Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
Narcotics research, rehabilitation, and treatment. Hearings, Ninety ... Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...
—(348your money on, but methadone maintenance can't be forgotten, becauseit is the most likely procedure to engage an addict. It is themost likely procedure to lead him into a productive and crime-freelife.Mr. Murphy. Doctor, I am glad to see that you suggest that a collectionbank of data, particularly from federally funded programs,be instituted. I think my colleagues here and the expert witnesses wehave that have testified before us liave all suggested this. Seemingly,this is one thing we all agree on, that we are not collecting all ourinformation.Have you any ideas how we could do this ?Dr. Kramer. In order to gather the maximum amount of data, youhave to have a handle on the people who potentially can provide it.The only handle that is generally available to the Federal Governmentis if they give the money, they can insist on the answers. In addition,nonfederally funded programs might have the opportunity to seekspecial grants to provide personnel who will assist in compiling avariety of information for the use of tlie program as well as for submissionto the data bank. The data banks may be set up on a regionalbasis with some sort of a central bank, perhaps, here in Washington.Some degree of regionalization may be appropriate, because the kindsof programs, the extent of drug abuse, differs from one part of thecountry to another.Mr. Murphy. Comisel suggests the confidentiality element involvedhere, that we are revealing—obviously if you are starting tallcabout collecting data, you are revealing names, et cetera. The Governorof Georgia stated today that the Army was reluctant to turn over tohim information about fellows who were about to be discharged whoare addicts because of the confidential nature of that infoniiation.How would you handle that ?Dr. Kramer. Absolutely, I believe that any law which is writtenwhich provides for the collection of such infomiation must mcludean absolute provision for confidentiality—I would underline thatmustbe built into it or else the individuals involved in collecting datawill be reluctant, patients will be reluctant to go into programs thatthey fear might reveal them.The importance of collection of data is not the importance of findingout specifically who the individuals are, but rather understandingthe problem as a scientific one.Mr. Murphy. Thank you. Doctor.Mr. Perito. Just two more questions, Doctor.We heard from Dr. Frances Gearing and she revealed some veryimpressive statistics about the efficacy of the methadone maintenanceapproach as far as the reduction of crime is concerned for those addictsunder treatment. Do you know of any similar studies of efficacy oftreatment modality related to reduction in crime rate on diiig-freetherapeutic approaches ?Dr. Kramer. Yes; the civil commitment program in Californiaalso reported on the reduction in convictions of individuals on outpatientstatus in their ]Drogram and it sliowed a fairly marked decreasein convictions. The problem in this particular data is that inpractice, when someone committed to the civil addict program inCalifornia is rearrested, even on new charges, often the new charges
—649are not pressed when the civil commitment authorities decide to returnthe man to CRC, the civdl commitment inpatient program. Prosecutorsfeel that is sufficient; they drop the charges. This is, perhaps, onereason why there was a reduction in the crime rate.In addition though, it is possible that the very close parole supervisionitself, even with the people on parole from the civil commitmentprogram, does have an effect in reducing crime. Credit shouldnot be taken away from the program, because they may deser^'e it.Mr. Peijito. Doctor, do you think that lack of proper aftercarefacilities has injured the effectiveness of some of the NARA treatmentprograms ^Dr. Kramer. I am not familiar with any information which wouldsuggest that the aftercare facilities are inadequate. From what littleI have heard, and again this is hearsay, the aftercare facilities for themost part are rather good in the NAIiA program. They are well run,as far as I know, with serious and concerned people running them.question. What do you think has been theMr. Perito. One finalbiggest roadblock to the problems confronted by the abstinenceprograms ?Dr. Kramer. The roadblocks to the abstinence programs are basedin a well-known but little understood fact; that is, that once an individualhas been seriously addicted for a relatively prolonged periodof time to opiates, the desire to reproduce that opiate effect is sopersistent and powerful that very few people have successfully givenup their drug.Mr. Murphy. I think the ranking minority member might havesome questions.Mr. Wiggins. I will yield to Mr. Blommer.Mr. Blommer. Doctor, I believe that California is pix)bably typicalof the Federal institutions that contain a number of addicts, and Iam talking about prison institutions, a number of heroin addicts thatfor various reasons are not receiving any type of treatment. Is thatcorrect ?Dr. Kramer. Yes ; of course.Mr. Blommer. Do you have any suggestions as to programs thatmight benefit a man who is in prison for maybe a very long periodof time, looking toward the day when he will get out ?Dr. Kramer. I do not know of any specific inpatient programsincarceration programs, perhaps, would be the better term—which willbetter insure a result when the man gets out of prison. One thoughtthat I did have, which I do not think is apropos at this moment inour history, but potentially may be apropos sometime in the future3 years, 5 years, 10 years—is that when we learn better techniques toretain addicts on the street so that they do not go back to opiates,reconsideration of certain individuals who have been imprisoned forvery long mandatory minimums might at that point be made—bothFederal mandatory minimums and State mandatory minimums.A man, for example, who is sent up for 20 years in 1971 on perhapsa third sales "beef" may in 5 years still be facing 15 years mandatoryminimum and yet we may have the technolog}^ which will, thoughnot guarantee, which might, let us say, offer at least a 70- or 80-percentchance that he will be a useful citizen. I think that it is not the answerto your question, but I take the opportunity to mention it.
- 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
- Page 656 and 657: :636D. NARCO, Inc.Narcotics Addicti
- Page 658 and 659: 638crimes to obtain the necessary m
- Page 660 and 661: 640million to $25 milliou per year.
- Page 662 and 663: 642Mr. Perito. Thank yoii. Mr. Chai
- Page 664 and 665: 644narcotic antagonist, and the oth
- Page 666 and 667: 646. Dr. Kramer. From what I have s
- Page 670 and 671: —650I know of no techinque in pri
- Page 672 and 673: 652Dr. Kramer. Yes, sir. As a matte
- Page 674 and 675: :'654prison and who liave no—wlio
- Page 676 and 677: 65GDr. KT?A:\rEij. 1 suspect tliat
- Page 678 and 679: 658support some of the inethadone p
- Page 680 and 681: '6660Dr. IvKAisrKK. 1 believe that
- Page 682 and 683: 662jrest that the Veterans' Adminis
- Page 684 and 685: 664opiates may be ingested in sever
- Page 686 and 687: 666(5) It suppresses the desire for
- Page 688 and 689: 668Many people have benefited from
- Page 690 and 691: —G70Other researches which may di
- Page 692 and 693: 672synthetic painkillers, our commi
- Page 694 and 695: 074IV. A universal ban on legitimat
- Page 696 and 697: ..676iTlius we must look to educati
- Page 698 and 699: 678states, from Arnold Becker, publ
- Page 700 and 701: 680However, we must look at rehabil
- Page 702 and 703: :682(a) The natural history of narc
- Page 704 and 705: 684was a heavy user. The decrease i
- Page 706 and 707: 686(13) Wallace. R. K. : Physiologi
- Page 708 and 709: 688TABLE 9.-USE OF "HARD LIQUOR" BE
- Page 710: UFRAL BOOKBINDING CO. Q /-^ /-» .1
—649are not pressed when the civil commitment authorities decide to returnthe man to CRC, the civdl commitment inpatient program. Prosecutorsfeel that is sufficient; they drop the charges. This is, perhaps, onereason why there was a reduction in the crime rate.In addition though, it is possible that the very close parole supervisionitself, even with the people on parole from the civil commitmentprogram, does have an effect in reducing crime. Credit shouldnot be taken away from the program, because they may deser^'e it.Mr. Peijito. Doctor, do you think that lack of proper aftercarefacilities has injured the effectiveness of some of the NARA <strong>treatment</strong>programs ^Dr. Kramer. I am not familiar with any information which wouldsuggest that the aftercare facilities are inadequate. From what littleI have heard, <strong>and</strong> again this is hearsay, the aftercare facilities for themost part are rather good in the NAIiA program. They are well run,as far as I know, with serious <strong>and</strong> concerned people running them.question. What do you think has been theMr. Perito. One finalbiggest roadblock to the problems confronted by the abstinenceprograms ?Dr. Kramer. The roadblocks to the abstinence programs are basedin a well-known but little understood fact; that is, that once an individualhas been seriously addicted for a relatively prolonged periodof time to opiates, the desire to reproduce that opiate effect is sopersistent <strong>and</strong> powerful that very few people have successfully givenup their drug.Mr. Murphy. I think the ranking minority member might havesome questions.Mr. Wiggins. I will yield to Mr. Blommer.Mr. Blommer. Doctor, I believe that California is pix)bably typicalof the Federal institutions that contain a number of addicts, <strong>and</strong> Iam talking about prison institutions, a number of heroin addicts thatfor various reasons are not receiving any type of <strong>treatment</strong>. Is thatcorrect ?Dr. Kramer. Yes ; of course.Mr. Blommer. Do you have any suggestions as to programs thatmight benefit a man who is in prison for maybe a very long periodof time, looking toward the day when he will get out ?Dr. Kramer. I do not know of any specific inpatient programsincarceration programs, perhaps, would be the better term—which willbetter insure a result when the man gets out of prison. One thoughtthat I did have, which I do not think is apropos at this moment inour history, but potentially may be apropos sometime in the future3 years, 5 years, 10 years—is that when we learn better techniques toretain addicts on the street so that they do not go back to opiates,reconsideration of certain individuals who have been imprisoned forvery long m<strong>and</strong>atory minimums might at that point be made—bothFederal m<strong>and</strong>atory minimums <strong>and</strong> State m<strong>and</strong>atory minimums.A man, for example, who is sent up for 20 years in 1971 on perhapsa third sales "beef" may in 5 years still be facing 15 years m<strong>and</strong>atoryminimum <strong>and</strong> yet we may have the technolog}^ which will, thoughnot guarantee, which might, let us say, offer at least a 70- or 80-percentchance that he will be a useful citizen. I think that it is not the answerto your question, but I take the opportunity to mention it.
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