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

:629Yet, in spite of these efforts, there continues to be a tragic disparity betweenservices and the rapidly growing need. Between 1966 and 1969, 1,550 drug addictsvoluntarily applied for treatment at a small, State-funded out-patientclinic located in Boston. Since the beginning of 1970, when we appropriatedcity funds for that clinic, quadrupled the size of its staff, improved its methodof operation, and transferred it to the city's general hospital, an additional1,567 heroin addicts have requested help. The city of Boston's treatment facilitiescurrently have an active caseload of 650 patients, representing capacityoperation. Treatment is available to approximately 350 additional personsthrough a multiplicity of small programs—university and community hospitalbasedand self-help programs—which are primarily funded by the MassachusettsDepartment of Mental Health. An OEO-funded treatment program designedto serve three housing projects has not yet begun active operation. AnNIMH-funded drug abuse rehabilitation program which was approved in July1969 did not begin active opex-ation until February 1971. The city of Boston'streatment facilities receive no Federal support at the present time, althoughthey treat the majority of the addict patients in the city. One hundred fiftynew patients apply for treatment at those facilities each month. And the combinedcity-State-Federal resources provide the opportunity for help to only 1,000of Boston's 10.000 heroin users—10 percent of the people in need.At the same time that Boston is seeking to assist its addict population, weare constantly confronted with the problems of addicts from outside the citydesperaely seeking help. One out of every five persons applying to the city'streatment facilities is a non-Bostonian. Because of the enormoiis need of our ownresidents, in June 1970, we began a residency requirement in the city's treatmentfacilities. Unhappily, we refuse assistance to non-Bostonians, sendingthem back to their own communities most of which have no treatment resourcesavailable, to continue their lives of addiction and crime. That is not apleasant task, but we have no other choice. With no financial assistance fromthe Federal Government, insufficient funding from the State, Boston—whichgets its resources solely from the property tax in a city where over 50 percentof the property is tax-exempt—is struggling to pay for the vast majority ofIJatients now in treatment, and to provide services for hundreds more who wantto be cured.My recommendations to Congress are these(1) Increase the amount of Federal support available to our Nation's majorcities. I am greatly dismayed that while over S50 cities. States, and privateagencies applied for community drug abuse prevention grants, under the DrugAbuse Education Act of 1970, only 46 could be awarded since the administrationhad appropriated only $6 million of the congressionally approved authorizationof $20 million for fiscal 1971. I am equally dismayed by the administration'sfailure to fully fund the Comprehensive Drug Treatment and Rehabilitation Actof 1970. A 30 percent effort will not solve the crisis of drug abuse which thisNation faces.(2) Increase the amount of Federal support for services. Federal support isnow generally tied to research projects rather than on-going programs of treatment,rehabilitation, and education. We agree that such programs should becarefully evaluated, but the delivery of services should receive high priority forFederal support. It will do us no good to know 5 years from now how we couldhave met this challenge.(3) Do not treat this problem through an emphasis on any single approach.Drug abuse and drug addiction are complex pi'oblems which are not susceptibleto simple solutions. The city of Boston's drug abuse control program which Ihave outlined above emphasizes a coordinated effort in treatment, law enforcement,education, and community action. I strongly believe that such a comprehensiveapproach is essentia!.am proud of the city of Boston's program to combat drug abuse. I am proudIof the many Boston citizens who give freely of their money and time to workin their own neighborhoods. I am proud of the willingness of many privateagencies to work closely with public agencies. I am proud of this city's healthprofessionals, educatoi's, law enforcement officers, community leaders, and youngpeople who are struggling to communicate with each other and work togetherto cope with this problem.It is too soon to measure the effectiveness of Boston's efforts. Although wecannot state with scientific accuracy the impact of our programs, we do seeencouraging signs. We can point to persons who have overcome their drug addic-