Senator TUNNEY. Were you here, Chief, when District Attorney Horan was testifying?

Chief WILSON. Yes, sir.

Senator TUNNEY. You were here?

Chief WILSON. Yes, sir.

Senator TUNNEY. Did you hear him talk about private physicians? Chief WILSON. Yes, sir.

Senator TUNNEY. Making methadone available to those who then sell it?

Chief WILSON. Yes, sir.

Senator TUNNEY. What is being done about that?

Chief WILSON. My understanding is that they have been taken to the U.S. attorney and presented to the grand jury without success. Inspector BISHOP. We have presented the facts to the U.S. Attorney's Office. It has gone as far as the grand jury and the U.S. Attorney's Office decided not to pursue it any farther.

Senator TUNNEY. Why not?

Chief WILSON. That is, of course, the prerogative of the U.S. Attorney's Office.

Senator TUNNEY. I understand it is the pregogative of the U.S. Attorney's Office-but I am wondering why not? A District Attorney in Virginia says six people have died in the last couple of years attributable to overdoses of methadone. He says he knows of four physicians selling methadone to nonaddicts. They are, in turn, selling it at substantial profits to themselves to young people apparently shooting it and dying of overdoses. I am curious to know why the U.S. attorney decided to drop charges against the physicians.

Inspector BISHOP. I don't like to speak for the U.S. Attorney's Office, but they felt the individual would abide by the guidelines and the laws after our case had been presented. We subsequently sent people around and they have changed their method of operation somewhat. We feel it is still a sham but they do manage to fill the bill. Senator TUNNEY. Is still a sham?

Inspector BISHOP. We feel that way personally but legally we are not able to get enough evidence to present a case now.

Senator TUNNEY. You mean your undercover agents aren't able to get enough evidence?

Inspector BISHOP. That is correct. We would have to send an undercover man in with needle marks on him and he would have to give a urine specimen. He might be able to get the first prescription. The way it originally started it was an out and out farce. There was no examination and there were no records kept. Now there is some semblence of records kept. Some are not readable, but records are being kept in accordance with the law. The individual is given a brief examination and is required to submit to a urine analysis. There are things that you can't send a fresh undercover man or any kind of undercover man not using narcotics to pursue it any further. We are not able to meet the prerequisites of prosecution, but we still feel it is easy to get methadone.

Senator TUNNEY. Is it easy to get the methadone from physicians here in the District of Columbia?

Inspector BISHOP. From some; yes.

Senator TUNNEY. And yet you do not have enough evidence to be able to bring charges?

Inspector BISHOP. At the present time we do not. We did have at one time. We had several cases pending but the operation has tightened up somewhat and we are not able to get enough for prosecution at this time.

Senator TUNNEY. So, in other words, the situation is considered to be better if you can't get enough for prosecution?

Inspector BISHOP. Again, as I stated before, I think it is a shame. There are records kept which the law requires. The man is examined by the doctor, which the law requires, but the type of examination would take another doctor to determine just how thorough an examination it is and how much addiction the individual has that goes there. This is another important factor. Is this indeed a treatment program that the doctor is carrying on or is he just giving anybody methadoneanybody who has needle marks or appears to be an addict?

Senator TUNNEY. But there is some prima facie evidence that he has to be an addict?

Inspector BISHOP. There is a tightening up to meet the minimum standards to beat the law.

Senator BUCKLEY. Chief Wilson, in answer to the question asked of you by Senator Weicker about the whole corridor problem you mentioned, on a couple of occasions, this was basically a responsibility, this coordination, of the Bureau of Narcotics. Does your Department work closely with that Bureau?

Chief WILSON. Yes, sir; we have for some time. We don't presently have but for some time we had a Bureau agent inhouse primarily because, until last year, we did not have wiretap authority of our own. We don't have to work as closely with them as we did then because up until last fall we had to rely on Federal wiretap authority. This required us to have a Federal agent on all wiretaps that we were operating or were working with. We have had very good cooperation.

Senator BUCKLEY. Do you have any basis for making a judgment as to how effectively they are coordinating your effort with your department

Chief WILSON. I think our coordination is reasonably effective. We have contacts in New York and Philadelphia and I feel we have reasonably good coordination beyond what is going on there, and what is going on here.

The Bureau does considerable work in this city in conjunction with us and second, I have a general feeling our coordination with other departments is reasonably good.

Senator BUCKLEY. Thank you very much.

Senator WEICKER. May I just ask one more question to pursue the questioning of Senator Buckley? Could you tell us how many persons are assigned from this Bureau to Washington, D.C.?

Inspector BISHOP. That number fluctuates. They shift people from the Washington field office to the Baltimore field office depending on where they are putting the emphasis at the particular time. I have seen as many as 25. I have seen the number in past years down to 10 or 11 but the numbers have increased. Their authorized strength is probably in the thirties.

Senator WEICKER. This covers Baltimore and Washington areas? Inspector BISHOP. No, sir. Regional office has a field office there and a field office in Washington. Depending on the particular investigation they are running, and the importance they will move men back

and forth. We will have men here from Baltimore supplementing their investigation here and vice versa.

Senator WEICKER. Thank you very much

Senator TUNNEY. Our next witness is Dr. Robert DuPont, Director, Narcotics Treatment Administration, Department of Human Resources, Washington, D.C.

Dr. DuPont, many thanks for being a witness today.

I have to leave the hearing room for about 5 minutes while you read your statement. Senator Buckley, would you take over the chair? Senator BUCKLEY. Thank you.

STATEMENT OF DR. ROBERT L. DUPONT, DIRECTOR, NARCOTICS TREATMENT ADMINISTRATION

Dr. DUPONT. During 1969 and 1970, this committee played a central role in the mobilization of our community, and the Nation, to deal with the epidemic of heroin addiction which is not only destroying thousands of lives, but generating crime which is tearing apart our cities.

Because of the historic role of the committee, it is a special privilege for me to appear before you today.

The Narcotics Treatment Administration was formed February 18, 1970, to develop a comprehensive program to combat heroin addiction in the District of Columbia.

When we began, there were 153 heroin addicts in treatment in the city-almost all in the Department of Corrections pilot program which began September 15, 1969. On December 31, 1969, the Bureau of Narcotics and Dangerous Drugs listed 1,636 heroin addicts in the District of Columbia. We then estimated the total at close to 5,000. Our first priority was to engage in effective treatment of all 5,000 addicts within 3 years. We also began a preventive education and research program.

NTA is now 16 months old. On June 18, 1971, we had 3,413 heroin addict patients in active treatment. Of these, 713 were abstinent, 1,671 were on methadone maintenance and 969 were receiving decreasing doses of methadone leading to abstinence.

But even as our treatment programs were exceeding our projections, our research division showed that our initial estimates of the size of the problem of heroin addiction were low. We now estimate that there are about 17,000 heroin addicts in the city. Thus, despite the fact that we have established the largest and fastest growing city-operated heroin addiction treatment program in the Nation, we are only treating about 20 percent of the total number of heroin addicts in the city.

There is no evidence that the epidemic of heroin addiction in the District of Columbia has worsened in the last year. In fact, using the rate of overdose deaths as an indicator of the extent of heroin addiction, we found that the death rate has slightly declined in the last 9 months in Washington. Thus, although our estimates of the extent of the problem grew from 5,000 to 17,000 in the last 12 years we have no evidence that the problem worsened.

We, at NTA, are proud of our achievements in saving thousands of our citizens from the slavery of heroin addiction. We are proud that we have contributed to the reduction in crime in the District of Columbia. We are proud of our research contributions to the field.

But, we are sobered by the realization that our job has only begun. We realize, more than ever, that this problem is not merely local. Heroin addiction is a national crisis.

We are greatly encouraged by the President's recent appointment of Dr. Jerome Jaffee to lead a new national effort to deal with the epidemic of heroin addiction.

We recognize that this appointment and the President's request for additional funds signals a new national commitment. We look forward to the assistance this will bring.

Some people in this field are deeply pessimistic about the future. I am not. I am convinced that as we understand more about this epidemic that we can develop techniques to end it. As we develop a national sense of urgency, we will make available the resources which will permit us to use fully these new techniques.

It is thus, with a sense of pride in our initial accomplishments and a dedication to end the epidemic of heroin addiction, that I appear before you today.

Senator BUCKLEY. Thank you, Dr. DuPont.

In the course of your testimony you spoke of the preventive program the NTA instituted. Would you describe it for us in detail?

Dr. DUPONT. The preventive program has several parts. It is focused particularly on a mobile unit that is traveling around the city appearing at schools and other public places bringing information and setting up rap sessions with former addicts to talk about the problem of heroin addiction. It also provides speakers to the schools in the community.

Our preventive education efforts have also included public education through the mass media. We have focused on alerting the community on the dimensions of the heroin problem. However, this area is one where we feel the least confidence in terms of dealing with the total problem. It is very difficult to be convinced that setting up rap sessions or putting on programs at schools is really doing the job. The tragedy is that many people who use heroin have brothers and sisters and good friends who have not only used heroin and watched their lives destroyed, but who have died from overdoses. Thus many people turning to heroin addiction already know a great deal about it. I am not optimistic about this particular part of our work.

Senator BUCKLEY. Your assessment jibes with that which I have heard, unfortunately, in other areas.

One problem that has been particularly vexing in New York and some suburban areas of New York City is the lack of control over methadone. We have heard testimony about that here. Are you utilizing or thinking about the type of controls over the supply of methadone? Have you been computerizing the information as to who got a particular dose when so as to prevent an addict from shopping around and getting two or three times as much as he ought to have? Dr. DUPONT. Yes. This is of grave concern. Methadone is a synthetic opiate which, when injected, produces euphoria. The potential for abuse of methadone is very great and must be guarded against at all times.

Of equal importance, methadone can be lethal to the nonpatient and so it presents a special kind of public health problem.

At NTA we have done everything we can think of to prevent diversion of the methadone and also to reduce the likelihood of accidental

ingestion. There remains a problem, however, and this is that you have to balance conflicting goals. One goal has to do with the rehabilitation of the addict into the mainstream of society, which cannot be done if they must come 7 days a week to a clinic for the indefinite period of time. The second goal is the protection of the public. At NTA a patient must come for 90 days to an NTA clinic before he gets his first take-home medicine, which is issued in a locked box in a childproof bottle in a noninjectable tablet. All of these procedures are designed as safeguards. In addition, the patient must sign a form stating that he understands the dangers of the drug methadone and that he will keep it home in his locked box. When we realize that we have issued approximately 200,000 take-home doses of methadone, we realize that even a small percentage can be a serious problem. On the other hand these procedures apply only to the NTA program. There are larger questions about methadone availability in our society. Senator BUCKLEY. I was addressing my question to that.

Dr. DUPONT. Here is the problem which has not been adequately thought about. Methadone is available in every pharmacy in this city and other cities and has been for many years. I was just talking yesterday about this with Dr. Jerome Jaffee, the new national leader in this area, and I know this is a top priority in his mind also. He is trying to formulate new Federal regulations of some kind, perhaps through the Food and Drug Administration, which will truly insure that the public safety is protected. The public is now not safe.

Senator BUCKLEY. Do you have any coordination with equivalent groups in Virginia and Baltimore on methadone problems?

Dr. DUPONT. Well, we work with the Council of Governments in the metropolitan area-not at a State level. I have met with the people from the Maryland State Drug Abuse Authority. This has recently been reorganized, so the people I was meeting with are out of office now. A new group has taken over and I haven't met with the new group yet. I don't have close relationships with the State people in either Maryland or Virginia.

Senator BUCKLEY. Do you believe that such relationships should be fostered and developed?

Dr. DUPONT. Yes; I do. In fact I had intended earlier in the week to call Dr. Soloman, who is Secretary of Health for the State of Maryland, to try to set up coordinated efforts. I think we must have an areawide registry of methadone so patient-addicts cannot get methadone in a Baltimore program and a District of Columbia program. This is perfectly possible today. I think this is a top priority. I will call Dr. Soloman this week.

Senator BUCKLEY. You mentioned that the NTA treats approximately 20 percent of the estimated addicted population of the District. Is this because you do not have sufficient facilities or because you have to rely on addicts volunteering to come to you?

Dr. DUPONT. It is absolutely the lack of adequate facilities. The addicts come and come and come to the programs. I think it is a crisis in our community that NTA is now turning away addicts who are coming to seek treatment. We have been doing this for the past 6 weeks. The problem is clearly the lack of sufficient facilities.

We find that as soon as we open a new center it fills with patients. A recent example of this was at 59 M Street NE., where we opened a center in the first week of March. That center now has about 400 patients in treatment at just one location.