Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
Narcotics research, rehabilitation, and treatment. Hearings, Ninety ... Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
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11(1Mr. "VViGGixs. How does a patient qualify for the program, Doctor?Dr. Gearing. Well, that is a little bit out of my field, but a patientapplies for admission. He is screened and he has to meet certaincriteria.Mr. Wiggins. Would it be accurate to say that all of the patientsare voluntary?Dr. Gearing. Absolutely. In fact, they have to sign a voluntarycommitment to take the medication.Mr. Wiggins. Is there a method, so far as you know, of course inthe State of New York, whereby courts may compel attendance tomethadone programs as a condition to probation, for example?Dr. Gearing. Compel ?Mr. Wiggins. Yes, ma'am.Dr. Gearing. No; I think they can give the patient the option oftaking methadone or going into one of the other nonmedication programs.Mr. Wiggins. Have you had any experience in evaluating other programsin which you might give us some guidance concerning thewisdom of compulsory methadone programs.Dr. Gearing. No ; I sort of shudder at the thought of compulsorytreatment programs. I would think that voluntary treatment programsin prisons might be useful.I think to legislate medication goes against my physician's blood.Mr. Wiggins. Yes, ma'am.You describe in your prepared statement certain security techniquesthat are employed to insure that your patients are not using the programto satisfy their own drug needs. How is this information authenticated?More specifically, let us suppose that a patient qualified, how do youknow that he is not also continuing to feed his heroin addiction on thestreet ?Dr. Gearing. Well, he is periodically tested with urine samples.Initially, he has a urine sample taken every time he comes in. Whilethe patients are being built up to their tolerance dose, many of themdo shoot heroin, there is no question about it.Mr. Wiggins. Will a urine sample detect the presence of heroin ?Dr. Gearing. No : it will detect the breakdown products, morphine,and also since we in New York still cut it with quinine, it also detectsquinine.Mr. Wiggins. In that event you can still tell whether a patient iscontinuing to feed his heroin addiction by shooting heroin from th"street ?Dr. Gearing. Yes.Mr. Wiggins. How about the other drugs ?Dr. Gearing. This is really a program-type question. I happen toknow something about it, but this is not really my field.The other drugs, amphetamines, barbiturates, methadone, and cocaine,can be detected in urine. Marihuana and alcohol ; no.Mr. Wiggins. Let's suppose a patient signs up for and qualifies fora program in New York City and he also tries to sign up and qualifyfor another program to get a double dosage. How is that prevented 2Dr. Gearing. We are attempting to prevent this in that we havewhat is known as a data bank where each patient that applies for a
- Page 72 and 73: —1958-681959-«419691962-64196219
- Page 74 and 75: —62abuse and has brought about th
- Page 76 and 77: 64bank robbery or an assault. You d
- Page 78 and 79: 66Mr. Wiggins. Would the stopping o
- Page 80 and 81: 68—Chairman Pepper. Can you give
- Page 82 and 83: :70The problem then would be the wi
- Page 84 and 85: ;72taking exceptional measures in t
- Page 86 and 87: )—74pay serious attention to this
- Page 88 and 89: ;76From 1958 to 1961, he served as
- Page 90 and 91: 78deine in painkilling drugs. So if
- Page 92 and 93: ;80ning capabilities, responsibilit
- Page 94 and 95: ;:;82terials. If they could introdu
- Page 96 and 97: 84Figure 1infrared Ektachrome film
- Page 98 and 99: ;86Figure 3.—Tones of wheat (W) a
- Page 100 and 101: 88ers at the poppyfields or at any
- Page 102 and 103: :90;:tional situations has handicap
- Page 104 and 105: ;;92Locating illicit opium cropsDet
- Page 106 and 107: 94Jaffe. Well, there would be some
- Page 108 and 109: 96Mr. Jaffe. Primarily on the fact
- Page 110 and 111: 98in the same ball park about what
- Page 112 and 113: 100Chairman Pepper. Mr, Waldie, do
- Page 114 and 115: ::102agencies and input data would
- Page 116 and 117: 104most facilities are barely able
- Page 118 and 119: ;106We have also studied a ^roup of
- Page 120 and 121: 108Dr. Gearing. Yes, sir; I would n
- Page 124 and 125: 112program is put into the machiner
- Page 126 and 127: I114you have some data there that s
- Page 128 and 129: 116Dr. Gearing. It depends on what
- Page 130 and 131: 118Chairman Pepper. Would you have
- Page 132 and 133: 120it not be so that we could proje
- Page 134 and 135: .122admission rate was approximatel
- Page 136 and 137: 124BESULTS(1) Although many of the
- Page 138 and 139: 1262. All the members of the methad
- Page 140 and 141: 128HETHADOHE MAINTENANCE TREATMENT
- Page 142 and 143: 11 1 1 1 1 11130Methadone Halnten?n
- Page 144 and 145: 132TABLE 2.-METHAD0NE MAINTENANCE T
- Page 146 and 147: 134Figure 9 Methadone tlaintenance
- Page 148 and 149: 136Methadone Ka'ntanance Treatmf:nt
- Page 150 and 151: :::.::.138Appendix A^—Methadone M
- Page 152 and 153: 140nance treatment patients showing
- Page 154 and 155: 142Figure 3 •lethadone Kaintenanc
- Page 156 and 157: 144Dr. DuPoNT. 1,760 on methadone m
- Page 158 and 159: :146there are dramatic reductions i
- Page 160 and 161: 148Health insurance coverage for me
- Page 162 and 163: 150Dr. DtjPont. Well, there are no
- Page 164 and 165: 152Mr. Blommer. You would agree the
- Page 166 and 167: 154done. Where is the evidence ? No
- Page 168 and 169: 156There are several reasons a pers
- Page 170 and 171: 158It would seem to me a very busy
11(1Mr. "VViGGixs. How does a patient qualify for the program, Doctor?Dr. Gearing. Well, that is a little bit out of my field, but a patientapplies for admission. He is screened <strong>and</strong> he has to meet certaincriteria.Mr. Wiggins. Would it be accurate to say that all of the patientsare voluntary?Dr. Gearing. Absolutely. In fact, they have to sign a voluntarycommitment to take the medication.Mr. Wiggins. Is there a method, so far as you know, of course inthe State of New York, whereby courts may compel attendance tomethadone programs as a condition to probation, for example?Dr. Gearing. Compel ?Mr. Wiggins. Yes, ma'am.Dr. Gearing. No; I think they can give the patient the option oftaking methadone or going into one of the other nonmedication programs.Mr. Wiggins. Have you had any experience in evaluating other programsin which you might give us some guidance concerning thewisdom of compulsory methadone programs.Dr. Gearing. No ; I sort of shudder at the thought of compulsory<strong>treatment</strong> programs. I would think that voluntary <strong>treatment</strong> programsin prisons might be useful.I think to legislate medication goes against my physician's blood.Mr. Wiggins. Yes, ma'am.You describe in your prepared statement certain security techniquesthat are employed to insure that your patients are not using the programto satisfy their own drug needs. How is this information authenticated?More specifically, let us suppose that a patient qualified, how do youknow that he is not also continuing to feed his heroin addiction on thestreet ?Dr. Gearing. Well, he is periodically tested with urine samples.Initially, he has a urine sample taken every time he comes in. Whilethe patients are being built up to their tolerance dose, many of themdo shoot heroin, there is no question about it.Mr. Wiggins. Will a urine sample detect the presence of heroin ?Dr. Gearing. No : it will detect the breakdown products, morphine,<strong>and</strong> also since we in New York still cut it with quinine, it also detectsquinine.Mr. Wiggins. In that event you can still tell whether a patient iscontinuing to feed his heroin addiction by shooting heroin from th"street ?Dr. Gearing. Yes.Mr. Wiggins. How about the other drugs ?Dr. Gearing. This is really a program-type question. I happen toknow something about it, but this is not really my field.The other drugs, amphetamines, barbiturates, methadone, <strong>and</strong> cocaine,can be detected in urine. Marihuana <strong>and</strong> alcohol ; no.Mr. Wiggins. Let's suppose a patient signs up for <strong>and</strong> qualifies fora program in New York City <strong>and</strong> he also tries to sign up <strong>and</strong> qualifyfor another program to get a double dosage. How is that prevented 2Dr. Gearing. We are attempting to prevent this in that we havewhat is known as a data bank where each patient that applies for a
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