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experience. I was Governor of my State for three terms. I have had some experience with State mental health authorities, and directors and so on, and the population of our State is 200,000 less than your

own.

When I held hearings in my capital city, and we were able to reach into the underground for witnesses to testify, I found the number of narcotics addicts and drug abusers there staggering as compared to the estimates that were being held by public officials in that State. I think you would probably find the same in your own State.

Because the facts are, the community mental health centers in America have not been treating the drug abuser or alcoholic with anywhere near adequacy. Hospitals have not been available to them when they needed help. When they went to a doctor to get help, nine times out of 10 they wound up with a policeman there before the doctor talked to

them.

You probably heard me give the statement about the young man in my capital city, a young man who went into the hospital. They called the vice squad, and he was told that he would receive treatment, when and if he gave them the sources of supply. He naturally didnt give information because it meant his life. He was turned back out on the street.

I have raised my own estimate in my State from what I would have considered 300 to 500 addicts to 3,000 to 5,000. It has a lesser population than your own.

I just think that our reporting services in this country are bad.

In the State of New York, for example, we have seen estimates of from 50,000 to 100,000 heroin addicts. In New York City, they have 50,000 on the registry at the present time, and I would hazard a guess it is probably four times that much.

I want to compliment you on your dedication and perseverence, and also the Governor for his extreme interest in these fields.

I think what you are giving to us will be extremely helpful as we consider this legislation, and I hope you will extend my greetings to the Governor when you go home.

It has been a pleasure to have you with us today, Dr. Gaver.

Dr. GAVER. Thank you very much.

Senator HUGHES. The hearing is adjourned.

(Whereupon, at 12:30 p.m., the subcommittee was recessed to reconvene at 9:45 a.m., Tuesday, March 24, 1970.)

FEDERAL DRUG ABUSE AND DRUG DEPENDENCE PREVENTION, TREATMENT, AND REHABILITATION ACT OF 1970

TUESDAY, MARCH 24, 1970

U.S. SENATE,

SPECIAL SUBCOMMITTEE ON ALCOHOLISM AND NARCOTICS OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE, Washington, D.C. The subcommittee met at 9:55 a.m., pursuant to recess, in room 4232, New Senate Office Building, Senator Harold E. Hughes (chairman of the subcommittee) presiding.

Present: Senators Hughes, Yarborough, and Dominick.

Staff members present: Robert Harris, staff director; Wade Clarke, majority counsel; Jay Cutler, minority counsel; and Richard J. Spelts, minority counsel.

Senator HUGHES. The Subcommittee on Alcoholism and Narcotics will come to order.

The chair calls first Dr. Egeberg and Dr. Miller.

Welcome again to the subcommittee. We are grateful for your taking the time to come before us this morning to testify.

STATEMENT OF DR. ROGER 0. EGEBERG, ASSISTANT SECRETARY
FOR HEALTH AND SCIENTIFIC AFFAIRS, DEPARTMENT OF
HEALTH, EDUCATION, AND WELFARE; ACCOMPANIED BY MOR-
TON G. MILLER, M.D., ASSOCIATE DIRECTOR FOR SPECIAL AND
COLLABORATIVE PROGRAMS, NATIONAL INSTITUTE OF MENTAL
HEALTH, DEPARTMENT OF HEALTH, EDUCATION, AND WEL-
FARE, AND THEODORE ELLENBOGEN, CONSULTANT

Senator HUGHES. You may proceed as you desire.
Dr. EGEBERG. Thank you, Senator.

I want to apologize first for the delay in getting my statement to you. It is just one of the delays which occur when things have to be okayed by a large number of people within your own department, and then a number of other departments, and I am sorry.

Senator HUGHES. It is all right. I got into the office early this morning and read both your statement and Dr. Miller's statement. I anticipated they might be late. It is not unusual. I am glad I don't work under those circumstances, Doctor.

Dr. EGEBERG. Thank you. If I may, I will start my written testimony here.

I do appreciate the opportunity to present the views of the Department of Health, Education and Welfare on S. 3562, the proposed Federal Drug Abuse and Drug Dependence Prevention, Treatment and Rehabilitation Act of 1970.

May I say at the outset that we in the Department are very grateful for the support of the Chairman and for his sincere and enlightened concern for the problem of drug abuse. It has been my pleasure to appear before this subcommittee in connection with the related problems of drug abuse and alcoholism, and I have a deep respect for the dedication with which the Chairman has addressed himself to solution of these problems. We welcome and we appreciate the opportunity to work with the Chairman and members of the subcommittee.

The legislation under consideration in these hearings clearly is addressed to aspects of fundamental importance to the solution of our increasing drug-abuse problems. There can be no doubt either of the need for increased efforts to prevent drug abuse and provide effective treatment and rehabilitation for its victims, nor of the need for Federal leadership in these endeavors.

Indeed, these activities are essential complements to the law enforcement activities directed at stemming the illicit traffic in dangerous drugs. This administration is fully committed to such a balanced approach, because we feel it provides the most rational and effective. way of coping with the worsening drug-abuse problem in the United States.

For this reason, the administration has recommended comprehensive legislation to provide more effective regulatory control of narcotics ad dangerous drugs. It has also expanded programs for the treatment and rehabilitation of drug addicts.

In 1971, the first full budget year of this administration, programs for treatment, rehabilitation, research, training and education of the public to the dangers of drug abuse will reach a level of over $56 million in the Department of HEW, alone. This amount is 50 percent higher than that provided for in the 1969 appropriations.

Mr. Chairman, at this point let me introduce Dr. Morton Miller, associate director for Special and Collaborative Programs, of the National Institute of Mental Health. Dr. Miller will review for the subcommittee the scope of our programs concerned with drug-abuse prevention, treatment and rehabilitation and the implications of S. 3562 with respect to these activities, and on my right is a man you are well familiar with, Mr. Theodore Ellenbogen, who is the former assistant general counsel for legislation of the Department of HEW, and who is now helping us as a consultant.

First, however, I would like to offer some general comments on the bill.

In accord with the Chairman's request, we will omit comments on titles IV, V, and VI of the bill. Title IV and VI, as I understand it, are to be taken up by other Senate committees under whose jurisdiction consideration of these titles more appropriately falls.

With respect to title V, we defer to the Civil Service Commission, the Department of Defense, and the Veterans Administration whose programs and responsibilities would be directly affected by provisions of this title.

In addition, Mr. Chairman, we will provide a detailed report on S. 3562 to your request. I would, therefore, like to speak in general terms about its provisions and implications and its relationship to drugabuse activities now being carried out by the Department of Health, Education and Welfare.

The bill is aimed at restructuring and coordinating Federal efforts relating to prevention, treatment, and rehabilitation. We certainly share your belief, Mr. Chairman, that the best hope of reducing the problems of drug abuse and drug dependence lies in improved efforts to prevent the misuse of dangerous drugs and to provide the most effective treatment and rehabilitation for persons who suffer from problems of drug abuse.

We do not believe, however, that S. 3562 would provide a significant degree of improvement in the authority we now have, and in some instances the bill would tend to constrain our ability to respond to the need in these areas. While I would be the last person to say that we have everything we might possibly need to mount needed programs to solve problems of drug abuse and dependency, I submit that, in terms of statutory authority and the capacity for effective coordination, our present arrangements are more desirable than those proposed in S. 3562.

Let me explain this view. As you know, Mr. Chairman, the major responsibility for drug-abuse activities in the Department resides with the National Institute of Mental Health. Other departmental components, including the Office of Education and the Social and Rehabilitation Service, and other components of the Public Health Service are involved in activities relating to drug abuse. However, the focus for our activities is NIMH.

Under the broad authority of the Public Health Service Act and the specific authority of the Narcotic Addict Rehabilitation Act and the Community Mental Health Centers Act, NIMH is involved in a comprehensive program involving every facet of the drug problem from fundamental research to patient rehabilitation and public education.

However, the Department retains great flexibility in the organization of these programs as a result of Reorganization Plan No. 3 of 1966. Under that plan, all functions and responsibilities of the Public Health Service and its officers were transferred to the Secretary of Health, Education, and Welfare and the Secretary has the authority to delegate and redelegate them in whatever manner he feels is appropriate.

Obviously, the Secretary has found it appropriate to place the major responsibility for drug abuse in the National Institute of Mental Health. But in so doing, he retains the flexibility that is essential to the conduct of the Department's broad-ranging health activities.

We do not believe, therefore, that the establishment by law of a seperate administration within the Department would enhance our capacity to carry forward our responsibilities in the area of drug abuse. Indeed, it would have the opposite effect, in that it would deny to the Secretary the ability he now has to organize and structure drug abuse activities in response to need.

Insofar as coordination of Departmental activities is concerned, the Secretary has established a Departmental Committee on Drug Abuse whose prime function is to oversee and coordinate our work in this area. The committee is chaired by my Deputy, Dr. Jesse L. Steinfeld, who is the Surgeon General of the Public Health Service, and includes representatives of the NIMH, the Office of Education, the

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