Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
Narcotics research, rehabilitation, and treatment. Hearings, Ninety ... Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
476sponsoring the developinent and evaluation of narcotic antagonists, such ascj'Clazocine and naloxone, and longer-acting narcotic substitutes such as L-alphaacetyl-methadol.A longer acting narcotic substitute would greatl.y decrease thecost of a maintenance program and allow the patient to live a more normal life.We are also supporting research into the development of a nontoxic removableimplant which can deliver an antagonist drug such as cyclazocine slowly into thepatient's system over a period of time so that the need for repeated medicationwould be markedly reduced. While these treatment approaches are promising, itis far too early to assess their ultimate safety and efficacy.With regard to prevention of drug abuse, the Institute together with otherFederal agencies is sponsoring a public information and education eiTort. Informationand education alone, however, will not be sufficient to prevent drug abuse.In many instances, drug abuse stems from motives and social conditions whichare not readily affected b}" education. Prevention efforts must include, therefore,broad programs of social reform and psychological help to allow meaningful,satisfying lives for adolescents as well as adults. Prevention efforts must, ofcourse, also include efforts to limit the suppl}' of illicit drugs and the diversionof legal drugs into illicit channels.Question 9. Would more money for research in these areas hasten the discoveryof effective cures and treatment?Answer. Yes; it is highly probable that additional funds would have thisresvilt.In recent years there have been two major developments which increase thelikelihood of "payoff" in the treatment area from additional research. The firstof these is that an increasing number of competent scientists are now availableto vmdertake research in the drug abuse area. In the past, few skilled investigatorswere available to undertake studies in this area.Second, recent research work in several basic fields now has increased thelikelihood of significant breakthroughs in the near future that may well havesubstantial implications for treatment programs. For example, the work ofDr. Julius Axelrod, the Nobel laureate, in the NIMH intramural researchlaboratories, on Dopamine; and that of Dr. William ^Martin at the NIMH AddictionResearch Center in Lexington, Ky., on tryptamine, represent significantprogress in our understanding of basic neurological processes underlying narcoticaddiction.Question 10. What role in research do you believe should be played by privateindustry and private scientific organizations such as the National Academy of SciencesResearch Council?Answer. Apart from the research efforts of pharmaceutical companies, whichare for the most part focused on commercially feasible compounds, roles forprivate industry in drug abuse research are only beginning to emerge. The NIMHwould encourage the participation of private industry in this area.Several private foundations have expressed interest regarding roles theymight play in narcotic addiction and drug abuse research. On May 26 SecretaryRichardson and representatives of other Federal agencies will be meeting withfoundation executives to explore this matter in greater detail.Staff of the NIMH have initiated discussions with the Division of BehavioralSciences of the National Academy of Sciences regarding a role for the Academyin evaluating the impact of the NIMH drug information and education program.The Academy has expressed interest in this project but no formal agreementshave as yet been reached. In addition, the National Academy of Sciences recentlybrought together a panel of experts in drug abuse research to advise iton possible roles for the Academy regarding heroin and related drugs. The Academyis considering undertaking activities through its Divisions of MedicalSciences and Behavioral Sciences but has not as yet reached linal decision regardingthese activities and has not made them public.Question 11. What system have you developed to prevent a recurrence of the problemsthat now exist with regard to the lack of information on marihuana? We understandthat so little is known about marihiiana that it has been necessary to increase thefimding in marihuana research from $1.5 million in 1969 to $3 .3 million in 1971 while
477research on narcotics in the same period has merely increased from $3.2 million to$3.9 million?An.swer. Budget increases have been specifically earmarked for marihuana researchduring the past 3 j'ears. The administration has earmarked these funds inresponse to growing public interest in determining the health consequences ofmarihuana use and as a result of specific congressional directives on this subject.The estimated expenditure for fiscal j-ear 1971 is $2.8 million rather than $3.3million.Initial work in the marihuana research program concentrated on developingtechnicjues to produce natural and synthetic material of known composition andstrength. Only by knowing the dose administered can researchers draw meaningfulinterpretations from their results.The marihuana contract program has established a system of production andsupply of both natural and synthetic material with high qualitj- control. Theavailability of material of known potency has stimulated a large number ofstudies. In fiscal year 1971, research was focused on the effects of synthetic andnatural marihuana in animals, and important advances have been made in determiningthe fate of marihuana compounds in animals and man.The primary metabolic products of the two presently known active constituentsof marihuana, delta-8 and delta-9 tetrahydrocannabinal, have been identified,isolated, and their molecular structures described.Studies of the effects of marihuana on perception, cognition, and motor performanceare underway and have begim to clarify the consequences of actxtemarihuana use, as described in the Secretary's report to the Congress recently.The biochemistry and mechanism of action of marihtiana are also under investigationwith a variety of tools, and the potential impact of marihuana use on driving,memory, and attention are being carefully investigated. Perhaps the most importantquestion concerning marihuana is the effect of long-term use at low andmoderate dosage levels. Two controlled studies are underway in foreign populationsto determine what impact chronic u-e may have upon health, occupational,social, and illness variables. In this country, careful studies are underway todetermine tolerance to marihuana, cross-tolerance between marihuana and alcohol,opiates and hallunciogens, and synergism with other psychoa^-tive drugs.The effects of marihuana on reproductive processes are under scrutiny, with bothneurological and behavioral exannnations of successive generations of animalsexposed to marihuana leaf and synthetic materials.To avoid a recurrence of the knowledge gap problem associated with marihuana,the Department is actively assessing the abuse potential of new drugs thatcome on the market. In addition, community and health surveys now enable us atan early stage to s.ystematically studj^ the health and social consequences of varioussubstances that are being used.There are two additional steps that could be taken to obtain information asearly as possible about new drugs of abuse : The first step would be to expand ourcapabilities to evaluate the abuse potential of drugs being produced; the secondstep would be to establish drug surveillance in the streets that would enable us tobecome quickly aware of what drugs are starting to be abused and to take appropriatesteps to coimter such abuse. These steps would give us warning and hopefullylead time. However, research into the genetic, carcinogenic, and other ])hysiologicaland behavioral effects of drugs alwaj's take some time and cannot beaccomplished instantaneously.Question 12. How much money has been spent on research into narcotics, intomarihuana, into central nervous system stimulants, and into narcotic antagonists,over the last 4 years?Answer. Table I gives the requested information for fiscal year 1969. Noteand (b)that all NIMH research activities are included in this table. Tables II (a)present similar data for fiscal year 1970. The detailed presentation for fiscal year1970 also deals with the NIMH grants program in drug abuse as funded by theDivision of Narcotic and Drug Abuse (top row of figures) and other units of NIMH(second row of figures). The final amounts to be spent out of the fiscal year 1971budget for these various categories are not j-et known. (Data is not available forfiscal year 1968.)60^96—71—pt. 2 10
- 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 and 492: 471ainpheta.mines, or barbiturates.
- Page 493 and 494: 473In the meantime, the Institute d
- Page 495: 475treated in the community centers
- 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
- Page 542 and 543: .522than a State psychiatric hospit
- Page 544 and 545: 524Department of Mental Hygiene), R
477<strong>research</strong> on narcotics in the same period has merely increased from $3.2 million to$3.9 million?An.swer. Budget increases have been specifically earmarked for marihuana <strong>research</strong>during the past 3 j'ears. The administration has earmarked these funds inresponse to growing public interest in determining the health consequences ofmarihuana use <strong>and</strong> as a result of specific congressional directives on this subject.The estimated expenditure for fiscal j-ear 1971 is $2.8 million rather than $3.3million.Initial work in the marihuana <strong>research</strong> program concentrated on developingtechnicjues to produce natural <strong>and</strong> synthetic material of known composition <strong>and</strong>strength. Only by knowing the dose administered can <strong>research</strong>ers draw meaningfulinterpretations from their results.The marihuana contract program has established a system of production <strong>and</strong>supply of both natural <strong>and</strong> synthetic material with high qualitj- control. Theavailability of material of known potency has stimulated a large number ofstudies. In fiscal year 1971, <strong>research</strong> was focused on the effects of synthetic <strong>and</strong>natural marihuana in animals, <strong>and</strong> important advances have been made in determiningthe fate of marihuana compounds in animals <strong>and</strong> man.The primary metabolic products of the two presently known active constituentsof marihuana, delta-8 <strong>and</strong> delta-9 tetrahydrocannabinal, have been identified,isolated, <strong>and</strong> their molecular structures described.Studies of the effects of marihuana on perception, cognition, <strong>and</strong> motor performanceare underway <strong>and</strong> have begim to clarify the consequences of actxtemarihuana use, as described in the Secretary's report to the Congress recently.The biochemistry <strong>and</strong> mechanism of action of marihtiana are also under investigationwith a variety of tools, <strong>and</strong> the potential impact of marihuana use on driving,memory, <strong>and</strong> attention are being carefully investigated. Perhaps the most importantquestion concerning marihuana is the effect of long-term use at low <strong>and</strong>moderate dosage levels. Two controlled studies are underway in foreign populationsto determine what impact chronic u-e may have upon health, occupational,social, <strong>and</strong> illness variables. In this country, careful studies are underway todetermine tolerance to marihuana, cross-tolerance between marihuana <strong>and</strong> alcohol,opiates <strong>and</strong> hallunciogens, <strong>and</strong> synergism with other psychoa^-tive drugs.The effects of marihuana on reproductive processes are under scrutiny, with bothneurological <strong>and</strong> behavioral exannnations of successive generations of animalsexposed to marihuana leaf <strong>and</strong> synthetic materials.To avoid a recurrence of the knowledge gap problem associated with marihuana,the Department is actively assessing the abuse potential of new drugs thatcome on the market. In addition, community <strong>and</strong> health surveys now enable us atan early stage to s.ystematically studj^ the health <strong>and</strong> social consequences of varioussubstances that are being used.There are two additional steps that could be taken to obtain information asearly as possible about new drugs of abuse : The first step would be to exp<strong>and</strong> ourcapabilities to evaluate the abuse potential of drugs being produced; the secondstep would be to establish drug surveillance in the streets that would enable us tobecome quickly aware of what drugs are starting to be abused <strong>and</strong> to take appropriatesteps to coimter such abuse. These steps would give us warning <strong>and</strong> hopefullylead time. However, <strong>research</strong> into the genetic, carcinogenic, <strong>and</strong> other ])hysiological<strong>and</strong> behavioral effects of drugs alwaj's take some time <strong>and</strong> cannot beaccomplished instantaneously.Question 12. How much money has been spent on <strong>research</strong> into narcotics, intomarihuana, into central nervous system stimulants, <strong>and</strong> into narcotic antagonists,over the last 4 years?Answer. Table I gives the requested information for fiscal year 1969. Note<strong>and</strong> (b)that all NIMH <strong>research</strong> activities are included in this table. Tables II (a)present similar data for fiscal year 1970. The detailed presentation for fiscal year1970 also deals with the NIMH grants program in drug abuse as funded by theDivision of Narcotic <strong>and</strong> Drug Abuse (top row of figures) <strong>and</strong> other units of NIMH(second row of figures). The final amounts to be spent out of the fiscal year 1971budget for these various categories are not j-et known. (Data is not available forfiscal year 1968.)60^96—71—pt. 2 10