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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386Mr. Brasco. But that is another late-start deyelopment? T ^A'Mr. IxGERSOLL. It is another late start.!^i"'-iMr. Brasco. "With no money.Mr. IxGERSOLL. No ; I wouldn't say that, sir.Mr. Brasco. Or little money.Mr. Ingersoll. We have put quite a bit of money into this. Affain,we are getting off into an area that I can't discuss openly, primarilybecause I don't want to let everybod}^ on the other side know whatwe are doing. But it takes time to develop these things. T^nhiether youput a lot of money in or a little bit of money, you can onh' buy a certainamount of brainwork, and this is essentially what we are dealing with.However. I can report that we are in the pilot test phase of one ofthese kinds of defaces at this time.Mr. Brasco. I would think that that would be the saddest situationof all, if in this country we couldn't—and I just can't believe that wecan't—develop the necessary scientific knowledge to beat this problem.I know it is difficult to put all the pieces together at one time, findthe necessary brainpower and the necessary money to go headlonginto a crash program to try to come up with something that is moreeffective than what we have at the outside now: methadone.!Mr. IxGERSOLL. I can assure you, Mr. Brasco. that we know wliatthe technology is or the theory is involved in this and we have producedan instrument. It is being pilot tested now. It has proven tobe very successful. It is a very large thing and we have got to be ableto reduce it, miniaturize it, so it can be a more practical tool.Mr. Brasco. One last thing. I noticed in your testimony you spokeabout methadone getting into the streets. I wasn't concerned aboutthe statistics at this point. When it is brought into the street, it is notused orally, is it; or is it used to shoot up, as one would use heroin?Mr. IxGERSOLL. It may be used in any way. It depends upon theform it is in. If it is in tablet form, it will probably be dissolved andshot.]Mr. Brasco. That is exactly what I mean. It would seem to me ifone was taking it orally, you don't get the same effect as you do fromtaking it intravenously.Mr. IxGERSOLL. That is right.Mr. Brasco. And orally would indicate to me an addict wanted totaper off and that puts him, I would think for practical purposes, ina much less-harmful position toward society than if he is using itintravenously. Why can't we just make it in such a form that it can'tbe shot up ?]Mr. IxGERSOLL. Since methadone also has therapeutic utility as ananalgesic, it is manufactured commercially not only for withdrawal ormaintenance programs, but also for other treatment purposes.Mr. Brasco. So that you are saying we do need the tablets ?Mr. Ingersoll. May Dr. Lewis respond to that ?Mr. Brasco. Yes.Dr. Lewis. I think one of the major manufacturers of methadone hasevolved a tablet which is very difficult to dissolve, so that for injectablepurposes, that particular tablet would not be acceptable to the addictwho wants to inject.

387Mr. Brasco. Well, as I understand it, Doctor — you stop me if I amAvrong—the substance that is used to drink, the orange juice, theoral that you drink, that if you tried to reduce that to liquid it becomesgummy, so that type you can't shoot up. But it would just seem to methat the tablet should be able to be produced in the same way if weeven need a tablet.It seems to me, at this point, the hearings have only indicated tome that the only need for the tablet is one of convenience, so thatrather than one carrying eight bottles around for an over-the-weekendsupply, they take the tablets.Now, I am not aware that the tablets are used for any other purpose,other than one of convenience, and if that is the only purpose,I would think we should do away with them, if that is causing aproblem in the streets.Mr. Ingersoll. Well, as far as the maintenance programs are concerned,our regulations and FDA's protocol require oral administrationunder close supervision. The use of tablets or liquid that canbe used for injection is not allowed. The methadone being prescribedby these physicians that I talked about earlier, who are operatingoutside the scope of the guidelines can be used for injection.Their traditional attitude is that the Government can't dictate totliem how to treat their patients or how to prescribe to their patients.Mr. Brasco. Is there a legitimate use for these tablets at this point ?Can't we just outlaw them or prevent them from being manufactured ?Mr. Ingersoll. I would like Dr. Lewis, again, to give a medicalclarification on that.Mr. Brasco. This is one of our problems. We are manufacturing thesethings now.Dr. Lewis. The prime use of methadone has been for analgesia. It is amilder analgesic than some of the others we have, but it is effective.It has an antitussive effect to reduce irritative cough, and in sirupform it is especially good for that. The old-fashioned manufacturedtablet still has some value. It does have insipients in it which, if anindividual dissolves it and injects it, makes him likely to have someuntoward effects.Mr. Brasco. But wouldn't we be better off—when you measuie thebenefits the tablets have, as opposed to its defects when it goes intothe streets and is shot intravenously—wouldn't we be better off withoutthe tablet ? I mean if it is just used for colds.Dr. Lewis. I think as far as the street form of the problem is concerned,we w^ould be better off without any form suitable for injection,whether it is an individual tablet or Tang suspense or lime juice suspenseor something of that sort.Mr. Brasco. But you say we can do that.Dr. Lewis. Yes.Mr. Brasco. Get a form that is not capable of being injected?Dr. Lewis. Or virtually incapable.Mr. Brasco. Thank you. I have no further questions.Chairman Pepper. Mr. Ingersoll, just a question or two.What percentage of the heroin that comes into this country wouldyou say comes from the laboratories of France ?

386Mr. Brasco. But that is another late-start deyelopment? T ^A'Mr. IxGERSOLL. It is another late start.!^i"'-iMr. Brasco. "With no money.Mr. IxGERSOLL. No ; I wouldn't say that, sir.Mr. Brasco. Or little money.Mr. Ingersoll. We have put quite a bit of money into this. Affain,we are getting off into an area that I can't discuss openly, primarilybecause I don't want to let everybod}^ on the other side know whatwe are doing. But it takes time to develop these things. T^nhiether youput a lot of money in or a little bit of money, you can onh' buy a certainamount of brainwork, <strong>and</strong> this is essentially what we are dealing with.However. I can report that we are in the pilot test phase of one ofthese kinds of defaces at this time.Mr. Brasco. I would think that that would be the saddest situationof all, if in this country we couldn't—<strong>and</strong> I just can't believe that wecan't—develop the necessary scientific knowledge to beat this problem.I know it is difficult to put all the pieces together at one time, findthe necessary brainpower <strong>and</strong> the necessary money to go headlonginto a crash program to try to come up with something that is moreeffective than what we have at the outside now: methadone.!Mr. IxGERSOLL. I can assure you, Mr. Brasco. that we know wliatthe technology is or the theory is involved in this <strong>and</strong> we have producedan instrument. It is being pilot tested now. It has proven tobe very successful. It is a very large thing <strong>and</strong> we have got to be ableto reduce it, miniaturize it, so it can be a more practical tool.Mr. Brasco. One last thing. I noticed in your testimony you spokeabout methadone getting into the streets. I wasn't concerned aboutthe statistics at this point. When it is brought into the street, it is notused orally, is it; or is it used to shoot up, as one would use heroin?Mr. IxGERSOLL. It may be used in any way. It depends upon theform it is in. If it is in tablet form, it will probably be dissolved <strong>and</strong>shot.]Mr. Brasco. That is exactly what I mean. It would seem to me ifone was taking it orally, you don't get the same effect as you do fromtaking it intravenously.Mr. IxGERSOLL. That is right.Mr. Brasco. And orally would indicate to me an addict wanted totaper off <strong>and</strong> that puts him, I would think for practical purposes, ina much less-harmful position toward society than if he is using itintravenously. Why can't we just make it in such a form that it can'tbe shot up ?]Mr. IxGERSOLL. Since methadone also has therapeutic utility as ananalgesic, it is manufactured commercially not only for withdrawal ormaintenance programs, but also for other <strong>treatment</strong> purposes.Mr. Brasco. So that you are saying we do need the tablets ?Mr. Ingersoll. May Dr. Lewis respond to that ?Mr. Brasco. Yes.Dr. Lewis. I think one of the major manufacturers of methadone hasevolved a tablet which is very difficult to dissolve, so that for injectablepurposes, that particular tablet would not be acceptable to the addictwho wants to inject.

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