AFTER THE PARTIAL TEST BAN TREATY
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Document Number (FOIA) /ESDN (CREST):
CIA-RDP66B00403R000100180002-8
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RIFPUB
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K
Document Page Count:
4
Document Creation Date:
December 19, 2016
Document Release Date:
December 29, 2005
Sequence Number:
2
Case Number:
Publication Date:
May 21, 1964
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OPEN
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For 9 BPA6 f, 000100180pm12;8
the social pressure of groups; and, third,
drug therapy. In working with addicts,
however, he is sharply limited with respect
to the tools he can currently utilize. He
can and does use interpersonal relationships
on a 1-to-1 basis, but this approach has.
in general, failed to produce the desired
change in addicts. As for group approaches,
the professional in and out of the hospital
has seldom learned to harness for reha-
bilitative work the social pressures existing
in the patient group on the ward and on
the street, and in family, friendship, and
organizational groups in the neighborhood
and in the larger community. In contrast,
the addict has been successful in utilizing
the ward group and most neighborlriood and
community groups in which he participates
to support his struggle against change.
Even when he is struggling to change, these
groups frequently apply pressures which pre-
vent his progress.
Finally the question arises whether the
most potent tool denied the physician is not
medically indicated drug therapy. Unlike
the situation in mental illness where the
doctor may use his discretion in prescribing
drugs he considers appropriate, the physician
does not, feel legally free to prescribe nar-
cotics as he sees fit in the course of medically
treating an addict. At the same time that
the physician's hands are tied in treating
the addict, the addict himself is able to
utilize narcotics at will in defensive efforts
to maintain his deviance and to resist
change.
The proscription against flexible drug
therapy appears on the surface to be ac-
cepted by staff members without question.
It is seldom discussed except inferentially.
Yet it is such, a basic question that, regard-
less of what the answers might be, avoidance
of the question is one of the more conspicu-
nus features of staff reaction. There is an
interesting contrast between the constant
imaginative discussion among patients about
drug use in addictive behavior and the con-
stant avoidance of imaginative discussion
among staff members about drug use for
therapeutic purposes.
Despite the self-imposed restrictions on ex-
ploring alternative approaches to treating ad-
dicts, staff members have spent considerable
time discussing both with patients and at
staff meetings questions involving hospital
medication. Such matters include metha-
done reduction procedures, proper sleeping
medication, the effects of certain drugs ad-
ministered on the ward, methods of admin-
istering drugs (i.e., parenterally or orally),
manipulation of staff members by patients
to get drugs, and the like. These are almost
exclusively discussed as problems of manage-
ment rather than of therapy.
The closest the staff has come to consider-
ing a broader view of the therapeutic use of
drugs was in the establishment of a drug
clinic in which nonnarcotic drugs were dis-
pensed to outpatients. Although this clinic
has been discontinued as such, medication
of various sorts is sometimes prescribed by
team leaders and after-care therapists to
those awaiting admission and to outpatients.
These procedures have been questioned and
changed from time to time and remarks
jocularly passed by staff members about doc-
tors becoming pushers. The truth of the
matter would seem to be that the staff is
indeed trying hard to push the hospital, its
service, and its various treatment views, but
that the community has stacked the cards
in favor of the nonmedical pusher on the
street.
CONCLUSION
We have outlined a theoretical continuum
for the treatment of narcotic addiction in a
community-based program and elaborated
some of the difficulties such a program faces
from community attitudes patient attitudes
and idiosyncrasies, professional attitudes,
and legal limitations. How then, can addic-
tion as a public health problem be ap-
proached under existing knowledge? We
must repeat our original statement that, in
the light of all these hindrances to thera-
peutic progress, the basic approach must be
preventive. This does not preclude the
simultaneous effort at development of a
more successful treatment program for
those already addicted, but it does recognize
the reality that reshuffling or elaborating
upon our present procedures in the manage-
ment of this disease may continue to meet
with the apparent failure that has charac-
terized treatment efforts to such a degree in
the past.
It must be recognized that the problems
presented to the medical profession and, in
fact, to our society as a whole by present-day
narcotic addiction are essentially problems
of social deviation and disorganization.-
Since those who are recruited into the ranks
of the addict population are young people,
mostly adolescents, this deviation can be
seen primarily as a problem of youth. It has
been found, incidentally, that a certain pro-
portion of addicts do give up their use of
drugs either with or without medical help,
when they grow older-in-their S0's or 40's.
We do not know precisely why; perhaps some
maturational factor is at work. Our con-
cern must be with the prevention of those
wasted 20 years or so in the lives of those
who succumb to a chronic disease at the age
of 15 or 16.
A new kind of environmental sanitation is
called for. Those things which need to be
eliminated from the narcotogenic environ-
ment are the breeders of frustration, aliena-
tion, rootlessness, and aimlessness. We can-
not, unfortunately, isolate the disease-carry-
Ing bacillus or in the traditional way
immunize the growing child in the environ-
ment to prevent his succumbing to addic-
tion, but we can effect environmental
changes that may provide a kind of psy-
chiatric vaccination for those children we
know will be exposed to the addiction-carry-
ing agents. Two kinds 'of attack through
environmental change are indicated: first, a
general strengthening of population resist-
ance to the disease of drug addiction, and,
second, amelioration or elimination of the
contributory environmental factors.
This brings us to a consideration of those
environmental factors that are contributing
to the present increase in addiction in the
United States. What is there in the struc-
ture of our present-day society that drives
young people into drug addiction or that
makes addiction necessary as a way of life?
We have been discussing narcotic-primarily
heroin-addiction, but we must not lose
sight of the fact that or present-day culture
is characterized also by the tremendous
problem of addiction to alcohol and that
many professionals are concerned about
cigarette smoking which is so universal and,
in some senses, addictive. Smoking, gam-
bling, particularly in the stock market, or
Hi-Fi addiction are respectable forms of ad-
dictive behavior, but they suggest that the
present structure of our society fosters the
development of such activities as defenses
against its assaults.
What is it that makes society so relentless
and vindictive in its attitudes toward the
narcotic addict as compared with the alco-
holic? Actually persons under the influence
of alcohol may cause more damage to them-
selves and to others than under the influence
of narcotic drugs, However, the fact that
alcohol is cheaply and legally available, while
heroin is not, means that the average drug
addict must turn 4r theft,to support his
habit. Does this threat to our property have
some influence on our attitudes? Does the
historical association of opium with Eastern
cultures arouse hidden fears and prejudices?
Interesting but fruitless as such specula-
tion may be, the fact remains that a neces-
sary first step in the management of the
narcotic addict as a patient is a fundamental
change in the classification of his disease.
Like other public health problems, addiction
must be seen as a civil, not a criminal matter,
and the criminal behavior that may result
from the addiction must not be confused
with the disease itself. With this funda-
mental change in approach, there must be
a creative and industrious application to
narcotic addiction of all that is presently
known and applied to other public health
problems about epidemiology, laboratory
technics, and clinical medical management.
It is to be hoped that such an attack on
this "communicable disease" will yield some
of the success that has resulted in the
elimination of other major public health
problems.
Mr. JAVITS. Mr. President, I pointed
out that this question ties directly into
the bill which was passed, and which Is
now law, providing for community
mental health centers.. This has opened
a new era in the treatment of the men-
tally ill, and, with the fine cooperation
of the Senator from Alabama [Mr. HILL],
the chairman of our committee, it allows
hospital treatment also for narcotics
addicts who are mentally ill.
AFTER THE PARTIAL TEST BAN
TREATY
Mr. JAVITS. Mr. President, a very
interesting article appeared in the Bul-
letin of Atomic Scientists on what fol-
lows the test ban treaty and what open-
ings It makes for further efforts In the
same direction. Though I do not agree
with some of the thesis involved in that
article, it is nonetheless such a penetrat-
ing study that I think it should be made
available to Senators.
The signing of a partial nuclear test
ban treaty by the major powers last year
was a notable advance along the road to
effective disarmament. The recent
agreement between the United States and
the Soviet Union to freeze production of
nuclear materials marks another step in
this direction. However worthwhile
these measures are, they should serve as
a spur to more intensive efforts for agree-
ments that will reduce the dangers to
the world of general war. Continuing
efforts must be made especially on verifi-
cation and veto-free international ma-
chinery for inspection of compliance
with disarmament agreements and
peacekeeping.
Ways in which the partial test ban
treaty can be followed up are discussed
by Bernhard G. Bechhoefer, author of
"Postwar Negotiations for Arms Control,"
who is a consultant on arms control at
the Brookings Institution, a research as-
sociate at the Johns Hopkins University
School of Advanced International Stud-
ies, and a former officer in the Depart-
ment of State. There are certain
aspects of this article with which I do
not agree-as for example an effort to
establish a modified republic plan in
central Europe-but it is as a whole per-
ceptive enough to be worth the attention
of my colleagues.
I ask unanimous consent to have
printed in the RECORD the article by
Bernhard G. Bechhoefer entitled, "The
Test Ban Treaty: Some Further Consid-
erations," which appeared in the Bulle-
Approved For Release 2006/02/09 : CIA-RDP66B00403R0001001-80002-8
Approved for 66 00100180002-8
196. ' JygP&R? : - ? X 99
The airbase development, involving the
purchase of costly equipment in France, was
the latest reported effort to attain party
with the Moroccans or better. During the
fighting last October, the Algerian National
People's Army was severely dealt with by the
better equipped, better staffed 'Moroccan
force,
About 110 Soviet-made tanks have come
into Algeria from Egypt or Cuba since the
frontier crisis. Cuban and Soviet instruc-
tors are operating a tank school fvr the Al-
gerians at Bebeau, south of Sidi Biel Abbes,
in western Algeria.
A total' of 8,000 Egyptian technicians, In-
structors and other military personnel are In
Algeria, according to reliable sources.
DRUG ADDICTION AS A HEALTH
PROBLEM
Mr. JAVITS. Mr. President, for a very
long time I. have taken a great' interest
in the problem of drug addiction as a
health problem and have sponsored pro
posed legislation to bring that about in
The enactment into law of the Com-
munity Mental Health Centers Act of
1963 opens up a new era in the treat-
ment of the mentally ill and apportuni-
ties for new approaches to the treat-
ment of narcotic addiction. This leg-
islation is based on the belief that most-
mentally ill persons can be treated suc-
cessfully in their own commulties and
restored to a useful role with their fam-
ilies without first being subject to pro-
longed custodial hospitalization. At my
initiative, provision was made for the
community health centers to treat drug
addicts who are mentally ill, a problem
which is especially concentrated in
metropolitan areas. Three