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

506of urine testing, plus psychotherapy provided in a weekly groiq)j)sycho therapy meeting.The gentlemen on my left and right are individuals who participateilin such a program and shortly will give you some of their impressionson the benefit of their experiences.In the survey of just exactly what happened to these individuals,following their release from a correctional institution, we learned that85 percent of these individuals will reexpose themselves to a narcoticexperience within 12 weeks after release from a correctional institutiondespite the fact that they face the possibility of being returnedto jail.In exploring this matter further we also learned that despite thefact that 85 percent will reexpose themselves to a narcotic experience,there were only 15 percent that indicated so little control that theyimmediately relapsed into continuing drug use that necessitated theirimmediate removal from the program.The great majority attempted to cope with this need for or urgefor drugs through intermittent episodes of exposure and then becomingabstinent for a varying period.As we became acquainted with this pattern of behavior and soughtmore effective therapeutic means for coping with this disorder, wewere very fortunate in becoming aware of some of the experimentswith naloxone being carried out by a New York group of researchersunder the leadership of Drs. Max Fink and A. M. Freedman, whohad learned that large doses of naloxone, namely, between 2,000 and2,500 milligrams, administered on a daily basis, would provide atotal blockage lasting for a period of 24 hours. However, this raiseda very formidable problem because of the costliness and scarcity ofsupplies of the naloxone handicapping expanded investigation.Since our investigations had outlined some of the patterns of theepisodic and intermittent usage, it was suggested, in view of thescarcity of naloxone, that a compromise might be effected b}^ utilizinga system of low dosage, although this yielded only partialblockade.Employing this aj^proach, it was learned that the low dosageblockade did not appear to achieve a greater level of retention thanabstinence alone in retaining individuals in the program. The longerthe individual was retained in the program, the more meaningfulthis was felt to be. The hypothesis had been that a dosage range ofbetween 200 and 800 milligrams, given only at night, would blockadethe ev^ening hours, a time when these individuals were considered to bemost vulnerable to drug usage since all were requu'ed to maintain ajob as a condition of their parole.We found in the course of the pilot study that we could administerthe naloxone either up or down the scale of dosage very (piicklywithout any Ul or particular disturbing effects on the patients,although the effects were short lived; namely, 3 to 5 hours. In thecourse of this treatment many of the individuals soon learneil tobypass this period of time through their self-experimentation, discoveringif they gave the drug beyond this time interval they couldstill get their high.As we revievved the results of the pilot investigation and totaledthe dosages of naloxone that had been used in this experiment, we