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

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178.^06V f\QrK-'SEt G^ouP/AJ6SIS'rercjtnt'MALESFEMALES/5--/^
179had an arrest rate of 2.8 percent per patient-month of treatment while the latter(the dropouts) had an arrest rate of 5.7 percent per month after leaving theprogram.Table 3 reports arrest rates after 6 months in the community for heroin addictsreleased from the Department of Corrections before the start of NTA in 1970.This table is included for comparison purposes.Tables 4 and 5 contain data on employment rates and dirty urine rates. Bothare encouraging but suggest the need for increased counseling and job placement.The 150 patients in the youth program fared less well (see client's functioningin the Youth Division programs—^May 15, 1970—Nov. 15, 1970). Only 1 percentof these youths received methadone maintenance treatment while an additional10 percent received either methadone detoxification or emergency short-termmethadone treatment (methadone hold). Thus 89 percent of the sample neverreceived methadone. Forty-two percent of the youth clients were arrested duringthe course of the 6-month followup. Sixty of the 150 youths remained in the programafter 6 months (40 percent retention rate) but only 18 of these were stillgiving regular urine samples (12 percent of 150).The results of the Youth Division program were generally similar to theresults of the abstinence programs for adults. The results of the abstinence programsare not as encouraging as the results from high dose methadone maintenancetreatment. However, it must be emphasized that while there were manyfailures in the abstinence programs there were at least a few apparent successes—forexample while 42 percent of the youths were arrested during the 6months followup, 58 percent were not arrested.This summary relates to NTA's performance with patients who were in theprogram from May 15 through November 15, 1970. 'Since May 15, there have beensome improvements in our programs and a great enlargement. On January 8, 1971,NTA had 2,670 reportable patients. Of this total 1,402 receiving methadone maintenancetreatment, 526 were on methadone detoxification, and 35 were on emergencydoses of methadone (methadone hold). Thus 1,963 (74 percent) werereceiving methadone and 707 (26 percent) were abstinent.
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NARCOTICS RESEARCH, REHABILITATION,
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::VEXHIBIT NO. 4 (a) AND (b)Eddy, D
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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
Page 140 and 141: 128HETHADOHE MAINTENANCE TREATMENT
Page 142 and 143: 11 1 1 1 1 11130Methadone Halnten?n
Page 144 and 145: 132TABLE 2.-METHAD0NE MAINTENANCE T
Page 146 and 147: 134Figure 9 Methadone tlaintenance
Page 148 and 149: 136Methadone Ka'ntanance Treatmf:nt
Page 150 and 151: :::.::.138Appendix A^—Methadone M
Page 152 and 153: 140nance treatment patients showing
Page 154 and 155: 142Figure 3 •lethadone Kaintenanc
Page 156 and 157: 144Dr. DuPoNT. 1,760 on methadone m
Page 158 and 159: :146there are dramatic reductions i
Page 160 and 161: 148Health insurance coverage for me
Page 162 and 163: 150Dr. DtjPont. Well, there are no
Page 164 and 165: 152Mr. Blommer. You would agree the
Page 166 and 167: 154done. Where is the evidence ? No
Page 168 and 169: 156There are several reasons a pers
Page 170 and 171: 158It would seem to me a very busy
Page 172 and 173: 160we had before. I don't think it
Page 174 and 175: 162heroin addiction and support all
Page 176 and 177: 164Dr. DuPoNT. I am reluctant to ge
Page 178 and 179: 166Using this figure as rule of thu
Page 180 and 181: )168ment facilities for heroin addi
Page 182 and 183: .170parole departments. None were c
Page 184 and 185: ::172Table 2.— Selected character
Page 186 and 187: 174TABLE 3.—HEROIN ADDICTION RATE
Page 188 and 189: 176W.a^^cc-V.c Cffv..AdF-ro ftcoKjL
Page 192 and 193: I180*i coo)u->CM>—'CMUJCOO O COa>
Page 194 and 195: I(/I182esiMmin0)^> oo.00 =E|c O.2 o
Page 196 and 197: 184encouraged to return to methadon
Page 198 and 199: 186or other side effects. This incr
Page 200 and 201: :188number as that on the bottle. W
Page 202 and 203: 190Attachment ThreeTo all medical s
Page 204 and 205: -jI IALLI192ATTACHMENT- FIVE,J: IPA
Page 206 and 207: 194ATTACHMENT NINEGOVERNMENT OF THE
Page 208 and 209: ......—196half of the addicts sta
Page 210 and 211: 198CONCLUSIONSCertain patterns emer
Page 212 and 213: 200TABLE 5.— PROFILE OF BARBITUAR
Page 214 and 215: 202TABLE ll.-SUPPORT OF HEROIN HABI
Page 216 and 217: 204TABLE 17.-AGE OF ADDICTS AND NON
Page 218 and 219: 206TABLE 23.—PRESENT MARITAL STAT
Page 220 and 221: 208TABLE 28.-MILITARY SERVICEAddict
Page 222 and 223: :210The committee is pleased to cal
Page 224 and 225: 212sists of a network of 21 geograp
Page 226 and 227: 214(6) Basic studies on the nature
Page 228 and 229: 216in fact, constitute autonomous o
Page 230 and 231: Chairman Pepper. Mr. Perito?218;; M
Page 232 and 233: ^'220is not a very forgiving drug.
Page 234 and 235: '222Furthermore, in our present con
Page 236 and 237: —224the Federal Government decide
Page 238 and 239: -—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
Page 272 and 273:
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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Page 355 and 356:
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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-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.
Page 493 and 494:
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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Page 503 and 504:
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
Page 509 and 510:
489I do not think I should explain
Page 511 and 512:
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.
Page 523 and 524:
503synthesized a large number of na
Page 525 and 526:
505STATEMENT OE DR. ALBERT KURLAND,
Page 527 and 528:
507discovered if we iiad taken the
Page 529 and 530:
509Mr. Perito. Dr. Kurland, do you
Page 531 and 532:
511Chairman Pepper. Has the Food an
Page 533 and 534:
513]Mr. Steiger. Do you feel from y
Page 535 and 536:
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
Page 544 and 545:
524Department of Mental Hygiene), R
Page 546 and 547:
TABLE 3—COMPARISON OF THE 1ST POS
Page 548 and 549:
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 ,
Page 554 and 555:
'-534Chart No. U (case No. 672)Disp
Page 556 and 557:
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
Page 576 and 577:
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
Page 620 and 621:
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
Page 696 and 697:
..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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