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

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472Lastly, I might mention the program being conducted at the AddictionResearch Center b.v Dr. WilHam Martin to develop improved methods of determiningthe abuse potential of drugs before they become problems on the street orin the clinic, and to study pharmacological treatments for narcotic addiction.Dr. Martin and his associates are invêstigating the conditions vmder which animalswill self-administer drugs and are determining to what extent each drug inducesphysical and psychological dependence, behavioral toxicity, and harmful physiologicaleffects. At this point, I would like to introduce Dr. William Martin, whocan tell you in more detail about these research programs.Question 1. What is the total amount of money that has been spent on narcoticaddiction and drug abuse research from 1968 through 1971 and what is the projectionfor fiscal 19721Answer. The total amounts spent on narcotic addiction and drug abuse researchwithin the Division of Narcotic Addiction and Drug Abuse, and related projectsfunded by other divisions, from 1968 through 1970, and the projections for 1971and 1972 are itemized as follows:Thousands of dollars19681. Research grants:DNADAOther divisions.. .2. Contracts (marihuana study)3. Intramural research (addiction research center)Lexington, Ky4. Other dir operations (operating costs within Divisionof Narcotic Addiction and Drug Abuse)Total Institute, drug abuse research activities
473In the meantime, the Institute develops its own estimate of budgetary requirementsbased on estimates made at the Division (scientific) levels. A major factorin the development of these estimates is the amount required to continue specificprojects which have been initiated in previous years.When the ceiling for the Institute is initially amiounced, our estimate of requirementsis compared to the ceiling. There are opportimities for discussion of alternativesand options, and appeals for revision and additional funds are entertainedby the Department. During this process, the need for additional research isweighed against otlier requirements, such as additional manpower programs andthe need to provide community-based services. Within the general area of researchand the ceiling and earmarlvings which are ultimately placed upon it, the Institutehas fle.xibility with respect to determing those priority programs in v/hich uncommittedfunds will be utilized for program growth.Question 4- Hoio is the total budget for drug abuse research allocated? What are the'priorities?Answer. D\iring the past 3 years, the administration has earmarked specificfunds for marihuana research in response to growing public interest in determiningthe health consequences of marihuana use and as a result of specificcongressional directives on this subject. Other research priorities include: (1)Evaluating drug abuse prevention, treatment, and rehabilitation services; (2)developing effective chemotherapeutic approaches, such as narcotic antagonistsand long-acting narcotic substitutes, to treating narcotic addicts; (3) carryingout basic physiological and behavioral research on the abuse potential and effectsof drugs; and (4) carrying on epidemiological studies of patterns of drug use andabuse.Question 5. Where are the policy decisions made as to which types of researchshall be funded and which areas of drug research need to be funded?Answer. Within the overall resources available to it for drug research, theNIMH establishes general priorities as described in the response to question 4.Under the guidance of the Office of the Director, NIMH, the Institute utilizesthe following advisory mechanisms:(a) Once a 3'ear, outside experts in drug abuse research come together to reviewthe research program of the Institute and to make recommendations regardingpriorities, emphases, and directions that the research program should take, bothlong range and short range.(b) Three times a year, a group of non-Federal experts come together to reviewspecific research proposals. In their deliberations, this group is guided, not onlyby the Vi'ork of the policymaking bodj^, but also by the nature and quality of theresearch proposals. The job of this committee is to insure that the researchproposed in a given priority area is scientifically sound.(c) Four times a j'ear the National Advisor}' jMental Health Council, composedof both professional and la.y members, meets to review general NIMH policyissues and particular grant applications. In the course of these meetings, drugresearch policy and grant proposals are considered. No grant may be fundedby the NIMH without approval of both the initial review group of non-Federalexperts and the National Advisory Mental Health Council.This system insures that two types of decisions are made in an appropriatemanner: (1) Broad policy decisions regarding priorities, and (2) decisionsregarding particular research protocols intended to further our knowledge withinpriority areas.Question 6. What arc the roles of the NIMH National Advisory Mental HealthCouncil, the Narcotic Addiction and Drug Abuse Review Committee and the Divisionof Narcotic Addiction and Drug Abuse in determining the funding priorities of drugabuse research?Answer. The Division of Narcotic Addiction and Drug Abuse is charged withadministering drug abuse research program within overall NIMH priorities. Itdevelops policy regarding funding priorities and assumes final responsibility forimplementing these priorities through the grant and contract mechanisms. TheDivision obtains the advice of nationally recognized consultants in the field ofnarcotic addiction and drug abuse, as well as panels which come together to adviseit on the progress being made in our re.search program and what future directionsit should take.
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NARCOTICS RESEARCH, REHABILITATION,
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::VEXHIBIT NO. 4 (a) AND (b)Eddy, D
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urden that such addiction imposes u
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1 (lata; (->) the sliariiis" oF iii
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9Chairman Pepper. The committee is
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::11quota production from unrecogni
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13in this country. This raises the
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15from other clinical projects of w
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:17practice, experience has indicat
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;19.I think a quota would be better
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21When methadone was first introduc
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:::::.—23American Society of Phar
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_'—25.I'BOCUREMENT AND ISSUE DATA
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'.28Fiscal years-1967 1968 1969 197
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30rally in opium. By indirect, the
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32We can, I think, most helpfully g
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34so intense that we haven't done v
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Dr. Eddy. Well, physicians, usually
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38Dr. Eddy. No.Chairman Pepper. Now
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:40get away with it as Dr. Keats su
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:—:42public health hazard was jud
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:44Bibliography(1 Nathan B. Eddy. "
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46(52) Nathan B. Eddy. "Dilaudid."
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48(98) "The New Narcotics, Post-gra
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^.50
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52entails the consideration of addi
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54Chairman Pepper. Have you found t
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56^.I wonder would you care to comm
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58Chairman Pepper. Without objectio
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—1958-681959-«419691962-64196219
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—62abuse and has brought about th
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64bank robbery or an assault. You d
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66Mr. Wiggins. Would the stopping o
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68—Chairman Pepper. Can you give
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:70The problem then would be the wi
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;72taking exceptional measures in t
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)—74pay serious attention to this
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;76From 1958 to 1961, he served as
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78deine in painkilling drugs. So if
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;80ning capabilities, responsibilit
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;:;82terials. If they could introdu
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84Figure 1infrared Ektachrome film
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;86Figure 3.—Tones of wheat (W) a
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88ers at the poppyfields or at any
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:90;:tional situations has handicap
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;;92Locating illicit opium cropsDet
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94Jaffe. Well, there would be some
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96Mr. Jaffe. Primarily on the fact
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98in the same ball park about what
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100Chairman Pepper. Mr, Waldie, do
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::102agencies and input data would
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104most facilities are barely able
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;106We have also studied a ^roup of
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108Dr. Gearing. Yes, sir; I would n
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110somethino: in the nei
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112program is put into the machiner
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I114you have some data there that s
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116Dr. Gearing. It depends on what
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118Chairman Pepper. Would you have
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120it not be so that we could proje
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.122admission rate was approximatel
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124BESULTS(1) Although many of the
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1262. All the members of the methad
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128HETHADOHE MAINTENANCE TREATMENT
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11 1 1 1 1 11130Methadone Halnten?n
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132TABLE 2.-METHAD0NE MAINTENANCE T
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134Figure 9 Methadone tlaintenance
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136Methadone Ka'ntanance Treatmf:nt
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:::.::.138Appendix A^—Methadone M
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140nance treatment patients showing
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142Figure 3 •lethadone Kaintenanc
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144Dr. DuPoNT. 1,760 on methadone m
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:146there are dramatic reductions i
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148Health insurance coverage for me
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150Dr. DtjPont. Well, there are no
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152Mr. Blommer. You would agree the
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154done. Where is the evidence ? No
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156There are several reasons a pers
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158It would seem to me a very busy
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160we had before. I don't think it
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162heroin addiction and support all
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164Dr. DuPoNT. I am reluctant to ge
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166Using this figure as rule of thu
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)168ment facilities for heroin addi
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.170parole departments. None were c
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::172Table 2.— Selected character
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174TABLE 3.—HEROIN ADDICTION RATE
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176W.a^^cc-V.c Cffv..AdF-ro ftcoKjL
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178.^06V f\QrK-'SEt GôuP/AJ6SIS're
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I180*i coo)u->CM>—'CMUJCOO O COa>
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I(/I182esiMmin0)^> oo.00 =E|c O.2 o
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184encouraged to return to methadon
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186or other side effects. This incr
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:188number as that on the bottle. W
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190Attachment ThreeTo all medical s
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-jI IALLI192ATTACHMENT- FIVE,J: IPA
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194ATTACHMENT NINEGOVERNMENT OF THE
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......—196half of the addicts sta
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198CONCLUSIONSCertain patterns emer
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200TABLE 5.— PROFILE OF BARBITUAR
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202TABLE ll.-SUPPORT OF HEROIN HABI
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204TABLE 17.-AGE OF ADDICTS AND NON
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206TABLE 23.—PRESENT MARITAL STAT
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208TABLE 28.-MILITARY SERVICEAddict
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:210The committee is pleased to cal
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212sists of a network of 21 geograp
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214(6) Basic studies on the nature
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216in fact, constitute autonomous o
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Chairman Pepper. Mr. Perito?218;; M
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^'220is not a very forgiving drug.
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'222Furthermore, in our present con
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—224the Federal Government decide
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-—I have presented one generic ki
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,clinic;?,>•
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230I realize we are running late.Do
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''232'']Vir. Winn. Tiien you mentio
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234So having put it in the area, ha
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,Memberships'—i236privilege of co
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;238A central hypothermic response
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;240South Bronx, Bedford-Stuyvesant
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242€are of patient addicts. We ha
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244hospitals in the city, came into
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246that came into my office, and I
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'Mr.;>•/nmo'.i,,;248deputy commis
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:250two Rockefeller Institute physi
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:252during pliase II that serious e
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254well-structured methadone mainte
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;:256nonsense and serves only to ad
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:258you best complete your statemen
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260Mr. Pertto. Based upon your expe
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262A a'reat case in point was a con
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«264Mr. Steiger. Did you discuss w
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—:266Mr. HoRAN. We don't support
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268Mr. Horan, let's back up a littl
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270It is not up to heroin or morphi
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272nesses yesterday who brought out
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274;Mr. Perito. It is my understand
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276So that at the end of the week t
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278steroid he lias in him we might
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280Mr. Perito. You are referriii"'
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282not drug free. I can say approxi
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28 A$2-a-day habit these individual
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•As286I got to the point once in
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288Mr. Steiger. You mentioned anoxi
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290Mr. Eangel. I could see then tha
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292Dr. Casriel. Mr. Keating, I have
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j294What period of time are ^ve tal
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296was March of 1970—he was admit
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298"The paper by Dole and Nyswander
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:300vent them from coming to New Yo
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302[Exhibit No.14(b)]Casriel Instit
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304to result from the insuflScient
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306It is this role of the intervent
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308EESULTSStudies concerning tlie p
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310The method derives from a specia
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312Why is this happening? What need
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m)effective with uncured alcoholics
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I316Casriel, who is medical-psychia
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318resort to heroin. One must not f
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.320in Permanent Cure of Narcotic A
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322!(4) '-Modification of Adaptatio
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324sections of the country, all sor
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;Mr.Pertto.niuch,I?,Mr. Peritq. Tha
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328Chairman Pepper. Mr. Steiger.Mr.
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, Mr., In''wMr, WiNx.nltiiink tlie
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:332"Stomach cramps" were found to
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'i.We334'""^li'anTOanlÊTPPEiL That
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:))))336would be deprived of any cl
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338less abuse liability than agents
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CONTENTSApril 26 1April 27 77April
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:•vEXHIBIT NO. 4 (a) AND (b)Eddy,
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:lovernor,vnEXHIBIT NO. 21 (a) and
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342have no desire to preempt the au
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344We hope these hearings will prov
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346tons in 1962 and to 155 tons in
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348SOUTHEAST ASIAAs you know also,
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350I would also point out as I did
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352their farmers who have been grow
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354told that much of the insurgency
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356Mr. IxGERSOLL. Well, again, Mr.
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358jority of the heroin problem in
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360years, but I have been frustrate
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362Mr, Steiger. If you were goin^ t
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364report marihuana among junior gr
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366And it seems to me tliat we Avou
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?368effectively, then maybe we will
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370improvement as far as the abilit
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372was there. Your visits probably
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374the purchase of Avitnesses—I s
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:376administrations to publicly say
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378Chairman Pepper. We will take a
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380Mr. Ingersoll. No. I don't recal
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:382can fulfill the vow made by the
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384have to give you the same answer
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386Mr. Brasco. But that is another
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388Mr. Ingeksoll. Well, that is the
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-39,3,Dr. Edwards held a surgical f
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395of Narcotics and Dangerous Drugs
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397Naloxone, recently approved for
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399for example, who might be abusin
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401Now, because of our attention ha
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403and this is only for the investi
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405effects this drug will produce i
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407Now, if it is not used intravene
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409Mr. Wiggins. Dr. Jennings, does
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411Penicillin is good for pneumonia
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413Mr. R ANGEL. But from the studie
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415Dr. Gardner. Again, we don't hav
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417Dr. Edwards. I suspect it at lea
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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 and 464: 443Chairmiui Pepper. Wliat is tlie
Page 465 and 466: 446The state of the art is promisin
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: 471ainpheta.mines, or barbiturates.
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
Page 515 and 516: 495Chairman Pepper. One other quest
Page 517 and 518: 497Dr. ViLLARREAL. So, it is a biol
Page 519 and 520: '.499could result in a laboratory s
Page 521 and 522: 5qifinds it in normal exploration.
Page 523 and 524: 503synthesized a large number of na
Page 525 and 526: 505STATEMENT OE DR. ALBERT KURLAND,
Page 527 and 528: 507discovered if we iiad taken the
Page 529 and 530: 509Mr. Perito. Dr. Kurland, do you
Page 531 and 532: 511Chairman Pepper. Has the Food an
Page 533 and 534: 513]Mr. Steiger. Do you feel from y
Page 535 and 536: 515In this second study there was a
Page 537 and 538: 517were any significant differences
Page 539: 519The Deceptive Communication and
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.522than a State psychiatric hospit
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524Department of Mental Hygiene), R
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TABLE 3—COMPARISON OF THE 1ST POS
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528TABLE 10—RELATIONSHIP OF AGE T
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530tution and his involvement in th
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Attachment No. 5;r\ N-CH,-CH=CHo ,
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'-534Chart No. U (case No. 672)Disp
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536Chart No. 4 (case No. 694)Illust
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538Chart No. 35 {case No. 697)Excep
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540This amount of heroin is roughly
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5msuccessful or not in that short a
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544Chairman Pepper. Would you repea
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54^creased amount of licit as well
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—54Sand the bureaucracy and the a
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,,Mr.550you have used some of the s
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552so many areas is also a pitiful
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55,4nitiide of heroin addiction in
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556reached $976.5 billion, we can w
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558Mr. Jones was appointed to the c
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560cant when you consider that Out
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562criminal act in his lifetime. Ye
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—564Mr. Perito. Would it be fair
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566Now, Dr. Cliambers, can yon resp
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—568Mr. Raxgel. Our distinguished
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;-570Mr. Jones. That is correct. Ou
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572the commissioner, $186 million i
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574there should be something in the
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576and the way in which the funds a
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57SDr. Chambers. I think wliat you
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580Education is the best way of pre
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58-2Certain essential facts must re
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584done through determined action,
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586druffs, has the Nation's largest
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:588To repeat, methadone maintenanc
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:590I believe the Federal Governmen
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:take no such satisfaction. We have
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594of value in the testimony you ha
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596gone ahead with several. We have
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598force within our State Police De
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60PRased on the proposed goal of 2.
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602STATEMENT OF HON. MILTON SIIAPP,
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(51)4and apprehend the wholesalers
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J'606[Exhibit No. 23Prepared Statem
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608Under our 1071-72 budget proposa
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GIOcenters for the treatment of her
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. Dr.612Bourne informs me that we h
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614Governors in Atlanta to which re
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616pretty bad news, because it indi
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618Scientific statistical ioformati
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620((')) Finally, I believe that al
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622Governor Carter. I certainly rec
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624programs that are now available,
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626all of the top officials in the
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628perhaps greater than some of the
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)630tion and many others attempting
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632(3) Long term residential self-h
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634for the support of drug service
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:636D. NARCO, Inc.Narcotics Addicti
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638crimes to obtain the necessary m
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640million to $25 milliou per year.
Page 662 and 663:
642Mr. Perito. Thank yoii. Mr. Chai
Page 664 and 665:
644narcotic antagonist, and the oth
Page 666 and 667:
646. Dr. Kramer. From what I have s
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—(348your money on, but methadone
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—650I know of no techinque in pri
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652Dr. Kramer. Yes, sir. As a matte
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:'654prison and who liave no—wlio
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65GDr. KT?A:\rEij. 1 suspect tliat
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658support some of the inethadone p
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'6660Dr. IvKAisrKK. 1 believe that
Page 682 and 683:
662jrest that the Veterans' Adminis
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664opiates may be ingested in sever
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666(5) It suppresses the desire for
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668Many people have benefited from
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—G70Other researches which may di
Page 692 and 693:
672synthetic painkillers, our commi
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074IV. A universal ban on legitimat
Page 696 and 697:
..676iTlius we must look to educati
Page 698 and 699:
678states, from Arnold Becker, publ
Page 700 and 701:
680However, we must look at rehabil
Page 702 and 703:
:682(a) The natural history of narc
Page 704 and 705:
684was a heavy user. The decrease i
Page 706 and 707:
686(13) Wallace. R. K. : Physiologi
Page 708 and 709:
688TABLE 9.-USE OF "HARD LIQUOR" BE
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UFRAL BOOKBINDING CO. Q /-^ /-» .1
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