Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
Narcotics research, rehabilitation, and treatment. Hearings, Ninety ... Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
566Now, Dr. Cliambers, can yon respond to the further part of thequestion relating to wliat percentage of that total remain drug free?Dr. Chambers. I think we can say this for you : We have a 3- to5-year commitment process. Those who are processed through theentire civil commitment, the 3 or the 5 years, are a relatively smallnumber of people thus far. Of those who have gone all the waythrough the program, roughly 25 percent are currently abstinent,according to a physical followup. I have a followup division whichgoes to the field at periodic times after decertification to physicallylocate, interview, and request a urine specimen from our decertifiedclients.That is not to suggest that 75 percent are now nonabstinent indi-A'iduals. Roughly 25 percent have either recertified themselves to usor have entered other treatment programs. They are not currentlyaddicts in the classical street sense. We have, therefore, a residualof approximately 50 percent who are in jail as a result of a newoffense, drug related, or have returned to drugs.I must emphasize, though, that we are still talking about a relativelysmall population because of the length of history of the commissionitself.Mr. Rangel. Well, notwithstanding the small number that youare dealing with, is it safe to say that New York State does not havethe answer to rehabilitating drug addicts ?Mr. Jones. Oh, that is a safe statement; absolutely.Mr. Rangel. The doctor was thinking about it.Dr. Chambers. Well, I do not think anyone has the answer, becauseI do not think there is an answer to drug addiction. For example, ifI may give you a personal bias, the longer I am around people whouse drugs, therefore around people who subsequently abuse drugs,the more I become convinced that drugs do large numbers of thingsfor people—not one thing. You do not handle only depression withdrugs ;you do not handle only anxiety with dru^s;you do not handleonly the loss of a job with drugs or the inability to get a job withdrugs. So as long as there are multiple reasons that drugs do somethingfor the individual, or even that he thinks drugs are doing somethingfor him, then I do not have an answer to the treatment of thosepeople.Mr. Rangel. Well, what would you suggest, Doctor, if you had theresponsibility of creating a Federal program and the Congress gaveyou the money to do what you thought had to be done? What areaswould you go into ?Dr. Chambers. Well, I think I share the same treatment philosophythat most drug professionals have today, that since we do not knowthe answer, since what we do know is that each of the modalities thathas been tried has been successful and each one has also been a failure,and until which time we use a multimodality approach, using all ofthe modalities, evaluating all of them with the same yardstick, thatis w^hat I will have to recommend. I must have substitution programs,lioth the antagonist programs and the maintenance programs. I musthave detoxification facilities; I must have halfway houses; I musthave purely abstinent residential centers.I guess I want everything we have tried and anything else I canthink of to try, put all of them in an experimental fi-anu> wIumv L
567can do controlled evaluation and actually see which is working bestwith which type of client.Mr. Rangel. What, if anything, has New York State done in thearea of research since we have not really found an effective rehabilitationmodality as yet? Is there any research being done with the,millions of dollars that are being spent?Dr. CiiAiMBERS. Of course there is research being done. There are^several levels of research. I would suggest that the commission has engagedin most, if not all, of the levels of research. For example, I havegreat faith tliat Dr. Mule's laboratory science work is a marked contributionto the field. In the otlier i-esearch areas, we have been fortunatewithin the commission to be able to randomly assign people tothe various kinds of facilities, the various kinds of programs that weoperate internally. These are being carefully monitored. In addition, Ialso have the data from the systems for all of the programs whichwe fund, rather than only for our civil committed clients. Those areall being evaluated now, with the same yardstick that I applied to thecommission.Mr. Rangel. Have you had any experience at all with a substitutedrug which is not addictive ?Dr. Chambers. It is my impression, and it is only that, that we havenot had a pure antagonist yet, which is what j^ou are asking for. Evennaloxone and cyclazocine have some agonistic characteristics whichsuggests they do have some abuse potential.Mr. Rangel. Does the drug Perse means anything to you ?Dr. Chambers. Yes.Mr. Rangel. Have you had any opportmiity to study its effectson drug addicts ?Dr. Chambers. No;I have not.Mr. Rangfx. Is there anyone with the New York State commissionthat is preparing to investigate the feasibility of using this drug ?Dr. Chambers. That question has to be directed to the commissioner.Mr. Jones. Yes ; there is. That is why I interrupted. Dr. Chambersmay not have even known yet about recent developments, as recent aslast week.A committee, Mr. Rangel, finally has been appointed to examinethis drug, the one to which you referred. Perse. It is one that, an effortthat started a year ago and finally culminated in the formation of thiscommittee^—I might say a committee of veiy highly critical medical experts,but I think the more critical they are, the better, frankly, fromthe point of view of results that may obtain. Some of the names of themembers of that committee. I am sure, will be familiar to you. Theyhave agreed upon a protocol to be followed. I have been assured thatthe requirements and the requests that the committee will make shortlyon Dr. Revici will be met ; namely, submission of his own protocol, asubmission of quantities of the drug that he has developed for analysis,and other inputs which they will shortly ask him to provide. He hasassured me that he will provide them and this committee will then startworking on the first indepth analysis of the whole theory and testing ofthe product that he has put forward.I might say that Dr. Mule, who is head of our laboratory, is the headof that committee.
- Page 535 and 536: 515In this second study there was a
- Page 537 and 538: 517were any significant differences
- Page 539: 519The Deceptive Communication and
- Page 542 and 543: .522than a State psychiatric hospit
- Page 544 and 545: 524Department of Mental Hygiene), R
- Page 546 and 547: TABLE 3—COMPARISON OF THE 1ST POS
- Page 548 and 549: 528TABLE 10—RELATIONSHIP OF AGE T
- Page 550 and 551: 530tution and his involvement in th
- Page 552 and 553: Attachment No. 5;r\ N-CH,-CH=CHo ,
- Page 554 and 555: '-534Chart No. U (case No. 672)Disp
- Page 556 and 557: 536Chart No. 4 (case No. 694)Illust
- Page 558 and 559: 538Chart No. 35 {case No. 697)Excep
- Page 560 and 561: 540This amount of heroin is roughly
- Page 562 and 563: 5msuccessful or not in that short a
- Page 564 and 565: 544Chairman Pepper. Would you repea
- Page 566 and 567: 54^creased amount of licit as well
- Page 568 and 569: —54Sand the bureaucracy and the a
- Page 570 and 571: ,,Mr.550you have used some of the s
- Page 572 and 573: 552so many areas is also a pitiful
- Page 574 and 575: 55,4nitiide of heroin addiction in
- Page 576 and 577: 556reached $976.5 billion, we can w
- Page 578 and 579: 558Mr. Jones was appointed to the c
- Page 580 and 581: 560cant when you consider that Out
- Page 582 and 583: 562criminal act in his lifetime. Ye
- Page 584 and 585: —564Mr. Perito. Would it be fair
- Page 588 and 589: —568Mr. Raxgel. Our distinguished
- Page 590 and 591: ;-570Mr. Jones. That is correct. Ou
- Page 592 and 593: 572the commissioner, $186 million i
- Page 594 and 595: 574there should be something in the
- Page 596 and 597: 576and the way in which the funds a
- Page 598 and 599: 57SDr. Chambers. I think wliat you
- Page 600 and 601: 580Education is the best way of pre
- Page 602 and 603: 58-2Certain essential facts must re
- Page 604 and 605: 584done through determined action,
- Page 606 and 607: 586druffs, has the Nation's largest
- Page 608 and 609: :588To repeat, methadone maintenanc
- Page 610 and 611: :590I believe the Federal Governmen
- Page 612 and 613: :take no such satisfaction. We have
- Page 614 and 615: 594of value in the testimony you ha
- Page 616 and 617: 596gone ahead with several. We have
- Page 618 and 619: 598force within our State Police De
- Page 620 and 621: 60PRased on the proposed goal of 2.
- Page 622 and 623: 602STATEMENT OF HON. MILTON SIIAPP,
- Page 624 and 625: (51)4and apprehend the wholesalers
- Page 626 and 627: J'606[Exhibit No. 23Prepared Statem
- Page 628 and 629: 608Under our 1071-72 budget proposa
- Page 630 and 631: GIOcenters for the treatment of her
- Page 632 and 633: . Dr.612Bourne informs me that we h
- Page 634 and 635: 614Governors in Atlanta to which re
566Now, Dr. Cliambers, can yon respond to the further part of thequestion relating to wliat percentage of that total remain drug free?Dr. Chambers. I think we can say this for you : We have a 3- to5-year commitment process. Those who are processed through theentire civil commitment, the 3 or the 5 years, are a relatively smallnumber of people thus far. Of those who have gone all the waythrough the program, roughly 25 percent are currently abstinent,according to a physical followup. I have a followup division whichgoes to the field at periodic times after decertification to physicallylocate, interview, <strong>and</strong> request a urine specimen from our decertifiedclients.That is not to suggest that 75 percent are now nonabstinent indi-A'iduals. Roughly 25 percent have either recertified themselves to usor have entered other <strong>treatment</strong> programs. They are not currentlyaddicts in the classical street sense. We have, therefore, a residualof approximately 50 percent who are in jail as a result of a newoffense, drug related, or have returned to drugs.I must emphasize, though, that we are still talking about a relativelysmall population because of the length of history of the commissionitself.Mr. Rangel. Well, notwithst<strong>and</strong>ing the small number that youare dealing with, is it safe to say that New York State does not havethe answer to rehabilitating drug addicts ?Mr. Jones. Oh, that is a safe statement; absolutely.Mr. Rangel. The doctor was thinking about it.Dr. Chambers. Well, I do not think anyone has the answer, becauseI do not think there is an answer to drug addiction. For example, ifI may give you a personal bias, the longer I am around people whouse drugs, therefore around people who subsequently abuse drugs,the more I become convinced that drugs do large numbers of thingsfor people—not one thing. You do not h<strong>and</strong>le only depression withdrugs ;you do not h<strong>and</strong>le only anxiety with dru^s;you do not h<strong>and</strong>leonly the loss of a job with drugs or the inability to get a job withdrugs. So as long as there are multiple reasons that drugs do somethingfor the individual, or even that he thinks drugs are doing somethingfor him, then I do not have an answer to the <strong>treatment</strong> of thosepeople.Mr. Rangel. Well, what would you suggest, Doctor, if you had theresponsibility of creating a Federal program <strong>and</strong> the Congress gaveyou the money to do what you thought had to be done? What areaswould you go into ?Dr. Chambers. Well, I think I share the same <strong>treatment</strong> philosophythat most drug professionals have today, that since we do not knowthe answer, since what we do know is that each of the modalities thathas been tried has been successful <strong>and</strong> each one has also been a failure,<strong>and</strong> until which time we use a multimodality approach, using all ofthe modalities, evaluating all of them with the same yardstick, thatis w^hat I will have to recommend. I must have substitution programs,lioth the antagonist programs <strong>and</strong> the maintenance programs. I musthave detoxification facilities; I must have halfway houses; I musthave purely abstinent residential centers.I guess I want everything we have tried <strong>and</strong> anything else I canthink of to try, put all of them in an experimental fi-anu> wIumv L
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