Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
Share Embed Flag
Download ePaper

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

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

library.whnlive.com
from library.whnlive.com More from this publisher
12.07.2015 Views

;:256nonsense and serves only to add confusion to an already confusedsituation.The confusion is not alleviated when a physician can stand beforethis committee, as one did in October of 1970, and state that the useof methadone in treatment is "paralleled in importance only by thediscovery of penicillin during this century." I don't know what thefounder of the polio vaccine feels about that statement, but it strikesme as grossly misleading.First of all, I would like to make clear that I support a properlyrun and properly controlled methadone treatment pi'ogram. BasicallyI support the original concepts of the program of Dr. Vincent Dole,in New York City. I firmly believe that with a certain class of addict,there is nowhere to go but up. On the other hand, I believe that manyof the original Dole concepts have been prostituted on the altar of thesimple solution. Tliei'e is too much of an attitude in some quarters toconsign anyone and everyone who has used heroin to methadone maintenance,regardless of his state of addiction. Even Vincent Dole admitsthat this method of treatment may consign its participants to a lifetimeof methadone addiction, since this compound is a physically addictiveone. I oppose such an easy consignment for two basic reasonsOne, because of the nature of hard narcotic use and the hard narcoticusers that we find in suburban Virginia—and I suspect that thesame would be true in most of suburban America—and two, the increasingavailability of this compound as a prime abuse drug.In connection with the first reason, it is important to remember someof Dr. Dole's original guidelines.(1) The addict should be at least 20 years of age(2) He should have at least 4 years mainline hard-narcotic addiction;and(3) Other methods of treatment must have been tried and failedbefore he would be committed to maintenance.I would suggest, members of the committee, that very, very fewaddicts in sulmrban America would meet just those three guidelines.In my jurisdiction. 77 percent of all our drug abuse cases, regardlessof drug, involves those aged 20 and below. The phenomena of drugabuse hit us in 1966, while heroin abuse did not hit us until 1969, inthe spring. The net effect of this is that today virtually all of ourheroin users have less than 2 years' mainline addiction. Most, if not allof them are below age 20 ; and when they first come to our attention,no other method of treatment has been tried in an attempt to cure them.Thus we can see that most of our addicts, and I use the term loosely, donot meet Vincent Dole's original guidelines.My concern is that in the search for the panacea for hard-narcoticabusers we might consign to a lifetime of methadone maintenancesome very young kids without ever attempting another route of cure.In my opinion, very few kids in my jurisdiction should be so consigned.An analogy to "throwing out the baby with the bath water" might fitour situation.I would not for 1 minute contest the right of the District of Columbiaor New York City to commit themselves fully to massive methadonemaintenance programs. But please, for Heaven's sake, let's not committhe rest of the country.

257I guess I have read most of what Drs. DiiPont and Dole say abouttheir programs, and their writings certainly substantiate their commitment—buttheir special jurisdictional needs appear to require it— myjurisdiction does not, and I suspect that the rest of suburban Americais in my situation and not in theirs.We presently have in Fairfax County a drug treatment programbased upon the therapeutic community concept.We have been in the business for quite some time now. We are satisfiedwith our methods of treatment, and if there comes a time when wehave a large scale number of hard-narcotic abusers, then we are probablygoing to take a much harder look at methadone. But that is notour situation today.The second problem in northern Virginia involves the use of methadoneas a prime abuse drug. Supposedly, the situation will be alleviatedby FDA regulations which may control the dispensing. I hope thoseguidelines do that, because prior to any guidelines our situation wasatrocious. In the spring of 1970 the Fairfax Police Department and I,after our second methadone overdose death, began to complain aboutthe availability of this drug in the marketplace. Unfortunately, threemore deaths were necessary before anything was done to tighten updispensing guidelines in the District, and two of those deaths involvedkids 16 years of age.We have tried, through the treatment program, the police departmentand my office, to evaluate our situation with regard to the availabilityof methadone. I would like to share with you some of the findingsthat we made, based on a cold, hard look at it in the past year.First. Large supplies of this drug have been coming out of the Districtof Columbia, primarily from private practitioners' offices. Muchof this methadone has been diverted into abuse circles and in somecases it has become the drug of choice. Some of it is being sold rightin the syringe at $1.,50 a cubic centimeter. This makes it an excellentprofit drug and as much as in the case of at least one physician, hedistributes 50 cubic centimeters at a time at $15 a throw.Upon resale of that at a $1.50 a cubic centimeter the profit isapparent.Mr. Peeito. Mr. Horan, has this doctor been prosecuted?Mr. HoRAN. To my Imowledge he has not. We have no jurisdictionalcontrol over him.In the District of Columbia he can do exactly what he is doing.Mr. Perito. Have you recommended to the District authorities thathe be prosecuted?Mr. Horan. I have had a great deal of contact with the narcoticssquad over the year, and the district attorney's office, and they feeltheir hands are somewhat tied. That is the impression I get.Mr. Sandman. Why are they tied ?Mr. HoRAN. Because, evidently, under the existing regulations hecan maintain an addict on methadone because he is making: a purelymedical iudgment, and. therefore, it is not criminal under District law.Mr. Waldie. Mr. Horan, may I interrupt you ?We are in the middle of a quorum call. I would like to have youcomplete your statement before the end of the second bell. Perhaps

257I guess I have read most of what Drs. DiiPont <strong>and</strong> Dole say abouttheir programs, <strong>and</strong> their writings certainly substantiate their commitment—buttheir special jurisdictional needs appear to require it— myjurisdiction does not, <strong>and</strong> I suspect that the rest of suburban Americais in my situation <strong>and</strong> not in theirs.We presently have in Fairfax County a drug <strong>treatment</strong> programbased upon the therapeutic community concept.We have been in the business for quite some time now. We are satisfiedwith our methods of <strong>treatment</strong>, <strong>and</strong> if there comes a time when wehave a large scale number of hard-narcotic abusers, then we are probablygoing to take a much harder look at methadone. But that is notour situation today.The second problem in northern Virginia involves the use of methadoneas a prime abuse drug. Supposedly, the situation will be alleviatedby FDA regulations which may control the dispensing. I hope thoseguidelines do that, because prior to any guidelines our situation wasatrocious. In the spring of 1970 the Fairfax Police Department <strong>and</strong> I,after our second methadone overdose death, began to complain aboutthe availability of this drug in the marketplace. Unfortunately, threemore deaths were necessary before anything was done to tighten updispensing guidelines in the District, <strong>and</strong> two of those deaths involvedkids 16 years of age.We have tried, through the <strong>treatment</strong> program, the police department<strong>and</strong> my office, to evaluate our situation with regard to the availabilityof methadone. I would like to share with you some of the findingsthat we made, based on a cold, hard look at it in the past year.First. Large supplies of this drug have been coming out of the Districtof Columbia, primarily from private practitioners' offices. Muchof this methadone has been diverted into abuse circles <strong>and</strong> in somecases it has become the drug of choice. Some of it is being sold rightin the syringe at $1.,50 a cubic centimeter. This makes it an excellentprofit drug <strong>and</strong> as much as in the case of at least one physician, hedistributes 50 cubic centimeters at a time at $15 a throw.Upon resale of that at a $1.50 a cubic centimeter the profit isapparent.Mr. Peeito. Mr. Horan, has this doctor been prosecuted?Mr. HoRAN. To my Imowledge he has not. We have no jurisdictionalcontrol over him.In the District of Columbia he can do exactly what he is doing.Mr. Perito. Have you recommended to the District authorities thathe be prosecuted?Mr. Horan. I have had a great deal of contact with the narcoticssquad over the year, <strong>and</strong> the district attorney's office, <strong>and</strong> they feeltheir h<strong>and</strong>s are somewhat tied. That is the impression I get.Mr. S<strong>and</strong>man. Why are they tied ?Mr. HoRAN. Because, evidently, under the existing regulations hecan maintain an addict on methadone because he is making: a purelymedical iudgment, <strong>and</strong>. therefore, it is not criminal under District law.Mr. Waldie. Mr. Horan, may I interrupt you ?We are in the middle of a quorum call. I would like to have youcomplete your statement before the end of the second bell. Perhaps

logo

products

Resources

Company

Terms of service
Privacy policy
Cookie policy
Cookie settings
Imprint
Change language
Made with love in Switzerland
© 2024 Yumpu.com all rights reserved

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!