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

:1;o22l"''Mr. Wiggins. A lot of people are inclined to take heroin for verypoor reasons, but they do it, nevertheless. Is methadone better thanheroin tDr. Jaffe. Well, oral methadone is a lot safer than heroin boughtfrom a pusher on the street without any question. If I had someoneabsolutely committed to finding out how a narcotic drug felt andyou presented me only two alternatives, either they wanted to buysome heroin on the street, cook it, or take a swallow of oral methadone,I think the answer would be obvious. They would be a lot better offand safer taking methadone. But I don't know if that is what youare driving at. .Mr. Raxgel. Let me ask this : Would your answer be the same itthe heroin was being taken orally, notwithstanding the difference mreaction?Dr. Jaffe. No; if these were known dosages of heroin and methadone,both taken orally, I don't think that it really makes much ciifferenceat all.Mr. RaXgel. Would it make much of a difference if the methadonewere injected?Dr. Jaffe. Oh, yes. Injectable narcotics produce some very reinforcingeffects in the sense that you can do research on animals andyou can show that animals, given an opportunity to inject_intravenouslyany one of the narcotics, learn very quickly to keep injectingthose drugs.Mr. Waldie. Doctor, may I interrupt you at this moment ?In response to Mr. Wiggins and Mr. Rangel's question, I understoodyou to say that if you had the same control over heroin in termsof quantity and the manner in which it is administered as you haveover methadone, the man taking heroin would be ill no better or worseposition than the man taking methadone ?Dr. Jaffe. No. The question was in response to a single dose.Further, j'ou are talking about chronic administration.Mr. Waldie. Let me phrase the question this way, then : There is aconcern among some people, and I share it, that we are substitutingone addictive drug for another. Is there some advantage to that substitution,to substitute methadone for heroin, other than the advantagesthat you have stated, that there might be an infection because ofthe intravenous injection and there might be adverse effects becauseof the impurity of the heroin ?Dr. Jaffe. Oh, yes. .):Mr. Waldie. Are there other results that are beneficial for use ofmethadone rather than heroin ?Dr. Jaffe. In our present context, without a,nj question. There aretwo; '' 'First of all, the oral absorption of heroin is somewhat erratic. Furthermore,the drug—and I am not sure this has been studied in detail—isprobably not even in significant quantity going to have smoothduration of action if you were to give it once a day under observation.mean, if you were still in the position of looki'^o- for somethingwhich lasts 24 hours, of letting peonle take it home for their own use.As soon as you begin letting people take it home to]H,have troublewith illicit diversion and'accidental ingestion."ff ! y rfCMJoefiii Y