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Bringing man-made drugs under control

Another drug threat - urgent but often overshadowed by global headlines about heroin and cocaine - is fast challenging rich and poor nations alike. It is an outpouring of rainbow-hued man-made pills, tablets, powders, and capsules, designed for medicinal use but diverted in a dozen stealthy ways to tragic abuse from New York to Karachi, from London to Lagos.

United Nations, United States, and third-world officials are trying to bring more of the drugs under international control. Too few people, they believe, realize the speed at which the threat is growing.

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Law enforcement agencies worldwide have been seizing man-made drugs in dramatically increasing rates, according to the UN Narcotic Drugs Division in Vienna:

Seizures of illegally diverted synthetic narcotics, including methadone, meperidine, and pentazocine, rose from 57,938 doses in 1979 to 642,245 in 1981. Amphetamine seizures increased from 15.1 million doses to 47.8 million, depressants from 12 million to 23 million, and LSD from 228,000 to 36.3 million.

(Seizures of LSD and the depressant methaqualone fell in 1982, according to preliminary UN figures. Other seizures remained high.)

The street names are colorful enough: speed, black mollies, mini-bennies, Ts and blues (also called tricycles and bicycles), fours and doors, toot, Bolivian rock, coco-snow, robin's eggs, window panes, blotter acid, angel dust, crystal, rocket fuel, and many more.

They alter thought and sensation by stimulating (methamphetamines or ''speed''), sedating (Secobarbital, Quaaludes), or causing hallucinations (LSD, PCP).

Yet there is nothing attractive about two major, little-realized consequences the world faces: the growth of illicit traffic in these drugs from rich nations to poor nations and the alarming abuse of legal, medicinal drugs, especially in the US. International traffic in laboratory drugs

Illicit international traffic is growing, usually from North American and European laboratories, factories, and pharmacies to users in Asia and Africa who are ignorant of their addictive powers and debilitating effects.

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In northeast Thailand, for example, laborers and truck drivers turn to amphetamines to boost energy levels during the day. In Bangkok young people gulp down tranquilizers and stimulants.

Already diplomats from Nigeria, Pakistan, and Turkey are warning in UN corridors: ''If you rich countries can't police your own drug companies, how do you expect us to control the opium poppy and marijuana our people grow?''

''The threat is clear,'' says one well-placed UN official. ''If the richer countries don't stop the flood of man-made drugs into the poorer ones, then they can expect less cooperation in cutting down the flow of heroin, cocaine, and marijuana in the opposite direction.''

Reagan administration policy is to bring pressure on all producing nations to reduce supplies of opium, cocaine, and marijuana. Now Washington can expect increasing pressure to put its own house in order.

In Islamabad, Toaha Qureshi, director of planning for the Pakistan Narcotics Control Board (PNCB) said in an interview that supplies of methaqualone, the active ingredient in widely trafficked Quaalude and Mandrax depressant tablets, enter Pakistan illegally from Switzerland and West Germany.

''We even see our addicts taking alternate puffs of heroin and crushed Quaalude powder mixed with tobacco,'' he said. ''Pakistan licenses some companies to import medicinal drugs but methaqualone comes in instead. . . .'' Abuse of legal drugs in the US

Many more Americans are being killed and put into hospitals by abusing legal, medical drugs than by using illicit drugs: 350,000 people from the 15 most abused, legal drugs between January 1980 and September 1982, compared with 150, 000 for illicit drugs in the same period.

Ten million young Americans (aged 18 to 25) have abused pharmaceutical products at some point in their lives, according to the 1982 Household Survey on Drug Abuse conducted by the National Institute on Drug Abuse. Abusers currently number almost 2.4 million, of whom 800,000 are between the ages of 12 and 17.

Americans bought a total of 3.3 billion doses of illicit man-made drugs in 1981, enough for about 14 doses for every man, woman, and child in the country.

Yet the budgets for drug diversion units operated by the US Drug Enforcement Administration were cut in 1981. The cuts have still not been restored, despite strong pressure in Congress.

Trafficking is rife in other wealthy countries as well.

In the Netherlands, Chief Superintendent John Oosterbroek of the National Criminal Intelligence Service said that large amounts of illegal amphetamines were produced in clandestine Dutch laboratories and shipped to Scandinavia. One big trafficker in the Netherlands, Karl Pauksch, was recently arrested.

In West Germany, the world's major drug manufacturer, an estimated 600,000 people are addicted to pharmaceutical drugs. Two-thirds are over 30 years old.

In Canada, outlaw motorcycle gangs counterfeit and distribute amphetamines, LSD, PCP, and other pharmaceuticals. ''We have about 5,000 of the gangs,'' Superintendent Rod Stamler, chief drug officer of the Royal Canadian Mounted Police, said in an interview.

''It's very tough to penetrate the gangs, since a condition for membership is to commit a crime against an innocent person selected by the gang - a young girl , for instance. Our undercover agents can't be a party to that.

''We do know that the gangs have ties to the Mafia in Canada. One informant was hired by the Mafia to murder two people in a major eastern US city. Working with the US, we were able to charge all the Mafia in that city with conspiracy. . . .''

Japan also has a major problem with some types of amphetamines. The official addiction figure of 5,000 is dismissed by UN experts as far too low.

In the US, the Drug Enforcement Administration (DEA) claims some success in reducing the international flow of methaqualone and Quaalude tablets.

Much more needs to be done, by doctors, by pharmacists, by drug companies, by law enforcement officials. Hampering progress are large drug companies who insist on the freedom to sell in the marketplace and to compete with each other in variety and advertising.

The man-made drugs have no history of traditional use, such as opium has in Asia (used for centuries by the Chinese, Thais, and Burmese) and coca leaves in the Andes mountains (chewed to offset the effects of high altitude and hunger). Modern man looks for escape

These are the modern products of Western man looking for changes in mood, trying to escape what he sees as the ''stress'' and ''tension'' of modern life. They are often directed at symptoms of such problems rather than physical illness.

''I heard a British doctor at a Commonwealth meeting talking about the need for basic cures to the five most common diseases in the world,'' says George T. Gitchel, in charge of stopping the diversion of legal drugs for the DEA.

''He said the currently accepted treatment for all but one of the diseases was based on remedies developed for soldiers in World War II.

''New treatments were urgently needed. Instead, research money was being sunk into variety after variety of tranquilizers, sedatives, and hypnotics for people in richer countries.''

This newspaper's investigation revealed that legal drugs are being diverted into illicit channels in the following ways:

1. Discreet but phony storefront ''clinics'' in many US cities that offer medication to relieve ''stress.''

Behind a facade of uniformed nurses and medical questionnaires, they break the law by dispensing only one kind of ''treatment'' - Quaalude tablets that are highly addictive depressants. (The name Quaalude was originally chosen to mean ''quiet interlude.'')

One ''clinic'' netted $5 million by writing prescriptions for the drug Preludin (a stimulant) and others in 27 months and by having them filled at 40 separate pharmacies.

A doctor who agreed to write prescriptions at such a clinic was later found to be earning $7,500 a year for five hours of work a week. He was paid $100 an hour plus $30 for every prescription he filled in for a combination of two depressant tablets: codeine plus aspirin called Esperin No. 4 and Doriden, a glutethimide.

Together, they are known in the drug culture jargon as ''fours and doors.''

In the US alone, the DEA has closed down about 40 clinics, including five in New York City. Seventy-four defendants faced trial - 27 physicians, 10 pharmacists, two lawyers, and 35 operators and moneymen.

2. Criminal methods inside the richer countries.

In one bizarre case, a street dealer in the US used five patients dying of cancer. He drove them all over five states for a month. They visited five doctors a day. At each stop the patients would say they were on vacation and had forgotten their prescriptions for Dilaudid, a synthetic opiate that is 8 to 12 times stronger than the morphine from which it is derived.

In most cases the doctors, seeing that the patients were genuinely ill, wrote out prescriptions on the spot. If a doctor wanted to check with their home physicians they would give a number to call. It rang in a public phone booth in his home city, where an accomplice would pretend to be the doctor and would give permission for the prescriptions to be filled.

In 30 days, the group collected 750 tablets of four milligrams each, costing 25 cents apiece. Since they were sold on the black market for $50 each, the group made $37,500 for an outlay of $187.50 plus expenses.

''The trafficker made money, and the patients had extra cash for medicine and comforts,'' a DEA source said. ''The patients figured that even if they'd been caught, no judge would have sent them to jail. . . .''

3. A small but troubling minority of doctors that deliberately overprescribes addictive man-made drugs to make money.

One MD in Britain was so casual that, having forgotten his wallet, he paid a taxi fare by dashing off an illegal prescription for the driver.

Some doctors in London are making up to $150,000 a year by selling to addicts prescriptions for methadone (a synthetic heroin), Diconal (an opiate), and Ritalin (an amphetamine), according to a recent report in the British Medical Journal.

After losing his job, one patient on methadone went to a private doctor and was given a prescription calling for 700 milligrams of methadone, 140 Diconal tablets, and 140 Ritalin tablets every two weeks. As many such ''patients'' do, he sold most of the drugs on the black market.

But he took some of them himself and became so ill he was admitted to the hospital. When he came out he returned to the private doctor, who immediately prescribed the same two-week dosages as before.

Then there is well-meant overprescription. Elderly people in Britain ''have become drug addicts at the expense of their doctors who grossly overprescribe,'' according to Peter Hobday, director of Age Concern, a charity organization. ''. . .You have one (pill) which makes you sleepy, and then you need another one to wake you up in the morning. . . .''

In the US, the DEA estimates that only about 2 percent of the 650,000 registered doctors and pharmacists divert drugs. But that 2 percent adds up to 13,000, far beyond the number the DEA can effectively police with its limited budget and manpower.

4. Thefts from pharmacies, hospitals, doctors, dealers, and drug manufacturers.

Typically, Canada reports a significant increase in break-and-enter cases: up 63.8 percent between 1977 and 1980 for controlled drugs and 20 percent for prescription drugs.

Guns are being used more often. In Canada, the theft of controlled drugs by armed robbery jumped 608 percent in the same period. For prescription drugs, the incidence jumped 214 percent, according to the drug squad of the Royal Canadian Mounted Police.

In the US, law enforcement has reduced thefts from manufacturers but much remains to be done to close the loopholes among doctors and pharmacists.

In one pending case in Los Angeles, the DEA has launched a $900,000 civil suit against a California drug company for failing to report excessive orders.

The company sold 16 million dosage units of Espirin No. 4, and another 16 million of Doriden to 10 pharmacies in Los Angeles in nine months in 1981-82. That's more than a much bigger chain received from its own suppliers for 137 stores.

Most pharmaceutical companies themselves support efforts to close the gaps. The 149-member Pharmaceutical Manufacturers Association in Washington has joined other bodies and the American Medical Association in an informal steering committee against drug diversion.

''We've created a computer system at state level,'' said spokesman Jeffrey C. Warren, ''to make it easier to pinpoint diversions. Our association is opposed to storefront clinics. We support education and preventative measures.''

People should be aware of what abused drugs can do, especially in light of magazines such as ''High Times.'' This glossy monthly published in New York advocates drug use of all kinds.

A recent issue, for example, carries advertising for a wide range of pep pills and other drugs. One for Amphetrazine, described as a ''continuous action stimulant,'' depicted bright-colored tablets above the exhortations:

''Win the battle against fatigue!''

''Stay alert for that long drive home.''

''Perk up a dreary day in the house or at work.''

Samples could be rushed to you for only $1.

No mention is made of possible addiction.

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