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

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

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49SDr. ViLLARREAL. That puts it very well; yes.Mr. Brasco. Thank you.Chairman Pepper. Mr. Steiger?Mr. Steiger. Thank you, Mr. Chairman.Doctor, I am sorry I missed what aj){)arently, by all reports, wasa fascinating discussion. You mentioned that the primates on cocaineexhibited the ability to undergo the most rigorous kinds of barriersin order to continue to acquire the cocaine.Is the brain structure sufficiently similar between the primatesthat you used and the addict on the street that we could assumethat there are many addicts that would undergo equally torturousefforts?Dr. ViLLARREAL. I think the evidence clearly shows that there is avery strong analogy between the two species. I personally know ofone addict w^ho spends $800 a month in cocaine. Spending $800 amonth in cocaine represents a lot of investment.Mr. Steiger. Is that stronger or more addictive than the heroin?Dr. ViLLARREAL. It is vcry difficult to make those conclusionsunequivocally.Mr. Steiger. Well, have you got any qualitative analysis of theprimate which would indicate the relative strengths of addiction tococaine and heroin?Dr. ViLLARREAL. We are doing work on those issues now, but wedo not have solid data yet.Mr. Steiger. Thank you, Mr. Chairman.Chairman Pepper. Mr. Mann.Mr. Mann. Doctor, are the services of your laboratory available todrug manufacturers on a fee or contract basis?Dr. ViLLARREAL. Wo have not done that because we have a commitmentwith the National Research Council and the way we test drugsfrom the private drug industry is through the mediation of theNational Research Council.My policy, the policy of my chairman, has been that we do not workwdth direct contracts with the drug industry but there is nothingreally specifiedMr. Mann. To prevent it.What basis does the National Research Council use or what agreementsdo they have with the private drug manufacturer to channelthe testing of their experimental drugs to your laboratory; do youknow?Dr. ViLLARREAL. Oil, ves. For some 30 years or so, the arrangementhas been an extremely informal arrangement. Dr. Nathan Eddycorresponds \vith the drug manufacturers and the drug manufacturersgive the drug dependence committee voluntary contributions everyt^year which support the work of the National Research Council onDrug Dependence. And then, as these private manufacturers producedrugs that require testing, they s(Uid those drugs to the NationalResearch Council group and they distribute them either to us formonkey tests or for the clinicians to do the cliuii^al work with themafter they are tested in monkeys.Mr. Mann. Well, some agency such as the National ResearchCouncil or a change in the thrust of the National Research Council

'.499could result in a laboratory such as 3'ou are having the primar}' functionof developing antagonists or in the drug dependency field.Dr. ViLLARREAL. That is correct.Mr. Mann. You would recommend that as well as the broadercoordinating effort?Dr. ViLLARREAL. That is right, because it would require the coordinationof clinicians, pharmaceutical chemists, pharmacologists, behaviorists,toxicologists.Mr. Mann. I am ver}' much interested in 3'our expression of confidencein the fact that naloxone may be an eventful cure.Dr. ViLLARREAL. I think Dr. Resnick may address to the limitationsof naloxone. Naloxone or one of its analogues will do the job.Mr. Mann. Based upon your experiments what motivation can begenerated for an addict to take naloxone?Dr. ViLLARREAL. Naloxouc is prett}' inert except in large doses. So,it is like water, like nothing.Mr. Mann. But assuming that he took it in a single dose and foundthat he got no kick, then, from the next dose of heroin, what is goingto make him continue on naloxone?Dr. ViLLARREAL. Well, these are questions about behavioral controlwhich I think would be better dealt with by those witnesses thatdeal with humans. I can think of some possibilities but I do not havefirsthand experience in that.Mr. Mann. Since your work is primarily with analgesics, you nodoubt have been involved in a study of the question of whether ornot an analgesic can ever be nondependency creating on a psychologicalbasis.Dr. ViLLARREAL. Well, cyclazocine itself is a pretty good analgesicexcept that it has some unpleasant side effects and its developerspreferred to promote pentazocine, Talwin, which is ^^idely used andhas remarkably reduced dependence potential compared with mor-])hine. It is a strong analgesic and it produces very little i)hysicalde])endence. There are very few people that abuse Talwin.To give you some figures, the standard clinical dose of morphine is10 milligrams. If you take 300 a dhj, you become very sev^erely dependentand have a horrendous abstinence syndrome.Now, the standard dose of Talwin, pentazocine, is 30 milligrams.There are people who have taken u]) to 900 milligrams a day, thirtyfold,the same 1 to 30 ratio as I said with morphine. Nine hundredmilligrams is 30 times the clinical dose, for long periods of time andthen withdrawal produces a very minimal abstinence. The subjectsfeel a few cramps, feel a little uneasy. There is a vast differencebetween pentazocine and morphine and I know there are better drugsthan pentazocine in the development stage.Mr. Mann. Thank you. Doctor.Chairman Pepper. Mr. Winn.Mr. Winn. Thank you, Mr. Chairman.Doctor, you keep referring to leadership and Congressman Mannwas asking you some questions on this. Who, other than the President—Ibelieve recently he has expressed his concern—should furnishthe leadership in this fight against drugs?Now, you mentioned the National Research Council. wShould welook to HEW, the National Science Foundation? Who should furnishthis leadership, in your opinion?^

'.499could result in a laboratory such as 3'ou are having the primar}' functionof developing antagonists or in the drug dependency field.Dr. ViLLARREAL. That is correct.Mr. Mann. You would recommend that as well as the broadercoordinating effort?Dr. ViLLARREAL. That is right, because it would require the coordinationof clinicians, pharmaceutical chemists, pharmacologists, behaviorists,toxicologists.Mr. Mann. I am ver}' much interested in 3'our expression of confidencein the fact that naloxone may be an eventful cure.Dr. ViLLARREAL. I think Dr. Resnick may address to the limitationsof naloxone. Naloxone or one of its analogues will do the job.Mr. Mann. Based upon your experiments what motivation can begenerated for an addict to take naloxone?Dr. ViLLARREAL. Naloxouc is prett}' inert except in large doses. So,it is like water, like nothing.Mr. Mann. But assuming that he took it in a single dose <strong>and</strong> foundthat he got no kick, then, from the next dose of heroin, what is goingto make him continue on naloxone?Dr. ViLLARREAL. Well, these are questions about behavioral controlwhich I think would be better dealt with by those witnesses thatdeal with humans. I can think of some possibilities but I do not havefirsth<strong>and</strong> experience in that.Mr. Mann. Since your work is primarily with analgesics, you nodoubt have been involved in a study of the question of whether ornot an analgesic can ever be nondependency creating on a psychologicalbasis.Dr. ViLLARREAL. Well, cyclazocine itself is a pretty good analgesicexcept that it has some unpleasant side effects <strong>and</strong> its developerspreferred to promote pentazocine, Talwin, which is ^^idely used <strong>and</strong>has remarkably reduced dependence potential compared with mor-])hine. It is a strong analgesic <strong>and</strong> it produces very little i)hysicalde])endence. There are very few people that abuse Talwin.To give you some figures, the st<strong>and</strong>ard clinical dose of morphine is10 milligrams. If you take 300 a dhj, you become very sev^erely dependent<strong>and</strong> have a horrendous abstinence syndrome.Now, the st<strong>and</strong>ard dose of Talwin, pentazocine, is 30 milligrams.There are people who have taken u]) to 900 milligrams a day, thirtyfold,the same 1 to 30 ratio as I said with morphine. Nine hundredmilligrams is 30 times the clinical dose, for long periods of time <strong>and</strong>then withdrawal produces a very minimal abstinence. The subjectsfeel a few cramps, feel a little uneasy. There is a vast differencebetween pentazocine <strong>and</strong> morphine <strong>and</strong> I know there are better drugsthan pentazocine in the development stage.Mr. Mann. Thank you. Doctor.Chairman Pepper. Mr. Winn.Mr. Winn. Thank you, Mr. Chairman.Doctor, you keep referring to leadership <strong>and</strong> Congressman Mannwas asking you some questions on this. Who, other than the President—Ibelieve recently he has expressed his concern—should furnishthe leadership in this fight against drugs?Now, you mentioned the National Research Council. wShould welook to HEW, the National Science Foundation? Who should furnishthis leadership, in your opinion?^

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