of the appendix consists of a series of scientific papers dealing
with the effects of cannabis.
The first in this series of papers was specially prepared for the Subcommittee
on Internal Security by Professor Arthur M. Zimmerman of the University of
Toronto, in response to a letter from Chairman James O. Eastland.
Some of the other papers, taken from recent scientific publications, were
covered in somewhat less technical terms in the presentations made before the
subcommittee by the scientists in question. A number were ordered into the
record in the course of the hearing. Others have been included in the Appendix
at the request of Senator Gurney because they contain information that was
omitted from the oral presentations and because it was felt that scientific
readers might wish to refer to the original articles.
In addition, Senator Gurney requested the publication in the Appendix of
several scientific papers which either help to fill in some of the gaps left by the
testimony of the scientific witnesses, or which are of interest because they
were referred to repeatedly by the witnesses.
U.S. Senate,
Committee on the Judiciary,
Subcommittee on Internal Security,
Washington, D.C., June 14, 1974.
Dr. Arthur M. Zimmerman,
Department of Zoology,
University of Toronto,
Toronto, Ontario, Canada
Dear Dr. Zimmerman : As you may have heard, the Senate Subcommittee
on Internal Security has recently held extensive hearings on cannabis which,
among other things, sought to throw light on the effects of cannabis on the
human organism. One of bur witnesses. Dr. Gabriel Nahas of Columbia Uni-
versity, has suggested that it would help to round out the evidence we have
already assembled if you were invited to provide the Subcommittee with a
report dealing with your recent research on the effects of THC on DNA and
RNA synthesis and on the cellular process in general. While it would be out
of the question to schedule any additional hearings at this juncture, a report
on your research could be incorporated in the printed record of our recent
hearings if you could manage to get it to us before June 21. It would be
helpful if your report could be written in language understandable to an in-
telligent layman with a smattering of scientific knowledge.
I hope it will prove possible for you to cooperate with us in this matter.
Sincerely,
James O. Eastland, U.S.S.
Statement of Arthur M. Zimmerman, Ph.D., University of Toronto,
Toronto, Ontario, Canada
[Dr. Arthur M. Zimmerman is Professor of Zoology at the University of
Toronto. Born in New York City on May 24. 1929. he attended New York
University where he obtained his B.A., M.Sc, and Ph.D. degrees. He was
instructor of pharmacology at the State Universitv of New York from 1958
to 1960 and Assistant Professor of Pharmacology from 1960 to 1964. He has
been in his present position as Professor of Zoology at the University of
Toronto since 1964. He is the author or co-author of 57 scientific papers, and
the editor and co-editor of four scientific books.]
(341)
342
Summary of Findings on the Effects of THC on Cell Metabolism
and Division
These studies clearly demonstrate that delta-9-tetrahydrocannabinol (THC)
at a modest dosage reduces the growth and delays cell division of a uni-cellular
protozoan Tetrahymena. These effects on cell growth are related to a depression
of cell metabolism, i.e. a reduction of DNA, RNA and protein synthesis. The
effects of THC are reflected in a reduction in the cell's ability to synthesize
and assemble RNA which is an essential component of the protein synthesis
system. The reduced cell synthesis, in the presence of THC, may be attributable
to the reduction of DNA synthesis which is known to direct cell metabolism.
Delta-9 tetrahydrocannabinol (THC), the psychoactive component of mari-
huana, has been shown to reduce cellular growth, delay cell division, and
interfere with DNA, RNA and protein synthesis in a carefully controlled
cellular system, Tetrahymena pyriformis. Tetrahymena, a unicellular ciliated
protozoan, serves as an excellent model for studying the effects of drugs on
cells. Effects on cell division are readily demonstrable in this system in which
cell division synchrony * can be readily achieved ; evaluation of drug effects is
facilitated by reference to the extensive background of biochemical and physio-
logical data which has been accumulated on these cells.
The growth of Tetrahymena in log phase cultures,2 over a period of 24 hours,
is reduced in the presence of 9.6 /iM. 3 THC. When concentrations are increased
above 16 nM there is further reduction in growth rate accompanied by ex-
tensive cytolysis (cellular breakdown). Cultures of Tetrahymena, which are
thermally treated so as to divide synchronously, display cell division delays
in the presence of THC. The effects of THC on the division schedule is
dependent on the concentration and duration of exposure as well as the stage
during the cell cycle at which the THC treatment is initiated. The studies with
division synchronized cultures complement and support the log growth experi-
ments. THC causes cell division delays and a reduction in the division indices ;
THC at concentrations of 3.2, 9.6, 16.0 /(M cause division delays of 5, 15 and
20 min, respectively.
The dosage of THC employed in these studies can be compared to the THC
which can be found in a "joint" (marihuana cigarette). If the THC (4-8
mg) from 1 or 2 marihuana cigarettes were extracted and were found in the
body fluid of a human (14 liters of body fluid in a 70 kg human), the cellular
fluid surrounding cells might contain as much as 0.3 to 0.6 fig/ml 4 which is
1-2 fiM.
Cellular biosynthesis (metabolism) is markedly inhibited in the presence of
9.6 fiM THC. The greatest reduction is found in RNA synthesis, followed by
reductions in DNA and protein synthesis. The protein synthesizing system in
Tetrahymena is affected by THC. This is reflected in a reduction in the amount
of nascent (new) proteins which are synthesized in THC treated organisms.
Moreover, there is a reduction in the amount of polyribosomal material B
available for protein synthesis ; in addition the synthesis of the various types
of RNA (ribosomal precursor RNA, 25S RNA, 17S RNA, 5S RNA and 4S
RNA) which are essential components of the protein system are partially
inhibited following the treatment of cells with THC.
details of research
Cell Growth
The exponential growth rates of Tetrahymena pyriformis in nutrient medium
containing various concentrations of THC (3.2-24 /iM.) were determined by
1 "Cell division synchrony" is a condition In which all cells present In the culture
evolve and divide simultaneously.
2 "Log phase culture" is a culture in which the cells evolve and divide in a random
manner.
3 "/iM" is a measurement of the strength of a solution. It stands for micromolar. which
is one one-millionth of the molecular weight of a substance taken up in a liter of
saturated solution.
4 "us/ml" — micrograms per milliliter (millionths of a gram per thousandths of a liter).
6 "Polyribosomal materials" — a ribosome consists of protein and RNA. In polyrobosomal
material, the ribosomes are found in clusters.
343
establishing the increases in cell number over a period of 24 hours. The growth
rate was depressed 11% with 9.6 fiM THC and 18% with 24 (iM at 16 hours ex-
ponential growth.
The cytological observations were made in conjunction with these growth
studies. After 1 hour exposure to THC at 3.2 and 9.6 ^M the normally pyri-
form cells were ovoid and somewhat rounded in shape; cell motility was slug-
gish and swimming pattern was irregular. At 16 and 24 ^M THC the cells
were predominately rounded in shape, motility was very sluggish and the
swimming pattern was concentric or static. These obesrvations were more
apparent after 2 hours of exposure. Some cells displayed cytolysis8 at this
2 hours time, at concentrations of 16 ^M or greater.
Cell Division
Exponentially growing Tetrahymena were induced to divide synchronously
by a series of 8 alternating thermal treatments. These cells proceed through
a division maxima 70 minutes after the last thermal treatment. Immediately
after the last thermal treatment cells were incubated with THC at concentra-
tions of 3.2-32 fiM THC. The effects of THC on the division schedule were
dependent on the concentration and duration of THC treatment as well as the
stage during the cell cycle at which the THC is applied. Delay of division
varied from 2.5 min at 3.2 pM, 15 min at 9.6 fiM and 20 min at 16 /iM
THC. The percentage of cells that completed division 1 was correlated with
the drug dose. Cell mounts showed that 91% divided at 3.2 /jM, whereas 54%
divided at 16 fiM.
Changes in division index (the percentage of cells showing division fur-
rows) resulting from THC treatment were analyzed as a function of time
after the last thermal shock. Cells incubated with 3.2 /xM THC showed division
maxima of 75% which was delayed 2.5 min relative to controls. In the presence
of 9.6 and 16 fiM THC cells showing maxima of 50 and 30% were delayed
15 and 20 min, respectively.
Studies were also conducted in which cells were exposed to THC for short
time intervals and then allowed to recover. Cells were pulsed with 9.6 fiM
THC for 10 min at various times preceding the first synchronous division.
The cells were most sensitive to THC when the drugs were applied during
the middle of the cell cycle, at which times division delays of 50 min were
recorded. Application of the drug earlier or later during the cycle caused
division delays of 10 to 20 min.
Macromolecular synthesis
Experiments were conducted to establish the effects of continuous exposure
to THC (3.2 or 9.6 /iM) on the incorporation of radioactively labelled pre-
cursors into acid precipitable material. The incorporation of "C thymidine,
3H uridine, "C phenylalanine or "C sodium acetate was used as an index of
DNA, RNA, protein or lipid synthesis respectively.
Incorporation of uridine into RNA was preferentially depressed by THC
treatment (9.6 /iM) over the exposure interval of 100 min. Incorporation of
thymidine into DNA and phenylalanine into protein was also reduced. The
relative depression of incorporation for the RNA fraction was 70%, DNA
fraction 30% and protein fraction 35%.
Cellular polysomes
Division synchronized Tetrahymena were incubated with 9.6 /iM THC for
55 min. The cells were lysed and the polysomes were extracted and character-
ized. The analysis indicated that there was a reduction in the amount of
polysomal material extractable from THC treated cells. The activity of cell
polysomes is reflected by their association with newly synthesized RNA and
in the synthesis of nascent (new) polypeptides (proteins). To monitor these
activities cells were treated with radioactive amino acids and radioactive
uridine in the presence of THC for 10 min and the polysomes were isolated
and subject to analysis.
6 "Cytolysis" — involves the disintegration of cells, particularly through the destruction
of the surface memhrane.
344
After treatment with THC, polypeptide (protein) synthesis was depressed
by approximately 60% and the activity of rapidly labelled RNA (messenger
RNA) was depressed by approximately 80% as calculated by specific activities.
Cellular RNA
The previous studies suggested that THC caused reduction in RNA and
protein synthesis. In order to determine the nature of inhibition of RNA
synthesis the effect of THC on the synthesis of the various species of RNA
was conducted. Nucleic acids were fractionated on methylated albumin kiesel-
guhr columns. Synchronized cells were treated with 9.6 pM THC for 55 min
in the presence of radioactive uridine. Synthesis of 4S RNA and 5S ribosomal
RNA fractions were depressed. Ribosomal RNA fractions 17S and 25S RNA
showed a 50% reduction as compared to controls.
Studies were also conducted in which cells were exposed to THC for 10 or
15 min and the RNA of these cells was analyzed. Short pulses of THC (32
fiM) show that ribosomal RNA and 4S RNA species were markedly affected
early and late during the cell cycle. Ribosomal precursor was most significantly
inhibited. The heterogeneous high molecular weight RNA species and the
tenuously bound RNA (presumed to be messenger RNA) were depressed at
about half the level of control non-treated cells.
[From Science, Jan. 26, 1973, volume 179, pages 391-393]
Delta-9 Tetrahydrocannabinol: Localization in Body Fat
(By David S. Kreuz and Julius Axelrod, Laboratory of Clinical Science, NIMH)
Abstract. [UC ^"-Tetrahydrocannabinol (A9THC) was injected subcutaneously
in rats every day for 1 to 26 days. Concentrations of A9THC and its metabolites,
11-hydroxytetrahydrocannabinol and 8,11-dihydroxytetrahydrocannabinol, were
determined in various tissues. After a single injection, the concentration of A9THC
in fat was ten times greater than in any other tissue examined, and persisted in
this tissue for 2 weeks. With repeated injection, A9THC and its metabolites
accumulated in fat and brain.
Previous studies have shown that [14C]A9-tetrahydrocannabinol (ATHC)
persists in the plasma of man for several days after its intravenous adminis-
tration (1) and that, after a single injection of [3H]A9THC to experimental
animals, total radioactivity remained in fat (2, 3) and brain (/«) for several days.
A major metabolite of A9THC, 11-hydroxytetrahydrocannabinol (11-hydroxy
THC) (5, 6), is behaviorally active in animals (5) and humans (7), whereas
8,11-dihydroxy tetrahydrocannabinol (8,11-dihydroxy THC) has been demon-
strated to be a nonactive metabolite (1, 5, 8).
Because of the lipophilic nature of A9THC, its persistence in plasma might
be due to sequestration in and slow release from fat. In chronic marihuana
users the effects of A9THC might result from accumulation of A9THC or an
active metabolite in brain. We now describe the selective accumulation and
retention of A9THC and its metabolites in fat after single and repeated subcu-
taneous doses of [14C1A9THC to rats.
Female Sprague-Dawley rats weighing 150 g were injected subcutaneously
just below the scapula every other dav with 14 «1 of an ethanol solution (1
mg/ml, 17.5 fic/mg) of [14C]A9THC (9). Forty-four hours after 1, 3, 6, 9,
or 13 doses of the THC solution, four rats were decapitated. The brain, lung,
and parts of the liver and perirenal fat pads were homogenized, and the A9THC.
11-hydroxy THC, and 8,11-dihydroxy THC were separated and measured by
extraction into heptane of various polarities (10).
There was a tenfold greater concentration of A9THC in fat than in the
other tissues (Fig. 1A), and there was a fourfold increase over the initial con-
centration in fat with repeated injection. In brain A9THC could not be detected
at day 2, but by day 7 could be measured (0.37 ng per gram of tissue), and
this concentration doubled by day 27.
The accumulation of 11-hydroxy THC, the active metabolite of A9THC, shows
a similar distribution (Fig. IB) except that its concentration in fat, although
345
O
c
ta
Accumulation of
[14C]A9THC
Accumulation of
[14C] 11 -hydroxy THC
B
- C
10
20 24 28
Accumulation of
[,4C] 8, 11-dihydroxy THC
T
20 24 28
Persistence in fat of A9 THC
and metabolites
D
A9 THC
J
11 -hydroxy THC
24 28
8, 11-dihydroxy THC
Time (days) •
Fig. 1. The distribution of ATHC, 11-hydroxy THC, and 8,1 1-dihydroxy THC in rat
tissues after repeated subcutaneous doses of F*C]A*THC. (A to C) The rC]A*THC was
given every other day for the stated number of days. (D) A single dose of ["CjATHC
was given, and tissues were examined at the times indicated. Results are expressed as
mean ± standard error of the mean for four animals at each time point.
higher than that for the other tissues, was less than that of A9THC in fat. In brain,
11-hydroxy THC was undetectable at day 2 but by day 27 reached a concentration
of 0.45 ng per gram of tissue.
The accumulation of 8,11-dihydroxy THC (Fig. 1C) is similar except for
fivefold greater accumulation in liver than in lung: 8,11-dihydroxy THC has
been shown to be formed readily in vitro in liver but not in lung (11).
The retention of A9THC and its metabolites in fat (Fig. ID) and the other
tissues was examined by injection of a single dose of [14C1A9THC and analyzing
the tissues periodically over 14 days for A9THC and metabolites. An approximate
346
half-life of 5 days was found for A9THC in fat, while 11-hydroxy THC and
8,11-dihydroxy THC persisted in smaller amounts over 14 days. In liver small
amounts (0.44 ng per gram of tissue) of A9THC and its metabolites were present
for 14 days, while in lung similar amounts were present for 2 days only.
Estimates were made of the residual unidentified polar metabolites (12). After
13 doses of [14C]A9THC, there were negligible amounts in brain, small amounts
in fat (0 to 5 ng per gram of tissue) and lung (3 to 10 ng per gram of tissue)
and large amounts (30 to 60 ng per gram of tissue) in liver. The amounts of polar
metabolites accumulating in liver and lung were greater than the sum of A8THC,
11-hydroxy THC, and 8,11-dihydroxy THC in these tissues.
The disappearance curve for A9THC in the plasma of man (1) and of total
radioactivity in rats (2) shows an initial rapid decline (half-time of minutes)
after intravenous administration followed by ,a long slow phase (half-time of
days), suggesting that A9THC is rapidly taken up in tissues or metabolized or
both. Since the disappearance curve for total metabolites is also biphasic (1), and
A9THC is present in plasma for a week after a single tracer dose (1), it is
probable that tissue sequestration, especially in fat, plays a dominant role in the
disposition of A9THC. The importance of fat localization of drugs in explaining
their duration of action has been shown for drugs such as thiopental (13) , dibena-
mine (14), and DDT (15). These drugs show a similar biphasic disappearance
curve from plasma, a high localization in fat, and a comparable rate of accumula-
tion in fat with repeated administration. DDT reaches maximum levels in fat of
man after 1 year of the normal amounts found in food (16). If the period of
injection of A9THC had been extended over a longer time, the plateau for
A9THC accumulation in fat might reach a much higher value than that reported
in Fig. 1A. With starvation, DDT concentrations increase in rat brain because
of mobilization from fat stores (17). It would be of interest to study this phe-
nomenon in those chronic marihuana users who report flashback (18).
REFERENCES AND NOTES
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1333 (1970) ; H. A. Klausner and J. V. Dingell, Life Sci. 10, 49 (1971).
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(5) H. D. Christensen, R. I. Freudenthal, J. T. Gidley, R. Rosenfeld, G. Boegli,
L. Testino, D. R. Brine, C. G. Pitt, M. E. Wall, Science 172, 165 (1971).
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(1970) ; Z. Ben-Zvi, R. Mechoulam, S. Burstein, J. Amer. Chem. Soc. 92, 3468
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W. E. Schwartz, T. F. Page, E. B. Truitt Science 168, 844 (1970).
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Christensen, J. Amer. Chem. Soc. 92, 3466 (1970) .
(9) A Hamilton microsyringe was used. Examination of the injection site after
13 injections revealed no gross pathological changes, and an ethanol extract
of the tissues at the site revealed 500 to 1000 count/min.
(10) The tissues were homogenized in three volumes of KH2P04-Na2HP04 buffer
(0.051/, pH 7.0) with a Polytron homogenizer. Four volumes of heptane were
.added, and the mixture was agitated with a Vortex mixer for 1 minute, then
shaken in a mechanical shaker for 30 minutes. After centrifugation at 1500(7
for 10 minutes, the organic extracts were dried with a gentle stream of nitro-
gen at room temperature to a volume of 0 to 4 ml, to which 1 ml of ethanol
and 10 ml of phosphor were added for determination of radioactivity in a
Packard scintillation counter. The samples were counted for 20 to 50 minutes
to obtain statistical significance, and correction was made for quenching by
channel ratio. The organic extracts used for chromatography were dried
completely, then 50 to 100 /A of ethanol was added for application to Eastman
silica gel sheets. This heptane extraction was followed sequentially by identi-
347
cal procedures with two other solvent mixtures : heptane and 1.5 percent
isoamyl alcohol, and heptane and 3 percent isoamyl alcohol. The heptane
extracted 90 percent of the ATHC, 10 percent of the 11-hydroxy THC, and
none of the 8,11-dihydroxy THC, whereas the heptane containing 1.5 percent
isoamyl alcohol extracted the remaining APTHC, 60 percent of the total
11-hydroxy THC, and 20 percent of the 8,11-dihydroxy THC. The final extrac-
tion with heptane and 3 percent isoamyl alcohol recovered the remaining
11-hydroxy THC, and 60 percent of the total 8,11-dihydroxy THC. The
amounts of each of the three compounds were determined by simultaneous
equations. The precision and specificity of the method was confirmed three
times on three thin-layer chromatography systems (hexane : acetone, 3:-:
chloroform : ethanol, 19:1, chloroform : acetone, 9:1). The partitions in all
four tissues were the same. The standard error of the mean for these pro-
cedures was 1.1 percent (2V = 16).
(11) K. Nakazawa and E. Costa. Nature 234, 48 (1971).
(12) Two 0.5-ml fractions were taken from each homogenate and from the final
residue after the three organic extractions. To each fraction 1.5 ml of NOS
solubilizer (Nuclear-Chicago) was added, and the tissue was digested for
1 to 2 days (until a clear solution was obtained). Two drops of a 1 percent
solution of SnCl2 were added (to reduce chemifluorescence) plus 1 ml of
ethanol and 10 ml of phosphor. There was, however, considerable variation
between duplicates.
(13) B. B. Brodie, E. Bernstein, L. C. Mark, J. Pharmacol. Exp. Ther. 106, 421
(1952) ; B. B. Brodie and A. M. Hogben, J. Pharm. Pharmacol. 8, 345 (1956).
(U) J. Axelrod, L. Aronow, B. B. Brodie, J. Pharmacol. Exp. Ther. 106, 166
(1952).
(15) E. P. Laug, A. A. Nelson, O. G. Fitzhugh. F. M. Kunze, ibid. 97, 268 (1949).
(16) W. J. Hayes, W. F. Durham, C. Cueto, J. Amer. Med. Ass. 162, 890 (1956).
(17) W. B. Dale, T. B. Gaines, W. J. Hayes, G. W. Pearse, Science 142, 1474
(1963).
(18) M. H. Keeler, Amer. J. Psychiat. 125, 384 (1968) .
[From Science, Feb. 1, 1974, Vol. 183, pp. 183-420]
Inhibition of Cellular Mediated Immunity in Marihuana Smokers
( By Gabriel G. Nahas. Nicole Suciu-Foca, Jean-Pierre Armand, and Akira Mori-
shima, Dept. of Anesthesiology, Surgery and Pediatrics, College of Physicians
and Surgeons, Columbia University )
Abstract. The cellular mediated immunity of 51 young chronic marihuana
smokers, as evaluated by the lymphocyte response in vitro to allogeneic cells and
to phytohemagglutinin, was significantly decreased and similar to that of patients
in whom impairment of T (thymus derived) cell immunity is known to occur.
This inhibition of blastogenesis might be related to an impairment of DNA
synthesis.
It has been previously reported (1) that delta -9-tetrahydrocannabinol (A9-
THC), a psychoactive substance of cannabis, when administered to rodents
alters their cellular mediated immune responsiveness, and it was suggested that
similar changes might also occur in man. In our study the mixed lymphocyte
culture (MLC) and phytohemagglutinin (PHA) responsiveness of 51 marihuana
smokers, 16 to 35 years old (median age 22). were studied. Onlv subjects who
had used cannabis products (at the exclusion of other drugs) at least once a week
(average four times a week) for at least 1 year (average 4 years) were selected
for this investigation.
Eighty-one healthy volunteers. 20 to 72 years of age (median age 44) were used
as controls. Purified lymphocyte suspensions were prepared from fresh samples
of venous blood by the Ficoll-Isopaque density gradient method (2). A micro-
culture system was used for screening of cellular responsiveness (3). For the
MLC test, 1 x 105 responding cells were incubated, per well, with 2X105 stimulating
cells pooled from a panel of ten donors, phenotypicallv different [allogeneic cells
in which 25 different HL-A specificities were represented U) ].
348
TABLE 1.— COMPARATIVE CELLULAR MEDIATED IMMUNITY OF NORMAL SUBJECTS, MARIHUANA SMOKERS, AND
PATIENTS WITH IMPAIRMENT OF T CELL IMMUNITY. THE IN VITRO BLASTOGENIC RESPONSE OF LYMPHOCYTES
WAS STUDIED BY THE MLC AND THE PHA TESTS. THE INCORPORATION RATE OF [3H]THYMIDINE OF THE T LYM-
PHOCYTES IS GIVEN IN COUNTS PER MINUTE ± THE STANDARD ERROR
MLC
PHA
Subjects
No.
tested
[3H)Thymidine
incorporated
(count/min)
No.
tested
pHJThymidine
incorporated
(count/min)
81
26400±200
14894±792
15816±420
8968±459
12001±272
12307±357
15679±499
81
16
23
21
51
23250±210
16
17501±124
23
21
26
24
34
13345±540
10516±580
13779±169
Normal controls
Cancer patients:
Primary tumors.
Regional spread.
Distant spread. _
Uremic patients
Transplant patients l
Marihuana smokers 2
' After 1 to 4 years of immunosupressive therapy.
2 At least 1 year, at least once a week; no other drug taken.
For the PHA test, 2 X 10s responding cells were incubated per well with 1 /xg of
purified PHA. The medium used was RPMI 1640 with penicillin, streptomycin,
and glutamine, to which 25 percent autologous serum was added.
Results are summarized in Table 2 and compared with data obtained in 60
patients with cancer, 20 patients with uremia, and 24 renal allograft recipients
with iatrogenically induced immunosuppression. The mean values registered in
the group of marihuana users were significantly lower than those of the normal,
but much older, control group. Since an inverse correlation exists between cellular
immunity, as reflected by in vitro lymphocyte blastogenesis and aging (5), results
obtained in the group of marihuana smokers may be interpreted as being indica-
tive of cellular hyporesponsiveness. Supporting this conclusion is the close simi-
larity between the depressed MLC and PHA responsiveness of marihuana users
and that of cancer (6), uremia (7), and immunosuppressed transplant patients
in whom impairment of T (thymus derived) cell immunity is known to occur.
Furthermore, we observed that in vitro inhibition of PHA-induced blastogenesis
of normal human lymphocytes started with 1.6 y.M THC and was complete with
20/xM.
The major psychologically active constituent of cannabis sative is AeTHC.
This substance, as well as its metabolites, is insoluble in H20, but is very fat
soluble, and has a half-life of several days in tissues where it might exert a cumu-
lative and pharmacological effect (8) : Such an effect might be related in a still
unknown way to the depressed cellular immune response in vitro of chronic
marihuana smokers. The effect of THC on adrenergic receptors (9) might also
play a role in its immunosuppressive activity, as was suggested for other drugs
administered continuously over a long period (10) .
This inhibition of blastogenesis might result from an impairment of DNA
synthesis. One of us (A.M.) sampled lymphocytes from four marihuana smokers,
cultivated the cells for 72 hours, and then observed a decreased number of cells
during the period of DNA synthesis ('S period of the cell cycle). There was also
an increased incidence of chromosomal breakages, such as that observed by others
(11), and an increase in the prevalence of micronuclei. Since it has been shown
that lymphocytes of normal individuals will undergo three or four divisional
cycles during 72 hours of culture (12), the observed micronuclei might indicate
that there is an increased anaphase lag with or without chromosomal breakage
during the preceding cell divisions in vitro. Anaphase lag, formation of hypodiploid
cells, and alterations of DNA content were also observed in cultures of human
lung explants exposed to marihuana smoke (13). Tetrahydrocannabinol in 3 to 9
fiM concentration inhibits the growth of tetrahymena by reducting DNA and
RNA synthesis (Ut).
Further studies are required to elucidate the exact mechanism by which
marihuana products might affect DNA synthesis and the genetic equilibrium
ofT (thymus derived) lymphocyte population.
349
REFERENCES AND NOTES
(1) G. G. Nahas, D. Zagury, I. W. Schwartz, M. D. Nagel, Nature (Lond.) 243,
407 (1973).
(2) N. Suciu-Foca, J. Buda, T. Thiem, T. Suciu, Transplantation 14, 711 (1972).
(3) N. Suciu-Foca, J. Buda, J. McManus, T. Thiem, K. Reemtsma, Cancer Res.,
in press.
(4) N. Suciu-Foca, J. Buda, J. McManus, K. Reemtsma, Excerpta Med. Int.
Congr. Ser. No. 275 (1973), p. 119.
(5) M. E. Weksler, Clin. Res. 31, 590 (1973).
(6) A. R. Cheema and E. A. Hersh, Cancer Res. 28, 851 (1971).
(7) H. Huber, D. Pastner, P. Dietrich, H. Braunsteiner, Clin. Exp. Immunol. 5,
75 (1969).
(8) D. S. Kreuz and J. Axelrod, Science 179, 391 (1973).
(9) J. Beaconfleld, J. Ginsburg, R. Rainbury, N. Engl. J. Med. 287, 209 (1972) ;
L. Vachon, M. Y. Fitzgerald, N. H. Solliday, I. A. Gould, E. A. Gaensler, Ibid
288,985 (1973).
(10) E. B. Raftery and A. M. Denman, Br. Med. J. 2, 452 (1973) ; J. W. Hadden,
E. M. Hadden", E. Middletown, Cell. Immunol. 1, 583 (1971) .
(11) M. A. Stenchever, T. J. Kunysz. M. A. Allen. Am. J. Obstet. Gynecol., in press.
(12) N. Kamata, A. Morishima, J. H. Tjio, Clin. Immunol. Jap. 2, 657 (1971).
(13) C. Leuchtenberger, R. Leuchtenberger, A. Schneider, Nature (Lond.) 241,
137 (1973) ; C. Leuchtenberger, R. Leuchtenberger, U. Ritter, ibid. 242, 403
(1973).
(14) A. M. Zimmerman and D. K. McClean, in Drugs and the Cell Cycle, A. M.
Zimmerman, G. M. Padilla, I. L. Cameron, Eds. (Academic Press, New York,
1973), pp. 67-94.
(15) Supported in part by the Philippe Foundation, a gift from H. G. Doll, State
of New York Department of Health Kidney Disease Institute research grant
C-48408, and NIH grant GM-09069-11. We thank G. Theim for technical
assistance.
[From American Journal of Obstetrics and Gynecology, Jan. 1, 1974]
Chromosome Breakage in Users of Marihuana
(By Morton A. Stenchever, M.D., Terry J. Kunysz, and Marjorie A. Allen,
Salt Lake City, Utah)
Forty-nine users of marihuana (29 male and 20 female) and 20 control
subjects (12 male and 8 female) were studied with peripheral blood lymphocyte
cultures for the presence of chromosome breaks and abnormal forms. An
average of 3.4 cells with breaks per 100 cells (range 0 to 8) were noted in
the user group, and 1 to 2 cells with breaks per 100 cells (range 0 to 5) were
noted in the control group. No significant differences were, noted in chromo-
some breakage between "heaiy" and "light" users, users of mixed drugs when
compared to users of marihuana only, users of marihuana and caffeine when
compared to marihuana users not using caffeine, and male and female users.
There were increases in numbers of cells with abnormal chromosome configu-
ration in users as compared to control subjects, but the numbers were too
small to be significant. The possible significance of these data is discussed.
The observation that psychoactive drugs could cause chromosome damage in
users was introduced by Cohen and associates (1.2) and Egozcue and col-
leagues (3). It was first reported that chromosome damage occurred because
of the use of lysergic acid diethylamide (LSD). However, a number of studies
since that time have cast doubt on whether this drug actually damages the
chromosomes of users (^-6*) and. in a recent review of the literature, Lang
(7) concluded that it probably did not. Most users of LSD also use other
drugs, particularly marihuana. Gilmour and co-workers (8) found no increase
in chromosome aberrations in "light" users of marihuana. However, they did
find an increase in chromosome breakage in 11 "heavy" users. In most cases,
all of these users were taking multiple drugs. In a study of rat cells, Pace
350
and associates (9) could find no significant increase in chromosome breakage
after exposure of the cells to marihuana in vitro. Studies by Neu and col-
leagues (10) and Stenchever and Allen (11) yielded no increased incidence
of chromosome -breakage in in vitro experiments in human cells exposed to
delta-9-tetrahydrocannabinol, one of the active ingredients in marihuana.
Marihuana, however, is a composite of a number of agents, and its effects
on chromosomes is still to be defined.
It is the purpose of this presentation to report results of the effect of
marihuana use on the chromosomes of a group of healthy college students.
MATERIAL AND METHODS
Forty-nine users (29 male and 20 female) and 20 control subjects (12 male
and 8 female) were studied concurrently. The average age of the users was
22 3 years (range 17 to 34) and the average age of the control subjects was
28.7 years (range 13 to 52). All of the users were college students. Some of
the control subjects were college students ; others were members of the staff,
working at the University. No individual in the control group was exposed
CELLS WITH BREAKS
Fig. 1. Per cent cells with chromosome breaks and abnormal forms in marihuana users and
control subjects.
to any drugs or medication for 6 months prior to the study, other than an
occasional aspirin, and none had been exposed to ionizing radiation of any
type for 6 months or more. A few used nicotine, and most used caffeine. The
major purpose of the control group was to test the method continuously for
the incidence of chromosome breakage. A careful history was taken from each
user and control subject and included exposure to all drugs and pesticides,
including the name of the agent, the dates exposed, and the dosage, as close
as could be estimated, exposure to x-irradiation, serious illnesses, pregnancy
history, history of caffeine use (including coffee, tea, and cola), and the use
of cigarettes, including the number smoked per day. The use of marihuana
was tabulated for each user according to date and amount used, classification
of drugs as estimated by the user, and the presence of any other drugs that
were used concurrently. All users smoked as their means of ingestion. Mari-
huana had been used for a minimum of 6 months and a maximum of 9 years
(average 3.0 years) and previously had been used between 5 hours and 30
days prior to the study.
From each subject, 10 c.c. of heparinized blood was obtained and treated
with phytohemagglutinin for 30 minutes in ice. Following this, a specimen
was centrifuged at 500 r.p.m. for 5 minutes. The lymphocyte-containing sera
were separated into three equal portions in small Erlenmeyer flasks. Dulbecco's
modified Eagle's medium with penicillin and streptomycin were added to each
351
flask to make a final volume of 10 ml. The flasks were then cultured at 37° C.
for 72 hours. Two hours prior to harvesting, 0.3 ml. of Demecolcine 7 (10
meg. per milliliter) was added to each flask, and harvesting was carried out
with the use of an air-dry technique. Slides were stained with carbofuchsin
and scored for the presence of chromatid and isochromatid breaks and ab-
normal forms. A chromatid break is described as a separation in a chromatid
arm with a dislocation of the fragment or with a separation greater than the
width of the chromosome arm. An isochromatid break is similarly defined
except that the breaks occur on the identical spot of both sister chromatids.
Chromatid and isochromatid gaps were also scored but were not included in
the analysis of the data because of the uncertainty of their biological signifi-
cance. Abnormal forms are described as tetraploid cells, cells with quadri-
radials, triradials, rings, or dicentric configurations, or cells with multiple
fragmentation. One hundred consecutive intact-appearing spreads were scored
for each patient. The individual doing the scoring did not know whether the
preparation was from a patient or a control subject. All cells with breaks
or abnormal forms were photographed for verification.
NUMBER
CASES
CELLS WITH BREAKS
•/. CELLS WITH ABNORMAL
CHROMOSOME CONFIGURATION
Fig. 2. Per cent cells with chromosome breaks and abnormal forms in users of mixed drugs
and users of marihuana alone.
Does marihuana use cause chromosome damage? Fig. 1 compares graphically
the breakage experience in breaks per 100 cells between the study group and
the control subjects. There was an average of 3.4 cells with breaks (range 0
to 8) per 100 cells per user and 1.2 cells with breaks (range 0 to 5) per
100 per control subject. The difference is significant (p = 0.05). While the
abnormal form data appear to be different for the two groups, the numbers
involved are too small to be significant. The majority of abnormal cells seen
were tetraploid cells and cells with fragmented chromosomes, with only one
triradial and one dicentric cell occurring in the study group and none in the
control group.
Does the concurrent use of other drugs influence the extent of chromosome
damage? Fig. 2 compares graphically the distribution of frequency of breaks
in users of marihuana only with those who have used other drugs as well.
Other drugs in this instance include barbiturates, amphetamines, tranquilizers,
mescaline, LSD. and heroin. While a variety of usage patterns occurred in
these subjects, no attempt was made to separate cases of use of each of the
other agents as numbers would be very small. Users of marihuana alone had
an average of 3.1 cells with breaks per 100 cells, whereas users of mixed drugs
Ciba Pharm. Co., Summit, New Jersey.
352
had 3.7 cells with breaks per 100 cells. These differences are not significant
at the p = 0.05 level. ■
Does *fce frequency of use relate to the extent of damage? Fig. 3 compares
the frequency of chromosome breakage in a group of individuals who were
considered to be heavy users (more than 2 exposures per week) with a group
of individuals known to be light users (one or less exposure per week). Light
users had used the drug between 6 months and 9 years (average 2.9 years)
and had last used it 18 hours to 30 days before the study (average 5.4 days).
Heavy users had used the drug 9 months to 7 years (average 3.4 years) and
had last used the drug 5 hours to 5 days (average 1.4 days) prior to the
study. Twenty-seven users fell into the "heavy" use category and had an
average breakage rate of 3.8 cells per 100, while 22 users were in the "light"
category and had a breakage rate of 3.2 cells per 100. The difference is not
significant at the p = 0.05 level.
"heavy" users
4 5 6 7 B
CELLS WITH BREAKS
I 2 3 4
"LIGHT" USERS
CELLS WITH BREAKS
Fig. 3. Per cent cells with chromosome breaks and abnormal forms in heavy and light users
of marihuana.
Does the use of caffeine as well as marihuana influence the extent of chro-
mosome damage? Fig. 4 compares the frequency of chromosome breaks in
marihuana users who also used caffeine in various forms with those who did
not. Attempts were made to define the amount of caffeine used per day. This
was carried out by ascertaining the average amount of coffee, tea, and cola
used by an individual in estimating the average amount of caffeine consumed
per day. This is, of necessity, a rough estimate. Forty-three individuals were
users, and 6 were not. Comparing two such groups is difficult, but, nonetheless,
the distribution of chromosome breaks in each group is such that no influence
of caffeine is suggested. Because of the unequal numbers, tests of significance
were not applied.
Do male and female subjects respond differently to marihuana with respect
to chromosome damage? Fig. 5 compares the frequency of chromosome breaks
between male (29) and female (20) subjects. Male subjects had an average
breakage rate of 3.7 cells per 100, and the rate for female subjects was 2.9
cells per 100. This difference was not significant at the p = 0.05 level.
Since both chromatid and isochromatid breaks occurred and no pattern of
breakage was noted, all breaks were tabulated as "total breaks." Fig. 6 shows
examples of chromosome breaks seen.
COMMENT
The data presented in this study seem to indicate that the use of marihuana
is a cause of chromosome breakage in lymphocytes of users. Multifactorial
analysis on computerized data carried out in this experiment comparing
variables of sex of individual, marihuana use, use of other drugs, and use of
353
caffeine demonstrated a positive correlation at the p = 0.05 level only for
the variable of marihuana use and chromosome breakage. In addition, the data
seemed to show that the degree of use is not critical as light users (those
using marihuana one time or less per week) had about as great a chance of
having chromosome breakage as did heavy users. Thus, it appears that with
respect to chromosome breakage the type of exposure afforded by the breaking
agent even with occasional use is strong enough to do damage. This is in
contrast to the observations of Gilmour and coworkers, (8) but it must be
pointed out that a larger series of patients is reported here than was used
by these authors.
10 -
NUMBER
CASES
MARIJUANA + CAFFE INE
MARIJUANA ONLY
CELLS WITH BREAKS
"H3 r~i
12 3
°l. CELLS WITH ABNORMAL
CHROMOSOME CONFIGURATION
Fig. 4. Per cent cells with chromosome breaks and abnormal forms in users of marihuana
and caffeine and marihuana alone.
Individuals studied in this series were college students whose general
nutrition and health were generally good. Unlike early studies of the effects
of mind-expanding drugs on chromosomes, the variables of malnutrition,
chronic infections, etc., seem less to be in effect.
One of the major problems that the observations presented in this paper
raise is a question of which compound or compounds absorbed by marihuana
use are actually causing chromosome breaks. It is also possible that a meta-
bolite of some compound of marihuana produced in the body is responsible for
the damage. One of the active ingredients of marihuana is delta-9 tetrahydro-
cannabinol, but it has been shown by Neu and colleagues (10) and Stenchever
and Allen (11) that this agent does not break chromosomes in vitro. There-
fore, it seems appropriate that other known compounds present in marihuana
should be studied in an in vitro system to try to identify specifically which
compound or compounds are doing the damage. Should this be fruitless, an
attempt to identify other metabolites and to study these in the in vitro
system would seem appropriate.
Perhaps one of the more important q\iestions that these data raise is that
the blame that had been placed on LSD as a chromosome-breaking agent may
indeed have belonged to marihuana. It is now reasonably well accepted (7)
that LSD in most cases is not the cause of chromosome damage. Since most
individuals using LSD in cited studies had also been using other drugs, notably
marihuana, it is possible that marihuana had indeed been the cause of the
chromosome damage noted. Such specu'ation becomes extremely important
when one considers the possible teratogenic effect of such drugs. In a recent
article by Jacobsen and Berlin (12) entitled "Possible reproductive detriment
in LSD users," it was pointed out that, in 140 women and their consorts who
had admitted to the use of LSD prior to or during nregnancy, 148 pregnancies
led to the birth of 83 live children, 8 of whom had major congenital defects.
354
Fifty-three therapeutic abortions produced 14 embryos, 4 of which had gross
defects. In addition, there was a probable increase in the spontaneous abortion
rate and in the amount of infertility noted over what might have been
expected by chance. These patients were using other drugs, and the most
interesting observation was that 100 percent of them had used marihuana. (12)
While it is possible that LSD was indeed the teratogenic agent in this series
and equally possible that problems occurred in these patients because of a
combination of drug uses, marihuana must still be considered a candidate for
the prime agent causing these reproductive problems. Since marihuana is
widely used, particularly in the young individuals of our society, this possi-
bility takes on a spectrum of overwhelming significance.
A major consideration in any experiment recording chromosome damage is
the legitimate question of what specifically chromosome damage implies. Cer-
tainly, x-irradiation and some viruses are capable of causing chromosome
breakage, and it would appear that a variety of other agents including mari-
10
NUMBER
CASES
MALES
"/. CELLS WITH BREAKS
I 2 3 4
V. CELLS WITH ABNORMAL
CHROMOSOME CONFIGURATION
3 4 5 6
CELLS WITH BREAKS
V. CELLS WITH ABNORMAL
CHROMOSOME CONFIGURATION
Fig. 5. Per cent cells with chromosome breaks and abnormal forms in male and female users.
»/
A*
K
A B * C
H J * |f* * G _ . ^ H ^** t
Fig. 6. Examples of chromatid {A to E, G, and H) and isochromatid breaks (F) seen in cells
of users.
355
huana are also capable of this damage. Specifically, most of the data available
are tangential data and neither prove nor disprove that a chromosome-breaking
agent is dangerous. X-ray is known to cause damage which will persist, and
in these individuals both teratogenesis and neoplasia seem more prevalent.
Certain disease states such as Bloom's syndrome, {13-15) Fanconi's anemia,
(16,17) and ataxia telangiectasia (IS) have been shown to be associated with
chromosome breakage; in ail such instances, the presence of neoplasia and
production of fetuses with congenital malformations are more common. If the
agent is specifically active before chromosome division takes place, an iso-
chromatid break will usually be found, whereas, if the agent acts after
chromosome division, a chromatid break will be seen. Both types of abnor-
malities were seen with about equal frequency in our observations, giving
rise to the possibility that the active agent responsible for the chromosome
damage was acting at different periods of the cell cycle. If it has a direct
affect on deoxyribonucleic acid replication, the possibility that it also behaves
as a mutagen cannot be overlooked. While observations here were made on
lymphocytes, it may be assumed that other cells of a body are equally sus-
ceptible to the damage taking place. Should gonadal cells be involved, the
possibility of teratogenesis cannot be overlooked. Should the individual be
pregnant at the time of use, a direct effect on the fetus may occur. Should
other tissues of the body be involved, the possibility for eventual neoplasia
must be considered. Only a long-term observation of large numbers of users
will determine which of these many possibilities are actually realities. Still,
because of the common use of this agent, it would seem that these observations
are essential.
Final comments about the technique are appropriate. It is essential that
experiments seeking chromosome damage be specifically controlled. The essen-
tial nature of the control is that the method for ascertaining chromosome
damage be continually tested. The prime purpose of the control group in this
experiment was twofold. The first was to furnish a continuous monitoring of
the tissue culture and cytologic methods so that any variation in the laboratory
which would lead to greater chromosome damage would be noted immediately
without reflecting necessarily on the drug under study. In our laboratory,
over the past several years, a spontaneous chromosome breakage rate of
between 1 and 2 per cent has been observed continually. Except for occasional
periods when virus infections are prevalent, we have not seen this breakage
rate exceeded. The second important purpose of the control group is to help
in eliminating bias in observations by the experimenters. By continually adding
control subjects to the study population, the individual making observations
for chromosome breaks does not know whether the culture observed is from
a user or a control subject. Thus, the opportunity for bias is lessened. In this
particular experiment, every damaged cell was photographed and reviewed by
the chief investigator. Two individuals, one from the control group and one
from the patient group, were found to have active herpetic lesions about the
face at the time the cultures were performed. The patient from the study
group demonstrated 7 per cent breakage while the control subject had 5
per cent breakage. To our knowledge, however, no other subject suffered from
viral infections at the time of study.
In view of the data presented in this study, it would seem prudent that
further observations with respect to chromosome damage cause by marihuana
use be documented. Further studies should incUide an attempt with an in vitro
system to identify which ingredients or metabolites are responsible for chromo-
some damage and animal experiments to determine whether marihuana is
teratogenic or carcinogenic ; these should be carried out as soon as possible.
The magnitude of the problem is overwhelming when one considers the number
of young people using this drug and the priority assigned to such studies
should be thus the highest possible.
The authors acknowledge Kathrvn Parks. Leslie Jerominski. and Marc
Stenchever for technical assistance and Stanley Pace for statistical evaluation
of the data.
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356
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(17) Swift, M. R., and Hirschhorn, K. : Ann. Intern. Med. 65: 496, 1966.
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V., and Miller, R. W. : Lancet 2 : 1193, 1966.
[From Neuropharmacology 1-14, 1973]
Marihuana: Effects on Deep and Surface Electroencephalograms of
Rhesus Monkeys
(By R. G. Heath, Department of Psychiatry and Neurology, Tulane University
School of Medicine, 1430 Tulane Avenue, New Orleans, Louisiana 70112)
(Accepted 21 April 1972)
SUMMARY
Six rhesus monkeys prepared with electrodes implanted into numerous specific
subcortical brain sites and over the brain surface under the skull were exposed
to smoke of marijuana containing a significant quantity of delta-9 tetrahydro-
cannabinol. Electroencephalograms were obtained before, during, and after
exposure to the marijuana smoke, which was delivered to the monkeys by use
of a specially designed head chamber. Control agents for the study were inert
marijuana of low delta-9 tetrahydrocannabinol content, tobacco, alcohol and
methamphetamine.
Exposure to smoke of active marijuana consistently induced distinct recording
changes in the septal region, occasionally accompanied by changes in recordings
from the cerebellum, postero ventral lateral thalamus, hippocampus, and orbital
and temporal cortices. Only generalized electroencephalographic changes, con-
sisting of slight shifts in the dominant frequency, were obtained in association
with the other agents used in the study.
Studies conducted in lower animals (dogs, rabbits, cats, rats) give some
indication that brain recordings from deep nuclear masses are affected more
than surface recordings by the active ingredients of marijuana (Hockman.
Perrin and Kalant, 1971: Boyd and Meritt. 1966: Christensen, Best and Herin.
1971; Bose, Saifi and Bhagwat, 1964). Hockman et ah (1971) reported con-
siderable delta activity and fast high-emplitude spindling from the amygdala,
ventramedial hypothalmus, hippocampus, and a number of cortical areas in
association with administration of delta-9 tetrahydrocannabinol (THC) to cats.
Christensen et al. (1971) reported predominantly hippocampal and septal
changes with THC in rats.
No studies have been found, however, of the effects of marijuana or its
known ingredients on the function of deep brain structures of sub-human
primates. The present report concerns the effects of marijuana smoke on deep
and surface electroencephalograms (EEGs), as well as on behavior, of rhesus
monkeys in which electrodes had been implanted for long-term study. For
comparison, the effects of methamphetamine, alcohol and tobacco smoke were
also studied.
357
Six feral-raised rhesus monkeys (3-6 yr old), obtained through the Tulane
Medical School Vivarium, were used for this study.
Electrode implantation
The operative procedure, which has previously been described (Heath, John
and Fontana, 1968), was carried out under Nembutal anaesthesia with roent-
genographic visualization of the ventricular system after pneumoencepha-
lography. Two types of silver-ball electrodes (Lustick and Heath, 1971) were
Fig. 1 . Transparent plastic box apparatus used to pump marijuana and tobacco smoke to monkeys.
stereotaxically implanted into a variety of deep sites and over the cortex of
the brain : a single ball electrode 0.025 in. in diameter and a bipolar electrode
composed of two silver balls 0.0S in. apart, each 0.015 in. in diameter. The
electrodes were soldered to two 10-place plugs which were fixed with Cranio-
plastic to the skull. All six monkeys had electrodes implanted into the following
8 sites : right septal region, right dentate nucleus of the cerebellum, right
fastigius nucleus of the cerebellum, postero ventral lateral thalamus, hippo-
campus bilaterally, mesencephalic reticulum, and over the right temporal
cortex. The remaining electrode placements varied : in two monkeys, single
(monopolar) silver-ball electrodes were also implanted into the caudate nucleus
and the hypothalamus (mammillary bodies) and over the frontal and occipital
cortices ; two other monkeys had bipolar electrodes into the centramedian
thalamus and the orbital cortex ; and two had bipolar electrodes over the
cerebellar cortex and into the orbital cortex.
Each monkey was allowed to rest for 3 weeks after implantation, to permit
all recording artifacts consequent to the operation to disappear. At the end
of the studies, the monkeys were killed and the brains fixed in 10% formalin
for later sectioning and staining by the Kluver-Berrara method, to permit
histologic study which established the absence of notable brain damage at
electrode tips (Lustick and Heath, 1971) and verified accuracy of the electrode
placements.
Recording procedures
Electroencephalograph^ (EEG) recordings were obtained on a 12-channel
Grass Model VI electroencephalograph. A 7-channel Ampex FR 1300 recorder
358
was used to record samples of significant recordings simultaneously on mag-
netic tape. The EEGs and the magnetic tape recordings were synchronized
with an EECO (Electronics Engineering Co. of California) 85S-A time code
generator/reader with one EEG channel used as a marker for the generator.
Another EEG channel was used to record activity from over the heart to indi-
cate pulse rate.
Activity of the right temporal cortex and of the right anterior septal
region during both baseline recordings and at intervals after exposure to
both marijuana and tobacco smoke were analyzed to determine brain activity
in the canonical delta, theta and alpha bandwidths. The measure of activity
was the average of the absolute amplitude. For this analysis an Electro-
physiological Monitor and Event Detector (EMED) was used which integrates
energy at predetermined frequencies (Heath, 1972a). Significance of the ac-
tivity in each of the canonical delta, theta, and alpha bandwidths at these
sites was obtained with a two sample f-test.
Test materials and mode of administration
Marijuana. — Marijuana was obtained by court order from Federal narcotics
agents. For this study, two different batches of marijuana were used. Assay
by gas chromatography of the crude petroleum ether extract from the dried
leaves showed that one batch contained 2.29% THC (referred to hereafter as
active marijuana). The other batch, in contrast, contained a barely detectable
quantity (0.1%) of THC (referred to hereafter as inert marijuana).
Marijuana smoke was delivered to the monkeys by use of a specially fabri-
cated transparent plastic box placed over the animal's head (Fig. 1). A pipe
was fixed to the box, and by means of a rubber bulb, the smoke was pumped
from the pipe into the plastic box ; it was mixed sufficiently with air or with
oxygen pumped through another opening to prevent anoxia.
It was not possible by this procedure of delivering smoke to the monkeys
(both marijuana and tobacco) to estimate the quantity of active material
absorbed by inhalation. Since the period of exposure to smoke for each test
reported here was the same (5 min), it was assumed that about the same
amount of smoke was inhaled on each occasion.
During the exposure of one monkey to marijuana smoke and to tobacco
smoke, air samples were obtained of both the room air and the air within the
smoke box and blood-gas analyses were made on an Instrumentation Labora-
tory I.L.-313 blood-gas analyzer. Blood samples were obtained before ex-
posure, during 5-min exposures (to both marijuana and tobacco smoke on
separate occasions), and at 10, 30, and 60 min after exposure to smoke.
Each of the 6 monkeys studied was exposed to marijuana smoke 2-5 times.
Tooacco. — The smoke from a standard brand of pipe tobacco was delivered
to the monkeys by use of the same apparatus that was used for delivery of
marijuana smoke.
Alcohol. — Each monkey received 5 ml of a solution consisting of 2.5 ml
U.S.P. absolute ethyl alcohol diluted with 2.5 ml water and injected i.v. at a
rate of 1.0 ml/min.
Methamphetamine. — Each monkey received 0.25 mg/kg of body weight of
methamphetamine injected i.v.
RESULTS
Active marijuana (2.29% delta-' tetrahydrocannabinol)
The behavioral responses of the 6 monkeys to the active marijuana smoke
were consistent, as were the responses of individual monkeys to repeated
exposure to the smoke, although the intensity of the responses varied. All
displayed dilated pupils and sharp reduction in level of awareness. The
monkeys would stare blankly into space, sometimes displaying spontaneous
nystagmus, and would become much less attentive or completely unresponsive
to environmental stimuli. When their hands or feet were grasped, the clasping
response, which was consistently elicited on baseline examinations, was absent.
Responses to pain (pinprick) and to sound (hand claps) were minimal to
absent. Although the monkeys were not particularly drowsy, spontaneous
359
motor movements were notably slowed, and passive tests of muscle tone
suggested a degree of catatonia, although true waxy flexibility never developed.
Electroencephalographic changes, which always accompanied the behavioral
changes, consistently began within 1-3 min after the monkey's initial exposure
to a high concentration of active marijuana smoke. They became increasingly
pronounced over a period of the next 5 min and then remained distinct for
at least 30 min. At that point the recording usually began a return toward
baseline, and generally in another hour the recording again resembled the
baseline EEG. With each exposure, the pulse rates of the monkeys increased
from 50 to 100%.
Although there were similarities in the EEGs of the 6 monkeys, there were
variations as well. A consistent feature was the profound change that occurred
in recordings from the septal leads. On occasion only this site was affected, but
usually other sites showed changes as well. When only the septal region was
affected, a delta wave at a frequency of 3-4 Hz characteristically appeared
(Figs. 2 and 3). Occasionally, a sharp wave was interspersed with this focal
delta activity. This slow wave and occasional sharp wave activity was inter-
mittent, bursts lasting 5-10 sec appearing every 20-30 sec. Sometimes the
slow wave in recordings from the septal region was accompanied by a similar
wave (frequency of 2—4 Hz) recorded from the mesencephalic reticulum or
the postero ventral lateral thalamus, or both, while no significant changes
appeared in recordings from other deep structures or from the surface (Figs.
4 and 5).
MARIJUANA
BASELINE
R T CX.
ORB CX.
L HIP
RSEP_
RC M THAL.
R MAMM
yv^Vv^^'^V^^AV^V/^V*v^h^^\^W\^*'^.'^.•*^'■^./
L P V L THAL_
R CBL FAS
R RET
EKG 144.
TCG
(/»Vyw
^rFjF
pm^T mr.T imiimiiiimiiimni imriT ittt't mrT m
MONK XG
. TTTTTTniTTUim'TnTVliuKiiiTnTmrnn
50pv Isec
Fig. 2. Baseline deep and surface EEGs obtained from Monkey XG. R T CX: right temporal cortex;
ORB CX: orbital cortex; L HIP: left hippocampus; R HIP: right hippocampus; R SEP: right septal
region ; R C M THAL : right centromedian thalamus ; R M AM M : right mammilary body ; L P V L THAL
left postero-ventral lateral thalamus; R CBL FAS: right cerebellum fastigius; R RET or R MES RET
right mesencephalic reticulum; R HYP: right hypothalamus; R A SEP: right anterior septal region
EKG or PULSE: EEG channel indicating pulse rate; TCG: EEG channel used as marker for time code
generator. (These abbreviations also apply to the other EEG figures in this paper.)
Another frequent recording change was the appearance of bursts of high-
amplitude spindles (approximating 16 Hz), most pronounced in the septal leads
but occasionally present in other deep leads and over the temporal cortex
(Figs. 6-8). The presence of spindles at other sites was sometimes synchronous
360
MARIJUANA
5 MIN POST EXPOSURE
R T CX.
ORB CX.
LHIP
RHIP
RSEP.
RCM THAL.
R MAMM
./*WWVVV\Vv^/wWV^^
,J\fcJ^^Vw^/"%JVv'^*4srt*v^^wu^^^
LP V L THAI
R CBL FAS
R RET
EKG 210.
TC6
T-wnnrnrrmiinitiiimiiiiiiiiim ip-.Tjr-i'^'nrr'mriiiiniiiiiiiiiimiiiiii irnnrrnr!ir.r7rnrHHiiiii::Mii»iiiiiiii i»rim-rr
MONK XG
50 /jv I sec
Fig. 3. Deep and surface EEGs obtained from Monkey XG 5 min after exposure to marijuana smoke.
Note focal delta activity in the septal lead. Artifact caused by eye-blinking is seen in the right temporal
cortex lead.
MARIJUANA
BASELINE
R T ex.
L HIP.
Ft HIP.
R SEP.
ORB CX.
CBL CX_
R CBL DEN iV
L P V L THAL_/'™'1,'~Svv»^^
alert ,. „ .drowsy .
jw^--»-~v/»n/'N*~w~y\jVv-~v^^^j^
R RET
TCG.
.:.i,u:;:uii;i;n i rmrr ittt; |"tt
■|rnnr,|T,!rTrr,ii
MONK XH
IfrTtTITTTTTrTrri
nmr | nrrr ittt- I'ttt i;;m,:.i: 1,1 | IT'
i ' i ■ '■ 'if1 ' , ll1 1
50jjv .Isec,
Fig. 4. Typical baseline EEGs obtained from Monkey XH.
361
MARIJUANA
5 MIN POST EXPOSURE
R T CX.
L HIP.
R HIP_
R SEP ~^\^F*rv\*-^uW*^'V\^
ORB CX.
CBL cx ^Kviv^vVvW^^V^^
R CBL DEN *w*^*wW^wAy^^
R CBL FAS V^^^W*Ml^^
L P V L THAL-^^aV^^/vV-^1"^^
R RET ^^•^AWVV-Vvvvy*vvw\/v\/V^^
EK6 ZZA^^UWJMAAriliMMMMMJM^
CG mmnm*ymqfmpf» mimmm^^iffmm wmnmj^jm^mmum uijtt
MONK XH 50jjv I sec
Fig. 5. EEGs obtained from Monkey XH 5 min after exposure to marijuana smoke. Note delta activity in
the right mesencephalic reticular (R RET) and left postero- ventral lateral thalamic leads along with focal
slowing in the septal lead.
MARIJUANA
BASELINE
R T CX.
ORB CX n^.w^vyvvrH^vW
L HIP
R HIP
V ' ' '■•> v L. ■ » .
R A SEP ;V'''Ar'»'.',^^-^VA^\/^,JW*,^W,-*^'',*v" 'PV.VVWW
CBL ANT LOBE ./^ >-~'~-' ^N^^^U^^^^— k^^^X^" 'v^-U»x->-v^^' "^ -^-^V^>.^w~^v^ \
R CBL DEN v»™</<yVvW^'%^^^^^^w^
R CBL FAS *A^r\|f^/V^^
R RET ifo^l^/V^M*^^
L P V L THAL
EKG 198
|mT7rrmrTruTlu;iuHii;iiiHiiiiiiii |iTTTTlrnTTr,iTT1ii;iiunuiuiiiiiiHii |nnrTnnrTrTT"riiwiii..:ui,i'„Hiii:: MT~TtTTTTTr~.l'
MONK XL 20pv I sec
Fig. 6. Typical baseline EEG obtained from Monkey XL. The pulse rate of the animal was rapid when this
recording was made. Post-marijuana recordings (Frgs. 7 and 8) do not show the monkey's maximal pulse
rate increase which did occur.
362
MARIJUANA
10 MIN POST EXPOSURE
R T CX_
ORB CX.
L HIP
R HIP_
-y-^^vYAW,.
R A SEP.
CBL ANT LOBE <g
R CBL DEN
R CBL FAS
R RET
L
P V L THAL [/VV^W^AV
i
EKG 200
TCG.
-r^qrprimniMii TOp^ri
MONK XL
T
IMllll FTTTT.TT'Tr
TTnTITTrrtTTr
20>jv I sec
Fig. 7. EEG from Monkey XL lOmin after exposure to marijuana smoke. Note spindling at certain sites.
MARIJUANA
50 MIN POST EXPOSURE
R A SEP.
CBL ANT LOBE.
R CBL DEN
R CBL FAS
R RET
L P V L THAL.
EKG 180
TCG
444444444444444444444444444444444444444444444444444444^
^^RPfjITTf
^ppjTF^W
T[^rrjrff
^irniraPv
MONK XL 20pv I sec
Fig. 8. EEG from Monkey XL 50 min after exposure to marijuana smoke.
363
MARIJUANA
BASELINE
L F - L T SC
R F-R T SC
R T CX /"w-wy*^**JlA .V""vV~v>^v>
R HIP
R ORB CX.
R A SEP_
. < , i ,
L P V L THAL _ -^vVo:^V^VVA\^^^ ;,^/;'^ ■'*>''
R CBL DEN_ <^^^
RCBLFAS_^^^
RHYP tyVv^Affe
R MES RET .^VT/Wll^XyY^
PULSE - I80_ ^i^i^^^^
TCG 20tjv I sec
Monkey XQ
Fig. 9. Baseline EEG obtained from Monkey XQ.
MARIJUANA
20 MIN POST EXPOSURE
LF-LT SC
RF-RT SC
i
R T CX yA/V^<\V^-vMV~v*^^w/^^
R HIP.
R ORB CX
R A SEP_
R CBL DEN
R CBL FAS
R HYP
R MES RET V\fAj^\^A\/f^r\j^y^^
PULSE - Z.O-^flf^fffl^flf^^
wiimiiimmmimltmTTfl|mTrl^lMiiM^
Monkey XQ
Fig. 10. EEG from Monkey XQ 20 min after exposure to marijuana smoke.
TCG.
364
with their appearance in the septal region and sometimes independent of it.
Other sites frequently involved were the postero-ventral lateral thalamus, both
deep cerebellar nuclei, orbital cortex and hippocampus.
In figures 9 and 10 spindling was constant in the cereballar nuclei when the
characteristic slow-wave was most prominent in the postero ventral lateral
thalamus and orbital cortex and was less obvious in the septal region and
the temporal cortex. Scalp leads, by visual inspection, did not reflect the slow-
wave activity present at deep sites. Spindling in cerebellar nuclei of the type
shown in Figure 10 occasionally appeared in baseline recordings when the
monkeys were relaxed, but was present more often (for a much higher per-
centage of recording time) after exposure to marijuana smoke. When spindles
appeared in recordings from the temporal cortex, they were visible but less
apparent in scalp recordings over the temporal region.
Results of the air samples obtained with marijuana smoke and with tobacco
smoke are shown in Table 1. Results of the blood-gas analyses are summarized
in Table 2. With exposure to smoke of marijuana mixed with oxygen, the
partial pressure of oxygen remained above baseline values while partial
pressure of carbon dioxide remained below baseline values. The values remained
within the normal limits after the smoke inhalation, indicating that there was
no hypoxia.
TABLE 1.— MARIJUANA SMOKE* AND TOBACCO SMOKE' AIR SAMPLES
ptC02(mm Hg) pt02(mm Hg)
Marijuana:
Sample taken inside smoke boxt 11.5 "8.1
Room air sample... - 6-4 146.7
Tobacco:
Sample taken inside smoke boxi 9.2 16£. 1
Room air sample 5.2 149. Z
•Supplementary oxygen mixed with smoke.
tPartial pressure (of CO2 or O2 in mm Hg).
tSmoke at highest density inside box when sample was taken.
TABLE 2.— MARIJUANA SMOKE* AND TOBACCO SMOKE' 5 MIN EXPOSURE TO EACH BLOOD-GAS ANALYSIS
ptC02(mm Hg)J ptOsOnm Hg)§ pH
Marijuana:
Before exposure
During exposure
10 min post
30 min post
60 min post
Tobacco:
Before exposure
During exposure «...
10 min post
30 min post
60 min post - -
♦Supplementary oxygen mixed with smoke.
tPartial pressure (of C02 or O2 in mm Hg).
JNormal p CO2 values in man at sea level=41.0 mm Hg (and below).
§Normal p O2 values in man at sea level = 94.0 mm Hg (and above).
Inert marijuana (0.1% delta-9 tetrahydrocannabinol)
Behavioral responses of the monkeys to smoke of inert marijuana were mini-
mal to absent. When the concentration of smoke in the chamber was high, the
monkeys showed some irritability but settled down promptly when the smoke
cleared.
Pulse rates increased from 10 to 20%.
By visual inspection, EEG changes were absent or limited to slight shifts
in the dominant frequency.
41.1
106.4
7.419
39.5
258.1
7.412
29.2
122.3
7.431
32.3
121.8
7.429
29.0
142.0
7.414
30.5
132.4
7.422
32.4
162.1
7.450
24.1
137.5
7.429
35.7
94.0
7.450
34.9
94.0
7.470
365
Tobacco
No notable changes were observed in behavior of the 6 monkeys as a result
of exposure to tobacco smoke.
Pulse rates rose from 10 to 19%.
Visual inspection of recordings indicated the possibility of a slight increase
in low-voltage beta activity at a frequency of 18 Hz.
Alcohol
In response to i.v. injections of alcohol, all 6 monkeys retched and one
vomited. All displayed rolling of the eyes and fleeting lateral nystagmus, and
all showed severely depressed awareness, tending to stare into space and
responding less to stimulation. Their behavior in response to the alcohol was
in some ways similar to that after exposure to marijuana smoke, but it was
also qualitatively different. Like their responses to active marijuana, the
monkeys showed reduction in level of awareness, stared blankly into space,
and were less responsive to sensory stimuli. Qualitatively, however, impair-
ment was less marked; catatonic features, for example, were less apparent.
Behavioral effects gradually subsided within 1-2 hr.
Pulse rates increased 5-20%.
Recording changes in association with the alcohol were insignificant. Visual
inspection of the EEGs suggested only that high frequencies (16-20 Hz) per-
sisted longer.
Methamphetamine
More consistent alerting and increased restlessness were the only behavioral
changes observable in the monkeys after administration of methamphetamine.
Pulse rates rose from 10 to 35%.
Their EEGs showed more consistent low-voltage fast activity than baseline
recordings (Fig. 11). Recordings of two of the monkeys showed intermittent
bursts of high-amplitude fast spindles (16-18 Hz), most pronounced in the
septal region. This change resembled those seen in the EEGs of some of the
monkeys when exposed to the marijuana smoke, but it was present a much
shorter time.
METHEDRINE
BASELINE 30 MIN POST 10 mg I.V. (0-25 mg /kg )
■ •■•....■-•■■■ - ■ .. • ..-.-. R T CX . v .-..■-■ •» . - -..., ■.■'■■*„.. ;.-J.)j-, -*.•...,.,••'....
■ •.--..' ■••,',. • ■■ •'>.*!*,■/ H ORB CX___ -•.■,,,*».-.. -.v- h •-.'.• ■ .''.,•■'•. ' .•.'.
i . ,■ . •■' ■.■,'..,- v'.,.'/,:.-' ■..,.- •'•',■ L HIP •',''•'. ■'.
,V;,,^-, I R HIP ..v.; '-'/'..V ■■'■'.■'■
.--/.--\v\- \..'>VV~\^'VVv*^,/Vv'----/>i-v~.'y--« " * SEP ...vv.\Va^_^^-s»^v-v--.---.v--.i''~-.\-'^- •■»' '■/■/*
- ._j.,'^- .,-... .-..._.,-. ■— --vv^i—.tw — ^.A-rv/v.^ R C M THAI ■ ' .—».j .-v „" /— -.• /,'.'.—•- ../-
_R MAMM B0DY_
_L P V L THAL_
R CBL FAS
R MES RET y^ .f+S'f*S~/'^.jJ »'¥.,",wv-*.- ^ — '"■*-o' ' -~ J>"
PULSE X-JJJJJJLlr --,--
Monkey 168 228 20uv.lsec
Fig. 11. Baseline EEG and EEG 30 min after intravenous injection of methamphetamine. Sites in the
septal region where intermittent minimal spindle bursts occurred are underlined.
Analyses of recordings
The typical results obtained with the EMED device when the monkeys were
exposed to marijuana smoke and to tobacco smoke are shown in Table 3. The
activity (average absolute amplitude) during a pretest epoch (baseline) is
compared with that during the 2 periods after exposure.
33-371 O - 74 - 25
366
TABLE 3.-EFFECT OF MARIJUANA AND OF TOBACCO ON EEG ACTIVITY EMED ANALYSES
Marijuana Tobacco
Bandwidth Rt. Tern. Cortex Rt. Ant. Septal Rt. Tern. Cortex Rt. Ant. Septal
DeltaB:aseline mean < 0.146 0.101 0.083 0.095
Pr^tmear^ .207 .222 .069 .066
post mean •t-y* ,1W <^icr <r\°t.
Significance level - <1% <*% <1% <l«>
ThetBaseline mean i -096 .049 -045 .049
Postmean^' """ -126 -088 .031 .030
SSeiivii;:::::::::::::: <i% <\% <i% <i%
^Baseline mean > -083 .020 .021 .026
Post mean' .113 -041 .018 .016
Significance level <1% <1% <1% <1%
i Determined from 10-min of continuous data.
There was a significant increase in activity in each bandwidth and at both
the anterior septal region and over the temporal cortex in association with
the marijuana smoke. This increased activity did not, however, seem to be
specific in location, and it was not confined to a particular frequency band.
With exposure to tobacco smoke, the EMED analysis showed a notable de-
crease in activity at all sites and at all frequencies.
DISCUSSION
The distinct changes recorded from specific subcortical structures of the
rhesus monkeys exposed to smoke of marijuana with high THC content lends
support to previous reports of studies in lower animals showing changes in
brain recordings from deep nuclear masses (Hockman et al, 1971; Boyd and
Meritt, 1966; Christensen et al, 1971; Bose et al, 1964). The scalp EEGs of
the monkeys only minimally reflected the profound activity occurring at deep
sites. This finding corresponds with data obtained from a study of marijuana
in a severely ill psychiatric patient in whom deep and surface electrodes were
implanted for diagnostic and therapeutic purposes (Heath, 1972a). On the
several occasions when the patient smoked a cigarette of marijuana with high
THC content from the same batch that was given to the 6 monkeys described
here, there was a notable absence of surface EEG changes, by visual inspection
in contrast to the distinct changes recorded from septal leads. These findings
agree with previous reports of negligible scalp EEG changes in human subjects
in association with smoking of marijuana (Gibbs, 1970; Wikler and Lloyd,
1945; Rodin, Domino and Porzak, 1970; Deliyannakis, Panagopoulos and
Huott, 1970).
The extent of involvement of subcortical sites in the monkeys was greater
than in the human subject we studied. Other reports indicate that animals
lower on the phylogenetic scale than the subhuman primates display even more
widespread brain involvement. More diffuse effects on brains of cats and rats
with administration of THC were, for example, reported by Hockman et al
(1971) and by Christensen et al (1971), suggesting that marijuana asserts
a more localized effect as one moves up phylogenetically.
None of the control substances used in this study induced the notable EEGs
from subcortical neural sites that have been identified with emotional ex-
pression (Heath, 1972b). Since smoke of tobacco and inert marijuana failed
to induce marked, focal subcortical recording changes, it is assumed that the
EEG alterations seen with active marijuana were a consequence of inhalation
of active materials — probably THC — rather than the smoke per se. Administra-
tion of alcohol and amphetamine, used as control materials because they induce
some behavioral changes similar to those seen in association with marijuana,
resulted in less dramatic recording changes. Alcohol induced only generalized
effects. Amphetamine induced some minimal spindling in septal recordings
along with generalized low-amplitude fast activity. These findings suggest that
active constituents of marijuana exert a unique effect on activity of brain
367
cells identified with pleasure feelings (Heath, 1964; Heath and Gallant, 1964;
Heath et al, 1968; Heath, 1972c).
The septal region (Heath, 1954a), from which the distinct recording changes
consistently occurred in the monkeys after inhalation of smoke of active mari-
juana, is rostral to the anterior commissure at the base of the anterior horn
of the lateral ventricles. As we defined the region, its rostral caudal extent
is 6-9 mm rostral to the anterior commissure and its lateral extent is 3 mm
from the midline. Dorsoventrally, it extends from the base of the ventricle
to the orbital cortex. Principal structures included within this region are the
nucleus accumbens septi and the nucleus of the diagonal band of Brocha. Elec-
trodes in the brains of these monkeys from which we recorded the most signi-
ficant EEG changes were at the stereotaxic AP coordinate of A-25.
Studies in our laboratories during the past 22 years have consistently identi-
fied activity of the septal region with pleasure, levels of awareness, and emo-
tional expression (Heath, 1964; Heath and Gallant, 1964; Heath et al., 1968;
Heath, 1972c). When function of this region is impaired, level of awareness
decreases, ability to experience pleasure is reduced, and emotionality is dam-
aged. Lesions in the septal region of cats and rhesus monkeys, for example,
have induced gross impairment in emotional expression and levels of aware-
ness (Heath, 1954b; Heath, 1959). Psychotomimetic chemicals that grossly
impair behavior of monkeys, such that it resembles the psychotic state of
humans, have induced abnormal spiking and slow-wave activity in the septal
region like that recorded from the septal region of psychotic patients (Heath
and Mickle, 1960; Heath and deBalbian Verster, 1961; Heath, 1966, Heath,
1970). Further, in a recent study in our laboratories, a consistent finding in
the EEGs of isolation-raised monkeys whose behavior was severely disturbed
was sharp spiking in the anterior septal leads (Heath, 1972d).
Activation of the septal region, on the other hand, heightens awareness and
induces pleasure. Such responses have been elicited with electrical and chemical
stimulation of the brains of patients (Heath, 1964 ; Heath, et al., 1968). Activity
of the septal region has been shown to be profoundly affected during pleasur-
able behavior states (Heath, 1972c).
Other subcortical sites of these rhesus monkeys most often affected by smoke
of active marijuana have been shown, by evoked potential studies, to be
directly connected to the septal region and to be involved in the phenomenon
of emotional expression (Heath, 1972b). Involvement of the sensory relay
nuclei (cerebellar nuclei for proprioception and postero ventral lateral thalamus
for somatosensory functions) provides a physiological basis for the clinical
observation that distoritions of body image and unusual somatic sensations
often accompany the mood changes that occur with marijuana smoking.
It may be that the pleasurable feelings associated with marijuana are
related to activation of the septal region and other neural sites implicated in
emotional expression. As our studies of human subjects have indicated, how-
ever, characteristically different recordings have been obtained from these
same brain sites during episodes of psychotic behavior. It is provocative that
an increasing number of reports indicate that chronic marijuana smoking can
induce distinct personality changes and even psychotic behavior (Tinklenberg,
Melges, Hollister and Gillespie. 1970 ; Melges, Tinklenberg, Hollister and Gilles-
pie, 1970 ; Kolansky and Moore, 1971 ) . Further, pneumoencephalographic evidence
suggests that marijuana can cause organic brain change (Campbell, Evans,
Thomson and Williams, 1971). Since the data presented in this study corres-
pond with those obtained from a study in a patient prepared with deep and
surface electrodes (Heath, 1972a), chronic exposure to marijuana smoke of the
rhesus monkey preparation could conceivably shed light on some of these
current issues.
Acknowledgements. — The author is grateful to C. J. Fontana, J. P. Wust, Jr.
and H. J. Daigle for their technical assistance with the study, and to L. S.
Lustick, M.S.. who conducted the analyses of the recordings using the Electro-
physio1 ogical Monitor and Event Detector.
Supported in part by the Behavioral Science Research Foundation, Inc., New
Orleans, Louisiana, and the Institute of Mental Hygiene of the City of New
Orleans, Louisiana.
368
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Bose, B. C, Saifi, A. Q. and Bhagwat, A. W. (1964). Observations on the phar-
macological action of cannabis indica, II. Archs int. Pharmacodyn. Thtr.
147: 285-290.
Boyd, E. S. and Meritt, D. A. (1966). Effects of barbiturates and a tetrahydro-
cannabinol derivative on recovery cycles of medial lemniscus, thalamus,
and reticular formation in the cat. J. Pharmac. exp. Ther. 151 : 376-384.
Campbell, A. M. G., Evans, M., Thomson, J. L. G. and Williams, M. J. (1971).
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Christensen, C. W., Best, J. B. and Herin, R. A. (1971). Changes seen in the
electroencephalograms and heart rate in the rat after administration of
marihuana intravenously. Fedn Proc. Fedn Am. Socs. exp. Biol. 30: abs:
375 (abs. #1017).
Deliyannakis, E., Panagopoulos, C. and Huott, A. D. (1970). The influence of
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Gibbs, F. A. (1970). Editorial. Clin. Electroenceph. 1: 127.
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phrenia. (Heath, R. G. and the Tulane University Department of Psychiatry
and Neurology, Eds.), pp. 3-5. Harvard University Press, Cambridge.
Heath, R. G. (1954b). Behavioral Changes Following Destructive Lesions in the
Subcortical Structures of the Forebrain in Cats. In: Studies in Schizo-
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Heath, R. G. (1959). Physiological and biochemical studies in schizophrenia
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Heath, R. G. (1964). Pleasure Response on Human Subjects to Direct Stimu-
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Heath, R. G. (1972b). Physiologic basis of emotional expression: evoked poten-
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Heath, R. G. (1972c). Pleasure and brain activity in man: Deep and surface
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Heath, R. G. (1972d). Electroencephalograph^ studies in isolation-raised mon-
keys with behavioral impairment. Dis. nerv. Syste. 33: 157-163.
Heath, R. G. and deBalbian Verster, F. (1961). Effects of chemical stimulation
to discrete brain areas. Am. J. Psychiat. 117 : 980-900.
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Devices in Psychiatry (Kline, N. and Laska, E., Eds.), pp. 178-189. Grune
& Stratton, New York.
Heath, R. G. and Mickle. W. A. (1960). Evaluation of Seven Years Experience
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pp. 214-247. Paul B. Hoeber, New York.
Hockman, C. H, Perrin, R. G. and Kalant, H. (1971). Electroencephalograph^
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Kolanskv, H. and Moore. W. T. (1971). Effects of marihuana on adolescents
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369
Lustick, L. S. and Heath, R. G. (1971). Comparative study of intracranial
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Melges, F. T., Tinklenberg, J. R., Hollister, L. E. and Gillespie, H. K. (1970).
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Tinklenberg, J. R., Melges, F. T., Hollister, L. E. and Gillespie, H. K. (1970).
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[From Arch Gen Psychiat/Vol. 26, June 1972]
Marihuana — Effects on Deep and Surface Electroencephalograms of Man
(By Robert G. Heath, MD, DMSci, New Orleans)
Effects of marihuana on electroencephalograms and behavior were observed
in a patient in whom electrodes had been implanted into numerous predeter-
mined deep nuclear sites and over the surface of the cortex of the brain. On
four occasions while the patient was smoking a marihuana cigarette, develop-
ment of euphoria was associated with the EEG appearance of distinct high-
emplitude slow-wave activity (1 to 3 hertz) focal in the septal region. No
significant changes were observed in EEGs recorded at other deep sites, over
the cortex, or from the scalp. Nor were similar distinct changes observed in
EEGs from deep sites of the brain of the same patient when effects of ampheta-
mine, alcohol, and tobacco smoking were studied for comparison with changes
induced by marihuana.
Physiologic studies in human subjects to clarify the relation between com-
monly abused drugs and brain function have thus far relied principally on
scalp electroencephalograms. Generalized changes have been recorded in scalp
EEGs after use of some drugs, but these nonspecific changes have provided
little information about how these drugs affect the brain. Despite the attention
given to cannabis (marihuana and hashish) during the past few years, only
a few reports have been found of the effects of marihuana smoking on scalp
EEGs of human beings. More than 25 years ago, Wikler and Lloyd (1)
described minimal and inconsistent scalp EEG changes in their study of the
effects of marihuana smoking on 19 long-term narcotics addicts. More recently,
Rodin and associates, (2) in a report on ten medical students who had
smoked marihuana for at least a year, found scalp EEGs to be normal in all
subjects : nine of the students had smoked marihuana at least once per week
and some as often as five to six times per week, and one had smoked it
twice per month. During the experiments, all ten students were encouraged
to smoke as many marihuana cigarettes as they wished in order to reach a
"high." By visual inspection of the EEGs, it was impossible to distinguish the
premarihuana from the postmarihuana EEGs. although there was a sugges-
tion of somewhat more persistent alpha rhythm with slower frequency com-
ponents after smoking, and power density spectral analysis confirmed the
impression.
Deliyannakis and associates (3) reported minimal and inconsistent EEG
findings in a study of 27 soldiers who were admitted hashish addicts. In this
study, as well as in others, (4) changes in activity in scalp recordings during
tobacco smoking, used for comparative purposes, were found to be of essentially
the same magnitude. Gibbs (5) has also commented on the rather obscure,
inconsistent, and seemingly nonspecific effects of marihuana on scalp EEGs.
A few studies conducted in lower animals (dogs, rabbits, cats, rats) give
some indication that the active ingredients of marihuana affect brain record-
370
ings from deep nuclear masses more than surface recordings. (6-9) No reports
have been found, however, of the effects of marihuana or its known ingredients
on the function of deep brain structures of subhuman primates or man.
The present report concerns the effects of marihuana smoking on behavior
and EEG recordings from numerous deep brain structures of a patient in
whom electrodes were implanted into deep nuclear masses, as well as sub-
durally over the surface, for diagnostic evaluation and for treatment of a
severe psychiatric disorder. Effects of amphetamine, alcohol, and tobacco
smoking were also observed for comparison with changes induced by
marihuana.
METHOD
History of Patient No. B-19. — The patient, who was 24 years old when
these studies were conducted in 1970, had a diagnosis of severe character
disorder with chronic depression and a three-year history of drug abuse. He
was considered a chronic suicidal risk, repeatedly having remarked, "I live
with the idea of suicide daily," and he actually made several abortive suicidal
attempts. His chronic depression was characterized by inability to experience
pleasure. Ingestion of drugs had offered fleeting relief from his persistent
anxiety and depression, and had led to habituation to sedatives and stimu-
lants, as well as to chronic use of marihuana and lysergic acid diethylamide
(LSD). All of his relationships (with family members, acquaintances, physi-
cians, and supporting hospital personnel) were characterized by coercion, mani-
pulation, and demand.
The patient's parents are both 55 years of age. His father, an officer in the
United States Army, retired when the patient was 18 years old. His one sibling
is a 19-year-old sister.
The patient's educational history (marked by repetition of grades and the
need for frequent discipline by teachers and principals) was chaotic — beyond
that expected by the frequent moves of the family, which included three tours
of duty outside the United States. He dropped out of high school after 3%
years and later held a variety of jobs (stock clerk, janitor) for brief periods.
One month of military service was terminated by medical discharge because
of "homosexual tendencies." For about three years before his hospitalization
for the procedures described in this report, he had been a vagrant, experi-
menting with drugs and engaging in numerous homosexual relationships.
The patient had been a moderately heavy tobacco smoker (averaging two
packs per day) since he was 16. He was a "social drinker" of alcohol, but
tended to drink excessively when alcohol was readily available.
His experimentation with drugs began when he was 21, with ingestion of
vanilla extract. He later became habituated to amphetamines, and used a
variety of other sedative and hallucinogenic chemicals (marihuana regularly,
nutmeg frequently, and LSD sporadically, as well as inhalants such as glues,
paint-thinners, and sedatives). At the time of this study, he was out on bail,
having been legally charged with possession of marihuana. He described a
variety of behavioral signs and symptoms in association with his use of mari-
huana before the studies reported here. The marihuana principally affected his
mood and emotions, he said ; usually he experienced euphoria, which he
described as a "rush," of varying intensity. On a few occasions, however, he
became depressed when he smoked marihuana, which he described as "very
potent," and once he had auditory halhicinations. He felt that both environ-
mental setting and potency of the marihuana affected his behavioral response
to it.
Because of his poor adjustment to high school, the patient first saw a
psychiatrist when he was 17. He was hospitalized in a state psychiatric in-
stitution in August 196S : discharge diagnosis five months later was "depressive
reaction." From July through October 1969 he was on the psvchiatrie service
of a Veterans' Administration Hospital, where hospital personnel described
him as uncooperative and coercive. His condition at discharge was essentiaHv
unchanged. Diagnoses were (1) personality disorder with homosexual behavior
and drug experimentation, and (2) temporal lobe dysfunction (based on EEG
371
LF - LT Sc
RF - RT Sc
LFCx
CZ-RF Cx
RF-RT Cx
LOCx
L AMY
R AMY
L CBL DEN
L CBL FAS
LA SEP
R M SEP
TCG
TCG
LCAU
L PSEP
R P V L THAL
RC NUC
ECG
~fr~*+1
Wftftt^HW*^^
Fig 1.— Typical baseline deep and surface EEGs obtained from pa-
tient B-19 during state of relaxation. LF-LT Sc, left frontal to left
temporal scalp; RF-RT Sc. right frontal to right temporal scalp; LF
Cx, left frontal cortex; CZ-RF Cx, central zone to right frontal cor-
tex; RF-RT Cx, right frontal to right temporal cortex; LO Cx, left oc-
cipital cortex; L AMY, left amygdala; R AMY. right amygdala; L CBL
DEN. left cerebellum dentate; L CBL FAS, left cerebellum fastigius;
LA SEP, left anterior septal; RM SEP, right midseptal; TCG, EEG
channel used as marker for time-code generator; L CAU. left cau-
date nucleus; RP V L THAL or R VEN LAT THA. right posterior ven-
trolateral thalamus; RC NUC or R CEN NUC THA, right central nu-
cleus of the thalamus; RA HYP, right anterior hypothalamus; R HIP,
right hippocampus; ECG, EEG channel indicating pulse rate.
findings). The patient's hospitalization for the studies described here began
5 months before the elective brain surgery.
Preoperative Examinations. — Results of physical and neurologic examinations
were within normal limits, as were the results of urinalyses and blood chemical
analyses.
Some of his preoperative conventional scalp EEGs showed abnormal bilateral
temporal slow-wave activity maximal on the left. Chlorolose activation caused
paroxysmal delta activity to appear over the right temporal region, and this
was further exaggerated by hyperventilation.
The following psychologic tests were administered : Aphasia Screening Test,
Benton Visual Retention Test, Bender Visual Motor Gestalt, Bender Recall,
Porteus Maze Test, Trailmaking Test, "Wechsler Memory Scale, Graham Kendall
Memory for Designs, Formboard, Finger tapping. Ballistic tapping, Dyna-
mometer, Grooved Pegboard, and Wechsler Adult Intelligence Scale (WAIS).
Briefly summarized, the tests indicated the patient was in the bright normal
range of adult intelligence, with verbal skills superior to perceptual motor
skills. The testing session was long and arduous since the patient was in-
ordinately compulsive and spent a great deal of time complaining and criti-
372
cizing. Verbal and nonverbal recall under both immediate and delayed con-
ditions was excellent. The ability to concentrate and to plan ahead was
unimpaired, and he had no problem with impulse control. Overall, his perform-
ance was exceptionally rigid, perfectionistic, and time-consuming, and was
accompanied by complaining and a negativistic attitude.
Electrode Placements. — The operative procedure was carried out with use
of a general anesthetic and with visualization of the ventricular system by air
and ethyl iodophenylundecylate. By techniques previously described, (10) elec-
LF-LT Sc
RF-RT Sc
LFCx
CZ-RF Cx
RF-RT Cx
LOCx
L AMY
R AMY
L CBL DEN
L CBL FAS
LA SEP
RMSEP
TCG
TCG
LCAU
LP SEP
RPVLTHAL
RCNUC
ECG
fTTTTTyi ITTTTVT] WT>Mn |IUIK1!!(III:IIU!!MII I \V'UV'\ NTTPfl ITT"!T1 tn:nilfTTTTT
mTn^mt^YT
uTmrm^TimmiT
***»***t*«»*^^
<(vi*N*N**^^A1r*^^,Av*/M^^
Fig 2.— Typical baseline deep and surface EEGs obtained from pa-
tient B-19 during state of alertness. (See Fig 1 for explanation of ab-
breviations.)
trodes were stereotaxically implanted into a variety of deep sites and over
the cortex of the brain. Stainless steel Teflon-insulated electrodes, 0.003 inch
in diameter, each with three to six leads separated by 0.08 inch, were im-
planted into the right midseptal region, (11) right hippocampus, left and
right amygdalae, right anterior hypothalamus, right posterior ventrolateral
thalamus, and left caudate nucleus, as well as at two subcortical sites within
the left lobe of the cerebellum. (The electrodes were intended for the fastigius
and dentate nuclei and are so labeled on the recordings shown in the figures.
Final roentgenograms, however, revealed them to be in the cerebellar cortex
and subcortical white matter.) Cortical leads were placed under the dura at
sites in the left and right frontal regions, left and right parietal regions, and
right temporal region. Triple-lead silver ball (12) polyvinyl chloride-insulated
electrodes were implanted into the left anterior and left posterior septal region.
The silver ball contact points were 0.02 inch in diameter, each 0.08 inch apart.
373
Intracerebral cannulas (13) (used for studies to be described in another
report) were implanted into the septal region bilaterally (about 0.08 inch
rostral to the anterior commussure on the left and at the level of the anterior
commissure on the right) and into the hippocampus.
By three weeks after operation, EEGs from the various brain sites had
stabilized, that is, all artifacts due to anesthesia and brain trauma incurred
at operation had disappeared.
Recording Procedures. — Recordings were obtained on two electroencephalo-
graphs, one 12-channel and one 8-channel (Grass Model VI). The two machines
were synchronized by use of a time-code generator. (One channel recorded
the pulse rate. )
Samples of significant recordings were simultaneously recorded on magnetic
tape through use of a 7-channel recorder (Ampex FR 1300). The EEGs and
the magnetic tape recordings were synchronized with an EECO (Electronics
Engineering Co. of California) 858-A time-code generator/reader with one
EEG channel used as a marker for the generator. Samples of baseline data
and of activity obtained at intervals when various materials were being tested
were analyzed to determine brain activity in the canonical delta-, theta-, and
alpha-band widths. The measure of activity was the average of the absolute
amplitude. For this analysis an Electrophysiological Monitor and Event De-
tector (EMED) was used which integrates energy at predetermined frequencies.
The average activity at four sites, three subcortical (left anterior septal region,
right midseptal region, and left amygdala) and one cortical (frontal cortex),
was obtained and evaluations were made of differences before and after use
of the various materials. Split-screen audiovisual tapes were made showing
the patient's behavior and EEGs just before smoking marihuana, while
smoking it, and later.
Test Materials and Mode of Administration. — Marihuana. — Marihuana was
obtained by court order from Federal narcotics agents. For smoking by the
patient, 1.5 gm of marihuana was rolled into a cigarette paper. On each of
the four occasions when the patient smoked marihuana for this study, only
one cigarette was used ; in each instance, about 0.25 gm of marihuana remained
in the unfinished portion of the cigarette so the patient had 1.25 gm. Assay
by gas chromatography of the marihuana indicated the content of tetrahydro-
cannabinol was 2.29% or 28.62 ing.
The patient inhaled deeply with each puff, and both physiologic and psycho-
logic effects appeared before he had finished smoking the cigarette. He was
instructed to push a button when he experienced a "rush" in response to the
marihuana ; this button automatically marked the EEG.
Tobacco. — For the tobacco study, the patient smoked one cigarette of a
popular brand, inhaling deeply with each puff, while the EEG recording was
obtained.
Alcohol. — The patient drank 6 oz of 90-proof bourbon mixed with 6 oz of
water for this study.
Amphetamine. — A dose of 15 mg of methamphetamine was injected intra-
venously.
In all instances, EEG recordings were obtained before the test material was
given, during its administration, and at regular intervals thereafter as long
as behavioral or physiologic effects persisted.
RESULTS
Postoperative. Premarihuana Behavior and Recordings. — During a six-week
period after the patient had recovered from all effects of the electrode im-
plantation and before the studies described here were begun, recordings lasting
at least one hour were obtained five days each week. These extensive baseline
EEGs were obtained during a wide range of levels of awareness, from deep
sleep to alert wakefulness, and during profoundly fluctuating psychologic
states. His behavior during this period included short episodes of overt psy-
chosis, episodes of irrational rage and fear, and a varietv of mood swings.
For several consecutive days, he would report he was feeling good, and his
behavior, as evaluated by his physician and ward personnel, was normal.
33-3T1 O - 74 - 26
374
Typical deep and surface EEGs obtained during such periods of alertness and
relaxation are shown in Figs. 1 and 2.
During brief episodes of psychotic behavior after electrode implantation
but before the studies described here, his recordings showed spike and slow-
wave activity from the anterior septal lead, a consistent finding in all patients
in our depth electrode series during psychotic periods. (10,14,15) (Since 1950,
60 patients have been studied by depth electrode techniques in the Tulane
laboratories.)
L FCX
C Z - R F CX
RF - RTCX
LOCX
L AMY
R AMY
L CBL DEN 1-3
i
L CBL DEN 4-6 M>4tt*b***<'^^
L CBL FAS 1-3 flS^^*''*^^
L CBL FAS 4-6 »<^Uni*h****V^
LA SEP
LP SEP
TCG
Y^VT^i
Tiipr™^mnm'™|ii """in .^11^^™^^
lir^ftlff^lll
TCG
LCAU
RM SEP
R VEN LAT THA ^l4\S*tW«<t^*^^
R CEN NUC THA ^t^^M,'^>¥^l^^
ECG 72/min
I
RAHYP
R HIP
50pv,1 sec
Fig 3.— Baseline deep and surface EEGs obtained from patient B-
19 just before smoking a marihuana cigarette. (See Fig 1 for expla-
nation of abbreviations.)
Results of psychologic testing after electrode implantation and before the
studies reported here were unchanged from those of the preoperative testing.
Marihuana. — Behavior and Results of Psychologic Testing. — The patient never
displayed psychotic signs and symptoms on the four occasions when he smoked
marihuana. His behavioral responses were those reported most consistently
with marihuana smoking. (16-19) On each occasion, mood changes began within
three to five minutes after his first deep inhalation of smoke. Intermittent peaks
of euphoria developed, coming in waves of 30 seconds to one minute, inter-
375
LFCx
CZ-RF Cx
RF-RT Cx
LO Cx
L AMY
R AMY
L CBL DEN 1-3
L CBL DEN 4-6 f^V*V^**^-r'-'V^^^
L CBL FAS 1 -3 *W^A^A^*Av/^
L CBL FAS 4-6 >*v\AA*%vNV*'''V*,Hv^^
LA SEP 'Vrw'%avV~'r1~'V/~'-V\J
L A SEP
vwv^A^/^-wVl N/V^A/^^^^"^
TCG
TilHfl[WW
1 rfjfm
TCG
LCAU
RM SEP
t \ mr-T rnpm htt iiiiiiiiiiihiiiitiiiihihitvt^ iTiT^Tit^T»ri,,iiMiM,ii......
R VEN LAT THA -VA*\^jy^W^V%N^^
R CEN NUC THA,vW./V*\ ;' \rt,*/V^W***^
ECG 134/rnin
RA HYP w <MV
'^/'V^W
50 uvisec
Fig 4. -Deep and surface EEGs obtained from patient B-19 15
minutes after smoking a marihuana cigarette. (See Fig 1 for expla-
nation of abbreviations.)
spersed with plateaus of 30 seconds to two minutes when mood remained
elevated significantly over baseline. The waves of euphoria were similar to
those he had described as having experienced in the past with marihuana
smoking. During these "rushes," he smiled broadly, sometimes giggled audibly,
and testified, using various descriptive adjectives, to the pleasure of the ex-
perience. Objective manifestations of the drug effects were silliness, flight of
ideas, and obviously shortened attention span, with varying degrees of im-
pairment of thinking.
On one occasion when he smoked marihuana and showed clearcut behavioral
effects, he was given most of the psychologic tests that had been used before
and after electrode implantation to establish a psychologic baseline. Tests
showed that in association with marihuana, he was more cordial, pleasant,
gregarious, and generally cooperative than during baseline testing sessions.
Recall, both immediate and delayed, was superior for verbal and nonverbal
material ; maintaining his attention, however, was more difficult. Planning and
foresight for the outcome of purposeful action sequences were notably poorer
than on previous evaluation (118 versus 135) and reflected less concern over
376
the results of his behavior. There was no sign of disregard for instruction or
direction nor of poor impulse control. Rather, he tended to take the test with
more ease than on any previous occasion and spent less energy planning ahead.
Dynamometric strength of hands was mildly depressed bilaterally. Gross
motor movement was excellent, although relatively slower with the nonpreferred
(left) hand Similar results were found on finger-tapping, being bilaterally
within expected limits but slightly slowed with the left hand. He showed
adequate fine motor coordination and manual dexterity. There were no ap-
parent sensorimotor deficits, results of these measures not differing signifi-
cantly from earlier evaluations.
Intellectually, he exhibited no notable changes in perceptual motor ability,
such as construction of three-dimensional geometric designs, or perception
and synthesis of part-whole relationships. On verbal tasks, his concentration
was only average, that is, somewhat poorer than previously, and his arith-
metic calculation was deficient and lower than previously measured.
Graphic reproduction of relatively simple geometric figures was good, al-
though lacking in the obsessive-compulsive accuracy which he had demon-
strated on previous testing. Originally, he required 37 minutes to complete the
drawing of eight figures, erasing repeatedly and seeking exaggerated precision.
Whereas his premarihuana drawings were flawless and perfectly organized
on the page, they were consistently expansive and drawn with great pressure
on the pencil. During the postmarihuana testing, the entire task took only
51/2 minutes, showed fewer erasures, and was notably less precise and less
expansive. His drawings had a sketchy quality which he would previously have
refused to produce or allow as acceptable. These findings recurred on another
test requiring the reproduction of designs by drawing. All drawings were well
done and showed fewer effects of a rigid and perfectionistic approach to the
tests.
L F CX
CZ - RF CX
Vsf/^Vvv^^***^*^/^-
RF - RT CX ^VV^*'*rtWf^^^
R AMY
L CBL DEN 1-3
L CBL DEN 4-6
LCBL FAS 1-3
L CBL FAS 4-6
LP SEP
R A SEP
*rvAv»v~«««"**'V^yV«VMwW^
Fig 5.— Deep and surface EEGs obtained from patient B-19 when
testing the automatic marker he himself used to signal "rushes" in
response to smoking marihuana. This procedure controlled for such
artifacts as movement. (See Fig 1 for explanation of abbreviations.)
L F CX
C2 - RF CX
RF - RT CX
L OCX
L AMY
R AMY
L CBL DEN t-3
L CBL DEN 4-6
L CBL FAS 1-3
L CBL FAS 4-6
LA SEP
R A SEP
MARKER
• A»^(<M^'W||flt**^l%f^YA'v\r^^
Fig 6.— Deep and surface EEGs obtained from patient B-19 when
he signaled a "rush." (See Fig 1 for explanation of abbreviations.)
377
Fig 7. -Deep and surface EEGs obtained from patient B-19 when
he was given 15 mg of methamphetamine intravenously. (See Fig 1
for explanation of abbreviations.)
Baseline 2 5 Hours After Injection
J^^A**^V1^^ CZ-RF Cx -W-V^M'W^^^/^V^
^^W^,Vv^V,^V>MV»-y^*S RF-RT Cx — - *^^^^»^»^^r^VJfAvWr«^V,yW*^
v^v.^W^v-%Mt*^^Mv^»>MV-»M*«'.i L AMY v^~^>*«vw^v^~V»«^-'-
R AMY **-Vv>'
- LCBL DEN 1-3 — ■
- L CBL DEN 4-6 — ■
.w^www*^*^* - L CBL FAS 1-3 - ""■"'■•"' ""'';••• "^
w.,-^w»v^*nv^;.w-v^-^"vv/vy*v*'^»/,,^A — L CBL FAS 4-6
»Vl„Vv;v^^A'»/*V^' RM SEP —
|J^_I^L-M-4-4-+4-4^~f-T!f^ ecg ^ufLH4-f444-H~^ 4.^4
20-pv sec
He was generally more cooperative and at ease than on any other testing
occasion ; he was able to accept less than perfect performance and complained
very little about difficulties with the tasks at hand. There was no evidence of
the remarkable compulsivity which he had demonstrated consistently in the
past.
Electroencephalograms. — Typical premarihuana recordings were like those
shown in Figs. 1 and 2. With onset of his behavioral response to marihuana,
within three to five minutes after the first deep inhalation of smoke, high-
voltage slow- wave activity (frequencies were predominantly 1 to 3 Hz) ap-
peared focally in the septal leads (Figs. 3 and 4). The electrical activity was
correlated with the patient's behavioral responses, changes being more pro-
nounced when mood elevation was greatest. The septal abnormality was most
prominent and synchronous when he reported "rushes." No significant changes
in other deep or surface leads were ever seen with marihuana in this patient.
He accurately signaled the "rush" when the marihuana initially affected him ;
the marks on the recordings made by the automatic signal coincided with the
appearance of EEG changes (Figs. 5 and 6). As behavioral signs and symptoms
(flightiness, distraction) became more pronounced, however, his attention was
impaired to such a degree that he no longer signaled the "rushes." When the
patient failed to use the signal during characteristic behavior such as silly
grimaces or giggling occurring with the synchronous high bursts of delta ac-
tivity, his response to inquiries was that he just "felt too good to bother
about ic." His pulse rate, as indicated on the recordings, was strikingly
higher during the "rushes."
On each of the four occasions when he smoked marihuana for these studies,
the strong, intermittent "rushes" of intense euphoria, including the interspersed
plateaus of mood e'evation, lasted for 45 minutes to one hour. Although the
"rushes" then subsided, the patient's well-being persisted to a slowly diminish-
ing degree for about two hours. When the "rushes" subsided, the high-amplitude
1 to 3 Hz activity in the septal leads disappeared and was replaced by more
rhythmical, lower amplitude 5 to 7 Hz activity also focal in the septal leads.
Tooacco. — No behavioral changes were observed as a result of tobacco
smoke, and the patient's pulse rate did not rise.
His EEGs while smoking tobacco were like his baseline EEGs during states
of alertness (Fig. 2) except that low-voltage fast activity was more prevalent.
Alcohol. — Although the patient became more euphoric and more talkative
(obviously a little "high") after his drink, changes in recordings were insig-
378
nificant, nothing occurring that was outside the range of fluctuations in base-
line EEGs. During the hour after consumption of alcohol, recordings resembled
his baseline EEGs during relaxation (Fig. 1) ; slower, slightly high-amplitude
activity occurred for longer periods. The patient's pulse rate did not change.
EFFECT OF MARIHUANA ON EEG ACTIVITY (PATIENT B-19)
Post-marihuana
Bandwidth Region Baseline mean1 mean Significance
Delta Left anterior septal 0.15 0.20 < 1%
Right midseptal - -09 .12 < 1%
Left frontal cortex -07 .08
Leftamygdala -- -11 "So-""
Theta Left anterior septal - -08 .08
Right midseptal -07 .07
Left frontal cortex - -06 .06
Leftamygdala - -07 .06
Alpha Left anterior septal -04 .04
Right midseptal - -10 -06 < 1%
Left frontal cortex -04 .04
Leftamygdala - - -04 .04
» Determined from ten minutes of continuous data.
Amphetamine. — The patient responded characteristically to the metham-
phetamine; he said he felt "quite good." He appeared euphoric and became
garrulous, and his mental activity was accelerated. Although there was an
increase in pulse rate, it was significantly less than the rise that occurred
with marihuana smoking.
Changes in EEG recordings were minimal; there was more consistent low-
voltage fast activity with some reduction of higher voltage slow frequencies
(Fig. 7). No focal changes were noted.
EMED Analyses. — Results obtained with the EMED device when the patient
was under the influence of marihuana are summarized in the Table. The
activity (average absolute amplitude) during a predrug epoch (baseline) is
compared with that during a postdrug period. Of the sites analyzed, only the
left anterior septal region and right midseptal region showed significant
changes. A significant increase in delta activity was observed at both sites,
and a significant decrease in alpha activity was noted in the right midseptal
region.
COMMENT
Patient No. B-19, in whom electrodes were implanted into many subcortical
sites for long-term diagnostic studies and treatment, provided an unusual
opportunity to study the effects of marihuana smoking on brain function.
Scalp recordings obtained from this patient showed minimal or no changes,
a finding consistent with other published reports. (1-8, 5) On the other hand,
consistent changes occurred in deep recordings from the septal region (11)
concomitant with the well-known and often described behavioral effects of
smoking marihuana. These recordings differed significantly from those ob-
tained with tobacco smoking or with use of alcohol or amphetamine ; the
changes were distinct, whereas the changes in deep recordings with the other
materials were minimal or absent. Of the changes in scalp recordings in
association with tobacco smoking reported in the literature, the most consistent
is a shift towards a higher alpha frequency in some subjects (20-22) ; changes
are more profound under special circumstances — for example, when a heavy
smoker smokes a cigarette after being deprived of tobacco for a significant
period of time. (23) Some of the behavioral effects induced in patient No.
B-19 by smoking marihuana were like those induced by alcohol or ampheta-
mine while others have not been observed in association with alcohol or
amphetamine.
When this study was conducted in early 1970, we were unaware of a
method for determining the exact dosage of marihuana which the patient
was absorbing: as he smoked a marihuana cigarette. Nor could we be certain
that the quantity of tetrahydrocannabinol represented all the active material
in the marihuana. We were, therefore, unable to give exact dosages. The pro-
379
cedure by Renault and associates, (24) using heart rate to demonstrate dose
response, was published after the studies presented here were completed and
after electrodes had been removed from the brain of patient No. B-19. The
maximum dose used by Renault and associates was 435 mg of marihuana
containing 1.5% tetrahydrocannabinol. The maximum heart rate response of
their patient on the highest dose of marihuana was 75%. The consistent in-
crease of 70% to 90% in the heart rate of patient No. B-19, while smoking
marihuana on the four tests, suggested that the quantity of active ingredients
he absorbed from our potent preparation (as determined by assay) was
significant.
Until the present study, investigations of marihuana effects in man focused
largely on behavioral responses, both subjective and objective, and on changes
in peripheral physiologic measurements. Brain physiology studies were limited
to scalp EEGs, which were obtained by a technique too insensitive to show
significant changes in brain activity. Because studies of marihuana in lower
animals (6-9) lacked essential behavioral data, which are dependent on sub-
jective reporting of changes in feelings and thoughts, interpretation of brain
physiologic changes was highly speculative. Establishment of a clear and
consistent correlation between subjective reports of behavioral changes and
alterations in brain function of this patient provides a link for conducting
more extensive and meaningful studies of the effects of marihuana and other
euphoria-producing drugs in animals.
Some subcortical studies of animals have previously been reported to be
affected by administration of delta^tetrahydrocannabinol (THC). Christensen
and associates (8) reported considerable delta activity and fast high-amplitude
spindles from the amygdala, ventromedial hypothalamus, hippocampus, and a
number of cortical regions after THC was given to rats. In our own studies
of rhesus monkeys, those which were exposed to marihuana smoke containing
significant levels of THC consistently showed a notable change in recordings
from the septal leads. (25) On occasion this region alone was affected, but
usually other sites showed changes as well. When only the septal region was
affected, a delta wave at a frequency of 2 to 4 Hz characteristically appeared,
resembling the EEGs obtained from patient No. B-19 when he smoked
marihuana.
On other occasions, EEGs of the monkeys showed additional changes.
Sometimes the slow wave in recordings from the septal region was accom-
panied by a similar wave (frequency of 2 to 4 Hz) recorded from the mesen-
cephalic reticulum and the posterior ventrolateral thalamus, while no signi-
ficant changes appeared in recordings from other deep structures or from the
surface. Another frequently occurring recording change was the appearance of
bursts of high-amplitude spindles (approximating 16 Hz), most pronounced
in the septal leads and occasionally present in other deep leads and over the
temporal cortex. The presence of spindles at other sites was sometimes syn-
chronous with their appearance in the septal region and sometimes independent
of it. Other often involved sites were the posterior ventrolateral thalamus,
both deep cerebellar nuclei, orbital cortex, and hippocampus. When marihuana
without active ingredients was used in the monkey for comparison, EEG
changes did not occur.
Our findings in the patient, as well as in rhesus monkeys, suggest that
marihuana asserts a more localized effect as the species moves up phylo-
genetically.
All these studies suggest that those sites identified as integral components
within pathways for expression of emotion and feeling are the most profoundly
affected. (26) The present study indicates that the nuclear sites principally
affected are the ones that have been correlated with the pleasure response.
The affected septal region, the site we defined in 1952, (11) is in the vicinity
of the nucleus accumbens at the base of the anterior horn of the lateral
ventricle rostral to the anterior commissure (15 mm in man and 7 to 8 mm
in the rhesus monkey).
Beginning with our first report, in 1952. (27) of 26 patients prepared with
deep and surface electrodes, we have demonstrated a relationship between
phvsioiogic activity of the septal region and the behavioral phenomena of
pleasure feelings and levels of awareness in man. These studies have involved
a variety of procedures in which pleasure responses have been elicited with
380
electrical and chemical stimulations to the septal region. (15,28-30) Specific
EBG changes, most consistently high-amplitude spindling in the septal region,
have correlated with subjective reports of pleasure — the most profound EEG
changes (and concomitant pleasure response) having been recorded during
orgasm. (31) In contrast, impaired activity of the septal region, in the form
of epileptiform activity, has been correlated with dysphoria, aberrant emotional
expression, and reduced awareness, (14,15,27,32,33) and destructive lesions
of the septal regions of animals have reduced awareness and impaired emo-
tional expression. (34)
Electrical stimulation of the septal region of patients has relieved intractable
physical pain (27) and administration of some narcotics has resulted in acti-
vation of recordings from the septal region. (28) Marihuana has also been
reported to alleviate physical pain. Evoked potential studies have demonstrated
a direct functional relationship between the septal region, where activity is
correlated with pleasure, and the relay nuclei for several sensory modalities.
(26, 35) These connections could offer a physiologic basis for the analgesic
effects of the drugs as well as of electrical stimulation of the septal region.
This relationship between pleasure sites and sensory nuclei likewise provides
a physiologic explanation for the consistent clinical observations that severe
disruptive behavior is associated with perceptual disturbances and that im-
paired perception, in turn, can induce disruptive behavior.
The altered activity recorded from the septal region and occasionally from
interconnected sites in association with marihuana is provocative, suggesting
that cells of the septal region are affected. As indicated earlier, stimulation
of these cells in a variety of ways has induced intense pleasure along with
heightened levels of awareness. This effect, by itself, is potentially therapeutic.
When activity of the septal region is impaired, however, deleterious behavioral
signs and symptoms occur, in the form of reduced motivation and anhedonia
(deficient pleasure), often accompanied by perceptive defects and thought dis-
turbances characteristic of reduced awareness. (10,21-31) Although the phys-
iologic effects induced in the septal region with smoking of marihuana were
consistent on four occasions in this particular patient, we found, in association
with a mixture of behavioral effects, considerable variation in EEGs of rhesus
monkeys which had been repeatedly exposed to marihuana smoke. (25) When
these EEGs showed spiking, in contrast to spindling or delta activity of the
type recorded from patient No. B-19, the monkeys were catatonic.
An unsettled issue is whether or not smoking marihuana can induce psychotic
behavior. Some investigators have reported that it can induce transient or
even chronic symptoms of psychosis. (36,37) whereas others have denied this
claim. In the present study and related studies in rhesus monkeys. (25)
smoking of marihuana altered activity in the septal region (and occasionally
interconnected deep sites) from which a distinct type of pathologic activity, in
the form of spikes and slow-waves, has been consistently recorded in a large
number of patients during periods of psychotic behavior. (14, 15, 27, 30, 32. 33)
Long-term studies now under wav in our laboratories with monkeys will, it
is hoped, shed additional light on this issue.
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(3) Delivannakis E. Panagopoulos 0. Huott AD: The influence of hashish
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(7) Boyd ES, Meritt DA: Effects of barbiturates and a tetrahydrocannabinol
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Studies in Schizophrenia. Cambridge, Mass, Harvard University Press, 1954,
pp 3-5.
(12) Lustick LS, Heath RG : Comparative study of intracranial electrodes
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(13) Heath RG, Founds WL Jr : A perfusion cannula for intracerebral micro-
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Int J Xeuropsychiat 2 :597-610, 1966.
(16) Hollister LE : Marihuana in man: Three years later. Science 172:21-
29, 1970.
(17) Weil AT, Zinberg NE, Nelsen JM : Clinical and psychological effects of
marihuana in man. Science 162 :1234-1242, 1968.
(18) Manno JE, Kiplinger GF, Haine SE, et al : Comparative effects of
smoking marihuana or placebo on human motor and mental performance. Clin
Pharmacol Ther 11:808-815, 1970.
(19) Keeler MH, Reifler CB, Liptzin MB: Spontaneous recurrence of mari-
huana effect. Amer J Psychiat 125 :384-386, 1968.
(20) Brown BB : Some characteristic EEG differences between heavy smoker
and nonsmoker subjects. Neuropsychologic 6 :381-388, 1968.
(21) Murphree HB, Pfeiffer CC, Price LM : Electroencephalographic changes
in man following smoking. Ann NY Acad Sci 142 :245-260, 1967.
(22) Hauser H, Schwarz BE, Roth G, et al : Electroencephalographic changes
related to smoking, abstracted. Electroenceph Clin Neurophysiol 10:576, 1958.
(23) Ulett JA, Itil TM : Quantitative electroencephalogram in smoking and
smoking deprivation. Science 164 :969-970, 1969.
(24) Renault PF, Shuster CR, Heinrich R. et al : Marihuana: Standardized
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174:589-591, 1971.
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grams of rhesus monkeys. Neuropharmacology, to be published.
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(29) Heath RG. deBalbian VF : Effects of chemical stimulation to discrete
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(82) UCLA Conference: Clinical neurophysiology: Newer diagnostic and
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(35) Heath RG : Electroencephalograph^ studies in isolation-raised monkeys
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Commentary on Dosages Used in Studies of Marihuana in Rhesus Monkeys
[Submitted by Professor Robert G. Heath, M.D.]
Some questions have been raised — particularly in regard to quantity of delta-9
THC consumed — concerning the relationship between Tulane studies of mari-
huana smoking in monkeys and the smoking of marihuana or hashish by human
subjects. To answer these questions, we compared intake of delta-9 THC by the
monkeys in the Tulane experiment with that of man, basing dosage in man and
methods for comparing monkeys with man on information existing in the scientific
literature.
According to Freireich and associates,1 comparisons of dose levels among differ-
ent species should be based upon body surface area per kilogram of body weight.
Using this formula, the dose of delta-9 THC for the monkey would be three times
that for man per unit of weight. Stadnickl and associates,2 following Freireich's
formula, based the amount of delta-9 THC given to rats at seven times the
human dose to achieve amounts equivalent to those received by human hashish
smokers.
Attached is a chart of dose comparisons, based on Freireich's comparison factor
for delta-9 THC. between h^bi^h or marihuana smoking in man and marihuana
smoking in monkeys used in the Tulane experiment. Human subjects are divided
into two groups, heavy hashish smokers 3 and moderate marihuana smokers, and
the monkeys into two groups, heavy and moderate marihuana smokers.
Investigators in this field would generally agree with two assumptions on which
we have established dose comparisons between monkey and man :
(1) With smoking, there is a 50% loss of delta-9 THC by pyrolysis, and
(2) An additional 20% loss occurs through lung absorption.
In our calculations (attached), we considered man's average body weight to
be 75 kilograms. Average body weight of the Tulane rhesus monkeys exposed to
heavy smoking was 4 kilograms ; of those exposed to moderate smoking, average
body weight was 5 kilograms.
The marihuana used in the Tulane study contained 3% delta-9 THC. The
marihuana smoked by human subjects is estimated to contain 1%, 1.5% and 2%
delta-9 THC because this is the range of potency for marihuana generally
available. (Please see Chart.)
Summarizing, the dosage for our heavily smoked monkeys was significantly
less than the quantity of delta-9 THC ingested by heavy hashish smokers. Fur-
ther, the quantity of delta-9 THC ingested by the monkeys per month was
slightly greater than that consumed by man smoking one 2% marihuana cigarette
per day. Since the monkeys which were moderately smoked were exposed only
1 Freireich, E. J., Gehan, E. A., Rail, D. P., Schmidt, L. H., and Skipper, H. E. Cancer
Chemotherapy Reports. 50 :219-244, 1966.
2 Stadnickl, S. W., Schaeppl, U., Rosenkranz, H., and Braude, M. C. Life Sciences.
Ik :463-472, 1974.
3Tennant, F. S., and Groesbeck, C. J. Arch. Oen. Psychiat. 27 :133-136, 1972.
383
twice a week, the dosage of active ingredient per smoking was considerably
higher than for man's smoking.
Robert G. Heath, M.D.
Chart attached.
Comparison Between Man and Monkey
heavy smoking
Man — Hashish
50 to 600 gm/month (3) : an average of 300 gm/month was chosen.
5% delta- 9 THC=80 mg delta- 9 THC/kg/month.
Mon key — Marih nana
53.7 mg delta- 9 THC/kg/month.
MODERATE SM0KING-0NE 1.5 G CIGARETTE PER DAY FOR 30 DAYS EQUALS 45 GRAMS PER MONTH
[In milligrams]
Quantity delta- Intake delta-
9 THC 9 THC per-
(milligrams) month
Percent delta-9 THC per cigarette (milligrams)
Man— Marihuana:
20 ---
'0.16
4.8
15
i.l2
3.6
10
1.08
2.4
J. 64
5.5
1 Per cigarette.
» Per smoking.
[From the Lancet, Dec. 4, 1971]
Cerebral Atrophy in Young Cannabis Smokers
(A. M. G. Campbell, Department of Neurology, Bristol Royal United Hospitals)
CM. Evans, Department of Psychiatry, Whitchurch Hospital. Cardiff)
(J. L. G. Thomson, Department of Radiology, Frenchay Hospital, Bristol)
(M. J. Williams, Department of Medicine, Bristol Royal Infirmary)
SUMMARY
Evidence of cerebral atrophy was demonstrated by air encephalography in
10 patients with histories of consistent cannabis smoking over a period of
3-11 years. The average age of the patients was 22 years ; all were males.
Amphetamines and lysergide (l.s.d.) had also been taken, but in much smaller
amounts. Measurements of the lateral and third ventricles were significantly
different from those in thirteen controls of a similar age-group.
INTRODUCTION
Personality changes and mental illness have been reported in chronic cannabis
smokers of previously normal personality. (1) Addicts often have impairment
of recent memory, (2) vegetative symptoms, and a tendency to reversed sleep
rhythm suggesting organic brain damage. If organic brain damage were con-
firmed, this would clearly lead to a different approach to the problem of increas-
ing drug abuse.
This study was prompted by the finding of cerebral atrophy on air encephal-
ography in four young patients referred to one of us (A. M. G. C.) for
neurological investigation of headache, memory loss, or behavior change. A
common factor in all four histories was prolonged heavy cannabis smoking.
Amphetamines and lysergide (l.s.d.) had also been taken, but in very much
smaller amounts. Since no recognized cause of the cerebral atrophy was appar-
ent, neurological and radiological investigation of other cannabis smokers
seemed indicated.
384
PATIENTS AND METHODS
Patients
The first four cases were unselected routine admissions for investigation of
neurological symptoms. The next five were under treatment by one of us (M. E.)
for drug abuse, and were referred for detailed investigations of cerebral func-
tion including air encephalography. They were selected because of known long-
standing cannabis smoking; two had been attending a drug-addiction center
for some time and the other three were the next cases which presented to psychi-
atric outpatients with histories of longstanding cannabis smoking. The tenth
patient was admitted as an emergency with a drug overdose and had a G-year
history of drug abuse with heavy cannabis intake. All these cases were given a
full clinical examination and were investigated by air encephalography.
It was fully explained to the patients that the test was to assess possible
brain damage with a view to ultimate prognosis, and our patients willingly
consented to this investigation, which was done under local anesthesia and
sedation.
Controls
One of the main difficulties in estimating the size of the cerebral ventricles by
air encephalography is the choice of controls. Most published series include
patients of all ages; however, the ventricles enlarge with age. (S) The mean
age of our patients was 22 years. To obtain normal values for the age range
15-25 years we reviewed the X-ray films and notes of all cases investigated by
air encephalography in our neuroradiological unit in which the findings had been
reported at the time as normal. We excluded all those with abnormal neuro-
logical signs, a raised cerebrospinalfluid (c.s.f.) protein, or other abnormal
features. In this way we obtained thirteen controls ; their case-notes indicated
that these had originally been referred because of symptoms such as headache,
loss of consciousness, or syncope. Subsequent follow-up on all of these patients
had not revealed the development of any neurological illness. A typical control
air encephalogram is shown in fig. 1. Particular attention should be paid to the
shape of the lateral ventricles anteriorly, especially the sharpness of the lateral
and inferior angles and the upward and inward curve of the floor of the body
and the posterior part of the frontal horns.
Of the thirteen controls, seven were female and six male. The series of ten
drug-taking patients were all male. However, air encephalograms on the female
controls were not significantly different from those of the male controls.
Radiology
The standard air-encephalography technique was used in all cases. About 25
ml. of air was injected into the lumbar subarachnoid space with the patient in
the sitting position, under basal sedation. Just enough cerebrospinal fluid for
routine laboratory testing was removed. Films of the patient's head were taken
in this position, and again with the patient supine and prone. Routine views of
the temporal horns were also taken. Measurements of the anterior ends of the
lateral ventricles were taken from films obtained in the anteroposterior position
with the patient supine. Measurements of the lateral ventricular size were
carried out using three standard diameters, and an accurate area measurement
was also obtained by using a planimeter, an instrument that mechanically inte-
grates a trace of the perimeter of an object into the area of the object. (3)
These measurements are illustrated in fig. 2 :
"A" is the widest transverse diameter of the frontal horn.
"B" is the oblique diameter from the lateral angle to the junction of the floor
of the body of the lateral ventricle with the medial wall.
"C", a line at right angles to B, 5 mm. from its lateral extremity, gives a
measure of the lateral angle of the ventricle.
"D" is the transverse diameter of the third ventricle, the posterior width being
taken from the film with the patient sitting up, and the anterior width from
the film with the patient supine.
"E" is the area of the shadow of the posterior part of the frontal horn of the
lateral ventricle (indicated in fig. 2 by the shaded area, and shown in fig. 3 for
all cases).
385
Fig. 2 — Measurements used in assessing ventricular tize (»ee
text).
Areas in sq.cm. shown in table.
Other Investigations
c.s.f. obtained at air encephalography was examined under the microscope
and analyzed for protein. Wassermann reaction, and Lange curve. The c.s.f.
pressure was normal in all cases. Skull and chest X-rays were taken in all
cases. Venous blood was tested for hemoglobin, leucocyte-count, erythrocyte-
sedimentation rate, urea, electrolytes, and liver function. Results were normal
except as stated in cases 1 and 9.
CASE-BEPOBTS
Case 1
An unemployed steel erector, aged 22, complained of generalized headache over
recent months. He had had a probable epileptic fit at age 13 but had not been
investigated or treated. It was not known whether he had suffered any birth
injury, and there was no family history of epilepsy. At age 18 he was in hospital
for 3* days because of a head injury. Three weeks later he had a grand-mal epi-
leptic attack, with four similar attacks in the next year. The head injury would
seem to have exacerbated preexisting epilepsy.
He had smoked cannabis regularly and frequently since the age of 16. l.s.d.
had been taken about twenty times, but he did not admit to taking amphetamine.
On examination he seemed restless, anxious, suspicious, irritable, and de-
spondent. There were no abnormal neurological signs.
Electroencephalography was outside normal limits, displaying minimal epi-
leptic features in all areas. There were no focal abnormalities.
CONTROLS
w W ¥ v w w W W W W W ir w
W V W W W \x7 w w w
10
Fl*. 3 — Outline! of the areas 01)
CASES
isured by ptanographJc method (sec tabic).
386
At air encephalography diameters A and B were within the normal range, but
diameters C were increased and the back ends of the lateral ventricles were
somewhat "square" (fig. 4). The third ventricle diameter D was towards the
upper limit of normal. The area measurement E was increased on both sides.
Case 2
An 18-year-old unemployed salesman was admitted for investigation of change
in behavior and impairment of recent memory. He said he was becoming increas-
ingly aggressive and could not understand his own behavior. There had been
frequent generalized headache over the previous month. He was an adopted
son and his own family history was unknown. At the age of 1 year he had
whooping-cough and at 13 he had hepatitis, but neither produced neurological
complications.
Drug abuse started when he was 14, amphetamines being passed to him by
a fellow choirboy. Within a year he was smoking cannabis regularly and fairly
heavily three times a week, and continued to do so. He had taken l.s.d. about
twenty times and heroin four times, but discontinued the amphetamines after
the first year. He abandoned A-level studies at a technical college and thereafter
could only work as a salesman for a short time.
On examination he was excited, exhibited pressure of speech, poor memory,
and lack of insight. There were no abnormal physical signs.
At air encephalography diameters A and C (especially C) were increased
on both sides. The width of the third ventricle posteriorly was outside normal
limits, and the trigone of the left lateral ventricle was rather "square". The
area measurement E was also increased on both sides, left more than right
(fig. 5).
e.e.g. was normal.
Case 8
A 21-year-old computer operator was admitted for investigation of frequent
frontal headaches of a year's duration. He also complained of poor concentration.
There was no history of birth injury or other significant illness. At age 8 he
had had a minor head injury and was unconscious for half-an-hour but did not
require hospital admission.
He had smoked cannabis regularly since the age of 15, had taken l.s.d. twice
and amphetamines about ten times. Since leaving grammar school he had
frequently changed his work, but after his marriage a few months before
admission he had stopped taking drugs, and had stayed in the same job.
On examination has was anxious, morose, and withdrawn. He was unable to
give a clear account of his symptoms, about which he seemed very concerned.
There were no abnormal physical signs.
At air encephalography the diameters A, B, and C of the left lateral ventricle
were well outside normal limits (fig. 6). The width of the third ventricle was
outside normal limits also, both anteriorly and posteriorly. The trigonal region
was "square" on the left side, the left temporal horn dilated, and the surface
sulci rather prominent. The area measurement E was increased on the left side.
Case 4
An unemployed laborer aged 24, son of an academic, complained of depres-
sion and left frontotemporal headache over the previous 10 months. He also had
attacks of photophobia, not necessarily associated with the headache. During
the previous year he had twice briefly lost his sense of awareness. He had not
fallen, convulsed, or lost consciousness, and witnesses described him as looking
vacant for a few moments. There was no significant past illness, but it was not
known whether he had suffered any birth injury nor if there was a family
history of epilepsy. Three years previously he had been involved in a motor
accident when he had a blow on the head, losing some teeth but without loss of
consciousness. Since leaving grammar school, aged 17, he had held many jobs for
short periods.
He gave a 4-year history of drug taking, but denied taking amphetamines. He
smoked cannabis regularly four times a week, l.s.d. had been taken on about
thirty occasions, and mescaline and "mandrax" (diphenylhydramine and metha-
qualone) occasionally.
On examination he was unkempt, withdrawn, and uncommunicative. He was
emotionally flattened, and at times his thoughts were disjointed. There were no
abnormal physical signs.
387
At air encephalography the diameters A, B, and C of the left lateral ventride
were all slightly increased (fig. 7). The width of the third ventricle was within
normal limits. The left trigonal region was rather "square". The area measure-
ment E was increased on the left side.
e.e.g. was normal.
Case 5
A 20-year-old clerk complained of loss of concentration and memory loss for
recent events over the previous 10 months. He had become irritable and de-
pressed and volunteered to being increasingly inefficient and careless at work.
His birth had been normal, and there was no history of significant illness or
trauma. .
He had started taking amphetamines at school when 14 years old, and within
a year was smoking cannabis. This had become the main drug of dependence,
although he had taken others, including two doses of l.s.d. Cannabis had been
smoked once or twice daily over the past 18 months.
On examination he was mentally retarded, thinking with obvious difficulty,
and with poor memory for recent events. There were no other abnormal neuro-
logical signs.
At air encephalography the diameters A and B were within normal range,
but the diameters C were slightly increased. The width of the third ventricle
was at the upper limit of normal. The area measurement E was within normal
limits.
Case 6
A 22-year-old unemployed man complained of difficulty in recalling recent
events, and also of periods of amnesia with occasional headaches. He described
permanent alteration of vision after some years of drug abuse, with alteration
of bright lights into colors : "On a sunny day I have a lot of extra color without
drugs— that's very nice". There was no history of birth injury, trauma to the
head, or significant past illness.
He had a 7-year history of drug abuse, starting with cannabis and ampheta-
mine at age 15. Cannabis remained the chief drug, although he had also taken
a large amount of l.s.d. and occasional barbiturates. He left school aged 15 and
then had 4 months at sea with the Merchant Navy. Since then he had been
unable to hold any job for long, and has not worked for the past 4 years. Over
the previous 18 months his mental state had rapidly deteriorated, with inter-
mittent confusional states and paranoid psychosis. There seemed to be a striking
difference between the bright lively youngster of 14 who was interested in
fishing and shooting and was able to strip down and maintain a motorcycle,
and the retarded, slothful, emotionally labile, and intolerant man of 22.
He had no abnormal neurological signs.
At air encephalography the diameters A and B were within the normal range
but the C diameters were increased (fig. 8). The width of the third ventricle
was towards the upper limit of normal, and the right temporal horn was larger
than the left. The area measurement E was increased on both sides.
Case 7
A 26-year-old unemployed clerk complained of poor memory and frontal
headache. He described several brief episodes over recent months during which
he noticed a sensation of heat in the head, pounding in the temples, and loss
of vision followed by visual hallucinations. There was no history of birth injury
or any subsequent trauma to the head. He had had eczema at age 2 and had
been treated with sedatives off and on for several years.
He first smoked cannabis at age 15, but stopped while in the Army for 4
years. He described regular and heavy dependence on cannabis over the past 2
years. A large amount of l.s.d. had been taken but not much barbiturate or
amphetamine.
Abnormal traits were characterized by superficial personal relationships,
failure to develop any continuing interest, and inability to learn from experience
or to apprehend any long-term consequence of his behavior. There were no
abnormal neurological signs.
At air encephalography the diameters A and B were within the range of
normal, but the C diameters were slightly increased. The width of the third
ventricle was towards the upper limit of normal. The surface sulci frontally
were rather prominent. The area measurement E was towards the upper limit
of normal.
388
e.e.g. showed paroxysmal slow activity in all areas with no focal abnormali-
ties, and the background pattern was normal.
Case 8
A 28-year-old man had been severely psyehiatrieally disabled with a schizo-
phrenic illness marked by episodes of excitement and confusion for over 5 years.
There was no history of birth injury or other significant past illness.
At age 16 he started taking amphetamines, having left his work as a clerk and
joined a group of potato pickers. At this time he also started drinking alcohol
heavily. When 17 he smoked cannabis for the first time, and had continued
taking it as the preferred drug since then. With money received as compensation
for a facial injury he financed a visit with friends to a Spanish island, where
he drank a lot of wine, smoked cannabis heavily, and took five doses of l.s.d.
despite the fact that it produced devastating reactions. He remained there for
6 months and was probably in a very confused and hallucinated state most of
that time. Six months later he was admitted to Whitchurch Hospital with a
schizophreniform reaction, and he has been under continual treatment since
then.
At recent examination there were no abnormal neurological signs, but over
the previous 6 years there have been frequent episodes of apparently spon-
taneous wide dilatation of the pupils.
At air encephalography the diameters A and B were within the normal range
but the C diameters were increased. The width of the third ventricle was outside
normal limits, particularly posteriorly. The left temporal horn was dilated
and the surface sulci over the left hemisphere were prominent. The area
measurement E was increased on both sides.
e.e.g. was normal.
Case 9
This 21-year-old man complained of poor concentration and memory over the
past year. He had no significant past illness, head inqury, or birth trauma.
He started taking amphetamines when 14 years old and was soon smoking
cannabis and taking barbiturates. From the age of 17 he had occasional l.s.d.
and intravenous morphine, but cannabis and barbiturates had remained the
main drugs. The recent clinical picture was that of an excited overactive state
with periods of confusion. He seemed to have a blurred and telescoped view of
his drug-taking history.
On neurological examination he was found to have some clumsiness of fine
movement of the left hand.
Serum-aspartate-aminotransferase was raised to 37 i.u. There was no history
of jaundice or excessive alcohol intake, and no evidence of hepatomegaly.
At air encephalography the diameters A, B, and C were well within normal
limits. The width of the third ventricle was also within normal rantre. The left
temporal horn, however, was much dilated. The area measurement E was well
within normal limits.
Case 10
This 26-year-old man was admitted as an emergency with an overdose of l.s.d.
He had been unemployed for several years after only a year at university, where
he had become less able to continue his work after starting taking drugs. There
was no history of birth injury, significant past illness, or trauma.
He gave a 7-year history of drug addiction, starting with amphetamines and
cannabis at age 19. By the time of admission he was taking large amounts of
these drugs as well as occasional l.s.d. He admitted to being in a perpetual
state of confusion and carelessness and complained of poor memory.
On examination after recovery from the acute episode of l.s.d. intoxication,
it was noted that he had persistent clumsiness of fine movement of the left
hand, but no other neurological signs :
At air encephalography the diameters A and B were within the normal range
but the diameters C were increased. The width of the third ventricle was towards
the upper limit of normal. The right temporal horn was a little dilated. The
area measurement E on the right side was towards the upper limit of normal.
An e.e.g. showed abnormal slow activity in the temporal lobes on both sides.
389
RESULTS
Descriptions of individual air encephalograms have been given with the case
histories. Comparison of the diameters of the lateral and third ventricles showed
that, between the control and the drug-abuse groups, the diameters A and B
were not statistically different. But the diameters C and D and the area
measurement E showed more striking changes, and these were statistically
significant. The table shows the measurements and distribution of C, D, and E
for the controls and the drug-abuse group. We could not measure D in one
control where the posterior diameter of the third ventricle was not well enough
shown. The area E measured by planimetry are shown in fig. 3.
MEASUREMENTS C AND D AND AREA MEASUREMENT E FOR THE CONTROL AND DRUG-ABUSE GROUPS
C(mm.)
D(mm.)
E(cm.i)
Right
Left
Anterior
Posterior
Right
Lef
Controls:
A
3
4
3
3
1.8
2.4
B
4
4
3
4
2.6
3.7
C
3
3
4
5
1.6
1.2
D
4
4
4
4
1.8
1.8
E
5
5
4
?
1.4
1.6
F
7
8
4
6
3.4
3.0
G
6
6
5
6
3.2
3.1
H
7
7
5
7
3.0
3.1
1
5
5
5
7
4
6
4
2.4
3.3
2.8
J
5
3.1
K
4
4
3
3
2.9
2.6
L
4
5
4
5
2.9
?.2
M
5
5
3
3
1.6
1.8
Cases:
1
7
8
5
6
4.6
5.8
2
9
9
5
8
4.0
4.4
3
4
9
8
8
2.6
4.9
4
5
10
4
S
2.9
4.1
5
6
6
7
6
3.2
3.0
6
9
9
6
b
4.0
4.3
7
6
6
7
7
3.2
3.4
8
8
8
5
8
4
10
5
4.3
2.1
4.6
9
5
2.2
10
6
6
6
6
3.4
2.4
4.8
5.0
7.6
4.1
6.0
4.7
6.7
2.5
3.4
2.6
6.5
3.9
<0. 05
<0.i01
<0. 01
<0. 01
<0. 01
<0. 01
Besides these differences in the bodies and frontal horns of the lateral ven-
tricles there were other isolated abnormal features in the drug addicts. Tem-
poral-horn dilatation was found in five of the cases, and in one of those the
dilatation of the horn was the sole abnormality found (case 9). The trigonal
region of the lateral ventricles as seen in the prone films was also considered
abnormally "square" in three of the cases (see fig. 4), and surface air showed
dilated sulci (>3 mm.) in two of the cases in the frontal region. There were
none of these abnormalities in the control group.
Study of the diameters A, B, and C and area E showed that on average the
left lateral ventricle is slightly larger than the right in both the control and
the drug-abuse groups, but that this difference is magnified in the drug-abusers.
This asymmetry is not uncommon, but has never been satisfactorily explained.
Its relationship to left-sided cerebral dominance is of interest, and in this respect
it should be noted that all our patients were right-handed.
DISCUSSION
Significant cerebral atrophy is rare in young people. It may happen after
head injury but can be attributed to this only when there has been post-
traumatic amnesia of several hours or evidence of focal neurological damage
at the time of the injury. (4) None of our patients who had had minor head
injuries (cases 1, 3, and 4) would satisfy these criteria, and we do not consider
that their head injuries played a part in the enlargement of the ventricular
33-371 O - 74
390
system Other causes for cerebral atrophy include head injury at birth, especially
in prolonged labor or in conditions causing anoxia : and some cases may also
be due to hypoplasia rather than atrophy, and differentiation may not be
possible. Severe infections in childhood when encephalitis has supervened, con-
genital syphilis, and toxoplasmosis may cause atrophy, as may congenital or
acquired vascular lesions. Other causes include hereditary disease such as
Huntington's chorea. Diffuse demyelinating conditions can produce quite rapid
cerebral atrophy in the second and third decade. It must be stressed that cereb-
ral atrophy indicates irreversible brain damage. We found no such causes for
cerebral atrophy in this series of drug addicts.
Booker et al. (3) emphasized that generalized abnormal ventricular size is
usually found in diffuse neurological disease rather than focal neurological
conditions. They showed that epilepsy is not associated with dilatation of the
cerebral ventricles unless the fits are extremely severe and extend over a long
period of time. In their series, which his very relevant to our work, there were
twenty-five non-neurological cases of a mean age of 3.2 (which is well above
our controls and drug-abuse series), and in this group they found a mean lateral
ventricular area measurement, determined by planimetry, of 2.90 sq. cm. for the
right ventricle and 2.98 sq.cm. for the left. These figures agree with our normal
control group and emphasize the difference from the addicted group.
In this epileptic series of 36 patients it is interesting that the mean
lateral ventricular area was less— 2.54 sq.cm. on the right and 2.60 sq.cm. on the
left_both in the normal range. Only in the cases of frank neurological disease
did the measurements approach those of our drug-abuse series — i.e., right side
3.9 sq.cm. and left side 4.63 sq.cm.— for this age group. We would emphasize,
therefore, that the findings of this ventricular size in our drug-dependent group
at this age is abnormal, and although these figures might be found in the
seventh or eighth decade they are abnormal for this age group.
The films demonstrate a definite pattern of cerebral atrophy. Apart from
the generalized dilatation of the body and posterior part of the frontal horns
of the lateral ventricles, the most striking feature is, perhaps, the dilatation of
the lateral and to some extent the inferior angle of the ventricle, and the falling
away of the floor, combined with the dilatation of the third ventricle. Although
no specific conclusions can be drawn from these changes— because similar
changes may be seen in parkinsonism and in the atrophy of old age and arterio-
sclerosis, for example — the appearances do nevertheless suggest that the worst
damage is in the region of the caudate nuclei, basal ganglia, and the structures
adjacent to the third ventricle. The occurrence of an isolated temporal horn dila-
tation in one case is of interest, but in another four cases this appearance was
combined with the generalized changes in the bodies and frontal horns.
The brains of monkeys given isotope-labelled cannabinols intravenously
showed concentration of the drug in the frontal lobes and cortex, geniculate
bodies, cerebellum, caudate nuclei, and putamen (5)— all structures near the
third and lateral ventricles. After 24 hours the drug had spread uniformly
throughout the brain. The fat solubility of the cannabinols (6) make it likely
that they would accumulate in nervous tissue, with its high fat content.
There is a very interesting parallel between the picture shown by encephalitis
lethargica and that of chronic abuse of cannabis and l.s.d. This was evidenced
in some of our cases by a reversal of sleep rhythms, hallucinations, and mental
changes. Hall, writing about the epidemic of encephalitis lethargica, (7)
commented :
"If the public asylums have seen little of the disease, the homes of sufferers
and the police courts for juvenile offenders told a different story, while in adults
the history of 'not being the man he was,' inability to work, being irritable and
difficult, a loss of memory and a falling-off in moral character are signs of this
infection".
Again, Hall mentions the extreme apathy produced by this disease, which is
followed by catatonia, and this indeed is another effect of cannabis both in
animals and man.
In encephalitis lethargica, the worst damage was in the basal ganglia, mid-
brain, thalamus, and floor of the third ventricle, and this is the very area where
we have demonstrated atrophy in our patients. Kennedy (8) postulated that,
in encephalitis lethargica, many of the symptoms were due to interference with
afferent impulses, and the same has been suggested about the action of cannabis
and i..s.d.
Our findings emphasize the importance of considering organic nervous symp-
toms and signs in any long-term assessment of the use of cannabis such as is
391
contemplated in India. The area of the brain showing damage in our cases sug-
gests it would be interesting to examine the cannabis-smoking habits of cases of
Parkinson's disease in the Indian population — Parkinson's disease being rela-
tively common in India.
Work on the impairment of recent memory in monkeys given cannabis is also
pertinent. (9) Several of our patients complained of poor memory for recent
events.
von Zerssen et al. (10) studied the diameter of the third ventricle in drug
abusers and controls by echoencephalography, finding that this measurement
was 7 mm. or more in the addicted group and less than 7 mm. in the control.
Details of the drugs used and the age-groups were not mentioned.
Cerebral atrophy is known to occur in alcoholism. (11) Kalaman found dila-
tation of the third ventricle in almost all of 87 patients regularly drinking alcohol
(12) only two of our cases (Nos. 8 and 10) had taken much alcohol,
and alcoholism is unusual in heavy cannabis smokers. The pattern of
drug taking was similar, in that most of our patients started on amphetamines
and with a short time were smoking cannabis regularly, l.s.d. had also been
taken, but cannabis became the predominant drug in all cases. For instance, if
cannabis had been smoked regularly three times a week for 3 years, it would have
been taken over 450 times, and this should be compared with the usual l.s.d.
average of ten to twenty doses. It is important to stress that morphine, heroin,
or cocaine had not been taken in any significant quantities. Some patients had
temporarily ceased to take drugs while in detention or in the Army, and it was
therefore impossible to relate the length of history to total dose or the extent of
cerebral atrophy.
It may be suggested that our cases were abnormal before they began smoking
cannabis, but in at least three cases where we know the history intimately these
individuals were entirely normal before they started drug taking. It would be
surprising to find cerebral atrophy of no apparent cause in consecutive cases,
selected only by their histories of chronic cannabis dependence.
Our findings indicate that there is a particular pattern of cerebral atrophy in
a series of young men who smoked cannabis. Although amphetamines and l.s.d.
may have an added effect, they are rapidly metabolized and excreted and would
not seem likely to have the cumulative effect on nervous tissue of the fat-soluble
components of cannabis. We feel that our results suggest that regular use of
cannabis produces cerebral atrophy in young adults.
For many years the production of cerebral atrophy in professional boxers was
not realized. We would suggest that a similar state of affairs is happening in
relation to drug abuse. Far too much attention has been paid to psychological
and behavioral disturbances, without relating these to the possibility of perma-
nent damage to the brain.
This work on man indicates an urgent need for further studies of the neuro-
logical consequences of drug abuse, and particularly the long-term effects of
cannabis smoking. Further radiological and neuropathological studies on man
and other primates are suggested. Serial psychometric and encephalographic
studies in the young drug-taking population would seem worthwhile.
We thank Prof. W. D. M. Paton, University of Oxford, and Prof. K. T. Evans,
of Cardiff Royal Infirmary, for helpful criticism ; Miss E. H. L. Duncan, lecturer
in statistics, University of Bristol ; Mr. J. Banham for the photographic work ;
and Mrs. Linda Nash for the secretarial help.
Requests for reprints should be addressed to A. M. G. C. and J. L. G. T.
REFERENCES
(1) Kolansky, H., Moore, W. T. J. Am. Med. Ass. 1971, 216, 486.
(2) Tinkerberg, J. R., Melges, F. T. Hollister, L. E. Gillespie, H. K. Nature,
1970, 226, 1171.
(3) Brooker, H. E., Mathews, C. G., Whitehurst, W. R. J. Neurol, Neurosurg.
Psychiat, 1969, 32, 241.
(It) Hunter R., Hurtwitz, L. S., Fullerton, P. M., Nieman, E. A., Davis, H.
Brain, 1962, 85, 295.
(5) Mclsaac, W. M., Fritchie, G. R., Idanapaan-Heikkila, J. E., Ho, R. T.,
Englert, L F. Nature, 1971, 239, 593.
(6) Gill, E. W., Paton, W. D. M., Pertwee, R. G. ibid. 1970, 228, 134.
(7) Hall, A. J. Epidemic Encephalitis. Bristol, 1924.
(8) Kennedy, F. Archs Neurol. Psychiat, 1922, 7, 53.
(9) Zimmerberg, B., Glick, S. D., Jarvik, M. E. Nature, 1971, 233, 343.
392
(10) von Zerseen, D., Fliege, K., Wolf, M. Lancet, 1970, ii, 313.
(11) Tumarkin, B. U.S. Armed Forces Med. J. 1955, 6, 67.
(12) Kalman, P. in Tanulmanyok az Alkoholizmus Pszichaiatria i Kovetez-
menyeirol ; p. 107, Budapest, 1969.
[The following letter from Professor W. D. M. Paton of Oxford to
Senator Gurney was ordered into the record.]
University Department of Pharmacology,
June 4, 191If.
Dear Senator Gurney : I am writing to you as chairman of the Senate Sub-
Committee, hearing on 16th May. At this hearing, after my testimony had been
taken, Dr. Kolodny was heard. His evidence included a rather severe criticism
of a paper entitled "Cerebral Atrophy in Young Cannabis Smokers," by Drs. A.
M. G. Campbell, M. Evans, J. L. G. Thomson and M. J. Williams published in
the Lancet on December 4th 1971. Since I knew the authors, particularly the
senior author Dr. Campbell, who was a senior and very experienced neurologist,
and had seen the work developing and the original x-rays, some comment from
me might have been helpful. I am writing now, with the suggestion, if you see
fit, that my comment might be included as an Appendix to the record, even
though one recognizes that it has not been tested by cross-examination.
I took the work seriously for the following reasons :
(1) There were two major difficulties in such work, namely that multiple
drug use is becoming the "norm", and that cerebral ventriculography (unlike
venepuncture) is not a minor procedure but can only be done ethically if there
are valid medical reasons for such an investigation. In the circumstances, the
authors did well to find 10 subjects with such a clear dominant pattern of
cannabis use (several hundreds of doses) again a varying pattern of much
lower use of other drugs. They also did well (as no one else appears to have
done) in identifying a group of the same age who were not drug users, appar-
ently free of neurological disease, to provide an estimate of ventricular size in
this young age range. Before accepting the detailed criticisms advanced (about
head injury and epilepsy), it is worth reading the analysis by Campbell et al.
both of these possibilities and of many other possible sources of brain damage
which needed to be excluded.
(2) Of all the drugs used by the drug-using subjects, there is little or no
evidence that any of them are cumulative apart from cannabis.
(3) Already, at the time of the paper, evidence had appeared that cannabis
could interfere with cell-division, and with brain biochemistry — making it per-
fectly possible that by either, or both mechanisms, loss of brain substance
could occur.
(4) Also, by the time of the paper, evidence had appeared suggesting that the
action of cannabis, studied by neurophysiological methods, was in the deeper
parts of the brain, in regions near the ventricles where (the authors suggested)
loss of substance might be occurring.
(5) Dr. Bromberg's paper (cited earlier) as well as later studies have
pointed to effects after heavy cannabis use persisting for months at least ; and
this undoubtedly raises the possibility that anatomical changes occur.
(6) A rather similar type of study (through without a control group) had
recently appeared, indicating that heavy alcohol use could produce loss of
brain substance (C. Brewer & L. Perrett (1971) : Brit. J. Addiction 66, 170-182).
The average age of this series was 50 years (range 39-62). This appeared to be
an entirely compatible result, the high fat-solubility of cannabis compared to
that of alcohol producing a similar but much earlier adverse action.
The paper by Dr. Campbell and his colleagues was not (and was not claimed
to be) incontestable proof that cannabis causes cerebral atrophy. But it is part
of a long and fruitful process in medicine whereby evidences of possible causal
processes are first brought forward (the paper by Dr. Kolodny and his col-
leagues is another such, the lack of medical constraint allowing the control
procedure to be further advanced). Such evidences are rarely in themselves
decisive ; but a great deal would be lost if they were excluded — including the
first suggestion that smoking was associated with lung cancer.
Yours sincerely,
William Paton.
393
[From Nature, Vol. 249, May 17, 1974]
Cannabinoid Content of Some English Reefers
(By J. W. Fairbairn, I. Hindmarch, S. Simic, and E. Tylden)
This paper reports the results of qualitative and quantitative analysis of 36
reefers or "proreefers" (samples of herbal or resin cannabis sufficient for one
reefer) produced in London and Leeds. As far as we know it is the first time
reefers in actual use have been so analyzed. The reefers were obtained from
three different groups : group A, regular smokers in the London area, some of
whom had asked for psychiatric help ; group B, regular users in Leeds, none of
whom had sought medical advice about their cannabis smoking; group C,
casual users in the London area. The results show a very wide variation in
potency and indicate that more than half were below the threshold dose.
The contents of each reefer were weighed, examined macroscopically and
microscopically and analysed (J) quantitatively for the main cannabinoid THC
^-tetrahydrocannabinol), CBN (cannabinol) and CBD (cannabidiol) (Table
1). Almost all the reefers contained tobacco mixed with varying proportions of
resin or herbal cannabis which, when possible, was separated and weighed.
We found a very high variation in potency, the content of the psychoactive
substance THC varying from 0.15 mg to 41.1 mg. As this variation has been
found in only 36 samples, it is almost certain that similar or greater variation
occurs regularly. In view of the known variability in the THC content of the
plant (cannabis sativa L.) from which the drug is obtained, the instability of
the active constituents, especially in badly prepared and stored material and
the "unstandardized" conditions in which the drug is distributed the variation is
perhaps not surprising. The lack of standardization means that a casual smoker,
used to low doses, may be accidentally exposed to highly potent material.
TABLE 1.— COMPONENTS AND ANALYTICAL DATA ON REEFERS
Contents
Weight
including
tobacco
Cannabinoids (mg)
Reefer No. (apart from tobacco') (g)
Group A:
1 Soft resin: (0.214 g) 0.744
2 Soft resin 0.752
3 Leaf only: sessile glands (0.511 g)2_
4 Coarse resin (0.118 g)2 -
5 Compact smooth resin (0.219 g)2
6 Resin: fine powder.. 0.778
7 Crumbly resin (0.224 g)2
8 Greenish brown resin (0.102 g) 0.996
9 Compact resins (0.327 g)2
10 Brown prism (0.278 g)2
11 Compressed herb (0.285 g)2
12 Leaf only: sessile glands (0.097 g)2
13 Herbal: stalks and seeds 1.135
14 Herbal: tops and seeds 0.460
Group B:
15 Leaf only, numerous sessile glands 1.724
16 Herb: bracts, leaf, seeds 1.730
17 Herb: stalk, leaf, seeds „ 1.309
18 Leaf only: sessile glands 1.166
19 Herb: leaf mainly 1.096
20 Herb: stalks, leaf, seeds 0.698
21 Leaf: flowering tops, seeds 1.202
22 Herb: leaf with sessile glands 0.887
23 Herb: seeds and leaf (0.317 g)2
24 Herb: bracts, seeds (0.440 g)*
25 Resin: greenish brown 0.941
26 Leaf and seeds (0.182 g)2
27 Herb: bracts, seeds 0.842
28 Fragments of green glass embedded in vegetable
debris 2 0.208
Group C:
29 Resin: fine powder 1.046
30 Herbal: bracts and leaves 0.910
31 Resin: small lumps 0.553
32 Herbal: unripe floral axis, immature seeds 0.383
33 Herbal: flowering tops, no seeds (0.224 g)
34 Herbal: with traces of resin 0.808
35 Resin: small lumps 0.637
36 Resin: greenish lumps 0.516
THC
CBN
CBD
28.39
Traces
16.68
24.98
Traces
14.65
11.13
Traces
Traces
8.21
3.10
2.74
5.99
2.73
6.60
5.06
0.89
1.76
3.72
1.23
9.36
3.34
0.55
3.01
2.70
12.14
30.76
2.06
5.38
9.51
1.97
0.36
2.85
1.89
Traces
Traces
0.52
4.35
0.64
0.15
0.74
0.11
41.11
Traces
Traces
18.05
4.89
Traces
17.56
4.50
Traces
12.92
Traces
Traces
11.85
Traces
Traces
9.56
1.89 ....
7.31
1.74 ....
7.11
0.83
4.25
4.48
1.09 ....
3.65
1.05 ....
2.52
0.52
0.75
1.38
0.16
0.35
0.38
0.16
0.32
0
0
0
9.37
0.99
5.99
8.38
0.86
1.36
5.59
0.67
3.64
5.02
0.71
Traces
3.00
0.33
1.25
2.02
Traces
Traces
1.38
0.36
2.82
0.99
0.26
2.03
1 All reefers contained tobacco except No. 15.
2 Pro-reefers, consisting of resin or herbal cannabis sufficient for one reefer.
394
TABLE 2.— MEAN DAILY USE OF REEFERS
Reefer number
Frequency of
use (d-1)
No. of users
THC consumed
(mg per
person per d)
Group A:
7
1
1
1
2
1-2
2
1
2
2
1
2
2-5
2
4
2
1-2
4
2
1
2
5-6
3-5
3 2
1
1
1
1
1
3
3
199
7
175
5-10
56-111
20-30
51-76
30
4-11
10-30
17-50
9
24
20
5
20
1.5
Group B:
1
41
3
27
10
35-88
2.5
16
8
24
20
H
26
4
15-29
20
36
11
25
24
3
11
20-40
25-50
26 -
15-18
3-5
27
15-25
1-3
Group C:
31
4
U
4
19
1
22
32 -
3
15
33 -
2
6
34
»2
0.6
35
12
0.1
36
12
0.1
• (Per week.)
On average each reefer in groups A and C was smoked by two people (Table
2) so that the mean dose of THC per person in group A would be 4 mg (range
0.1 to 14 mg) ; and in group C would be 2.2 mg (0.5-5.0 mg). For group B,
with an average of three people per reefer, the does would be 3.5 mg (0.2-13
mg). These doses are lower than those used by such workers as Numeyer and
Shagoury (2) (2-9 mg) and Isbell et. al. (3), who quote 3.5 as a threshold
dose and 16.2 mg sufficient to produce distinct depersonalization. On this basis
about two-thirds of the reefers, when shared, would produce effects less than
that of the threshold value of 3.5 mg THC. Casual smokers may therefore be
exposed to extremely small doses and so may falsely assume that cannabis is
a relatively harmless substance. Conclusions based on questionnaires to
smokers (4), such as students are probably of little value unless adequate infor-
mation on the potency of the reefer is also obtained.
All these doses refer to the actual amounts of THC in the reefers ; obviously
the amount reaching the blood stream will be affected by the manner in which
the reefer is made and, more importantly, whether the user inhales and if he
does how long he holds the smoke before expelling it (5).
A more important variable is the actual number of reefers smoked by an
individual per week. By careful questioning group A was found to consume 3.8
g cannabis per person per d (range 2 g to 6 g) ; group C 0.3 g (range 0.1 g to
1 g). For group B drug histories were collected using the techniques of partici-
pant observation (6) and actual weighing of the amounts used. The average
amount was 2.8 g per person per d (range 0.3 g to 8.3 g). As the reefers (Table
1) were collected at the time this information was obtained, it is possible to
calculate the daily intake of THC on the assumption that the reefer analyzed
represented those being smoked at that time. The results (Table 2) show that
for group A the average daily dose of THC is 60 mg per person, for group B 26
mg per person and for group C 8 mg. If the first two extremely high values of
group A are removed the average for the remainder is 37 mg per person.
Although these first two values are high they are not dissimilar from the values
of 150 mg THC d"1 quoted by Miras for regular users in Greece. (7) Some users
evidently compensate for low potency reefers by smoking 10-20 reefers d"1 and
395
in these circumstances the reported carcinogenic effects (8, 9) may become
significant.
Observation of some individuals, recorded before the analytical results were
known, confirms a dose-response relationships. For reefer 15 (41 mg THC per
dose) the user admitted he could not smoke more than 1 d"1, otherwise he was
unable to co-ordinate his movements. Reefer 22 (36 mg THC d) was from two
females whose most characteristic feature was a persistent hilarity ; neither was
in full time employment. The suppliers of reefers 3 and 8 (17 to 111 mg) were
all referred for mild cannabis psychoses, and were depressed and paranoid
when smoking heavily. These symptoms disappeared within 2 months of giving
up the drug. Reefer 27 (1-3 mg THC d) was from two small subgroups; none
of their members exhibited noticeable disorganization of the cognitive processes
and all seemed entirely capable of holding full time employment. They seemed
similar to the members of group C (casual smokers) who were in full time study
or employment. It is significant that students reduced their intake or gave up
drug altogether before examinations. Subjects who used reefer 28 (glass frag-
ments plus incense) made it from what they had bought as Turkish pollen hash
at il8 per ounce. Although they obviously expected a good high they experienced
no subjective euphoria ; most reported serious headaches instead.
We found no evidence of adulteration except in reefer 28. This indicates that
there is currently no shortage of genuine cannabis. Since THC decomposes into
the inactive CBN due to faulty preparation and prolonged storage, the relatively
high proportion of CBN in the group A reefers compared with group C indicates
significant breakdown. This may come as a surprise to group A as they claimed
to be nearer the sources of supply of cannabis, and therefore assumed they were
using fairly fresh and active material.
Reefer 3 was grown out of doors in Brixton, London, and collected in July.
Reefer 12 was grown in Dublin from Nigerian seeds and "harvested too early".
Reefer 15 was from seeds taken from Zambian "bush" and grown on a railway
embankment near Leeds ; the plants were harvested in September. None of the
samples contained the relatively potent flowering tops, yet they had quite high
THC content (21.8, 19.8 and 23.9 mg g_1 air-dried leaf respectively). These
results should therefore dispose of the idea that potent material cannot be grown
in a cool climate on unobtrusive sites sometimes with poor lighting conditions.
We hope to publish soon details of work on plants grow in this country over
several years, which confirm this conclusion. We have already pointed out (10)
the defect in the present international definition of cannabis as "the flowering
or fruiting tops of the cannabis plant (excluding the seeds and leaves when not
accompanied by the tops)" (11).
Some of the reefers used by experienced smokers were low in THC content
but nevertheless were claimed by the users to be satisfactory. One possible
explanation is the higher average CBD figures for group A (7.0 mg) than for
group C (2.1 mg). CBD is said to enhance the effect of THC (12). Furthermore,
since this work began, evidence has accumulated that the GLC peak corre-
sponding to CBD sometimes includes small amounts of other cannabinoids (18).
Synergism cannot be ruled out, and another possible explanation is the presence
of noncannabinoid active material in cannabis.
We thank those who suppled up with material and students at University
College Hospital, Royal Free Hospital and Bedford College, University of
London, who helped to make the necessary contacts in London.
REFERENCES
(1) Fairbairn, J. W., and Liebmann, J. A., J. Pharm. Pharmac., 23, 150-155
(1973).
(2) Neumeyer, J. L., and Shagoury, R. A., J. pharm. Sci., 60, 1433-1457
(1971).
(3) Isbell, H, Gorodetzky, C. W., Jasinski, D., Claussen, U, Spulak, F. von G.f
and Korte, F., Psychopharmacologia, 11, 184-188 (1967).
(4) Goode, E., Nature, 234, 225-227 (1971).
(5) Agurell, S., and Leander, K., Acta pharm. succica, 8, 391-402 (1971).
(6) Hindmarch, I., Drugs and Society, 1, 19-24 (1971).
(7) Miras, C. J., in Cannabis and its derivatives (edit, by Paton, W. D. M.,
and Crown, J.), 150 (Oxford University Press, London, 1972).
(8) Magus, R. D., and Harris, L. S., Fedn. Proc., 30, 279 (1971).
(9) Leuchtenberg, C, Leuchtenberger, R., and Schneider, A., Nature, 241,
137-139 (1973).
396
(10) Fairbairn, J. W., Liebmann, J. A., and Simic, S., J. Pharm. Pharmac,
23, 558-559 (19* 1).
(11) Single Convention on Narcotic Drugs, Article 1 (United Nations, New
York, 1961).
(12) Jones, G., and Pertwee, R. G., Br. J. Pharmac, 45, 375-7 (1972).
(13) Turner, C. E., and Hadley, K., J. pharm. Sci. 62, 251-255 (1973).
[From International Journal of Psychiatry, June 1972]
Clinical Effects of Marijuana on the Young
(Harold Kolansky, Chairman, Child Analysis Curriculum Committee,
Institute of the Philadelphia Association for Psychoanalysis)
(William Thomas Moore, Director, Child Analysis Division, Institute of
the Philadelphia Association for Psychoanalysis)
A five-year clinical study of thirty-eight patients, ages thirteen to twenty-four,
produces findings that marijuana alone causes serious psychological and neuro-
logical effects. For the moderate-to-heavy user, these can range from mild ego
disturbance to psychosis. The ill effects of marijuana are particularly accented
in the adolescent, who is struggling to master his disturbing bodily development
and normal psychological conflicts. The authors believe that marijuana is falsely
classified in the minds of many individuals as a "soft" drug or "harmless
escape." They recommend a major campaign to educate the public as to its
hazards, further research on its neurological effects, and continued illegaliza-
tion of all cannabis products.
During the past 6 years as practicing psychiatrists and psychoanalysts,
we have seen a clinical entity different from the routine syndromes of ado-
lescents and young adults. Long and careful diagnostic evaluation has convinced
us that this entity is a toxic reaction in the central nervous system due to
the regular use of marijuana or hashish.
Contrary to what is frequently reported, we have found the effect of mari-
juana to be not merely that of a mild intoxicant which causes a slight exag-
geration of usual adolescent behavior, but a specific and separate clinical syn-
drome unlike any other variation of the normal or abnormal manifestations
of adolescence.
We have found that marijuana and hashish have a chemical effect that
produces a brain syndrome marked by distortion of perceptions and reality.
This leads to an early impairment of judgment, a diminished attention and
concentration span, a slowing of time sense, difficulty with verbalization, and
a loss of thought continuity characterized by a flow of speech punctuated with
non sequiturs, which leaves the listener puzzled. In time, the chronic smoker
develops a detached look as decompensation of his ego occurs.
As a result of marijuana smoking, these symptoms prevail whether they
overlay normal or disturbed adolescence. In those individuals predisposed to
emotional disorders, the underlying illness may become more pronounced or
erupt for the first time during regu]ar use of marijuana. It is around this
point that some question has been raised about whether marijuana use is
the cause or the result of an individual's illness. We feel there should be
no confusion because, regardless of the underlying psychological difficulty,
mental changes — hallmarked by disturbed awareness of the self, apathy, con-
fusion, and poor reality testing — will occur in an individual who smokes
marijuana on a regular basis whether he is a normal adolescent, an adolescent
in conflict, or a severelv neurotic individual. Those who are already VI will
become additionally affected by marijuana use and thereby reduce their
chance for recovery. Those who are balancing between mental health and
illness will lose their balance, and those who are healthy will eventually
become symptomatic after prolonged pxnosure to the toxicitv of marijuana.
In the past year our 5-year clinical study, "Effects of Marihuana on Ado-
lescents and Young Adnlts," was published in the Journal of the American
Medical Association. Since that publication, a significant, and consistently
corroborative, response from practicing physicians throughout the United
397
States has substantially supported the findings of our clinical report. What
we described in our study was known already by many clinical physicians
because of their daily experience with patients who regularly use marijuana.
There have been many misleading articles by seemingly responsible indi-
viduals, minimizing tbe toxic eftects of cannabis derivatives containing delta-
9 transtetrahydrocannabinol (the effective chemical constituent of marijuana).
Many have even deemphasized the harmful eftects on the psychological devel-
opment of adolescents, with little, if any, conclusive clinical or laboratory
evidence. If one searches the available scientific literature of the United States
and foreign countries, the weight of the laboratory evidence from findings on
animals and humans leaves the reader with little doubt about the need for
caution in the use of these drugs by the youth of our society. Those few articles
that minimize the dangers of marijuana have received the most attention, thus
perpetuating the popular illusion that marijuana is an innocent drug. In
addition, the comparison between marijuana and alcohol or tobacco is frequently
employed as an argument. This only serves to confuse the issue, thereby
avoiding an independent assessment of the available medical data on marijuana.
Those who favor its use are insisting that positive proof of marijuana's
harmful effects be presented. We have submitted clinical evidence showing the
harm that marijuana can cause in the normal development of the adolescent.
We knew in advance there would be objections that our results are only
clinical and not reliable because they were not obtained under controlled
experimental conditions. For the practicing physician, the clinical setting is
his laboratory where he has become as adept at drawing reliable conclusions
from the clinical findings as the laboratory and experimental scientist is in his
controlled investigative setting. Many years before the invention of the micro-
scope or the era of the laboratory, physicians practiced medicine by the
development of their clinical skills. The causes and effects of numerous medical
entities were correctly described and understood years before clinical con-
clusions were reinforced by the laboratory.
Our society has misapplied caution in its insistence on definitive proof of the
ill effects of marijuana, consequently performing a disservice to itself. No
purpose has been served other than to allow our young people to go on denying
what they themselves know from within — that something happens to their
minds after prolonged marijuana use.
We have found that regular and long-term use of marijuana alone is enough
to affect adversely and permanently the life of a young person during that
fragile state of adolescence. Tet frequently he goes on to the use of other drugs,
such as amphetamines, barbiturates, lysergic acid diethylamide (LSD), and
heroin. Recently there has been increased public concern about the use of the
"hard drugs." Because people have been better informed about their dangerous
effects, there has been an increase in the effort to halt general drug use in
our young. However, marijuana is usually ignored or glossed over as being
less important or secondary to these "more dangerous" and "addicting" drugs.
Thus, by a semantic stroke, marijuana has continued in its role as a so-called
soft, nonaddictive drug or harmless escape, so that its identity as a mind-
altering toxin has remained ignored.
The increased use of heroin by adolescents, which has become alarming,
will continue to increase unless our society becomes educated about the dangers
of marijuana. Marijuana's destruction of normal mental functioning results
in a drug-induced emotional illness which readily prepares the way for the
young to seek out "harder drugs" as a solution. Until we are ready to face
the medical realities of marijuana use, we will not be able to resolve any of
the other drug problems which have invaded our society.
The medical reality that cannabis derivatives have a toxic effect on the
higher cerebral functions, which determine the final development of personality,
contributes to the snecial danger of mariiuana use to the developing adolescent
and young adult. In the following exposition, extracted primarily from our
paper. "Effects of Mariiuana on Adolescents and Toting Adults," we describe
the orgnnic. biologic, and psychological effects of this drug.
Between 1965 and 1970 we saw thirtv-eight individuals from ages thirteen
to twentv-four years, all of whom smoked mariiuana. All showed adverse
psychological effects: some also showed neurologic signs and svnmtoms. Of
the twenty males and eighteen females seen, there were eight with psychoses :
398
four of these attempted suicide. Included in these cases are thirteen unmarried
female patients who became sexually promiscuous while using marijuana;
seven of these became pregnant. In our own observations at local high schools
and at several college campuses, we have noted the openness of marijuana
smoking. Between twelve million and twenty million individuals in the United
States have smoked or are smoking marijuana.
In the last six years we noted a sizable increase in referrals of individuals
who showed an onset of psychiatric problems shortly after beginning marijuana
smoking. These individuals had either no premorbid psychiatric history or
had premorbid psychiatric symptoms that were extremely mild or almost
unnoticeable in contrast to the serious symptomatology which followed the
known onset of marijuana smoking. In our study, all in this group who smoked
marijuana more than a few times showed serious psychological effects, some-
times complicated by neurologic signs and symptoms. In thirty-eight of our
patients, our findings demonstrate effects ranging from mild to severe ego
decompensations (the latter represent psychoses). Simultaneously, we have
examined and treated many other marijuana smokers who either had severe
psychological problems prior to smoking marijuana or also used LSD, ampheta-
mines, or other drugs ; these patients had more complex findings and were not
included in this study of thirty-eight patients because we could not be certain
that symptoms were related to marijuana alone. We have studied some neu-
rotic individuals whose symptoms became more severe after smoking marijuana,
but, since their earlier symptomatology would becloud a study such as this,
we did not include them. Still others who had a marked predisposition to
psychosis and who became psychotic after beginning to smoke marijuana were
not included in this series, since our purpose was to report only the effects
seen as a consequence of marijuana smoking in those not showing a predis-
position to serious psychiatric problems. We have also seen many patients
older than twenty-four who have been smoking marijuana and have symptoms
similar to those we describe.
METHODS
Prior to 1965, we occasionally saw patients who smoked marijuana. The
thirty-eight patients described are part of a consultation practice that included
about five hundred referrals from 1965 to 1970.
Among our patients we found neurologic impairment in a few who smoked
marijuana four or five times weekly for many months. This impairment con-
sisted of slurred speech, staggering gait, hand tremors, thought disorders, and
disturbance in depth perception (such as overshooting exits on turnpikes,
misjudging traffic lights and stop signs at intersections, misjudging time in
catching a baseball, or undershooting a basketball net).
GENERAL PSYCHIATRIC CONSIDERATIONS
The thirty-eight patients studied consistently showed very poor social judg-
ment, poor attention span, poor concentration, confusion, anxiety, depression,
apathy, passivity, indifference, and often slowed and slurred speech. An altera-
tion of consciousness that included a split between an observing and an ex-
periencing portion of the ego, an inability to bring thoughts together, a
paranoid suspiciousness of others, and a regression to a more infantile state
were all very common. Sexual promiscuity was frequent, and the incidence
of unwanted pregnancies among female patients was high, as was the incidence
of venereal diseases. This grouping of symptoms was absent prior to the
onset of marijuana use, except in eleven patients who were conscious of mild
anxiety or occasional depression.
There was marked interference with personal cleanliness, grooming, dressing,
and study habits or work or both. These latter characteristics were present in
some patients prior to smoking marijuana, but were always markedly accentu-
ated following the onset of smoking. In one subgroup a clear-cut diagnosis of
psychosis was established; in these patients there was neither evidence of
psychosis or ego disturbance nor family history of psychosis prior to the
patients' use of marijuana. Several in this group were suicidal. Instead of
apathy, in some individuals hyperactivity, aggressiveness, and a type of
agitation were common. In no instance were these symptoms in evidence prior
to the use of marijuana.
399
ADOLESCENT DEVELOPMENT AND MABIJUANA
The nature of adolescent development is of importance in a discussion of
marijuana. The adolescent may begin to smoke marijuana and then suffer
damage in further psychological growth, development, and maturation.
In brief, adolescence has as its central driving force the organic, matura-
tional establishment of puberty. Kelated to physical changes of adolescence are
profound (normal) psychological changes.
The normal adolescent needs support and guided firmness from the parent.
If this is missing, he may turn increasingly to drugs. The adolescent living in
a ghetto has the added problem of the absence of daily necessities, making
reality harsh and the appeal of drugs even stronger. When the adolescent is
further exposed to equivocation by authorities in speech or writing on the
innocence or dangers of marijuana, then his urge toward a drug solution for
conflict may be enhanced. If there has been a lack of support and interest in
the child prior to adolescence and a lack of continuing interest, support, and
benevolent firmness by the parent in the teenage years, the adolescent may
even more readily turn to drugs.
To illustrate the issue of lack of firm guidance, several of our patients had
parents who talked to the adolescent of their own curiosity about the effects
of marijuana, without emphasizing its dangers. They emphasized the dis-
crepancies in the law without insisting that the youngster not use marijuana
or other drugs because of the serious effects that would occur. We have found
that equivocation by the parents has contributed to eventual drug experi-
mentation.
Most often the normal adolescent, weakened by his own rising sexual
pressures, body changes, and disillusionment with parental ideals, seeks peer
relationships to establish new ideals and thereby strengthen his own character.
Among his peers today, he finds many smoking marijuana. He cannot tolerate
the isolation from those who smoke. Also, the need to repudiate parental ideals
is strong. In his desperation to find new ideals, he turns to those who use
drugs. Even though their smoking frightens him, gradually he accepts their
drug use. He cannot see any changes in his friends as a result of smoking
cannabis (early changes are difficult even for the professional to detect). He
identifies, however, with their rebellious attitude toward authority as ex-
pressed by their use of marijuana. He may then smoke. At first, he is puzzled
and disappointed at not reaching a "high" (which he will not admit to his
new friends), and he fails to see any adverse effect upon himself other than
some exaggeration or distortion of sensory perceptions. He continues to smoke
in an attempt to achieve an effect. He thinks his parents and others are
alarmists ; he can see no harm in "smoking a little pot." He is unaware that
increased smoking over a period of time will likely deprive him of the ability to
resolve adequately his internal conflicts.
When we examined the effects of marijuana on the adolescents in our study,
we were struck by the accentuation of the very aspects of disturbing bodily
development and psychological conflicts which the adolescent had been struggling
to master. Marijuana greatly accentuates the inconsistencies of behavior, the
lack of control of impulses, the vagueness of thinking, and the uncertainty
of body identity. Moreover, dependency and passivity are enhanced at a time
when the more natural course would be to master dependant yearnings and
become independent. Rebellion toward parents and authority is increased while
the adolescent should be struggling to abandon such rebellion. His uncertainty
about sex grows while he smokes marijuana.
While the adolescent is mentally struggling to master his feelings about
his sudden body growth, marijuana smoking causes further changes in his
mental image of his body. Struggling to master new physical, intellectual, and
emotional strengths, he is also hampered by marijuana, leading to further
anxiety. Although he values clear thinking, coherent speech, alertness of
reasoning, good attention span, and concentration, he is now confronted with
at least temporary interference with these activities.
Our study showed no evidence of a predisposition to mental illness in these
patients prior to the development of psychopathologic symptoms once moderate-
to-heavy use of cannabis derivatives had begun. It is our impression that our
study demonstrates the possibility that moderate-to-heavy use of marijuana
400
in adolescents and young people without predisposition to psychoticillness may
lead to ego decompensation, ranging from mild ego disturbance to psychosis.
Clearly, there is in our patients a demonstration of an interruption of
normal psychological adolescent growth processes following the use of mari-
juana ; as a consequence, the adolescent may reach chronological adulthood
without achieving adult mental functioning or emotional responsiveness.
We are aware that claims are made that large numbers of adolescents and
young adults smoke marijuana regularly without developing symptoms or
changes in academic study, but, since these claims are made without the
necessary accompaniment of thorough psychiatric study of each individual,
they remain unsupported by scientific evidence. No judgment can be made on
the lack of development of symptoms in large, unselected populations of stu-
dents or others who smoke marijuana without such definitive individual psy-
chiatric history-taking and examination.
SOME CLINICAL SUBGROUPS
Borderline states (ego decompensation). — Six individuals fourteen to twenty
years of age, five male and one female, were seen in consultation. All these
individuals were seen chiefly because of complaints of general detrioration in
schoolwork, inability to concentrate or to pay attention in class, gradual de-
crease in academic standing, apathy, indifference, passivity, withdrawal from
social activities, and limitation of interest. All showed evidence of ego de-
compensation, including disturbance in reality testing, memory, social judg-
ment, time sense, concept formation, concentration, abstract thinking, and
speech production. All felt isolated from others. Four of these individuals
showed no prior history of these symptoms, although two showed some diffi-
culty in concentration in school prior to smoking marijuana. In the latter
two, the difficulty in concentration became far more pronounced following
regular smoking of marijuana. The following case study illustrates the border-
line state.
A nineteen-year-old boy entered college with an A average. He began smok-
ing marijuana early in the freshman year and within 2 months he became
apathetic, disoriented, and depressed. At the semester's end he had failed all
courses and lacked judgment in most other matters. Upon return to his home,
he discontinued marijuana after a total period of three-and-a-half months
of smoking. Gradually his apathy disappeared, his motivation returned, and his
personal appearance improved. He found employment, and in the following
academic year he enrolled at a different university as a preprofessional stu-
dent. His motivation and capabilities returned. As do so many of our patients,
this young man told his psychiatrist that he had observed changes in himself
while smoking marijuana ; he even went to a college counselor and told the
counselor that he felt he was having a thinking problem due to smoking mari-
juana. The counselor reassured him that the drug was harmless and that there
was no medical evidence of difficulties as a consequence of smoking.
Ego impairment voith marked sexual promiscuity. — Thirteen female indi-
duals with similar symptoms to those in the above group, all unmarried and
ranging in age from thirteen to twenty-two, were seen in consultation. This
group is singled out because of an unusual degree of sexual promiscuity, which
ranged from sexual relations with several individuals of the opposite sex to
relations with individuals of the same sex, individuals of both sexes, and
sometimes individuals of both sexes on the same evening. In the histories of
all these individuals, we were struck by the loss of sexual inhibitions after
short periods of marijuana smoking. Seven patients of this group became preg-
nant (one on several occasions), and four developed venereal diseases. Five
of the thirteen were engaged in homosexual activities which began after the
onset of smoking, and three attempted suicide. Each showed confusion, apathy,
depression, suicidal ideas, inappropriateness of affect, listlessness, feelings of
isolation, and disturbances in reality testing. Each patient who attended junior
high school, high school, or college showed a marked drop in academic per-
formance. The decline in academic performance was in direct proportion to
the frequency and amount of marijuana smoking. Most smoked three or more
times weekly.
In no instance was there sexual promiscuity prior to the beginning: of mari-
juana smoking, and in only two of the thirteen cases were there histories
401
of mild anxiety states prior to smoking. We take these results to indicate mari-
juana's effect on loosening superego controls and altering superego ideals.
Psychosis with suicidal attempts. — Four individuals, two male and two fe-
male between the ages of fourteen and seventeen, showed psychotic reactions
directly attributable to cannabis derivatives, and each attempted suicide. In
the usual type of adolescent psychosis, there is an antecedent history of very
poor ego organization. In no instance was there a history of such earlier ego
disorganization in these four psychotic patients ; nor prior to smoking mari-
juana was there psychosis, ego disturbance, family history of psychosis, fragile
ego, or suicidal attempts.
Psychosis without suicidal attempts. — Four individuals, all male between
the ages of eighteen and twenty-four, showed psychoses as a consequence of
smoking cannabis derivatives. As with the above group who attempted suicide,
this group showed no prior history of ego fragility, predisposition to psychosis,
or familial history of psychosis. Characteristic of some of our long-term mari-
juana smokers who develop paranoid delusions is an ability to function for a
period of time without others being aware of their illness. This concealment
is possible because they either join groups who share their aberrational
thinking or keep their delusional thoughts to themselves.
We have also noted that, as these individuals withdraw from marijuana,
delusions are given up more quickly in those patients who have been smoking
for a shorter period of time. However, as better reality testing is achieved,
these patients seem to be left with a residual of some memory difficulty and
impairment of concentration. One patient has shown this for two years at the
time of this writing.
It was our impression in these cases that the use of cannabis derivatives
caused such severe decompensation of the ego that it became necessary for the
ego to develop a delusional system, in an attempt to restore a new form of
reality. Apparently this type of paranoid reaction is a direct result of the
toxic effects of cannabis upon the ego organization of the patients described
in this study.
We have not included in this communication a large number of cases of
psychosis due to the use of other psychotomimetic drugs in combination with
cannabis derivatives. It is our impression that those patients who had been
taking LSD or mecaline or both with marijuana appeared to have more acute
psychotic reactions accompanied by greater panic and distress, resulting in
more frequent need for hospitalization, than those smoking marijuana alone.
SUMMARY AND RECOMMENDATIONS
Education. — We feel that the National Institute of Mental Health, other
responsible mental health agencies, and medical associations should coordinate
a large-scale educational effort to inform the public of the serious implications
of marijuana use. The press and the networks can aid immensely in this effort.
There is at this time enough information to bring equivocation to a halt. The
public, and particularly the young, can learn that marijuana alone causes
serious psychological and neurological effects.
Unless the marijuana problem is brought under better control, it is unlikely
that we will be able to influence effectively the hard-drug problem. All schools,
particularly elementary schools, must introduce or improve programs of in-
struction on marijuana to aid preventive efforts. Measures to control the
flow of marijuana must be increased.
Research. — Further research on the neurological effects of marijuana in
humans should be continued, as should psychopharmacological effects on ani-
mals and man. Additional clinical studies such as ours should be reported.
In view of the seriousness of chronic marijuana cough, respiratory studies
should be conducted to determine marijuana's effects on the entire respiratory
system. Long-range follow-up should be utilized to determine the possibility of
marijuana as a potential etiologic agent in Inns: malignancies. Some literature
has already suggested marijuana effects on other body systems, including circu-
latory, renal, and digestive. This work should continue.
Psychoanalytic and psychiatric research on the interferences in mental func-
tion, education, and development should continue.
Studies on recurrence of marijuana e^eots should be carried out.
Legalization and issues of public health. — If the National Commission on
Marijuana and Drug Abuse agrees with the clinical findings presented, then
402
it may decide, as we have, that marijuana is a public health concern. If the
Commission holds the opinion that the Government has a role in protecting
public health, then it would be logical that its recommendation would be to
prevent the importing, manufacturing, advertising, and sale of all cannabis
products.
Many individuals notable in fields other than medicine have advocated
legalization of the sale of cannabis. Their opinions are not based on the clinical
examination of those who use marijuana, but on hearsay, questionnaires, testi-
monials, and a misapplication of knowledge. They do a disservice to our young.
REFERENCES
1. Allentuck, S. (1941), Medical aspects. In The Marihuana Problem in the
City of New York. Reprinted in The Marihuana Papers, ed. D. Solomon, 269-
284. New York: Bobbs-Merrill, 1966.
2. Ames, F. (1958), A clinical and metabolic study of acute intoxication
with cannabis sativa and its role in the model psychosis. Journal of Mental
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3. Bronberg, W. (1934), Marihuana intoxication: clinical study of cannabis
sativa intoxication. American Journal of Psychiatry, 91 : 303-330.
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Health (1967), Dependence on cannabis (marihuana). JAMA, 201:368-371.
5. Council on Mental Health (1968), Marihuana and society. JAMA, 204:
1181-1182.
6. Editorial (1968), Marihuana thing. JAMA, 204:1187-1188.
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8. Gershon, S. (1970), On the pharmacology of marihuana. Journal of Be-
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10. Isbell, H., Gorodetsky, C. W., Jasinski, D. et al. (1967), Effects of (— )
Atranstetrahydro-cannabinol in man. Psychopharmacologia; 11: 184-188.
11. Kolansky, H. and Moore, W. T. (1970), Marihuana and the physician.
Philadelphia Medicine, Vol. 67, No. 4.
12. (1971), Effects of marihuana on adolescents and young adults.
JAMA, Vol. 216, No. 3.
13. Pearson, G. H. J. (1958), Adolescence and the Conflict of Generation,
1-186. New York : W. W. Norton.
14. Talbott, J. A. and Teague, J. W. (1969), Marihuana psychosis. JAMA,
210: 299-302.
15. Wieder, H. and Kaplan, E. H. (1969), Drug use in adolescents: psycho-
dynamic meaning and pharmacogenic effect. In The Psychoanalytic Study of
the Child, Vol. 24, eds. S. Eissler, A. Freud, H. Hartmann et al., 399-431. New
York : International Universities Press.
ACKNOWLEDGMENT
This report was presented to the National Commission on Marijuana and
Drug Abuse, Washington, D.C., on 17 May 1971.
[From the Journal of the American Medical Association, Oct. 2, 1972]
Toxic Effects of Chronic Marihuana Use
(By Harold Kolansky, MD, and William T. Moore, MD)
Thirteen adults between the ages of 20 and %1 years, all of whom smoked
cannabis products intensively (three to ten times per week) for a period of
16 months to six years, were seen during the period of 1969 through 1971. They
all demonstrated symptoms that simuultaneously began with cannnabis use
and disappeared within 3 to 2Jf months after cessation of drug use. In addition,
403
a correlation of symptoms was observed in relation to the duration and fre-
quency of smoking. When coupled with the stereotyped nature of the symptoms
regardless of psychological predisposition, a consideration of biochemical and
structural changes in the central nervous system (possibly cerebral cortex)
as a result of intensive cannabis use seemed to be in order. It would appear
that tho present medical and public approach to education regarding the danger
of marihuana use sheuld undergo some reassessment.
In April 1971 we published a paper describing 38 cases showing the clinical
effects of marihuana on adolescents and young adults, (i) With continued
clinical investigation, we have seen an increasing number of symptomatic
cases among preadolescents, adolescents, and young and older adults that have
confirmed our original impressions and at the same time have led us to an
increasing clinical conviction that there is a specific pathological organic re-
sponse in the central nervous system (CNS) to cannabis products. This specific
response was identified by a group of uniform symptoms common to all which
seem unrelated to individual psychological predisposition. As we previously
described, symptoms varied from mild ego decompensation to psychotic states.
We also considered that clinical findings resulting from chronic cannabis use
were suggestive of a temporary toxic cerebral state on a biochemical basis.
In a recent study, Campbell et al. (2) have demonstrated cerebral atrophy
by air encephalography in ten individuals who had smoked marihuana from
three to eleven years. The radiological report parallels another one of our
clinical impressions that cerebral structural changes may have occurred in
some instances of intense chronic cannabis use.
In our report (3) to the National Commission of Marihuana and Drug Abuse
on May 17, 1971, we again emphasized the deleterious effects of cannabis use
on the development of the adolescent personality. Although these effects were
described in psychological terms, we stressed our clinical hypothesis that psy-
chic changes were a result of a chemical (A9 tetrahydrocannabinol) damage to
the cerebral cortical cells. We further indicated that the symptoms described
by us should not be confused with the usual psychological phenomena, char-
acterized as either developmental changes or psychological aberrations. All the
individuals studied showed some uniformity of symptom response which to us
implied that a common toxic agent (cannnabis) was responsible for the ob-
served reaction. We also considered the possibility that similar reactions might
occur in any one who intensively used cannabis for an extended period of
time. We said :
"During the past six years, we have seen a clinical entity different from the
routine syndromes usually seen in adolescents and young adults. Long and care-
ful diagnostic evaluation convinced us that this entity is a toxic reaction in
the central nervous system due to regular use of marihuana and hashish."
Contrary to what is frequently reported, we have found the effect of mari-
huana to be not merely that of a mild intoxicant which cause a slight exaggera-
tion of usual adolescent behavior, but a specific and separate clinical syn-
drome unlike any other variation of the abnormal manifestations of adoles-
cence. We feel there should be no confusion, because regardless of the under-
lying psychological difficulty, mental changes — hallmarked by disturbed aware-
ness of the self, apathy, confusion and poor reality testing — will occur in an
individual who smokes marihuana on a regular basis whether he is a normal
adolescent, an adolescent in conflict, or a severely neurotic individual. (3)
Even when there is acknowledgment in public comments that marihuana
may be harmful to the adolescent, there is very little agreement that cannabis
is harmful to adults. This would seem to imply that the effects of cannabis
in the adolescent are determined purely by psychological factors, such as the
relative instability of the psyche in adolescence with all its individual varia-
tions, and also by the setting in which cannabis smoking takes place. We feel
that these are secondary factors in determining the effects of cannnabis on
human mental funerioninng. The direct or indirect chemical effect of this drug
on cerebral functioning has seempd to us to be the primary consideration.
Is it true that the toxic manifestations clearly seen in adolescence are not
to be found in adult cannabis user"? To date we have nr>t seen anv difference
in the symptom a tologv of the adult chronic marihuana-hashish smokers we
have examined from that seen in adolescents. Tn the series of adult cases re-
ported here, the uniformity of symptoms, the parallel relationship between the
404
appearance or disappearance of symptoms with the regular ise or discontinua-
tion of the drug, the more exclusive use of cannabis by adults (i.e., with mini-
mal or nonuse of other drugs), the absence of a significant relationship be-
tween psychological predisposition, and the type or severity of symptoms that
appear during regular cannabis use, all seem to indicate that persistent and
intensive marihuana or hashish smoking may affect the cerebral functioning of
any individual biochemically in much the same way regardless of age or psycho-
logical maturity. There is a stereotyped symptom complex in these cases mak-
ing a common toxic causality seem self-evident.
SYMPTOMATOLOGY
With a history of regular marihuana or hashish use (three to ten or more
times per week), the individual was characteristically apathetic and sluggish
in mental and physical responses. There was usually a loss of interest in
personal appearance and goallessness. Considerable flattening of effect at first
gave an impression of calm and well-being so that the patient seemed to be
at peace with himself and the world. This was usually accompanied by his own
conviction that he had recently developed an emotional maturity and insight
that was aided by or even a result of his generous use of cannabis. Having
found his "true self," he claimed that his aggression, ambition, and life goals
no longer needed to follow those of the mainstream of society. We considered
this to be a defensive use of denial and reaction formation in order to avoid
an outbreak of aggression due to diminished stability in his personality organi-
zation. His pseudoequanimity was easily disrupted when his personality change,
new philosophies, and drug consumption were questioned by old acquaintances
or family. Also, if anyone posed a threat to his supply of cannabis, the peaceful
facade quickly gave way to irritability or outbursts of irrational anger fre-
quently accompanied by vituperative verbal attack or sullen petulance. This
latter phenomenon was described in some of the cases cited by Marcovitz
and Myers (4) in their report. Grinspoon(5) not only fails to see such changes
described in other literature as being due to marihuana use but even states :
"I am not so certain, however, that these differences constitute personality
changes ; it may be more accurate to consider them manifestations of a pur-
poseful and extensive change in life style. ..."
Most of those we examined were physically thin and often appeared so tired
that they simulated the weariness and resignation of some of the aged. All
appeared older than their chronological age, an impression that was sometimes
reinforced by slowed physical movement. We thought such slow motion resulted
from a combination of an emotional lethargv and a slowing of the sense of
time: this latter effect has been cited by Melges et al. (6) as also contributing to
mental confusion in cannabis smokers. Frequently our patients complained of
tiredness, sleeping during the day. and wakefulness at night which seemed
similar to the reversal of sleep cycle referred to by Campbell et al. (2) as a
symptom of cerebral organicity.
The symptoms of mental confusion, slowed time sense, difficulty with recent
memory, and the incapability of completing: thoughts during: verbal commu-
nication that resulted in confused responses, seemed to imply some form of
organicity either of an acute biochemical nature as noted in cases with shorter
histories of cannabis use or. one might hypothesize, structural encephalopathy
when found in cases with prolonged heavy marihuana use. We are certain that
these symptoms cannot be explained simplv on the basis of psvchological pre-
disposition. Headaches, also described by Campbell et al. (2) were common. In
one of our cases (not reported in this series), the marihuana syndrome masked
a severe obsessional neurosis that was present before marihuana use. then re-
appeared after cessation of drug use. During marihuana toxicitv. his obses-
sional thinking and compulsive behavior were minimal and secondary to the
stereotyped symptoms described above.
METHODS
In general, we (1) used the same methodology in the Present study as in a
previous report. We established the mental status of each patient from a routine
psychiatric history and examination. The 13 patients were seen as a part of
a psychiatric consultation practice involving approximately 100 patients per
405
year with an even distribution of the usual diagnostic categories. In order to
establish a diagnosis we interviewed each member of this group as well as his
family approximately four to ten times in order to establish the patient's his-
tory and mental status. After a diagnostic impression was determined, each
patient was told of the relationship of his symptoms to chronic marihuana
use and each in turn was urged to relinquish the use of marihuana in the hope
of reversing his symptoms. Recommendations followed which included psycho-
therapy and psychoanalysis for two members of the group who had shown
predrug psychopathology. One of the individuals evaluated moved geograph-
ically, therefore, followup was not possible. Of the remaining ten members of
the group, a cessation of smoking resulted in either total or partial remission
of symptoms so that only a minimal supportive followup was necessary.
Some individuals raised questions regarding the methodology employed in
our previous report. Thus, comment on clinical diagnosis is in order. In ob-
taining medical history, the technique of drawing diagnostic conclusions by
clinical deduction has been a primary method of paving the way to estab-
lishing a diagnosis and pointing to the cause. Pathological entities first dis-
covered and etiologically determined by clinicians have been corroborated,
then elaborated upon by subsequent laboratory investigation. When an unusual
or unfamiliar syndrome is seen clinically, it is first compared with and dif-
ferentiated from the accumulated knowledge of clinical phenomena. Then after
it has been noted that the syndrome occurs repeatedly in the presence of a
common factor, and the removal of that factor results in diminished or absent
symptomatology, then that factor becomes suspect in the cause of the condition
under investigation. Also, if there is an increase in the symptomatology relative
to a qualitative or quantitative increased exposure to a substance, then it has
been reasonable to assume that the symptomatology is directly related to the
presence of the substance in question. After all of the differential diagnostic
possibilities are reviewed and thereby eliminated, the clinician may then
reinforce his diagnostic impression. By repeated exposure to this procedure
in many cases, the clinician may suggest an etiological diagnosis for the new
clinical syndrome. Because this clinical method used daily by practicing physi-
cians seems unfamiliar to nonclinicians, it cannot be a foregone conclusion
that the application of this method of clinical study and deduction is any less
scientific in its approach nor less valid in its conclusions than other methods
of investigation.
CLASSIFICATION
In our report on the effects of marihuana on adolescents and young adults,
we used psychoanalytic terminology to classify or group the cases according
to changes that occurred in the dynamic functioning of the psychic structure.
This seemed a practical way to emphasize the importance of the adverse
effects of regular cannabis use on the critical developmental mental process
during the adolescent stages of life. This was done in terms that were de-
scriptive of the relative intactness of those portions of the psychic structure
psychoanalytically referred to as the ego and super-ego.
Such a classification is no less applicable in this report, but we are de-
emphasizing that psychological classification in order to emphasize the organic
implications of our findings, also to emphasize the obviousness of cause and
effect. The symptoms seen in the 13 patients imply a biochemical reaction or
structural change in cerebral cells as a result of effects of chronic cannabis use.
We have tentatively grouped or classified these 13 cases in the following
manner :
1. Biochemical Change. — Those cases in which symptomatology indicated less
chronic or less intensive use of cannabis or both, and the patients developed
total remission of symptoms within a six-month period following the termina-
tion of drug use.
2. Biochemical Change With Susnected Structural Change. — Those cases In
which symptomatology indicated chronic intensive cannabis use : then upon
termination of drug use. only partial remission of symptoms were evident after
six months and no residual svmptoms were found after nine months.
3. Biochemical Change With Posxihle Structural Change. — Those cases in
which symptomato^gy indicated chronic intensive cannabis use: then upon
termination of drug use. partial remission of symptoms occurred after six
months and residual symptoms were present after nine months or more.
33-371 O - 74 - 28
406
EEPOET OF CASES
Group 1. — Case 1. — A 41-year-old white man who was an architect smoked
marihuana and hashish for only 18 months in addition to which he took an
occasional mild tranquilizer in order to sleep. He was married, had two children,
and had practiced in his profession for 16 years. While dating some younger
women he was introduced to marihuana smoking. He very quickly started to
smoke marihuana daily. Personality change was quite rapid and within months
he left his family, had begun divorce proceedings, and had made several pro-
fessional errors that resulted in severe financial loss to several of his clients.
His senior partners demanded that he submit to psychiatric evaluation. When
first seen he had been smoking daily for over one year. He demonstrated symp-
toms of ego decompensation that we attribute to chronic marihuana toxicity,
including confusion, distortion of time sense, apathy, forgetfulness, suspicious-
ness, and poor reality testing. After he realized the adverse effects of mari-
huana use, he was able to stop smoking with some initial difficulty. Six weeks
after stopping completely, his premarihuana-smoking personality was restored
and he demonstrated no clinical evidence of either biochemical or structural
changes in cerebral functioning. Even though at times his smoking was quite
intense, we related his early and complete remission to the relatively short
period of time that he had been smoking marihuana.
Case 2. — A 28-year-old white man, who was a teacher in a metropolitan
junior high school, smoked marihuana and hashish for three years. He had
used lysergic acid diethylamide (LSD) once but used no other drugs except
for an occasional barbiturate for insomnia. He was afraid to try amphetamines
because he had heard they could cause "brain damage." He began social smok-
ing on weekends and gradually increased to three or four times weekly. Within
two years he gave up teaching to become an artist even though he had no
previous training or experience in the arts. After he broke a one-year engage-
ment, he had two love affairs resulting in two pregnancies and abortions. His
father prevailed upon him to return to Philadelphia to seek professional help.
Upon examination he was confused, circumstantial, showed some memory dif-
ficulty, and a slowing of time sense. Occasionally an inappropriateness of
affect was apparent. Because of considerable reluctance to give up the pleasures
of marihuana, he only withdrew gradually from daily smoking. As with a
number of our cases he went through a period of distrust and chronic irrita-
bility that was accompanied by lying and the sneaking of marihuana. However,
as he smoked less, some return of order into his life permitted him to realize
the adverse effects of marihuana and therefore he decided to stop smoking
completely. After further symptom remission he returned to teaching, then later
became active in his father's business. After a short engagement he married.
A seven-month followup revealed a remission of his previous symptoms of
ego decompensation, but he could not clearly remember a number of life events
that occurred during the period of his most intense marihuana smoking.
Case 8. — A 25-year-old unmarried white man, a junior high school teacher,
became increasingly sarcastic and verbally abusive to his students, a striking
departure from his usual mild mannered behavior. He publicly made fun of
other teachers, students, and the school administrators. When seen for evalu-
ation, he revealed that he had been smoking marihuana for the past three
years on the average of two or three times per week. During the last six
months, however, he was regularly smoking several times each day. He admitted
using LSD on two occasions in college but found he was not interested in
other drugs. During his last year of college he almost failed because he had
not prepared his work and had lost interest in "conventional education." With-
in the past year he had been asked to vacate two different apartment houses
because of late parties and because he frequently provided quarters to tran-
sients who were considered "undesirable" by the landlord. His family lived in
another city and, therefore, on those occasions when he had nowhere to live
he slept in the park ; then, upon awakening he went to teach without washing
himself or changing his clothes. His daily teaching assignments were poorly
prepared and he frequently talked to students in class about irrelevant matters.
Later on he began to feel that students called him names and talked about
him, so he retaliated with verbal outbursts against them. He occasionally had
memory gaps during those weekends when he smoked continuously. He spoke
407
of ill-defined intense religious experiences; "the messengers of the gods were
trying to warn him of his enemies, the police." He felt the country was in
great danger of a take-over by the "military." He wanted to leave the northeast
in order to be in a warmer climate and to find a place where there would be
no competition because he felt that competition caused aggression which in any
form was the downfall of man. His conversation was usually rambling and
often punctuated with non sequiturs. He frequently asked if he was making
any sense and complained that at times he thought he might be losing his
mind.
This man showed the type of confusion and paranoia we have found to be
a frequent characteristic of heavy marihuana smokers. Quite regularly it was
accompanied by a vague self-awareness of mental disorder. After four months
he showed only partial remission of his symptoms. Suspiciousness was dim-
inished as was his confusion and forgetfulness. Because he left town before
we could determine the presence or absence of symptoms after six months,
we have included this case under the group showing only biochemical change.
Case 4. — A 28-year-old white married woman worked as a dental assistant.
She had one child in kindergarten, was happily married, and was an energetic
worker. Her employer considered her indispensable to his dental practice.
A number of her friends began to have marihuana parties to which she and
her husband were invited. She enjoyed cannabis much more than drinking
because of "no hangover." For a period of one year, she usually smoked on
weekends and only occasionally during the week. Her employer was the first
to notice her diminished efficiency when she regularly forgot to process x-ray
films and performed poorly in the dispatch of duties that previously had been
done flawlessly. In addition, carelessness about her personal appearance, at
first almost imperceptible, became increasingly obvious to her friends. Her
husband noted that she was more tired and irritable on Mondays and Tues-
days following heavy weekend smoking. Even though her smoking increased,
her husband decided to stop smoking himself because he was aware that his
sales record had markedly declined as a result of his negligence to details at
work over a four-month period. Having done so, he became concerned about
his wife. When he asked her to give up smoking, she refused. Now smoking
daily she lost her job, then had several love affairs with some of her smoking
companions. Shortly after she was referred for psychiatric consultation, she
was persuaded to stop smoking. Within three months her thinking became
clearer and she returned to her former level of functioning. She was rehired
by her former employer and was asymptomatic except for occasional feelings
of depersonalization that seemed to pass rather quickly.
Case 5. — A 35-year-old white housewife and mother of two children was a
vivacious and quite active individual prior to smoking cannabis. She was
respected, competent, responsible, and had no previous history of emotional
disorder. She was deeply involved in her home and community and considered
by all to be a stable individual. She was introduced to marihuana smoking
by a group of adolescents she had been teaching in a community youth organi-
zation. She immediately liked the effect and began to smoke regularly because
she had understood from all sources that it was harmless. During the last six
months of a two-year period she smoked marihuana almost daily. Over the
period of two years she gradually identified with adolescents in dress, language,
and ideals. Her home and marriage suffered in that they became secondary
and sometimes unimportant to her. Without discrimination she wanted to join
protest movements and marched for causes that frequently were in juxtaposi-
tion with each other. When she was approached by her husband or friends
about her activities she became belligerent and verbally assaultive. Over the
last six months she had become quite petulant and reclusive. Even her ado-
lescent friends began to avoid her except for the few who brought her marihuana.
At the time of psychiatric examination she showed apathy, mental confusion,
forgetfulness, feelings of depersonalization, and impairment of memory espe-
cially for more recent events. Time sense was distorted as was her ability to
converse coherently. Frequently she would sit for long periods of time remain-
ing detached or immobile especially when she had smoked more than once
that day.
Withdrawal from cannabis was slow and difficult. She held the drug in
high esteem and claimed it cleared her mind. Gradually as she withdrew she
408
became depressed and complained of frequent headaches that were not amenable
to salicylates. She developed hepatitis that required bed rest for several weeks.
With her source of cannabis involuntarily removed by her hospitalization, she
returned to her premarihuana-smoking personality. Further psychiatric follow-
up after a four-month period revealed that she was asymptomatic. Of her drug
experience, she said that the whole past year and a half seemed like a dream.
Case 6. — A 20-year-old college student was referred by her family physician
because of a marked and relatively sudden change in behavior and life style.
She had been an outstanding history major until the previous year when she
gave up living with a roommate, lived as a recluse, stopped attending classes
regularly, did not turn in assignments, frequently spent days in bed, appeared
apathetic, confused, withdrawn, and asocial. She often had periods of marked
depression, felt there was no purpose in school life and gave up her history
major, shifting her interest to economics, music, and then art. In each field,
she failed to study or produce and had strong wishes to drop out of school
and live in a commune.
During psychiatric examination she was lethargic, had difficulty concentrat-
ing, had trouble with memory and attention span, and spoke of long periods
of depression and sleeplessness. She had aimless relations with her former
friends and had no greater ambition "than to turn on with a joint." She moved
slowly and without purpose and had frequent headaches. Her symptom complex
had begun within months of beginning to smoke marihuana first on weekends
and then two or three times each week. At the time of referral she was
smoking four times each week. A review of the absence of symptoms prior to
the use of cannabis, the correlation of her apathetic withdrawal from respon-
sibility, and her thinking disorder with the onset of cannabis use motivated
her to try to give up using marihuana and within two months her smoking
stopped. Within weeks after that, much of tbe confusion, apathy, and poor
memory had disappeared. She returned to college, on a more limited basis,
and gradually had a return of interest. At the time of this writing, it was not
yet six months after cessation of cannabis use but she had had a recovery to
most of her precannabis-smoking personality. She had used amphetamines on
three occasions early in the period when she began marihuana use but had
given these up because her gratification with marihuana was more intense.
Group 2. — Case 7. — A white man, 24 years of age and a Vietnam veteran
began smoking while in Vietnam. He had never tried any other drugs but
thoroughly enjoyed smoking marihuana and especially hashish. Shortly after
returning from the service, he began to smoke two to three times weekly and
within a few months progressed to smoking every day which was to be his
habit for the next two years. Personality change was marked by apathy,
irritability, reclusiveness, slovenliness, mental confusion, frequent loss of recent
recall, losing and misplacing things, forgetfulness, and distortion of time sense
so that he even appeared at times to walk and move as though in slow motion.
He would not seek a job nor would he make plans to further his education.
He rationalized that he did not want to become a "slave to the system" and
needed a rest. He dated infrequently and seemed to have no personal interests
other than to maintain his supply of marihuana and hashish. Eventually he left
home and hitchhiked to the southwestern part of the United States. He lived
in a commune for a while then left for California in order to embrace a far
eastern religion. After one year he returned home, at which time he was
referred for psychiatric evaluation. He slowly and reluctantly gave up cannabis
use over a period of six months and gradually he returned to his premarihuana-
smoking personality. He decided to enter a community college but was fearful
that he would not be able to think clearly enough to do the work. He managed
to do well academically but with great effort because he had difficulty with
memory work, concentration, and sentence construction. As with so many
patients in our experience, he realized that marihuana had caused severe
impairment of his mental processes. For a ten-month period he had not
smoked but, even though he knew he should not use cannabis any further, he
still longed for it most of the time. Frequently he would get a "high feeling"
without apparent cause, while sitting in a classroom or while driving a car.
On several occasions while driving, he became so frightened that he pulled
over to the side of the road until the feeling of being "high" left him. Further
psychiatric folio wup is presently in progress.
409
Case 8. — A white man, 26 years old, was employed as a real estate agent.
He had done well in college and was considered to be one of the brighter
young men in a rather large national real estate firm. He was married but
had no children. He and his wife began running around with a "pot-smoking
crowd." Together they only smoked on weekends, however, he began to smoke
alone during the week. It rather quickly became a regular habit and before
the year was out he smoked daily. Eight months later he lost his job and
took up stone sculpturing as a result of a close friendship with an artist.
Eventually he was supported financially by his wife who had stopped smoking
because she felt the drug confused and depressed her. Although the patient
had no interest in taking other drugs, he revealed a special liking and daily
desire for hashish. He also developed apathy, confusion, irritability, disturb-
ance of time sense, forgetfulness, and some inappropriateness of affect. After
18 months of smoking he became interested in an Indian religion and borrowed
some money in order to travel to that far eastern country. When he left his
wife in order to do so she consulted one of us.
By the time he returned to this country five months later, further mental
deterioration was evident to all. He showed confused thinking, circumstan-
tiality, and paranoid ideas. Withdrawal from the drug was difficult because of
the patient's intense fondness for hashish. However, with persistence and
family support, he stopped smoking and as he did so, his symptoms remitted
concomitantly. Six months after cessation of drug use he was again gainfully
employed, reunited with his wife, but greatly shaken and disillusioned. He
still demonstrated some difficulty with concentration, some slowed time sense,
and occasional mild feelings of being high with no apparent stimulus. At the
nine-month followup he indicated that he had some feelings of depersonalization.
Case 9. — A 28-year-old white schoolteacher smoked marihuana and hashish
for six years. He admitted to the use of LSD on three occasions, each accom-
panied by a typical "acid trip" early in his drug history, the last of which
caused such terror as to make him stop using it. He began smoking marihuana
while he was a college senior. Over the next few years he progressed from
weekend smoking to using the drug three to four times per week. As a teacher
in a boys' boarding school he spent a great deal of his spare time with the
students discussing philosophy and politics. When it was discovered that he
had encouraged students to smoke marihuana he was in trouble with the
school administration. Finally his advocacy of the violent overthrow of the
Government resulted in his dismissal. Shortly afterward he obtained a position
at another private school and within the year had repeated his earlier experi-
ence. In addition, he developed a disinterest in sexual relations with his wife
and became interested in "depth philosophy" which he understood rather
poorly. His estrangement from reality became more obvious to all. When he
was prevailed upon to withdraw from marihuana use, a minimal return to
his previous personality occurred, but the remission was still not complete
after eight months. Even though his cognitive thinking was more sensible and
he seemed to be more firmly rooted in reality, he still complained of difficulty
with concentration and sometimes during conversations he had a tendency to
forget the content of his statements.
As with some other cases in this series, many years of marihuana use seems
to have resulted in symptoms that endure for many months after cessation.
This seems to at least imply some structural change of the CNS beyond a more
transient reaction that one would expect in a reversible, biochemical, cerebral
response. The persistence of a flatness of affect interspersed with an occasional
uncontrolled outburst of giggling and laughter or a brief inappropriate temper
tantrum accompanied by long periods of petulance, the frequency of headaches
that were not present before marihuana use, the consistent demonstration of
poor social judgment, the occasional mild feeling of "a high" without drug
stimulus are frequent residual symptoms among long-term cannabis users we
have examined. This patient also complained of some difficulty with his
memory, especially in recalling recent events.
Group 8. — Case 10. — A 34-year-old white advertising executive smoked mari-
huana for 31/2 years but took no LSD or other drugs. He was married for 12
years and the father of three children. For ten years he was considered one
of the more gifted and promising members in a prestigious advertising firm.
410
During his first year of weekend smoking he became perceptibly less ambitious
and energetic. He was less attentive to details at work and showed less interest
in his family. His wife had accompanied him in smoking and generally sup-
ported his less ambitious outlook on life. After habitual, forgetful, and costly
blundering, his partners "bought him out" of the firm. As he increased his
marihuana smoking over the next two years, personality deterioration was
more in evidence and he drifted from one job to another as the periods of
unemployment grew longer. Finally after 3*4 years of smoking, by now on a
daily basis, he was referred for psychiatric evaluation.
Marihuana use was given up by the patient with considerable difficulty.
He became irritable and argumentative when he could not smoke marihuana
and on two occasions resorted to physical assault upon two family members
after they had found and confiscated his supply. Recovery was gradual but
after a period of six months of total abstinence he returned to his pre-
marihuana-smoking personality. After several interim jobs he again found
employment in his chosen profession.
In the one-year followup interview, he complained of occasional mild feel-
ings of depersonalization and transient states of mild confusion. He also felt
his memory was not as good as it once had been and he had considerable
difficulty in concentration, especially when reading or when writing business
correspondence.
Case 11. — A white man, 32 years old, smoked marihuana and hashish for a
period of four years. Before he smoked he was gainfully employed as a success-
ful tree surgeon. He was ambitious and considered to be a stable and sensible
man. He was happily married and a devoted father to his three children.
After he had been introduced to marihuana smoking at a party, he smoked
socially and on infrequent occasions (one to two times monthly). Within a
year he had increased his marihuana smoking to three to four times weekly
and finally almost daily for a period of three years. Changes in his personality
occurred slowly and were only discernible to those who knew him well. At first
he became somewhat careless about his personal appearance and bathed in-
frequently. He began to oversleep in the morning and was frequently absent
from work so that a coworker had to take over double duties. He became
irresponsible in maintaining company records and was irritable with clients
and his superiors. He frequently fought with his wife over smoking, especially
when she began to express concern over his changing attitudes toward work
and family responsibilities. He castigated her for being "materialistic" and
rationalized his lack of industry and decreased ability to provide for the
family as the fault of "society" for requiring that a man "overproduce in order
to keep the captains of industry wealthy." He touted a self-styled pseudo-
socialism, then went through a rapid transition from an interest in health
foods to macrobiotics. When he became unemployed and went on relief, his
wife and family physician talked him into having a psychiatric evaluation.
He withdrew from smoking cannabis with considerable difficulty over a
three-month period of time. Eight months after he stopped smoking, some
semblance of his premarihuana-smoking personality returned and his former
employer rehired him because of the excellent job he had done prior to using
cannabis. A one-year followup revealed that he still had some difficulties with
memory and concentration. Fortunately his occupation required little of the
latter and he was able to perform his duties satisfactorily. Occasional irrita-
bility and some inappropriateness of affect were present. He complained of
frequent feelings of depersonalization or "feeling high" if he smoked too many
cigarettes, drank too much coffee, or took too many aspirins for his headaches
which were frequent and of long duration since he had given up cannabis.
He expressed a strong desire to go back to smoking marihuana and was
greatly discontended with his life. We did not feel this man's eventual prog-
nosis was too hopeful. When he refused the recommendation for psychotherapy,
we thought it was likely that he might return to cannabis use at some future
time.
Case 12. — A 38-year-old, white, married English professor, after smoking
only on weekends for about 18 months, increased the use of marihuana and
hashish to a dailv basis and continued to do so for over four years. He taught
his classes regularly and also held private seminars with chosen students
during which time marihuana smoking was encouraged in order to "think more
411
clearly." In addition to considering himself a visionary, he imagined he was
the reincarnation of Hamlet who conversed with his dead father during
solitary walks around the campus at night. He gradually turned his interests to
mysticism, then asked for a one-year sabbatical to be spent in solitary con-
templation. During the heaviest period of smoking, he was most seclusive and
in order to be alone walked out on his wife and children for a period of
six months. Because he eventually embraced an eastern religion that forbids
the use of drugs he slowly withdrew from the cannabis habit. As he did so,
his thinking became clearer and his memory improved; however, after six
months he still had difficulty with immediate recall, often demonstrated by
his forgetfulness and frequent loss of personal belongings. He returned to his
interest in English literature and after 14 months of abstinence from cannabis,
he was able to obtain employment in a small private school. One year after
cessation of marihuana use, he demonstrated and complained of some difficulty
in maintaining long periods of concentration and an inability to satisfactorily
convert his thoughts into written or spoken words. There was also evidence of
occasional inappropriateness of affect. Physically he appeared to be at least
15 to 20 years older than his chronological age.
Case IS. — A 23-year-old unmarried social worker was referred for diagnostic
study following an unwanted three-month pregnancy terminated by abortion.
This young woman had been smoking marihuana for four years. At first she
had smoked only on weekends, but after six months she began to smoke three
to five times weekly. She had always exhibited some immaturity in her per-
sonality, characterized by a tendency to confide in her mother more than was
appropriate for her age, and a "little-girl-like" attitude with her friends.
However, she had been a capable student and worker, had many friends, read
considerably, and thought clearly. Gradually, after beginning to smoke mari-
huana, her friends noticed that she became confused, loquacious, and silly in
her affect. Her case work deteriorated and she was criticized by her supervisor
for slovenly appearance and failure to prepare case material. She began dating
men of a much lower social status and began for the first time to have frequent
and indiscriminate sexual affairs. This previously cautious person paid no
attention to the lack of precautions taken by her lovers, resulting in gonorrhea
and finally in an unwanted pregnancy.
Upon examination her mood was inappropriately gay for the circumstances;
she was not able to give coherent history, thinking was slow, attention span
was poor, and ability to concentrate was impaired. She giggled a lot, com-
plained of headache, and her speech was slow and slurred.
Gradually she told the examiner about her forgetfulness, lack of caution
with her lovers, and the marked slip in her case work ability and presentation.
She also revealed that since the increase in marihuana smoking she was
frequently criticized by her superiors and friends for disheveled appearance,
forgetfulness, and silly laughter.
Because of her previous immaturity, intensive psychotherapy was recom-
mended. Within two months of beginning the treatment she stopped marihuana
smoking. Within three months there was a lessening of the confusion and
poor attention span. At the end of nine months the confusion, lack of concen-
tration, poor attention span, and inappropriate appearance had disappeared.
At the end of nine months her slurred speech was no longer evident. At the
end of two years of treatment she still had occasional headaches, and an occa-
sional "high period, exactly like those I had while smoking." These include the
giggling, a loss of time sense, and a devil-may-care attitude. We have noted
this return of a marihuana-like high in several of our chronic marihuana
smokers up to two years after smoking stopped.
SOME IMPLICATIONS
A topical review of the 13 individuals seen shows a definite correlation
between the presence of symptoms and cannabis use. Eight of the group
reported had taken no other drugs. It is unlikely that the minimal use of
other drugs reported in the remaining five could account for their symptoma-
tology. One of them used meprobamate infrequently, one used amphetamines
three times, and of the remaining three one had taken LSD only once, another
had taken it twice, and a third three times. Therefore, we thought it unlikely
412
that any drug other than cannabis could have been the causative agent in
producing the symptomatic changes in any of the 13 patients. The intensity of
symptoms and the presence of delusional content during use of the drug seemed
directly related to the frequency and length of time that cannabis had been
used. There also seemed to be some relationship between symptom intensity
and the strength of the drug that was used. Those who smoked hashish seemed
to be more symptomatic. The length of time necessary for the remission of
symptoms also appeared to be directly related to the duration and frequency
of smoking. In adition, the presence of residual symptoms months after
cessation of cannabis use showed some relationship of the symptom residual to
the duration and frequency of exposure. Lemberger et al. (7) have shown
that the chemical constituent A9 tetrahydrocannabinol is maintained in the
brain and other organs of humans for up to eight days after ingestion.
Mclsaac et al. (8) in 1971 showed with isotope labeled cannabis that concen-
tration of the drug occurred in the frontal lobes and cortices of monkeys.
Campbell et al. (2) in 1971 have pointed out that findings that indicate the
fat solubility of cannabis derivatives makes it likely that the accumulation of
this drug in nervous tissue would thereby cause a cumulative chemical effect.
This cumulative effect seemed to be demonstrated clinically by those cases in
this report who had relatively brief histories of cannabis use. In these indi-
viduals the biochemical effect is less likely to be confused by later structural
change. During the period of time between cessation of drug use and symptom
remission, those symptoms present are probably due to the effect of accumu-
lated chemical effect rather than structural change. In addition, patients one
through six all told of sometimes feeling some of the effects of cannabis for
several days after their last smoke. Rosenkrantz et al. (9) indicated that in
the brain tissue of all rats examined, there was a consistent severe loss of brain
protein and cell component UNA that play basic roles in brain function. The
occurrence of a stereotyped group of symptoms unrelated to psychological pre-
disposition in a number of individuals following chronic and extensive cannabis
use seems to us to at least imply the possibility of a similar biochemical
application in humans. In those cases where symptomatology, though dimin-
ished, was still present six months, nine months, and one year after drug
withdrawal raises an important possibility of more permanent structural
changes in the cerebral cortex, such as reported by Campbell et al. (2) in
all of their cases (all smoked three or more years), and all of whom showed
radiologic evidence of cerebral atrophy.
After seven years of clinical observation, we have become concerned that
marihuana and hashish use adversely affects cerebral functioning on a bio-
chemical basis. In the mildest cases there appears to be a temporary toxic
reaction when small amounts of cannabis are consumed over a short period
of time. However, in those individuals who demonstrate stereotyped sympto-
matology after prolonged and intensive cannabis use, the possibility of struc-
tural changes in the cerebral cortex must be raised.
The increasing accumulation of information indicates a need for a more
cautious approach to marihuana use and it becomes even more imperative
that there should be an increased number of investigative studies by other
medical specialty fields such as neurology, radiology, physiology, and pharma-
cology, in order to more clearly establish the qualitative and quantitative
effects on humans of this drug that has become so widely used in the
United States during the past ten years.
REFERENCES
(1) Kolansky H, Moore WT: Effects of marihuana on adolescents and young
adults. JAMA 216 :486-492, 1971.
(2) Campbell AMG, Evans M, Thomson JLG, et al : Cerebral atrophy in
young cannabis smokers. Lancet 2 :1219-1224. 1971.
(S) Kolansky H, Moore WT: Clinical effects of marihuana on the young.
Tnt J Psychiatry 10:55-67, 1972.
(4) Mareovitz E, Myers H J : The marihuana addict in the armv. War Med
6:382-391. 1944.
(5) Grinspoon L: Marihuana Reconsidered. New York, Bantam Books Inc,
1971.
413
(6) Melges FT, Tinklenberg JR, Hollister LE, et al : Marihuana and the
temporal span of awareness. Arch Gen Psychiatry 24 :564-567, 1971.
(7) Lemberger L, Silberstein SD, Axelrod J, et al : Marihuana: Studies on
the disposition and metabolism of delta-9-tetrahydrocannabinol in man. Science
170:1320-1322, 1970.
(8) Mclsaac WM, Fritchie GE, Idanapaan-Heikkila JE, et al : Distribution
of marihuana in monkey brain and concomitant behavioral effects Nature
230 : 593— 594 1971.
(9) Rosenkrantz H, Thomson GR. Schaeppi UH, et al : Acute oral toxicity
of cannabinoids in various species. Pharmacologist 19:105, 1971.
Cannabis as a Long-Acting Intoxicant*
Editorial Summary
(By Conrad J. Schwarz, M.B., Ch. B.)
1. Canadian, British and American national Commissions studying cannabis
in recent years have consistently agreed that it is a hazard to health and that
its use should be discouraged. These conclusions have been largely under-
reported by the media, which have focused most attention on the controversial
political, philosophical and legal discussions and recommendations.
2. A Thirteenth Century Medieval impression of the persistence of cannabis
in the human body for prolonged periods of time has recently been confirmed by
modern chemical tests.
3. Clinical observations suggest that this persistence of chemically active
ingredients in the human body is associated with ongoing psychological and
physical effects.
4. Physical and behavioral tolerance with increased dosage need can be
observed in regular cannabis users.
5. Studies suggest possible permanent cell changes in human lung and brain
tissue.
6. Health professionals should pay more attention to the continuing effects
of cannabis in regular users, and should encourage them to discontinue use,
which step will not infrequently bring about improvement in psychological and
physical health and thus demonstrate a presumptive relationship between
cannabis and the symptoms.
This paper will present some of the clinical and biochemical evidence which
indicates that ingredients of cannabis sativa have prolonged action in humans,
that the effects of this action are discernible in regular users, and that these
effects require the attention of the clinician in the assessment and treatment of
cannabis users.
This understanding has developed over about six years of clinical observation,
study of the literature, private, public and professional debate, and gradual
refinement of ideas in a series of published papers. (1-5)
It was only towards the end of this six years that there came to attention a
Thirteenth Century reference which anticipates the current understanding. Ro-
senthal (6, p. 100), translating from original manuscripts, describes the medi-
eval moslem recorder, Az Zarkashi, as stating the following of a certain Shaykh,
Ali Al-Hariri, a Thirteenth Century religious leader :
"This Hariri was very hard on habitual users of hashish. One of his followers
sent a messenger to him to upbraid him for his attitude. The Shayk said to the
messenger 'If the man mentioned is one of my followers, so that I have to
oblige him, let him give up hashish for 40 days until his body is free from it,
and 40 more days until he is rested from it after having become free. Then let
him come to me so that I shall inform him about it.' "
This observation can, of course, be dismissed by some because it is based only
on "clinical" observation, the author does not present a control group for
comparison and there is no demonstration in it of any direct cause-and-effect
relationship between hashish and the implied state of functioning of the indi-
vidual concerned. Outright rejection of such clinical impressions has been
common in the marihuana debate, but nonetheless cautionary clinical observa-
tions have persisted over the centuries.
* Paper read at the Annual Meeting of the North Pacific Society of Neurology and
Psychiatry, Vancouver, B.C., April 5, 1973.
414
For example, the original volumes of the British Indian Hemp Drugs Com-
mission Report of 1893^4 (7) give in considerable detail the verbatim testimony
of the 1,140 medical and nonmedical witnesses who appeared before it. Only
two declared that the excessive use of cannabis was not deleterious in the long
run, and only 243 (21.3%) were prepared to accept that even the moderate use
of cannabis was not deleterious.
In more recent times, the main bodies of the three major national commission
studies on cannabis, in Britain, America and Canada, contained a considerable
amount of evidence which led each of these commissions to conclude that the
use of marihuana and hashish should be discouraged. Despite the wide publicity
given to the humanitarian, philosophical and legal discussion of the use of
cannabis, the generally underreported clinical material in the main bodies of
these reports is largely of a serious cautionary nature, particularly in relation
to long term use.
The 1968 British Wootton Report (8) concluded that cannabis was a "dan-
gerous" drug (Section 70) and that "in the interests of public health, it is
necessary to maintain restrictions on the availability and use of this drug."
(Section 71)
Again, the President's Committee in the United States, in March, 1972, in its
first report (9), recommended "to the public and its policymakers a social
control policy, seeking to discourage marihuana use, while concentrating pri-
marily on prevention of heavy and very heavy use." (Page 134)
In May, 1972, the Commission of Inquiry into the Non-Medical Use of
Drugs (10), in Canada, concluded that in relation to cannabis "there must be
a continuing policy to discourage its use" (Page 301) on the grounds of indi-
vidual and public health concerns, which the Commission summarized as
follows :
"To sum up, then, it seems to us that there are at least four major grounds
for social concern : the probable harmful effects of cannabis on the maturing
process in adolescents ; the implications for safe driving arising from impair-
ment of cognitive functions and psychomotor abilities, from the additive inter-
action of cannabis and alcohol, and from the difficulties of recognizing or de-
tecting cannabis intoxication ; the possibility suggested by reports in other
countries and clinical observations on this Continent, that the long term, heavy
use of cannabis may result in a significant amount of mental deterioration and
disorder ; and the role played by cannabis in the development and spread of
multidrug use by stimulating a desire for drug experiences, and lowering inhi-
bitions about drug experimentation." (Page 274)
This much abbreviated general introduction indicates that a high level of
suspicion surrounding cannabis has survived over centuries. The question arises
as to whether or not there is any common factor underlying this shared opinion
arrived at in different countries, at different times and by different methods of
study. Since sociologists, philosophers, lawyers, religious leaders, politicians,
et cetera have advanced their theories, it does not seem inappropriate for a
clinician to suggest his. Quite against the tide of modern theory this clinician
would like to direct attention to the drug itself, not because it might be the only
factor, but because it is the factor which seems to have been most ignored to date.
The evidence that cannabis, in terms of human behavioral response, is a long-
acting intoxicant is based on the following points :
1. The active ingredient remains in the body for long periods of time.
2. The effects persist beyond the obvious stage of acute intoxication.
3. There are similarities between the acute state of intoxication and the
general functioning of the regular user.
4. Effects in the regular user show improvement on discontinuation of
cannabis.
5. Cumulation and tolerance can occur with cannabis.
6. In at least two systems of the body there is preliminary suggestion of
cellular change.
PERSISTENCE OF CANNABIS PRODUCTS IN HUMANS
The Lemberger group (11), using radioactive-labeled THC, demonstrated
that this active ingredient of cannabis persisted in human plasma for at least
three days in active form, and that metabolites continued to be excreted in
human feces for at least eight days. More recently, this group (12) has shown
that the metabolites of Delta-9-THC, particularly 11-hydroxy-THC, appear in
415
plasma very rapidly after inhalation, and somewhat more slowly after oral
administration. In both cases, the psychological effects reach a peak with peak
levels of the metabolite rather than with the peak levels of the Delta-9-THC
itself. From this, Lemberger has concluded that the psychological effects are
more likely to be due to the metabolite than to the original substance. The
significance of this is that the metabolites persist in the body longer than
Delta-9-THG, and if they are continually active, as suspected, this may explain
the prolongation of effects sometimes seen in users. It also offers a modern
biochemical basis for the Thirteenth Century observation of Al-Hariri.
PERSISTENCE OF CANNABIS EFFECTS IN HUMANS
In keeping with the biochemical findings of the Lemberger group, the acute
features of intoxication can persist beyond the average four hours generally
reported. If this occurs, the individual may continue in an acute confusional
state for several hours to several days, with fluctuating sensorial impairment
much more suggestive of a continuing toxic process than of an endogenous
psychotic rection (13). In this state there may be persistent minor physical
upsets and a continuation of a mild high, the latter often being described as a
subjective feeling of being "spaced out", with difficulties in concentration, at-
tention and immediate memory.
Similarities Between the Acutely Intoxicated Individual and the Regular
User
The acute effects of cannabis show similarities to some of the features which
have been ascribed to regular users. For example, impairment of immediate
memory, attention and concentration occur in the acute intoxicated state and
have been described as continuing characteristics of regular users (Ik, 15, 16).
On direct inquiry, such users not infrequently admit that memory is not as good
as it used to be. Names of friends and routine tasks may be forgotten, and there
may be a decline in the extent of vocabulary available to the individual so that
he may be unable to find what should be a familiar word.
The predominant feature of the acute state of intoxication is one of euphoria,
which is seldom defined but seems to apply to the general subjective state of
the individual, which is described as one of wellbeing, contentment and satis-
faction in the absence of external stimuli which would justify this feeling.
Some regular users demonstrate a feeling of contentment and acceptance of a
general life situation which objectively involves a diminution in real life
stimuli and a lower level of functioning than previously. Some regular users
remain happy within themselves as their work capacity, ambition, motivation,
living situation and personal hygiene decline. (14, 15, 16).
Other similarities between the acute state of intoxication and the general
functioning of the regular user involve the distorted sense of time, suspicious-
ness, paranoia and grandiosity, and also the mood changes.
These similarities have been presented in more detail elsewhere (5) and the
point may best be illustrated by contrasting and comparing two separate de-
scriptions of the different states.
Melges et al. (17), in describing the concept of temporal disintegration which
they regard as basic to acute marihuana intoxication, give this general de-
scription :
"The individual has difficulty in retaining, coordinating and serially indexing
those memories, perceptions and expectations that are relevant to the goal he is
pursuing." (P. 1118)
This statement seems to encompass and may even explain most of what
West (18) is saying in his sketch of certain regular users:
"The experienced clinician observes in many of these individuals personality
changes that seem to grow subtly over long periods of time : diminished drive,
lessened ambition, decreased motivation, apathy, shortened attention span,
distractibility, poor judgment, impaired communication skills, loss of effective-
ness, introversion, magical thinking, derealization and depersonalization, di-
minished capacity to carry out complex plans and prepare realistically for the
future, a peculiar fragmentation in the flow of thought, habit deterioration and
progressive loss of insight." (P. 461)
West concludes from this description :
"There is a clinical impression of organicity in this syndrome which I simply
cannot shake off or explain in any other fashion." (P. 461)
416
REVERSAL OF SYMPTOMATOLOGY ON DISCONTINUATION OF REGULAR USE
The general functioning of the regular user improves if he discontinues use.
Such improvement has been reported both in psychological features (5, 14, 15)
and in physical health. (19, 20) Users report back after two or three weeks of
abstinence from cannabis that they are feeling much better ("I hadn't realized
I was so tired previously."), thinking more clearly ("It's as if a fog I was not
aware of had lifted from my mind."), and beginning to pick up new interests
("I hadn't realized I had dropped so many old friends."). Memory is subjec-
tively improved, irritability is diminished, and sleep patterns which may have
been disturbed are normalized.
TOLERANCE
It has been stated that not only does tolerance not occur with cannabis,
but, in fact, reverse tolerance is tbe rule in that the individual who uses can-
nabis can come to require less than he needed at the beginning. This has been
subjectively reported fairly consistently, although its explanation has not been
clear. It may simply be that once one gets into regular use, one establishes con-
nections with a more reliable supplier, who provides more reliable material. On
the other hand, as past clinical observations and recent biochemical work have
suggested, it may be related to the fact that cannabis contains long-acting
chemicals which persist in the human body for a considerable period of time.
Thus in the initial stages, the regular user of cannabis may show reverse toler-
ance and need less simply because he still has some residue in his body and is
only topping up a partially empty gas tank.
Eventually, however, there are indications that actual tolerance can develop.
This is shown in the work of the Tennant group (19, 21) with American GIs in
Germany, a number of whom reported consistent doses over 50G of hashish
per month (500 marihuana cigarettes a month) ranging up to 600G per month
in some individuals (6,000 marihuana cigarettes a month). Miras (20) has
also confirmed that some of his patients in Greece require up to 6G of hashish
(60 marihuana cigarettes) in order to get high. Such responses suggest some
degree of physical and behavioral tolerance.
POSSIBILITY OF CELLULAR CHANGES
Finally, there are two aspects of the possible long term effects of cannabis
which suggest that what is generally a temporary, reversible state of low-
grade intoxication may at some point change to one of altered cell structure,
which may be of a more permanent nature.
The Tennant group have followed up their earlier clinical observations with
direct studies of lung tissue obtained from some of their heavy cannabis-using
soldiers. In a personal communication (21), Tennant has reported the micro-
scopic findings on lung biopsies from 17 of their cases and the complete autopsy
on one soldier user who died in an accident. The men were all American GIs
stationed in Germany. The accident victim and 16 of 17 others were white and
the age range was 18-22. They all reported very heavy use of hashish above a
level of 50G per month, which is equivalent to about 500 marihuana cigarettes
monthly or about 17 marihuana cigarettes daily.
On microscopic examination, the lung tissue examined showed no normal
epithelium in any samples ; instead, there was squamous cell metaplasia and
atypical cells in all samples, and basal cell hyperplasia and subepithelial gland
changes in most. These findings were compared to those of other studies of
cigarette smokers of different ages and of nonsmokers. The Tennant group
concluded "The respiratory epithelium of the hashish smokers . . . resembles
more closely that of heavy cigarette smokers of a much older age group than
either light smokers or nonsmokers. It also more closely resembles the epithe-
lium of patients who died of lung cancer."
In addition to these pathological changes in lung tissue, another study sug-
gests changes in the brain. Campbell et al. (16), in December, 1971, reported
that ten patients who had used cannabis regularly for periods ranging from 3
to 11 years, and whose average age was 22, showed clinical features of a chronic
brain syndrome similar to encephalitis lethargica, with memory impairment,
mood swings, headache and reversal of sleep pattern, and x-ray evidence on
pneumoencephalogram of cerebral atrophy. They concluded that other drug use
by these individuals was minimal and that there was no explanation for the
cerebral atrophy other than cannabis use. Their findings have been challenged
but have not, so far, been disproven.
417
CONCLUSION
A significant change occurs in the clinician's thinking and in his treatment
approach when he begins to look at regular users of cannabis as at least in
part suffering from a fluctuating, low-grade state of intoxication rather than
as solelv struggling to develop some new personality adjustment.
The personality change theory has been favored by a number of clinicians
who described it variously as a movement towards an amotivational syndrome
or a nonactivist role in relation to society. To some extent, regular users
themselves, while generally denying that cannabis could be a factor, have
accepted a similar identification of themselves as being antimaterialistic and
rejecting of society's standards.
These changes are interesting in that they can be conveniently interpreted
by clinicians as negative and by users as positive. For example, it is not too
difficult to see how the description by West (18) given above in a clinician's
words can be amended for use by some regular users — and even by some
observers — who see in cannabis use a growth experience for the individual. The
"diminished drive", "lessened ambition", "decreased motivation", and even
"apathy" are interpreted as being a justifiable reaction to a materialistic
society, which places heavy emphasis on money, aggression and resistance to
change. "Magical thinking" and experiences of "derealization and depersonali-
zation" as seen as creative steps towards finding oneself. The "diminished
capacity to prepare realistically for the future" becomes a politically motivated
rejection of society's values and goals. The "habit deterioration" takes on an
entirely different meaning when it is seen as a return to nature.
The importance of at least initially taking an organically oriented approach
to the regular user rather than conducting a psychodynamic exploration of his
personality lies in its therapeutic application. As Al-Hariri implied in the
Thirteenth Century (p. 100), there is not much point in trying to do psycho-
therapy with someone who is intoxicated. The state of intoxication must first
be ended and then the emerging basic personality can be explored.
In practice, this first step can, not infrequently, be achieved with the regular
cannabis user by any helping person who is alert to the possibility that a con-
tinuing biochemical process may be part of the observed phenomena. The clini-
cian, in particular, should not assume that an individual's cannabis use is
irrelevant to his seeking some kind of help, even for an apparently unrelated
condition.
A careful inquiry into the actual extent and frequency of use, a detailed
functional inquiry into the general physical state of the individual, and a
detailed mental status examination of the individual user will not infrequently
draw attention to the facts that (1) the user may be indulging in cannabis
much more frequently than his initial "only on social occasions" statement would
suggest, and (2) the drug does have persistent, fluctuating, low-grade effects
in relation to his psychological or physical functioning.
If these insights can be brought out from the individual himself, he may then
be agreeable to a trial discontinuation and even after a couple of weeks he may
note sufficient improvement in himself that he concludes either to reduce his use
considerably or even to discontinue use completely. In the light of the persistent,
cautionary clinical material which indicates that cannabis is a long-acting in-
toxicant, even the former would appear to be a justifiable exercise in preven-
tative medicine.
REFEEENCES
(1) Schwarz, C. J., Brit.Col.Med.J., 1967, 9, 274.
(2) Schwarz, C. J., Can.,Psychiat.Assoc.J., 1969, 14, 591.
(3) Schwarz, C. J., Brit.Col.Med.J., 1969, 11, 273.
(4) Schwarz, C. J., in Drug Abuse: Data and Debate (edited by P. H.
Blachley) C. C. Thomas, Springfield, 1970.
(5) Schwarz, C. J., in Marihuana: Debate and Data (edited by P. H. Blach-
ley) Continuing Educ.Pub., Oregon, 1972.
(6) Rosenthal, F., The Herb: Hashish versus Medieval Moslem Society, E. J.
Brill, Leiden, 1971.
(7) Report of the Indian Hemp Drugs Commission, 1893-94, Simla, India,
1894.
(8) Cannabis: Report by the Advisory Committee on Drug Dependence, Lon-
don, 1968.
(9) Marihuana : A Signal of Misunderstanding— First Report of the National
Commission on Marihuana and Drug Abuse, Washington, 1972.
418
(10) Cannabis: A Report of the Commission of Inquiry into the Non-medical
use of Drugs, Ottawa, 1972. . .
(11) Lemberger, L., Silberstein, S. D., Axelrod, J., and Kopm, I. J., Science,
1970, 170, 1320. ■
i2) Lemberger, L., Weiss, J. L., Watanabe, A. M., Galanter, I. M., Wyatt,
R J. and Cardon, P. V., New England J. Med., 1972, 286, 685.
(IS) Talbott, J. A., and Teague, J. W., J. A.M. A, 1969, 210, 299.
(lli) Kolansky, H., and Moore, W. T., J.A.M.A, 1972, 222, 35.
(15) Kornhaber, A., J.A.M.A., 1971, 215, 1988.
(16) Campbell, A. M. G. Evans, M., and Thomson, J. L. G., Lancet, 1971, 2,
1219
(17) Melges, F. T., Tinklenberg, J. R., Hollister, L. E. and Gillespie, H. K.,
Science, 1970, 168, 1118.
(18) West, L. J., Ann.Int.Med., 1970, 73, 449.
(19) Tennant, F. S., Preble, M., and Prendergast, T. J., J.A.M.A., 1971, 216,
1965. _ _
(20) Miras, C. J., In Drugs and Youth (edited by J. R. Wittenborn) C. C.
Thomas, Springfield, 1969.
(21) Guerry, R. L, Henderson, R. L, Tennant, F. S. and Johnston, W. W.,
(personal communication — to be published J.A.M.A.)
[From Microgram, Vol. VII, No. 2, February 1974]
A considerable controversy has arisen in recent months regarding the taxo-
nomic classification of marihuana.
Traditionally, marihuana has been regarded as being of the genus cannabis,
species sativa, with several agronomic varieties recognized within that species
among them indica, americana, and ruderalis. Drawing upon the body of knowl-
edge prevailing at that time, the framers of the original Marihuana Tax Act in
1937 wrote the definition of marihuana which is still in use in the Uniformed
Controlled Substances Act, to wit, ". . . all parts of the plant cannabis sativa
L . . ."
Recently, however, Dr. Richard E. Schultes, Professor of Botany, Harvard
University, has, as a result of research into the problem, arrived at the conclu-
sion that there are at least three species of the genus cannabis — indica, and
ruderalis, besides sativa. Although there are, in his view, sufOcient basic tax-
onomic differences between the three to legitimately classify them as species,
there are no constant differences in the resinous materials, most notably the
tetrahydrocannabinol (THC) content from one to the other. Also, the exact
species can only be determined if the whole plant is present for examination —
a circumstance rarely encountered in a forensic situation.
As a consequence, given this hypothesis, it cannot be determined with legal
certainty, on the average marihuana submission, whether or not cannabis
sativa, among the three possibilities, is present. Allthough a technical descrip-
tion of Dr. Schultes' work is beyond the scope of this communication, its impli-
cations are clear. Dr. Schultes has appeared on many occasions as a defense
expert witness. In a number of these occasions, his testimony has been rebutted
by several expert botanists, most notable among them Dr. Ernest Small of the
Central Experimental Farm, Biosystematics Research Institute, Canada Depart-
ment of Agriculture, Ottawa, Canada.
One major contention of Dr. Schultes is that the entire subject of the classifi-
cation of cannabis has not been fully explored or studied, and that the mono-
typic classification which is accepted by the bulk of the scientific community is
done so out of a basic ignorance of the subject. Dr. Small, however, has con-
ducted considerable research into this area, and has concluded that sativa is,
indeed, the only species of cannabis. The results of his research have been sub-
mitted for publication to the U.N. Bulletin on Narcotics.
Although the consensus of the scientific community remains in favor of the
monotypic classification, the issue will continue to be raised in court. Basically,
it can be argued that :
1. Given the prevailing opinion at the time the legislation was written ; given
also the fact that any of the purported species contains THC, it was the intent
of Congress to control marihuana, regardless of species.
419
2. The bulk of the scientific community still regards cannabis as monotypic.
Dr. Schultes represents basically a minority viewpoint, and his research has
been criticized by Dr. Small and others. Therefore, on a factual basis, Cannabis
may be regarded as monotypic.
There are, at this time, three rulings on the Federal level on the monotypic
nature of cannabis; the citations are as follows:
United States vs. John Moore (E.D.Pa. No. 69-137) 330 Fed. Supp. 684 (1970).
United States vs. Eric Honeyman, et al., (71-1035-RHS) Northern District,
California, 1972.
United States vs. Mitchell Rothberg, et al., (7-SR-164) 351 Fed. Supp. 1115
(1972). Eastern District, New York.
The latter case was argued before Judge John R. Bartels, Sr., in the Eastern
District of New York. It is interesting to note that after taking testimony for
the defense from Drs. Schultes and William Klein, of the St. Louis Botanical
Gardens, and Dr. Small for the prosecution, Judge Bartels retained the services
of Dr. Arthur Chronquist of the New York Botanical Gardens, who performed
a study of the conflicting testimony and other pertinent literature. His study
convinced him that 1 ". . . the casual opinion that I had . . . has been very con-
siderably firmed up as a strong opinion that there is only one species of
cannabis."
To date, cases involving transfer or possession of marihuana have been dis-
missed on a local level in Dade County, Florida and Washington, D.C. In a
recent decision, Judge Charles Halleck of the Superior Court of the District of
Columbia, dismissed charges of possession of cannabis on the grounds that the
statute failed to delineate the exact substance being proscribed ; Judge Halleck
had taken testimony from a botanist who recognized five different species of
cannabis.
Although this controversy transcends the expertise of the forensic chemist
or criminalist, he will be asked frequently, none the less, for advice from prose-
cutors faced with this defense. In these instances, they should be apprised of
the general outlines of each hypothesis and supplied with the various prece-
dents. Judges, for the most part, prefer to rule on issues such as this one on
precedent, rather than break unfamiliar legal ground. Also, most jurists attempt
to interpret the law in terms of the intent of the legislative branch at the time
they wrote he law. These circumstances tend to produce rulings favorable to
the prosecution on this issue. Clearly, given the fact that tetrahydrocannabinol
exists in all varities of cannabis in amounts which have no direct bearing on
the variety per se, this "species controversy" represents little more than an
attempt on the part of the defense to utilize scientific research of a relatively
academic nature to introduce a technicality into legal proceedings involving this
drug substance. In support of this viewpoint, Dr. Small has stated, "[T]he
consensus among botanical taxonomists [is] that "species" are arbitrary sub-
jective units, whose comprehensiveness depends simply on how the units are
defined." 2
MARIHUANA AND THE RADICAL LEFT
[Excerpts from the "Anarchists Cookbook"]
The Anakchist Cookbook
(By William Powell, with a prefatory note on Anarchism Today by
P. M. Bergman)
FOREWORD
This book is for the people of the United States of America. It is not written
for the members of fringe political groups, such as The Weathermen, or The
Minutemen. Those radical groups don't need this book. They already know
everything that's in here. If the real people of America, the silent majority,
1 Transcript of testimony of Arthur Chroncmist before Judge John R. Bartels, Sr.,
Federal District Court, Eastern District. New York, November 14, 1972.
2 Private communication, March 5, 1974.
420
are going to survive, they must educate themselves. That is the purpose of
this book.
In this day and age, ignorance is not only inexcusable, it is criminal and
perhaps fatal. The Anarchist Cookbook is not a revolutionary work in itself,
just as a gun cannot shoot, but I have a sincere hope that it may stir some
stagnant brain cells into action. If the people of the United States do not
protect themselves against the fascists, capitalists, and communists, they will
not be around much longer. Do I sound like an alarmist? Follow the process
of disintegration: from the most immediate capitalist pollution; through the
rising inflation, which is creating an atmosphere ripe for communism ; to the
final repression of the people by the fascists in power.
Maybe I use the term revolution too frequently in this book, without really
defining it. I will do so here. I do not particularly like any form of government
but, if the majority of the people seem to think that they are incapable of
governing themselves and want a government, then I think the principles the
United States was born with are about the best there are. So now revolution
comes to mean revitalization, bringing America back to where she was two
hundred years ago. This is the first time I've thought of myself as a re-
actionary.
I believe that the people in power — not only political power, but also
economic and social power — will not nonviolently give up that power to the
people. Power is not a material possession that be given, it is the ability to
act. Power must be taken, it is never given.
I hope that, by the time the two hundredth anniversary of The First
American Revolution rolls around, we will be able to look back at the sixties
and early seventies as a dark era in the great history of a free nation.
INTRODUCTION
The human race, throughout its long history, has always tried to uncover
the meaning or essence of certain ideas or concepts according to their par-
ticular frames of reference. This is also true of the twentieth century, but
man is traveling so fast and his frame of reference is becoming so large that
it is almost impossible to keep up with it. Throughout history, persons have
attempted to redefine and put dated definitions to currently prevalent questions :
This also has become increasingly difficult in this age of massive technological
discoveries coupled with a perpetual information and propaganda bombard-
ment by the media. So I feel that an attempt on my part to redefine anarchy
in terms of the twentieth century would be a pointless task. Such a pastime
is best left to the politicians and the academicians.
This is not the age of slender men in black capes lurking in alleyways with
round bombs, just as it is not the age of political discussions in a Munich
beer hall. This is a truly unique age, where the individual has become the
supreme agent of anarchist theory, without his even being aware of it.
Anarchy can no longer be defined as freedom from oppression or lack of
governmental control. It has gone further than that. It has become, especially
in the young people today, a state of mind, an essence of being. It can be
expressed as "doing their own thing," or maybe just simply having the choice
to do or not to do.
Anarchy or anarchistic theory is the only ideology that is in the least bit
optimistic. It places the full weight of responsibility where it should be — on
the shoulders of all the people, not just the select few. Its basic premise relies
on an unshakable faith in human nature, and the primary goodness of the
human race.
Today, young people are not blind idealists. They are perhaps the most ra-
tional and practical generation this country has ever seen. There is no great
movement comparable to the Russian or French revolutions. There are just a
great many indivduals working as entities unto themselves, to create a new
world order. Today has brought forth a great revival of anarchy in all fields :
politics, arts, music, education, and even to a small degree in business. Although
this surge of individualism is present, you won't find too many people willing
to call it anarchy. But that's just terminology.
An anarchist is not necessarily a revolutionary, although it is more common
than not that a person who has attempted to rid himself of exterior controls,
for the purpose of developing his own philosophy, will find himself oppressed.
421
This oppression may lead the individual to formulate ideas of insurrection
and revolution.
This book is for anarchists — those who feel able to discipline themselves —
on all the subjects (from drugs, to weapons, to explosives) that are currently
illegal and suppressed in this country. It is my firm belief that the only laws
an individual can truly respect and obey are those he instills in himself.
This is not a revolutionary book in any traditional sense, but its premise is
the sanctity of human dignity. If this human individual dignity and pride
cannot be attained in the existing social order, there is only one choice for a
real man, and that is revolution.
There will never be a traditional revolution in this country, in the sense of
the Russian or French revolutions. The revolution in this countrv has already
started. It is a multi-faceted battle on many different fronts. It is a battle
politically between the young freedom fighters in Chicago and the stagnant
system, represented by arthritic old men making laws they do not understand,
and making wars they have no feeling for. It is a battle between the poor
blacks and the rich employers. It is a battle between the artists and the
censors. It is a battle between the Black Panthers and the police. It is a battle
between the welfare mother and the bureaucracy of the city, and suprisingly
enough it encompasses the yearly battle between the taxpayer and the Internal
Revenue Service. All these battles are but part of a larger war, being fought
to liberate the minds and bodies of the people who feel freedom is the most
important concept in their lives.
If I could come out in this book and advocate complete revolution and the
violent overthrow of the United States of America, without being thrown in
jail, I would not have written The Anarchist Cookbook, and there would be
no need for it.
Read this book, but keep in mind that the topics written about here are
illegal and constitutes a threat. Also, more imnortantlv. almost all the recipes
are dangerous, especially to the individual who plays around with them without
knowing what he is doing. Use care, caution, and common sense. This book is
not for children or morons.
POT LOAF
1 packet onion soup mix 2 lbs. ground beef
1 (16 oz.) can whole peeled tomatoes 1 egg
y2 cup chopped grass 4 slices bread, crumbed
Mix all ingredients and shape into a loaf. Bake for one hour in 400-degree oven.
Serves about six.
CHILI BEAN POT
2 lbs. pinto beans Vi clove garlic
1 lb. bacon, cut into two-inch sections 1 cup chopped grass
2 cups red wine V2 cup mushrooms
4 tablespoons chili powder
Soak beans overnight in water. In a large pot pour boiling water over beans and
simmer for at least an hour, adding more water to keep beans covered. Now add
all other ingredients and continue to simmer for another three hours. Salt to
taste. Serves about ten.
BIRD STUFFING
5 cups rye bread crumbs % cup chopped onions
2 tablespoons poultry seasoning 3 tablespoons melted butter
y2 cup each of raisins and almonds % cup chopped grass
y2 cup celery 2 tablespoons red wine
Mix it all together, then stuff it in.
APPLE POT
4 apples (cored) 4 cherries
V2 cup brown sugar % cup chopped grass
% cup water 2 tablespoons cinnamon
Powder the grass in a blender, then mix grass with sugar and water. Stuff cores
with this paste. Sprinkle apples with cinnamon, and top with a cherry. Bake for
25 minutes at 350 degrees.
33-371 O - 74 - 29
422
POT BEOWNIES
1
1
%
i
i
y2 cup flour
3 tablespoons shortening
2 tablespoons honey
pinch of salt
14 teaspoon baking powder
y2 cup sugar
2 tablespoons corn syrup
Sift flour, baking powder, and salt together. Mix shortening, sugar, honey, syrup,
and egg. Then blend in chocolate and other ingredients, mix well. Spread in an
eight-inch pan and bake for 20 minutes at 350 degrees.
egg (beaten)
tablespoon water
cup grass
square melted chocolate
teaspoon vanilla
cup chopped nuts
BANANA BREAD
1 cup mashed bananas
2 cups sifted flour
% cup chopped grass
y2 teaspoon salt
1 cup chopped nuts
y2 cup shortening
2 eggs
1 teaspoon lemon juice
3 teaspoons baking powder
1 cup sugar
Mix the shortening and sugar, beat eggs, and add to mixture. Separately mix
bananas with lemon juice and add to the first mixture. Sift flour, salt, and baking
powder together, then mix all ingredients together. Bake for 1% hours at 375
degrees.
SESAME SEED COOKIES
3 oz. ground roast sesame seeds
3 tablespoons ground almonds
y^ teaspoon nutmeg
14 cup honey
% teaspoon ground ginger
y2 teaspoon cinnamon
14 oz. grass
Toast the grass until slightly brown and then crush it in a mortar. Mix crushed
grass with all other ingredients, in a skillet. Place skillet over low flame and
add 1 tablespoon of salt butter. Allow it to cook. When cool, roll mixture into
little balls and dip them into the sesame seeds.
If you happen to be in the country at a place where pot is being grown, here s
one of the greatest recipes you can try. Pick a medium-sized leaf off the marihuana
plant and dip it into a cup of drawn butter, add salt, and eat.
[From the Berkeley Barb, May 20, 1966]
Tukn On/Tune In/Dbop Out
(By Timothy Leary PhD)
INTRODUCTION
This is the first of a series of columns by Timothy Leary, Ph.D. spelling
out a theory and method of becoming a conscious person. The blue-print for
a new religion. The working plan for a new species. The subsequent columns
will present detailed, practical, day-by-day, step-by-step instructions, for
rearranging your life, for establishing a harmony with your nervous system,
your cells, your molecules and the multiple energy networks around you.
The lessons are designed to be decoded at several levels of consciousness.
They can be read when you are in a state of routine symbolic awareness.
They can (and should) be read when your symbolic mind is turned down and
your sense organs are turned on.
Check these words out with your naked sense endings; check them out
against your cellular wisdom.
wesson I
Turn on!
Tune in ! •,.
Drop out!
423
Lesson II
Turn on to your seven external sense organs and your seven internal sense
organs. Turn on to your cellular wisdom. Turn on to your molecular blue-prints.
Tune in to the natural energy that covers this planet.
Drop out Your body is not designed to deal with metal, stone, symbols,
machinery. Start an orderly, peaceful sequence of detaching yourself from
artifacts. Your symbol-addicted society tells you to turn off, cash in, cop out.
Your cells tell you to turn on, tune in, drop out.
Lesson III
Turn on! The human body is a galaxy of energy systems, memory banks,
communication networks. The current model of a billion-year experiment in
receiving, decoding and harmonizing with energy. The history of evolution is
stored in DNA strands buried in your cells and available to consciousness. It
is possible for the knowledgeable person to move consciousness precisely and
planfully to these various levels. You can "turn on" with or (partially)
without chemicals. In the next few months in these columns I shall teach
you how.
Tune in! The human body is designed to adapt smoothly to the other energy
systems in this planet. After you "tune in" you must be able to hook-up your
expanded consciousness in a harmonious flow with the external world. In the
next few months in these columns I shall teach you how to rearrange your
movements and your environment.
Drop out! Modern civilization is a dangerous, insane process-destructive of
man's natural potential, murderous to other species of life, symbol addicted,
anti-life. Drop out of the social game.
The generation of Americans under the age of thirty is a mutant species,
sharing territory with a dangerous, deviant species (i.e. those over the age of
thirty who are addicted to power, control and violence). To preserve your
sanity and return to harmonious order you must quit your attachments to
American society gracefully, lovingly, planfully.
Quit school. Present education methods are neurologically crippling and
antagonistic to your cellular wisdom. Quit school internally by turning on and
tuning in. When you have done this (and not before) quit school. For good.
American social institutions are made by robots for robots — lustful of and
observed by materials, things, dead symbols. Quit your job internally and
then (and not before) quit your job. For good.
It is possible to live in this planet without joining the anti-life social systems.
I shall teach you how.
Exercise I
Go into a serene environment — a quiet room, a hillside, a beach, a garden.
Bring with you an unopened tin can, a candle, a piece of fruit (sliced open
so the seed is visible). Have one shoe on and the other foot bare.
Observe these three objects and meditate on the fact that your body is two
billion years old.
[From Disorientation : Notes from the Underdog]
Drugs
"Some people would eat cow manure if someone said it would get them high.
At least it would kill them slowly." — Berkeley BARB
Drugs are an integral part of the culture, the life style, and the day-to-day
living of Berkeley. But that does not mean there are no problems or that
there aren't some important things to say about drug use.
The heavy stuff should probably be first. There are drug busts everywhere,
of course, but in Berkeley it's particularly tough. The establishment doesn't
really care that much about the drugs — it is the culture and politics with
which drugs are associated that trouble 'The Man.' He knows that they all
are connected.
What can you do to protect yourself :
(1) The key thing is not to give the cops an excuse ("probable cause") for
searching your house or car. One important thing in this respect is the smell
424
of pot— it carries a long way and judges accept this as reason for a search
without warrant. Burn incense, keep windows closed, stay away from rooms
near the street, etc.
(2) Stopping people in cars is common under the excuse of some minor traffic
violation, real or not. If this happens, driver should get out and walk to the
cop car while people in the car get rid of the evidence.
(3) Buy from dealers that you know personally. Making these precautions
a natural part of the drug ritual will pay off.
"Burns" do happen in Berkeley, but they can be avoided by: (1) Knowing
your dealer; (2) Staying ahead of your supply so you can try stuff before
you buy ; (3) Watching the underground rags for drug prices and markets so
you know fair prices. Watching out for fake grass, grass weaker than it's
'advertised to be,' and acid, mescaline, etc., cut with bad shit (some acid is
being cut with strychnine, a fine high but a poison and potentially addictive).
Unfortunately, "burns" are being systematically organized by the "Mafia"
(the underground capitalists).
"Your mind might think it's flying, baby, on those little pills, but you ought
to know it's dying "cause speed kills"— Canned Heat. Not only have speed,
heroine, and barbituates messed up people badly, but they can also destroy the
community. It was a speed-heroine-Mafla combination that turned beautiful
Haight into the horror it is today and the threat is increasing on the Berkeley
scene. Pot, acid, mescaline, psilocybin are the drugs of revolutionary people;
speed and heroine are the last gasp of decayed death trip America.
Good vibes now. Well, everybody has their own tastes, but acid still seems
to be the best, most complete trip. Mescaline is like acid but less a mind
trip, "milder" and a good pot-to-acid transition. Psyilocybin is hard to come
by, but worth an effort. Take good old dramamine before a mescaline trip and
avoid the stomach discomfort that sometimes occurs. M.D.A. is a new kind of
mescaline, a very very heavy mind trip that you have to be prepared for
but an incredible experience. Taking heavy drugs outside, especially in one of
the fantastic parks around, is almost always more far-out and an almost sure
guarantee of a good trip for the first time.
Bad trips. Keep with you the various numbers listed in the underground
papers for help — especially the Free Clinic and the various switchboards. Avoid
giving or taking any drugs to deal with a bad trip. This is especially serious
in the case of thorizine, which will probably be fatal if there was any STP
in what you originally took. Milder tranquilizers like Librium are OK but
the best cure is to talk somebody down. Reassure them, calm them, tell them
that you've had similar experiences and come out okay, etc. If it's you on
the bummer, find somebody to talk to, try to be calm, look around you for
things to groove on, try and groove on things that are burning you.
Society hates drugs because they can give people ideas and visions of beauty
and love that make them realize that this current society has to be brought
down and totally rebuilt. The final "burn" is when you let your trips all
become "commercialized" or escapist. Escapist trips become a necessity some-
times, and "psychedelic" trips with candles, glow balls, etc. can be fun but
if that's all that drugs mean, then society has kept you within its box — even
on drugs.
"We will continue to use drugs to inspire us to new visions of life knowing
that these visions can only be realized through revolutionary action" — Berkeley
Liberation Program. Freak out, dig it, and fight for a world where it is not
a bummer to come down.
Resolution on Cannabis of the General Council of the Canadian Medical
Association at Its 105th Annual Meeting in Montreal, P.Q. — June, 1972
Moved by : C. J. Schwarz, British Columbia
Second by : W. J. Corbett, British Columbia
Motion :
Whereas the Commission of Inquiry into the Non-Medical use of Drugs, like
the similar national study groups in Britain (the Wootton Committee, 1968) and
the United States (the National Commission on Marihuana and Drug Abuse,
1972) has clearly presented adequate evidence for its general conclusion that
in relation to cannabis there must be "A continuing policy to discourage its use"
425
(p 301) on the grounds of individual and public health concerns and whereas
the commission based this conclusion on evidence which led to the following
statement in its report "To sum up, then, it seems to us that there are at least
four major grounds for social concern: The probably harmful effects of can-
nabis on the maturing process in adolescents : The implications for safe driving
arising from impairment of cognitive functions and psychomotor abilities, from
the additive interaction of cannabis and alcohol, and from the difficulties of rec-
ognizing or detecting cannabis intoxication : the possibility suggested by reports
in other countries and clinical observations on this continent, that the long-term,
heavy use of cannabis may result in a significant amount of mental deterioration
and disorder : the role of cannabis in the development and spread of multi-drug
use by stimulating a desire for drug experiences and lowering inhibitions about
drug experimentation." (p. 274) and whereas the commission indicates else-
where in its reports that (A) there is growing concern that tolerance can
develop to cannabis with some individuals requiring stronger preparations or
increased amounts (pp. 119-213) : and (B) that there is already appearing on
the Canadian scene a significant shift from marihuana to hashish (pp. 169 and
188). Be it resolved that: In view of the above serious indicators of hazard to
health, the Canadian Medical Association is prepared to give the following
explicit guidance to the public at this time :
1. Our collective medical opinion is that the adolescent and adult public
should now be clearly advised against the informal use of cannabis, either in
the form of marihuana or hashish.
2. Those who disagree with this advice are urged to take the following steps :
(A) Familiarize themselves with the cautionary medical reports on cannabis
contained in the Canadian, British and American commission reports of recent
years.
(B) Refrain from encouraging others to use cannabis and specifically avoid
introducing new individuals to it.
(C) Users should undertake, if necessary with the help of a physician, an
objective review of their own mental and physical functioning with respect to
their use of cannabis.
Resolution on Cannabis of the General Council of the Canadian Medical
Association at Its 106th Annual Meeting in Vancouver, B.C. — June, 1973
Moved by : Dr. K. Hill
Seconded by : L. Cunningham
That a new resolution be offered as follows :
Whereas recent and ongoing studies of the long term effects of cannabis sup-
port the persistently cautionary clinical opinions of physicians over the years
and reinforce the conclusions of the recent national commission studies in
Canada, Britain and the United States, that the use of cannabis should be dis-
couraged on grounds of individual and public health concerns, Be it
Resolved, that the C.M.A. reaffirms its 1972 annual meeting resolution and
clearly advises the Canadian public against the non-medical use of cannabis.
Biographical Notes of Department of Defense Witnesses
David O. Cooke, Deputy Assistant Secretary of Defense (Administration)
Mr. Cooke has been involved in Defense management since 1958 when he was
a member of Secretary of Defense McElroy's task force on reorganization which
led to the passage of the DoD Reorganization Act of 1958. In 1959 he developed
a DoD policy reference book for Secretary of Defense Gates and in 1960 served
on special DoD reorganization study groups under Mr. Gates.
In January 1961 Mr. Cooke was assigned to the Office of Organizational and
Management Planning which Secretary McNamara established upon assuming
office. This was the office which did much of the preliminary work leading to
the major organizational changes that have taken place within the DoD since
1961. In the summer of 1964 Mr. Cooke assumed the position of Director of
Organizational and Management Planning within the Office of the Assistant
Secretary of Defense (Administration). On January 31. 1969 Mr. Cooke became
the Deputy Assistant Secretary of Defense (Administration) under the Assist-
ant Secretary of Defense (Administration). When the latter position was
disestablished, he was transferred to his present position under the Assistant
Secretary of Defense (Comptroller).
426
Mr. Cooke is a graduate of New York State University College at Buffalo,
New York (B.S., 1941) and received an M.S. from New York State University
at Albany, New York in 1942. He received his law degree from the George
Washington University Law School in 1950 where he was a member of the
Law Review and Order of the COIF. He is a member of the District of Columbia
Bar, the District of Columbia Court of Appeals, and the Court of Military
Appeals.
Mr. Cooke is a retired Captain, United States Navy. During his active duty
he served is a wide variety of assignment mainly involving legal duties.
Mr. Cooke is married to Marion McDonald Cooke, also a lawyer. They have
three children : Michele, Lot and David. He currently resides at 1412 23rd Road
South, Arlington, Virginia.
Mr. Cooke is a member of the American Bar Association, the U.S. Maritime
Law Association, the Federal Bar Association, and the Armed Forces Manage-
ment Association. Recently, he was appointed to the General Administration
Board, Graduate School, U.S. Department of Agriculture.
By virtue of his very high level experience in the Pentagon since 1957, Mr.
Cooke is familiar with Defense problems across the board and has developed
close personal relationships with most of the present civilian and military lead-
ers within DoD.
John F. Mazzuchi, Ph. D., Staff Assistant for Education and Information
Office of Drug and Alcohol Abuse Prevention
Date and place of birth —
June 28, 1940— Washington, DC.
Education —
BA (English) — University of Notre Dame, Notre Dame, Indiana — 1962.
MA (Counseling)— The Catholic University of America, Washington, D.C.
Ph.D. (Counseling) — The Catholic University of America, Washington, D.C.
Employment —
Marianapolis Preparatory School, Thompson, Connecticut, 1962 to 1967 —
Chairman of the Department of English ; Dean of Studies ; and School Counselor.
The Heights, Washington, D.C, 1969 and 1971— Instructor in the Summer
Seminar Program and Counselor for the Community Study Program.
The Catholic University of America, Washington, D.C, 1971 and 1972—
Graduate Teaching Assistant and Director of the Student Practicum in Coun-
seling.
Naval Personnel Research and Development Laboratory, Measurements Di-
vision, Washington, D.C, 1972 to 1973 — Counseling Research Psychologist in
the areas of Drug Abuse and Career Development.
Office of the Deputy Assistant Secretary of Defense for Drug and Alcohol
Abuse, Washington, D.C, 1973 to Present— Administrative Specialist for Drug
and Alcohol Abuse Education and Information.
Memberships —
Professional — The American Personnel and Guidance Association and The
National Vocational Guidance Association.
Civic — Board of Directors, Americana Center Community.
Publications —
The Marine Assignment Preference Schedule, Revised (MAPC). Approved
for use by the United States Marine Corps. 1972.
The Review of In-Country Experiences (revice). Approved for use by the
Department of the Navy. 1972 Co-author.
Determining the Attitudinal and Personality Correlates of Drug Abuse. Paper
presented at the National Convention of the American Personnel and Guidance
Association, San Diego, California. 1973 Co-author.
A Multivariate Comparison of Drug Users and Non-Users. Arthur C F.
Gilbert and John F. Mazzuchi, Naval Personnel Research and Development
Laboratory, Washington, D.C. 1973.
Granting Occupational Preference To Marine Recruits : A Solution or A
Problem? John F. Mazzuchi and Arthur C F. Gilbert. The Vocational Guidance
Quarterly (In Press).
Present duties —
Staff Assistant for Drug Education and Information. Primary Duties: to
participate in overall planning of goals and objectives for DoD drug and
alcohol abuse educational and information programs ; to develop and coordi-
427
nate policies and programs relating to the training of military personnel in the
fields of drug and alcohol abuse prevention and control and drug and alcohol
rehabilitation and counseling ; to develop new and revised educational material
for approval of supervisors and review committees; to review reports, make
surveys and develop evaluative criteria to assess the effectiveness and relevance
of materials in use. Secondary Duties — to maintain contact with other federal
agencies as well as other OSD elements and Service education and training
representatives on behalf of the Deputy Assistant Secretary to exchange views
and information ; to assist in the development of materials for release through
OIAF and public media ; to review for quality and relevance drug and alcohol
prevention films, pamphlets and other materials; to make on sight visits to
military bases to assist in the development and implementation of drug and
alcohol education programs.
Brig. Gen. William A. Temple
Brigadier General William A. Temple is Director of Special Investigations
and Commander of the Air Force Office of Special Investigations.
General Temple was born in Philadelphia, Pa., on Dec. 13, 1924. He attended
Indiana University for one year prior to entering the United States Military
Academy, West Point, N.Y., in 1943, from which he graduated with a bachelor
of science degree and commission as second lieutenant in 1946. He has a
bachelor of laws degree, 1951, and a master's degree in international relations,
1964, from George Washington University.
While a cadet at the Academy, he attended flying training and received his
pilot wings in 1946. He then went to multiengine transition flying school and
in November 1946 was assigned as a design and development officer with the
Air Proving Ground Command at Eglin Army Air Field, Fla. From August
1948 to July 1951 he attended the University of Minnesota for two years and
then George Washington University for one year where he received his law
degree.
General Temple then was named Assistant Judge Advocate for the Alaskan
Air Command with headquarters at Elmendorf, Alaska. In August 1953 he was
transferred to Headquarters Military Transport Service at Andrews Air Force
Base, Md., where he was Assistant Chief Pilot. From February 1955 to July
1958, he served as a Legislative Liaison action officer in the Office of the Secre-
tary of the Air Force.
He next attended B-47 Stratojet combat crew training and was transferred
to Homestead Air Force Base, Fla., where he served as B^7 aircraft com-
mander and operations officer in the 527th and 524th Bombardment Squadrons.
In July 1960 he was assigned to Headquarters Strategic Air Command (SAC)
at Offutt Air Force Base, Nebr., in the Directorate of Personnel where as Chief
of Boards he was responsible for the separation and board branch and flying
status branch. He entered the Air War College at Maxwell Air Force Base,
Ala., in August 1963.
After completion of B-52 Stratofortress combat crew training at Castle
Air Force Base, Calif., in November 1964, he was assigned to the 6th Strategic
Aerospace Wing at Walker Air Force Base, N. Mex., as Chief of the Programs
and Scheduling Branch and later was Chief of the Training Division.
General Temple returned to the Pentagon in March 1966 and was assigned to
the Office of the Secretary of Defense as an assistant for manpower and
reserve affairs. In November 1968 he was transferred to Griffiss Air Force
Base, N.Y., as Vice Commander of the 416th Bombardment Wing and later was
Commander. His next assignment was in May 1970 at McCoy Air Force Base,
Fla., as Commander of the 306th Bombardment Wing.
General Temple joined the Air Force Office of Special Investigations (OSI)
in August 1971, attended the Special Investigators Course, and served as Deputy
Director of Special Investigations. He became Director of Special Investigations
and Commander, Air Force Office of Special Investigations, in April 1972.
His military decorations and awards include the Legion of Merit with one
oak leaf cluster and the Air Force Commendation Medal with one oak leaf
cluster. He is a command pilot.
General Temple is married to the former Geraldine Henderson of Pansey,
Ala. They have five sons : John ; Michael ; Scott ; and twins, David and Donald.
He was promoted to the grade of brigadier general effective August 1, 1972,
with date of rank July 12, 1972 and has been selected for promotion to the
grade of major general.
428
Colonel Frank W. Zimmerman, Jr.
Native Texan.
Received MD degree from University of Texas Medical Branch, Galveston,
Texas, 1959.
Completed a general rotating internship at Wilford Hall USAF Medical
Center, Lackland AFB, TX, 1960.
Completed residency training in Neurology and Psychiatry at University of
Texas Medical Branch, Galveston, 1963.
Certified by the American Board of Psychiatry and Neurology in 1966.
Served as Chief, Inpatient Psychiatric Service, USAF Hospital Wiesbaden,
1963-67.
Served as Chief, Mental Health Services Branch, USAF Medical Center
Wright-Patterson, Wright-Patterson AFB, Ohio, 1967-70.
Came to Washington as Consultant in Psychiatry to AF Surgeon General
July 1970.
Elected Fellow, American Psychiatric Association, 1971.
David N. Planton (GS-14), Naval Investigative Service
Mr. David N. Planton was born in Ohio in 1925, and immediately following
graduation from high school, he enlisted in the U.S. Navy in 1943 as a seaman
recruit, through the V-12 program. He began his commissioned career in the
Navy following his graduation from Marquette University in 1945. While on
active duty, Mr. Planton served on various ships, but resigned from active duty
in 1948 to seek employment in the intelligence field.
His employment as a civilian Special Agent with Naval Intelligence began
at Jacksonville, Florida in 1950 and he has had a steady progression within the
Naval Investigative Service since that time as a criminal and counterintelligence
investigator. Past key assignments have been as the Assistant Supervising
Agent, Naval Investigative Service Office at Charleston, South Carolina, and as
the Supervising Agent of the Naval Investigative Service Office in New York
City.
Since January 1972, Mr. Planton (GS-14) has been the Head of the Criminal
Division of the Naval Investigative Service Headquarters at Alexandria, Vir-
ginia. In this position, he exercises technical direction, coordination, and control
of Naval Investigative Service resources in all operational activities involving
criminal matters and plans, coordinates and provides technical supervision of
criminal intelligence and neutralization programs with the mission of the Naval
Investigative Service.
Mr. Planton will report as the Supervising Agent of the Naval Investigative
Service Office in the Philippines in July 1974.
He retired from the Naval Intelligence Reserve in June 1973, as a Captain,
after nearly thirty years of Naval Service. He is married to the former Norma
Voncile Reid, of Jacksonville, Florida, and they have four children and two
grandchildren.
Stanley J. Kreider, Commander, Medical Corps, U.S. Navy
Present assignment — Assistant Head, Psychiatry Branch, Professional Divi-
sion, Bureau of Medicine and Surgery, Navy Department, Washington, D.C.
Previous military assignments — Naval Aviation Cadet, 1954—1955 ; Designated
Naval Aviator, September 1955; Attack Squadron Eighty-Six, 1955-1959; At-
tack Squadron Forty-Three, 1959-1960; and Fighter Squadron 725 (Reserve),
1961-1964.
Education — Illinois Wesleyan University, B.A., 1961 and University of Chi-
cago, M.D., 1965.
Professional training — Rotating Internship, Naval Hospital, Great Lakes, IL,
1965-1966 and Psychiatry Residency, Naval Hospital, Philadelphia, PA, 1966-
1969.
Professional assignments — Staff Psychiatrist, Naval Hospital, Philadelphia,
PA, July 1969-October 1969; Chief of Psychatry, Naval Support Activity Hos-
pital, Danang, Republic of Vietnam, November 1969-May 1970; Division Psy-
chiatrist, First Marine Division, Danang, Republic of Vietnam, May 1970-
July 1970; Head, Mental Health Unit, and Senior Assistant Medical Officer,
429
Medical Department, U.S. Naval Academy, Annapolis, MD, 1970-1973; and
Bureau of Medicine and Surgery, 1973-present. „,,.,..
Professional activities — American Medical Association ; Association of Military
Surgeons of the United States, Aerospace Medical Association; and American
Psychiatric Association.
Colonel Habold Tufts, Military Police Corps, United States Abmy Com-
mander, United States Army Criminal Investigation Command
Henry H. Tufts was born at Salem, Massachusetts, on 13 September 1917.
Following graduation from Peabody High School, Peabody, Massachusetts, he
attended Suffolk University, Boston, Massachusetts, graduating with a Juris
Doctor Degree in 1942.
His military career began on 3 February 1942 when he enlisted in the regular
Army. He served as a Corporal in the Field Artillery until he graduated from
Officer Candidate School on 3 December 1942 and was commissioned a Second
Lieutenant of Field Artillery.
From December 1942 until December 1944 he was assigned battery duties
with the 18th and the 693rd Field Artillery Battalion at Fort Sill, Oklahoma.
With the 693rd he prepared for overseas movement at the Desert Training
Center at Camp Iron Mountain, California. He was promoted to First Lieuten-
ant before deploying to the European Theater of Operations in Janury 1945.
While serving in the European Theater he commanded a battery of the 868th
Field Artillery Battalion. He returned to the United States in November 1945
and was separated from active duty in January 1946.
He reentered active duty in November 1947 as a First Lieutenant, Military
Police Corps. His first duty assignment was to the Military Police School
Advanced Course, then at Carlisle Barracks, Pennsylvania. Upon graduation
from the course he was assigned duties as a member of the Military Police
School Faculty. Initially assigned as an instructor in the Law Section of the
Investigations Department, he later became Chief of the Law Section. In
January 1949 he was promoted to Captain. In October 1950 he moved with the
Military Police School to Camp Gordon, Georgia.
He remained with the Military Police School at Camp Gordon until August
1952 when he was reassigned to the Provost Marshal Section of Headquarters,
U.S. Forces Austria. In this assignment he performed duties as a Military
Police Officer and was later assigned as the Assistant Provost Marshal of the
Command. He was promoted to Major in 1953. In June 1955 he returned from
overseas service to attend the Army Command and General Staff College at
Fort Leavenworth. Kansas. Following graduation from this school iji 1956 he
was assigned duties as the Provost Marshal and Commanding Officer of the
New England Military Police Detachment with Headquarters in Boston,
Massachusetts.
In November 1957 he was assigned as a personnel staff officer in the Office
of the Deputy Chief of Staff for Personnel, Headquarters, Department of the
Armv, Washington, D.C. He was promoted to Lieutenant Colonel in July
1960.
In July 1962 he was assigned as Provost Marshal of the 1st Cavalry Division
in Korea. In July 1963 he was reassigned to Headquarters, United States
Army Pacific in Hawaii where he was assigned duties as Theater Provost
Marshal. He was promoted to Colonel in July 1966.
In 1967 he was reassigned to the Military Police School at Fort Gordon,
Georgia. His initial assignment was as Director of Instruction. This was
followed later by duty as both Assistant Commandant and Commandant of
the Military Police School.
In November 1968 he was reassigned to Headquarters, Department of the
Army to be the Chief of the Planning Group for the centralization of CID
activities in the Army. In August 1969 he became the first Commanding Officer
of the United States Army Criminal Investigation Agencv. In September 1971,
he became the first Commanding Officer of the United States Criminal Investi-
gation Command, a worldwide investigatory body with Headquarters in
Washington. D.C.
Colonel Tufts was retired from the Regular Army in August 1971. Follow-
ing his retirement, he was immediately recalled to active duty at the direc-
430
tion of the President to continue serving as Commanding Officer of the Criminal
Investigation Command.
In addition to numerous campaign ribbons, Colonel Tufts has also been
awarded the Distinguished Service Medal for outstanding performance of
duty in a position of great responsibility. He also holds the Bronze Star Medal
and the Army Commendation Medal.
Colonel Tufts is married to the former Margret Lawrence. They have 3
children. They reside at 8509 Etta Drive, Springfield, Virginia.
Col. John J. Castellot, Sb.
Col. John J. Castellot, Sr., MD., M.C. graduated from The University of
Rochester in 1950 and The University of Rochester School of Medicine in
1954. He is a board certified specialist in internal medicine and a Fellow of
the American College of Physicians. He served in the Army as an enlisted
man in 1945-6 and has served as a Medical Corps officer from 1954 to the
present time. He has served at several station and general hospitals in CONUS
and Germany as a practicing internist. During 1971-2 he was the Medical
Consultant for the U.S. Army in Vietnam and supervised the medical aspects
of the alcohol and drug program there. Since his return in July 1972 Col.
Castellot has occupied the position of Chief, Alcohol and Drug Policy Office,
Office of the Army Surgeon General.
Colonel Wayne B. Sargent
Colonel Sargent graduated from the University of Florida in 1950 and entered
the Regular Army as an Infantry Officer. He has served in combat in Korea and
in the Republic of Vietnam. He has commanded a Mechanized Infantry Battalion
in Germany, an Aviation Battalion in Vietnam and a Brigade of the 2nd Infantry
Division in Korea. Colonel Sargent is a graduate of the Industrial College of the
Armed Forces, completing that program in 1972. Since September 4, 1973, he
has been the Chief of the Alcohol and Drug Policy Division, Office of the Deputy
Chief of Staff for Personnel, Department of the Army.
INDEX
(Note. — The Senate Internal Security Subcommittee attaches no significance
to the mere fact of the appearance of the name of an individual or organization
in this index. )
A
Page
Abapoulios, M. A 191
"Abnormalities of Mitosis, DNA Metabolism and Growth in Human Lung
Cultures Exposed to Smoke from Marihuana Cigarettes, and Their Simi-
larity With Alterations Evoked by Tobacco Cigarette Smoke" (article). 137
"Abnormalities of the Respiratory System in Hashish Smokers" (article)- 294
Abrams, General 207
Academic Press 72, 84, 349
Acapulco - 13
Acta Genetica et Statistica Medica (publication) 137
Acta Pharmaceutica Suecica (publication) 395
"Addiction — An Artificially Induced Drive" (book) 170
Addiction Research Foundation (Ontario) 183
"Addiction and Society" (book) vm, 170
"Adolescence and the Conflict of Generation" (book) 402
"Adverse Reactions Associated With Cannabis Products in India"
(article) 31
Afghanistan 4, 336
Agriculture, Department of - 318
Agurell, S 346, 395
Albert Einstein Medical Center vin, 154
al-Hariri, Ali 201, 413, 417
Alaska 316
Algeria 226
Alienating Influence of Marihuana, The (publication) 186
Allen, Marjorie A 85,86,110,349,350,353,356
Allentuck, S 402
American Academy of Child Psychiatry 155
American Board of Psychiatry and Neurology 155, 183
American Cancer Society 126
American Forces in South Vietnam 315
American Journal of Obstretrics and Gynecology (publication) 85,
110, 262, 349, 356
American Journal of Psychiatry (publication) 31, 171, 347, 368, 381, 382, 402
American Medical Association (AMA) vn, 30
American Orthopsychiatric Association 183
American Psychiatric Association 190
American Psychoanalytic Association 155
Ames, F 402
Amphoria (organization) 26
Amsterdam 335
"Anarchist Cook Book, The" (book) 227,419-421
Anderson, Samuel W 192
Andrews. J. C 356
Annals of Internal Medicine (publication) 31,236,356,382,418
Annals of the N.Y. Academy of Science 238, 346, 356, 381
Annapolis 1^
Aptheker, Bettina 229
Archibald, R 356
Archives of General Psychiatry (publication) 31,
54, 67, 290, 356, 368, 369, 382, 413
(i)
II
Page
Archives of Internationales Pharmacodynamie et de Therepie (publica-
tion) 368, 381
Archives of Neurology and Psychiatry 391
Archives of Otolaryngology (publication) 289
Arizona 197
Armand, Dr. Jean Pierre 94,104,113,347
Aronow, L 347
Aronowitz, Al 229
Artman, Charles (Charlie Brown) 212
Ashbury Films 26
Ashraf, Makil 16
Associated Press (AP) 263
Atlantic Coast 15
Atomic Energy Commission (AEC) 207
Augier 151
Australia 16
Australia-New Zealand Meeting (report) 31
Avant-Garde (publication) 227
Axelrod, Dr. Julius vm, ix, 199, 201, 206, 231, 238, 280, 344, 346, 347, 349
Testimony of 142-146
Babies Hospital, New York vn
Back, N 110
Bangkok 278, 320
Banham, J 391
Bantam Books, Inc 412
Barak 119
Bartels, Judge John R., Jr 3,4,12,419
Bateman 221
Baudelaire, Charles 211
Baumann, T 356
Beaconfield, J 349
Beaubrun, M , 31, 154
Beaumont Hospital 148
Becker, Howard S 221
Bedford College 395
Behavioral Science Research Foundation, Inc 367
Bejerot, Dr. Nils vm, xi, xvn, 107
Testimony of 170-177
Bellevue Hospital 151
Benabud 151
Bennett, Gordon 258
Ben-Zvi, Z 346
Bergman, P. M 419
Berkeley v, 2, 20, 22, 48, 49, 207, 212-215, 423, 424
Berkeley Barb (newspaper) 422, 423
Berkeley Daily Gazette (newspaper) 220,226
Berkeley (School Board) 28
Berkeley liberation program 424
Berkeley Uprising v
Bernstein, E 347
Berlin 88, 353
Berlin, C. M 356
Best, J. B 368,381
Bewley 174
Bexley Hospital 182
Bhagwat, A. W 368,381
"Bhang Psychosis" (article) 31
Biochemical Pharmacology (publication) 346
"Biochemistry, Schizophrenias and Affective Illnesses" (book) 368
Biological Psychiatry (publication) 368,381
Biophysical Society Abstracts (publication) 369,381
Biosystematics Research Institute 418
Ill
Page
Blanc, Dr. William A 94
Blanchard, Elmer *JJ
Blachley, P. H 4J£
Black Panther Party J°
Black Panthers z^ *f J
Bloom, A. D oojj
Bloom, D f5b
Bloom, G. E *5b
Bloomquist, Dr ^U
Blum, Dr. Richard l***
Bobbs-Merrill 402
Bock, N 355
Boegli, G 346
Borgen, C. A 119,356
Bose, B. C 368, d 81
Boston Globe (newspaper) 218,219
Bottel, Helen 216
Boyd, E. S 368,381
Braden, Tom 254
Braenden, Dr. Olav J 127, 138, 156
Brain (publication) 391
Braude, M. C 382
Braunsteiner, H 349
Brecker, Edward M 26, 93, 129, 259, 261
Brewer, C „ 392
Brill, Dr. Henry vii, xv, xvi, 42, 94, 236. 259
Testimony of 30-36
Brill, E. J 417
Brine, D. R 346
Bristol Royal Infirmary 383
Bristol Royal United Hospitals 383
Bristol, University of 391
British Columbia 200
Medical Journal, The 417
Narcotic Addiction Foundation 200
University of vra,21, 200
Student Health Service vni, 200
Medical Association vm, 205
Drug Habituation Committee 200
British Indian Hemp Drugs Commission Report 414
British Journal of Addiction (publication) 392
British Journal of Pharmacology (publication) 396
British Journal of Psychiatry (publication) 31
British Medical Journal (publication) 349
British Medical Research Council 71
British Pharmacological Society 71
Brodie, B. B 347
Bromberg, Dr. W 78, 84, 392
Bronberg, W 402
Brooker, H. E 391
Brotherhood of Eternal Love vi, 12, 228, 261
Brown, B. B 381
Buckley, William F., Jr 221
Buda, J 349
Buffalo, University of 84
Bulletin on Narcotics (publication) 31, 236
Burstein, S. H 346
C
Cabinet Committee on International Drug Control 319
Cairo 236
Cairo University viii, 176, 177
Calaveras County 19
California 26, 27, 225, 239, 273
IV
Page
California, University of xiv, 235
At Berkeley v, vn, vm, 18, 19, 206, 217, 222, 227-229
At Los Angeles 222, 304
Medical School 19
School of Public Health 304
San Francisco 109
Student Health Service (Berkeley) vn, 19, 29, 68, 329
Campbell, Dr. A. M. G__ x, 21, 62, 77, 156, 157, 160, 168, 232, 368, 383, 392, 412, 418
Cameron, I. L 349
Canada 1
180, 182, 184, 200, 203, 205, 250, 251, 255, 250, 258, 260, 263, 264
Department of Agriculture 418
National Commission on Labor Relations 250
Department of National Health and Welfare (Methadone Advisory
Committee) ; 200
Canadian Medical Association 201,203,205,261,424,425
Cancer Chemotherapy Reports (publication) 382
Cancer Research (publication) 349
"Cannabis and Its Derivatives" (book) 395
Cannabis : Report by the Advisory Committee on Drug Dependence 417
Captain, John 26
Cardiff Royal Infirmary 391
Cardon, P. V 418
Caribbean 17
Caroll, James 225
Carthage Foundation 244
"Case Against the Drugged Mind, The" (book) 183,186
Case, M. P 356
Case Western Reserve University 85
Castellot, Col. John J 46,287
Testimony of 314-340
C. C. Thomas Co 417,418
Cellular Immunology (publication) 349
Cerebral Atrophy in Young Cannabis Smokers (study) 118
Cheema, A. R L 349
Chicago 33, 421
"Childhood Antecedents of Alcohol and Drug Abuse" (Doctoral Disserta-
tion 304
"Child's Garden of Grass, A" (book) 23,24
Chin, Susan 192
China 174
Chopra, G. S 31
Christensen, C. W 368,381
Christensen, H. D 346
"Chromosome Breakage in Users of Marihuana" (article) 85,110
"Chromosomal Damage in Human Leukocytes Induced by Lysergic Acid
Diethylamide" (article) 110
Chronquist, Dr. Arthur 419
Ciba Pharmaceutical Co 351
City College of New York (CCNY) 142
Clark, W. Crawford 192
Claussen, U 395
Clay, Gen. Frank B 207,314,322,323
Testimony of 43-48
Cleveland 126
Clinical Electroencephology (publication) 368,380
Clinical & Experimental Immunology (publication) 349
Clinical Immunology of Japan (publication) 349
Clinical Pharmacology and Therapeutics (publication) 381
"Clinical and Psychological Effect of Marihuana in Man" (study) 216
Clinical Research (publication) 349
Clinical Toxicology (publication) ------- ^H>
Cohen, Dr. M. M 85, 110, 114, 1< 8, 349, 355
"Coleridge, on Coleridge and Opium" (book) *0'
Coleridge, Samuel Taylor 2^
Colombia 4' 1<J
Page
College de France 94
Columbia Daily Spectator (student newspaper) 263
Columbia Presbyterian Medical Center 85
Columbia University vii, vin, 93, 94, 126, 146, 148, 190, 202, 225, 263, 341, 347
College of Physicians and Surgeons vii, 50, 92-94, 104, 109, 190, 191, 202
Psychiatric Institute 50
Columbus, N. Mex 6
Comitas 154
Commission of Inquiry into the Non-Medical Use of Drugs 184, 414, 418, 424
Commissioner of Customs 315
Committee on Alcoholism and Drug Abuse 36
Committee on Alcoholism and Drug Dependence 402
Committee on Drug Dependence 71
Committee for the Investigation of Cannabis Consumption 177
Committee for a Sane Drug Policy (SANE) 262
Communist Party 229
Communists 229
"Comparison of Marihuana Users and Non-Users, A" (article) 218
Comprehensive Psychiatry (publication) 192
"Computers and Electronic Devices in Psychiatry" (book) 368, 381
Constable, Rosalind 229
Consumers Union 26, 219, 220, 254, 257, 259, 260, 261, 264
Consumers Union Report 223
Continuing Education Publications 417
Cooke, David O 151, 287, 425, 426
Testimony of 314-340
Corbett, W. J 424
Corey, J. J 356
Costa, E 347
Council on Mental Health 402
Cowan, Keith 199, 209, 234, 337
Testimony of 250-264
Crabtree, R. F 346
Crompton 236
Cueto, C 347
Cunningham, L 425
D
Dade County, Fla 419
Dahnke, G. S 356
Daigle. H. J 367
Daily Californian (student newspaper) 19, 22, 220
Dale. W. B 347
Daul, Dr. Carolyn 95
Davis 119
Davis, Dr 26
Davis, H 391
Davis, Dr. Joseph 300, 301
Davis, W. M 356
Davison, Gen. Michael 277, 288, 313
DAWN (Drug Abuse Warning Network) 298
deBalbian, Verster F 368, 381
"Deception of Drugs, The" (article) 250
"Deceased Amounts of Desoxyribose Nucleic Acid (DNA) in Male Germ
Cells as a Possible Cause of Human Infertility" (article) 137
Deliyannakis, E ; 368, 380
Denman, A. M 349
Department of Defense (DOD) __xrx. 43. 45. 46. 250. 271. 278. 313-319. 321. 324, 337
"Depression of Plasma Testosterone Levels After Chronic Intensive Mari-
hauana Use" (article) 120, 161
de Quincey. Thomas 211
DeSoize, Dr 101
Detroit 253
Detroit Free Press (newspaper) 222,244
Diamond, L. K 356
VI
Page
Dietrich, P 349
Dingell, J. V 346
Dirty Speech Movement — ▼
Diseases of the Nervous System (publication) 368, 382
Disorientation (publication) 423
Dohrn, Jennifer 226
Doll, Henri G JE»!K
Domino, E. F 369, 380
Donner Laboratory of Medical Physics vni, 206
Doorenbos, Dr. Norman VI
"Doors of Perception" (essay) 211
Drewes, H. R 346
"Drug Abuse: Data and Debate" (book) 417
Drug Abuse Development File 321
"Drug Abuse in Different Cultural Groups in Jamaica" (article) 31
"Drug Abuse as a Factor" (book) 190
Drug Enforcement Administration (DEA) v,
xm, 2-4, 6, 15-17, 41, 47, 195, 244, 268, 334, 337
"Drug Scene, The" (book) 36
"Drug Use and Its Relations to Alcohol and Cigarette Consumption in the
U.S. Military Community of West Germany" (article) 290
"Drugs of Abuse: An Introduction to Their Actions and Potential Haz-
ards" (pamphlet) 220
Drugs and the Cell Cycle (publication) 349
"Drugs in Society" (bulletin) 262,395
Duncan, E. H. L 391
Dupont, Dr 307, 337
Durham, W. F 347
E
East India Co 211
Eastland, Senator James O v-xx, 1-48, 341
Eddy, Dr J78,
Edelson, Edward . 217
"Effect of Opium Alkaloids on Mitosis and DNA Synthesis" (article) 114
"Effect of Oral Administration of Delta-9 THC on Memory, Speech and
Perception of Thermal Stimulation" (article) 192
"Effectiveness of Drug Education" (article) 302
"Effects of Grass, The" (book) 23
"Effects of Marihuana on Adolescents and Young Adults" (article) 397
"Effects of Marihuana and Tobacco Smoke on DNA and Chromosomal
Complement in Human Lung Explants" (article) 137
"Effects of Marihuana and Tobacco Smoke on Human Lung Physiology"
(article) 114
"Effects of Sensual Drugs on Behavior: Clues to the Function of the
Brain" (article) 250
Efron, Edith 225
Egeberg, Dr. Roger O 221
Egozcue, J 349, 356
Egypt VIII, 177, 284
Eissler, S 402
"Electrical Studies on the Unanesthetized Brain" (book) 368
Electroencephalography and Clinical Neurophysiology (publication) — 380,381
Electronics Engineering Co 358
Ellington H9
England x, 2, 16, 83, 232, 255, 262
Englert, L. F 346,391
Eros and Civilization (publication) 212
Esquire (magazine) ^ 223
Esser, Dr. Robert A 94
Europe xix, 288, 306, 318. 319, 320, 322, 323, 333-35
Evans, K. T 391
Evans, Dr. M 368,383,392,412,418
"Evils' of Marihuana— More Fantasy Than Fact?" (article) 32
Excerpta Med. Int. Congr. Ser. (publication) 349
VII
F Page
Fairbairn, Dr 258, 393, 395, 396
Fanconi, G 356
Far East 172, 337
FCC (Federal Communications Commission) 225
Federal Bureau of Narcotics 3
Federal Drug Administration (FDA) vii
Federation Proceedings (Federation of American Societies for Experi-
mental Biology) 368, 369, 380, 381, 395
Fentiman, A. F 346
Filthy Speech Movement 212, 215
First American Revolution 420
Fitzgerald, M. Y 349
Fitzhugh, O. G 347
Fliege, K 392
Florida 5, 9, 17
Department of Law Enforcement 5
Foltz, R. L 346
Fontana, C. J 357,367,368,381
Ford Foundation 256
Forney, R. B 346
Fort, Dr. Joel xiv, 220, 222, 224, 225
Fort Pierce 15
Founds, W. L., Jr 381
Fourth Field Army Hospital 154
Framingham studies 103
France 15, 16,251
Frankfurt 333
Frederick Ayer Foundation 126
Free Speech Movement 212, 215
Freidenthal, R. I 346
Freireich, E. J 382
French Revolution 420, 421
Frenchay Hospital 383
Freud, A 402
Frick, Dr. Henry C 94
Fritchie, G. E 346, 391, 413
Frosch, W. A 355
Fullerton, P. M 391
"Future Shock" (book) 229
G
Gaensler, E. A 349
Gaines, T. B 347
Gainesville Marihuana Dealers Association 5
Galanter, I. M 418
Galen 120
Gallent, D. M 367
Gallatin (Coast Guard Cutter) 17
Gardner, L. I 356
Gehan, E. A 382
Geneva 177
George Washington University 142
Georgetown University (School of Medicine) 154
Gerald, P. S 356
Gerber 119
German Government 312
German, J 356
Germany xiii,
xix, 45, 47, 202, 207, 270, 271, 276, 278, 279, 281, 296, 297, 310, 311,
318, 320, 323, 336, 416
Germany, Federal Republic of 320,332
Gershon, S 402
Gibbs, F. A 368,380
Gidley, J. T 346
Gill, E. W 391
Gillespie, H. K 369,391
33-371 O - 74 - 30
VIII
Page
Gilniour, D. G 85,349,350,356
Gingras, Dr. Gustav 261
Ginsberg, Allen 212, 215, 229
Ginbsurg, J 349
Glasgow, University of 200
Glick, S. D 391
Goode, E 178, 264, 395
Goodman, Paul 212
Gordon Town 148
Gorodetzky, C. W 395,402
Gould, I. A 349
Great Britain 174, 251, 256
Greece 31, 243, 258, 416
Green 178
Greenfield 151
Green wald, L xiv
Griffin, Donald 15
Griffin, John 15
Grinspoon, Dr. Lester 93,139,217,218,223,224,252,262-264,412
Groesbeck, C. J 54,293,382
Grossman, William 31
Grune & Stratton, Inc 368, 381
Guerrero-Figueroa, R 382
Guerry, Maj. Roderick L 294, 302, 418
Gurney, Senator Edward J 49-141, 147-197, 341, 392
H
Hadden, E. M 349
Hadden, J. W 349
Hadley, K 396
Hahnemann Medical College vm, 155
Haight-Ashbury 213, 424
Haine, S. E 381
Haines , 178
Haislip, Gene R 3
Hall, A. J 391
Hall. Dr. John A. S vn, x, xi, 168
Testimony of 147-154
Halleck, Judge Charles 419
Harbison 119
Harmon, J 191
Harper (magazine) 229
Harper & Row 368,381
Harris, Dr. Louis S ix, 395
Hartmann, D 402
Hartmann, H 402
Harvard University 139, 190, 211, 217, 218, 252. 418
Children's Cancer Research Foundation 126
Children's Medical Center 126
Medical School 36, 215
Harvard University Press _. 217, 368, 381, 382
"Hashish Bronchitis" (article) 289
Hauser, H 381
Hawaii 315
Hayes, W. J 347
Health, Education, and Welfare (HEW) 195-197,222,223,243,283-284
Third annual report 241, 242, 243, 244
Heath, Dr. Robert G vin,
x. 75. 77. 78, 95, 96, 145, 146, 180, 210, 238, 243, 356, 357, 358, 367-
369, 381-383
Testimony of 50-70
"Heaven and Hell" (essay) 211
Hecht, F 356
Heidelberg k 333
IX
Page
Heinrich, R 381
Helsinki „;"^, tlL
Henderson, Dr. R. L 289,294,418
"Herb, The: Hashish Versus Medieval Moslem Society" (book) 417
Herin,' R. A 368' o?i
Hersh, E. A 349
Hewlett, J. H. G 180
Heyndrickx, A «3
"High Priest" (book) 212,215
Hill, Dr. K 425
Himwich, H. E 368
Hindmarch, I 393, 395
Hirschhorn, K 355, 356
Ho, B. T 346,391
Hockman, C. H 368, 380
Hogben, A. M 347
Hollister, L. E 21,179,369,381,391,413,418
Holmes, Justice 225
Holstein 174
Hong Kong 320, 337
Hospital Marie Lannelongue (Paris) 93
Houlton, Martin Williard 6
House Committee on Foreign Affairs 315
Houtt, A. D 380
Hraoui, Salim 16
Hsu, Dr 101
Huber, H 349
"Human Cytogenetics" (book) 85
Hunter, R 391
Huott, A. D 368
Hurtwitz, L. S 391
Huxley, Aldous 211
Hyman, Dr. Allen I 94
Hyman, Dr. George A 94
I
Idanapaan-Heikkila, J. E 391, 413
Illinois Bar Association 256
IMS Company 298
"In the Beginning, Leary Turned on Ginsberg and Ginsberg Decided to
Turn on the Whole World" (article) 223
"In Drugs and Youth" (book) 418
India 31, 201
Indian Hemp Drugs Commission Report 201
"Inhibition of Cellular Mediated Immunity in Marihuana Smokers"
(article) 31, 113
Institute for Experimental Cancer Research vn
Institute of Mental Hygiene (New Orleans) 367
Institute of Philadelphia Association for Psychoanalysis viii, 155, 396
Institute of Psychiatry 180
Internal Revenue Service 5,421
International Council on Alcohol and Drug Addictions 177
International Journal of Addiction (publication) 191,290
International Journal of Neuropsychiatry 51, 368, 381, 396, 412
International Opium Conference (2d) 170
International Review of Neurobiology (publication) 368
International Universities Press 402
Inui, N 137
Iran 336
Irwin & Co., Ltd 186
Irwin, Samuel 220, 356
Isbell, H 395, 402
Italy xix, 312
Itil, T. M 381
J Page
Jacksonville 15
Jacobsen, 0. B 88, 353, 356
Jaffe, Joseph 192
Jamaica 4, 5, 9, 30, 124, 147-149, 151-153, 243, 272
Ministry of Health 148
Psychiatric News (publication) 31
Japan xix, 172, 317
Jarvik, M. E 391
Jarvis, J. A 356
Jasinski, D 395, 402
Jerominski, Leslie 355
John S. B 357, 368, 381
John Wiley & Sons, Inc 250
Johnston, W. W 418
Joint Military Customs Group 317
Jones, G 396
Jones, Dr. Hardin B viii, xi, 48, 199, 311, 331
Testimony of 206-286
Jones, Mrs. Hardin 207
Jones, Helen C 250
Journal of Behavioral Neuropsychiatry 402
Journal of Drug Issues 256
Journal of Mental Science 402
Journal of Nervous and Mental Disease 368, 381
Journal of Neurology, Neurosurgery, Psychology 391
Journal of Neuropharmacology 67
Journal of Pharmaceutical Science 395, 396
Journal of Pharmacology, Belgium 73
Journal of Pharmacology and Experimental Therapeutics 347, 368, 381
Journal of Pharmacy & Pharmacology 346, 347, 375, 396
Journal of the American Chemical Society 346
Journal of the American Medical Association (JAMA) 78,
88, 156-158, 160, 166, 263, 289, 347, 356, 368, 369, 380, 382, 391, 396,
402, 412, 418
Justice Department 3
K
Kaiser Hospital 19
Kalant, H 368, 380
Kalman, P 392
Kamata, N 349
Kamin, Malcolm S 256
Kaplan, E. H 402
Kaplan, John 215, 219, 223
Karachi, Pakistan 9, 16
Karls, Dr. Joannes H 94
Karolinska Institute viii, 170
Kaymakealan, S 31
Keeler, M. H 347,381,382
Keio University 109
Kennedy, F 391
Kerouac . 212
Kif in Morocco (article) 191
King, Dr. Donald W 94
King, S 356
King's College 147
Kingston Hospital, Jamaica vti, 147, 149
Kingston, Jamaica 148, 151
Kiplinger, G. F 381
Kitty Hawk (ship) 331
Kitzinger 151
Klausner, H. A 346
Klein, Dr. William 419
Kline, N 368, 381
XI
Page
Kolansky, Dr. Harold vni, x, xi, 21, 82, 193, 238, 368, 382, 391, 396, 402, 412, 418
Testimony of 154-169
Koler, R. D 356
Koloder, Robert M 117
Kolodny Dr. Robert vm, x, xi, 47, 186, 191, 240, 280, 392
Testimony of 117-126
Kopin, I. J 346,418
Korea 154, 317
Kornhaber, A 418
Korte, F 395
Kralik, P. M 346
Kreider, Comdr. S. J 287,428
Testimony of 314-340
Kreuz, David S 344,349
Kunysz, Terry J 85, 110, 349
Kunze, F. M 347
Kurland, A. A 356
L
LaGuardia, Mayor 83
LaGuardia report _ 172
Lancet (publication) 62, 156, 356, 368, 383, 392, 412, 418
Lang, S. Y 356
Laska, E 368, _81
Laug, E. P 347
Lausanne, Switzerland ^^ xz£
University of 127,148
League of Nations 106
Leander, K 395
"Learning To Live With Drug Abuse" (article) 25b
Leary, Dr. Timothy vi, xv, 12, 212, 215, 223, 224, 226, 228, 257, 261, 422
Lebanon — 4' 16
Le Dain Commission (National Commission on the Non-Medical Use of
Drugs) 80, 205, 251, 255, 257, 258, 263
Le Dain Report 188> 260, 261
Leeds 393, 395
LeFebure, Claude 94> £*}■
Leighty, E. G 346
Lele, K. P.
356
Lemberger,"Dr."L ix, 160, 346, 413, 414, 418
Leonard, John 93, 178
Leuchtenberger, Dr. Cecile vn, rx, x, 75, 114, 150, 303, 349, 395
Testimony of 126~™
Leuchtenberger. Dr. Rudolf 114, 127, 129, 135, 137, 349, 395
Licit and Illicit Drugs (publication) 219, 254, 259, 261
Liebmann, J. A 395, 396
Life Sciences (publication) 346, 382
Lindberg JJ2
Ling JJ9
Lippman, Walter 257
Liptzin, M. B 381
Litt, Dr. I. F 114
"Little Red School Book, The" (book) 229
Lloyd, B. J., Jr 369,380
London - 177, 180, 182, 393, 395
Medical School 148
School of Hygiene 176
University of 147, 176, 177, 255, 395
Los Angeles 288, 289, 306
Free Press (underground newspaper) 226
Louisiana 17
Louria, Dr. Donald B TO, 260
Testimony of ^ooo
Love, Kenny 229
XII
Page
Lund, Sweden 177
University 177
Lustick, L. S 357,369,381
Lyle Stuart, Inc 227
Mc
McAllister, Dr. Ferdinand F 94
McClean, D. K 349
McGill University 250
McGlothin 151, 178
Mclsaac, W. M 160,346,391,413
McLeod, M. J 356
McManus, J 349
McNamara, Robert S 321
M
MacLean, J. R 356
Magus, R. D 395
Mailer, Norman 229
Maine, Col 337
Malaysia 320
Malcolm, Dr. Andrew vin, xi, xvi, 197, 230, 234, 329, 332
Testimony of 182-189
Malitz, Sidney 192
Manger, Dr. William M 94
Manila 320
Manno, J. E 381
Mantilla-Plata 119
Moaists 229
Marcovitz, E 412
Marcuse, Herbert 212
Mark, Dr. Lester C 94,347
"Marihuana" (article) 217
"Marihuana" (book) 72> 84
"Marihuana— A Signal of Misunderstanding" (publication) 30
"Marihuana: Debate and Data" (book) 417
"Marihuana, Deceptive Weed" (book) 93, 186, 263
"Marihuana Flashbacks" (article) J>1
"Marihuana — The New Prohibition" (book) 215, 219, 223
"Marihuana Papers, The" (book) 402
"Marihuana Problem in the City of New York, The" (article) 402
"Marihuana Reconsidered" (book) 139, 217, 412
Marinello, M. J JljJ
Maruffo, C. A 35°
Masters & Johnson 47, 240
Masters, Dr. William H 47, 117, 122, 186, 240, 280
Mathews, C. G 391
Max Planck Institute of Psychiatry 177
Maximilian, C 3^6
Mayor's Advisory Committee on Narcotics Addiction (Washington, D.C.)_ 223
Mazzuchi, Dr. John F 287, 426
Testimony of 314-340
Mead, Dr. Margaret 221
Meade-Johnson VI
Mechoulam, Dr. R 72, 84, 260, 346
Media Support Committee 338
"Medical Aspects of Drug Abuse" (book) 190
Medical Economics (publication) 256, 259
"Medical Manifestations Associated With Hashish" (article) 289
Medical Research Council 71, 84
Medical Service Digest (publication) 250
Medical Society of New York County 36
Medical Society of New York State 36
Medical Tribune (publication) 243,244
Melges, F. T 159,369,391,413,415,418
Menezes, F 346
XIII
Page
Merari 119
Meritt, D. A 368,381
Mexico 4, 6, 13, 197, 272
Miami 5, 9, 15
Miami, University of (Medical School) 300
Michelangelo (ship) 15
Michigan, University of 252
Mickle, W. A 368
Microgram (publication) 418
Mideast v, 124, 172, 174, 201, 334
Middletown, E 349
Mikuriya 224
Milby, W. E ^ 356
Military Assistance and Advisory Group (Iran) 336
Miller, R. W 356
Milstein, Dr. M 114
Minnesota, University of (Medical School) 93
Miras, Dr. C. J 119,156,395,418
Mississippi, University of vi
School of Pharmacy vi
Research Institute of Pharmaceutical Sciences vi
Missouri, University of 310
Munich 177
Murphree, H. B 381
Monroe, R. R 381
Montagu, Ashley 229
Moore, Dr. William T vm, x, 21, 82, 193. 238, 368, 382, 391, 412, 418
Testimony of 154-169
Moreau 241
Morishima, Dr. Akira vn, ix, 74, 94, 96, 104, 105, 113, 114, 125, 263, 347, 349
Testimony of 109-117
Morocco 4, 5, 17, 31, 94, 107
"Morphological and Cytochemical Effects of Marihuana Cigarette Smoke
on Epitheliod Cells of Lung Explants From Mice" (article) 129
N
Nagel, M. D 349
Nahas, Dr. Gabriel G vn,
ix, xx, 31, 74, 113, 115, 116, 146, 178, 179, 186, 191, 202, 260, 262,
263, 341, 347, 348
Testimony of 92-108
Nakazawa, K 347
Naples, Italy 320
Nash, Linda 391
National Commission on Marihuana and Drug Abuse 30,
31, 41, 94, 95, 157, 158, 161, 167, 168, 255, 259, 401-403, 414, 424
First Report 417
National Commission on the Non-Medical Use of Drugs (see also Le Dain
Commission) 251
National Coordinating Council for Drug Abuse Education 26,260
National Drug Reporter (newsletter) 26,260
National Heart Institute 142
National Institute for Drug Abuse (NIDA) 307,337
National Institute of Mental Health (NIMH) vi,
vm, ix, 51, 76, 94, 101, 143, 153, 161, 243, 344, 401
Ad Hoc Advisory Committee on Schizophrenia 51
Drug Abuse Center 143
Narcotic Addict Rehabilitation Branch 52
National Institutes of Health (NIH) 71,116,122,125,199,239,240
National Lawyers Guild 277
National Organization for the Reform of Marihuana Laws (NORML)__ xin,
23, 24, 26, 252, 256, 257, 259, 260, 262-264
National Research Council vn
National Review (newspaper) 221
XIV
Page
Nature (publication) 114,
129, 137, 218, 346, 347, 349, 369, 391, 393, 395, 413
Naval Investigative Service (NIS) 320,326,327,331,428
Nelsen, Dr. Judith M 83,216,381
Nelson, A. A 347
Nepal 4, 168
Neu, R. L 86,353,356
Neumeyer, J. L 395
Neurological Institute of New York 50, 148
Neuropharmacology (publication) 356
Neuropsychologia (publication) 381
New England Journal of Medicine (publication) 80,
120, 161, 186, 191, 263, 349, 355, 356, 418
New Information Guidelines (document) 337
New Jersey 37
New Jersey Medical School vn, 36, 37
New Left xix, 221, 226-229
New Mexico xvin, 6
New York 15-17, 182
New York Botanical Gardens 419
New York City 16,242,273
Department of Health 109
New York Hospital 182
New York Post (newspaper) 229
New York State 30
Council on Drug Addiction vi
Department of Mental Hygiene vn, 30
New York State Psychiatric Institute vin, xvn, 189
Drug Dependence Committee vn, xvri, 190
Radiation Safety Committee 190
New York Times (newspaper) 93,224,225,229,254
Book review 217
Book section 93
Newton ' 250
Nobel Prize vin, 143, 199
Nogales, Ariz 5
NORML. (See National Organization for the Reform of Marihuana
Laws.)
North Africa 94, 103
North Pacific Society of Neurology and Psychiatry 413
North Palm Beach 15
Nieman, E. A 391
"Nightmare Drugs" (book) 36
Nilsson I. M 346
Nixon, Richard M 220,319
Nuremberg 333
O
Oakland, Calif 19
Oakland Tribune (newspaper) 224
O'Doherty, D. S 368
Office of Education 307
Ohlsson, A 346
Okinawa 317
Ontario Addiction Research Foundation 253
Ontario College of Pharmacy vin
Drug Advisory Committee vin, 183
Operation Panhandle 5
Oregon xvtii
Oregon, University of (Medical School) 220
Orly Airport 15
Ottawa Laboratories 254
Overcoming Drugs (book) 36
Oxford, University of vii, ix, x, 70, 71, 255, 391, 392
Oxford University Press 395
XV
P Page
Pace -> 86, 119
Pace, H. B 356
Pace, Stanley 355
Pacific Command (PACOM) 317, 318
Padilla, G. M 349
Page, T. F 346
Pahnke, W. N 356
Paine, Dr. R 180
Pakistan 16
Customs : 17
Sea Customs 16
Textile plant 16
Palm Beach Gardens 15
Panagopoulos, C 368, 380
Panama 17
Paris 15
Paris, University of vn, 93
Parks, Kathryn 355
Pastner, D 349
Paton, Dr. W. D. M vn, rx, x, xi, xx, 84, 101, 106, 156, 260, 296, 391, 392, 395
Testimony of 70-79
Payne, J. P 71
Payne, R 178
Peacock, S. M 381
Pearse, G. W 347
Pearson, G. H. J 402
Ped. Res. (publication) 114
Penang 320
Pendergast, R. J., Jr 290
Pendergast, Dr. Tom 310, 418
Pennsylvania Hospital 50, 148
Pennsylvania, University of (School of Medicine) vrri, 155
Perito, Paul . 26
Perrett, L 392
Perrin. R. G 368.380
Persaud 119
Pertwee, Dr. R. G 72, 84, 391, 396
Petersen 221
Pfeiffer, C. C 381
"Pharmacological Principles and Practice" (book) 71
Pharmacological Reviews (publication) 238
Pharmacologists (publication) 413
Philadelphia 50, 298
Philadelphia Medicine (publication) 402
Phillioe Foundation 107, 349
Philippines 317, 320, 336, 337
Phoenix 197
Pillard. R. C 80
Pines. Dr. Kermit L 94
Pinnacle. Jamaica 148
Pitt, C. G 346
Pittsburgh. University of 51, 155
Planton. David N 287.428
Testimony of 314-340
Plavboy (magazine) 224
Playboy Foundation 259
Plaves 119
Podhoretz, N 212
Poe, Edgar Allen 211
Porzak, J. P 369,380
Possee Comitatus Act 319
"Possible Reproductive Detriment in LSD Users" (article) 88
"Pot: A Rational Approach" (article) 224
Powell. William 419
XVI
Page
Powelson, Dr. Harvey vn, x, xi, 32, 34, 36, 46, 68, 329
Testimony of 18-29
Powes, H. O 356
Preble, M 418
Presbyterian Hospital 190
Price, L. M 381
Priest 224
Prince 151
Prince Edward Island 251,257
Prince Edward Island, University of 250
'Principles and Practice of Hedonic Psychology and an Explication of
the Seven Levels of Consciousness" (Pleasure) (article) 224
Psychiatric Association Journal (Canada) (publication) 417
"Psychiatric Effects of Hashish" (article) 54,290
Psychoanalytic Institute 19
"Psychoanalytic Study of the Child, The" (book) 402
Psychobiology (publication) 250
Psychology Today (magazine) 224
Psychopharmacologia ( publication ) 395, 402
"Psychopharmacological Hazards of Legalizing Marihuana in the U.S."
(article) 190
"Psychotic Reactions Following Canabis Use" (article) 31
Puerto Rico 13
"Pursuit of Intoxication, The" (book) 183,186
R
Rackow, Dr. Herbert 94
Rafaelson, Dr 156
Raferty, E. B 349
Rainbury, R 349
Rail, D. P 382
Ramey, E. R 368
Rastafari cult 148, 150, 151
Rat, The (underground newspaper) 226
Raven Press 186
Ray Films 26
Recording Industry Association of America 225
"Reefer Madness" (movie) 259
Reemtsma, K 349
Regional Council of Child Psychiatry 154
Reiner, C. B 381
Renault, P. F 381
"Report on Drug Abuse in the Armed Forces in Vietnam, A" (article) 250
Report on Marihuana and Health (3d) 194
Report of the Indian Hemp Drugs Commission 417
Reproductive Biology Research Foundation vm, 117, 122, 191
"Respiratory Manifestations of Hashish Smoking" (article) 289
Rhein Main Air Base, Germany 318,319
Rich, Frank H 223
Ritter, U 137, 349
Richter, Ralph W 94
Reisen 250
Robbins, E. S 356
Rol)in VIII (sea tug) 17
Robson 74
Rockland State Hospital vm, 182
Rodin, E. A :___ 369,380
Roeder 171
Role of Communications and Behavioral Knowledge (study) 250
"Role of Pleasure in Behavior, The" (book) 368,381
Rome 177
Rosenfeld, R 346
Rosenkranz. H 382, 413
Rosenthal, F 417
Rowe, H. M 346
XVII
Page
Royal College of Physicians 182
Royal College of Physicians and Surgeons (Canada) ^uu
Royal Free Hospital 395
Royes gj
Rubin, Jerry xv> *£<
Rubin, Vera JJ*
Russian Revolution 4JU» *^x
S
Saifl, A. Q 368'|^
Saigon fl
St. Catherine, Jamaica x*°
St. Goran Hospital (Stockholm) 1™
St. Johns River I5
St. Louis vni, 1°1
Botanical Gardens 4i^
Salamink, Dr J5C
Salt Lake City 34J
San Francisco xrv, 26, 183, 215, 220, 242, 317
San Juan 13
Sandberg, F 346
SANE. (See Committee for a Sane Drug Policy.)
Sargent, Col. Wayne B 287,430
Testimony of 314-340
Sawitsky, A 356
Schaeppi, U. H 382,413
Scharer, K 356
Scheiris, C £3
Schepens, P ^3
Schieldahl, Peter 227
Schmid, W 356
Schmidt, L. H 382
Schneider, A 114, 137, 349
Schrader, F 137
Schramm 119
Schultes, Dr. Richard E 418,419
Schwartz, I. W 319
Schwartz, W. E 346
Schwarz, B. E 381
Schwarz, Dr. Conrad J vm, xi, 21, 78, 199, 413, 417, 424
Testimony of 200-206
Schweizerische Medizenische Wochenschrift (publication) 356
Science (magazine) VIII>
ix, 94, 110, 113, 191, 215, 238, 344, 346, 347, 349, 355, 356, 368, 380,
381, 413, 418
Sciences, The (publication) xiv
Scientific American (magazine) 217
Sea Trader (ship) 17
Semuels, Marsha 262
"Sensual Drugs : Dehabilitation and Rehabilitation of the Mind" (book)__ 207
7th Fleet 320
Shafer Commission vn,
xv, xvi, 26, 27, 32, 33, 34, 35, 45, 95, 196, 217, 220, 221, 222, 241, 256,
283
Shafer, Governor 168, 222
Shafer Report 188, 216, 223, 225, 242, 259
Shagoury, R. A 395
Shapiro, Dr. M. B 180
Shaw, George Bernard 39
Shuster, C. R 381
Silberstein, S. D 413, 418
Simic, S 393, 396
Simon & Schuster 186,229
Singapore 320, 337
Singlaub, Gen. John K 207
XVIII
Page
Single Convention on Narcotic Drugs (Article 1) 396
Skipper, H. E 382
"Slow Progress on the Marihuana Front" (article) 254
Small, Dr. Ernest 418, 419
Smith 151
Smith, J. W 31
Smithsonian Institution 185
Smoky Barracks 299
Snell 140
Society of Biological Psychiatry 51
Solliday, N. H 349
Solomon, D 4°2
Sonnenreich, Michael 26
Soueif, Dr. M. I vra, xi, 236, 242, 283, 284
Testimony of 177-181
South Africa 16
South Carolina, University of 302
South Korea XIX
Southeast Asia 207, 270, 271, 273-276, 278, 281, 282, 285, 315, 332, 336
Spain 16
Spulak, F. von G ^y5
Stadnicki, S. W 382
Stanford University 21, 215, 217-219
Stanton, M. D 31
Stenchever, Marc 355
Stenchever, Dr. Morton A vii, x, xm, 110, 210, 243, 262, 349, 350, 353, 356
Testimony of 84-92
Stockholm 170, 172, 173
Students for a Democratic Society (SDS) 228
"Studies in Schizophrenia" (book) 368,381,382
"Study of Chronic Use of Marihuana Demonstrates No Chomosome Breaks,
Brain Damage, or Untoward Effects" (article) 243
"Study of Drug Abuse and Its Prevention for the Armed Forces of the
United States, A" (article) 250
Stroup, K. Keith 263
Subic Bay 320
Subic Bay Naval Base 320
Suciu-Foca, Dr. Nicole 94, 104, 113, 347, 349
Suciu, T 349
Sullivan 74
Sultan, Mohammed 16
Summit, N.J 351
"Superfly" (movie) 224
Sweden '■ vni, xvii, 172, 174
Swift, M. R 356
Swiss Institute for Experimental Cancer Research 126
Switzerland vn, 139, 148, 303
Symbionese Liberation Army (SLA) 228
T
Tabor, Gen 313
Taiwan xrx
Talbott, J. A 402,418
Tamarkin, N. R 346
Tanulmanyok az Alkoholizmus Pszichaiatria i Kovetezmenyeirol (publica-
tion) -- 392
"Targets for Change : Perspectives on an Active Sociology" (book) 221
Tartaglino, Andrew C v, 244-246
Testimony of 2-18
Tatetsu 172
Teague, J. W 402,418
Temple, Gen. William A 287, 427
Testimony of 314-340
Tennant, Dr. Forest S., Jr vm, x, xi, xm, xix, 54, 287, 326, 327, 382, 416, 418
Testimony of 288-314
Teratology (publication) 356
Testino, L 346
XIX
Page
Thacore, V. R 31
Thailand 271- 315> 317
Theim, G 349
"Theory of Addiction as an Artificially Induced Drive, A" (article) 171
Thiem, T 349
Thompson, G. R 413
Thomson, J. L. G 368, 383, 392, 412, 418
"Thoughts of Chairman Jerry" (article) 227
Thurmond, Senator Strom 1-48, 142-146, 287, 199-264
Time (magazine) 197, 216, 229
Tinklenberg, J. R 179,369,391,413,418
Tisdale, V 356
Tjio, J. H 349,356
Tomer, Allen 229
"Tolerance to and Dependence on Cannabis" (article) 31
Toro, Dr. Gelson 117,122,186
Toronto 230, 341
Toronto Globe and Mail (newspaper) 253
Toronto, University of 182, 341
Toulouse, University of (Cancer Institute) 104
Medical School 92
Transplantation (publication) 349
Trotskyists 229
Truitt, E. B 346
Tucson 197
Tufts, Col. Henry H 287, 429
Testimony of 314-340
Tulane University 63. 95, 145, 180, 243, 382
School of Medicine vin, 50, 51, 52, 356, 357
Tumarkin, B 392
Turner, C. E 396
Turner, Dr. Carlton vi
TV Guide (magazine) 225
Tylden, Dr. Elisabeth 72, 84, 393
"Tyranny of the Group, The" (book) 183
U
UCLA (See California, University of, at Los Angeles)
Ulett, J. A 381
Uneerleider 222
Uniform Code of Military Justice 43
United Kingdom 80, 81
United Nations 156, 203, 256, 396
Bulletin on Narcotics (publication) 32, 418
Narcotics Commission vi
Narcotic Laboratory 127
United States __ xvn,
1, 4-6, 9, 13-17, 37, 39, 54, 107, 108, 139, 152, 174, 176, 195, 197, 203,
208, 222, 230, 236, 237, 242, 245, 246, 250, 251, 253-256, 259-261, 271,
272, 281, 284, 288, 289, 293, 296, 298, 299, 306, 310, 313-319, 322, 329,
333, 414, 420, 421
Air Force 269, 285, 316, 321, 326-328, 334, 336, 339
Armed Forces vi, 13, 45-47, 250, 269-272, 274, 278, 279, 282-285, 287
Medical Journal (publication) 392
Army xix, 44, 269, 275, 279, 285, 290, 300, 302, 308, 316, 320, 322, 328, 336
Criminal Investigation Command 319, 326, 335, 336
Drug Information Center __ _ 320
Europe (USAREUR) vin,
287, 288, 290, 293, 294, 298, 299, 303, 304, 311, 313, 314, 320, 323, 324
Hospital (Wurzburg, West Germany) 293,302
Medical Corps Reserve 117
Coast Guard 17
Customs "~5,~6, 315-319
Government Printing Office 30
Navy 269, 285, 316, 322, 328, 336, 337
Public Health Service 127, 142
XX
Page
United States vs. Eric Honeyman et al 419
United States vs. John Moore 419
United States vs. Mitchell Rothoerg et al 419
U.S. News and World Report (magazine) 32,33,332
Utah 21
Utah, University of 84,85,243,262
College of Medicine vn, 85
University College Hospital (London) 71,395
V
Vachon, L 349
Vancouver, B.C 413
Vanderbilt Clinic 190
Veterans' Administration 43
Vietnam 46, 215, 230, 236, 241, 270, 272, 275, 315, 317, 331, 332, 337
von Zerseen, D 392
W
Walker, Matthew 148
Wall, M. B 346
Wall, M. E 346
Waller, Dr. Coy vi
Walt, Gen. Lewis W 82
Walter, J. L 346
Walter Reed Army Hospital 93, 154
War Medicine (publication) 412
Warner, S 356
Washington ( State) 252
Washington, D.C 224, 229, 259, 260, 419
Washington Post (newspaper) 217, 254, 255
Washington Star-News (newspaper) 254
Washington University (School of Medicine) 117
Watanabe, J. L 418
Weathermen 228, 261
Weil, Dr. Andrew T 83, 215, 218, 224, 256, 381
Weir, D. R 137
Weksler, M. E 349
Werner, Dr. Sidney C 94
West 151
West Germany 288-290, 293, 312, 324, 332
West Indies 31
University of vn, 148
West, L. J 415, 418
Western Reserve University vn, 126
Whitchurch Hospital 383
White Panther Society 227,228
Whitehead 178
Whitehurst, W. R 391
Wieder, H 402
Wikler, A 369, 380
Wilber, Dr 337
Williams 151
Williams, Dr. M. J 368,383,392
Williams & Wilkins 368
Williamson, E 346
Wiss, J. L 418
Wittenborn, J. R 418
Wolf, M 392
Wooten Report 80, 414
World Health Organization (WHO) vn, vni, xrv, 30, 76, 127, 170, 177
Panel on Drug Dependence 177
Wust, J. P., Jr 367
W. W. Norton & Co 402
Wyatt, R. J 418
XXI
X Page
Xerox College Publishing Co 221
Y
Yale University 117
Yates, A 178
Young Men's Christian Association (YMCA) 262
Z
Zagury, D 349
Zeidenberg, Dr. Phillip vni, xi, xvn, xvm, 94
Testimony of 189-197
Zimmerberg, B 391
Zimmerman, Dr. Arthur M K, 341, 349
Zimmerman, Col. Frank W 287, 428
Testimony of 314-340
Zinberg, Dr. Norman E 83, 216, 218, 219, 223, 224, 263, 264
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