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in the civil commitment area is being strenuously challenged in the courts. We are confident that the courts will ultimately hold that a man cannot be restrained in a jail without proof of criminal conduct and without due process of law merely because the jail is denominated a hospital, be it civilian or military.

tenance.

Moreover, the lack of success of confinement programs must be compared with alternative methods of treating addiction. One of the most important new developments is the program of methadone mainInitial successes have been noted in reducing the criminal activity of former heroin addicts. Dole, Successful Treatment of 750 Criminal Addicts, 206 Journal of the American Medical Association 2708 (1968). In New York City, programs are underway at, among other places, the Beth Israel Hospital and the Addiction Treatment and Research Corporation in Bedford Stuyvesant. There is a two year waiting list for the latter program. These programs seek to evaluate the effectiveness of methadone without the kind of extensive psychotherapeutic counselling and job placement services that were offered in the pioneer Dole-Ny swander programs at the Rockefeller Institute. One impediment to widespread experimentation with methadone has been the hostility of the Bureau of Narcotics. as far back as 1925, the Supreme Court ruled that a doctor may administer narcotics to an addict in the course of treatment. Linder v. United States, 268 U.S. 5 (1925).

Yet

Another feasible alternative is the widespread use of therapeutic and psychological counselling programs administered by "half-way" houses. Some experimentation with such programs is occurring in the military right now, and with some success. While these programs require a great deal of patience and substantial funding, they are probably no more time consuming and no more costly than compulsory commitment programs. They certainly do far less violence to individual rights.

The essential prerequisite of these alternatives is their voluntary nature. All of the proposals to retain addicts in the service against their will are totally inconsistent with this voluntary approach. Many addicts were probably draftees in the first instance and in Vietnam against their will. It is singularly inappropriate to compel them to remain in the service because they have become addicted in Vietnam.

We suggest a two-fold alternative to this form of coercion. First, those addicted servicemen with a substantial period of time left to serve should be offerred the opportunity to undertake rehabilitative programs within the military on their own initiative. If they refuse, then they should be discharged in a non-punitive fashion. It is unrealistic, and perhaps bizarre, to suggest that men will become addicted to heroin as an "easy out" from the services. Even if, in an isolated case, someone should seek such an "easy out," it is hard to believe that the armed services would derive much benefit from the retention of someone who would resort to such a suicidal escape.

Second, returning addicted servicemen near the end of their period of required service should be released on schedule and then afforded the opportunity to participate in voluntary programs run either by the Veteran's Administration or other public agencies, with funds provided by the federal government.

However these services are to be provided, the addicted servicemen should not be compelled to remain in the military in order to secure rehabilitation. There is no reason why treatment cannot be

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The

afforded to such men without retaining them in the service. same funds required to treat those who are compulsorily retained could be earmarked instead for treatment through the Veteran's Administration or other public agencies.

As with so many other public problems, one of the answers is proper funding. In this instance, the wrong answers--those which are punitive and compulsory--provide no savings. It is the height of cynicism to keep a man in the service until he is certified as "cured" and yet provide no funds to enable the military to effect such rehabilitation. If such funds are not forthcoming, then addicts will either be kept in the service indefinitely or will be subjected to perfunctory detoxification and certified as "cured."

For similar reasons we emphatically oppose the provision of H.R. 8388 which allows addicts to be released from active duty in order to secure private treatment but requires that they be returned to active duty if such treatment fails.

We urge support for those proposals which require that veterans who are addicted not be denied treatment at Veteran's Administration facilities because they received punitive discharges. Of the 50,000 ex-servicemen who are drug addicts, a substantial number were probably given punitive discharges. It was a callous and self-defeating policy from the start.

users

Finally, we would oppose the inclusion of marijuana
the definition of "drug dependent

person."

in

The ACLU believes that possession of marijuana should never be made a criminal offense. The circumstances surrounding marijuana use are entirely different from those obtaining with regard to heroin use. Marijuana is not addictive. Lumping them together is symptomatic of the mistakes of the past and is hardly designed to convince young servicemen that intelligent efforts are being made.

In conclusion, we see two fundamental problems with the proposed programs for dealing with military drug use. First, the methods of identifying heroin addicts raise serious constitutional problems. Second, compulsory retention in the services is destructive of ultimate rehabilitation; it approximates the discredited and probably unconstitutional programs of compulsory civil commitment. Policies based on a voluntary approach are not only consistent with civil liberties, but have a far greater likelihood of

success.

(Recess.)

Senator HUGHES. The committee is reconvened.

I would like to ask one more question. On the basis of information that is put out on confidentiality of tests, I asked the Department of Defense yesterday if they did not assume that many people who are addicted to narcotics, now that they know there is going to be a urinalysis, will go cold turkey and go under this screen, come up negative on the urinalysis. They will come out and get a fix as rapidly as they can. They can even carry it with them in the process of coming home in the hope of getting through the examination without a positive test, avoiding being held and avoiding the possibility of being prosecuted.

There is a negative phase of identification. We are not merely going to be identifying those who have drug or narcotic problems because it is going to force them underground and it is going to force them to go through the testing without the use of drugs.

Because there are only two main testing places in Vietnam, the procedure will be, I understand, to fly in urinalysis samples from all over the country. There exists the possibility of exchanging urine samples and getting positive results when they may have been actually negative and creating identification problems. The records are apparently going to be stamped on the positive tests in the process of taking urinalysis forcefully. That could possibly identify a test as positive instead of negative and stamp a man's record for a long time which would create problems. Would you care to comment on that?

Mr. NEIER. My comment is that I'm sure you are right. This kind of self-detoxification for brief periods of time is something that has been experienced by the New York State Narcotic and Drug Addiction and Control, which has medical testing of persons who are to be committed to the facilities of the Narcotics Addiction Rehabilitation Commission.

Senator HUGHES. Thank you.

Mr. Chairman, I would like to place in the record at the end of the proceedings a statement by Senator Strom Thurmond as though given before the committee.

Senator CRANSTON. Without objection, fine.

STATEMENT BY HON. STROM THURMOND, A U.S. SENATOR FROM THE STATE OF SOUTH CAROLINA

Senator THURMOND. Mr. Chairman, before I begin asking Administrator Donald Johnson questions about the VA's programs to meet the drug abuse problem, I would like to comment on President Nixon's proposals. It is heartening to see the effective response to this problem that President Nixon has initiated. President Nixon's program is one of far-reaching capabilities. With the executive branch of our Government working with our Armed Forces and the Veterans' Administration, a workable system should be developed. President Nixon has provided for surveillance and supervision to determine the results of proposed plans. This supervision is necessary to coordinate all drug reform activities.

I would like to compliment Mr. Johnson on his actions and future VA plans. Mr. Johnson has a great problem to face and solve; how

ever,

because of his ability and experience, I am sure he will cope with any problem that may arise. I would like to thank Mr. Johnson for testifying before this joint hearing and giving us the reactions of the VA to drug addiction.

Drug abuse has become too much of a problem in our Armed Forces. However, drug abuse has infected a large number of our civilian young people as well. We must meet this problem head on if we expect results. (Further information supplied for the record follows:)

QUESTIONS SUBMITTED BY HON. STROM THURMOND, A U.S. SENATOR FROM THE STATE OF SOUTH CAROLINA TO HON. DONALD E. JOHNSON, ADMINISTRATOR OF VETERANS AFFAIRS, VETERANS' ADMINISTRATION, WITH RESPONSES

Question. I notice from your testimony that you are exploring the developments of a program to help ex-addicts find employment. How far has this been investigated and what concrete actions have been taken?

Answer.-The VA has initiated employment assistance programs for veterans who have been rehabilitated by the VA. However, it must be noted that we are providing this care to a limited number of ex-addicts because most veterans who have been discharged with a drug abuse problem are not at present eligible for participation in VA educational and training programs. In the event statutory changes are made which will allow the VA to provide employment training and job assistance to presently non-qualified servicemen, you can be sure that this agency will expand the job fairs, patient-hospital employment programs, and all other pertinent employment areas.

Question.-How many former addicts are presently employed or does the VA plan to employ in its rehabilitation programs?

Answer.-Former addicts are working in our drug treatment units. In its experience to date the VA has found that former addicts employed as counselors at our drug treatment centers can communicate most effectively with the drug abusers. We have at least one former addict employed at every one of our operating units, and it is intended that each subsequently opened facility will employ at least one former addict as a rehabilitation counselor.

Question. You mentioned that the President's Special Action Office for Drug Abuse Prevention will coordinate the work of all Federal agencies. Do you believe that this agency will have the necessary authority and personnel to implement the VA's rehabilitation program?

Answer. It is our understanding that the Special Action Office will not implement the proposed drug abuse programs with its own staff. It will arrange for implementing operations to be carried out by other Federal agencies. The Director of the Special Action Office will develop and introduce new programs where necessary. He will provide policy and program guides based upon direct research and on evaluation of programs presently being carried out by other agencies such as the VA. We believe that this approach will allow for the necessary implementation of the VA's rehabilitation program.

Question. You stated that your experience indicated the need for three to six weeks as an in-patent in these rehabilitation centers. How extensive has your research into this time period been, and on what facts do you base this finding? Answer. The length of time you mention provides a general guideline for inpatient treatment. It is a period for stabilization and detoxification. Some patients could be ready to leave the hospital after two weeks, other patients would remain longer-probably four or six weeks. The time period is recommended as being flexible, and not hard and fast.

Question. Has the VA done research on ramifications of methadone maintenance?

Answer. The VA has not been treating heroin addicts long enough to have begun an extensive program of research into methadone maintenance. Use of methadone in the VA is closely controlled in these ways. Each investigator must file through Dr. Kaim's office, the FDA form for permission to use this drug on a maintenance basis of longer than 30 days. Additional controls are in effect at each VA hospital, through the Pharmacy Service. VA personnel keep appraised of current developments through the current scientific literature. Treatment units have been in operation less than one year. Adequate funding has prevented the VA from beginning an elaborate medical research program. in drug dependence.

Senator CRANSTON (presiding). I apologize for my absence but I had to go to the Senate floor. I understand your testimony was exceedingly constructive and helpful.

Mr. NEIER. Thank you very much.

Senator CRANSTON. I just want to ask you two things. If the VA or DOD believes it must turn over incriminating evidence to the Department of Justice, would the state of the law require that any patient be warned in advance or would it be advisable or necessary to warn a patient in advance before he makes any such statements and before he begins any treatment?

Mr. NEIER. I think that is right. I think that would also extend to any medical testing. I think a person would have to have a right to refuse to submit to any medical testing if he knew that any information was or could be used for law enforcement purposes.

Senator CRANSTON. Would the law actually require specifically that he be advised of this?

Mr. NEIER. I would think that the Miranda rule would require that he be advised of that.

Senator CRANSTON. Could you file a supplemental memo on that, please.

Mr. NEIER. Yes, I would be happy to.

Senator CRANSTON. I would be very grateful if you would examine S. 2108, the bill I have introduced on this problem, and provide us with your comments on that.

Mr. NEIER. I would be happy to do so. I just saw it for the first time this morning but I will be happy to submit something very shortly.

(The information referred to, subsequently submitted, appears on p. 202.)

Senator CRANSTON. Thank you very, very much. I deeply appreciate your coming today.

We will now stand in recess until 1:30. (Recess.)

AFTERNOON SESSION

Senator CRANSTON. The committee will come to order.

Our first witness this afternoon is Senator Lloyd Bentsen of Texas. Senator, we are delighted to have you with us.

STATEMENT OF HON. LLOYD BENTSEN, A U.S. SENATOR FROM THE STATE OF TEXAS

Senator BENTSEN. Thank you. I want to congratulate the distinguished chairman on the interest of his subcommittee and the work that he has done on this most serious of problems.

The recent publicity that we have had concerning addiction of servicemen in Vietnam has highlighted the problem of drug abuse and addiction for us. One of the most recent reports stated that an estimated 10 percent of the servicemen in Vietnam were now addicted to or using heroin, and I would assume that this is probably a conservative estimate. It must be something more than that.

We see that we have need for a comprehensive approach to this epidemic, and I believe this approach should inculcate some four goals. One, of course, is to reduce the supply of drugs. The second is to do