Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
Narcotics research, rehabilitation, and treatment. Hearings, Ninety ... Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
444tific leadership, might produce something that would deal adequatelywith this challenging and tragic national problem.I can hardly believe that you have all the personnel and all thefacilities and the ability to implement all the programs that yourscientific mind would like to see implemented and what we are lookingfor is something to recommend to the Congress.If they do not want to do it, this is up to them. The President hasjust stated this week that he intends to launch a massive attack uponthe drug problem in this country. Well, what sort of an attack is hegoing to mount? What do you mean, a massive program?We just read in the paper yesterday of two young people founddead on the steps of a hospital from taking heroin.So, we are dealing with something that is taking the lives of a lot otpeople in this countr}-, costing our people a lot of money, paralyzingour courts, and generally it is one of the great tragedies of the country.What we are looking for is wdiat can be done more than is beingdone in the technical research field. What more research can becarried on wisely? And then the next thing we want to know from j^ouand others is what kind of treatment and rehabilitation program shouldbe in effect in every community in America to deal adequately withthis problem, and that is what we are going to recommend to theHouse.Now, if the House does not want to do it, it will not be our fault,but we want to offer to them what we believe they should do in thenational interest and we want you to tell us what we can recommend.And do not be modest about it. Do not feel that you are in any wayviolating any obligations. We, as a committee of Congress, are justasking you to give us technical advice. Whether the Bureau of Managementand Budget recommends it, or whether Congress appropriatesit, is not your business but we are asking you as adviser to thecommittee, as a witness here today, to tell us if you were speakingonly as a scientist, not as an administrator limited by other obligationsand responsibilities, if you were advising us as a scientist, what yonthink you could wisely do in the national interest with respect to theheroin problem in the area of research.Dr. Brown. I deeplj^ respect your concern and I think it is not somuch a matter of having blinders on so much as focusing on theproblem. I really think it is more— -the best spirit of the latter ratherthan putting blinders on as jon describe it.Indeed, as we described our research efforts in terms of basicunderstanding of the brain, some additional resources would be usefuland I think would provide the base for ver}' important answers interms of exploring the promising leads that Dr. Martin and othersof your mtnesses have described, such as the blocking agents and theantagonists.As you know, Mr. Chairman, I personally explored in some depththe wisdom of trjdng to see whether we can get an immunizing agent,a vaccine. This is controversial and difficult. It may or may not payoff and it has to do with a different approach than having an antagonistor blocking agent. It has to do with the fact that the state of theart is such that we could take a chemical such as heroin or tetrahydrocannabinol,or cocaine, link it to a protein, develop antibodies sothat perhaps we could have people protected in the sense that you areprotected from polio.
446The state of the art is promising. I am not sure how much money,but perhaps just a small $2 or $3 million effort might pa>' dividendsin 2 or 3 years.This is worth trying. It is the sort of lead, I think, that is promising.We would not begin such a program unless we spentChairman Pepper. You could even give that to somebody who hasnot become an addict to keep him from becoming one; could you not?Dr. Brown. Well, the problem with an approach as new as this isthat it is fraught, if I can use a fancy word, "loaded" would be abetter word, with ethical and moral difficulties but, on the other hand,the problem is so severe that I think every lead is worth pursuing.Chairman Pepper. Well, parents give their children shots toimmunize them against smallpox and typhoid fever and all, and withthe current tendency of young people to take drugs, you mightimmunize them against drugs as j^ou go along if you could developyour immunization product.Dr. Brown. Well, I do not mean to get at all fight about so seriousand weighty a topic but, for example, just picture the issue we wouldhave to face if we were to develop such a vaccine against alcoholand whether or not people would want to immunize against a fifetimeof alcohol. This gives us a sense of the problem, so I think you wouldnot be immunizing against heroin unless you Avere fairly far down thesocial, legal, ethical pike. What I am trying to sa}', resources expendedon this kind of approach might develop new kinds of knowledge thatmight be helpful in terms of treatment programs.The state of the art, and science, is somewhat primitive along the linesDr. Martin and I have spoken to. Perhaps, what is really troublingthe committee and the society about the state of the art, about howto treat this problem, is even more primitive and we do have a caseof just exploring with great difficulty, find out the best treatmentprogram. Our inability to distinguish the effectiveness of, say, amethadone program from a multiservice clinic or to distinguish thosewho would benefit from methadone from those who would not, areareas of clinical research or evaluation research that are well worthexploring and some modest resources in these areas would pay handsomedividends.Lastly, I would like to say that I am pleased and proud that thePresident does plan new drug abuse initiatives and that I wouldexpect that new resources \Adll become available and I am hopefulthat they will be also in the area of research so I think you are on thesame wavelength as the PresidentChairman Pepper. How much are you spending now in jourDepartment to develop a vaccine drug?Dr. Brown. Right now we are spending no actual money, sir.It is just an example of a kind of scientific technological thinking.Chairman Pepper. Why are you not spending money on that?Dr. Brown. For several reasons. One is because that is a far-outpromising lead and with the resources we have available, we arespending the money on the more promising far-out leads.Chairman Pepper. Well, I guess you are telling us, then, you donot have enough money to spend on the far-out leads. You are tryingto spend what you have got on the leads that are more profitable andmore probable but you never know when the far-out one, the longshot, is going to win the race; do you?60-296—71—pt. 2 8
- Page 413 and 414: -39,3,Dr. Edwards held a surgical f
- Page 415 and 416: 395of Narcotics and Dangerous Drugs
- Page 417 and 418: 397Naloxone, recently approved for
- Page 419 and 420: 399for example, who might be abusin
- Page 421 and 422: 401Now, because of our attention ha
- Page 423 and 424: 403and this is only for the investi
- Page 425 and 426: 405effects this drug will produce i
- Page 427 and 428: 407Now, if it is not used intravene
- Page 429 and 430: 409Mr. Wiggins. Dr. Jennings, does
- Page 431 and 432: 411Penicillin is good for pneumonia
- Page 433 and 434: 413Mr. R ANGEL. But from the studie
- Page 435 and 436: 415Dr. Gardner. Again, we don't hav
- Page 437 and 438: 417Dr. Edwards. I suspect it at lea
- Page 439 and 440: 419On the other hand, if serious si
- Page 441 and 442: 421of the best known programs. Alth
- Page 443 and 444: 423Medical Association, American Ps
- Page 445 and 446: 425of the United States Pharmacopei
- Page 447 and 448: 4275. Repeated examinations. Physic
- Page 449 and 450: 429agement and rehabilitation of se
- Page 451 and 452: —431As the agenc.v within HEW whi
- Page 453 and 454: 433and complex acts such as driving
- Page 455 and 456: 435(Inig induces physical and psych
- Page 457 and 458: 437Chiiirmtin Pepper. Doctor, I thi
- Page 459 and 460: 439A large proportion of youngsters
- Page 461 and 462: 441Dr. Brown, what would you say is
- Page 463: 443Chairmiui Pepper. Wliat is tlie
- Page 467 and 468: 447Lot nie ask you first, is tlic d
- Page 469 and 470: 449Chairman Pepper. Do you happen t
- Page 471 and 472: 451want you to take a look at. We w
- Page 473 and 474: 453In addition to that, there seems
- Page 475 and 476: 455the Mfldict is having a program
- Page 477 and 478: 457—on drugs? By that I mean, vei
- Page 479 and 480: 459\\ e are basically saying, in or
- Page 481 and 482: —;461that this is the extent to w
- Page 483 and 484: 463We could go into the drug area a
- Page 485 and 486: .465program that was i)ut into Jack
- Page 487 and 488: 467Mr. Brasco. Possibly. However, w
- Page 489 and 490: 469him, arrange to get somebody els
- Page 491 and 492: 471ainpheta.mines, or barbiturates.
- Page 493 and 494: 473In the meantime, the Institute d
- Page 495 and 496: 475treated in the community centers
- Page 497 and 498: 477research on narcotics in the sam
- Page 499 and 500: 479c 53 03E
- Page 501 and 502: NARCOTICS RESEARCH, REHABILITATION,
- Page 503 and 504: 483spending for research through NI
- Page 505 and 506: 485There has been no concerted seri
- Page 507 and 508: 487it is left in one of their veins
- Page 509 and 510: 489I do not think I should explain
- Page 511 and 512: 491Dr. ViLLARREAL. Until the reflex
- Page 513 and 514: 493evidence strongly shows is that
446The state of the art is promising. I am not sure how much money,but perhaps just a small $2 or $3 million effort might pa>' dividendsin 2 or 3 years.This is worth trying. It is the sort of lead, I think, that is promising.We would not begin such a program unless we spentChairman Pepper. You could even give that to somebody who hasnot become an addict to keep him from becoming one; could you not?Dr. Brown. Well, the problem with an approach as new as this isthat it is fraught, if I can use a fancy word, "loaded" would be abetter word, with ethical <strong>and</strong> moral difficulties but, on the other h<strong>and</strong>,the problem is so severe that I think every lead is worth pursuing.Chairman Pepper. Well, parents give their children shots toimmunize them against smallpox <strong>and</strong> typhoid fever <strong>and</strong> all, <strong>and</strong> withthe current tendency of young people to take drugs, you mightimmunize them against drugs as j^ou go along if you could developyour immunization product.Dr. Brown. Well, I do not mean to get at all fight about so serious<strong>and</strong> weighty a topic but, for example, just picture the issue we wouldhave to face if we were to develop such a vaccine against alcohol<strong>and</strong> whether or not people would want to immunize against a fifetimeof alcohol. This gives us a sense of the problem, so I think you wouldnot be immunizing against heroin unless you Avere fairly far down thesocial, legal, ethical pike. What I am trying to sa}', resources expendedon this kind of approach might develop new kinds of knowledge thatmight be helpful in terms of <strong>treatment</strong> programs.The state of the art, <strong>and</strong> science, is somewhat primitive along the linesDr. Martin <strong>and</strong> I have spoken to. Perhaps, what is really troublingthe committee <strong>and</strong> the society about the state of the art, about howto treat this problem, is even more primitive <strong>and</strong> we do have a caseof just exploring with great difficulty, find out the best <strong>treatment</strong>program. Our inability to distinguish the effectiveness of, say, amethadone program from a multiservice clinic or to distinguish thosewho would benefit from methadone from those who would not, areareas of clinical <strong>research</strong> or evaluation <strong>research</strong> that are well worthexploring <strong>and</strong> some modest resources in these areas would pay h<strong>and</strong>somedividends.Lastly, I would like to say that I am pleased <strong>and</strong> proud that thePresident does plan new drug abuse initiatives <strong>and</strong> that I wouldexpect that new resources \Adll become available <strong>and</strong> I am hopefulthat they will be also in the area of <strong>research</strong> so I think you are on thesame wavelength as the PresidentChairman Pepper. How much are you spending now in jourDepartment to develop a vaccine drug?Dr. Brown. Right now we are spending no actual money, sir.It is just an example of a kind of scientific technological thinking.Chairman Pepper. Why are you not spending money on that?Dr. Brown. For several reasons. One is because that is a far-outpromising lead <strong>and</strong> with the resources we have available, we arespending the money on the more promising far-out leads.Chairman Pepper. Well, I guess you are telling us, then, you donot have enough money to spend on the far-out leads. You are tryingto spend what you have got on the leads that are more profitable <strong>and</strong>more probable but you never know when the far-out one, the longshot, is going to win the race; do you?60-296—71—pt. 2 8
Change language