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

514frMr. McCoy. I believe I could if I asked the doctor or my therapist,if they saw fit that I really needed to pro back on it.Mr. Steicier. Is that the situation, Doctor?Dr. KuRLAND. To a certain extent that is correct, but it also dependsupon the supplies of naloxone, and we hoard that. It is more preciousright now than gold.Mr. Steiger. Thank you very much.Chairman Pepper. Mr. Kurland, we want to thank you. I thinkvour testimonv this morning vivitllv shows that a lot of things can bedone if we just provide the money and the j:)eople to do them, ^'ougive us encouragement.Mr. McCoy, Mr. Taylor, we want to thank you gentleman or comingand we want to commend you for the motivation that has led you totake advantage of this program of Dr. Kurland 's and get yourselffree of diugs. We pray you will stay free of it and you will give yourexperience to as many others as you can and encourage them to followyour example. Thaiik 3^ou.(Dr. Kurland's prepared statement follows:)[Exhibit No. 20]Prepared Statement of Dr. Albert A. Kurland, Director,Maryland State Psychiatric Research CenterIt is assumed that the members of the Select Committee on Crime of the Houseof Representatives, on the basis of its previous hearings, are quite familiar withthe many aspects of the abuse of narcotic drugs and the destructive effects on thesocial fabric that accompany this activity, and briefly state my own positionrelative to the medical approaches seeking to cope with this abuse. Essentially, itagrees with that of most authorities that the traditional techniques of psychiatrictreatment have not been particularly effecti\-e in the management of opiatedependence and there is a need for more effective therapeutic measures. Inpursuit of this objective, this investigator (see attachment No. 1), has carriedout a series of clinical studies of the narcotic abuser. The first of these initiatedin 1960, began with the survey of the cour.se followed by narcotic addicts admittedon either a voluntary basis or by order of the court to a State psychiatric hospital.This survey reemphasized the unrewarding accomplishments of hospitalization,except for detoxification (see attachment No. 2). Because of these findings therewas carried out a second study exploring the possibility of managing the detoxifiednarcotic abuser over whom mandatory supervision could be maintained in anoutpatient setting, employing abstinence combined with a sj^stem of dailymonitoring.The statistical data obtained from the study (see attachment No. 3) indicatedthat a population of parolees with a history of narcotic abuse, if promptly confrontedwith evidence of their illicit use of opiates, would respond to their beingchallenged. The magnitude of this response was indicated l)y a retention rate inwhich approximately percent :^.')of the participants remained in the program fora period of 6 months or longer. Moreover, if one eliminated the absconders fromthe program as being j^oorly motivated, as indicated by the lack of e\idence ofopiate usage at the time of their flight, the retention rate approximated oO percent(see attachment No. 4). The data also revealed a total of 23 new arrests in thispopulation of approximately 400 parolees during the i)eriod of their participations.When the nature of this population is considered, this was felt to be a ratherencouraging finding.Although there was a strong desire to compare the statistical information withthe data i)eing obtained from methadone programs, this had not been possible fora nuniljer of reasons. This was the absence of svu-h information on a comparablepopulation of subjects with no possiblity of obtaining such information in theforeseeable future. This arose from the fornndablc issue that such attcnptod comparisonwould have posed ethically. In our opinion, it would hav(; been quiteobjectionable to have placed a ijopulation of parolees, who had been renderedabstinent as a result of their incarceration, back on a projirain of niethadonomaintenance immediately on their nsleasc to the {n-v socirl \ .