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

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324sections of the country, all sorts of small towns out of Boston ; out inPalmer they have heroin and it is becoming more and more available,whatever the efforts of the Bureau of Narcotics and Dangerous Drugs.All they have done is to serve to drive the price up, and make it moreprofitable. They have also, in large measure, prevented doctors fromtreating this disease for a long time.They in large measure are responsible for this epidemic. We mustdo something to remove the addict from the streets, to remove himfrom the drug market. Obviously, with all the efforts of the narcoticsacts and the customs ser\ice, and what have you, more and moreheroin has come into this country every day. It is getting cheaperand better and our efforts must be concentrated on the addict in thestreet, getting him out of the market.This is why I feel tliat methadone is extremely valuable. I don'thave the same feelings about methadone that the previous witnessesdo. But I think of it in terms of removing the addict from the drugscene. Perse has this possibility, too, and I think it is an extremelyvaluable and useful thing.It also makes possible the study of addiction on the cellular level.This is the first time that they have a nonnarcotic antitoxin to thenarcotic. There are techniques, for instance, for injecting this materialdirectly into the brain, and in my hospital in Boston city they canput whatever they want to in any given area of the brain directlyand this can be studied, and this Perse is a tremendous breakthrough.I certainly hope we will be able to use it very soon.Chairnian Pepper. Well, Doctor, you said you sent about how m.anypatients down from Boston to New York?Dr. Davidsox. Between 45 and 50.Chairman Pepper, You can testify that about how many of thoseseemed to be cured or were detoxified ?Dr. Davidson. A great many of them do v.liat Reverend Masseyand Dr. Casriel pointed out, that they use it to cut down on theirhabits.I would say of those that I found, about one-third are clean. Thatis a tremendous cure.You know, for instance, there is one patient I did send down whocame back and said, "Doctor," she said, "I don't remember any morewhat it is like to be high. My body doesn't remember what it waslike to be higli on heroin.''Her roommate uses heroin, and her fiance uses heroin, and in abouta month she was using heroin again.I think that is in microcosm a good picture of the generalization.But when they told me that she didn't remember what it was liketo be high, that is extremely important because, you know, once youare hooked and you have the craving, however much will ])ower youcan apply, it just isn't enough, liecause day after day after day itis practically impossible, ])eo]ile will succumb.Everybody has a different strength of will, but everybody hashis breaking point, and this is why the cure rate, so-called, in placeslike Lexington and any other medical treatment has been in theneighborhood of 2 percent all these years.
—325Chairman Pepper. "Well, Doctor, once a person, as you say. getshooked on heroin, it is almost a livino; death if he can't cret some relieffrom it.In the first place, the fellow has cot to take several shots a day,and they tell me that yon mi
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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
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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
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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
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270It is not up to heroin or morphi
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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 332 and 333: .320in Permanent Cure of Narcotic A
Page 334 and 335: 322!(4) '-Modification of Adaptatio
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
Page 384 and 385: 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
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378Chairman Pepper. We will take a
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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
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386Mr. Brasco. But that is another
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388Mr. Ingeksoll. Well, that is the
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-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
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407Now, if it is not used intravene
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409Mr. Wiggins. Dr. Jennings, does
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411Penicillin is good for pneumonia
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413Mr. R ANGEL. But from the studie
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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
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—431As the agenc.v within HEW whi
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433and complex acts such as driving
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435(Inig induces physical and psych
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437Chiiirmtin Pepper. Doctor, I thi
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439A large proportion of youngsters
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441Dr. Brown, what would you say is
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443Chairmiui Pepper. Wliat is tlie
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446The state of the art is promisin
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447Lot nie ask you first, is tlic d
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449Chairman Pepper. Do you happen t
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451want you to take a look at. We w
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453In addition to that, there seems
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455the Mfldict is having a program
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457—on drugs? By that I mean, vei
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459\\ e are basically saying, in or
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—;461that this is the extent to w
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463We could go into the drug area a
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.465program that was i)ut into Jack
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467Mr. Brasco. Possibly. However, w
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469him, arrange to get somebody els
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471ainpheta.mines, or barbiturates.
Page 493 and 494:
473In the meantime, the Institute d
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475treated in the community centers
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477research on narcotics in the sam
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479c 53 03E
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483spending for research through NI
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485There has been no concerted seri
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487it is left in one of their veins
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489I do not think I should explain
Page 511 and 512:
491Dr. ViLLARREAL. Until the reflex
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493evidence strongly shows is that
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495Chairman Pepper. One other quest
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497Dr. ViLLARREAL. So, it is a biol
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'.499could result in a laboratory s
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5qifinds it in normal exploration.
Page 523 and 524:
503synthesized a large number of na
Page 525 and 526:
505STATEMENT OE DR. ALBERT KURLAND,
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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
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517were any significant differences
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519The Deceptive Communication and
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.522than a State psychiatric hospit
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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
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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
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538Chart No. 35 {case No. 697)Excep
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540This amount of heroin is roughly
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5msuccessful or not in that short a
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544Chairman Pepper. Would you repea
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54^creased amount of licit as well
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—54Sand the bureaucracy and the a
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,,Mr.550you have used some of the s
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552so many areas is also a pitiful
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55,4nitiide of heroin addiction in
Page 576 and 577:
556reached $976.5 billion, we can w
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558Mr. Jones was appointed to the c
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560cant when you consider that Out
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562criminal act in his lifetime. Ye
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—564Mr. Perito. Would it be fair
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566Now, Dr. Cliambers, can yon resp
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—568Mr. Raxgel. Our distinguished
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;-570Mr. Jones. That is correct. Ou
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572the commissioner, $186 million i
Page 594 and 595:
574there should be something in the
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576and the way in which the funds a
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57SDr. Chambers. I think wliat you
Page 600 and 601:
580Education is the best way of pre
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58-2Certain essential facts must re
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584done through determined action,
Page 606 and 607:
586druffs, has the Nation's largest
Page 608 and 609:
:588To repeat, methadone maintenanc
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:590I believe the Federal Governmen
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:take no such satisfaction. We have
Page 614 and 615:
594of value in the testimony you ha
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596gone ahead with several. We have
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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
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GIOcenters for the treatment of her
Page 632 and 633:
. Dr.612Bourne informs me that we h
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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,
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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
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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
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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
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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
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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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