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Drug abuse, especially among our young people, has reached crisis proportions in this country. As chairman of the Senate Subcommittee to Investigate Juvenile Delinquency, I have heard countless witnesses in Washington, and throughout the country-some in Californiatell of the grave peril we face, as a Nation, from the rapid spread of heroin addiction, and the abuse of nonopiate drugs such as amphetamines, barbiturates, and tranquilizers.
I am deeply concerned, not only as a U.S. Senator, but as the father of a 16-year-old boy, that we must find new and better ways to deal " with this drug epidemic. We must find ways to extricate those already involved in the tragic cycle of drug dependency and addiction, and to prevent even greater numbers of our young people from establishing destructive patterns of drug use.
This is what we want to find out from the California experience; 4 Are we opening the door, or perhaps how can we keep from opening the door to wide numbers of additional users of a different type of drug?
We are all too familiar with the devastating consequences of heroin addiction for the individual addict, the addict's family, and society as a whole. In order to support his habit, the addict is driven to engage in criminal activities, often threatening the personal safety of our citizens.
The cost-in human and economic terms-is enormous. Billions of dollars are expended each year to protect our citizens from drug-related crime. Billions of dollars of merchandise are stolen each year. Many innocent people have been killed and physically assaulted. Hundreds of thousands of otherwise productive lives have been lost to the destructive, endless cycle of heroin addiction.
As we have learned from bitter experience, there are no simple solutions to the epidemic of narcotic addiction. There are no panaceas no magic wands! But, there are a number of treatment modalities which have had a degree of success in rehabilitating certain addicts.
Our hearings today will focus on a drug which has received a great deal of attention in the past several years-methadone. It has been utilized extensively in the treatment of heroin addicts.
Methadone is a narcotic similar to heroin and morphine. Although it is dangerously addictive, methadone has been used successfully to detoxify or maintain heroin addicts. In maintenance programs, methadone addiction is substituted for heroin addiction. But the methadone acts to suppress the craving for heroin. The chronic addict can be stabilized and permitted to concentrate on rehabilitative efforts. For some addicts, methadone can lead to a productive life in a community. It is important to emphasize that methadone is not a "cure" for heroin addiction. Any effort to use the drug itself, as a simple, inexpensive, large-scale answer to heroin addiction is, in my judgment, ill-conceived and will lead to a "turnstyle or breadline" type of treatment. Pressure for hastily developed, large-scale, underfinanced, understaffed programs must be resisted. Methadone maintenance may open the door to rehabilitation for some addicts, but an addict must desperately want to change his lifestyle, and must have extraordinary motivation in order to benefit from the program.
However successful methadone maintenance has been in treating certain addicts, we must not use methadone to "smoke-screen" the effect of drug addiction on our society, and the social conditions that spawn drug addiction. We must make certain that our society continues to give adequate attention to the causes of the original heroin addiction. Methadone maintenance should not provide a "fix" for a complex social, political, medical, and psychological problem. Equally important, we must deal with the escalating numbers of multiple nonopiate drug abusers for which methadone is not even a partial
In 1968, there were fewer than 400 patients enrolled in methadone treatment programs nationwide; today there are more than 60,0000 patients in more than 400 programs. Proposed Federal regulations contemplate an even broader proliferation of methadone distribution. This rapid expansion of methadone programs, and the quantity of methadone dispensed, has simultaneously provided increased opportunity for diversion of methadone into the illicit market.
In many cities, methadone is already widely available in the illicit market. A recent survey of heroin addicts in New York City found that 92 percent had been offered illicit methadone; that 56 percent had purchased illicit methadone; and that 13 percent had sold methadone. Illegal methadone has several primary origins: carelessness or unscrupulous physicians; thefts and diversion from methadone programs; and patients enrolled in methadone programs. In some communities, one or more physicians have contributed substantially to the illicit traffic. A physician in the District of Columbia was recently convicted on 22 counts of illicit methadone distribution. It was alleged that he sold 11,000 prescriptions-815,000 10 mg. doses and accumulated more than a quarter million dollars for his efforts. We went to make certain that no physician or no citizen of this country has a chance of making a quarter million dollar profit out of a program which is originally designed to treat heroin addicts. This is one of the purposes for our being here. This is one of the reasons that the legislation before us has been introduced. Here in California, State agents recently arrested a pair of methadone runners carrying 2,000 methadone pills destined for southern California. Several Arizona physirians were allegedly the sources for these pills.
Employees and volunteers associated with methadone programs have been implicated as sources of illegal methadone. It appears, however, that such diversion is usually unwittingly permitted, and can be attributed to poor organization and loose controls. A recent development has been armed robberies of methadone clinics in Baltimore and New York City. In these instances, substantial amounts of methadone were stolen.
The most frequently cited source of illegal methadone is the patients themselves. Some addict-patients who have "take home" privileges for ambulatory maintenance programs sell part of their supply. Recent studies have found that nearly two-thirds-and I think this is extremely important-that nearly two-thirds of the addicts who purchased illegal methadone obtained it from individuals enrolled in methadone programs designed to treat the heroin habit. This can be very profitable. Average daily dosages range from 40 to 180 milli