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

164Dr. DuPoNT. I am reluctant to get involved in encouraging thatunless there is some reason to believe it is likely to succeed. It is veryhurtful to people to talk them off methadone when they really need tobe on it. We have had some very bad experiences with people whohave discontinued methadone under some overt or covert staff pressuresand then who go back to heroin and leave the program.Mr. Steiger. Excuse me.Mr. Keating. Yes.Mr. Steiger. A person who is addicted or dependent on methadonein the oral form, and he abstains, are his withdrawal symptoms physicallyas stringent as the heroin addict ?Dr. DtrPoNT. They tend to be, dose-for-dose, less intense and oflonger duration, but, of course, the dose-for-dose qualification is importantbecause the street heroin addict is likely to have a smallertotal dose. The peo]:)le who are on methadone maintenance have verypainful withdrawal symptoms if they stop abruptly. If they detoxifyover weeks or months the common experience is easy until the patientis down to about 20 or 30 milligrams a day, at which time he will startdeveloping hunger for the drug again and he may start shooting heroinagain.When he takes his last dose of methadone, if he doesn't go back toheroin, he will have insomnia, aching of his joints and muscles, whichwill last for several days to several weeks.Chairman Pepper. Mr. Brasco ?Mr. Brasco. Thank you.There are several observations that have been made, Doctor, and itis sort of puzzling me. I share the concern of my colleagues about theproblem of methadone traffic in the street. It would appear to me thatif there is no euphoria attached to drinking meliadone, then therewould be no need or no reason for an addict to be taking it in the street,unlessDr. DuPoxT. He shoots it, they inject it.Mr. Brasco. All right. Now, the next thing is if he does that andbased on my own experience in the area, having practiced criminal lawfor some 10 years, addicts are not stupid when it comes to their ownneeds.Are the problems that you talk about concerning greater withdrawaleffects in usmg methadone, and obviously if they are obtaining itillicitly they are paying for it anyway. Wliat would be the advantageof using methadone when an addict can get heroin in the streets easily.Dr. DuPoNT. Well, if the methadone is cheaper he would take themethadone, and I think with the widespread availability of methadoneon the street it is cheaper, dose for dose.Mr. Brasco. So what you are basically saying is that the people thatare trafficking in the street are using it to shoot it up because of theavailability and the fact that it is cheaper ?Dr. DuPoxT. Oh, yes.Mr. Brasco. One other thing.I agree with my colleague, Mr. Rangel, that the support programssurrounding the methadone program that Dr. Gearing talked about, ifthey were given to underprivileged people without the problem ofaddiction they would be very effective in doing a job to lessen crimerates in deprived areas. But in your program I am wondering whether