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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24(The following letter was received for the record.)[Exhibit No. 3]Assistant Secretary of Defense,Washington, D.C., June 28, 1971.Hon. Claude Pepper,House of Representatives,Washington, B.C.Dear Mr. Pepper : This is in reply to your letter of June 7 in which you requestedour views on the use of opium derivative drugs in the military medicalservices and statistical data representing procurement and issues of these drugitems, as well as synthetic pharmaceuticals with similar effects."A consensus of military medical opinion on the need for opium derivativedrugs to treat casualties in the field and in hospitals." It is the consensus ofthe Military Medical Departments that opiate drugs have an established placein medical practice and cannot adequately be replaced by any other substances.The need for opiate drugs is predicated on the pi-inciple that the highest possiblequality of medical care should be rendered to military personnel and theirdependents. While it is true that there are many occasions when the syntheticanalgesic drugs would suffice, there is also a substantial number of indicationswhere the opiate drugs are clearly superior. For example, it has not beendemonstrated that the synthetic drugs are equal in efficacy to the opiates inmyocardial infarction, acute pulmonary edema, and in relief of pain in theseverely wounded."A consensus of military medical opinion on (a) the use of, and (b) the effectivenessof synthetic analgesic substitutes to treat casualties in the field andin hospitals." The synthetic analgesics have a significant and increasing usefulnessin treating casualties in the field and in hospitals. However, there remainsa substantial proportion of casualties in whom the opiate drugs are clearlypreferable. In addition, many of the synthetic analgesics have only a veryshort period of experience with their use and it would be unwise to restrictmedical practice by relying solely on these newer compounds."A consensus of military medical opinion on the advisability of eliminatingopium derivative drugs and the substitution of synthetic analgesics." It wouldbe inadvisable to eliminate opiate drugs from medical and surgical practice. ItIs evident that the amount of opiate drugs used could be greatly curtailed bysubstitution of the synthetic drugs. However, the total removal of opiates frommedical practice would result in less than optimum treatment of countless individualshaving life-threatening diseases and injuries.Statistical data representing procurements and issues of centrally managedopium derivative drugs, as well as synthetic pharmaceuticals with similar effects,is attached as enclosure 1. This data represents the latest 4 complete fiscalyears. Data prior to fiscal year 1967 is not available. Miss Hastings of yourstaff agreed to the submission reflecting this period of time.Although most of the opium derivative drugs are procured and issued to themilitary medical services by the Defense Supply Agency, larger medical facilitieslocally procure nonstandard, slow moving opium derivative drugs. These facilitiesare all registered with the Bureau of Narcotics and Dangerous Drugs.Attached as enclosure 2 is a copy of the regulation "Safeguarding of Sensitive. Drug Abuse Control, and Pilferable Items of Supply" as per your request.The Veterans' Administration does not procure these items from the Departmentof Defense. The Veterans' Administration has its own procurement systemand buys these items directly from vendors.There are no separate regulations or security precautions applicable to syntheticanalgesics versus opium derivatives. The governing factor in this instanceis whether the Bureau of Narcotics and Dangerous Drugs has classified the itemin one of five schedules for controlled substances. If so. security measures arerequired ; however, these items are dispensed by prescription only.I trust this information will be of assistance to you and the committee.Sincerely,Louis M. Roussei.ot, M.D., F.A.C.S.

_'—25.I'BOCUREMENT AND ISSUE DATA FOB CENTRALLY STOCKED OpIUM DERIVATIVEDrugs and Synthetic Analgesics With Similar EffectsThe information in tliis enclosure is qualified as follows :1. Procurement quantities are indicated by the fiscal year in which contractsw^ere awarded (or delivery orders processed). Actual delivery to DSA depotsand subsequent issue to DSA customers does not normally correspond to thesefiscal years. In addition tlo Army, Navy and Air Force units, the DSA has interagencyagreements to supply medical materiel directly to the followingFederal agencies : NASA, USAID, D.C. Government, U.S. Coast Guard, FAA andGSA. Certain Army, Navy and Air Force units also supply directly to other Federaland foreign agencies. For example, the Republic of Vietnam Armed Forcesand USAID in Vietnam are supplied with medical materiel from the U.S. ArmyMedical Depot in Okinawa.2. In some cases, procurement and issue data do not appear to be related. Thiscan occur when items are being phased out of the distribution system or newitems are added to the armamentarium. Further, changing mobilization reservemateriel objectives may be responsible.3. Only those forms of propoxyphene containing at least 65mg are included.4. Methadon is n(jt managed centrally as yet.Fiscal years19671968 1969 19706505-114-8950—Codeine sulfate tablets, NF, 32 mg., 20's:Procured by DPSC ^ 24,700Issued to:Army _ _ ._ 4,797Navy 1,678Air Force 640IVIAP 20Other = _.. 36505-114-8975— Codeine sulfate tablets, NF, 32 mg., lOO's:Procured by DPSC 92,016Issued to:Army ^fek 9,525Navy 9,420Air Force. 9,088MAP 9.803Others 14,9876505-615-8979—Codeine phosphate, USP, 1 oz. (28.35 gm.):Procured by DPSC 2,502Issued to:Army 5,306Navy - _. 1,752Air Force 576MAP...,. 144Oth^ir 196505-864-8092— Codeine phosphate injection, USP, 30 mg.cartridge-needle unit 1 cc, 20's:Procured by DPSC iIssued to:Army.... 2,610Navy.. 1,367Air Force 1,071MAP.L-.Other 26505-864-8091—Codeine phosphate injection, USP, 60 mg.,cartridge-needle unit 1 cc, 20's:Procured by DPSC .^^..^ ic..: 4,230Issued to: ^ ' =Army 1,181Navy 1,293Air Force. 7323,638IVIAP .Other6505-929-8986— Hydromorphine, HOI injection, NF, 2 mg.cartridge-needle unit 1 cc, 20's:Procured by DPSC 10,200Issued to:ArmyNavyAir Force 19MAPOtherSee footnotes at end of article.

_'—25.I'BOCUREMENT AND ISSUE DATA FOB CENTRALLY STOCKED OpIUM DERIVATIVEDrugs <strong>and</strong> Synthetic Analgesics With Similar EffectsThe information in tliis enclosure is qualified as follows :1. Procurement quantities are indicated by the fiscal year in which contractsw^ere awarded (or delivery orders processed). Actual delivery to DSA depots<strong>and</strong> subsequent issue to DSA customers does not normally correspond to thesefiscal years. In addition tlo Army, Navy <strong>and</strong> Air Force units, the DSA has interagencyagreements to supply medical materiel directly to the followingFederal agencies : NASA, USAID, D.C. Government, U.S. Coast Guard, FAA <strong>and</strong>GSA. Certain Army, Navy <strong>and</strong> Air Force units also supply directly to other Federal<strong>and</strong> foreign agencies. For example, the Republic of Vietnam Armed Forces<strong>and</strong> USAID in Vietnam are supplied with medical materiel from the U.S. ArmyMedical Depot in Okinawa.2. In some cases, procurement <strong>and</strong> issue data do not appear to be related. Thiscan occur when items are being phased out of the distribution system or newitems are added to the armamentarium. Further, changing mobilization reservemateriel objectives may be responsible.3. Only those forms of propoxyphene containing at least 65mg are included.4. Methadon is n(jt managed centrally as yet.Fiscal years19671968 1969 19706505-114-8950—Codeine sulfate tablets, NF, 32 mg., 20's:Procured by DPSC ^ 24,700Issued to:Army _ _ ._ 4,797Navy 1,678Air Force 640IVIAP 20Other = _.. 36505-114-8975— Codeine sulfate tablets, NF, 32 mg., lOO's:Procured by DPSC 92,016Issued to:Army ^fek 9,525Navy 9,420Air Force. 9,088MAP 9.803Others 14,9876505-615-8979—Codeine phosphate, USP, 1 oz. (28.35 gm.):Procured by DPSC 2,502Issued to:Army 5,306Navy - _. 1,752Air Force 576MAP...,. 144Oth^ir 196505-864-8092— Codeine phosphate injection, USP, 30 mg.cartridge-needle unit 1 cc, 20's:Procured by DPSC iIssued to:Army.... 2,610Navy.. 1,367Air Force 1,071MAP.L-.Other 26505-864-8091—Codeine phosphate injection, USP, 60 mg.,cartridge-needle unit 1 cc, 20's:Procured by DPSC .^^..^ ic..: 4,230Issued to: ^ ' =Army 1,181Navy 1,293Air Force. 7323,638IVIAP .Other6505-929-8986— Hydromorphine, HOI injection, NF, 2 mg.cartridge-needle unit 1 cc, 20's:Procured by DPSC 10,200Issued to:ArmyNavyAir Force 19MAPOtherSee footnotes at end of article.

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