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

504forth. It is to be hoped that these investigations coupled with appropriate studiesin man will lay the groundwork for the design of effective treatment schemesfor human addicts.It appears that one of the most important requirements of this form of treatmentwill be the maintenance of continuous levels of the antagonist around the clock.We do not have yet a preparation of antagonist drugs that will conveniently allowthe meeting of the requirement of continuous coverage. However, sources workingunder contract with NIMH are attempting to develop slow-release preparationswhich might maintain effective tissue levels of antagonists for periods of at leastseveral days.There are a number of very potent narcotic antagonists, most of which are sittingidly on the shelves of private pharmaceutical houses. Potent narcotic antagonistshave only a small market in their established medical use (as antidotes for narcoticsoverdose) . The potential market for the use of antagonists in the treatmentof narcotics addicts is not very large either. Furthermore, it is uncertain whatfraction of the total population of addicts might be amenable to long-term controlwith antagonists. We have, then, a good number of substances that are goodcandidates for development as tools for the treatment of addicts. Yet, we cannotexpect private drug industry to take the initative in these endeavors.The responsibility for this research and development work has fallen in thehands of those of us interested in the solution of the problem of narcotics dependence.Unfortunately, separate groups of investigators working in a looselycoordinated way cannot be expected to have the eflicienc.y, all the practical knowhow,and the wide variety of resources which drug industry has available for newdrug development.It is to be hoped that the efforts of investigators currently working on thedevelopment of antagonists for the treatment of narcotic dependence wouldbecome formally organized and formally supported by those agencies in governmentthat have responsibilities in the area of drug dependence. Private drug industryshould also be encouraged to participate in these efforts, if necessar^y throughformal arrangements such as government contracts.Chairman Pepper. The committee is pleased no^v to call as thenext witness Dr. Albert Kiirland, director of the Maryland StatePsychiatric Research Center in Bahimore.Kiirland holds a medical degree from the University of Mary-"Dr.land. He is a certified board psychiatrist, a fellow of the AmericanPsychiatric Association, a member of the American Medical Association,the Society of Psychophysiological Research, the Council onMedical Television, and a long list of other professional societies andcommittees.Dr. Kiirland has recently received a grant of more than $66,000from the National Institute of Mental Health to conduct a controlledstudy of the narcotic antagonist naloxone, and its effectiveness intreatment of the narcotic drug abuser. Over nearly a 2-year period,Dr. Kurland has been administering naloxone to approximately 75parolees from Maryland correctional institutions. This preliminaryresearch has been su])ported by State and private fimds.Dr. Kurland is here to advise the committee on the current statusof his research, its success thus far in rehabilitation of herion addicts,and the ]:)rospects for broader application of this nonaddictive treatmentapproach in the future.We are very much jjlcased to have you with us today, Dr. Kurland.Mr. Perito, will you inquire?Mr. Perito. Thank you, Mr. Chairman.D]-. Kurland, you have ])resented us with a rather extensive statement.Would you care to ofTer that statement at this point for therecord?