ings. But in the jurisdictional problems we face, it is a problem for the military, a problem for the Veterans' Administration, and a problem for the civilian sector. And it involves jurisdiction questions in the construction of the Senate, and that by itself, by its very nature, poses a great problem for us. It is not as simple as a lot of people seem to think it might be. In addition to providing the authorization through legislation, we then have to come back and fight through other committees for appropriations. It is not a matter of simply passing a bill and thinking the money is available. I think it is long enough that we have made statements that have held out hope and fulfilled nothing.

That has been done in the past year in the field of alcoholism. We passed landmark legislation that authorized over $300 million in the next 3 years, and we have not appropriated 10 cents to fulfill that authorization. Unless this country makes the commitment that it is absolutely essential, not only for the commitment of the money, but to solve these problems, then what are we doing?

We are not reaching the people with solutions, but rather we are reaching the stage of an epidemic that is eating at the heart and soul of America, not only the military. It can destroy the very nature of the social structure of this great Nation. It is eating at our lives, our children, our businesses, and everything we deal with and I thank God the reality of what has been happening is finally coming to light.

I want to say just a word or two of appreciation to those men who have risked what they have risked in coming here to testify publicly, before God and country, so to speak.

I know what that risk is. I have had to take it myself in the past and I have pledged many people in the past to do that and to take that risk, for the sake of those still suffering. I will still say that in this country there is a way that you will be accepted back in the social structure and the public structure. This Nation should not be dedicated to move against those people who have made a mistake because this is the time for reconciliation and for forgiveness for those who are ill and suffering. We must indeed face this very serious problem of our Nation.

I am grateful you are here.

Don, you have proposed a very comprehensive recommendation which is excellent.

I ask these questions not because I differ in my programs, or because I endorse any, but because we are searching, and I would like to have your valid opinions.

We all make mistakes in trying to do the right thing, and you cautioned us against making those mistakes.

In the last few days, we have seen several pieces of legislation proposed in both Houses of Congress.

Among those pieces of legislation, they propose a vital increase in handling or facing the problem with local community mental health clinics, primarily increasing by well over a hundred-perhaps 200, the number of those clinics with appropriations to handle the problem. My own experience has led me to believe that getting an addict on the street into a community mental health clinic is about as difficult. as getting him into the service.

What is your opinion about this type of an all-out approach? Mr. JUHL. My feeling, and my experience, to cite this Sacramento example, I think it is a fairly classic one.

There was great difficulty in getting addicts into any community hospitals or health centers prior to the time they could come in contact with people that could refer them and could talk their language, and in some cases we would go with them to these public agencies.

The Aquarian Effort deals very, very closely with mental health services in Sacramento. We now have enough confidence in both the public sector and the streets. If this is to be done in other communities, I feel it is very, very important that you include with these facilities the ability to ferret out and use some agencies and some individuals, some people hired from the street, that will help this addicted person relate to the help he may get inside of the hospital.

Without that, you are right, most people on the street would rather die of an overdose than call an ambulance, because behind that ambulance comes the police, and behind the police comes prison.

This is the reality in the streets. I do not know if you recognize it or not. One of the laws of the street is if you overdose from barbiturates, from heroin, tough luck, you die in the garbage can, you die in an alley.

Your buddies who shoot dope are not going to call a doctor. They will not take a chance on themselves getting arrested, and until this type of an impression changes, until we can do something about the laws that arrest people, against those that come in for treatment, they will not come in.

Mr. ANGLIN. I would like to speak on that issue. When I was with the addicts' servicing agency in New York, my last task, I was director of a network of storefronts, and we were handling about 300 using-addicts a day.

Our intention was two-fold, one to treat heroin addicts on the street, and for those who could not respond to treatment, to induct them into therapeutic communities.

It has been my experience, and I am talking about a hard-core addict. I am not talking of a youngster on it a few months.

Those people I have seen respond to ambulatory treatment.

The big problem I know of is that they do not come in, but there are encounter groups that do reach those streets.

I am talking now about the heroin addict. I have yet to see a committed heroin addict respond to treatment on an ambulatory basis and get well.

I know you are familiar, Senator, with the AA culture. People do recover in AA, and it is because they place themselves in AA, and that is, in fact, a therapeutic community.

They are friends, and they get together in meetings, and every ounce of their time is taken up with that community, and, therefore, they can recover from their addiction, even though they do not go into a center or a treatment house, but they are in fact in a therapeutic community anyway.

The point we are making here is that the drug addict can come to a clinic for 2 or 3 days a week, and so on, and he does not get the help he needs, because there is no continuity. You do not know what

he has been doing for those other days. You cannot talk to him about his problems, or his behavior, and because of the stigma, and the reality of illegally taking drugs, he is still bound by the code of the street and by the ethics of the drug culture, and I would like to say, I was at a shooting gallery one time, and somebody had an overdose, and we took him and stood him up in an alley somewhere, between a telephone pole and a garage on the other side of town, and that is how it is.

If a person dies while you are using drugs, what you do is immediately get rid of him, so he does not bring any heat on everybody else, and this is cold, but that is the culture, and I am very pessimistic about treatment on an ambulatory basis for committed heroin addicts. The only alternative to the ambulatory basis is methadone, and that is another ballgame with its pros and cons.

Senator HUGHES. We could go on about that for a long time, but I do want to get a couple of rapid opinions.

The evidence indicates there are already tens of thousands of discharged American veterans in this country with drug and narcotic problems.

The evidence indicates in the last 2 calendar years that 16,000 men were discharged with these problems-11,000 of them less than honorably discharged. I want to relate to those men particularly right now. Should we attempt to structure the law, in your opinion, to bring those men back into a Veterans' Administration facility, or should we handle them in the civilian sector?

If these men will come into a facility to get cleaned up, should we then try to adopt a procedure that will restore their rights as veterans of the military services of the United States, and to their families, all of the benefits that go as a result of serving the country?

Mr. ANGLIN. As I understand your question, you say the person who has previously received a bad discharge from drugs?

Senator HUGHES. Or a good one. Many may have received an honorable discharge.

Mr. ANGLIN. If a person receives a bad discharge, are you suggesting his discharge be replaced by a good one?

Senator HUGHES. Yes.

Mr. ANGLIN. I see.

Senator HUGHES. I am asking if you think it should be done.
Mr. ANGLIN. Yes; I think it should be done.

I think about the whole use of methadone, I think in the reality, at least in the immediate future, we will not have enough property to treat everyone we want on an ambulatory basis.

We may have to engage in a multimodality mix, as a holding effort, while we begin to do research, and train and get some kind of a breakthrough that will maybe innoculate somebody against it.

I do not know if this will ever happen, and in support of the therapeutic community, you will get program directors out of these programs in the future.

Mr. JUHL. There are two points I would like to address myself to right now.

One, the veterans of bad discharges on the street right now, it will take a massive amount of educational effort for him to come back to anything close to the VA or the military.

Senator HUGHES. Will they go to your program ?
Mr. JUHL. They are coming to our program.

Senator HUGHES. If we were to get you the funds to provide the services for veterans, could you do it?

Mr. JUHL. We are handling it now, and we would be willing to handle more, in cooperation with other programs, and other attempts, for sure.

My feeling right now is that the alienation is so high in a person with a less than honorable discharge, that you would never be able to get him to go back to the VA.

The guys that are there now, we may be able to save that VA image to the point that they will approach it, but most of these people will not go.

I think probably most of you guys will agree.

(General agreement by the panel.)

Senator CRANSTON. How many people are you helping now? Mr. JUHL. At the present time, we are an outpatient clinic. We were receiving about 5,000 calls a month for help. We are dealing with people in our detoxification ward, in different ways, individual counseling, group counseling, as well as educational programs. We are dealing in both the military and the civilian sector.

We have 37 employees, and most of them work about 16 to 18 hours per day, by the way, with a wage that balances on the poverty line. Senator CRANSTON. What is your budget?

Mr. JUHL. Our budget at the present time is about $160,000 from one agency, and then some contracts with school districts, and so on, as well as donations.

Senator CRANSTON. What is the one agency?

Mr. JUHL. We have an agency; I am sorry. The California Council on Criminal Justice.

Senator CRANSTON. Is there any Federal money in the program? Mr. TURNER. The transfer of the funds, as I know it, they have left somewhere around a million dollars for the State of California to deal with this problem, and most of the funds have been transferred into law enforcement agencies, for their programs at this point, and that is something I would like to make a point of to you, if I can Senator Cranston.

There are a lot of community programs that are trying to help out, especially minority programs, but they do not have the money or the know-how to set up a realistic program, and everything is being referred to criminal justice, and the other existing agencies have not got the funds appropriated, and it is a very difficult situation.

We need manpower. I cannot afford to take another fellow on like myself or Don, and to say come into the program, as a volunteer, and spend a year living on welfare, or living on nothing, because we need you, we know your talents, and we know you can relate to these people.

I have to give that somebody some incentive, some money, for he has to raise his family adequately, and this is where the problem lies. Senator HUGHES. Could I ask a couple of rapid questions in addition to that?

No. 1, if I understood you right, Don, you recommended detoxification centers for those in the military whose time is running out, if necessary, and if they are addicted.

You want them detained and cleared up?

Mr. JUHL. Right. A lot of guys coming back are getting an early out, say 30 days or whatever.

I recommend that people that are ready to hit the streets that are dirty, that they not be cut loose.

I think they should be retained in the military until they are at least physically cleaned.

This is the initial step.

Now, as mentioned before, physical detoxification is only the first step, but then we owe them at least the first step.

If they were in the acute forms of malaria, we would not let them walk out, and be on the streets of San Francisco, or New York or anywhere else.

These are people that have a sickness, and the military or anybody else has no right to let them out on the streets with that sickness.

Senator HUGHES. Would you accept compulsory civil commitment in lieu of prison?

Mr. JUHL. I would not accept anything in lieu of prison, but I would accept a very strong commitment, and possibly some other alternative besides prison.

I do not think we should punish people for mental illness.

Senator HUGHES. In your opinion a person that is addicted or dependent on drugs or narcotics is a sick person?

Mr. JUHL. Very definitely so. I am talking about the drug user, the person dependent on drugs.

Senator HUGHES. And the sickness is first?

Mr. JUHL. That is right. His crime is simply a manifestation of his illness.

Senator HUGHES. Well, Mr. Chairman, there is much more I could go into, but I believe they have answered the particular questions that I wanted to get to in relationship with the military and the Veterans' Administration. Again, I want to thank you for your patience on my behalf.

Senator CRANSTON. You have all been tremendously helpful. We are going to send the transcript to the VA so they can review it at once, and also when other witnesses come before us, so they can be prepared to comment on suggestions.

Senator HUGHES. Mr. Chairman, I would like to have that sent to Assistant Secretary Kelley in the Pentagon also, if you can.

He will be testifying again next week with regard to this matter, and I think some of this may be relatively new information, as far as they are concerned.

It would be helpful to them in their program.

Senator CRANSTON. I will see that it is done.

Mr. JUHL. If there is anything we can do, we are always pleased to help.

Senator CRANSTON. Our next witness is Dr. Sidney Cohen, clinical professor of psychiatry at UCLA Medical School and the Neuropsychiatric Institute. Dr. Cohen has had a long and distinguished career in Federal service where he was Director of the Division of Narcotic Addiction and Drug Abuse at NIMH. He is a world-recognized authority in this field, and we are extremely grateful for his presence this day.