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

Dr. Eddy. Well, physicians, usually physicians are not all thatfamiliar with new products. I think there should be some reasonabledelay in order to familiarize them with the substitutes. As I saidearlier, we banned heroin from the medical practice without too muchresistance, partly because we kept morphine, which in many instanceswas advantafjeous over heroin and heroin was not all that popular inthe United States. When the attempt was made to ban heroin in GreatBritain there was a tremendous furor and the Home Office eventuallywithdrew the ban and heroin is still permissible in Great Britain.If we were to attempt to ban, by congressional action, the use ofmorphine in clinical medicine I think there would very justifiably bea fjood deal of resistance on the part of physicians. The natural opiatesare what they are accustomed to and you would have to give them anopDortunity to become accustomed to things to be used alternatively.Mr. WkvOtxs. I have difficulty in reconciling your statement thatmedical resistance would be iustified in view of your earlier statement,there are adequate substitutes for morphine now existing.Dr. Eddy. Well, those substitutes are there, but not all of the physiciansin the country are aware of them and familiar with their use.They would say: "Well, what am I going to do for John Jones forwhom I must have morphine in order to get him through this operationor to handle his broken leg or something else. I don't know anythingabout this compound. I have never heard of it." You have got togive him an opportunity to familiarize himself, carry on some sort ofcampaign to get them to accept the alternative.I was very active, took a very great interest in the introduction ofpentazocine. It was quite slow m coming on the market for reasons Idon't need to go into. I was particularly interested because it appearedto be completely free of physical dependence factors, and it is reasonablyso. We did not expect any abuse of it at all. There has been avery small amount of abuse because a few people who have abusedother drugs have found the reactions of it pleasant to them and havegone on to use excessive amounts, but the number is very small. Itdoes have antagonistic properties if given to a person already dependenton morphine. It was likely the withdrawal phenomena would beprecipitated and would probably make him sick and probably veryangry with his doctor if the doctor w^as not aware of what was goingon. But the reaction to it has been exceedingly good. It is an agonistantagonistand physicians are accepting it, and I think we can getthem to accept it and other compounds of this sort to a sufficient extentso that medical practice would not suffer for lack of the opiates.But this takes a little time.Mr. Wtootns. I would like to ask two additional questions. Doctor.How would you describe the ease of manufacturing the existing substitutesfor morphine? That question is really aimed at whether or notwe can expect a lot of backyard or backroom clandestine laboratoriesturninir out the substitutes if the United States were to prohibit theuse of morphine.Dr. Eddy. Well, none of the synthetics are all that easy to produce.It would require a very skilled, very well-equipped technical chemicallaboratory to produce them. It isn't anything like the ease with whichheroin is obtained from morphine. You can cook up hei-oin in your