12.07.2015
•
Views
.170parole departments. None were civilly committed. About 100 lived in three NTAhalfway houses. Seventy were residents almost always for less than 3 weeks, ontwo NTA detoxification wards at District of Columbia General Hospital. Theremainder, about 2,600, were outpatients. Fifty-four percent were receivingmethadone maintenance, 26 percent were in abstinence programs, and 20 percentwere receiving decreasing doses of methadone leading to abstinence.The unprecedented, sharp dip in the rate of serious crimes in Washingtonduring 1970 (see fig. 5) was widely attributed to increased police presence andparticularly to the effectiveness of the NTA treatment programs (9)How much do treatment progrwms cost?An economic study of drug addiction demonstrates that if NTA can successfullytreat only 40 percent of 1,000 patients (a low estimate on the basis ofperformance studies) the cost of treatment for 1 year will be $1,400,000. Thebenefits in terms of reduced criminal activity will be $5,750,770. This shows abenefit-cost ratio of 4.1 to 1 (6).On January 14, 1971, when NTA had 2,793 patients, the total cost »f the programwas less than $4 million a year.References(1) Kozel, N., Brown, B., DuPont, R. : "Narcotics and crime: a study of narcoticsinvolvement in an offender population." Narcotics Treatment Administration,1971.(2) Glendinning, S. : "District of Columbia coroner's office study." NarcoticsTreatment Administration, 1970.(3) Johnston, E. H., Goldbaum, R., Welton, R. L. : "Investigation of suddendeaths in addicts." Medical Annals of the District of Columbia, 38: 375-380, 1969.(4) Adams, S., Meadows, D. F., Reynolds, C. W. : "Narcotic-involved inmates inthe Department of Corrections." District of Columbia Department of CorrectionsResearch Report No. 12, 1969.(5) Robins, L. N., Murphy, G. E. : "Drug use in a normal population of youngNegro men." Am. J. Publ. Hlth., 57 : 1580-1596, 1967.(6) Holahan, J. : "The economics of drug addiction and control in Washington,D.C. : a model for estimation and costs and benefits of rehabilitation."Special Report by the Office of Planning and Research of the District ofColumbia Department of Corrections, 1970.(7) Gearing, F. R. : "Successes and failures in methadone maintenance treatmentof heroin addition in New York City." Presented at the Third NationalConference on Methadone Treatment, Nov. 14, 1970.(8) Brown, B. S., DuPont, R. L. : "6-month followup of heroin addicts in a largemultimodality treatment program." Narcotics Treatment Administration,1971.(9) DuPont, R. L. : "Urban crime and the rapid development of a large heroinaddition treatment program." Presented at the Third National Conferenceon Methadone Treatment, Nov. 16, 1970, accepted for publication in J. Am.Med. Assoc, 1971.Table 1.— The number of opioid overdose deaths each month from, July throughDecember 1970July 9August 5September 9October 8November 7December 4Total 42Average per month 7
171i
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NARCOTICS RESEARCH, REHABILITATION,
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::VEXHIBIT NO. 4 (a) AND (b)Eddy, D
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NARCOTICS RESEARCH, REHABILITATION,
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urden that such addiction imposes u
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1 (lata; (->) the sliariiis" oF iii
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9Chairman Pepper. The committee is
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::11quota production from unrecogni
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13in this country. This raises the
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15from other clinical projects of w
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:17practice, experience has indicat
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;19.I think a quota would be better
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21When methadone was first introduc
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:::::.—23American Society of Phar
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_'—25.I'BOCUREMENT AND ISSUE DATA
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'.28Fiscal years-1967 1968 1969 197
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30rally in opium. By indirect, the
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32We can, I think, most helpfully g
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34so intense that we haven't done v
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Dr. Eddy. Well, physicians, usually
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38Dr. Eddy. No.Chairman Pepper. Now
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:40get away with it as Dr. Keats su
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:—:42public health hazard was jud
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:44Bibliography(1 Nathan B. Eddy. "
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46(52) Nathan B. Eddy. "Dilaudid."
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48(98) "The New Narcotics, Post-gra
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^.50
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52entails the consideration of addi
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54Chairman Pepper. Have you found t
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56^.I wonder would you care to comm
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58Chairman Pepper. Without objectio
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—1958-681959-«419691962-64196219
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—62abuse and has brought about th
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64bank robbery or an assault. You d
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66Mr. Wiggins. Would the stopping o
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68—Chairman Pepper. Can you give
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:70The problem then would be the wi
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;72taking exceptional measures in t
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)—74pay serious attention to this
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;76From 1958 to 1961, he served as
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78deine in painkilling drugs. So if
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;80ning capabilities, responsibilit
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;:;82terials. If they could introdu
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84Figure 1infrared Ektachrome film
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;86Figure 3.—Tones of wheat (W) a
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88ers at the poppyfields or at any
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:90;:tional situations has handicap
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;;92Locating illicit opium cropsDet
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94Jaffe. Well, there would be some
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96Mr. Jaffe. Primarily on the fact
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98in the same ball park about what
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100Chairman Pepper. Mr, Waldie, do
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::102agencies and input data would
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104most facilities are barely able
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;106We have also studied a ^roup of
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108Dr. Gearing. Yes, sir; I would n
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110somethino: in the nei
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112program is put into the machiner
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I114you have some data there that s
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116Dr. Gearing. It depends on what
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118Chairman Pepper. Would you have
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120it not be so that we could proje
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.122admission rate was approximatel
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124BESULTS(1) Although many of the
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1262. All the members of the methad
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128HETHADOHE MAINTENANCE TREATMENT
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11 1 1 1 1 11130Methadone Halnten?n
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132TABLE 2.-METHAD0NE MAINTENANCE T
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134Figure 9 Methadone tlaintenance
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136Methadone Ka'ntanance Treatmf:nt
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:::.::.138Appendix A^—Methadone M
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140nance treatment patients showing
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142Figure 3 •lethadone Kaintenanc
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144Dr. DuPoNT. 1,760 on methadone m
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:146there are dramatic reductions i
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148Health insurance coverage for me
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150Dr. DtjPont. Well, there are no
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152Mr. Blommer. You would agree the
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154done. Where is the evidence ? No
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156There are several reasons a pers
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158It would seem to me a very busy
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160we had before. I don't think it
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162heroin addiction and support all
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164Dr. DuPoNT. I am reluctant to ge
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166Using this figure as rule of thu
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)168ment facilities for heroin addi
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::172Table 2.— Selected character
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174TABLE 3.—HEROIN ADDICTION RATE
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176W.a^^cc-V.c Cffv..AdF-ro ftcoKjL
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178.^06V f\QrK-'SEt G^ouP/AJ6SIS're
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I180*i coo)u->CM>—'CMUJCOO O COa>
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I(/I182esiMmin0)^> oo.00 =E|c O.2 o
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184encouraged to return to methadon
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186or other side effects. This incr
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:188number as that on the bottle. W
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190Attachment ThreeTo all medical s
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-jI IALLI192ATTACHMENT- FIVE,J: IPA
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194ATTACHMENT NINEGOVERNMENT OF THE
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......—196half of the addicts sta
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198CONCLUSIONSCertain patterns emer
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200TABLE 5.— PROFILE OF BARBITUAR
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202TABLE ll.-SUPPORT OF HEROIN HABI
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204TABLE 17.-AGE OF ADDICTS AND NON
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206TABLE 23.—PRESENT MARITAL STAT
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208TABLE 28.-MILITARY SERVICEAddict
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:210The committee is pleased to cal
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212sists of a network of 21 geograp
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214(6) Basic studies on the nature
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216in fact, constitute autonomous o
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Chairman Pepper. Mr. Perito?218;; M
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^'220is not a very forgiving drug.
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'222Furthermore, in our present con
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—224the Federal Government decide
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-—I have presented one generic ki
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,clinic;?,>•
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230I realize we are running late.Do
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''232'']Vir. Winn. Tiien you mentio
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234So having put it in the area, ha
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,Memberships'—i236privilege of co
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;238A central hypothermic response
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;240South Bronx, Bedford-Stuyvesant
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242€are of patient addicts. We ha
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244hospitals in the city, came into
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246that came into my office, and I
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'Mr.;>•/nmo'.i,,;248deputy commis
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:250two Rockefeller Institute physi
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:252during pliase II that serious e
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254well-structured methadone mainte
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;:256nonsense and serves only to ad
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:258you best complete your statemen
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260Mr. Pertto. Based upon your expe
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262A a'reat case in point was a con
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«264Mr. Steiger. Did you discuss w
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—:266Mr. HoRAN. We don't support
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268Mr. Horan, let's back up a littl
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270It is not up to heroin or morphi
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272nesses yesterday who brought out
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274;Mr. Perito. It is my understand
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276So that at the end of the week t
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278steroid he lias in him we might
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280Mr. Perito. You are referriii"'
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282not drug free. I can say approxi
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28 A$2-a-day habit these individual
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•As286I got to the point once in
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288Mr. Steiger. You mentioned anoxi
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290Mr. Eangel. I could see then tha
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292Dr. Casriel. Mr. Keating, I have
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j294What period of time are ^ve tal
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296was March of 1970—he was admit
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298"The paper by Dole and Nyswander
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:300vent them from coming to New Yo
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302[Exhibit No.14(b)]Casriel Instit
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304to result from the insuflScient
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306It is this role of the intervent
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308EESULTSStudies concerning tlie p
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310The method derives from a specia
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312Why is this happening? What need
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m)effective with uncured alcoholics
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I316Casriel, who is medical-psychia
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318resort to heroin. One must not f
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.320in Permanent Cure of Narcotic A
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322!(4) '-Modification of Adaptatio
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324sections of the country, all sor
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;Mr.Pertto.niuch,I?,Mr. Peritq. Tha
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328Chairman Pepper. Mr. Steiger.Mr.
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, Mr., In''wMr, WiNx.nltiiink tlie
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:332"Stomach cramps" were found to
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'i.We334'""^li'anTOanl^ETPPEiL That
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:))))336would be deprived of any cl
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338less abuse liability than agents
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NARCOTICS RESEARCH, REHABILITATION,
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CONTENTSApril 26 1April 27 77April
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:•vEXHIBIT NO. 4 (a) AND (b)Eddy,
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:lovernor,vnEXHIBIT NO. 21 (a) and
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342have no desire to preempt the au
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344We hope these hearings will prov
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346tons in 1962 and to 155 tons in
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348SOUTHEAST ASIAAs you know also,
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350I would also point out as I did
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352their farmers who have been grow
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354told that much of the insurgency
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356Mr. IxGERSOLL. Well, again, Mr.
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358jority of the heroin problem in
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360years, but I have been frustrate
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362Mr, Steiger. If you were goin^ t
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364report marihuana among junior gr
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366And it seems to me tliat we Avou
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?368effectively, then maybe we will
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370improvement as far as the abilit
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372was there. Your visits probably
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374the purchase of Avitnesses—I s
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:376administrations to publicly say
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378Chairman Pepper. We will take a
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380Mr. Ingersoll. No. I don't recal
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:382can fulfill the vow made by the
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384have to give you the same answer
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386Mr. Brasco. But that is another
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388Mr. Ingeksoll. Well, that is the
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NARCOTICS RESEARCH, REHABILITATION,
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-39,3,Dr. Edwards held a surgical f
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395of Narcotics and Dangerous Drugs
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397Naloxone, recently approved for
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399for example, who might be abusin
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401Now, because of our attention ha
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403and this is only for the investi
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405effects this drug will produce i
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407Now, if it is not used intravene
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409Mr. Wiggins. Dr. Jennings, does
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411Penicillin is good for pneumonia
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413Mr. R ANGEL. But from the studie
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415Dr. Gardner. Again, we don't hav
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417Dr. Edwards. I suspect it at lea
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419On the other hand, if serious si
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421of the best known programs. Alth
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423Medical Association, American Ps
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425of the United States Pharmacopei
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4275. Repeated examinations. Physic
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429agement and rehabilitation of se
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—431As the agenc.v within HEW whi
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433and complex acts such as driving
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435(Inig induces physical and psych
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437Chiiirmtin Pepper. Doctor, I thi
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439A large proportion of youngsters
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441Dr. Brown, what would you say is
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443Chairmiui Pepper. Wliat is tlie
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446The state of the art is promisin
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447Lot nie ask you first, is tlic d
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449Chairman Pepper. Do you happen t
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451want you to take a look at. We w
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453In addition to that, there seems
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455the Mfldict is having a program
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457—on drugs? By that I mean, vei
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459\\ e are basically saying, in or
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—;461that this is the extent to w
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463We could go into the drug area a
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.465program that was i)ut into Jack
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467Mr. Brasco. Possibly. However, w
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469him, arrange to get somebody els
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471ainpheta.mines, or barbiturates.
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473In the meantime, the Institute d
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475treated in the community centers
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477research on narcotics in the sam
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479c 53 03E
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NARCOTICS RESEARCH, REHABILITATION,
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483spending for research through NI
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485There has been no concerted seri
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487it is left in one of their veins
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489I do not think I should explain
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491Dr. ViLLARREAL. Until the reflex
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493evidence strongly shows is that
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495Chairman Pepper. One other quest
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497Dr. ViLLARREAL. So, it is a biol
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'.499could result in a laboratory s
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5qifinds it in normal exploration.
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503synthesized a large number of na
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505STATEMENT OE DR. ALBERT KURLAND,
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507discovered if we iiad taken the
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509Mr. Perito. Dr. Kurland, do you
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511Chairman Pepper. Has the Food an
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513]Mr. Steiger. Do you feel from y
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515In this second study there was a
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517were any significant differences
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519The Deceptive Communication and
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.522than a State psychiatric hospit
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524Department of Mental Hygiene), R
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TABLE 3—COMPARISON OF THE 1ST POS
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528TABLE 10—RELATIONSHIP OF AGE T
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530tution and his involvement in th
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Attachment No. 5;r\ N-CH,-CH=CHo ,
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'-534Chart No. U (case No. 672)Disp
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536Chart No. 4 (case No. 694)Illust
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538Chart No. 35 {case No. 697)Excep
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540This amount of heroin is roughly
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5msuccessful or not in that short a
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544Chairman Pepper. Would you repea
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54^creased amount of licit as well
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—54Sand the bureaucracy and the a
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,,Mr.550you have used some of the s
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552so many areas is also a pitiful
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55,4nitiide of heroin addiction in
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556reached $976.5 billion, we can w
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558Mr. Jones was appointed to the c
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560cant when you consider that Out
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562criminal act in his lifetime. Ye
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—564Mr. Perito. Would it be fair
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566Now, Dr. Cliambers, can yon resp
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—568Mr. Raxgel. Our distinguished
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;-570Mr. Jones. That is correct. Ou
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572the commissioner, $186 million i
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574there should be something in the
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576and the way in which the funds a
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57SDr. Chambers. I think wliat you
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580Education is the best way of pre
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58-2Certain essential facts must re
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584done through determined action,
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586druffs, has the Nation's largest
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:588To repeat, methadone maintenanc
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:590I believe the Federal Governmen
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:take no such satisfaction. We have
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594of value in the testimony you ha
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596gone ahead with several. We have
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598force within our State Police De
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60PRased on the proposed goal of 2.
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602STATEMENT OF HON. MILTON SIIAPP,
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(51)4and apprehend the wholesalers
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J'606[Exhibit No. 23Prepared Statem
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608Under our 1071-72 budget proposa
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GIOcenters for the treatment of her
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. Dr.612Bourne informs me that we h
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614Governors in Atlanta to which re
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616pretty bad news, because it indi
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618Scientific statistical ioformati
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620((')) Finally, I believe that al
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622Governor Carter. I certainly rec
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624programs that are now available,
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626all of the top officials in the
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628perhaps greater than some of the
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)630tion and many others attempting
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632(3) Long term residential self-h
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634for the support of drug service
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:636D. NARCO, Inc.Narcotics Addicti
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638crimes to obtain the necessary m
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640million to $25 milliou per year.
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642Mr. Perito. Thank yoii. Mr. Chai
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644narcotic antagonist, and the oth
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646. Dr. Kramer. From what I have s
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—(348your money on, but methadone
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—650I know of no techinque in pri
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652Dr. Kramer. Yes, sir. As a matte
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:'654prison and who liave no—wlio
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65GDr. KT?A:\rEij. 1 suspect tliat
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658support some of the inethadone p
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'6660Dr. IvKAisrKK. 1 believe that
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662jrest that the Veterans' Adminis
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664opiates may be ingested in sever
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666(5) It suppresses the desire for
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668Many people have benefited from
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—G70Other researches which may di
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672synthetic painkillers, our commi
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074IV. A universal ban on legitimat
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..676iTlius we must look to educati
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678states, from Arnold Becker, publ
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680However, we must look at rehabil
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:682(a) The natural history of narc
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684was a heavy user. The decrease i
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686(13) Wallace. R. K. : Physiologi
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688TABLE 9.-USE OF "HARD LIQUOR" BE
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