address themselves to the general care of the seamen and we have not established any. Mr. ROGERS. Well, military personnel, too? Dr. WILSON. Only by contract, sir, with the military. Mr. ROGERS. I understand you can do it, but you treat about 12 million people, don't you? Dr. WILSON. No, we have roughly a million and a half visits, but not a million and a half people. Mr. ROGERS. Well, a million and a half people are treated, they come in there on a million and a half visits, rather. You mean there are no addicts in this group? Dr. WILSON. The specific question you asked is, whether we had centers for drug addiction treatment, and the answer to that is "No." If you asked, "Do we apply ourselves to the problem of drug addiction, when it appears," the answer to that is "Yes". Mr. ROGERS. So you can treat drug addiction in public health hospitals and clinics? Dr. WILSON. Yes. Mr. ROGERS. You have the capability? Dr. WILSON. We have the capacity to do it. We have not organized it in a center type treatment, because that particular population has not, up to this point, presented a problem that would merit a develop ment of centers. Mr. ROGERS. But in communities where they exist, there may be a severe addiction problem? Dr. WILSON. But the hospitals have been addressed to a particular target, the beneficiaries of the Public Health Service. Mr. ROGERS. But the authority there would allow you to establish those for whatever population existed in the community, I presume? Dr. WILSON. As a part of our study of the use of Public Health Service hospitals as a community resources, this is obviously one of the issues that will be studied extremely carefully, as you and I discussed on a number of occasions. Mr. ROGERS. Well, we perhaps will put this authority in the legislation. Mr. Kyros. Mr. KYROS. No questions. Mr. ROGERS. Dr. Roy. Mr. Roy. I want to go back to Dr. Brown's statement with regard to what I suppose one might call Dr. Jaffe's traffic bearing. He has apparently treated about 2,000 patients in Illinois. I think a very conservative estimate of the number of addicts in Illinois would probably be about 10,000? Dr. BROWN. I would think that is about right. Mr. Roy. So, apparently he reached about 20 percent of the addiets in the State of Illinois. So, I suppose that he has not reached more, either because he has not had enough authority or enough money, or perhaps, even because he has not had a civil commitment law. Now, the thing that troubles me is that he is going to bring to us the same persuasion, persuasive ability to achieve a budget from 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 tragedies 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 yet 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 |