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

440Dr. Brown. Our current estimate is 250,000. We in truth have thesame estimate as you have heard. Several hundred thousand, perhapssomewhere between 150,000 and 400,000. Our best guess is a quarterof a milUon.Chairman Pepper. Now, Dr. Edwards told us today that about30,000 people are being maintained; that is, are being treated constantlyby the use of methadone. Do you generally agree with thatfigure?Dr. Brown. Yes; I think it is a little on the high side, and if I wereasked to give a number, I would have guessed closer to 20,000 than30,000.Chairman Pepper. So, to use a maximum figure, of your estimateof possibly 250,000 heroin addicts in the country, about less than50,000 of them are being treated by any kinds of drugs?Dr. Brown. Yes; there is an additional small number that are onother drugs, mostly experimental ones that you have spoken of.These include cyclazocine and naloxone, but that additional thousandsthat you can count on one hand, so it still falls under 50,000.Chairman Pepper. So, the maximum number in your opinion, ofheroin addicts in the United States being treated by some kinds ofdrugs would be under 50,000?Dr. Brown. Yes, sir.Chau-man Pepper. That would leave approximately 200,000heroin addicts that are to be treated by some other method.What are the other methods currently used in the treatment ofheroin addiction other than the use of drugs?Dr. Brown. There are several methods. One is the therapeuticcommunity, particularly Synanon and other similar models. One isthe comprehensive approach that combines counseling, jobs, vocationalreferral, and training. This is often called multimodality.Dr. Jaffe has popularized this phrase.There is individual treatment that a physician might take on withan individual patient to see what he can do. There are specific subtreatmentssuch as being a member of a halfway house or some othersemi-institutional setting.This is the range of treatments that I am aware of. Mr. Bestemanmight want to expand on a few others.Mr. Besteman. I think essentially most have been covered. Thereare still some treatment programs that go on in the traditional institution,care away from the home community, and we do know ofcrisis treatment centeris that are more related to drug abuse than theyare, say, to addiction.Chairman Pepper. Those are clinical or institutional approaches;are they not?Dr. Brown. Yes.Chairman Pepper. They require personnel, require trying to putthe person in a proper frame of mind, trying to get him a job, givehim therapeutic treatment that may be necessary and the like. It issort of an institutional approach. And also sort of a multiple approach.Dr. Brown. That is correct.Chairman Pepper. A psychological as well as physical approachto the individual.