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

540This amount of heroin is roughly equivalent to about $20 or $30worth of heroin as available in the streets.In our studies we have treated addicts who have volunteered foradmission in the inpatient treatment center of a municipal hosj)italin the East Harlem section of New York City. This population ispredommantl}^ low income, predominantly Negro and Puerto Rican,with low educational levels, and many are receiving extensive welfareassistance.Our patients range in age from 17 to 54 years and the duration oftheir addiction has been from 2 to 30 years.After these individuals are admitted to the hospital, they arewithdrawn from heroin over a period of about a week. They are thenkept in the hospital in a drug-free state for about another week andthey are then inducted on cyclazocine to the mamtenance dose ofgeneralh' 4 milligrams a day.Now, you have heard about side effects of cyclazocine and it is truethat during this induction period, during the buildup, patients doexperience side effects. However, these side effects do gradually subsideand completely disappear after the maintenance doses arereached.During our very early studies, we used a 21 -day period of inductionin order to try to minimize the side effects. More recently, however,we have developed and employed a rapid induction technique wherebj"we have been able to build patients up to the 4 milligrams of cyclazocinein a period of onl}^ 4 days. And of more than 70 patients that havebeen inducted in the maintenance levels by this rapid method, therehas only been one patient who did not complete the induction and wehave had no patients at all who have discontinued treatment becauseof any secondary drug effects.Mr. Perito. Doctor, excuse me. How is it that we have heardso much about the alleged agonistic or side effects of cj'clazocine? Howdid it get a bad name, so to speak?Dr. Resnick. Whenever you start with any new drug and there isanxiety about it, this anxiety is transmitted to the patients and Ithink that even if you are given an orange sugar-coated pill thatyou were concerned about, the patients would have bad side effects.When you are familiar with the drug and you are comfortable withit and you can tell the patients in advance that you know about itand you know what is gohig to happen and you tell them in advancewhat they can expect to happen, it is true they do get these sideeffects but they are able to tolerate them, particularly -when they knowthat once they reach this maintenance level, all of these effects wDldisappear.Chairman Pepper. How often do you give the doses to them whenyou reach the maintenance level?Dr. Resnick. The cyclazocine is effective for approximately a 24-hour period and, therefore, for it to continue its effectiveness, it hasto be taken once a day.Chairman Pepper. Once every 24 hours.Dr. Resnick. Once every 24 hours.Chairman Pepper. And hoAv much does it cost nov>?Di'. Resnick. How much does cyclazocine cost? I have not thevaguest idea. Sterling-Winthrop Laboratories is kind enough to supply