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

666(5) It suppresses the desire for opiates. Patients cease talking or evendreaming obsessively about drugs.(6) No notable toxic effects are encountered. There is, for example, nointerference in menstrual function and women on this program have conceived,and while still receiving methadone carried vo term and easilydelivered healihy babies. At birth there was nunim^il evidence of withdrawalsymptoms in the infants and no acrive thereapy was required.The results of this approach so far have been startlingly good, and others whohave used it have had similar results. Though use of methdone is the sine quanon of the program there is recognition that patients have other life problemsand efforts are made to assist them. Psychotherapy is not considered essentialthough it is available if necessary. Freed from the need for the cycle of hustling,scoring, fixing, nodding, and hustling again, blockaded from feeling the effects ofa shot of heroin which he may try once or twice to prove to himself that a blockadereally exists, the patient can now proceed with the ordinary business of reconstructingand living his life.In Dole and Nyswander's series ( milligrnms of nalorphine and his pup''! size is reme.'sured 20 to 30minutes later. Pupillary construction indicates a negative test while dilation ispositive. In positive or questionable tests urinalysis for opiates is requested sinceit is more reliable than the screening test. For the most part this type of screeningis used in parole and probation programs.More pertinent to this discussion is the use of opiate antagonists as a therapeutictoi^l, Cycl.'izocine. and more recently naloxone, luilh i)f wliich .•tc invi\--tig-!-tionnl drugs, have been used on a regular daily dosage schedule in several experimentaltreatment programs. In the hospital the patient receives the medicationin gradually increasing doses till a daily maintenance level is reached. Asan outpatient he continues to receive the medication regularly. Should the patientuse an opiate, it will have either no effect or a markedly dimiTushed effect, dependingon dose and time relationships between the cyclazo'nne .and the opiate.IJnlike disulfirani (Antabuse) which produces unpleasant and potentially danger-