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

38Dr. Eddy. No.Chairman Pepper. Now, would you care to comment about the use ofmethadone as a drug in the treatment of heroin addiction?Dr. Eddy. In the use of methadone you use, or you accustom, theindividual, you stabilize the individual on a dosage level which,through the mechanism of cross-tolerance, prevents him from gettinganj' acute reaction to the methadone which he is taking or a dose ofheroin which he might take. Therefore, you stabilize him in a statewhere he is in a stable mood so far as drug use is concerned and is of amind to turn his attention to other things rather than simply to hispreviously drug-seeking behavior. Therefore, he no longer needs to goout in the street and steal cars and televisions and so on to buy hisheroin. Ke has an opportunity to concern himself with getting a job,and supporting his family.Mr. Pepper. How do you think methadone should be furnished tothe addict?Dr. Eddy. Through a team effort to help handle all of his problems,not just simply to supply him with drugs, because you must have thepsychotherapy, the vocational assistance, the job help and housinghelp, perhaps, and all this while he is stabilized on methadone. Otherwisehe has other reasons for trying to go back to other drugs, eventhough he is not getting any satisfaction out of his heroin.Chairman Pepper. In other words, a prescription of methadone by aphysician is not the answer to the problem alone ?Dr. Eddy. Very definitely not. Theoretically, in a very rare instance,it would be possible for a private physician with very close rapportwith his patient to put that patient on methadone and keep close contactwith him and treat him satisfactorily. But practically, writing prescriptionsfor drug-dependent people for methadone, letting them goto tlie drugstore and buy it without doing anything else for him, isnot the answer at all. You just give him the opportunity to use excessiveamounts of methadone or to sell some of it to somebody else, go toanother doctor and get some more. You have no control over the propositionat all. You have not accomplished what you have set out to do.Chairman Pepper. Doctor, one other question.What is your opinion as to the medical need for amphetamines^Dr. Eddy. The legitimate need is very small indeed.Mr. Wiggins. Doctor, what is the difference between methadonemaintenance or stabilization and heroin maintenance or stabilization,assuming the heroin was made available at no cost or minimum costto the patient ?Dr. Eddy. Theoretically, none when you supply the heroin. If youare going to be successful you have got to supply him \yith enoughheroin to maintain him in a reasonably stable state. Practically, thereare differences because at the present time they are still^ sujiplyingheroin in England to be taken by injection, which maintains theritual of heroin abuse which the individual has been subject to previously.In the methadone maintenance program the drug is given bymouth and therefore you upset the ritual, which goes along with hisdependence, and probably is a very significant factor in the maintenanceof dependence.Put more than that, you can build up to a dose of methadone whichwill maintain the individual in the stable state throughout the 24-