Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
Narcotics research, rehabilitation, and treatment. Hearings, Ninety ... Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
586druffs, has the Nation's largest addict population and probably the Nation'slargest drug abuser population.Yet, the National Institute of Mental Health, in setting up its recent 25target cities program, did not include a single city in New York State.Our division of research has made the projection that, out of every 1.000 nonwhiteghetto males. 500 will experiment with drugs, 470 will smoke marihuana,300 will try amphetamines, 280 will try barbiturates, 190 will try narcotics, 60will try all four, and 100 will become addicts. We similarly project that 70percent of these narcotic addicts will become known to the police, 60 percent willreceive some form of formal treatment, and 40 percent will remain addicts forat least 10 years.Despite this knowledge, and despite the obvious dimensions of the problemin New I'^ork City and New York State, previous Federal regulations have permittedFederal officials to exclude aid if there is a finding of "appropriate andadequate local facilities."And, naturally, in New York State, since such findings were always affirmative,the Federal Government has largely directed its efforts elsewhere. Onecynical observer recently expressed the view that New York State is beingpenalized for its initiative and effort. Cynical or not, the record is that theFederal Government provides only minimal supi>ort to the New York Stateprogram and insufficient support to the individual programs in our cities.we have two NIMH research contracts totaling $107,000. We re-At present,ceived $114,807 in Federal funds for our state-wide survey but we obtainedthese funds from the New York State Office for Crime Control Planning outof its State block grant funds. Finally, we received $60,000 in funds from theU.S. Department of Labor for an on-the-job training program for our addicts.All of the $1.06 million in proposals we made to the Office of Education wererejected, although two non-commission programs were approved.We do not at this time know the fate of our applications to the NationalInstitute of Mental Health, which total $6.8 million.Obviously, our total program proposals exceed available funds. Originally,when it was still hoped the Congress would appropriate the full amount of theactual authorization, we submitted preliminary applications to NIMH totaling$27.0 million.We were not demanding the whole of the national appropriation. We weregoing on the record not only with a statement of our program needs but alsowith a declaration of those areas of program endeavor in which we and theFederal Government could cooperate to our mutual benefit.We still seek cooperation on these and other programs. Again, we beseech theCongress to make the authorized funds available.It is worth noting here that, despite our budget problems at the state level,we did not ask the Federal Government to assume any part of the cost offinancing our existing programs. We approached the Federal Government withnew programs, programs which we believe would not only improve servicesfor drug abusers but add significantly to our knowledge and expertise with respectto treatment and prevention programs.For example, we proposed to create : a day care center for youthful drugabusers : a community house program ; a therapeutic community center ; a multimodalitymethadone program ; a therapeutic center for nonopiate abusers : atherapeutic center for adolescent heroin users ; a paraprofessional workers program; a program to combat discrimination in employment against addicts ; anda variety of education and prevention projects.When we speak of priorities, let's establish a very high priority on evaluatingthe effectiveness of existing drug education programs—before we spend largesums of money on new education programs.New York State had hoped that such evaluative research would be possibleunder the Drug Education Act but HEW officials advised us that there wereno funds in Public Law 91-527 to support such a project.Gentlemen, for all of our money spent, both you and I, we know so preciouslittle about drug abuse that it is shocking. We suspect that a factor in the spreadof drug abuse has been the failure of drug education programs. Indeed, manyauthorities are suggesting that we are experiencing an abuse of drug abuseeducation.Nor is our need confined to program evaluation. Our division of researchhas developed an impressive list of research needs, projects which we wouldlike to conduct cooperatively with the Federal Government.
587For instance, we need to study acute drug reactions among youth, withiimportant concentration on post treatment activities. We need an intensiveinvestigationof narcotic deaths among youths, vpith emphasis upon life styles,drug habits, etc., and the incidents preceding death.We must very soon analyze the relationship of marijuana use and subsequentdrug abuse looking not only at transitional factors but also at the phe-^nomenon of association, especially among multiple drug users.Our current knowledge of onset factors is quite limited, and must be improvedquickly by expert etiological research. We must probe the onset of druguse among young people, with special emphasis upon attitudinal studies.We need to study the economics of narcotic addiction, and the patterns ofdrug abuse in the new underground. We should survey official attitudes ondrugs and rehabilitation.We need to do foUowup studies on arrested addicts, and, even to do studiesonthe children of addicts.The list is virtually endless, but, it is not impossible.In this important instance, we want to do more because we have done somuch and we know we have the capability to produce the data and findings thatwill help resolve this national dilemma.Our list of completed research projects, in addition to the mammoth statewidesurvey and the on-going special attitudinal and incidence studies in schoolsthroughout our state, is worthy of your consideration. It is attached as anexhibit to this statement.We do not include this list to boast of our accomplishments but to demonstrateto you the vital role quality research plays in any effective drug programand to underscore again our desperate need for knowledge—and for assistance.We should, as Governor Rockefeller has suggested, conduct exhaustive researchinto other chemical means of controlling addiction to narcotics and alsoto control dependence on other substances. Our interim success in the very long^fight against drug abuse could well depend upon our finding such a chemical.However, to those who see such chemicals as methadone as a final solution,or to the others who now jump to proclaim acetyl methydol, let me remindyou that chemical maintenance for narcotic addiction does not apply to thevast majority of drug abusers in our society, because the majority are notnarcotic addicts.Some Members of Congress, like drug professionals and lay persons aroundthe country, reach out to methadone and methadone maintenance as a panaceato our problems of narcotic addiction.There have been significant accomplishments with methadone ; it has workedfor many addicts. But, it is very much still an experimental program.There are many unanswered questions about methadone ; so many questionsin fact persist about methadone maintenance that we cannot at this time callit an answer.There is strong evidence that a successful maintenance program requires highlyeffective supportive services. There is evidence suggesting that methadone haslimited value in treating today's multidrug abuser. In addition to certain medicalproblems, there are problems of dose manipulation and the abuse of other drugs.A series of studies conducted with one group of long-term, stabilizetl methadonepatients disclosed that, during an 8 week period, members of the study groupwere dnig free only 41 i)ercent of the time.On the other hand, the group abused heroin 35 percent of the time, with lesseruse of other drugs. It was disclosed that 14 jiereent of the group resorted todaily supplementation of their methadone dosage during this period, and that32 percent of the total study group used cocaine at least once during the 8 weekperiod.A separate study of a stabilized group in another State revealed that 82.5percent of the patients had abused at least one of the detectable drugs duringa 1 month period. Specifically, 77.5 percent had abused heroin, 30 percent hadabused the barbiturates and 25 percent had abused amphetamines. Sixty percenthad abused at least two different classes of drugs and 22.5 percent had abused allthree.Moreover, a followup study of this same group 8 months later disclosed thatthe incidence of drug abuse increased from 82.5 percent to 97.4 percent. Multipledrug abuse was also found to have increased, from 60 percent of the patients to76.9 percent.
- 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 586 and 587: 566Now, Dr. Cliambers, can yon resp
- 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 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
- Page 636 and 637: 616pretty bad news, because it indi
- Page 638 and 639: 618Scientific statistical ioformati
- Page 640 and 641: 620((')) Finally, I believe that al
- Page 642 and 643: 622Governor Carter. I certainly rec
- Page 644 and 645: 624programs that are now available,
- Page 646 and 647: 626all of the top officials in the
- Page 648 and 649: 628perhaps greater than some of the
- Page 650 and 651: )630tion and many others attempting
- Page 652 and 653: 632(3) Long term residential self-h
- Page 654 and 655: 634for the support of drug service
587For instance, we need to study acute drug reactions among youth, withiimportant concentration on post <strong>treatment</strong> activities. We need an intensiveinvestigationof narcotic deaths among youths, vpith emphasis upon life styles,drug habits, etc., <strong>and</strong> the incidents preceding death.We must very soon analyze the relationship of marijuana use <strong>and</strong> subsequentdrug abuse looking not only at transitional factors but also at the phe-^nomenon of association, especially among multiple drug users.Our current knowledge of onset factors is quite limited, <strong>and</strong> must be improvedquickly by expert etiological <strong>research</strong>. We must probe the onset of druguse among young people, with special emphasis upon attitudinal studies.We need to study the economics of narcotic addiction, <strong>and</strong> the patterns ofdrug abuse in the new underground. We should survey official attitudes ondrugs <strong>and</strong> <strong>rehabilitation</strong>.We need to do foUowup studies on arrested addicts, <strong>and</strong>, even to do studiesonthe children of addicts.The list is virtually endless, but, it is not impossible.In this important instance, we want to do more because we have done somuch <strong>and</strong> we know we have the capability to produce the data <strong>and</strong> findings thatwill help resolve this national dilemma.Our list of completed <strong>research</strong> projects, in addition to the mammoth statewidesurvey <strong>and</strong> the on-going special attitudinal <strong>and</strong> incidence studies in schoolsthroughout our state, is worthy of your consideration. It is attached as anexhibit to this statement.We do not include this list to boast of our accomplishments but to demonstrateto you the vital role quality <strong>research</strong> plays in any effective drug program<strong>and</strong> to underscore again our desperate need for knowledge—<strong>and</strong> for assistance.We should, as Governor Rockefeller has suggested, conduct exhaustive <strong>research</strong>into other chemical means of controlling addiction to narcotics <strong>and</strong> alsoto control dependence on other substances. Our interim success in the very long^fight against drug abuse could well depend upon our finding such a chemical.However, to those who see such chemicals as methadone as a final solution,or to the others who now jump to proclaim acetyl methydol, let me remindyou that chemical maintenance for narcotic addiction does not apply to thevast majority of drug abusers in our society, because the majority are notnarcotic addicts.Some Members of Congress, like drug professionals <strong>and</strong> lay persons aroundthe country, reach out to methadone <strong>and</strong> methadone maintenance as a panaceato our problems of narcotic addiction.There have been significant accomplishments with methadone ; it has workedfor many addicts. But, it is very much still an experimental program.There are many unanswered questions about methadone ; so many questionsin fact persist about methadone maintenance that we cannot at this time callit an answer.There is strong evidence that a successful maintenance program requires highlyeffective supportive services. There is evidence suggesting that methadone haslimited value in treating today's multidrug abuser. In addition to certain medicalproblems, there are problems of dose manipulation <strong>and</strong> the abuse of other drugs.A series of studies conducted with one group of long-term, stabilizetl methadonepatients disclosed that, during an 8 week period, members of the study groupwere dnig free only 41 i)ercent of the time.On the other h<strong>and</strong>, the group abused heroin 35 percent of the time, with lesseruse of other drugs. It was disclosed that 14 jiereent of the group resorted todaily supplementation of their methadone dosage during this period, <strong>and</strong> that32 percent of the total study group used cocaine at least once during the 8 weekperiod.A separate study of a stabilized group in another State revealed that 82.5percent of the patients had abused at least one of the detectable drugs duringa 1 month period. Specifically, 77.5 percent had abused heroin, 30 percent hadabused the barbiturates <strong>and</strong> 25 percent had abused amphetamines. Sixty percenthad abused at least two different classes of drugs <strong>and</strong> 22.5 percent had abused allthree.Moreover, a followup study of this same group 8 months later disclosed thatthe incidence of drug abuse increased from 82.5 percent to 97.4 percent. Multipledrug abuse was also found to have increased, from 60 percent of the patients to76.9 percent.
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