Comprehensive Health Planning in the
Department of Administration. Dr. Ja-
cob Koomen, State Health Director, tem-
porarily will supervise operations of
the Office of Comprehensive Health
Planning.
Dr. Cameron, on loan from the Uni-
versity of North Carolina School of
Public Health during the past year, is
leaving North Carolina to assume, ef-
fective July 1st, the position of Pro-
fessor and Chairman of the Department
of Health Administration in the newly-
created School of Health at the Uni-
versity of Oklahoma Medical Center in
Oklahoma City. He also will serve as
Health Planning Consultant to the Ok-
lahoma Health Planning Office and to
the Oklahoma Department of Public
Heatlh.
Dr. Koomen will retain his appoint-
ment as State Director of Public Health
and Secretary to the State Board of
Health.
"In view of the expanding role of the
Office of Comprehensive Health Plan-
ning, both in the coordination of State
and private health activities in North
Carolina and in Federal-State relations
in the health field, the further develop-
ment of an active, effective health plan-
ning program is in the best interest of
all the health services in the State,"
Governor Moore said.
"The Health Planning Office, recog-
nized nationally as one of the best in
the country, is playing a major role in
the State program for the maximum
development and use of all our re-
sources pertaining to health," the Gov-
ernor added. "We have been fortunate
in having a man of Dr. Cameron's ex-
perience -and capability to guide the
office during its first difficult year. We
also are very fortunate in having a
man of Dr. Koomen's insight and ability
to continue this work for the next sev-
eral months."
Dr. Cameron, a native of Tennessee,
has been active in public health in
North Carolina since 1953 serving ini-
tially as an epidemiologist for the North
Carolina State Board of Health and later
as the first director of the Board's de-
monstration program in Home Accident
Prevention. He joined the faculty of
the Department of Public Health Ad-
ministration in the University of North
Carolina School of Public Health in 1955
and at present, holds the rank of full
professor. During the 1966-67 academic
year, he completed a study for the
U. S. Public Health Service dealing with
trends and developments in health
planning in the United States.
He has served as consultant to many
health organizations in North Carolina
and in the Southeast and has directed
studies dealing with health manpower,
community health services, and with
planning to meet the State's major
needs in the field of health. He is
President-elect of the North Carolina
Public Health Association.
With approval of the Governor, Dr.
Koomen was named by the State Board
of Health as State Health Director in
May of 1966, and has been active with
the State's comprehensive health plan-
ning program since its inception, serv-
ing both on the Technical Committee
and on the Governor's Advisory Coun-
cil on Comprehensive Health Planing.
May, 1968
THE HEALTH BULLETIN
Health Careers
Recruif-menf-
to Become
Major Education
Effort
North Carolina Blue Cross and Blue
Shield, Inc. has announced a major edu-
cation effort in behalf of health careers
recruitment; distribution of a book enti-
tled "The Hospital People" to persons
interested in pursuing hospital careers.
H. C. Cranford, Jr. Director of Public
Relations, said distribution of the book
is part of a continuing effort by North
Carolina Blue Cross and Blue Shield,
Inc. to help the hospitals of North Car-
olina meet their critical need for nurses,
technicians and other personnel.
"In recent years public attention has
focused on the technological advances
hospitals have made in patient care,"
Cranford said, 'but frequently over-
looked are the human hands which
operate the new machines and the
human minds which evaluate new tech-
niques.
"More than 200 job classifications are
within a hospitail's walls. While per-
sonnel filling these job classifications
vary in background, education and
skills, they have a common goal— bet-
ter patient care— and a firm belief that
a hospitail is 'people caring for peo-
ple'."
Supporting the idea that technology
is useless without technologists, the
Blue Cross book, "The Hospital Peo-
ple," recognizes these individuals and
their coworkers who stand ready not
only in time of illness, emergency or
disaster, but who serve the community
in other hospital related ways:
1 . Conducting educational programs
to keep professional and super-
visory staff informed of latest
scientific advances and techniques.
2. Conducting programs to educate
the general public in aspects of
health care.
3. Cooperating with agencies to car-
ry out screening programs to
detect early symptoms of disease.
"The Hospital People" has been wide-
ly utilized in health careers education
and recruitment porgrams and as a tool
in helping to explain the rising costs
of hospital care. The book graphically
illustrates the vast amount of special
equipment, highly skilled health care
team members and expanded facilities
which are needed to provide optimum
health care for all the people.
THE HEALTH BULLETIN
First Published — April 1886
The official publication of the North Caro-
lina State Board of Health. 608 Cooper
Memorial Health Building, 225 North Mc-
Dowell Street, Raleigh, N. C. Published
monthly. Second Class Postage paid at
Raleigh, N. C. Sent free upon request.
Editorial Board
Charles M. Cameron. Jr , M D , M.P.H.
Raleigh
John C Lumsden. B.C.H.E.
Jacob Koomen. Jr., M.D., MP.H.
John Andrews, B.S.
Glenn A Flinchum. B S.
H, W, Stevens. M.D.. M.P.H.. Asheville
Guest Ed.— Edwin S. Preston, M.A.,LL.D.
Vol. 83
May, 1968
No. 5
THE HEALTH BULLETIN
May, 1968
NARCOTICS
by
Afyin Shuster
Copyrighted 1968 by the New
York Times Company and is
reprinted by permission.
LONDON - "The real question," the
doctor said after prescribing heroin for
a young commercial artist, "is whether
we are about to develop in this coun-
try an American-type black market in
narcotics."
The doctor was speaking from a desk
in a narcotics clinic in central London
that is representative of the 'treatment
centers" the Government hopes to have
in sufficient numbers in the spring
when a major change takes place in
the "British system" of handling addicts
The Government has come to the
conclusion that its old methods of
handling the heroin addict have failed.
The philosophy remains the same— a
drug addict is a sick person and not
a criminal and should receive the drugs
he needs legally so he can continue
living as near normal a life as possible.
But the way the Brtish will dispense
the drugs will change in the spring.
General practitioners will no longer be
permitted to prescribe heroin for an
addict. He will have to refer all comers
to one of the new "treatment centers"
to be set up under the psychit'-ic de-
partments of hospitals.
The major reason for the change is
that a few doctors were prescribing too
much heroin for their addict patients,
giving them a surplus either to sell to
others reluctant to go to the doctor or
to try to "push" on the non-addicted.
The young artist, sitting in the wait-
ing room of the clinic, put it this way:
"I used to go to a private doctor.
He charged me 2 pounds ($4.80 a
week) and gave me all I needed. But
I decided to come here where every-
thing was free— the doctor and the
heroin.
"But some of my friends made their
living from this other doctor I knew.
They could get more than enough from
him. Then they would sell it. They
were able to sell so much they could
afford another visit to the doctor, pay
their rent, buy their food, and live it up
in the West End night clubs."
The surplus was reasonably priced,
undercutting any heroin that might be
brought into Britain illicitly. The result
is that the international traffic in heroin
has remained virtually clear of these
shores.
May, 1968
THE HEALTH BULLETIN
Even those receiving free heroin
have occasionally turned to the "black
nnarket."
"I bought a couple," one young man
openly adnnitted to the clinic doctor
last week. "You haven't given me
enough. It cost me a pound a grain."
The real fear here is that the new
system may well break down under a
flood of heroin addicts. No one really
knows how many there are in this
country, and the Ministry of Health may
not have the facilities to handle them
all when they are channeled to the
treatment centers.
The doctors there will be careful in
what they prescribe, and the "surplus"
market will be sharply reduced. This
could leave the field open for the illicit
international dealers. For other addicts
may prefer to remain away from the
"treatment centers" and buy from illegal
sources as long as their money holds
out.
"The addicts are essentially shy peo-
ple." a doctor said. "They may not like
change. They may regard the centers
as something like a probation officer.
They may not like having their name
sent to the Home Office, a system that
goes into effect at the end of this
month. The hospital center may just
seem too much like government to
make them feel comfortable. The illicit
market could come."
The theory behind the treatment cen-
ters is that under the guidance of spe-
cially trained doctors the addicts may
be persuaded slowly to give up their
heroin addiction.
"The goal is to switch them from
heroin to methadone (a narcotic with-
out the withdrawal symptoms of heroin)
to nothing," the doctor in the clinic
said. But of course that seldom works.
We have had some success in switching
them from heroin to the stimulant
methadrine."
The Government also hopes to be
able to persuade more addicts to accept
hospitalization, but there is a serious
question whether the hospital system
will be able to handle any large num-
bers. For example, as of early this
year, only 42 heroin addicts were being
treated as in-patients in the London
area. How much more space will be
available for such patients remains to
be seen.
Another change will be in the pre-
scription themselves. Heretofore, a gen-
eral practitioner merely gave an addict
a prescription for a week's supply. He
picked up all the heroin at the same
time and was free to sell some.
Now the doctor will prescribe a
week's supply of the free heroin, but
he will mail it direct to the addict's
pharmacist. This will prevent the addict
from attempting to alter the form to
obtain more heroin and enable the
pharmacist to control the flow of it by
dispersing it daily. It is unlikely an ad-
dict will sell his daily supply.
Officials of the Ministry of Health
have come to no firm conclusion as to
why Britain has experienced its rise in
addiction. They say only that it is part
of the "social phenomenon" being ex-
perienced in other countries, as express-
ed particularly in a "rebellion by
youth." Most of the addicted in this
country fall within the youthful cate-
gory.
Many experts here believe that Brit-
tain will have to come one day to com-
pulsory hospitalization. But for the
time being the Ministry of Health
wants to try its new system.
"I like this place," said an addict
last week after getting his sterile hypo-
dermic needles from a pretty nurse. "I
like the doctor and the nurse. But I've
got junkie friends who just wouldn't
come to a place like this."
That is why the British doctors are
worried.
THE HEALTH BULLETIN
May, 1968
StafF of the North Carolina Hospital Association. Seated, left to right: Mrs. Ann
Flake, secretary to assistant executive director; John H. Ketner, assistant executive
director; John P. Marston, program coordinator for health careers. Standing, left to
right: Mrs. Ellen Walters, staff assistant; Marion Foster, executive director; Mrs.
Brenda Johnson, secretary to executive director.
Your North Corolino
Hospital Associotion
The North Carolina Hospital Associa-
tion shall be a voluntary non-profit
organization, the purpose of which
shall be to promote the development,
improvement, and perpetuation of hos-
pitals and related health services for
the people of North Carolina.
—from NCHA Bylaws
Fulfilling the challenging goal are six
people in the Association office located
on Oberlin Road in Raleigh.
Marion J. Foster, executive director,
has been with the Association since
1956. The advent of Federal programs
such as Medicare has increased the com-
plexity of the hospital administrators'
responsibility, and the Association,
through Mr. Foster's law background
and experience, has provided invalua-
ble guidance in this area.
Prior to joining the Association Mr.
Foster was staff attorney for the AHA
in Chicago, and he has served as legis-
lative assistant for the Washington Serv-
ice Bureau of the AHA.
Mrs. Brenda Johnson, Mr. Foster's
secretary, relieves him of many routine
duties by answering requests or supply-
May, 1968
THE HEALTH BULLETIN
ing material needed by hospitals and
other agencies. Five years of active
involvement in various functions of the
Association qualify Brenda as a main-
spring of the Association.
John R. Ketner, assistant executive
director, joined the Association April 1,
1965.
Having served as business manager
and assistant administrator of Cabarrus
Hospitail in Concord, Mr. Ketner brings
to the Association many years of experi-
ence in hospital administration and
accounting.
He is currently treasurer of the North
Carolina Health Council and holds mem-
bership status with the American Col-
lege of Hospital Administrators. He is
also a Fellov^ of the American Associa-
tion of Hospital Accountants.
A new staff members is John P.
Marston who became Program Coordi-
nator for Health Careers in April. With-
in the next few weeks he will name
new co-workers for this prorgam which
seeks to attract qualified young people
to health careers.
Experienced in mass communication
and journalism, Mr. Marston was direc-
tor of communications and public affairs
with the North Carolina Board of
Science and Technology before he
joined the Association staff.
He has also served as assistant direc-
tor of the News Bureau with the Uni-
versity of North Carolina at Greensboro.
The office receptionist is Mrs. Ann
Flake who also keeps the Association's
books, answers correspondence for Mr.
Ketner and can supply many answers
for interested inquirers.
Mrs. Ellen Walters, staff assistant, is
currently working on a 50-year history
of the Association. Her duties are
varied, and her position is new, so her
role will be an expanding one.
These are your Hospital Association
people, and like the "Hospital People,"
they are people helping people.
//
Drownproofing —
Water Survival
The Public Health Service again an-
nounces the availability of a wallet
card describing a water survival tech-
nique called "Drownproofing." This
technique with proper instruction can
readily be learned by adults and chil-
dren.
Entitled "Safety Tips In - On - And
Around the Water," the card is being
distributed by the Service's Injury Con-
trol Program of the National Center for
Urban and Industrial Health in Cincin-
nati.
"Drownproofing," said Dr. Richard E.
Marland, Chief of the Center's Injury
Control Program, "uses simple aquatic
skills to keep a person afloat— even in
rough water— for a long period with a
minimum expenditure of effort and
energy.
"The technique enables a person to
take advantage of his best floating posi-
tion so that, with simple movements of
the arms and legs, he can breathe in
an up-and-down bobbing action.
"Drownproofing is not a skill that a
non-swimmer can perform successfully
without instruction from someone train-
ed in lifesaving and swimming tech-
niques. Parents particularly are urged
to seek this instruction for themselves
and their children at their local pool,
swim club or swimming organization."
The drownproofing technique was
developed by the late Fred R. Lanoue,
former professor of physical education
and head swimming coach at Georgia
Institute of Technology. The card also
features other safety tips which were
prepared in cooperation with American
National Red Cross. The card may be
obtained free in quantities of up to 100
by writing Public Inquiries, National
Center for Urban and Industrial Health,
222 East Central Parkway, Cincinnati,
Ohio 45202.
8
THE HEALTH BULLETIN
May, 1968
Glue-Sniffing
By JIM CHESNUTT
Times StafF Writer
"Feellhy peectures, meester?" And
from under the counter they come. That
you understand.
But glue?
From under the counter yet?
That is exactly the state of the glue
business in several sections of Raleigh
now. Notably, dime and variety stores
located near the high and junior high
schools are finding it necessary to place
some kind of curtailment on purchasing
glue. The glue, authorities are finding,
is being used as a stimulant in increas-
ing numbers by Raleigh students.
Gary Allen, manager of the Person
Street Variety Store, said, "I've not had
as much call for the glue since I put
restrictions on buying it." The glue, in
Allen's store, has been placed "under
the counter" and is limited to two tubes
per purchaser. Allen recently had to
turn in three girls for shoplifting 22
tubes.
Two of the girls have subsequently
left Enloe, where they were in school,
one leaving for extenuating acts (tru-
ancy) and the other dropping out.
"The girl that left (truancy) told me
her 17-year-old friend was really hook-
ed," Mrs. Phyllis Wren, probation offi-
cer counselor said. "She also told me
she knew at least 15 other kids sniffing
glue during the lunch hour."
"Everybody's Doing It"
Gary Clark, principal of Enloe, said,
"We have yet to find anybody sniffing
glue on this campus. I've never sus-
pended a student for sniffing glue; she
did it away from school, anyway."
Clark observed it was usual for a
student to use the "but everybody's do-
ing it" approach to a problem. "We
realize it can become serious, and we'll
do everything to stop it. But at present,
it's a small group participation.
Both assistant principal. Bill Johnson,
and Judy Barrett, woman's guidance
counselor, agreed the problem at Enloe
was, at present, largely non-existant
said Johnson. "The only connection at
Enloe has been school drop-outs com-
pletely outside our juridiction."
Mrs. Wren first started noticing the
rising incidents of glue-sniffing in the
early spring— around February. "To catch
a person is extremely hard," she said.
"We had a couple of boys caught run-
ning from the police. It turned out they
were on glue— they appeared drunk,
with bulging eyes. Glue afFects stu-
dents much like alcohol; it gives them a
false courage."
"But they don't realize — and their
parents don't realize — the extreme
danger of messing with this stuff," Mrs.
Wren said. "It damages the brain, lungs
and the liver. I've got a girl at Oakberry
School for the mentally retarded now
because of glue-sniffing."
"Friends Sneak G!ue"
Glue-sniffers seem to come from the
middle to the upper middle classes in
the Raleigh School system. "Just last
week, one of my girls in a detention
home had friends try to sneak glue to
her," Mrs. Wren said, bringing an old
paper bag from her desk. "The nurse
noticed the girls acting strangely and
searched the room. She found this un-
der the mattress."
The bag had been spread with glue
and folded to napkin size.
The symptoms parents could look for,
Mrs. Wren said, are hacky coughs and
paleness. "One kid wrote in a notebook
'The best thing is you don't get sick like
with whiskey.' He was telling another
girl how he had been sniffing the night
before."
While the total number of students
involved may be small, they seem to
be influencing each other in their ex-
perimentations. "The boys and girls
travel together, and if one starts to use
May, 1968
THE HEALTH BULLETIN
it, the other will." Mrs. Wren said she
"expected" sex experimentation and
activity followed in many instances as
in the use of alcohol too.
Bill Casey, another probation coun-
selor, agreed the instances occurred in
groups. "I've got 10 boys who run
around together who are involved," he
said. He reported instances from Ay-
cock and Carroll.
R. J. Proctor, the principal at Charles
B. Aycock, said: "We've not had one
incident at the school." He had heard
about it outside the school, however.
"We've caught some boys carrying
glue, but they apparently hadn't used
it at the school," he said. "We've also
heard rumors about it going on out-
side the school. I understand some of
the high school kids are doing it— I hear
this from my own students."
Other schools contacted had no in-
volvement with incidents at the school.
Clifton Edwards, principal of Josephus
Daniels Junior High said, "We've not
had any problems at all. We have the
normal day to day disciplinary prob-
lems, but so far we've not had that."
Joseph Holliday, the principal of
Needham Broughton concurred. "I have
no knowledge and no indication of any-
thing like {his going on," he said.
Casey, the probation officer, said the
Ben Franklin Store, near Aycock, had
reported incidents involving students
and glue. As a result manager B. S.
Baker has started having students sign
when they buy the glue.
"I'm having them do that," Baker
said, "to discourage them. For some
reason I had students buying five and
six tubes at the time, and I got suspi-
cious. Now, they have to sign, and they
can only buy one tube at the ti'me.
Some have refused to sign and we
haven't sold it to them."
Baker said, "I first became aware of
the seriousness of the problem when
one of the school secretaries called me.
Of course, I was willing to do anything
I could to help."
Overnight Baker's glue sales plum-
meted. From selling a gross of glue a
week, he now sells about a half dozen
tubes in that time.
Several Raleigh youth centers have
been adversely affected by reported in-
cidents. Phillip Brown, another coun-
selor, said the Jones Street Y.W.C.A.
had been having some minor problems.
"Don't mistake the meaning," he said,
"it is still a good place for kids to go,
but there is an undesirable element
occasionally occuring." How much of
this is directly related to the glue-snifF-
ing is debatable. "We have had reports
of it happening in the bathrooms," he
said. "We need more parents to super-
vise places such as this," the counselor
agreed. "The parents come and drop
kids off, and pick them up at 11. What
has happened in the meantime they
know nothing about."
"My girls back from training schools
won't go there," Mrs. Wren said. "They
say ifs too rough and they'll get in
trouble."
Brown reported a juvenile transfer
case of his from Alabama, a 16-year-
old taken to the hospital after taking
a large dosage of medicine and chasing
it with lighter fluid. "The doctor said
the hairs on the inside of his nose had
been burned out. It looked like glue-
sniffing had done it."
The counselors agreed one reason
for the rise of glue-sniffing incidents is
the unavailability of drugs to the young
students. The secretary in the juvenile
office said her brother had reported
seeing a student use glue in his class
at Millbrook.
Cary Allen, the manager of the Per-
son Street store, said, "I'm no moralist.
I know the kids can get hold of a lot
of things that can harm them, but I can
prevent them getting the glue here, at
least." — Raleigh Times
10
THE HEALTH BULLETIN
May, 1968
John T. Kerr Appointed
to New Position
The newly-created position of exec-
utive director of the N. C. Association
of Nursing Homes authorized by the
membership at the March meeting in
Raleigh, was filled with the appoint-
ment of John T. Kerr of Durham. He
commenced work with the Association
on May 1. Announcement of the ap-
pointment was made by Charles E.
Priest, Association president from Fay-
etteville.
Kerr has been working since the first
of the month from the Raleigh offices
of John Harden Associates but will
move to Durham soon. His duties will
include staff responsibilities, govern-
mental relations, legislative activity and
public relations.
A graduate of the University of
North Carolina at Chapel Hill, Kerr was
formerly director of the health careers
program for the North Carolina Hos-
pital Education & Research Foundation
in Raleigh and public relations director