Leon Brill

Cyclazocine, a Long Acting Narcotic Antagonist: ITS Voluntary Acceptance as a Treatment Modality by Narcotics Abusers

Martin and co-workers (1965b) have proposed that the regular administration of cyclazocine, a long acting narcotic antagonist, might be useful in the treatment of ambulatory patients who are highly motivated to avoid relapse to the compulsive use of narcotics. The purpose of this paper is twofold: 1) To present the pharmacology of cyclazocine and the rationale for its use in the treatment of narcotic addicts, and 2) To describe briefly the patients who have voluntarily accepted this form of treatment and our early experiences with them.

Drug Abuse as a Social Problem1

To conclude, we must understand that narcotic addiction is a complex multi-faceted problem which has not responded to traditional rehabilitation approaches. There appears to be a need, consequently, for establishment of a variety of research programs geared to answer the outstanding questions, and for the coordinated efforts of community agencies to sustain the addict in the community by offering him a spectrum of services on a number of levels—to my mind—along the lines of the comprehensive community mental health center described earlier. We need to undertake socio-cultural studies to understand the addict in his own “tribal culture,” his outlook and private goals, resistances to abstinence and the “square” culture. An epidemiological, public health, and community psychiatry approach also appears indicated in order to study the etiology, manner of spread, prevention and control of narcotic addiction and the optimal points of intervention.We are finally realizing that the problem of narcotic addiction ha...

Some Comments on the Paper "Social Control in Therapeutic Communities" by Dan Waldorf *

In the paper prepared for the Columbia University Bureau of Applied Social Research (CBASR), entitled “Social Control in Therapeutic Communities for the Treatment of Drug Addicts,” Waldorf attempts to draw distinctions between the “coercive” (correctional) and “voluntary” types of therapeutic community. The California Rehabilitation Center in California and the Bayview Rehabilitation Center of the New York State Narcotic Addiction Control Commission are described as primarily coercive or correctional; Mendocino State Hospital in California and the Phoenix House units on Hart Island are described as voluntary, relying more heavily on “normative” (Etzione’s term) self-government and regulation of internal processes. Waldorf makes clear his strong preference for the voluntary facilities and details some of the reasons for this. Though Waldorf attempts to present a balanced picture, the paper is nevertheless replete with gross oversimplifications of the many complex treatment and evaluation problems involved. He begins by stressing the cardinal emphases emanating from the philosophy or “concept” of a therapeutic community, including such elements as the need to involve residents in the decision-making processes, to establish multiple leadership not based on specific authority, to improve communication between staff and *The views expressed in this article are those of the author only and not necessarily of the N.Y. State Narcotic Addiction Control Commission. 45