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

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.320in Permanent Cure of Narcotic Addicts" in this magazine (vol. 4, No. 8, October1966), or to Day top itself, wliicli tias recently prepared a detailed brochure outliningits activities.Premedical[Exhibit No. 14(g)]CtJREICtJLUM VlTAE OF DANIEL H. CaSRIEL, M.D., DiEECTOR, AREBATRAINING(1) Rutgers University, four semesters, prelaw and accounting, September1941 to March 1943.(2) Iowa State College, two semesters, engineering. Army specialized trainingprogram, September 1943 to March 1944.(3) Indiana University, three semesters, premed., March 1944 to January 1945.Medical(1) University of Cincinnati, September 1945 to June 1949; M.D., June 1949.Post Graduate Training(1) Internship: Brooklyn Jewish Hospital, July 1949 to June 1950.(2) Psychiatric residency: Kingsbridge V.A.R., Bronx, N.Y., July 1950 toOctober 1950 ; March 1952 to December 1953 (including Manhattan State Hospitaland Jewish Board of Guardian, for child therapy, Letchworth Village for mentaldefectives )(3) One year credit for assistant chief and chief, neuropsychiatric service,Ryukyus Army Hospital, Okinawa, October 1950 to February 1952 (Captain,Medical Corps, U.S. Army).Military Service(1) Active duty, March 1943 to February 1946, October 1950 to March 1952;inactive reserve, November 1942 to November 1962.Analytic Training(1) Columbia Psychoanalytic Institute for Training and Research, September1952 to February 1954.(2) Persoual analysis: Dr. A. Kardiner, December 1952 to June 1960.LICENSURE, ETC.(1) Qualified p.sychiatrist. State of New York, 1954.',',(2) Diplomate, American Board of Psychiatry and Neurologv in Psvchiatry,1957.(3) New York State Board License No. 73985.(4) License to practice medicine :(a) Ohio, 1949, by examination:(b) New Jersey, 1950, by reciprocity ;(c) New York, 1953. by examination ; and(d) California, 19G0, by examination and reciprocity.PROFESSIONAL POSITIONS(1) Private practice of analytic psychiatry since December in."3 (80-90 percentof working time). Director of Clinical Institute of the Casriel method(new identity process).(2) University Consultation Center, Bronx. N.Y., December 1953 to June 1954.(3) Three schools project of the New York City Youth Board and Board ofEducation, December 1953 to June 19.56.(4) Assistant clinical attending, Hillside Hospital O.P.D.. Mt. Sinai Hospital,t)eoeni))er 19,")3 to June 19."6.(.">) Court psychiatrist to New York City Court of Special Sessions. September1954 to June 1957.(6) Posthospital resident housing program of Jewish Community Service ofLong Island Hospital, June 1956 to June 1961.(7) Therapist to the Girls' Club of Brooklvn, N.Y.. September 19.56 to June1961.
( 19'321(8) Instructor to New York City teachers and guidance counselor, September1956 to June lOnO.(0) Lecturer to probation officers, court of special sessions. September 1959 toSeptember 1961.(10) Staff drug addiction services, Metropolitan Hospital; associate attending.Flower Fifth Avenue Hospital ; instructor in psychiatry. New York MedicalCollege, September 1960 to June 1903.(11) Psychiatric consultant, NIMH; grant to study drug addiction in theU.S. Army. July. August 1962.(12) Psychiatric consultant to the Synanon Foundation, August 1962 to June1964.(13) Consultant: Probation Department, Kings County, New York State SupremeCourt : consultant. Halfway House Daytop Lodge for Drug Addiction,June 1962 to March 1966.(14) Psvchiatric consultant to the Girls Service League of New York City,May 1963.(15) Consultant therapist for youth and work project of the YMCA VocationalService Center in Bedford-Stuyvesant, Brooklyn, February 1965 to February1966.(16) Consultant and therapist for the restoration of young through trainingprogram : A program conducted in cooperation with the New York City Departmentof Correction, March 1965 to September 1965.(17) Cofounder and medical-psychiatric director of Daytop Village, Inc. (anonprofit therapeutic community and an extension of Daytop Lodge). By January1970. 300 people in four physical facilities and four outpatient (SPAN)facilities.(18) Consultant BAN/-BAN/LSD (barbiturates, amphetamines and narcotics).1965 to 1968. An ODP clinic, supervised by the New York State SupremeCourt. Department of Probation. 2d Judicial District.) Temple Medical School, clinical assistant professor of psychiatry, July1967 to date.(20) Group relations Ongoing Workshops, member of board of advisors andchief, ps.vchiatric services, 1968.( 21 ) Board of consultants. Country Place, Warren, Conn.(22) SANE, board of consultants, 1968.(23) Board of directors. Spruce Institute, Philadelphia, Pa., 1967 to date.MEMBERSHIPS(1) New York County and State Medical Association, 1953.(2) American Medical Association, 1953.(3) American Psychiatric Association and District Branch, 1952.(4) Medical Correctional Officers' Association, 1963.(5) American Society of Psychoanalytic Physicians, 1958 (president, 1966 to1967).(6) Association for the Advancement of Psychotherapy, 1962.(7) Pan-American Medical Association, 1967, member of the council in thesection on psychiatry, January 15. 1969.(8) ^Member. Royal Society of Health, 1969.(9) American Public Health Association.PUBLICATIONSBook"So Fair A House." the story of Synanon, Prentice Hall, 225 pages, December5. 1963.Articles(1) "Suicidal Gestures in Occupational Personnel on Okinawa," U.S. ArmedForces, Medical Journal, vol. Ill, No. 12, December 1962.(2) "Intramural Psychiatric Service in a Public High School." New YorkState Journal of Medicine, vol. 56, No. 12, June 1956.(3) "A Mental Hygiene Clinic in a High School," the School Review, Summer1957.
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NARCOTICS RESEARCH, REHABILITATION,
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::VEXHIBIT NO. 4 (a) AND (b)Eddy, D
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urden that such addiction imposes u
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1 (lata; (->) the sliariiis" oF iii
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9Chairman Pepper. The committee is
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::11quota production from unrecogni
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13in this country. This raises the
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15from other clinical projects of w
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:17practice, experience has indicat
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;19.I think a quota would be better
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21When methadone was first introduc
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:::::.—23American Society of Phar
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_'—25.I'BOCUREMENT AND ISSUE DATA
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'.28Fiscal years-1967 1968 1969 197
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30rally in opium. By indirect, the
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32We can, I think, most helpfully g
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34so intense that we haven't done v
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Dr. Eddy. Well, physicians, usually
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38Dr. Eddy. No.Chairman Pepper. Now
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:40get away with it as Dr. Keats su
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:—:42public health hazard was jud
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:44Bibliography(1 Nathan B. Eddy. "
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46(52) Nathan B. Eddy. "Dilaudid."
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48(98) "The New Narcotics, Post-gra
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^.50
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52entails the consideration of addi
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54Chairman Pepper. Have you found t
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56^.I wonder would you care to comm
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58Chairman Pepper. Without objectio
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—1958-681959-«419691962-64196219
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—62abuse and has brought about th
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64bank robbery or an assault. You d
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66Mr. Wiggins. Would the stopping o
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68—Chairman Pepper. Can you give
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:70The problem then would be the wi
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;72taking exceptional measures in t
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)—74pay serious attention to this
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;76From 1958 to 1961, he served as
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78deine in painkilling drugs. So if
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;80ning capabilities, responsibilit
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;:;82terials. If they could introdu
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84Figure 1infrared Ektachrome film
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;86Figure 3.—Tones of wheat (W) a
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88ers at the poppyfields or at any
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:90;:tional situations has handicap
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;;92Locating illicit opium cropsDet
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94Jaffe. Well, there would be some
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96Mr. Jaffe. Primarily on the fact
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98in the same ball park about what
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100Chairman Pepper. Mr, Waldie, do
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::102agencies and input data would
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104most facilities are barely able
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;106We have also studied a ^roup of
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108Dr. Gearing. Yes, sir; I would n
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110somethino: in the nei
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112program is put into the machiner
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I114you have some data there that s
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116Dr. Gearing. It depends on what
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118Chairman Pepper. Would you have
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120it not be so that we could proje
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.122admission rate was approximatel
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124BESULTS(1) Although many of the
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1262. All the members of the methad
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128HETHADOHE MAINTENANCE TREATMENT
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11 1 1 1 1 11130Methadone Halnten?n
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132TABLE 2.-METHAD0NE MAINTENANCE T
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134Figure 9 Methadone tlaintenance
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136Methadone Ka'ntanance Treatmf:nt
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:::.::.138Appendix A^—Methadone M
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140nance treatment patients showing
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142Figure 3 •lethadone Kaintenanc
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144Dr. DuPoNT. 1,760 on methadone m
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:146there are dramatic reductions i
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148Health insurance coverage for me
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150Dr. DtjPont. Well, there are no
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152Mr. Blommer. You would agree the
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154done. Where is the evidence ? No
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156There are several reasons a pers
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158It would seem to me a very busy
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160we had before. I don't think it
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162heroin addiction and support all
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164Dr. DuPoNT. I am reluctant to ge
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166Using this figure as rule of thu
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)168ment facilities for heroin addi
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.170parole departments. None were c
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::172Table 2.— Selected character
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174TABLE 3.—HEROIN ADDICTION RATE
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176W.a^^cc-V.c Cffv..AdF-ro ftcoKjL
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178.^06V f\QrK-'SEt G^ouP/AJ6SIS're
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I180*i coo)u->CM>—'CMUJCOO O COa>
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I(/I182esiMmin0)^> oo.00 =E|c O.2 o
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184encouraged to return to methadon
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186or other side effects. This incr
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:188number as that on the bottle. W
Page 202 and 203:
190Attachment ThreeTo all medical s
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-jI IALLI192ATTACHMENT- FIVE,J: IPA
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194ATTACHMENT NINEGOVERNMENT OF THE
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......—196half of the addicts sta
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198CONCLUSIONSCertain patterns emer
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200TABLE 5.— PROFILE OF BARBITUAR
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202TABLE ll.-SUPPORT OF HEROIN HABI
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204TABLE 17.-AGE OF ADDICTS AND NON
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206TABLE 23.—PRESENT MARITAL STAT
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208TABLE 28.-MILITARY SERVICEAddict
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:210The committee is pleased to cal
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212sists of a network of 21 geograp
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214(6) Basic studies on the nature
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216in fact, constitute autonomous o
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Chairman Pepper. Mr. Perito?218;; M
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^'220is not a very forgiving drug.
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'222Furthermore, in our present con
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—224the Federal Government decide
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-—I have presented one generic ki
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,clinic;?,>•
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230I realize we are running late.Do
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''232'']Vir. Winn. Tiien you mentio
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234So having put it in the area, ha
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,Memberships'—i236privilege of co
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;238A central hypothermic response
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;240South Bronx, Bedford-Stuyvesant
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242€are of patient addicts. We ha
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244hospitals in the city, came into
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246that came into my office, and I
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'Mr.;>•/nmo'.i,,;248deputy commis
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:250two Rockefeller Institute physi
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:252during pliase II that serious e
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254well-structured methadone mainte
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;:256nonsense and serves only to ad
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:258you best complete your statemen
Page 272 and 273:
260Mr. Pertto. Based upon your expe
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262A a'reat case in point was a con
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«264Mr. Steiger. Did you discuss w
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—:266Mr. HoRAN. We don't support
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268Mr. Horan, let's back up a littl
Page 282 and 283: 270It is not up to heroin or morphi
Page 284 and 285: 272nesses yesterday who brought out
Page 286 and 287: 274;Mr. Perito. It is my understand
Page 288 and 289: 276So that at the end of the week t
Page 290 and 291: 278steroid he lias in him we might
Page 292 and 293: 280Mr. Perito. You are referriii"'
Page 294 and 295: 282not drug free. I can say approxi
Page 296 and 297: 28 A$2-a-day habit these individual
Page 298 and 299: •As286I got to the point once in
Page 300 and 301: 288Mr. Steiger. You mentioned anoxi
Page 302 and 303: 290Mr. Eangel. I could see then tha
Page 304 and 305: 292Dr. Casriel. Mr. Keating, I have
Page 306 and 307: j294What period of time are ^ve tal
Page 308 and 309: 296was March of 1970—he was admit
Page 310 and 311: 298"The paper by Dole and Nyswander
Page 312 and 313: :300vent them from coming to New Yo
Page 314 and 315: 302[Exhibit No.14(b)]Casriel Instit
Page 316 and 317: 304to result from the insuflScient
Page 318 and 319: 306It is this role of the intervent
Page 320 and 321: 308EESULTSStudies concerning tlie p
Page 322 and 323: 310The method derives from a specia
Page 324 and 325: 312Why is this happening? What need
Page 326 and 327: m)effective with uncured alcoholics
Page 328 and 329: I316Casriel, who is medical-psychia
Page 330 and 331: 318resort to heroin. One must not f
Page 334 and 335: 322!(4) '-Modification of Adaptatio
Page 336 and 337: 324sections of the country, all sor
Page 338 and 339: ;Mr.Pertto.niuch,I?,Mr. Peritq. Tha
Page 340 and 341: 328Chairman Pepper. Mr. Steiger.Mr.
Page 342 and 343: , Mr., In''wMr, WiNx.nltiiink tlie
Page 344 and 345: :332"Stomach cramps" were found to
Page 346 and 347: 'i.We334'""^li'anTOanl^ETPPEiL That
Page 348 and 349: :))))336would be deprived of any cl
Page 350 and 351: 338less abuse liability than agents
Page 353 and 354: NARCOTICS RESEARCH, REHABILITATION,
Page 355 and 356: CONTENTSApril 26 1April 27 77April
Page 357 and 358: :•vEXHIBIT NO. 4 (a) AND (b)Eddy,
Page 359: :lovernor,vnEXHIBIT NO. 21 (a) and
Page 362 and 363: 342have no desire to preempt the au
Page 364 and 365: 344We hope these hearings will prov
Page 366 and 367: 346tons in 1962 and to 155 tons in
Page 368 and 369: 348SOUTHEAST ASIAAs you know also,
Page 370 and 371: 350I would also point out as I did
Page 372 and 373: 352their farmers who have been grow
Page 374 and 375: 354told that much of the insurgency
Page 376 and 377: 356Mr. IxGERSOLL. Well, again, Mr.
Page 378 and 379: 358jority of the heroin problem in
Page 380 and 381: 360years, but I have been frustrate
Page 382 and 383:
362Mr, Steiger. If you were goin^ t
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364report marihuana among junior gr
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366And it seems to me tliat we Avou
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?368effectively, then maybe we will
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370improvement as far as the abilit
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372was there. Your visits probably
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374the purchase of Avitnesses—I s
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:376administrations to publicly say
Page 398 and 399:
378Chairman Pepper. We will take a
Page 400 and 401:
380Mr. Ingersoll. No. I don't recal
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:382can fulfill the vow made by the
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384have to give you the same answer
Page 406 and 407:
386Mr. Brasco. But that is another
Page 408 and 409:
388Mr. Ingeksoll. Well, that is the
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Page 413 and 414:
-39,3,Dr. Edwards held a surgical f
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395of Narcotics and Dangerous Drugs
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397Naloxone, recently approved for
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399for example, who might be abusin
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401Now, because of our attention ha
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403and this is only for the investi
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405effects this drug will produce i
Page 427 and 428:
407Now, if it is not used intravene
Page 429 and 430:
409Mr. Wiggins. Dr. Jennings, does
Page 431 and 432:
411Penicillin is good for pneumonia
Page 433 and 434:
413Mr. R ANGEL. But from the studie
Page 435 and 436:
415Dr. Gardner. Again, we don't hav
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417Dr. Edwards. I suspect it at lea
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419On the other hand, if serious si
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421of the best known programs. Alth
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423Medical Association, American Ps
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425of the United States Pharmacopei
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4275. Repeated examinations. Physic
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429agement and rehabilitation of se
Page 451 and 452:
—431As the agenc.v within HEW whi
Page 453 and 454:
433and complex acts such as driving
Page 455 and 456:
435(Inig induces physical and psych
Page 457 and 458:
437Chiiirmtin Pepper. Doctor, I thi
Page 459 and 460:
439A large proportion of youngsters
Page 461 and 462:
441Dr. Brown, what would you say is
Page 463 and 464:
443Chairmiui Pepper. Wliat is tlie
Page 465 and 466:
446The state of the art is promisin
Page 467 and 468:
447Lot nie ask you first, is tlic d
Page 469 and 470:
449Chairman Pepper. Do you happen t
Page 471 and 472:
451want you to take a look at. We w
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453In addition to that, there seems
Page 475 and 476:
455the Mfldict is having a program
Page 477 and 478:
457—on drugs? By that I mean, vei
Page 479 and 480:
459\\ e are basically saying, in or
Page 481 and 482:
—;461that this is the extent to w
Page 483 and 484:
463We could go into the drug area a
Page 485 and 486:
.465program that was i)ut into Jack
Page 487 and 488:
467Mr. Brasco. Possibly. However, w
Page 489 and 490:
469him, arrange to get somebody els
Page 491 and 492:
471ainpheta.mines, or barbiturates.
Page 493 and 494:
473In the meantime, the Institute d
Page 495 and 496:
475treated in the community centers
Page 497 and 498:
477research on narcotics in the sam
Page 499 and 500:
479c 53 03E
Page 501 and 502:
Page 503 and 504:
483spending for research through NI
Page 505 and 506:
485There has been no concerted seri
Page 507 and 508:
487it is left in one of their veins
Page 509 and 510:
489I do not think I should explain
Page 511 and 512:
491Dr. ViLLARREAL. Until the reflex
Page 513 and 514:
493evidence strongly shows is that
Page 515 and 516:
495Chairman Pepper. One other quest
Page 517 and 518:
497Dr. ViLLARREAL. So, it is a biol
Page 519 and 520:
'.499could result in a laboratory s
Page 521 and 522:
5qifinds it in normal exploration.
Page 523 and 524:
503synthesized a large number of na
Page 525 and 526:
505STATEMENT OE DR. ALBERT KURLAND,
Page 527 and 528:
507discovered if we iiad taken the
Page 529 and 530:
509Mr. Perito. Dr. Kurland, do you
Page 531 and 532:
511Chairman Pepper. Has the Food an
Page 533 and 534:
513]Mr. Steiger. Do you feel from y
Page 535 and 536:
515In this second study there was a
Page 537 and 538:
517were any significant differences
Page 539:
519The Deceptive Communication and
Page 542 and 543:
.522than a State psychiatric hospit
Page 544 and 545:
524Department of Mental Hygiene), R
Page 546 and 547:
TABLE 3—COMPARISON OF THE 1ST POS
Page 548 and 549:
528TABLE 10—RELATIONSHIP OF AGE T
Page 550 and 551:
530tution and his involvement in th
Page 552 and 553:
Attachment No. 5;r\ N-CH,-CH=CHo ,
Page 554 and 555:
'-534Chart No. U (case No. 672)Disp
Page 556 and 557:
536Chart No. 4 (case No. 694)Illust
Page 558 and 559:
538Chart No. 35 {case No. 697)Excep
Page 560 and 561:
540This amount of heroin is roughly
Page 562 and 563:
5msuccessful or not in that short a
Page 564 and 565:
544Chairman Pepper. Would you repea
Page 566 and 567:
54^creased amount of licit as well
Page 568 and 569:
—54Sand the bureaucracy and the a
Page 570 and 571:
,,Mr.550you have used some of the s
Page 572 and 573:
552so many areas is also a pitiful
Page 574 and 575:
55,4nitiide of heroin addiction in
Page 576 and 577:
556reached $976.5 billion, we can w
Page 578 and 579:
558Mr. Jones was appointed to the c
Page 580 and 581:
560cant when you consider that Out
Page 582 and 583:
562criminal act in his lifetime. Ye
Page 584 and 585:
—564Mr. Perito. Would it be fair
Page 586 and 587:
566Now, Dr. Cliambers, can yon resp
Page 588 and 589:
—568Mr. Raxgel. Our distinguished
Page 590 and 591:
;-570Mr. Jones. That is correct. Ou
Page 592 and 593:
572the commissioner, $186 million i
Page 594 and 595:
574there should be something in the
Page 596 and 597:
576and the way in which the funds a
Page 598 and 599:
57SDr. Chambers. I think wliat you
Page 600 and 601:
580Education is the best way of pre
Page 602 and 603:
58-2Certain essential facts must re
Page 604 and 605:
584done through determined action,
Page 606 and 607:
586druffs, has the Nation's largest
Page 608 and 609:
:588To repeat, methadone maintenanc
Page 610 and 611:
:590I believe the Federal Governmen
Page 612 and 613:
:take no such satisfaction. We have
Page 614 and 615:
594of value in the testimony you ha
Page 616 and 617:
596gone ahead with several. We have
Page 618 and 619:
598force within our State Police De
Page 620 and 621:
60PRased on the proposed goal of 2.
Page 622 and 623:
602STATEMENT OF HON. MILTON SIIAPP,
Page 624 and 625:
(51)4and apprehend the wholesalers
Page 626 and 627:
J'606[Exhibit No. 23Prepared Statem
Page 628 and 629:
608Under our 1071-72 budget proposa
Page 630 and 631:
GIOcenters for the treatment of her
Page 632 and 633:
. Dr.612Bourne informs me that we h
Page 634 and 635:
614Governors in Atlanta to which re
Page 636 and 637:
616pretty bad news, because it indi
Page 638 and 639:
618Scientific statistical ioformati
Page 640 and 641:
620((')) Finally, I believe that al
Page 642 and 643:
622Governor Carter. I certainly rec
Page 644 and 645:
624programs that are now available,
Page 646 and 647:
626all of the top officials in the
Page 648 and 649:
628perhaps greater than some of the
Page 650 and 651:
)630tion and many others attempting
Page 652 and 653:
632(3) Long term residential self-h
Page 654 and 655:
634for the support of drug service
Page 656 and 657:
:636D. NARCO, Inc.Narcotics Addicti
Page 658 and 659:
638crimes to obtain the necessary m
Page 660 and 661:
640million to $25 milliou per year.
Page 662 and 663:
642Mr. Perito. Thank yoii. Mr. Chai
Page 664 and 665:
644narcotic antagonist, and the oth
Page 666 and 667:
646. Dr. Kramer. From what I have s
Page 668 and 669:
—(348your money on, but methadone
Page 670 and 671:
—650I know of no techinque in pri
Page 672 and 673:
652Dr. Kramer. Yes, sir. As a matte
Page 674 and 675:
:'654prison and who liave no—wlio
Page 676 and 677:
65GDr. KT?A:\rEij. 1 suspect tliat
Page 678 and 679:
658support some of the inethadone p
Page 680 and 681:
'6660Dr. IvKAisrKK. 1 believe that
Page 682 and 683:
662jrest that the Veterans' Adminis
Page 684 and 685:
664opiates may be ingested in sever
Page 686 and 687:
666(5) It suppresses the desire for
Page 688 and 689:
668Many people have benefited from
Page 690 and 691:
—G70Other researches which may di
Page 692 and 693:
672synthetic painkillers, our commi
Page 694 and 695:
074IV. A universal ban on legitimat
Page 696 and 697:
..676iTlius we must look to educati
Page 698 and 699:
678states, from Arnold Becker, publ
Page 700 and 701:
680However, we must look at rehabil
Page 702 and 703:
:682(a) The natural history of narc
Page 704 and 705:
684was a heavy user. The decrease i
Page 706 and 707:
686(13) Wallace. R. K. : Physiologi
Page 708 and 709:
688TABLE 9.-USE OF "HARD LIQUOR" BE
Page 710:
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