Dr. JAFFE. Well, we are obviously more fortunate. Perhaps we have planned better. But in terms of beds, we have not built our beds within traditional medical facilities. This has permitted us to expand greatly. It is very hard to get beds within medical facilites.

The way we have developed them. It is considerably easier and considerably better for the patients.

Mr. ROGERS. Where do you get your beds?

Dr. JAFFE. Well, for example, the Salvation Army has a facility on the south side of Chicago, which it has intended for use in alcoholics, which they felt was no longer needed for that. We have that facility there.

There is a staff quarters and mental health center south of Chicago. We have the staff quarters there and we have room for 70 people there. We have a facility that is an old mansion. We have 30 or 40 people there.

Mr. ROGERS. What is the longest period of time you would probably keep someone as an inpatient in the community health center?

Dr. JAFFE. It varies, in some cases from 2 weeks to, in some cases. 2 years. We call it residential. We have, for example, an old retreat, formerly used by a group of nuns, taken over by our facility. That houses 70 people.

So it is a lot easier to find 70 beds that way than build a 70-bed hospital that requires it to be built around a concept of medical illness and infirmity. Our people need a place to live, but they do not need a place that defines them as being sick and unable to provide for themselves. They need a retreat rather than a place that emphasizes invalidism.

Mr. ROGERS. Have you asked the National Institute of Mental Health how many drug programs they can get started immediately in their community mental health centers?

Dr. JAFFE. I haven't asked that question specifically; no.
Mr. ROGERS. Would you let us know?

Dr. JAFFE. I will make inquiry.

Mr. ROGERS. I would think this would be a good place to begin. This would give us some knowledge of capability. I would think that each of those centers would know or could easily find out what is available in their communities. I would think you would have to start somewhere to get an inventory of what the capability is.

Dr. JAFFE. We have already started that and are looking into that. Mr. ROGERS. What have you found?

Dr. JAFFE. We have found that a study funded by one of the groups required modification to even ask the question of what the capacity was. In enumeration, a census of treatment programs provides little for planning unless it tells you how many patients you treat in resident status, total inpatient status, outpatient status, and the cost.

We finally had to abandon the question of cost because we felt no programs could provide that data in even a primitive way.

Now, that contract has been modified, and we think we will get that census of what the treatment capacity of the United States is, not just around mental health centers but around private groups, around State acilities. We don't know what the census is of the treatment resources. that has already been undertaken more than 2 weeks ago. ROGERS. Who has that?

Dr. JAFFE. I don't know what group has the contract. I think NIMH had let the contract. They tried to help us get the census. Mr. ROGERS. How much was it, do you know?

Dr. JAFFE. It was a $50,000 contract.

Mr. ROGERS. I think if you would keep us advised on that and let us know the results of it. I would think the American hospitalization and community mental health centers program could quickly give you a census by simply sending out a questionnaire to their constituent people. It might give it very quickly.

Dr. JAFFE. We will ask them to do so.

Mr. ROGERS. I am sure they would cooperate with you, because I think it is essential to know what we can do, and I don't know how you can proceed, as you say, unless you know what is available and you know what needs to be done.

(The following statement was received for the record:)

UTILIZATION OF COMMUNITY MENTAL HEALTH CENTERS AS DRUG ABUSE TREATMENT

UNITS

It is not possible without an institution by institution, and community by community investigation to determine which Community Mental Health Centers (CMHC's) could appropriately utilize drug abuse treatment units. In conducting such a census, we would examine the need for a drug treatment center in each applicable community. We have initiated early evaluations of the needs of individual communities and in the future we will be able to determine those CMHC's in which drug treatment programs should be established.

Mr. ROGERS. Thank you for coming back.

This committee is planning a trip to South Vietnam. We will leave Thursday evening in order to try to see for ourselves some of the problems involved. We are very much concerned about the present programs. We are glad you have been out there, and we think your input into the military will be helpful.

I think we have not yet seen sufficient movement in trying to get the military to coordinate with the VA, with communities, and I realize this takes some time.

But the committee is going to look into this very carefully so we will know how to gear the provisions of this bill.

Thank you so much for your presence and for your generosity with your time.

The committee stands adjourned until tomorrow at 10 o'clock. (Whereupon, the subcommittee adjourned, to reconvene at 10 a.m., Tuesday, August 3, 1971.)

SPECIAL ACTION OFFICE FOR DRUG ABUSE

PREVENTION

THURSDAY, AUGUST 5, 1971

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON PUBLIC HEALTH AND ENVIRONMENT,
COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

Washington, D.C. The subcommittee met, at 10 a.m., pursuant to notice in room 2318, Rayburn House Office Building, Hon. Paul G. Rogers (chairman) presiding.

Mr. ROGERS. The committee will come to order, please.

Our hearing today on the narcotics abuse problem is scheduled to hear from the pharmaceutical industry and its response to this committee's proposal that the major research-oriented pharmaceutical firms pool their scientific resources in the development of long-acting, nonaddicting drugs to block effects of heroin addiction.

It was just this last week that this committee initiated discussions with the industry to determine whether there may be promise in such an approach to narcotic addiction control, and I am gratified to learn that there is a research development opportunity here to which greater attention can and should be given.

This morning, because of the short notice, all of the presidents of the companies could not appear, but we are pleased to have the president and chairman of the board of Smith Kline & French Laboratories here with us, and, of course, speaking for all of the industry, Mr. C. Joseph Stetler, the president of the Pharmaceutical Manufacturers Association.

We will resume hearings in September when Congress reconvenes, and those additional people in the pharmaceutical industry who might want to testify will be welcome to do so at that time.

The development of a nonaddicting narcotic antagonist would give us a major weapon to deal with the heroin epidemic which we are now witnessing in this Nation. What we hope for is a safe and much more effective successor to methadone which will not be as addicting as methadone is.

Now, of course, I do not minimize the research and development challenge that this will pose for the pharmaceutical industry. There are many scientific bridges to cross, but I do hope that the major drug manufacturers will be willing to thoroughly commit themselves to this task, regardless of its difficulty. And if, this morning, we do receive the response which we hope for from the industry, this committee will take all appropriate steps to obtain cooperation from the Federal and State agencies and the scientific and other groups in the

field, and from the medical and scientific communities at large. Assistance, I am sure, will be needed from the National Institute of Mental Health, the Food and Drug Administration, the Addiction Research Centers at Lexington and Fort Worth, and others with scientific know-how.

I also hope that we can have a summit conference this fall of scientific leaders of industry, Federal and State agencies, and universities and medical schools so we could get the project going.

Our first witness this morning is Mr. C. Joseph Stetler, president of the Pharmaceutical Manufacturers Association, accompanied by Dr. John G. Adams, vice president for scientific and professionalˇrelations, and Bruce J. Brennan, vice president and general counsel.

We welcome you, gentlemen, to the committee, and we will be pleased to receive your statement.

STATEMENT OF C. JOSEPH STETLER, PRESIDENT, PHARMACEUTICAL MANUFACTURERS ASSOCIATION; ACCOMPANIED BY DR. JOHN G. ADAMS, VICE PRESIDENT FOR SCIENTIFIC AND PROFESSIONAL RELATIONS; AND BRUCE J. BRENNAN, VICE PRESIDENT AND GENERAL COUNSEL

Mr. STETLER. Thank you, Mr. Chairman, and members of the committee. You have identified my associates, and we are here representing the Pharmaceutical Manufacturers Association.

Our association consists of 120 firms whose mission it is to research, develop, and produce and distribute the great majority of the medicines prescribed and dispensed in the United States.

Our association has been following your current series of hearings with interest and approbation. Fortunately, on Tuesday of this week, our board of directors had its regularly scheduled meeting and it was possible for me at that time to discuss with them our previous conversations which tied in with the statement you just made and your release of yesterday. I am glad to be able to say that they have authorized me to appear here today to offer the continued cooperation of the prescription drug industry in developing more effective means of treating narcotic dependence, including heroin which, as you know, has no legitimate medical use, and, also, in meeting the national need for alternatives to the presently abused narcotics.

We share the deep concern of the President, of this committee, and others over the Nation's drug abuse problem. We agree that more can and should be done by industry and Government, individually and jointly, in the search for solutions. We hope to have the opportunity to work with you, and with the governmental agencies operating in this field. I confidently believe that the experience, expertise, and facilities of this industry can, and will, materially increase the potential for the success of any related future research efforts.

In considering this subject we must do so, however, with the realization that the effort is far from new. For over a century, since the introduction of morphine in medical practice the search has been carried on for medications which will safely remove pain and not exose the user to the potential of dependence. Work has been carried in universities, in Government institutions and, very substanv, in drug research laboratories.