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

419On the other hand, if serious side effects or other adverse developmentsshowed up during the course of the investigation, it might bethat we would want to terminate the long-term use of the drug.Chairman Pepper. Let me see if I can summarize what you aresaying. You are saying that you have not yet evaluated what theeffect of the use of methadone over a long period of time is. You aresaying also, as I understand it, that there is no immediate prospectthat you are going to abruptly cut off methadone from these programsunless the data that comes in to you from these people who are usingthe methadone treatment show disturbing effects with respect toindividuals or groups. Is that about it?Dr. Jennings. That is correct, sir.Chairman Pepper. Do all the 277 programs that you say you arenow o])erating conform to this protocol?Dr. Edwards. No. We are in the ]:>rocess right now of going throughand inspecting all of the programs. We started out with the 50 or sothat we suspected probably needed inspection most. There is noquestion that there are some deficiencies in a number of these programsand vre are trying to come to grips with them.Chairman Pepper. That was going to be my next question. Whatare the deficiencies in the clinics which may be closed?Dr. Edwards. Dr. Gardner has been involved and he can tell youspecifically what the problems are.Dr. Gardner. Largely, the lack of adequate supervision of thosewho are under treatment, lack of adequate screening procedures to determinewhether, in fact, somebody is addicted when they comeinto the program, the lack of adequate controls of the drug as it isused, so that it can be obtained for illicit distribution on the streets.Chairman Pepper. Do I understand your position to be thatyou do not recommend or approve the general distribution of methadoneto every herohi addict, but that there should be an examinationof the individual before he is given methadone; is that your position?Dr. Gardner. We think it may be useful for many people Weneed to find out more about it, because w^e don't know who would dobest on methadone and who would do best with other kinds ofprograms.Chairman Pepper. But you do not recommend that it be givenindiscriminateh' to every heroin addict?Dr. Edwards. Absolutely not. And again. Dr. Gardner pointedout, first, we had to be assured that the}' are heroin addicts. Wedon't want to make a methadone addict out of someone who isn't aheroin addict.Dr. Gardner. I think this is extremely important. If the physicianis going to take on the responsibility of giving a potent drug like this,then he also has to take on the responsibilitj^ of adequately clinicallyfollowing that particular patient and keeping records on him and thisis all we are asking of the medical profession really.Chairman Pepper. Doctor, we could ask you questions all daybut we have kept you and Dr. Gardner and Dr. Jennings long enough.Dr. Edwards. Thank you, Mr. Chairman.(The following material was received for the record:)