Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
Narcotics research, rehabilitation, and treatment. Hearings, Ninety ... Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
:332"Stomach cramps" were found to be generally "slight" with only one "bad"with Perse ; and "moderate" or "bad" with one "none" without it.The "no sleep" symptom varied a lot with Perse—three "bad." three "none,"the rest "moderate" ; without Perse—generally "bad" or "moderate."The sympton of "irritability" varied also with about sis patients recording"none," two "bad," the others "slight" or "moderate" with Perse; while themajority noted the symptom as "bad," with the rest "moderate' or "slight,"without.With Perse "tension and nerviousness" was recorded by most as "bad" withsome "moderate" or "slight" and one "none." Without Perse, all put down "bad"with the exception of one "slight.""Craving" seemed notably diminished with Perse, the majority recording"none." Without it, the symptom was noted by most as "bad."In answer to the last symptom, "tiredness," seven recorded it as "bad" withthree "slight" or "none" and two "moderate" with Per.se ; while eight noted itas "bad," the rest "moderate" or "slight" and one "none" without Perse.All patients, with the exception of two, recorded that Perse made their withdrawalsymptoms better. The two that differed said that Perse had "no effect"and were, incidentally, addicted to rather high daily dosages of methadone.Methadone addicts have been found to require a longer period to withdraw thando heroin addicts. Most likely the chances of a successful withdrawal for thesepeople would have been greater if the perse therapy had been continued over alonger period of time.In response to the question involving the overall success of withdrawal onPerse the majority of the patients said that it was indeed "successful," with twostating that it was "partially" so and two that it was "not successful." Again,these last two were addicted to methadone and probably needed more time whichthis particular study was not set up to give.Many of the users involved remarked verbally as well as in the questionnairethat they were struck by the fact that they experienced "no craving" for dopeon Perse. One girl mentioned that she "forgot what it was like to be stoned."That perse seems to block off the craving for drugs in most people is an importantattribute. This craving or the desire to return to drugs after experiencing theusual withdrawal distress and being clean is the result of "complex rationalizationswhich are difficult for the nonaddict to \inderstand." ^A person assumes several different attitudes as he becomes addicted to drugsHe sees himself as an addict : he desires to increase his dosage ; he is constantlydependent on the drug ; and he sees the drug as a kind of panacea and variousmoral taboos wear off as the immediate beneficial effects of the drug becomerealized. Inherent in all this is a "reversal of effects" ^ in which the opiate "originallyforeign to the body, becomes intrinsic" ^ as the union between it and thebrain cells grows stronger. It becomes a nutritive element—a "means of carryingout the business of the entire organism." ^ This reversal occurs gradually andpermiates deeply.Drug addiction itself and the accompanying attitudes are all the result of theuser's awareness and fear of withdrawal distress. Even after "successful" withdrawalthese attitudes, although formed as a result of withdrawal distress, persistsindependent of it. Therefore the fact that perse seems to block off thedesire for opiates is of considerable value in the face of the deep seated, somewhatirreversible nature of drug addiction.There were problems encountered in the study which revealed the need to"tease out" psychological from physical withdrawal symptoms. Strangely enough,withdrawal symptoms have been known to reoccur in some after a year of abstainencefrom narcotics. Perhaps a double-blind study would solve some of theproblem in separating the psychological from the physical and help evaluateperse.Certain patients involved in this pioneer study were not psychologically readyto withdraw from their addiction. Obviously a study of this kind can only beuseful to addicts who are ready for it. Perhaps a preliminary preparation ofpatients involved in further perse studies would somewhat insure their readinessto undergo withdrawal and to respond as objectively as possible.^Alfred R. Llndesmith, "Opiate Addiction"; (Princlpia Press of Illinois, Inc., 1957)p. 12."..2 Ibid., p. 29.3 Ibid., p. 29.*Ibid.. p. 29.
333The Perse experiment also revealed the need for a standardized environmentconducive to drug withdrawal. Some patients were placed together and lefton a "ward" with nothing to do but dwell on their symptoms ; while others hadto find their own acco^nmodations outside and report to Dr. Revici daily. Withdrawalpatients need people around them. Patients left alone have been known tosuffer longer distress. A supportive staff would help to guide and encourage thepatients in their individual interests and activities ; to maintain a therapeuticatoniisphere conducive to both psychological withdrawal from the whole drugmilieu and physical withdrawal from the drug itself.Again, in order to receive pertinent, cogent results from a study like this theenvironment must be standardized and rehabilitative. The dosages of thePerse administered must also be standardized according to the extent of theindividual patient's addiction. Because of the preliminary nature of this experimentthese things were not fully accomplished. Different dosages were givento different patients, the extent of whose addiction was not often clear. Somepeople needed more than the allotted time for withdrawal as has been pointedout. A fixed potentcy and a definite schedule should be maintained in relationto each patient.Enough followup information on each subject involved is also important ifthere are accurate, cumulative results to be gained. All of the patients were notable to be located following the study and less than half filled out the questionnaireneeded in this evaluation.That there is a definite need for a more solid, clear method to be followedfor future studies with Perse is obvious. Preliminary preparation of patients, arehabilitative environment, a supportive staff, standardized dosages of Perse,and extensive followups of each subject would all help in revealing more clearlythe merits of Perse. But i-egardless of the beginning nature of this study andits often varied results, it is obvious that Perse causes a definite altei'ing ofwithdrawal distress. Indeed, many heroin addicts reported complete successwith Perse ; and the overall effect of the drug on those addicted to methadone—a notoriously difficult drug to kick—were encouraging enough to warrantmore extensive study. Methadone itself has been proven to be a very beneficialtranquilizer to heroin addicts of certain temperaments. Its only drawbackis that it is addictive. If Perse could solve this problem methadone could beused more freely in drug therapy.This preliminary study with Perse has revealed the strong possibility that anonaddictive cure for narcotics addiction has been discovered. The dilemma ofaddiction becomes more urgent every day and this new medication could possiblybe a cure. This in itself is enough to warrant more extensive tests of Perse.NflmpPerseStudy
- 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 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 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
- Page 386 and 387: 366And it seems to me tliat we Avou
- Page 388 and 389: ?368effectively, then maybe we will
- Page 390 and 391: 370improvement as far as the abilit
- Page 392 and 393: 372was there. Your visits probably
:332"Stomach cramps" were found to be generally "slight" with only one "bad"with Perse ; <strong>and</strong> "moderate" or "bad" with one "none" without it.The "no sleep" symptom varied a lot with Perse—three "bad." three "none,"the rest "moderate" ; without Perse—generally "bad" or "moderate."The sympton of "irritability" varied also with about sis patients recording"none," two "bad," the others "slight" or "moderate" with Perse; while themajority noted the symptom as "bad," with the rest "moderate' or "slight,"without.With Perse "tension <strong>and</strong> nerviousness" was recorded by most as "bad" withsome "moderate" or "slight" <strong>and</strong> one "none." Without Perse, all put down "bad"with the exception of one "slight.""Craving" seemed notably diminished with Perse, the majority recording"none." Without it, the symptom was noted by most as "bad."In answer to the last symptom, "tiredness," seven recorded it as "bad" withthree "slight" or "none" <strong>and</strong> two "moderate" with Per.se ; while eight noted itas "bad," the rest "moderate" or "slight" <strong>and</strong> one "none" without Perse.All patients, with the exception of two, recorded that Perse made their withdrawalsymptoms better. The two that differed said that Perse had "no effect"<strong>and</strong> were, incidentally, addicted to rather high daily dosages of methadone.Methadone addicts have been found to require a longer period to withdraw th<strong>and</strong>o heroin addicts. Most likely the chances of a successful withdrawal for thesepeople would have been greater if the perse therapy had been continued over alonger period of time.In response to the question involving the overall success of withdrawal onPerse the majority of the patients said that it was indeed "successful," with twostating that it was "partially" so <strong>and</strong> two that it was "not successful." Again,these last two were addicted to methadone <strong>and</strong> probably needed more time whichthis particular study was not set up to give.Many of the users involved remarked verbally as well as in the questionnairethat they were struck by the fact that they experienced "no craving" for dopeon Perse. One girl mentioned that she "forgot what it was like to be stoned."That perse seems to block off the craving for drugs in most people is an importantattribute. This craving or the desire to return to drugs after experiencing theusual withdrawal distress <strong>and</strong> being clean is the result of "complex rationalizationswhich are difficult for the nonaddict to \inderst<strong>and</strong>." ^A person assumes several different attitudes as he becomes addicted to drugsHe sees himself as an addict : he desires to increase his dosage ; he is constantlydependent on the drug ; <strong>and</strong> he sees the drug as a kind of panacea <strong>and</strong> variousmoral taboos wear off as the immediate beneficial effects of the drug becomerealized. Inherent in all this is a "reversal of effects" ^ in which the opiate "originallyforeign to the body, becomes intrinsic" ^ as the union between it <strong>and</strong> thebrain cells grows stronger. It becomes a nutritive element—a "means of carryingout the business of the entire organism." ^ This reversal occurs gradually <strong>and</strong>permiates deeply.Drug addiction itself <strong>and</strong> the accompanying attitudes are all the result of theuser's awareness <strong>and</strong> fear of withdrawal distress. Even after "successful" withdrawalthese attitudes, although formed as a result of withdrawal distress, persistsindependent of it. Therefore the fact that perse seems to block off thedesire for opiates is of considerable value in the face of the deep seated, somewhatirreversible nature of drug addiction.There were problems encountered in the study which revealed the need to"tease out" psychological from physical withdrawal symptoms. Strangely enough,withdrawal symptoms have been known to reoccur in some after a year of abstainencefrom narcotics. Perhaps a double-blind study would solve some of theproblem in separating the psychological from the physical <strong>and</strong> help evaluateperse.Certain patients involved in this pioneer study were not psychologically readyto withdraw from their addiction. Obviously a study of this kind can only beuseful to addicts who are ready for it. Perhaps a preliminary preparation ofpatients involved in further perse studies would somewhat insure their readinessto undergo withdrawal <strong>and</strong> to respond as objectively as possible.^Alfred R. Llndesmith, "Opiate Addiction"; (Princlpia Press of Illinois, Inc., 1957)p. 12."..2 Ibid., p. 29.3 Ibid., p. 29.*Ibid.. p. 29.
Change language