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

659if properly operated iiiider ])roper supervision of public iuithorities.Would you agree ?Dr. Kramer. Yes, sir; I would indeed. We have one such programin California. There are several similiar programs in other Stateswhich are privately run, I believe generally on a noni:)rotit basis, thoughI believe there may be one or two which are even prolitmaking institutions,supported by outside contributions and the patient's fee ; yes, sir.Chairman Pepper. Now, Dr. Smith also stated, as I recall it, thatthese facilities should be a\ailable in almost every community wherethere was a narcotics problem. When one of the Governors testified herethis morning, I believe Governor Carter of Georgia, he said addictsdid not Avant to go across town where they had to get in a bus or a taxi,you get more im'olved where they are more or less connnunity facilities.Do vou agree ?Dr. Kramer. I certaijily agree. Some of our patients have to travelthree-quarters of an hour each way to come to our ju-ogram. Whenthey must come very, very frequently, it is certainly an imposition ontheir time, particularly the ones who linally do get a job.Chairman Pepper. Xow, just two more questions. One is, what canAve do to get most of the addicts into the treatment program? Dr.Jaft'e told me j^ersonally that we would get al)0ut 50 percent, maybe,of the addicts into a voluntary program. Would you agree? Has thatbeen your experience? ITow can we get a larger number of addicts intoan effective program ?Dr. Kramer. At this moment in time, I think that were I to guessabout what proportion of all long-term addicts, again over a year ortwo, would come, for example, into methadone or other programs, I donot care which, the overwhelming majority Avould go into methadoneprograms. One thing we do not kno^^•, we do not know A^hat AA'Ouldhappen Avhen Ave finally get those 50 percent into treatment.What I find, for example, is that a man aa'Iio has been uiiAvilling tocome into a treatment program sees seA'eral of his friends in a treatment])rogram. He has denigrated tlie vnhm of the program. He sees hisfriends Avho are noAv not going to jail, aaIio are leading decent liA^es.He then comes and asks for help. I suspect that Ave might findthat larger and larger numbers of addicts Avill present themselves ifAve proA^ide effective programs.One situation may shed some light on this. Because of the supportof the Governor of Oregon, extensiA^e methadone facilities Avere madeavailable in that State. It Avas estimated that Oregon had l)etAA-een250 and 300 addicts. They noAv have roughly oOO patients on methadone.I am not saying that they have all the addicts in the State, butI think this might be a testing grouiid, a community in Avhich thereare a relatively limited number of addicts which might lie a microcosmfor all other programs. We iniglit be able to learn something frompeople in Oregon as to hoAv completely people are Avilling to comeinto a program Avhen the doors are open and anybody avIio needs itand is appro])riate for this can get treatment.have not been able to take care of the addicts that AveSo far, AvehaA^e.Chairman Pepper. Would you recoimnend any kind of hiAv thatwould refjuire anyone involuntarily to be brought into treatment in aprogram if he Avere found to be a heroin addict?