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

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

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12.07.2015 Views

:210The committee is pleased to call now Dr. Jerome H. Jaffe, a distinguisheddoctor and the director of one of the Nation's largest drugabuseprograms.Dr. Jaffe is associate professor of psychiatry at the University ofChicago, and director of the drug abuse program of the Illinois Departmentof Mental Health.Dr. Jaffe holds both a bachelor's and master's degree in psychologyfrom Temple University and an M.D. from the Temple UniversitySchool of Medicine.He has been the holder of a U.S. Public Health Service Post DoctoralFellowship in Pharmacology and has twice received the U.S. PublicHealth Service Career Development Award.Dr. Jaffe is a member of numerous scientific and honorary organizations.He is a member of the editorial board of the InternationalJournal of the Addictions; a member of the Review Committee ofNIMH's Center for Studies of Narcotics and Dangerous Drugs; aconsultant to the Illinois Narcotic Advisory Council and the NewYork State Narcotic Addiction Control Commission. He also servesas secretary of the section on drug abuse of the World Psychiatric Association;a consultant to the Department of Health, Education, andWelfare; and special consultant to the World Health Organization'sExpert Committee on Drug Dependence.He is also the author of numerous articles on drug addiction.Dr. Jaffe, we are indeed pleased to receive your testimony today.Mr. Perito, will you inquire ?Mr. Perito. Thank you, Mr. Chairman.Dr. Jaffe, I understand that you have a prepared statement; isthat correct ?STATEMENT OF DR. JEROME H. JAITE, DIRECTOR, ILLINOISDRUG ABUSE PROGRAM ^Dr. Jaffe. That is correct.Mr. Perito. Would you care to present that to the committee ?Dr. Jaffe. Yes. I would like to comment briefly on four areas relatedto the problem of narcotics addiction and drug abuseFirst. The spectrum of treatment services required to treat narcoticsusers, and our experiences in the State of Illinois in developing amultimodality program for delivering such services.Second. A progress report on acetyl-methadol, a drug that we believemay have significant advantages over methadone in the treatmentof heroin users.Third. Our current estimates on the effect of treatment in reducingantisocial activity.Fourth. My own views on the kinds of research that will be requiredif we are to avoid another pandemic of drug use similar to theone we are now experiencing.1 Subsequent to Dr. Jaffa's appearance before the committee. President Nixon, on June 12,1971, named Dr. Jaffe as his chief consultant on drucr abuse and drnp dependence andproposed his name for consideration by the Senate as Director of the President's proposedSpecial Action OflSce on Drug Abuse Prevention.

:;211In the State of Illinois our efforts to develop treatment programsbegan in 1966. Our approach to treatment was based on a very clearset of premises and principles(1) Narcotic users are a heterogeneous group requiring differenttreatments.(2) To determine which treatments were most appropriate for agiven community required a community diagnosis.(3) Treatment programs should be located in the communitieswhere patients lived.(4) No program, no matter how sound it might appear to be theoreticallyor how appealing it was emotionally, would be continuedunless objective evaluation revealed it to be effective and to justifythe expenditure of public funds.Initially, our program could be called a controlled comparison ofseveral different approaches, somewhat competitive, but friendly. Wedeveloped a therapeutic community—Gateway Houses—modeled afterDaytop Village. We explored the use of narcotic antagonists such ascyclazocine ; we developed halfway houses, a specialized hospital unitand we used methadone for maintenance at both high doses and lowdoses.Later we began to wonder why it was necessary to have a separateunit for each approach. It became obvious that such separatism was arelic of old rivalries and philosophical disputes that had no place ina scientifically run and evaluated program. With some effort we wereable to get most of our units to offer all of the available approaches ina more or less eclectic fashion.In other words, at a single facility a patient could participate in amethadone maintenance program, later withdraw, live in a residentialself-regulating community, reenter the community at large on anabstinent basis, or elect to take cyclazocine and in the event of arelapse, move back into a residential facility, or if he was holding ajob merely start again on methadone on an ambulatory basis. Hernight then wait for a number of months—until it was his vacationtime—move into the facilities and then withdraw from methodone.Not every unit is able to sustain specialized treatment services. Forexample, we have one unit under the leadership of Dr. John Chappiethat specializes in the care of addicts with serious medical problems,alcoholism, psychosis, and pregnancy. Yet this unit serves the entirenetwork and a patient who needs such treatment is merely transferredwithout any interruption of treatment.We believe that to reach the majority of addicts it requires morethan one approach or modality. We also believe that we have demonstratedthat all of the modalities can be accommodated within asingle administrative structure. The advantage to this approach isthat program planning and expansion can then be based on the resultsof a fair and uniform evaluation system imposed by the administrativestructure rather than by emotion, rhetoric, and a political trialat arms in the lists of the mass media. This kind of eclectic programhas come to be called the multimodality approach.Currently lodged in the department of mental health and operatedwith the cooperation of the University of Chicago, the program con-

:210The committee is pleased to call now Dr. Jerome H. Jaffe, a distinguisheddoctor <strong>and</strong> the director of one of the Nation's largest drugabuseprograms.Dr. Jaffe is associate professor of psychiatry at the University ofChicago, <strong>and</strong> director of the drug abuse program of the Illinois Departmentof Mental Health.Dr. Jaffe holds both a bachelor's <strong>and</strong> master's degree in psychologyfrom Temple University <strong>and</strong> an M.D. from the Temple UniversitySchool of Medicine.He has been the holder of a U.S. Public Health Service Post DoctoralFellowship in Pharmacology <strong>and</strong> has twice received the U.S. PublicHealth Service Career Development Award.Dr. Jaffe is a member of numerous scientific <strong>and</strong> honorary organizations.He is a member of the editorial board of the InternationalJournal of the Addictions; a member of the Review Committee ofNIMH's Center for Studies of <strong>Narcotics</strong> <strong>and</strong> Dangerous Drugs; aconsultant to the Illinois Narcotic Advisory Council <strong>and</strong> the NewYork State Narcotic Addiction Control Commission. He also servesas secretary of the section on drug abuse of the World Psychiatric Association;a consultant to the Department of Health, Education, <strong>and</strong>Welfare; <strong>and</strong> special consultant to the World Health Organization'sExpert Committee on Drug Dependence.He is also the author of numerous articles on drug addiction.Dr. Jaffe, we are indeed pleased to receive your testimony today.Mr. Perito, will you inquire ?Mr. Perito. Thank you, Mr. Chairman.Dr. Jaffe, I underst<strong>and</strong> that you have a prepared statement; isthat correct ?STATEMENT OF DR. JEROME H. JAITE, DIRECTOR, ILLINOISDRUG ABUSE PROGRAM ^Dr. Jaffe. That is correct.Mr. Perito. Would you care to present that to the committee ?Dr. Jaffe. Yes. I would like to comment briefly on four areas relatedto the problem of narcotics addiction <strong>and</strong> drug abuseFirst. The spectrum of <strong>treatment</strong> services required to treat narcoticsusers, <strong>and</strong> our experiences in the State of Illinois in developing amultimodality program for delivering such services.Second. A progress report on acetyl-methadol, a drug that we believemay have significant advantages over methadone in the <strong>treatment</strong>of heroin users.Third. Our current estimates on the effect of <strong>treatment</strong> in reducingantisocial activity.Fourth. My own views on the kinds of <strong>research</strong> that will be requiredif we are to avoid another p<strong>and</strong>emic of drug use similar to theone we are now experiencing.1 Subsequent to Dr. Jaffa's appearance before the committee. President Nixon, on June 12,1971, named Dr. Jaffe as his chief consultant on drucr abuse <strong>and</strong> drnp dependence <strong>and</strong>proposed his name for consideration by the Senate as Director of the President's proposedSpecial Action OflSce on Drug Abuse Prevention.

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