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

115Dr. Gearing. The New York City program, which started on November1, was wondering where they were going to get their patients.They now have a waiting list of over 1,000 patients. They have 3,000who may be accepted, and money for 2,000, and the other 1,000 willbe waiting.Mr. Brasco. The question really is : In New York there are monetarylimitations?Dr. Gearing. It is monetary limitations and staffing.Mr. Brasco. And staffing ?Dr. Gearing. Yes; and also finding locations which will accept anarcotic treatment program in the area. Not every area of New YorkCity, as you may know, enjoys the idea of having a methadone maintenancetreatment program on their block.Mr. Brasco. Unfortunately, I do know something about that.Might we integrate that with a hospital service? Might that helpcut down on that problem ? In other words, use a portion of a hospital ?Dr. Gearing. This has been done at Delafield and the WashingtonHeights Center. There are two units in the Washington HeightsHealth Center and one in the Delafield Hospital.Mr. Brasco. Thank you.Chairman Pepper. Mr. Steiger.Mr. Steiger. Thank you. I was very interested, Doctor, in Mr. Wiggins'approach on the possibility of the patient continuing his heroinhabit undetected. The urine analysis is the only method that thisprogram uses to detect the heroin ?Dr. Gearing. It is the only method there is, as far as I know, andit only detects heroin taken within the last 24 hours.Mr. Steiger. I assume they use interviews also; I mean, they askthem?Dr. Gearing. The patients squeal on each other.Mr. Steiger. ^Yhat is the incentive to squeal ?Dr. Gearing. Pride in the program.Mr. Steiger. Is there any method you know of, of beating the test,beating the urine analysis ?Dr. Gearing. Oh, I am sure there is. The urine analysis is not usedin the punitive sense. It is used primarily for counseling. They don'tshake their finger and say "You have been a bad boy."Mr. Steiger. An addict who was continuing a heroin habit and hadthe desire, he could conceivabl}^ continue it and stay in the programundetected ?Dr. Gearing. I wouldn't say undetected; no. There have been, Ithink, something like 1 percent of the patients who have been droppedfrom the program for continual shooting of heroin after they werereaching—supposedly—a stabilizinsr dose. The theory here is that inthese patients this treatment doesn't work, obviously.Mr. Steiger. The ingenuity of the addict is fairly well known. Hewill do a great many things to achieve—to acquire— the drug anduse it. It occurs to me that maybe we, as an interested coneressionalcommittee, might want to explore possibly a more efficacious test.This would be my only concern, because we have had reports of urineanalysis, the methods of beating urine analysis itself, some very ingeniousmethods. It occurs to me it might be worth while to explore abetter test.