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

116Dr. Gearing. It depends on what you are concentrating on. Are youconcerned about the urine or the patient ? I really don't know whatdifference the urine makes if he has become a productive citizen andis able to function and is staying out of jail, because I suspect that incertain groups of the population, we could test for a variety of drugsand find habitual users, even among such illustrious people as amongour Congress.Mr. Wiggins. Users of what ?Dr. Gearing. Drugs, amphetamines, barbiturates, tranquilizers, pepuppills, et cetera.Mr. Wiggins. I just didn't want you to be misunderstood as accusingMembers of Congress shooting heroin.Dr. Gearing. No. I think in a rehabilitation program of this kindone can get overly hung up on urine testing, which is a very expensiveand time-consuming part of the operation. I think it is very goodfrom a counseling standpoint to let the patient know that big brotheris watching him, but as far as handling the patient and his problem,it is not his urine you are concerned about.Mr. Steiger. The whole problem, it seems to me, the basic objectionto the problem in terms of laymen is we are substituting onedependence for another, and in this instance we may not even be doingthat. We may simply be mitigating the original dependence.I would like to ask one question : On urine analysis, have you beenable to get a statistically representative group of people who have beenthrough the program for a given period, whatever that may be, andnow no longer take methadone and are no longer addictive and areproductive ? Are' there any fisrures like that ?Dr. Gearing. We are in the process of trying to find those people.They can find those who haven't made it. That is the easiest thing,because we can find them through our other reporter services.We have a group of some 20 percent of the patients who have leftthe program that we haven't been able to find through these sources.We are now in the process of trying to find out what proportion ofthese people are, in fact, drug free.Mr. Steiger. My question is: In your opinion is it possible forsomebody, through the methadone maintenance program, to achieveindependence from methadone and anything else, or do we have to anticipatethat he will be a methadone addict for the rest of his life '?Dr. Gearing. From the information I have at the present time Iwould equate methadone maintenance with insulin for diabetics, asprobably a lifelong commitment for many of the patients.Chairman Pepper. Mr. Mann.Mr. Mann. Doctor, in your evaluation, what employment problemsor patterns do you find these people having and is the community prejudicedor reluctant to employ these neonle ?Dr. Gearing. The answer to the last question is yes. in some areas.The experience that has come about in the pro.Qfram is that it is likegetting the first olive out of the bottle. Gettin.q; the first man on methadonemaintenance employed in a particular industry or jxroiin is thetough one. Once they have accepted the first one and thev find outthat he is a useful citizen, then getting other people into that is asimnler iob. That is one point.The main point, I think, is that many of them have to be given