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

«264Mr. Steiger. Did you discuss with the District of Columbia authoritiesthis particular physician ?Mr. HoRAN. Yes ; I did.Mr. Steiger. Did they corroborate your observance?Mr. HoRAx. As a matter of fact, the District of Columbia Policeindicated to me that on four occasions they had detectives who wentto this doctor's office and got methadone.Mr. Steiger. Do you know what action they took against him ?Mr. IIoran. There was a grand jury proceeding, and the grand jurydid not indict. I am only basing this on hearsay, as to what the grandjury proceeding was. There has never been a prosecution for illegaldispensing against that physician.Mr. Steiger. Is there an AMA organization in the District?Mr. HoRAN. I believe there is.Mr. Steiger. Do you know if anybody has called this matter to theirattention ?Mr. IIoiLVx. I think it has been. I think it has been brought to theattention of the D.C. Medical Society.Mr. Steiger. As far as you know—this fellow—there was no actiontaken to limit this activity ?Mr. HoRAN. No ; there was not.Mr. Steiger. Now, these other three that you are aware of, are theyconducting as extensive an operation as this gentleman?Mr. HoRAN. One of them may be bigger.Mr. Steiger. Is it possible that there are other physicians that youaren't aware of?Mr. HoRAN. Oh, yes; I am sure of that. "What happens to you. Ithink, is that certain physicians develop a name in drug circles, thatname is mentioned, and it is kind of a public relations program to becomeknown and then you become the source.I think that is what happens. Maybe the kids in ^MontgomeryCounty are going to someone else; I don't know.]Mr. Steiger. Have you ever checked with the FDA to find out ifany of these four have a so-called IND number issued by the FDA ?Mr. HoRAN. I have checked with them on two of them and they do.Mr. Steiger. They do ?Mr. HoRAN. Two of them do.Mr. Steiger. What was the response of the FDA when you advisedthem of your observance ?Mr. HoRAN. We never had an awful lot of success with FDA. Iguess we had about as much success as the Bureau of Narcotics andDangerous Drugs. There seem to be some loggerheads between the twoof them as to what the policy should be. I final Iv brought it to theattention of Virginia's two U.S. Senators and "at least, based onthe speech that Senator Byrd gave on the floor of the Senate, he didn'thave an awful lot of success with FDA, either.Mr. Steiger. I think loggerheads is a very general philosophy.I take it, then, as recited both bv the chairman and INTr. ^Nlann.'and Tguess everybody else, that you do favor very specific Fodornl statuteswhich obviously would be applicable in the District of ColumbiaMr. HoRAN. Yes, sir ; I do.

265Mr. Steiger. Limiting the dispensing of methadone ?Mr. HoRAN. At this time I don't think private practitioners shouldbe in the business.Mr. Steiger. Based on your testimony, at an estimated cost of 25cents, this man is making a profit of $14.75 a patient, less the overheadfor rent and lights and heat, and at the rate of 10 patients an hour,he is there for somewhere in the neighborhood of $150 an hour ?Mr. HoRAN. At least.Mr. Steiger. Mr. Chairman, I won't pursue this any further, but Iwould like to compliment the staff and Mr. Horan for spelling this outso specifically. I think one of our basic problems has always been thetendency to accept the medical profession as being incapable of thekind of action you described, and I, for one, have never subscribed tothat, the sanctity of any profession. They are just people, and I wouldhope that we would be able to do something, Mr. Chairman.Chairman Pepper. I am sure the committee will give very seriousconsideration to that problem.Mr. Horan. I would suggest, Mr. Chairman, if I might, I think oneof the difficulties that you run into is that by and large medicine as agroup has never paid much attention to this subject because it was justbeyond normal medical needs. I think what has happened is that youdo have a very small percentage in the clinical end, and of course theyare some of the great minds on the subject, Jaffe, Wyland. and Dole.Those are the people who have the most experience with it. Medicinegenerally has never dealt with it.It is not taught in medical schools. When the private practitionergets into this business he is dealing with a very difficult situation becausehe is not really in a knowledgeable position.Chairman Pepper. If I may corroborate what you said, my wife andI have been identified for a long time with the Parkinson Foundationand Institute, and we have come in contact with some of the outstandingauthorities who have developed and discovered methods for thepractical application of L-Dopa in the treatment of Parkinson's disease,and these authorities say very strongly that the average practitionersshould not be permitted to give L-Dopa because they don'tknow that much about it.I know a Senator here in the Congress right now who was beinggiven, by certain medical authorities, large quantities of L-Dopa. Oneof the outstanding authorities in the country visited the Senator andreduced his dosage very much and he improved, because it is a specializedsubject and you have to know a lot about it before you canwisely dispense it.HoRAN. Yes, sir.JNIr.Chairman Pepper. Have you finished ?Mr. Steiger. Yes, sir.Chairman Pepper. Mr. Rangel.Mr. Rangel. Yes.Mr. Horan, you support the efforts being made b}^ the District ofColumbia and New York City in the area of treating addicts with theuse of methadone ?Mr. Horan. Yes ; in a certain class of cases.]Mr, Rangel. And you also support its use in the jails of FairfaxCounty ?60-296—71—pt. 1 18

265Mr. Steiger. Limiting the dispensing of methadone ?Mr. HoRAN. At this time I don't think private practitioners shouldbe in the business.Mr. Steiger. Based on your testimony, at an estimated cost of 25cents, this man is making a profit of $14.75 a patient, less the overheadfor rent <strong>and</strong> lights <strong>and</strong> heat, <strong>and</strong> at the rate of 10 patients an hour,he is there for somewhere in the neighborhood of $150 an hour ?Mr. HoRAN. At least.Mr. Steiger. Mr. Chairman, I won't pursue this any further, but Iwould like to compliment the staff <strong>and</strong> Mr. Horan for spelling this outso specifically. I think one of our basic problems has always been thetendency to accept the medical profession as being incapable of thekind of action you described, <strong>and</strong> I, for one, have never subscribed tothat, the sanctity of any profession. They are just people, <strong>and</strong> I wouldhope that we would be able to do something, Mr. Chairman.Chairman Pepper. I am sure the committee will give very seriousconsideration to that problem.Mr. Horan. I would suggest, Mr. Chairman, if I might, I think oneof the difficulties that you run into is that by <strong>and</strong> large medicine as agroup has never paid much attention to this subject because it was justbeyond normal medical needs. I think what has happened is that youdo have a very small percentage in the clinical end, <strong>and</strong> of course theyare some of the great minds on the subject, Jaffe, Wyl<strong>and</strong>. <strong>and</strong> Dole.Those are the people who have the most experience with it. Medicinegenerally has never dealt with it.It is not taught in medical schools. When the private practitionergets into this business he is dealing with a very difficult situation becausehe is not really in a knowledgeable position.Chairman Pepper. If I may corroborate what you said, my wife <strong>and</strong>I have been identified for a long time with the Parkinson Foundation<strong>and</strong> Institute, <strong>and</strong> we have come in contact with some of the outst<strong>and</strong>ingauthorities who have developed <strong>and</strong> discovered methods for thepractical application of L-Dopa in the <strong>treatment</strong> of Parkinson's disease,<strong>and</strong> these authorities say very strongly that the average practitionersshould not be permitted to give L-Dopa because they don'tknow that much about it.I know a Senator here in the Congress right now who was beinggiven, by certain medical authorities, large quantities of L-Dopa. Oneof the outst<strong>and</strong>ing authorities in the country visited the Senator <strong>and</strong>reduced his dosage very much <strong>and</strong> he improved, because it is a specializedsubject <strong>and</strong> you have to know a lot about it before you canwisely dispense it.HoRAN. Yes, sir.JNIr.Chairman Pepper. Have you finished ?Mr. Steiger. Yes, sir.Chairman Pepper. Mr. Rangel.Mr. Rangel. Yes.Mr. Horan, you support the efforts being made b}^ the District ofColumbia <strong>and</strong> New York City in the area of treating addicts with theuse of methadone ?Mr. Horan. Yes ; in a certain class of cases.]Mr, Rangel. And you also support its use in the jails of FairfaxCounty ?60-296—71—pt. 1 18

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