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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214(6) Basic studies on the nature of the biochemical events involvedin tolerance and physical dependence.Research requires people. It is simply inadequate to make moneyavailable and expect that trained and competent researchers -will materializefrom the ether. These individuals require support before theyare ready to conduct their own research and not all of those who receivesuch support will develop into able researchers. Thus, some supportfor training of new researchers or the retraining of researchersfrom other fields is a prerequisite to a long-run attempt to conduct theresearch I have described.Thank you.Chairman Pepper. That was a very able and comprehensive statement.Dr. Jaffe.Mr. Perito, do you have any questions ?Mr. Perito. Thank you, Mr. Chairman.Dr. JafFe, you started the program in Illinois in 1967 ?Dr. Jaffe. Well, the legislature passed the appropriations bill andit was signed in August of 1967. It took us a number of months to findout how to use that appropriation because we were an entirely newagency in a sense.We took the first patient, under the aegis of the Department ofPsychiatry of the University of Chicago in January 1968, and thatbegan in my own office at the university. We sort of got started in anunusual way.Mr. Perito. You have gone from one patient to 1,590 patients fromJanuary 1, 1968, up until the present time ?Dr. Jaffe. We have at least doubled our patient load every year, andintend to double it again this year. It is, we think, a very orderly rateof growth.Mr. Perito. Does your program or programs, rather, have a waitinglist at the present time?Dr. Jaffe. Yes ; it has had a waiting list from the first day that wetook in the first patient. No matter how fast we expand, we have alwayshad people waiting for treatment.Mr. Perito. Your program is the largest in Chicago ; is that correct ?Dr. Jaffe. Yes.Mr. Pepito. Are there other large programs working in conjunctionwith yours ?Dr. Jaffe. Well, we have no mechanism for monitoring the size ofother programs. Unofficially, I think the largest program that doesnot come under our aegis has 50 or 60 people.Mr. Perito. Do you receive any Federal moneys for your program ?Dr. Jaffe. There is one grant from the National Institute of MentalHealth to the University of Chicago.Mr. Perito. Is this a research or a service grant ?Dr. Jaffe. There is a service grant.Chairman Pepper. How much Federal assistance do you receive?Dr. Jaffe. The first year it was about $450,000 to $500,000. It wasa matching grant. It has decreased by 10 percent each year thereafter.Mr. Perito. What do you figure the cost is, per patient-year, to iimyour program at the present time ?Dr. Jaffe. Well, I can give you some exact figui-es, but I wouldlike to give you some context in which to put them.

215About 20 percent of our patients are living in a residential setting.At present, we use no traditional hospitals at $80 per day, but wehave developed more efficient—and we think more rational—ways ofhandling patients who are drug abusers, since for the most part, correctlyhandled they are not acutely ill. Our residential settings stillcost us about $10 to $12 per patient per day, or $3,500 per year.Our outpatient methadone program costs between $800 and $1,500per patient per year.Again, I give you this range because the longer somebody is intreatment, if they remain continuously in treatment, the less costly itis to treat them. Once they become stabilized they get a job and theyare functioning reasonably well.At that stage, it does not take as much personnel or staffing to maintainthat person in a functioning state. So that for a patient in theearly stages of treatment, you have to have more input. As our programhas matured, our outpatient cost per patient have actually gonedown in spite of inflation.Now, if you want an overall cost for treating 1,600 people with theresearch we have conducted, with our evaluation with our equipmentcosts, the cost is a little over $2.4 million to treat 1,600 people.Again, I caution you that we only reached 1,600 January 1, so youare going to look at a mean patient load of about 1,400 over an entireyear.In a program that is expanding it is more rational to look at theprojected cost when it stabilizes. At that point we expect that residentialcosts will be in the neighborhood of $3,000 to $3,500 per patientper year, and outpatient costs will be about $1,200.Mr. Perito. Do most of your funds emanate from the State ofIllinois?Dr. Jaffe. The State of Illinois.Mr, Perito. Do you receive any money for your program from theUniversity of Chicago ?Dr. Jaffe. Only to the extent that the University of Chicago makescommitments to faculty people and provides fringe benefits to thosefaculty people, and these benefits that are very difficult to charge togrants. In that sense we are supported primarily by the Federalgrant and the State of Illinois.On the other hand, we sort of cannibalize a lot of the brainpowerat the University of Chicago and have no way of compensating themfor the unofficial consultation time and the time that we take up intrying to plan strategy.Mr. Perito. Doctor, how large is your staff at the present time,that is your full-time staff ?Dr. Jaffe. Well, there are approximately 135 total State positionsat this time. At the university there are perhaps 40 positions. Ourprogram was designed to maximize where possible community participationand the co-opting of whatever community resources couldbe brought to bear on this problem. Since there is a great reluctanceof community people to donate their time to the State, we arrange tocontract with specifically developed not-for-profit corporations to operatecertain components of this program. Although we evaluate themand although we consider them operating arms of the program, they,

214(6) Basic studies on the nature of the biochemical events involvedin tolerance <strong>and</strong> physical dependence.Research requires people. It is simply inadequate to make moneyavailable <strong>and</strong> expect that trained <strong>and</strong> competent <strong>research</strong>ers -will materializefrom the ether. These individuals require support before theyare ready to conduct their own <strong>research</strong> <strong>and</strong> not all of those who receivesuch support will develop into able <strong>research</strong>ers. Thus, some supportfor training of new <strong>research</strong>ers or the retraining of <strong>research</strong>ersfrom other fields is a prerequisite to a long-run attempt to conduct the<strong>research</strong> I have described.Thank you.Chairman Pepper. That was a very able <strong>and</strong> comprehensive statement.Dr. Jaffe.Mr. Perito, do you have any questions ?Mr. Perito. Thank you, Mr. Chairman.Dr. JafFe, you started the program in Illinois in 1967 ?Dr. Jaffe. Well, the legislature passed the appropriations bill <strong>and</strong>it was signed in August of 1967. It took us a number of months to findout how to use that appropriation because we were an entirely newagency in a sense.We took the first patient, under the aegis of the Department ofPsychiatry of the University of Chicago in January 1968, <strong>and</strong> thatbegan in my own office at the university. We sort of got started in anunusual way.Mr. Perito. You have gone from one patient to 1,590 patients fromJanuary 1, 1968, up until the present time ?Dr. Jaffe. We have at least doubled our patient load every year, <strong>and</strong>intend to double it again this year. It is, we think, a very orderly rateof growth.Mr. Perito. Does your program or programs, rather, have a waitinglist at the present time?Dr. Jaffe. Yes ; it has had a waiting list from the first day that wetook in the first patient. No matter how fast we exp<strong>and</strong>, we have alwayshad people waiting for <strong>treatment</strong>.Mr. Perito. Your program is the largest in Chicago ; is that correct ?Dr. Jaffe. Yes.Mr. Pepito. Are there other large programs working in conjunctionwith yours ?Dr. Jaffe. Well, we have no mechanism for monitoring the size ofother programs. Unofficially, I think the largest program that doesnot come under our aegis has 50 or 60 people.Mr. Perito. Do you receive any Federal moneys for your program ?Dr. Jaffe. There is one grant from the National Institute of MentalHealth to the University of Chicago.Mr. Perito. Is this a <strong>research</strong> or a service grant ?Dr. Jaffe. There is a service grant.Chairman Pepper. How much Federal assistance do you receive?Dr. Jaffe. The first year it was about $450,000 to $500,000. It wasa matching grant. It has decreased by 10 percent each year thereafter.Mr. Perito. What do you figure the cost is, per patient-year, to iimyour program at the present time ?Dr. Jaffe. Well, I can give you some exact figui-es, but I wouldlike to give you some context in which to put them.

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