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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270It is not up to heroin or morphine, but it is probably on the levelwith Demerol ; anybody who has ever had Demerol will agree it hasa good euphoria.li a guy comes into jail and is really not an addict, he is going toget a high.Mr. Winn. Wait just a minute. I want to point out strongly, Mr.Chairman, that this is in direct conflict with testimony we have heardin the past from several of these other experts. I want to point it outbecause it is completely different.Chairman Pepper. Apropos of what my colleague said, the way Ibelieve it was stated by Dr. Jaife this morning was that with the firstlittle bit of taking of methadone you do get a high, but then if the doctorgiving it keeps on experimenting with the individual and gets to apoint where that person is stabilized and he doesn't get a high,Wasn'tthat the gist?Mr. Winn. I believe that was Dr. Jaffe's ptatem.ent, Mr. Chairman,but I believe one of the other experts said that there was no euphoricsensation from orally taken methadone.Mr. HoRAN. I say that is flat out untrue.I think the problem is that they are constantly asking a true addictis there any euphoria, and he is telling the truth, for him there isnone, but he is comparing it to heroin. It is like the Irishman and theEnglishman seeing the guy la3'ing in the ditch. The Englishman said,"Look, that guy is drunk." The Irishman said, "No, he isn't, hemoved."It is about the same ball park, really.There is medical research that will substantiate the fact tliat ifyou get to a certain level of heroin use, say the guy who is maybe ahundred dollars a day in the vein, he gets to a certain level where theheroin itself is noneuphoric because he has gotten too high on thescale, there is no euphoria left in the drug for him.In fact, there are some in research who sav you could create thesame blockage M-ith high doses of heroin as you do with high dosesof methadone, because you reach the point where the drug itselfreaches the block.Mr. Winn, Let me ask you one more question.Of the drug deaths that you referred to, could the drug deaths befrom an overdose of oral methadone ?Mr, HoRAN. That is a very good question. In two of the cases itappears that the dead boy was taking it both orally and intravenously.It could have been the combination, although our pathologistsuspects that because of the massive infusion when you go in throughthe vein, that is what causes the quick respiratory system depression.Mr. Winn. We have had some statements made here and the factspresented to us, that some of the deaths not in Fairfax County, butsome of the deaths from methadone really proved out to be not deathsfrom methadone at all, but a combination of lots of other things; isthat possible ?jNIr.HoRAN. Sure it is.Chairman Pepper. The committee has to go to the floor to vote.We will take a brief recess. We will be back in a few minutes.(A brief recess was taken.)

271Chairman Pepper. The committee will come to order, please.Mr. Keatinsr, ttouIcI you like to examine ?]Mr. IvEATixG. ^Ir. Horan, I was not here for your entire testimony.However, the portions that I heard in the question and answer portionof vour statement I found to be excellent.I think ]Mr. Ranp:el had indicated, and I agfree, that the goal we wantto achieve is rehabilitation and not total maintenance for the lifetimeof the addict. So I don't have any specific question, but I wantedto make those comments.Chairman Pepper. Thank you.]Mr. Horan, your testimony about the drug problem in FairfaxCounty is of particular interest to those of us who are on this committeenow who were members of the committee in the last Congress,because either in the latter part of 1969 or the early part of 1970 weheld a hearing in Fairfax Countv, vou recall, in the courthouse?]Mr. HoRAxrYes, sir : the fall of 1969.Chairman Pepper. What interested us was that here was a very finecounty, composed of very fine citizens, high level of income, primarilyresidential in character, that had a heroin problem.I recall very well that we had some students from one of your highschools who testified at our hearing and told about the prevalence ofdrugs in the schools, the high schools.So, you, as the Commonwealth's attorney of Fairfax, are telling usthat in 1969 the drug problem in Fairfax County became serious andcontinues to be, I imagine, a very serious problem.Mr. HoRAx. Yes, sir ; is it.Chairman Pepper. Do you find that drugs, either in one way or another,are related to the crime problem in your county ?Mr. Horan. Mr. Chairman, we have seen in the last 2 years, anyway,a veiy high percentage of drug-related crime. They aren't actuallycoming into the court as a drug case, a drug prosecution, but in thearea of burglary or robbery. We had two murders last year where thedefense to the murder was that it was committed under the influenceof LSD. So we have seen a very high percentage of drug- related crime.Chairman Pepper. So you are concerned about the drug problem inrelationship to crime primarily as the Commonwealth's attorney.You have observed, as a prosecuting attorney, certain reactions tothe use of methadone which have also concerned you and which youhave been very ably telling us about here today. You are speaking, ofcourse, out of your experience as a prosecuting attorney, not as a medicaldoctor, I assume ?Mr. HoRAN. That is right.Chairman Pepper. I suppose we all agree that somehow or anotherwe must find a way of dealing adequately with the drug problem, particularlyheroin problem, and we don't want to create another problemin tryinsf to get rid of the first,Mr. HoRAX. Exactly.Chairman Pepper. You have raised a very serious question as towhether or not a private physician, unskilled in respect to this substanceof methadone and others of similar character, should have autliorityto distribute it. dispense it. There is always a possibility ofabuse. We are very much concerned about that very thinp-. We had "wit-

270It is not up to heroin or morphine, but it is probably on the levelwith Demerol ; anybody who has ever had Demerol will agree it hasa good euphoria.li a guy comes into jail <strong>and</strong> is really not an addict, he is going toget a high.Mr. Winn. Wait just a minute. I want to point out strongly, Mr.Chairman, that this is in direct conflict with testimony we have heardin the past from several of these other experts. I want to point it outbecause it is completely different.Chairman Pepper. Apropos of what my colleague said, the way Ibelieve it was stated by Dr. Jaife this morning was that with the firstlittle bit of taking of methadone you do get a high, but then if the doctorgiving it keeps on experimenting with the individual <strong>and</strong> gets to apoint where that person is stabilized <strong>and</strong> he doesn't get a high,Wasn'tthat the gist?Mr. Winn. I believe that was Dr. Jaffe's ptatem.ent, Mr. Chairman,but I believe one of the other experts said that there was no euphoricsensation from orally taken methadone.Mr. HoRAN. I say that is flat out untrue.I think the problem is that they are constantly asking a true addictis there any euphoria, <strong>and</strong> he is telling the truth, for him there isnone, but he is comparing it to heroin. It is like the Irishman <strong>and</strong> theEnglishman seeing the guy la3'ing in the ditch. The Englishman said,"Look, that guy is drunk." The Irishman said, "No, he isn't, hemoved."It is about the same ball park, really.There is medical <strong>research</strong> that will substantiate the fact tliat ifyou get to a certain level of heroin use, say the guy who is maybe ahundred dollars a day in the vein, he gets to a certain level where theheroin itself is noneuphoric because he has gotten too high on thescale, there is no euphoria left in the drug for him.In fact, there are some in <strong>research</strong> who sav you could create thesame blockage M-ith high doses of heroin as you do with high dosesof methadone, because you reach the point where the drug itselfreaches the block.Mr. Winn, Let me ask you one more question.Of the drug deaths that you referred to, could the drug deaths befrom an overdose of oral methadone ?Mr, HoRAN. That is a very good question. In two of the cases itappears that the dead boy was taking it both orally <strong>and</strong> intravenously.It could have been the combination, although our pathologistsuspects that because of the massive infusion when you go in throughthe vein, that is what causes the quick respiratory system depression.Mr. Winn. We have had some statements made here <strong>and</strong> the factspresented to us, that some of the deaths not in Fairfax County, butsome of the deaths from methadone really proved out to be not deathsfrom methadone at all, but a combination of lots of other things; isthat possible ?jNIr.HoRAN. Sure it is.Chairman Pepper. The committee has to go to the floor to vote.We will take a brief recess. We will be back in a few minutes.(A brief recess was taken.)

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