Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...

112program is put into the machinery and matched by his first name,last name, and his mother's maiden name, which seems to be moreuseful than the birth date, to prevent this kind of duplication.So far, I think two have been picked up.Mr. Wiggins. If a person just simply used a different name, wouldhe be detected ?Dr. Gearing. No. What purpose would be served by a patient goingto more than one program 'iMr. Wiggins. Well, 1 don't know, Doctor. Maybe you can help me.Dr. Gearing. Because he takes his medication daily. He takes hismedication at the clinic. He is giving no medication to take home.Mr. Wiggins. I understand that. Would a person who is dependentupon methadone and had a prior history of heroin addiction, get agreater euphoric effect, or whatever the impact may be, from a seconddose of methadone than he would from just one ?Dr. Gearing. You will have to ask the patients. I don't know.I know the experience with the majority of the patients who havebeen in the program for some months, many of them ask to have theirdosages cut down. They do not develop a tolerance like with heroinwhere they have to get increasing dosage. At the stabilizing dose, somewherebetween 80 and 120 milligrams a day, they don't appear to cravemore.Mr. Wiggins. Is that conclusion generally held in the medical community; namely, that a stabilizing tolerance is achieved with methadoneprograms, unlike other analgesic substances ?Dr. Gearing. I don't think there is anything about the drug addictionfield that is universally held in the medical profession.Mr. Wiggins. Do you have any comment about that? Have your colleagues,so far as you know, come to a contrary conclusion?Dr. Gearing. None who work for the program; no.Mr. Wiggins. Doctor, I gather that there is some diversion inmethadone and that it can be obtained occasionally on the street. Whatdo you believe is the source of that diversion?Dr. Gearing. In New York City the source of that diversion is almostexclusively the private-practice physician who, in being kind tohis patient, gives him not one dose but several doses, such as a prescriptionfor several doses or a week's supply.Mr. Wiggins. Do you have any recommendations to this committeeon how that problem might be curtailed ?Dr. Gearing. I think my recommendation is that I wish that physicianswere not giving it in their private offices, but apparently that isbeing done.Mr. Wiggins. Will it be your recommendation that the private dispensingof methadone outside of a control clinic be banned entirely ?Dr. Gearing. No; the recommendation is that those physicians wlioare interested in working with drug addicts in methadone maintenanceaffiliate themselves wnth some kind of an ongoing progi-am and that asthe patients become stabilized and no longer need the supportive servicesof a total program that the private sector could then take on thepatient.Mr. Wiggins. Doctor, so far the witnesses agree that methadone is adangerous addicting narcotic, and 1 am sure you agice with thatstatement.Dr. Gearing. Yes.