the Federal legislature, that he had to achieve a budget from the State legislature, the same abilities to coordinate, the same access to ongoing and past research, but do you think we can anticipate any greater achievement nationwide than that which he achieved in Illinois? Dr. BROWN. Yes. Mr. Roy. Why? Dr. BROWN. I think because of two reasons. One is, I think the justifiable anxiety within the country on the narcotics and drug abuse problem. Mr. Roy. Reflected by $271 million when last year the State of New York spent $136 million and Governor Rockefeller's man and Mayor Lindsay's man, who have been handling these programs, said they didn't have enough money last year. Isn't it possible he is going to run into a situation here, or is in fact, running into a situation here of not enough money? At least the Secretary does not think so. He thinks he has all of the money he can handle; isn't that correct? Secretary RICHARDSON. I think in fairness to Dr. Brown, that these are questions which you can much more directly get answers from Dr. Jaffe next week. I would only add that the President has undertaken to respond to what he defined as an emergency and in which I would think all would agree genuinely is an emergency. He has proposed to equip Dr. Jaffe with both the funds, and the authority, to do whatever is required, whatever can practically be done to cope with that emergency. And so the question then would be, "Did the State of Illinois give him that same degree of authority and that same degree of funding?", and I don't think Dr. Brown or I would know that. We do know, whatever may be his situation there, that it is the purpose of the administration to do what has to be done from here on, insofar as the Federal role is concerned. Mr. Roy. I stand ready to be persuaded, and I am not persuaded at the present time, because of the amount of money being budgeted, because of what appears to me to be some lack of authority and because we have no indication from past performance anywhere in the Nation that voluntary treatment programs alone are going to be enough. With that statement. I won't pursue it any further. Mr. ROGERS. Now, the committee may have more questions that we would like to go into. We do have a call to the floor, and we have our distinguished colleague, John Murphy from New York, who has made a very specialized study of this whole problem. And he was anxious to hear the testimony of HEW before he testified and deferred to the Secretary. What we would like to do, if it is convenient with you, Mr. Murphy, is go answer and come right back, or if you prefer, a different arrangement, we would make it. Mr. MURPHY. Whatever the committee would like to do. Mr. ROGERS. This is the second bell, if we can answer and come right back, because I know your statement will be very important because you made some visits just now to military bases and so forth. And I know the committee wants to hear it. Mr. MURPHY. I would like to say, though, I think the Fort Worth tragedy with a demoralized staff, demoralized patients, certainly is something we have to face immediately. We have in this legislation the exclusion of law enforcement agencies and yet we are going to transfer a Federal treatment facility over to the Bureau of Prisons. I want to address myself to that when we get back. Mr. ROGERS. I think the committee would be very anxious to hear it, because I am sure the Congress is going to act on this matter this coming week. Mr. Secretary, thank you for being here with your very able associates, and we are grateful to you for your appearance here today. Secretary RICHARDSON. We appreciated the opportunity, Mr. Chairman, and members of the subcommittee. Mr. ROGERS. The committee will stand in recess for 10 minutes. (A brief recess was taken.) Mr. ROGERS. The subcommittee will come to order. We have as our next witness our distinguished colleague, my good friend John Murphy of New York, who is also a member of the full committee. The committee knows of your great interest in this problem and the personal effort that you have taken and gone to, assemble some facts and information on what the problem is and what we ought to do about it. So, we are particularly interested to hear your testimony today, knowing of your very recent trip to some of the facilities and the extent of the problem. So, the committee welcomes you. and we are pleased that we can hear your testimony. STATEMENT OF HON. JOHN M. MURPHY, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW YORK Mr. MURPHY. I want to thank the chairman for those kind words. I congratulate him on the recent floor action whereby the House adopted his amendment to the HEW appropriations bill, adding $14 million to bring funding of the Public Health Service hospital system up to last year's level. We know that the Public Health Service is staffing and budgeting its hospitals at way below capacity, inclding the hospital on Staten Island that the committee visited and for which the chairman made an outstanding presentation earlier this year. I think one of the great trag edies is the Forth Worth addict treatment facility, which I visited just a week ago, about a week after this subcommittee made an on the spot visit. I saw a staff that was demoralized, a staff that had been so cutback that it could not perform its basic mission. There is a certain manning level that is necessary, whether you have one addict or 500 addicts. The staff had been phased down to the point where they couldn't properly oversee or supervise the number of addicts that were there at the time. And I think that to transfer that facility to the Bureau of Prisons, seems to apply in the case of one of the intents of H.R. 9264 which seeks to separate any type of function in the bill from the Department of Justice. We know the Bureau of Prisons, of course, has a direct relationship to them. At the outset, I will refer to two questions that Dr. Roy addressed to the Secretary of Health, Education, and Welfare. The first question is, what triggering mechanisms are there as far as an addicted military man is concerned, to get him into either a public health program or a veterans program or a community mental health program, or one of the many other treatment programs that are available. The Secretary had no language or idea on the matter, but I had communicated to this committee and to all Members of the House on March 16, 1971, H.R. 6172, which I reintroduced yesterday on the 29th of July, and which is now H.R. 10223, with slightly revised language. The second page of that bill contains the triggering mechanism that I recommend should be part and parcel of any approach to the military drug problem. Of course, when we talk about H.R. 9264, I think we have to understand there is an interrelationship between NARA, between H.R. 9264 and our military drug problems. We may not be able to reach it with amendments to this bill, but we will have to amend NARA and also enact this military drug bill to legally be able to do the following: My military drug bill provides that not less than 30 days prior to the date on which any member is to be retired, discharged, or separated from active military service pursuant to subsection (a) of this section, the Secretary concerned, shall file a petition with the U.S. attorney for the district in which such member will be separated from active military service or with the U.S. attorney for the district within which the permanent home of record of such member is located, requesting that such member be admitted to a hospital of the Public Health Service for treatment of his drug dependency. The Secretary shall not file a petition with respect to any member if the Secretary determines that such member has voluntarily filed or will file within the 30-day period prior to his expected date of separation from active military service a petition with appropriate U.S. attorney requesting that such member be admitted to a hospital of the Public Health Service for treatment of his drug dependency. Any petition filed by the Secretary concerned or member under this section shall set forth the name and address of the member, and so forth, and his military base. The Secretary bases the separation of such member from active military service by reason of drug dependency, which is a physical disability separation. And then, we trigger NARA. He then comes under the civil commitment provisions of NARA, which, I think, is an answer the Secretary might well look to. And, I think the committee could probably forward it to him for his consideration. Second, Dr. Roy asked the effects of voluntary movement into this program. This triggering mechanism I just mentioned has voluntary and involuntary movement, because you must have both voluntary and involuntary commitment if we are going to control the drug abuse problem. There is some experience as far as involuntary input into the program is concerned. It came in my testimony before the House Judiciary Committee on June 23, on the NARA amendments that I proposed. I will go through this, because it is very interesting and gets to what Dr. Roy was referring to. Figures were made available to me that indicate that under title 2 of NARA, which involves involuntary commitment, even though the number of inmates is comparatively small, the plan does seem to work. As of December 30, 1970, 414 inmates had been released to aftercare following an average institutionalization of slightly over 15 months; 297 or 72 percent were still active, and 28 percent had violated and absconded. I feel that the fact that 72 percent were relatively law abiding is a tremendous improvement over the 2-percent cure rate of addicts in Federal institutions of which we used to hear. Seventy percent of all inmates in Federal institutions have a drug problem. I feel the provisions in my bill, H.R. 5612, to expand those eligible under NARA is a critical one. The question that the chairman addressed to the Secretary on how much methadone was being used, and what other drugs were being used, was one that I have current information on. Here are statistics I will submit to the committee for the record, statistical reports as of June 2, 1971, from the Narcotic Addict Rehabilitation Branch. These are community-based grant programs, the number of patients remaining in treatment programs as of April 30, 1970. And it goes through 23 centers, including Hartford, Conn., New Haven, Conn., Baltimore, Md., Chicago, Ill., Boston, Mass., Kansas City, Mo., St. Louis, Mo., Marlboro, N.J., Jersey City, N.J., Albuquerque, N. Mex., and Brooklyn, N.Y. The total patients are 816 that receive drug-free therapy. We have appropriated $30 million for research, and these are all the addicts we have on drug-free therapy. The number on chemotheraphy maintenance totaled 5,638. Those on methadone 5,624 on naloxone 14. That is the extent of the experience of this agency with that number of people. They are not trying any other type of chemical. They are strictly a methadone maintenance operation, and I just don't think that the Department has gotten into research or properly put emphasis on research for other types of drugs in spite of what they said this morning. I would like to submit this report for the record. Mr. ROGERS. Without objection, it will be received as part of the record, and I agree with you in your conclusions there, that presently, they are just depending on methadone and there is no real effort to try to change it. (See "Statistical Report-1971, Narcotic Addict Rehabilitation Branch," p. 1027, this hearing.) Mr. MURPHY. Dr. Edwards of the Food and Drug Administration testified that Eli Lilly is their supplier of methadone. When we talk about methadone deaths I point out that we had five in my county, five teenage methadone deaths in 2 weeks. We have had children who go into a parent's icebox and take out methadone that has been placed in orange juice. We have many deaths in the city of New York when children or teenagers buy or accidentally take the methadone that was given to an addict by one of these many Federal treatment programs. The Secretary said there were 260,000 addicts in America and vet at Lexington, we are treating 500. So the Federal Government involvement in the direct treatment of addicts, including Fort Worth, where they gain their expertise, happened to be 760 addicts out of 260,000 addicts in the United States. In the face of this, the Department of Health, Education, and Welfare wants to close Fort Worth, and phase back Lexington. They want to get rid of an entire Public Health Service system as well as the 5,000 Public Health Service doctors with their medical expertise, and contract out their patients to other agencies, a policy with which I don't agree. And, I am going to support your amendment or your resolution on Monday on the floor. I would like to get into the military problems and interaction that I think is necessary, It is ironic that these hearings are being held on the anniversary of the advent of the massive heroin problem in Vietnam. Suddenly last summer in late July, a newly packaged, widely distributed, deadly potent form of heroin was being practically given away to our troops. By September, a majority of all servicemen hospitalized in Vietnam were drug abuse cases. By October, we were losing two men a day to heroin overdoses. By the end of 1970, the situation had gotten so bad an intelligence analyst at the American Embassy in Saigon said, "The Pot-Head Army of 1969 is rapidly turning into 1971's Army of heroin addicts." One of the marines in the Navy's so-called voluntary amnesty program in Miramar told me he was assigned as guard at the American Embassy. That is an example of the extent of heroin usage. It is used by the guards at the American Embassy in Saigon. The American Government was well aware of this development right from the beginning. I have obtained a copy of an Army memorandum designated as a fact sheet designed to demonstrate the increased incidence of drug abuse deaths of Army personnel in the Republic of Vietnam during the period from January 1, 1969 to September 30, 1970. This alarming report was prepared at the request of Gen. Creighton W. Abrams and is dated October 23, 1970. The report shows that for the first 7 months of 1970, there was an average of two soldiers a month dying from drug overdoses. This was an increase of 50 percent over the monthly average for 1969. However, once the new supply of heroin reached our troops in late summer, known drug overdose deaths increased 175 percent in August and September according to the Abrams memo. As ominous as the report to General Abrams was, reports by American military hospitals in Vietnam indicated that many O.D.'s went undetected or unconfirmed and that our drug casualty figures were actually much higher. U.S. medical personnel reported that when the known O.D.'s were combined with suspected overdose deaths, the increase for August and September was 1,000 percent, or 46 deaths. During the first 18 days in October 1970, there were 35 known overdose deaths among our troops. At that rate, instead of the two deaths a month, we were experiencing from January through July, we were experiencing two deaths a dav. That percentage of increase was an astronomical 2900 percent. Such alarming statistics should have led the Government to massive remedial action immediately-not 9 months later. Now that action appropriate to the problem has begun, I urge this committee which has such an excellent record in this area to use its power and prestige to properly implement those aspects of the domestic drug program which have relevance to our addicted servicemen. As a Congressman and as a former member of the Military Establishment, I was greatly disturbed over this growing shadow of drug addiction that has now overtaken large numbers of our soldiers, sailors, and airmen. |