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

;:619As a result of this effort, the State of Michigan has launched a comprehensivestatewide drug abuse control program including education, treatment-rehabilitation,and enforcement. More than 3,000 heroin addicts are now in various treatmentmodalities in Michigan, Approximately 1,000 of these are in State-supportedprograms. We plan to expand this number to 2,000 by the end of fiscal 1971-72.During the current fiscal year the State is spending approximately .$2.5 millionon drug control programs. The request for the next fi.scal year is more than ^'•'1million.The treatment-rehabilitation program in Michigan recognizes tliat(1) Drug dependence is an outgrowth of conditions which exist in the comnuinityand therefore each community must to some extent design and control itsown program(2) No single modality of treatment will be succes.sful for all drug-dependentI'versons. therefore we must support a variety of treatment approaches (includingmethadone maintenance, support of Syanon, droi>in and crisis centers) and overthe coming years determine the proper modality for different types of proi)lems;(3) Because of tlie experimental nature of treatment for drug dependence therate of failure will be high. We must be willing to take risks and iearn from ourfailures as well as our successes. To facilitate this learning process, we plan todevelop systems for constantly evaluating drug programs.I believe the Federal Government can play an essential role in providing treatmentand rehabilitation programs for heroin addicts throughout the country. Asand our States, the de-with so many other pressing problems facing our citiesmands for services are increasing while the available resources are growing moreand more limited.In providing Federal assistance for addict treatment and rehabilitation, I wouldlike to make the following suggestions based on our experience in Michigan :(1) A program of Federal funding which relies on traditional agencies andwhich includes ponderous Federal controls will not necessarily be productive.(2) A treatment or rehabilitation program, to succeed, must include communityparticipation. Community control should be encouraged, including the administrationof the program by the community to be served. In proposing this, Irecognize the high risk nature of this approach and caution that failures should beexpected if we are to experiment with new and possibly more effective approaches,(3) Because we presently lack answers, any federally assisted program .•shouldprovide the maximum ability to innovate, and equally important, to eliminateprograms that prove unworkable and ineffective. It would be a tragedy if fundingand administration were so structured as to prevent the experimentation withnew ideas or which perpetuated ineffective programs,(4) Drug free alternatives should be encouraged, I believe it is important thatalternative life styles, such as Synauon, be encouraged because they can have a.significant impact on our culture and our approach to drugs. Ti*eatment programsthat rely on other drugs, e.g. methadone maintenance, can help reduce additionrelated crime, but they may, in the long run, reinforce the "chemical culture"aspect of our society that is itself a partial cause of narcotic addition. In Michigan,we are hoping to establish a working relationship between the strongly indep»endeutSynanon organization and State government whereby the State can assistSynauon without destroying its essential autonomy while retaining the necessaryaccountability for public funds. The success of this effort, I believe, may be amodel for the Federal Government and for other States in assisting this uniquecommunity that has played such an important role in developing truly drug freealternatives to narcotic addition,(5) I believe the funding mechanism for narcotic treatment and rehabilitationprograms should be based on the revenue sharing or bloc grant approach.Over the long run, drug abuse treatment and rehabilitation should be incorporatedinto other community health and social services available to our citizens.To create a separate funding mechanism, bureacracy, and constituency for drugabuse funds could reduce the effectiveness of Federal assistance. In addition, theparticular circumstances of each State differ widely and maximum leeway shouldbe given to develop specialized approaches. Because of the resources now beingapplied by the States to this and other social problems. I believe State governmentshould be the vehicle for administering these fund.s. The success in INIichiganof the allocation of crime control funds is evidence that States can work produc-,tively with cities, counties, and other units of government in allocating funds forthe greatest impact.