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Problems of Drug Dependence 1982 Proceedings of the 44Th Annual Scientific Meeting The National Institute Drug Abuse MONOGRAPH SERIES Problems of Drug Dependence 1982 Proceedings of the 44th Annual Scientific Meeting The Committee on Problems of Drug Dependence, Inc. U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICE • Public Health Service • Alcohol, Drug Abuse, and Mental Health Administration Problems of Drug Dependence, 1982 Proceedings of the 44th Annual Scientific Meeting, The Committee on Problems of Drug Dependence, Inc. Editor, Louis S. Harris, Ph.D. NIDA Research Monograph 43 April 1983 DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Alcohol, Drug Abuse, and Mental Health Administration National Institute on Drug Abuse Office of Science 5600 Fishers Lane Rockville, Maryland 20657 NIDA Research Monographs are prepared by the research divisions of the National Institute on Drug Abuse and published by its Office of Science. The primary objective of the series is to provide critical reviews of research problem areas and techniques, the content of state-of-the-art confer- ences, integrative research reviews and significant original research. Its dual publication emphasis is rapid and targeted dissemination to the scientific and professional community. Editorial Advisory Board Avram Goldstein, M.D. Addiction Research Foundation Palo Alto, California Jerome Jaffe, M.D. University of Connecticut School of Medicine Farmington, Connecticut Reese T. Jones, M.D. Langley Porter Neuropsychiatric Institute University of California San Francisco, California Jack Mendelson, M.D. Alcohol and Drug Abuse Research Center Harvard Medical School McLean Hospital Belmont, Massachusetts Helen Nowlis, Ph.D. Rochester, New York Lee Robins, Ph.D. Washington University School of Medicine St. Louis, Missouri NIDA Research Monograph Series William Pollin, M.D. DIRECTOR, NIDA Jack Dwell, M.D. ASSOCIATE DIRECTOR, OFFICE OF SCIENCE, NIDA EDITOR-IN-CHIEF Eleanor W. Waldrop MANAGING EDITOR Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857 For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402 Problems of Drug Dependence, 1982 Proceedings of the 44th Annual Scientific Meeting, The Committee on Problems of Drug Dependence, Inc. MEMBERS, COMMITTEE ON PROBLEMS OF DRUG DEPENDENCE, INC. Dr. Joseph Brady, Chairman Dr. Martin Adler Dr. Sidney Archer Dr. William Beaver Dr. Richard Bonnie Dr. Theodore Cicero Dr. Troy Duster Dr. Charles Gorodetzky Dr. Theresa Harwood Dr. Leo Hollister Dr. Jerome Jaffe Dr. Harold Kalant Dr. Charles O'Brien Dr. C. R. Schuster, Jr. Dr. Henry Swain EXECUTIVE SECRETARY Dr. Joseph Cochin MEMBERS, BOARD OF DIRECTORS Dr. E. L. Way, Chairman Am. Soc. Pharmacol. Exptl. Ther. Dr. Raymond W. Houde Am. Soc. Clin. Pharmacol. Ther. Dr. Keith F. Killam Am. Coll. Neuropsychopharmacol. Dr. Everette May Am. Chemical Society Dr. Jack Mendelson Am. Psychiatric Assn. Dr. Beny J. Primm Natl. Medical Assn. Dr. Lee N. Robins Am. Sociological Assn. Dr. Edward C. Senay Am. Medical Assn. Dr. James Woods Am. Psychological Assn. PERMANENT LIAISON Dr. Louis S. Harris Dr. Arthur Jacobson MEMBERS, PROGRAM COMMITTEE Dr. Louis S. Harris, Chairman Dr. Everette L. May Mrs. Joyce H. Pye MEMBERS, COMMITTEE ON ARRANGEMENTS Dr. Harold Kalant Dr. William Gilliland CONTRIBUTING FIRMS, 1981-82 The following firms have supported the work of the Committee on Problems of Drug Dependence, Inc. through contributions during the previous fiscal year. Abbott Laboratories Ayerst of Canada Boehringer Ingelheim International Bristol Laboratories Burroughs Wellcome Co. CIBA-GEIGY Clin-Midy of America, Inc. Dupont Glaxo Hoechst-Roussel Pharmaceuticals, Inc. Hoffmann-La Roche Inc. ICI Americas Inc. Johnson & Johnson Knoll Pharmaceutical Company Lederle Laboratories (Cyanamid) Lilly Research Laboratories McNeil Pharmaceutical Merck Sharp & Dohme Research Labs Ortho Pharmaceutical Corporation Pennwalt Corporation Pharmaceutical Div. Pfizer Central Research Reckitt & Colman Pharmaceutical Div. Schering Searle Research & Development SISA Incorporated Smith, Kline & French Laboratories Sterling Drug Inc. Syntex The Upjohn Company USV Pharmaceutical Corp. (Revlon) Wyeth Laboratories Zambon ACKNOWLEDGENT The papers in this monograph were presented or read by title at the 44th Annual Scientific Meeting of the Committee on Problems of Drug Dependence, Inc., in Toronto, Ontario, Canada, on June 27- 30, 1982. Louis S. Harris, Ph.D., who edited the monograph, is Chairman, Department of Pharmacology, Medical College of Virginia, Richmond, Virginia. Opinions expressed in the papers are those of the authors and do not necessarily reflect the opinions or official policy of the National Institute on Drug Abuse or any other part of the Department of Health and Human Services. The United States Government does not endorse or favor any specific commercial product or commodity. Trade or proprietary names appearing in this publication are used only because they are considered essential in the context of the studies reported herein. COPYRIGHT STATUS The table at the bottom of page 33 is copyrighted by the Journal of Studies on Alcohol, Inc., New Brunswick, NJ 08903, and is reproduced with their permission. Its further reproduction with- out specific permission of the copyright holder is prohibited. The table at the top of page 31 is adapted from material copy- righted by the Journal of Studies on Alcohol, Inc., and the table on page 173 is adapted from material copyrighted by Plenum Press, New York, NY 10013. They are used here by permission of the copyright holders. Before reprinting, readers are advised to determine their copyright status or to secure permission of the copyright holders. All other material except quoted passages from copyrighted sources is in the public domain and may be reproduced without permission. Citation as to source is appreciated. Library of Congress catalog card number 83-600528 DHHS publication number (ADM) 83-1264 Printed 1983 NIDA Research Monographs are indexed in the Index Medicus. They are selectively included in the coverage of the American Statistics Index, BioSciences Information Service, Chemical Abstracts, Current Contents, Psychological Abstracts, and Psychopharmacology Abstracts. v Foreword The Proceedings of each Annual Scientific Meeting of the Committee on Problems of Drug Dependence (CPDD) comprise a kind of contour map of one year’s explorations and advances along the frontiers of our knowledge about drug abuse. The remarkably broad range of research interests among the membership of the CPDD is reflected in the record of its meetings and the expertise of its membership, which includes biochemists and pharmacologists, physicians, sociologists, psychologists and other public health professionals. The proceedings of its annual meeting enable the reader to consider the vast scientific territory of recent research advances in substance abuse in a single volume. For that reason, the National Institute on Drug Abuse is once again pleased to publish the CPDD proceedings in its Research Monograph series. As in past years this volume contains a variety of timely papers and progress reports on ongoing investigations in the field as well as the annual report of the CPDD Drug Testing Program which evaluates the efficacy and dependence liability of new compounds. Several of the papers from the 44th Annual Scientific Meeting, held in Toronto on June 27-30, 1982, present Canadian perspectives on issues of common concern. Approximately half of the projects discussed are fully or partially supported by NIDA but much work is also underwritten by our sister Institutes in ADAMHA, by other Federal agencies, by State governments, by the governments of other countries, and by private industry. A most important contribution of the CPDD is its linking of the efforts of all of these groups to enlarge our understanding of psychoactive substances and their effects on human health and behaviors. This should help lead toward more effective prevention and treatment of the serious public health consequences of drug abuse. William Pollin, M.D. Director National Institute on Drug Abuse vii Contents Foreword William Pollin vii Plenary Session The J. Michael Morrison Award, 1982 Robert C. Petersen 1 Pharmacological Treatment of Narcotic Addiction (The Eighth Nathan B. Eddy Memorial Award Lecture) Vincent P. Dole and Marie E. Nyswander 5 Chemical Dependence in Canada: A View From the Hill Ian W. D. Herderson 10 Cultural Aspects of Alcohol and Drug Problems in Canada Juan Carlos Negrete 21 The Addiction Research Foundation-Mandate, Role, and Directions Joan A. Marshman 36 Symposium: Advances in Treatment of Drug Dependence Recent Advances in Opiate Detoxification: Clonidine and Lofexidine Arnold M. Washton and Richard B. Resnick 44 Methadone Maintenance: An Update Edward C. Senay 51 Psychotherapy for Opiate Addicts George E. Woody, Lester Luborsky, A. Thomas McLellan, Charles P. O’Brien, Aaron T. Beck, Jack Blaine, Ira Herman, and Anita Hole 59 ix Opioid Antagonists: Do They Have a Role in Treatment Programs? Charles P. O’Brien, Robert A. Greenstein, Bradley Evans, George E. Woody, and Robin Arndt 71 Annual Reports Progress Report: Medical College of Virginia--Sigma Agonists L. S. Harris, M. D. Aceto, R. L. Balster, and B. R. Martin 79 Progress Report from the NIDA Addiction Research Center (Preclinical Laboratory), Lexington, Kentucky C. W. Gorodetzky , E. J. Cone, S. R. Goldberg, S. Herling, M. E. Risner, H. E. Shannon, and D. B. Vaupel 85 Progress Report of the NIDA Addiction Research Center, Baltimore, Marylard
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