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ED 105 350 CG 009 723 Betros, Emeel S.; and Others Anomalies in Drug Abuse Treatment. Interim Report of the Temporary State Comm

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ED 105 350 CG 009 723 Betros, Emeel S.; and Others Anomalies in Drug Abuse Treatment. Interim Report of the Temporary State Comm 11 DOCUMENT RESUME ED 105 350 CG 009 723 AUTHOR Betros, Emeel S.; And Others TITLE Anomalies in Drug Abuse Treatment. Interim Report of the Temporary State Commission to Evaluate the Drug Laws. Legislative Document No. 11. INSTITUTION New York State Temporary Commission to Evaluate the Drug Laws, Albany. PUB DATE 75 NOTE 286p. EDRS PRICE MF-$0.76 HC-$14.59 PLUS POSTAGE DESCRIPTORS Alcoholism; *Drug Abuse; *Drug Therapy; Informa4-ion Seeking; *Program Evaluation; *State Government; State Legislation; *State Programs; Surveys ABSTRACT This interim report of the Temporary New York State Commission to Evaluate the Drug Laws seeks to provide the executive department and the legislature with comprehensive information on the social, fiscel and health problems associated with narcotics addition, and drug abuse. This report is the result of the following: (1) several meetings with treatment, research and law enforcement personnel; (2)a series of visits to treatment and research facilities throughout the state; (3) a variety of questionnaires answered by representatives from more than 400 programs in the state; and (4) six public hearings. The report is sharply critical in many areas; however, no other state has even begun to approach the comprehensiveness of the treatment programs available in New York. Topics discussed in the report include:(1) the methadone controversy;(2) abstinence programs; (3) alcoholism--emphasis without stress;(4) children and parents--time for reconciliation; (5) the Drug Abuse Control Commission; and (6) drunk driving. (Author/PC) STATE OF NEW YORK (1975) LEGISLATIVE DOCUMENT NO. 11 Anomalies in Drug Abuse Treatment U S DEPARTMENT OFHEALTH, EDUCATION & WELFARE NATIONAL INSTITUTE OF 14\ EDUCATION THIS DOCUMENT HASBEEN REPRO N OLCEO EXACTLY ASRECEIVED FROM THE PERSON OR ORGANIZATION ORIGIN ATING IT POINTS OF VIEWOR OPINIONS r STATED DO NOT NECESSA'.LY REPRE SENT OFFICIAL NATIONAL INSTITUTE OF Cr4 EOuCATIoN POSITION ORPOLICY Interim Report of the Temporary State Commission Laws s Assemblyman EmeelS. Betros, Chairman LETTER OF TRANSMITTAL To The Governor and The Legislatureof The State of New York: Pursuant to Chapter 474 of theLaws of 1970, as amend- ed in 1974, the Temporary StateCommission to Evaluate the Drug Laws hereby respectfully submitsthe following report. Assemblyman Emeel S. Betros, Chairman Judge Irving Lang, Vice Chairman Senator Robert Garcia, Secretary Henry Brill, M.D. Senator John R. Dunne Senator Joseph L. Galiber Assemblyman Alan G. Hevesi Senator Tarky Lombardi, Jr. Assemblyman Dale M. Volker .,- ii PERSONNEL OF THE COMMISSION COMMISSION MEMBERS Assemblyman Emeel S. Betros, Chairman Judge Irving Lang, Vice Chairman Senator Robert Garcia, Secretary Henry Brill, M.D. Senator John R. Dunne Senator Joseph L. Galiber Assemblyman Alan G. Hevesi Senator Tarky Lombardi, Jr. Assemblyman Dale M. Volker EX-OFFICIO MEMBERS Warren M. Anderson, President Pro Tem of the Senate Stanley Steingut, Speaker of the Assembly, Represented by Assemblyman Mark T. Southall Albert H. Blumenthal, Majority Leader of the Assembly Manfred Ohrenstein, Minority Leader of the Senate Perry B. Duryea, Jr., Minority Leader of the Assembly John J. Marchi, Chairman, Senate Finance Committee Burton G. Hecht, Chairman, Assembly Ways & Means Committee William T. Conklin, Senate Majority Floor Leader STAFF Harvard Hollenberg, Chief Counsel Ruth Brooks, Administrative Assistant to the Chairman Michael H. Wolfe, Assistant Counsel Audrey Philip, Administrative Aide Evelyn DeGroot, Administrative Aide iii ACKNOWLEDGEMENT On behalf of the Commission I wishto express our appreciation to the many witnesses who took the time to testify atour hearings, and to the treatment, research, and lawenforce- ment personnel who cooperated with Commission staff members in helping to analyze thepresent dimensions of the drug problem,as well as cur- rent treatment techniques. EMEEL S. BETROS Chairman iv TABLE OF CONTENTS INTRODUCTION; FINDINGS AND RECOMMENDATIONS 1 CHAPTER I RESOLVING THE METHADONE CONTROVERSY 17 Private versus Public 26 Law Enforcement 46 Recommendations 49 CHAPTER II ABSTINENCE PROGRAMS: PROHIBITION IS NOTENOUGH 52 Recommendations 70 CHAPTER III ALCOHOLISM -- EMPHASIS WITHOUT STRESS 73 What is Alcoholism? 75 Treatment Opportunities 78 A Case Study 84 Research and Education 92 Recommendations 95 Letter To Chairman from State Department of Mental Hygiene, Division of Alcoholism 99 CHAPTER IV CHILDREN AND PARENTS: TIME FOR RECONCILIATION 109 What We Have Learned in Five Years 109 Reinventing the Parent 116 Two Programs Which Reconcile Families 121 Reinventing the Extended Family 137 Recommendations 139 V CHAPTER V THE DRUG ABUSE CONTROL COMMISSION -- A REAPPRAISAL 148 Accountability 152 Evaluation 155 Organization 161 Recommendations 167 CHAPTER VI DRUNK DRIVING: AN OVERVIEW 169 A. The Canadian Experience 169 B. The European Experience -- A Partial View 181 C. The United States 185 D. New York State 201 Recommendations 218 APPENDIX A EQUITABLE'S EXPERIENCE WITH DRUGABUSE AMONG EMPLOYEES AND THE HIRING OF REHABILITATED EX-ADDICTS 221 APPENDIX B DRUG ABUSE CONTROL COMMISSIONREQUIREMENTS FOR OPERATING A METHADONE PROGRAM 234 NEW YORK STATE HEALTH DEPARTMENT'SREQUIREMENTS FOR OPERATING A METHADONE PROGRAM 250 FOOD AND DRUG ADMINISTRATION REGULATIONSFOR THE OPERATION OF A METHADONE PROGRAM 256 APPENDIX C LIST OF WITNESSES AT COMMISSION HEARINGS 271 INTRODUCTION; FINDINGS AND RECOMMENDATIONS The Temporary State Commission to Evaluatethe Drug Laws has, in its five year history, addressedthe problem of treatment on three prior occasions. In 1972, the Commission advocated a comprehensive system ofregulating the manufacture, distribution, and therapeutic applicationof controlled substances, which would protect against the diversionof mood-altering drugs, but which could also encourage theexpansion of treatment and research (Controlled Substances, LegislativeDocument No. 10, 1972). The Commission then carefully balancedthe risks and the opportunities entailed in the employmentof genuinely rehabilitated addicts, and found that a verifiably goodrehabilitation or work record coupled with the capabilityto perform a specific task were sufficient to reduce the risk ofemploying reformed addicts to essentially that of employingpersons with no history of addiction (Employing the Rehabilitated Addict,Legislative Document No. 10, 1973). Also, in 1973, the Commission carefrlly evaluated reasons for the success of othercountries in dealing with their own drug problems and found that theunderlying principle of successful rehabilitationalways included attempts, with proper safeguards, to reintegrate the addict with society (How People Overseas Deal with Drugs, Legislative Document No. 11, 1973). One of the most striking observations made by the Commission, while abroad, was that whateversuccess the Japanese, the British, the Dutch, or others could cite with regardto preventing drug abuse, the most significant common denominator was often positive action to promote the individual health and development of each child. This observation became the thesis of our study of American drug abuse prevention techniques, particularly those being attempted in New York State (Drug, Abuse Prevention, Legislative Document No. 11, 1974). While analyzing the question of prevention, we discussed the role of treatment as a tertiary form of prevention, that is, after the fact of drug abuse. It became clea,r to us that the treatment of drug and alcohol abuse in New York Statewas so complicated by philosophical and practical questions that further analysis would be justified, under our mandate "to provide the executive department and the legislature with comprehensive information on the social, fiscal and health problems associated with narcotics addiction, and drug abuse..."* This report is the result of a series of visits, both announced and unannounced, to treatment and research facilities throughout the State. It is the result of several meetings with treatment, research and law enforcement personnel. It is the result of tireless efforts by the Commission staff to read through hundreds of books, papers and monographs on the subjects discussed in this report. It is the result of a variety of questionnaires answered by more than four hundred programs throughout the State. It is also the result of six public hearings held: in New York City on September 4, 1974; *Chapter 474, Laws of 1970. J in Mineola, Long Island on September 5th; in Buffaloon Septem- ber 24th; in Syracuse on September 25th; and inPoughkeepsie on October 2nd. A joint hearing on drunk drivingwas held by this Commission with the Joint Select Committeeon Transportation and the Senate Standing Committee on Transportation inMineola, New York, on October 17, 1974. Although this report is sharply critical ofmany aspects of drug and alcohol abuse treatment in New York State, we believe that two prefatory qualifications are vital to an understanding of the treatment problem in its true perspective. First, no other State has even begun to approach the comprehen- siveness and true diversity of the treatmentprograms in New York.* Except in the area of alcohol abuse, the faults we find are those of unsuccessful planning; they are not mistakes resulting from not caring. Second, while we tend to.suoport the methadone maintenance approach, among other modalities of treatment for heroin addiction, we are also mindful of the drawbacks of methadone, and we fully encourage efforts to develop long- acting narcotic antagonist compounds
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