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

574there should be something in the nature of a clinic? It need not belarge. It might be private as well as public. But do you agree withothers who have testified here that there needs to be not only the administrationof a drug to counteract the heroin addiction, whateverthe accepted drug may be, but in addition to that, there needs to betheiapeutic care, occupational assistance, general aid and considerationgiven to the addict ? What kind of facility do you find from your experienceto be the most desirable one for the treatment and rehabilitationof heroin addicts ?Mr. JoxES. As Dr. Chambers mentioned, Congressman Pepper, Iwould be wary of trying to isolate any one program as the most efficientor the most efficacious that we should pursue. I think the onlyrational approach has to be the one that we have followed; namely,a multimodality approach. Even with regard to methadone, which isi-eportedly the most successful to date, it speaks in terms of quiclaiessof easing the problem that we are addressing, you see. But even themost ardent supporters of the methadone approach, I think, will admitthat it is a modality that is suitable for no more than 25 or 30 percent ofthe total population, you see. So that it would be a mistake to say, well,we ought to go all out for methadone, because it simply can't be appliedsuccessfully to the bulk of people that we are addressing.The same thing would hold true for the therapeutic treatment, thetherapeutic community approach. Not all addicts, of course, will respondto that kind of modality or treatment. It is awfully difficult to tryto isolate one method and sell it to this Congress or to the administrationas the one that should be followed.Mr. Rangel. It is true. Commissioner, that most people who are unawareof wliat is going on in the drug addiction area do ask for results.But it seems to me that there should be a Federal program which woulddissiminate the results that are coming in from all of the States ratherthan having any one mimicipality or any one State ask what they aredoing with their particular addicts. But we are now listening to thisadministration declaring war on addiction and everyone is being apologetic.But on page 18 of your prepared statement, you indicate that theNational Institute of Mental Health, in setting up its recent 25-targetcity programs, did not include a single city in New York State. Well,I would like to direct my question to the liaison here and ask how canyou avoid being critical ?Mr. Hesse. With a great deal of difficulty. Congressman.I am sorry ; that is a facetious answer and I should not give it.No, we were rather upset at the guidelines which were incorporatedinto Public Law 91-211 by the Congress when it passed that bill andthe guidelines that were adopted by the National Institute of MentalHealth, because it did not give us what we thought was a meaningfulopportunity to participate and we very much hope that in the future,such opportunities will be forthcoming.We would like to see the National Institute of JNIental Health, if Imay take just a second here, implement the provision of Public Law91-513 whicli requires the Secretary of HEW to establish priorities forthe States having the more significant problems of drug abuse. To thebest of our knowledge, that has not been done. Possibly if the moneyhad been forthcoming, it would have been done. But ceitainly, if you