And if we give you the protection of antitrust, then you would be more free to exchange ideas, would you not?

Dr. ADAMS. I defer to Mr. Stetler on the question of antitrust.

Mr. STETLER. I think any collaborative arrangements that are started would be done obviously with Government cooperation and, to some extent, supervision. We would not attempt to say to you that in this effort, or any other, all of the competitive instincts of this industry are going to be suddenly submerged.

Mr. NELSEN. I understand that.

Mr. STETLER. But I do say, in this instance given the initial limited target and relatively new areas to be explored and the recognition of the common problem that exists, that this would not be a major obstacle to an effective collaborative effort.

Mr. NELSEN. I join with Mr. Preyer in wishing you well in the endeavor and appeal, as a member of the committee to the industry, to give us the help we need.

Thank you, Mr. Chairman.

Mr. ROGERS. Mr. Symington?

Mr. SYMINGTON. Thank you, Mr. Chairman.

Dr. Adams, you mentioned a possibility of genetic vulnerability to heroin. Would it follow that a long-time user is likely to convey such a vulnerability to his children?

Dr. ADAMS. I do not think I can answer your question specifically. I am not a geneticist, but if there is a genetic factor, it would seem to follow that it could be transmitted to successive generations if there is, in fact, a gene of some type involved.

Mr. SYMINGTON. I was wondering, from heroin addiction itself, regardless of whether there was an original genetic vulnerability or at least the relative vulnerability, if it could be created in future generations by the use of the drug by a given person?

Dr. ADAMS. Well, apart from any direct drug ingestion or a genetic abnormality, the mere fact that these people are sick, that their social and as a mater of fact, their physical-physiological qualities are affected, which, in turn, will affect the lives of their children, this certainly can have an effect. Now, it is not the straightforward genetic type of a problem, but it certainly becomes a sociological problem and may lead successive generations to become victims of the same weakness and the same disease.

Mr. SYMINGTON. As far as you know, you cannot inherit physical dependence?

Dr. ADAMS. As a result of ingestion, I do not think so. But I do not know. It may be something that is worthy of investigation. This is what I meant earlier. And perhaps this is a new avenue that should be pursued.

Mr. SYMINGTON. Another thing-and perhaps this is for Mr. Stetler.

You mentioned that the subcommittee should consider additional funds for the evaluations of the Lexington Center. In your view, based on your knowledge of what they are doing there, are these funds sufficient today for what they are doing? Are you seeking additional funds for this study, or do you feel that they are underfunded as it is?

Mr. STETLER. I think they are underfunded as it is. I was shocked to get the statistics that were new to me, that I mentioned in our testimony,

of their capability to scream only half a dozen or less compounds a year. It just seems obvious, without a lot of exploration, that that is an inadequate capability on the part of the facility. Absent any further mandate or assignment, I think that they do not currently have enough money to do their job.

Mr. SYMINGTON. What would be a fair number of compounds per annum?

Mr. STETLER. I really do not know. I have a feeling that there are a great many more than a half a dozen a year that are available and worked up to the point where they could be processed. It seems to be one of those obvious inadequacies. We are going to be interested in following it up, and I think you probably might be, too.

Mr. SYMINGTON. You mentioned that methadone was a German discovery. We must assume that they did not rest on their oars for a quarter of a century after that. To what extent are we able to communicate and learn from European pharmaceutical firms and scientists in the scientific community there, in a cooperative fashion, so that breakthroughs are hastened?

Mr. STETLER. I will let Dr. Adams answer specifically on what has evolved with respect to methadone. I think that we have made some good progress in the last few years, in terms of a better capability for coordinating research efforts with prescription manufacturers overseas. We have an organization which is now just 3 years old, which is a federation of associations of pharmaceutical manufacturers from all over the world. This provides us with an increased capability.

Our companies are extending their operations, both research and marketing, to many, many countries of the world. This puts us in closer contact with not only the commercial but the scientific communities in these countries, so that the capability exists and is improving. Now, Dr. Adams might comment on what-if he knows has happened in the methadone field.

Dr. ADAMS. I can only comment that a number of derivatives of methadone have been synthesized and tested for a number of purposes. One is for an analgesic that would not have addiction properties. Other properties investigated would include their capabilities as blocking agents or as antagonists.

As a matter of fact, one of them is under investigation now, acetylmethadol, which seems to have some promise as a blocking agent, which has not been established yet.

But, as far as other research in Europe is concerned, I cannot comment on that. I simply do not know, because much of that is not reported in the American literature. But it seems reasonable to assume that the same kind of research programs on analgesic drugs are being conducted in Europe as are being conducted here, and it might be worth while to have an exchange of information on this very serious problem, because it is not only serious in the United States. This is a worldwide problem in terms of heroin addiction.

Mr. SYMINGTON. Well, I would think that there would be a way that you would try to establish a structure. And perhaps there is something going on in the U.N. now. I believe I saw a paper from the U.N. the other day that indicated that a worldwide attack was being made on heroin addiction, but certainly we do not want to just rely on the American journalists for things that are not printed there, and I hope

to explore that. I think it is interesting that methadone was developed, I take it, not as an alternative to heroin but as an alternative perhaps to morphine. It was developed as a painkiller by the Germans, and it was only accidentally that they discovered that it was an alternative to heroin, and was addicting but not as severe.

Dr. ADAMS. That is a fairly recent discovery. As I recall, the use of methadone as a blocking agent for withdrawal was introduced as recently as 1965.

Mr. SYMINGTON. Why did they develop the drug?

Dr. ADAMS. As a substitute for opium because of the problems they were having in obtaining opium in World War II.

Mr. BRENNAN. Mr. Symington, I might add one thing, too, on your question concerning what we might do through the U.N. or take advantage of work that is being done in foreign countries.

There is a committee of the World Health Organization specifically designed to look at drug dependence questions, and, as Mr. Stetler mentioned, this international pharmaceutical manufacturers association has, just a few months ago, been given nongovernmental organization status within the WHO, so we now can more closely relate to WHO and its committees as more or less a semiofficial member. So, I think that, too, that exchange will now be facilitated and increased. Mr. SYMINGTON. I hope so. Thank you very much.

Mr. ROGERS. Dr. Carter?

Mr. CARTER. Thank you, Mr. Chairman.

Do you have a great deal of experience, Doctor, with heroin addicts or morphine addicts?

Dr. ADAMS. NO; I have none, Dr. Carter. I am a pharmacologist by profession.

Mr. CARTER. Yes, sir. Did you ever ask a heroin addict that if he had all of the heroin that he could ever use would he ever quit the habit? Dr. ADAMS. NO; I have never asked the question, but I can tell you from my reading that the recurrence is very, very great.

Mr. CARTER. Well, I had a rather interesting conversation with Dr. Seivers at the Department of Pharmacology of the University of Michigan not too long ago.

In the course of our conversation we were talking with an addict. and I asked him this question, and he said "No, he would never quit.' And Dr. Seivers stated-and he has had very wide experience, I guess as much as any man in the country-Dr. Seivers said he had never heard one say that he would kick the habit if he could get all of the heroin he wanted. So, we do have a great problem with this, because of the characteristics of heroin itself.

You mentioned an analgesic called Naloxone; is that right?
Dr. ADAMS. Yes.

Mr. CARTER. What precisely-or in general, either does this particular medicine do?

Dr. ADAMS. Well, so far as we know, apparently when it is given in advance of the taking of heroin and some of the other opium derivatives, apparently it fits on whatever receptor is involved and prevents the access of that receptor to the heroin when it is injected subsequently, and, effectively, then, blocks or antagonize the effect of the heroin or other addictive drug.

Mr. CARTER. It does not do anything about the patient's desire for heroin, does it?

Dr. ADAMS. No; on the basis of some of the material I have read, apparently there is a recurrence, there is relapse following the Naloxone. So, it is not the perfect answer to the problem.

Mr. CARTER. They will still have it.

Are you familiar with the use of Nalline?
Dr. ADAMS. Yes, I am.

Mr. CARTER. Could describe that?

Dr. ADAMS. Yes. Nalline is also a narcotic antagonist used generally, however, in the acute episode of morphine poisoning rather than with the trial or maintenance of narcotic addicts. It is a very effective drug. Mr. CARTER. You are correct. All opiates have a respiratory depressant effect. Of course, one of the great problems, as I see it, is to develop a drug which will relieve pain and yet not be addictive, if that can be done.

If we could take heroin even, or morphine, and keep the pain-relieving properties and knock out that which causes the euphora and, from that, addiction, then we would be accomplishing something. But I wonder about the use of an antagonist. I believe we are going to have to develop a different type of drug. It is a very complicated sort of thing. According to our estimates, although we have a great problem, it is approximately half that much. We have about 365,000 addicts, I believe, in our country at the present time.

That is the estimate, is it not?

Dr. ADAMS. I am not familiar with that figure, either.

I thought it was closer to 50,000 for heroin.

Mr. CARTER. 360,000, something like that. I believe that is right. 365,000. The Federal Government has records of about 62,000 people who are addicted at the present time.

Dr. ADAMS. Yes; I am familiar with the figure. I was not familiar with the 300,000 figure.

Mr. CARTER. I believe that is correct. It is a great problem, and certainly I want to compliment you, gentlemen, in the work you are doing. It is a tremendous problem, and, on my part, I want to cooperate, and I want to see a partnership between Government and industry, and with the members of the scientific groups throughout the country, to see if we can stop the craving in some of these addicts for heroin or morphine or whatever drug they are addicted to. I thank the chairman. Mr. ROGERS. Mr. Hastings.

Mr. HASTINGS. Thank you, Mr. Chairman.

I would like to join my colleagues in commending your industry and especially your willingness to cooperate and trying to come up with some solution to this serious problem.

When this subcommittee was in New York City holding hearings, Mayor Lindsay made a statement, and I am going to quote it, and then I am going to ask you for a comment.

He stated:

In the absence of the significant Federal research effort, New York City has acted to sponsor a nationwide program for development of new antagonist drugslong-lasting, non-addictive compounds which will block the effect of heroin for weeks or months at a time.

With intensive research we believe it should be feasible to develop an innoculation against heroin which would be administered to youngsters in the same way as that seen against such infectious diseases as small pox, polio, and measles. New York City has had to start this research effort on its own.

Are you familiar at all with what he might be referring to?

Dr. ADAMS. Yes; it has been suggested if one were to conjugate heroin, for example, with a protein, that when injected this would act as an antigen and produce antibodies so any subsequent injection of heroin would produce antibody and antigen reaction that would be so frightening to the patient that chances are they would discontinue the use of heroin.

Mr. HASTINGS. Is this research that your industry has been involved in or individual companies?

Dr. ADAMS. I am not aware of any of our companies having been engaged in that kind of research, but I would certainly think they are familiar with the concept.

Mr. CARTER. If the distinguished gentleman would yield on that, a drug which is very effective in alcoholism, of course, is antabuse which is causing such reaction as he mentions. I am sure you are familiar with that.

Dr. ADAMS. Yes.

Mr. CARTER. With that particular drug.

But if we could develop something like that in heroin users, they would not want to take heroin if they were on such a drug. I think, and I think the gentlemen in this group might be interested to know that when a person, an alcoholic, has been taking antabuse and he takes alcohol, he has such a tremendous reaction that it is very frightening. By means of this drug, we have been able to actually cure alcoholics.

I thank you.

Dr. ADAMS. The other element there, Mr. Hastings, would be that the presence of antibodies would prevent the effect of the heroin, too, so that effectively the patient would be vaccinated against it.

Now, whether that would prove to be the solution to his problem remains to be seen.

Unfortunately, the record is that most of these people revert-or possibly he might look for some other sort of stimulation to produce the same kind of euphoria that he previously had obtained with something like heroin.

Mr. HASTINGS. I take it that you do not think this avenue offers really too much hope for solving the problem?

Dr. ADAMS. I would not be that pessimistic about it.

Mr. HASTINGS. Why has there not been more research on the part of industry or individual companies if it does, in fact, offer some hope? Dr. ADAMS. I cannot give you an answer to that, Mr. Hastings, but it seems to me it is an avenue that deserves further exploration.

Mr. HASTINGS. It is surprising that it is the city of New York, not the Federal Government or industry, that has bothered to take a further look at this, if it offers any hope at all.

Mr. STETLER. I think it is one of the answers that obviously will be looked at carefully with the new emphasis or capability at the Federal Government level. I think that anybody would be hard pressed to say, really, why it has not been done before.

Mr. HASTINGS. You mentioned that you had a total research budget of how much, over $600 million?

Dr. ADAMS. Over $600 million for the year 1970.

Mr. HASTINGS. And your testimony was you made a contribution to the Drug Dependence Committee of NAS of about $200,000?