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

249Mr. Hangel. That is a solid form ?Dr. GoLLANCE. It is a solid tablet. It is dissolved in water. It is likea large Alka-Seltzer and it fizzes up and it leaves a sludge and theydrink it when dissolved.Mr. Eangel. If all of methadone was required by law to be dispensedonly in the form in which you dispense it, would that noteliminate the possibility of injections ?Dr. GoLLANCE. Yes ; and I might point out that methadone is a difficultdrug to synthesize. There is only one manufacturer that I knowof in thi^ country, so it is not the type of drug that you can bootlegand make it surreptitiously.]\Ir. Rangel. Thank you.Mr. Waldie. Thank you.Are there any other questions ?Doctor, we appreciate very much your appearance before thecommittee.(The following material was received for the record from Dr.Gollance:)[Exhibit No. 13(a)]Methadone Maintenance Treatment Program(Reprinted from Maryland State Medical Journal, November, 1970, Vol. 19, pages74-77. © 1970 by the Medical and Chirurgical Faculty of the State of Maryland, Baltimore,Maryland. Printed in U.S.A.)By Harvey Gollance, M.D., Associate Director, Beth Israel Medical Center,Administrator, Methadone Maintenance Treatment Program, New York, N.T.Drug afldiction has reached epidemic proportions in Isfeio York City and inother sections of the United States as well. An effective treatment for severe heroinaddicts known as the methadone maintenance treatment program has ieendeveloped at Rockefeller University and has continued in a greatly expandedprogram at the Beth Israel Medical Center in New York.Facilities for the treatment of narcotic addiction were almost nonexistent inNew York until the 1950's. It was then that the increase in the number of addictsin the low-income areas was recognized, as was the increase in the use of narcoticsby the young. Concerned city authorities prompted the department ofhospitals to establish facilities for adolescent drug users. As a result, a 140-bedhospital. Riverside Hospital, was opened in 19.52. Psychiatrists and strong rehabilitativeand supportive services were provided. In addition, beds were obtainedin a proprietary hospital. Manhattan General Hospital, to detoxify narcoticpatients. With one exception, the chiefs of service of the municipal generalcare hospitals resisted the treatment of drug addicts in their service. Few physicianswere interested, and almost all refused to treat the addicts.A study was done by Columbia University in the late 1950's of 248 patientsdischarged from Riverside Hospital. It showed that almost 100 percent of thepatients still alive became readdicted shortly after discharge. Ray E. Trussell,M.D., director of the School of Public Health and Administrative Medicine ofColumbia University, during a sabbatical leave, had been appointed commissionerof hospitals of New York City in 1961. Dr. Trussell, as a result of theRiverside Hospital study, and because of additional serious administrativeproblems, decided that Riverside Hospital should be closed, and that we shouldseek new approaches to treat drug addicts. Riverside Hospital was closed in196.3. Although it had given its patients some social assistance, it failed both inpreventing readdiction and in rehabilitating its patients. It seemed clear thatthe answer to the treatment of narcotic addiction lay in new directions to bedetermined by future research.research encouragedThe Health Research Council of New York City was interested in encouragingresearch in the area of drug addiction, and in 1963 they initiated a grant to60-296—71 —pt. 1 17