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                    <text>-

October l0, i97l

mey-wy.

wan—wt

«‘

my":

HIP."

Dr. E.

W.

Gill

Oxford, England
Dear Dr.

Gill,

at the
suggestions that
there were many acive ingredients of cannabis and the evidence
presented was of great interest; as was the data on the variety
of contents of the constituents of cannabis from specimens from
different parts of the world. As Dr. Freedman mentioned, we are
involved in comparing the effects of cannabis in Athens and New
York, and your presentation would be of special interest to me
I

Dutch

and

very

much

enjoyed your presentation

interdisciplinary society meetings.

my

such is

The

associates.
May

available
Many

l

?

prevail on

you

to

send us a

preprint

when

thanks.
Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiatry

�</text>
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                    <text>Oclober l0, I97l

Springer Veriag

Berlin,

Germany

Genfiemen:
On my

re+urn from an exfended Trip

i

found +he

proofs of +he figures for the arficle 993 for Psychopharmacologia.
Anflcipafing fhe delay, i had refurned fhe qalleys earlier, and
am now enclosing the figures with fhe page of the
galley duplicafe
#0 which fhe figures refer.
i

lifies

have indicafed +heir locafion.

in prinfing The figures, The edifor has removed The
from each figure, leaving fhem unidenfifled. |+ ls
necessary

Thai +he figures receive +he proper idenfificafion:

l. Primary Baseline Cross Della (0-3.5

Hz)

2. Primary Baseline Cross Alpha (7.5 - l3.5 Hz)
3. Primary Baseline Cross Befa

(+ 40 Hz)

Firsl Derivaflve Baseline Cross
5. First Derivafive Baseline Cross
4.

Average Frequency
Alpha

(l0-l6

6. Firsf Derivafive Baseline Cross Befa (+50 Hz)
Thank you

for your cooprafion.
Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiatry

Hz)

�</text>
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                    <text>OcTober 9, l97|

Prof. Alfred M. Freedman
Chairman, DeparTmenT of PsychlaTry
New York Medical College
Dear Al:
The following noTes are wriTTen in response To your
informaTion
for
as To my relaTionship wiTh L. Bucci, M.D.
requesT
l
firsT meT Luigi when
T0 The DeparTmenT, and his inTeresT
me To requesT his appoinTmenT To my

he applied for an appolnTmenT
in psychoTropic drugs allowed

division.

His firsT assignmenT was an evaluaTion of The
duraTion and poTency of fluphenazine enanThaTe compared wiTh
oral fluphenazine; and This laTer was augmenTed by a comparison
wiTh fluphenazine decanoaTe. As is our cusTom, we esTablished
a proTocoi for The admission of paTlenTs To The program, Their
supervision and raTings, and The Types of evaluaTions required. MosT
criTical in such evaluaTions, is The adminisTraTion of The
proposed dosages for The proposed lengThs of Time, wiTh The
physician allowed To use his judgmenT in each case as To The
From The very ouTseT, Luigi had
proper dosage To be deployed.
more difficulTy Than Two oTher TherapisTs (Maria Fuchs and Jovan
Simeon) in carrying ouT The proTocol. The dosages were more
variable Than ThaT of The oTher physicians; There were repeaTed
supplemenTaTions wiTh oTher drugs, parTicularly MAO inhibiTors
(despiTe proscripTion in The proTocol); and The records were mainTained in an idiosyncraTic meThod.
aT

LaboraTory TesTs were noT requesTed as required, and
various Times, The duraTion of TreaTmenT was suffciienle

aiTered ThaT The drug Trial Took
anTicipaTed.

many more monThs Than we had

AT The end of The experimenT, we noTed ThaT The
evaluaTion of secondary effecTs for Dr. Bucci's paTlenTs was aT
IeasT Two Times ThaT of The oTher physicians. On examining The

records and The available cases, we noTed a marked discrepancy
beTween The evaluaTion criTeria he used, and Those of The resT of
The sTaff. AfTer considerable review, l concluded ThaT The idiosyncraTic naTure of his judgmenTs was sufficienle differenT Than

�"nv -vw,mw&gt;n~ m-w—I—H—o-w

my

experience

To

‘iw_mwww.’.

--

mm w.wmmwwwvww i,”
TVWV

preclude his usefulness in

of The Division of Biological PsychlaTry.

The

ﬂ_»_r..i.,.._..........-.wv-

research programs

His opinions wiTh regard To The TreaTmenT of
MAO inhibiTors are based on sTudies which
he has published. i have read Two of These reporTs, and recall
ThaT They failed To saTisfy my criTeria for an academic reporT—They were deficienT boTh in conTrols and in independenT evaluaTlons.

psychoTic paTlenTs wiTh

In adleion, i am aTTaching a xerox c0py of a reporT
which he published from The work aT MeTropoiiytn HospiTai. i
do noT recall seeing The proTocoi filed or approved, and I
suspecT ThaT This sTudy was done conTrary To The rules of
The school. This, despiTe, my urging him To file The becessary
documenTs before a sTudy is conTemplaTed, parTicularly one
ThaT is as unique as This one.
On

The posiTive

side,

i

would

recall

To

your aTTenTion

his enThusiasm for Teaching and parTlculariy his drive To
asserT The posiTion of psychopharmacoiogisT To The DepaTmenT.
There was a disTincT dissoclaTion beTween his enThusiasm and his
abiiiTy, and for This reason, i requesTed his Transfer from The
research divisions and failed To supporT his requesT for
promoTion.

Sincerely yours,
Max

Fink,

M.D.

Professor of PsychlaTry

-

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                    <text>—

_,.,

,

7-»

W-.ww aw

~~..r.—w—~—~-...ﬂ

-

mr cup-u .v-q—

w—.

v”

.-,

,,

..._ l...

,

._

,

w

.0“

v

.7

.

W.

.

4‘.

...-

w-vv—M»

October 31, 1971
Dr. Jonathan 0. Cole
Boston State Hospital
Boston, Massachusetts
Dear Jon,

Enclosed are the
(1)
(2)
(3)
(4)

Also,

final drafts for the

Volavka

Theories

Fink
Fink and Abrams

Q

copies of Small and Small.

Note:

Abrams paper (clinical)
made on page 17.

Note:

Fink (theory) has page

I enjoyed the work. I

their standards.

&amp;

A

is included for the
S

of the citations missing.

hope the

editors find the material

Will follow tomorrow.
up to

volume:

Neurophysiology
Medical

Pitts

two

additions

ECT

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

MF:kt
83¢ o

,

�</text>
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                    <text>October 21, 1971
Dr. Henri Gastaut
Centre Hospitalier at Universitaire de Marseille

Hopital de la
DD

13

Jean~Mou1in

- Marseille

Timone

(5

E

),

France

Dear Dr. Gantaut:

Enclosed is a short summary of the data presented at the
recent interesting symposium in Marseille.
Again,

we

thank you for your kind

invitation.

Sincerely yours,
Pink, M.D.
Professor of Psychiatry

Max

MF:kt

enc .

�</text>
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                    <text>~»—.a—v 'r-F'

.

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September

.
,

H

Dr. Fred A. Clark,

m,,..._.wﬂ.,q,..s..,w.n

,..__._.,,

,.....y-,-

2i, l97l

Jr.

A. H. Robins Co.
l407 Cummings Drive

Richmond, Virginia
Dear Fred,

as,

,

have read the
andimin (fenfluraminei,
I

,vnmnmu’m

questions:

summary portion of the submission on
l6—6l8 (vol. 4.l) with the following

NDA

.m.‘

is the presentation clear and does

.»

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air")

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claims of the

the

the 'labelling' section present the data clearly and
concisely, sufficient the convince the examiner that the claims
for a new drug as 'safe' and 'effectlve' can be substantiated;
Are there additbonal studies that should be considered 7
impression is that the summary is written poorly; that
redundancy, leaving an impression of 'padding'; and
some important issues regarding anorexigenlcs are omitted (persistence of effects, tolerance, dependence, and similarity or
dissimilarity to dextroamphetamlne clinically). The summary is
complete and sufficient in demonstrating that extensive pharmacologlc,
metabolic, toxicologic, and clinical studies were done. Indeed, the
amount of data and number of studies are impressive. Yet, i can
easily imagine the text Inducing doubts. Some criticisms to be found

there is

in the

My

much

details are:
the

same

tables

inﬂate/‘9’"?!

v:

njaqw-

whole

1

,0,

it substantiate

Does

_

1125's.».-

NDA;

data is presented in a variety of ways;

do not present the

salient issues clearly;

sections appear as testimonials, diminishing the

merit of the data base; and,

,.
(a

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some language is obtuse, leading the examiner to focus
rather than ideas.

on

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-2There are two types of data that seem to be treated less
adequately than one could wish. One issue in the use of the
anorexlgenlcs is the extent to which they inhibit appetite, reduce
food intake (or increase metabolism) to yield a gradual loss in
weight, and to do so safely. The criticism of dextroamphetamine
is the short time it is effective (7tolerance), its abuse
potential (?dependence), and the occasional toxicity expressed
as insomnia, irritability and tremor. (The same can be said about
other stimulating anorexigenics.) i find the comparison of
fenfluramine and dextroamphetamine incomplete. The tables on
pp. 28—33 are impressive but they lack clinical data. Perhaps
the two drugs should be contrasted as to stimulation, secondary
effects, abuse potential (has this been demonstrated or tested 7),
and dependence. Such a comparison could emphasize the unique
properties of fenfluramlne, make the labelling claims distinctive,
and allow for approval as separate from the anxiety occasioned by
dextroamphetamlne abuse.

issue is duration of effect. A principal
criticism of dextroamphetamine is a limited period of efficacy.
These data doeaot allow for a decision as to whether continued
use of fenfluramlne is associated with tolerance, or whether
weight loss is sustained. Are increasing doses necessary to
sustain weight loss 7
The second

v-yw-rw-r

("wuv

‘7...“ n-c

clear,

With regard to the labelling
and useful as far as it goes.

cited above, although these answers
labelling.

section, find
It is deficient
i

may

not

be

it

adequate,

in the issues

necessary for

opportunity to discuss the conclusions of the
committee meeting on anorexigenlcs with Elmer Garner and
Donald F. Klein. Both indicated that the agreement in the committee
i

FDA

had an

limited; that no anorexlgenic was really 'proven'; and none
sustained wieght loss. l enquired about the questions of tolerance
and dependence, and these seemed the principal anxiety in
approving new compounds. "Do we really need another drug to be
abused ?" l suggested fenfluramine may be significantly different
than dextroamphetamine, and Dr. Gardner seemed attentive and
interested. He said the FDA was about to allow an NBA for
another anorexigenic, and he expressed the opinion that there was
little reason to hold up an approval for fenfluramine.

was

My

separately.

specific

comments are attached. The volume

is returned

leaving for Europe and will return October 7. l have
dictated and typed these notes rather hastily, knowing you wished
a reply as eoon as practical. My thanks for the opportunity to read
these data, and i trust the submission will not fail. if i can
be of help at the FDA, l have no hesitation to meet with them.
i

am

Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiatry

,

7,.

..

,

“.7

.7.”

we...“

,

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�</text>
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v...

w“...

.-

A

20 September

a-n-v-v-wwnwww-wn1—.mw~.v.u—-v-.~’-..-«.murmur—“v

ww.w.-rn

PD

l97l

Dr. N. Matussek

Max

Planck

Institute

Munich. Germany

Dear Dr. Matussek,
I have been asked by our National Institute of Mental
Health to organize a meeting on the general problem of the
biochemical and neurophysiologic data of induced seizures. in
man and animals, with specific reference to electroconvulsive
therapy. In discussing the work from various laboratories. some
of which may be unpublished, your name was suggested as one
to whom I may write for information as to work in progress.
I

work, or

would be

grateful for

any infbrmation regarding your

that of your co-workers. that is ongoing andmight

on the problem of electroconvulsive therapy in man. I
should be particularly interested in any preprints of your

bear

recent work.

spring,

The

conference, should

1972 in the United

Thank you

it

States.

be held.

is planned for late

for your reply.
Sincerely yours,
Fink. M.D.
Professor of Psychiatry

Max

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(’3’;

20 Sepfember l97l

Dear Jon,

Following our conversation,
The

I

Though? some more about

question of Joe Tecce. Enclosed ls

our recenf reviews of fhe penfofhal

diphasic response which
physical lines,

The

we

a

EEG

reprinf of

response. if shows

have lnferprefed along

In our

sfudy of amobarblfal and dexTroamphefamlne, assimilar curve was
in evidence, alfhough we chose To disregard fhe
and focus on fhe long farm

My

effects.

besf.

Wm."

l.

a

classical

operafion of a springnmechanism.

w

m.

one of

Sincerely,

iniflal changes

�</text>
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                    <text>V'—" —.

V

r‘w

.W—q“..- .

mp7. '..'~mvlw"-u'.

~wr-1-

um‘ wwm www.mm... m.—_____.,.__

v... v .__.__v

v

We _

.¢_~W--W..VMMVV,_

20 September 1971

Dr. Jon Heiser
University of California

Irvine, California

Dear Dr. Heiser,

that

I

Your experiences are most interesting, and
you are extending your studies.

am

delighted

In our assessment of the EEG changes with anticholinergic
drugs, the changes in the theta/delta (2-7 cps) and the fast
beta (22-30 cps) were the most interesting. We used a conventional
frequency analyzer in our studies, and confirmed some of the
changes with our computer analyses using period analyses. But
many years earlier, the same work had been done very well by
Romano and Engel in 1944 (AMM Arch Nburol Phyohiat.,51:356-377)
using hand methods. Should these prove too painful or expensive,
and a frequency analyser unavailable, we would be willing to
cooperate, should you be able to collect the tapes necessary
for our analyses.
most important measure would, indeed, be the EKG and
heart rate, and these could also be analyzed using some of the
available computer processing methods. But they can also be
done by hand and eye.
A

I

am

not clear about the 'csrdiovascular toxicity of the
have not been too impressed with the cardiovascular

tricyclics'. I

effects of our compounds except for thioridazine, which does have
clearly defined effects on cardiac function, and is interdicted
on that score in my units.
Hickey

is busy planning an extensive set of studies,

I am delighted to have him back. Give my best to
John Kramer (should he return from his infatuation

and
Elliott and
with the W.H.)

Bank

Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

W”

_W. _r_.-wee_.

.v—w ..

m v»

�</text>
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                    <text>F”

1...’

.r.“_._.e_m__.v...~w

twmwu—WW—t— ‘va-xmm vm—v

20 September 1971

Dr. 2. Taintor
462 Grider Street
Buffalo, New York
Dear Dr.

Tainter,

would be pleased to participate in the continuing
education program on November 6, 1971 on the subject of
Narcotic Antagonists in the Treatment of Opiate Dependence.
In the event that I am unable to pparticipate, Dr. Richard
Reenick of our staff will present our experience.
We

of

The
Max

report should be listed as

a

joint presentation

Fink, H.D., Richard Reanick, H.D. and Arthur Zeke,
Thank you

M.D.

for your invitation.
Sincerely yours,
Max

Fink ’ NJ).

Professor of Psychiatry

�</text>
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                    <text>mum-war:
1'

"my

VAWU.MWW.W

.w—n-p—vrmw-

w
_

SepTember 20, i97l

._.wuwv.-mu.w

.

pmmwwv

MW

5.
w.

w.

awn

uw-ww

nwmvvv'

Dear KaThy,
am enclosing anoTher of The ECT papers. This one has
exTensive
revision, and would apprecleTe your help.
undergone
Please refype a clean draff, omiTTlng The Tables and references.
in The TexT, check The references which should be ciTed noT
as superscrist, buT ln ( ).
i

i

rv

When The

do 50. Send The
mnumpww

i

Dr. WalTer Essman

DeparTmenT of Psychology

Queens College -

Flushing,

“mg-”Wm,

v-u

drafT is compleTed, if your can xerox a copy,
original and The drafT which ediTed To:

New

CUNY

York

il367

Send The xerox To me.

if

you cannoT geT The Typed drafT xeroxed, send The
and
Typed drafT To Renee and she will send The xeroxed
original
To WalT Essman.

i'm leaving for Europe Tomorrow, and shall reTurn on
OcTober 7. Try To geT The drafTs To WaiT Essman in Time for me
To geT Them back.
There are

Two To

go, wlfh The deadline moved up To l0/l5.

Renee seems To be doing well, even amid The usual confusion.
have SpenT The lasT week in WashingTon, Kalamazoo, and Richmond;
and find myself in AThens, AmsTerdam, and Wurzburg nesT few weeks.
The flying is sfalied: would you believe ThaT if has rained or
been lFR every day in SepTember ThaT l have been home i
i

Keep George happy, and your

fingers flying.
My

love,

�</text>
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                    <text>September 19, 1971
Dr. Leon Hellman

Montefiore Hospital
Bronx, New York
Dear Leon,
My thanks for your advice and help for Mickey Taylor.
returned from his visit enthusiastic about his work and
duly concerned_thst a proper evaluation of his questions
required support and facilities that were beyond the means of

He

our Department.

0n inquiry in our medical school, he was referred to
Dr. A, Louis Sothren, who has some facilities similar to
your own. He has discussed the protocol with Mickey Taylor,
and following your recommendations a protocol is being prepared

for

NIMH.

I have urged him to consult
grateful for your advice and help.
My best regards for a happy

you and continue
new

to

be

year.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

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                    <text>19

September 1971

Dr. R. ﬂechoulam
School 03 Pharmacy

Hebrew University
Jerusalem

Dear Dr. Mechoulam,

Following our interesting discussions in New York, I
met with Dr. Bernard Loev and his associates at SKF, to request
supplies of SKF 5390 (EA 1476) and that either they or I file
an IND for studies of this compound in man. He has written that
they are unwilling to file an IND, unwilling to provide the
compound, or to support an IND from my laboratory.
He indicated that he expected you in Philadelphia
about October 11. Perhaps you could visit us in ﬂew York to

discuss this further

?

Interest in a long acting antagonist is all at the
verbal level in the 8.5. today, but if you wish to propose an
attack on the problem, it is altogether possible that funds could

be found by Dr. Freedman.
Have a

pleasant trip West.
Sincerely yours,
Fink, 3.9.
Professor of Psychiatry

Max

P.S. I will be out of the

U.S

until October

8.

�</text>
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                    <text>l9 September l97l
Arthur Sugerman, M.B.
Neuropsychiatric Institute
Princeton, New Jersey

A.
NJ

Dear Art,
has been a long time since we chatted about ECDEU
reading
affairs, or about stocks, and I was reminded of thisin in the
addicts
in
narcotic
on
recent
prazepam
report
your
Journal of Clinical Pharmacology. I found your report interesting

It

for it confirmed some of our observations with tybamate in a
similar group of subjects. We had tried to maintain patients on
tybamate during the post-drug withdrawal period, in the hOpe
thatbb tybamate would 'block' the craving for opiates and reduce
recidivism.

Unfortunately, our patients liked tybamate itself,
that
particularly when combined with alcohol. They reported
small doses of tybamate and small doses of alcohol acted

synergistically to give
can do

them a cheap

'high‘.

So far. there seems to be little more that we
for the Opiate dependent but reduce their symptoms

during withdrawal, or maintain them on methadone indefinitely.
the antagonists show these
still believe that our workwewith
have had difficulty in convincing
drugs to be most useful, but
the authorities that more efforts should be spent in this area.

we

My

best regards.

and

my

best wishes for

a happy new

Sincerely yours,
Max

Fink, M.D.

year.

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                    <text>.

7“,.

em...-

W.

,,___ .vvwr _~_...__..... , "wave—”mp-.."

WWW..-

..

94% 7/

Ron. Paul Rogers
U.S. House of Representatives
Washington, D.C.
Dear Mr. Rogers,
You may recall that this laboratory has been in the
forefront of research in the use of narcotic antagonists (naloxone and cyclazocine) in the treatment and prophylaxis of
opiate abuse; and that we organized the 1970 missing on this
subject at the New York Academy of Medicine. I am writing to
you at the suggestion of Professor Daniel Freedman of the
University of Chicago, for I shared with him some of my doubts
about our present national effort, and he recommended that I

share these doubts with you.

September 8 meeting on new approaches to
the treatment of Opiate abuse organized by Drs. Jerome Jaffe and
Robert Rees of the special office of the President. That meeting
was a distinct disappointment, for the agenda was poorly prepared;
the chairman was clearly ambivalent about the approaches and
his interest in them; and the industry representatives were

I attended the

unwilling to alter their present committments, expressing the
that there was little more that could be done.

view

Your committee is reviewing the President's reqiest for
the development of a centralized approach to drug abuse. Such
an office could have some merit, were the officers available
with experience and knwledge to lead the national effort. The
preliminary suggestions for the control of abuse in the military;
their cavalier dismissal of suggestions for prophylaxis in the
armed forces; and their apparent mishandling of the problem of
narcotic antagonists makes me less than sanguine that the
President's request will serve a useful purpose. It is true that
the established agency for research, the National Institute of
Hental Health, his lacked leadership, but the approach of
a new office, with its own large staff and apparent inexperience
cannot serve a useful public purpose.
h
1. a “933i :5.1:“?og‘ﬁﬁztézr:3§1§°2%ngohhassle};ease,tags
is also probable
that naloxone is the drug of choice at present. It have
a distinct
naloxone
and
may
that a combination of cyclasocine
role in the present crisis in opiate dependence, particplarly in
h

�, .,.

. .

.

.w.»,-:..-.Wvn-“r-p-V awn”.- .m «an—~71

.rr-wrm—V~ﬁv-nTv‘r -,..

.

,

a confined population, as in the
treatment and for prophylaxis.

.

.

-“T—vr.w..,..«.

wrew...‘

military in

.—

W¢U&lt;

‘rr—wr

5w

mung—.7,“

Viet—Nai, both

~

u

—-

weww

v

for

the meeting, I would conclude that Rude/DuPont are
the efforts necessary to develop a long acting
antagonist. While they ascribe their difficulties to the practical
issues of raw materials, patents and limited staff, it is clear
that they have other issues of greater concern to them, and
their efforts in the area of drug abuse control are only the
minimum required to assuage public demands.
From

not able to

make

It is also my opinion that the leadership in the
President's office is also ambivalent, for they have not the

experience with the combination of naloxone and cyclzocine, as
well as having a public committment to methadone.
For these reasons, among others,

it

may

be useful for

your Committee to consider the special commission approac -a commission dedicated to evaluate the possible uses and
roles for the narcotic antagonists. Such a commission could:
.2

m'rwrsmﬂv

assure adequate supplies of naloxone for clinical
in
trials, part by alleviating the artificial quotas for the
raw materials, principally thebaine;

I

coordinate, finance, and evaluate clinical
and naloxone, particularly in prophylaxis

~

V-I'

studies of cyclazocine
in the military;

invite contracts for the development of a long
formulation
of naloxone— (our experience with a
acting
silastic polymer formulation of naloxone makes us believe this
approach to be feasible);
support studies of

antagonists; and,

new

provide an independent evaluation of methadone
and the antagonists in treatment.
rv-vwnm—t—w-u

w-rnwmvr

«aroma-w,

m

(
-.q.

"v“

w.

was»:

v

&gt;'rvrvr»raraul

Such a commission could

include

some

of the industry

representatives, called together at your request by the P.M.A.,
and some independent university members.
The President's interest in drug abuse is commendable;
the approach of developing a new office committeed to no
definite goal makes it likely that it will be less efficient
than a commission approach- even one designed as an integral
part of the existing National Institute of Mental Health
structure could be considered.

I shall be in

Europe

until October 8, but should

you or

interested in discussing these views further, I
your staff
shall be available thereafter.
be

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

:

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w...

a'r&lt;'»"fF'.-,Immr77“l'n-r)

“

September 19, 1971

Prof. Dr.

H. M. van Praag

Psychiatric Univ. Clinic
Oostersingel

S9

Groningen, Holland
Dear Dr. Van Praag,

I look forward to joining you in Amsterdam on September
30. ﬂy present plans call for my arrival on Wednesday, September
29 about noon, and I have booked a room at the Amsterdam Hilton.
Any messages regarding last minute arrangements can be sent there.
Professor Alfred Freedman has elected to prepare and He
read the report on "Cannabis Psychosis' that you requested.
is scheduled to arrive early Wednesday morning on an overnight

flight

from New York.

In the cannabis discussion, should you wish it, we could
chronic studies in volunteers,
present the findings of our acute and
and
EEG
some preliminary data on
the
changes,
with emphasis on
Athens.
from
acnnabis
users
our study of chronic
manuscripts are not fully prepared, but should be
available to you by October 15 at the latest.
The

Again,

my

thanks for your kind

invitation.
Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiatry

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war-vlw'm

~w¢w

um..—

.
.4.

vv-u—I—vu-

5‘
Mar

w—w—w—w

‘.'.~“

w”...

mum-wuw

an,“

'frrr-

September 19, 1971

Dear Tom,

I have received a mott helpful and affirmative response
from Dr. Jan Ottosson, and I am.encouraged that we will be able

to carry out our goals.
w

1m.

See you about October 10.

«Wu

:vv

"r‘

—,'

«,.w«.gm\

Sincerely yours,

14-21-

:3«\

Max

(VF-wtmw—F‘V‘y

E

“M

;;
391‘»;

.&lt;

r'nﬁ'

.-

avg!

Fink,

24.1).

�</text>
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:I;

”5!":W‘m-

‘”

"
2:
1.
r

2;

September 17, 1971
PD

Dr. U.

J. Jovanovic

Universitats‘Nervenklinik u. Polyklinik

87 Wurzburg
West Germany

Dear Dr. Jovenovic,
York on Pan Am Flight 100 on
Wednesday morning, September 22, arriving Frankfurt at
11:59 p.m. Wednesday evening. You have arranged for me to
stay at the Hotel Rebstock, and I would be grateful if you
would notify the hotel of my late arrival, and arrange

I plan to leave

transportation

New

if that is still feasible.

I look forward to the conference with enthusiasm.

“Wary“,vzﬂ:

‘wr'n-

2"

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

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                    <text>Septemb a' 17, 1971
Dear Costas,

First, let me thank you for the cortesy and assistance
staff gave Dr. Volavka. He returned tired, but assured

you and your

that the studies will provide the data

we

anticipated.

I met Costas Miras and discussed the continuation of the
present studies, my desire to bring in some U.S. cannabis for
trials, and the proposed extension of the studies you suggested.
For the cannabis, he did not believe that a direct import license
would be as useful‘as a shipment via the W.H.0. in Geneva, and
indicated that he Would make the necessary arrangements.
I will be in Europe on Wednesday, and should be able to
Spend a few days in Athens. I am scheduled to arrive on Saturday
about noon or 1 p.m., and can remain until Wednesday morning.
Costas Miras said that he would be available , and I would
appreciate

if

we

could discuss the following:

1. The data of phase

I,

and anynhelp we can give you;

2. Phase 2, the specific protocols add timetables;

rent;

3. Equipment needed for part 2 (can you arrange to
he lend you some equipment; or, can you make your

may

tape recorder available);

4. Importation of U.S. cannabis, and the export of
your samples for our assay;
5. your proposals for a new contract.

I hope this agenda is agreeable. I have requested
accommodations at the Grand Bretagne, and would be pleased if I
can meet a member of your staff on Saturday afternoon to go over
the available data.
My

best regards.
Sincerely yours,
Max

Fink, M.D.

�</text>
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                    <text>September 17, 1971
Dr. Ronald Lipmao
FEE—HIM}!

5600 Fishers Lane
Rockville, Maryland

20852

Dear Ron,

visited mo thuraday, and I found his study
he is
interesting, his goals a-bitioua. To the extant thorn
and
intcraated
able
wa
are
interested in evaluating drug effects,
data
about
in helping him. I gave him detailed suggestions
recording, equipment, processing costs, and soot background
of the experiences of my laboratory.
Dr. Sheard

‘

In addition, I referred him to Dr. Russell Monroe who
has a similar project in Baltimore; suggested he consider the
use of an activation test (the alpha-chloralosa procedure, for
example) to classify his patients; and wrote a letter of introduction to Russ Monroe for him. Both men have similar processing
problems, similar quostions, and in this day of limited funds, their
working in tandem may reduce their coats.
With regard to the lactate proposal, I discussed your
call with Dra. Taylor and Abrams, and suggested that they call
you directly for specific ways that they can improve their
preposal. Should they wish to re~apply and accept your advice,

I indicated that

my

prior agreement

was

assured.

for your efforts on their behalfm
9r. Sheard to me. I hope I was helpful to him.
Thanks

and

for referring

Sincerely yours,
Fink, ﬂ.D.
Professor of Psychiatry

Max

�</text>
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                    <text>September 17, 1971
Dr. Russell Monroe

University Hospital
Baltimore, Maryland
Dear Russ,

letter.

A

combination of happenstances leads

me

to write this

episodic states/alpha
application for a study of me
by NIMH for an 'outside'
chloralose/EEG/psychopaths was sent to
hear, there were some questions
opinion. As you will undoubtedly
and I believe Dr.
by the committee about the EEG quantification,
Your

Shah

will call

you about

this.

the PRB-NIMH staff referred Dr. Michael
in a similar
Sheard of Yale University to me. He is interested
behavioral
EEG
and
problem, and plans to evaluate lithium, itsThe PRB sent him to
effects, in psychopaths in a reformatory.
systems to
me for the possibility of using our quantification
parallel to your own, and
assist him. His studies are remarkably
studies,
I took the liberty of telling him of your planned
He
enquired as to
suggesting that he contact you directly.
EEG
for classification,
the availability of procedures to use the of activated
EEG,
and I was able to review the whole problem
including your interest in alpha-chloralose.
well trained;
He is an interesting, bright, and apparently
and you should find it interesting to meet him.
David Paskeqitz.
As part of my review, I read the report by
he or you wish to visit us, it may be
It is good, and should
raises have been
mutually helpful. Some of the issues hehave
some data that could
examined by my associates, and we may
The same day,

make your

7143;.

4"???"

31‘?

My

efforts easier

and more rewarding.

best regards.
Sincerely yours,

km“:

.

Max

Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>"-

-w

an»

w-.r&lt;y—,—.»n

unnrmmw

September 14, 1971
Mr.

Pierce

Immigration Service
20 West Broadway

New

York City

Dear Mr.

Pierce,

Following our distussion, I am filing the enclosed
B-l petition on behalf of Alexander Maurice DON of Johannesburg,
South Africa. Dr. Don, who received training in psychiatry
with me in St. Louis in 1964-65, has been invited by this
Department to join our faculty. His experience in psychopharmacology
equips him to develop a special program in the treatment of
opiate dependent veterans who are now being admitted to the

facility at Montrose,

York. Through our Dean's Committee
we have been asked to
establish the treatment program on a ’crash' basis, recognizing
the emergency nature of the problem as outlined by the

V.A.

New

affiliation with that treatment center,

President in June.

Dr. Don Besires to emigrate to the 6.5. The consul in
Johannesburg has indicated to him that no visa can, in due
course, be issued prio to December of this year.

It is our belief that his early arrival will permit us
to establish the treatment programs when they are urgently
requested. We do not have the personnel to establish this
unit, and have invited Dr. Don to do so.
We

would be

grateful for your assistance in bringing

this scientist to the United States.

will reimburse your office for the cost of cables
to Johannesburg pursuant to the authorization under this application.
we

Sincerely yours,
Fink, M.D.
Professor of psyciatry

Max

�</text>
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                    <text>September 13, 1971

Fritz Freyhan,
Editor,

M.D.

Comprehensive Peychiatry
153 West 11 Street
New York 10011
Dear

Fritz,
I

am

pleased to enclose a draft copy of a report of

our experiences with multiple monitored convulsive therapy,
Clinical Experiences with multiple Electrooonvulsive Treatments,
for your consideration for Comprehensive Psychiatry.
We have been able to assess the clinical efficacy
and the effects on memory of unilateral electrode placements,
and these studies led us to multiple treatments. We have been

surprised that the clinical results of multiple treatments
is not much greater than one seizure—- suggesting that the
biochemical changes after one seizure are near maximal, and
that some development, in time, is necessary for the full
development of the changes which are the basis for clinical
results. The finding is similar to the observations with
antidepressant medications.
I believe the report will interest our readers.
my

best regards.
Sincerely yours,
Fink, 24.1).
Professor of Psychiatry

Max

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                    <text>"A

September 13, 1971
Dear Jon,
Two

One
One

it

Enclosed is the third paper for SeminaAA in Pbychiatny.
others are in final typing and should be out by the week~end.
is in fair shape and will have to go through another revision.
paper is still eluding me, and I will try again to extract

from

St. Louis.

._.».-,-

awn-rm

,Vnr'a",

I have asked three 'experts' to answer our questions.
set is in, the others should follow in a few days.
As

WM'W

.‘

'r

10 days,

return.

I wrote, unfortunately I will be in Europe for
but.should wrap it up within a few days on my

I heard that

you testified before Congress about the
you wish another 'expert' to appear,
be glad to do so. I had the opportunity to see him in action

Jaffe

bill. If

I'll

with representatives of industry regarding a development of
a long-acting antagonist, and was not particularly impressed.
v

r
-"

My

best regards.

U'VE'V‘

Sincerely yours,
"IV-\n,‘1-n'l,ﬂ'.?'ﬂ'

~17

0'

.arﬂ'vwwr‘v‘wa‘wﬂ

~mW§rw

mm:

Max

Fink, M.D.

One

�</text>
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                    <text>September 12, 1971
Dr. Thomas Williams
VA

Hospital
Lake City, Utah

Salt

Dear Tom,

I have reserved space at the Dorado Beach Hotel in
Pnert Rico for the period April 18 to 21, 1972.

I

have not heard from Ottosson, and

been returned.

neither letter has

I will be away from September 21 to October 7, I
am troubled that I am unable to do much more until then.
In our conversation, I recall your saying that you will be East
about that time. Please arrange to visit me in New York
during the week of October 10. I think one day's work then
should get us flying.
As

Hope yau have settled in at Utah.
summary on Depression so much

Incidentally, I
that I am having
distributed to the resident staff. I trust that it is not
liked your

'confidential'

any longer.

Sincerely yours,
Hex Fink, M.D.

it

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                    <text>September 12, 1971
Dr. Franz Josph Kuhn

Boehringer-Ingelheim

West Germany

Dear Dr. Kuhn,

data of the GPA—l Dopa study is still being
analyses are completed and these show some
effects for l-Dopa but more for GPA. The l-Dopa effect is
probably not significantly different from placebo.
The

analyzed.

promise

The EEG

The boys

it

are

now completing

the behavioral data, and

by the end of the next week.

I am writing today to clarify some points about my next
to
Europe. I plan to be at the allep EEG meetings in
trip
wurzburg, and had hoped to arrange to visit Ingelheim with
you, should this type of visit be useful to you in discussing
EEG analyses with your oo-workers.
Earlier this week, Dr.
Terry called to say that attempts were being made for me to
visit Munich and to hold some conferences in other laboratories.
While such visits are most enlightening and occasionally useful,
I do not have the time to go on the lecture trail during this
trip. It is necessary that I spend as much time as possible
in Athens and Amsterdam.to carry out my own work in these

cities.

For

this reason,

and since I have not heard directly from
planning to go from Wﬂrzburg to Athens. In the event that
a visit to Ingelheim would be potentially useful to you and to
my laboratory, I shall be pleased to arrange a visit on another
trip, as I plan to be in EurOpe on a few occasions during the next
six months (until my work in Athens 15 completed.

you, I

am

I will send the data and the analyses as soon as the boys
have completed the work.
my

best regards.

Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

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                    <text>Spetember 12, 1971
Major John O'Brien
23

Inf. Division

South Viet—Nam

Dear Major,
Your story in the New York Times today prompts me to write
to you, and to send you the enclosed report of research in the
treatment of opiate dependence, as these data may be useful to

Since this report was written, it has been possible to
induct more than 40 patients into cyclazocine therapy without
any side effects in 4 days, by combining two of the drugs
listed here, cyclazocine and naloxone.
you.

It

my contention since late Spring when the
of
the
crisis in heroin use in Viet-Nam reached
first details
the prophylactic use of cyclazocine and
that
our newspapers,
naloxone, given daily to troops in an andemeic area, should
provide protection against drug abuse, in much the same way
that the daily administration of atabrine was useful during
an earlier war in preventing malaria.

has been

These data have been submitted to the Department of
Defense and the recommendations have been made in the New York
Times. However, both the DOD and the new office of the President
are unwilling to risk the problems of a trial in Viet—Nam. To
undertake a test study, they say, would be too expensive and
too difficult, and would not receive the support of the field
commanders._

Should these data interest you in your efforts, perhaps
inquiries from the field may Spur some trials.
Good luck

in your efforts

!

Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry
P.S. Should you doubt my credentials, please know that I am
a consultant to the FDA, to various industries, and was
Captain, MC during the second WW.

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                    <text>'mv’tryu;

September 10, 1971
Dr. Ralph Jacobsen
Endo

Laboratories

Garden City,

New

York

Dear Ralph,

I

subjects

am pleased to enclose
who received naloxone

the case summaries of nine

in oral doses above

200 mg/day,

received doses to 3,000 mg/day. We
including subjects
have requested the complete hematologic profiles obtained by
Dr. Lerner and his staff, and these are included.
who

present study program, using naloxone concentrate,
is underway. Dr. Zaks has screened a number of applicants, and
these are now in their periods of detoxification and medical
examinations.
The

pleasure to see you in Washington last week,
I look forward to the development of both EN 1639—A and
naloxone pamoate, as both compounds seem to hold much promise for
the eventual solution of the problem of opiate dependence, not
only in our soldiers in Southeast Asia, but the many patients
in our ghettos as well.
and

It

was a

Thank you, again,

for your support

and enthusiasm.

Sincerely yours,

‘
.,

.
221-,

.£~mvﬂwmnﬂ‘mn-vr:

Fink, M.D.
Professor of Psychiatry

Max

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                    <text>Septemebre 10, 1971

Dear Andy,

I spent 6-days in Europe,
exhausted, returned to find your
some maneuvers

for you.

two

in Washington, and

letters,

First, as to your questions.

and to the Department of Psychiatry,

somewhat

and immediately

tried

Your appointment to the V.A.

should,like all appointments at

the medical school, be independent of me or any other person—all appointments are for an indefinite term, and while tenure
is granted only after five years service, there are no discharges
of staff members except with an extensive warning.
to the visa, I called Washington and after

As

many

calls,

reached the best office. I indicated that your appointment to the
VA was in the national interest since you are coming to develop
a drug addiction treatment program focussed on the returning

Viet—Nam

file

a

veteran. Under these conditions,

special

will allow

"Temporary 'H"

petition"-~

it is

and

if

possible to
approved,

it

you to come to the states, and wait here for the
permanent number to be assigned. At that time, you will have
to visit the immigration offices (possibly in Washington) for
certain formalities. With this information, I am prepared to
file this petition on your behalf, and will do so as soon as it

is received.

The State Board problem is more thorny. Dr. Volavka has
struggled with the Board, and I would defer your questions to
him. As he is in Athens for a.few weeks, I will hold up this
inquiry until he returns, and ask hint to answer you.

I do not know about bathelo quarters at either location,
but will defer this inquiry also until some data is established
and then can ask

specifically.

In Washington this week, the principal question was the
ways to expedite the development of a narcotic antagonist
of long duration and to improve on the available drugs. Funds are
available, and should your enthusiasm not flag, I am confident
that we can build as strong a program as your energies will allow.

best

I am up to my eyeballs in work; and on top of it all, am
planning to return to Europe on September 21 for two or three
weeks. Our projects in Athens are doing very well; and the work
will be expanded to Jamaica this winter. I look forward to your
joingng the group-- I now have four fine co-workers in clinical
programs, and three experimentalists-- my best group ever.
Our

best to Betty.
As

ever,

�</text>
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                    <text>m -.-. .. -&lt;u~

.31...- m' ATV-nﬂplw—H

September 10, 1971

Director
BNDD

Department of Justice
Washington, D.C. 20537
Dear

Sir,

I have filed for and hold BNDD registrations #
for the investigation of opiates
and cannabis derivatives. In requesting supplies of cannabis
from the National Institute of Health, Dr. Monique Broude
requested that I submit, in addition to the proper protocols,
completed order forms, 9 222C.

AF

1732103 and PF 002455

I am writing to request a supply of these forms,
properly imprinted, for the continued use of these study

programs.

Thank you

for your cooperation.
Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>September 9. 1971
Dr. Louis A. Gottscha1k
Professor and Chief

Department of Psychiatry

5 Human

University of Ca1ifornia, Irvine
Ca1ifornia Co11ege of Medicine

Behavior

S. Manchester Avenue
Orange, Ca1ifornia 92668
101

Dear Lou:

writing in support of the app1ication of Dr. JohnhimKramer
for promotion. I am de1ighted to do so. for I have known
since 1930 and have fo11owed his career with interest.
I am

received part of his training at Hi11side Hospita1 with me,
exhibited exce11ence as a researcher. which 1ed me to recommend
him for a research career. He e1ected to try his hand in private
practice and, as you know, returned to an academic career about
six years ago.
Since then, he has contributed to our understanding of
opiate and amphetamine psychosis. In his presentations I to
have
scientific societies. he is carefu1 and conservative.
for
me
a
in
him
formu1ating
program
asked
to assist
recentiy
been
have
in
and
regard
this
contributions
his
heroin de1ivery
dependence
in
nationa1
His
prominence
opiate
most bsefu1.
research has 1ed to his c1ose association with the specia1 office
of the President, devoted to drug abuse contro1.
Because of his research interests, his keen awareness of
po1itica1 issues. and his contributions to the prob1ems of
He

drug dependence, I

am

p1eased to recommend him for promotion.
Sincere1y yours,

Max

MH/rs

Fink,

M.D.

�</text>
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                    <text>September 9, 1971

Mr. Leon

Brill, Director

Dear Mr.

Brill:

Bureau of Program Planning
N.Y. Narcotic Control Commission
1855 Broadway
New York, New York
10023

writing in regard to your request for permission to reprint
our article "Narcotics Antagonists: Another Approach to Addiction Therapy".
This article has appeared in a principal Journal and has been reprinted
I am

publications already. It would serve little purpose and would
reflect on our integrity to have it reprinted again.
in

two

I

regret that

I cannot

grant permission to reprint this material.
Sincerely yours,
Max

MF/rs

Fink,

M.D.

�</text>
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                    <text>September 9, 1971

It

To Whom

May

Concern:
RE:

Maureen Garcia

Mrs. Maureen Garcia has been working for me as an EEG
Technician since October 19. 1970. She received her training

at

New

York

University.

is a dedicated worker with a serious interest in providing
artifact free records. She is fuiiy trained, and I believe, can
make significant contributions to the A.S.E.T.
She

Sincereiy yours,
Max

MF/rs

Fink,

M.D.

�</text>
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                    <text>September 7, l97l

Dr. G.F. Blane
G.F. BLANE, RECKITT
Pull, England

&amp; COLMAN

Dear Gerry:

Enclosed is a U.S. import permit #3252 for the
1

tnﬂlsfer of

official

of Etorphine. I would appreciate your
sending copies of the available reports on the human use of
Etorphine, and as much of Etorphine as you can make available.
,

I have

gm.

Just returned

from Europe and will be

the

attending
meetings in Washington on narcotic antagonists on September 9.
Many thanks for your cooperation.
Sincerely yours,
Max

MF/rs

Fink,

M.D.

�</text>
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                    <text>November 25, 1971

Dear Dr.

Aylett,

Yesterday afternoon, the mail delivery brought your letter,
dated October 7, 1971, indicating that you would be in New York
this
week, and would like to visit. I very much regret that the letter
had not arrived earlier, for I would surely have written and made the
arrangements you requested.
For your information, the letter was postmarked Oct 8
from S.E.5; the postage was 9 pence; marked airmail-— but
must have
been sent by surface mail.

it

Should your office receive this in time to send you a
note,
would be pleased to have you call on December 10, for I will
be
in my laboratory, and would be pleased to have you visit:
call~ 212 369 8488; or at night— 516 466 5444.

we

Regretfully,
sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>1..W— Mm:—

mm.

,....,,,_..—w_v—————

November 25, 1971

Representative Paul Rogers

u.s.

House of Representatives
Washington, D.C.
Dear Mr. Rogers,

It

was kind of you to spend so much time

to discuss the pending drug abuse

legislation.

last Friday

return to New York, I discussed the suggestions for
increased participation by scientists for the hearings next week with
On my

Drs. Alfred Freedman (New York ledical College), Jonathan 0? Cole
(Boston University), and Daniel X. Freedman (Chicago 0.), and each
indicated that participation in the hearings would be beneficial.
Should

it

Should

this

be useful, I will be available on Thurdday,
Besenber or Friday, December 3. I plan to return from meetings
in Mexico City Wednesday afternoon, and could change my itinerary to
arrive in Washington Wednesday evening.
2

be

useful, please call

(212 369 7900 x245,246) and my secretary will
telex the Camino Real Hotel in Mexico City.

my

office in

New

get the message to

York
me. Or,

Dre. Alfred Freedman, Jonathan 0. Cole and Daniel Freedman
AP: 212 369 7900 x222; JOC:
can also appear and can be reached at
617 436 6000; and DXP: Department of Psychiatry, U. Chicago.
—

legislation
the nation.

Again,

my

thanks for the opportunity to discuss the pending

which seems so important to the drug abuse control

efforts of

Sincerely yours,
Max

FInk, M.D.

Professor of Fsychiatry

�</text>
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                    <text>November 23, 1971

David

40

New

J. Impastato,

Fifth

York,

Avenue
New

M.D.

York 10011

Dear David:
Your comments on the Q
A section for the forthcoming
issue of Seminars in Psychiatry were most helpful. We have re—
vised the sections most relevant to the suggestions, and I am
pleased to enclose a revised copy for your files.
&amp;

candor.

Again,

we

want to thank you

for your cooperation

Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

Ming
Enc.

and

�</text>
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                    <text>Novoaber 23, 1971

Honorable Mr. John Tunney
U.S. Senate

washington, D.C. 20510
Dear Mr. Tunney:
2809

In response to your suggestion, I have read the text of Sonata

- a bill to establish six regional centers of excellence in drug

abuse research and education.

The intent is admirable and the mission necessary. But the
has two major flaws it defines the centers on a regional basis;
and in the text, allows tne assignment to possibly be made by the White

bill

—

House.

Selection of centers on a regional basis will inhibit the de—
velopment of centers in proximity to each other; and encourage some to
develop where no experience exists. If one center is encouraged in the
far West, should it be in Los Angelou, Palo Alto, or Portland ~ three
active research centers? In New York, should it be at the ﬂew York ﬂedical Collage, Downstatc ﬂedical Center, Albert Einstein Medical Center
or SUNY at Stony arook — each center now having active programs and fine
leadcra?
The proaant Senate 3111, 82097, provides for a transfer of authority tron NINE to the White House. This transfer, for research and
education, is fraught with the hazard that the White House will enclurnge
political appointees without adequate regard for scientific experience.
It will be a handipap to the present research efforts in drug abuse, al-

coholian, and psychopharnacology to have the authority for research transferred to tho limited team aasemblod there now. The good intentions of

$2809

will be subject to political considerations, independent of excel-

lence of centcra, and will not achieva the resulta wiahcd for
ity in in the White Houac.

if

euthote

�Honorable Hr. John Tunnoy

November 23. 1971

it

not true that tho mechanisms for the results anticipated
exist in the program grants and the career awards of
the National Institute of Mental Roalth? Perhaps the aaciact way to
achieve the mission is to allocate additional, earmarked funds for drug
abuse research and training (an: on a regional basis). Indeed, the lim—
itations in tho present prograanatic aupport in the shortage of funds,
not the shortage of applicant: or ideas.
Is

by 32809 already

Should you wish to discuss these
I can be reached at 212~369-7900.

comments

in public or in caucra,

Sincerely yours,
ﬂax Fink, H.D.

Professor of Psychiatry

MF:ig

cc; Senator d. Hughes, Iowa
Senator J. Javits, New York

�</text>
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                    <text>November 23, 1971

Lothsr B. Kalinowsky, ﬁ.D.
115 East 82nd Street
York, ﬂew York 10028

New

Dear bother:
Your comments about the

Q

s

A

were most cogent.

We very much
regret 'mieleading' you. In our first discussion, I had hoped to be able to quote the answers from each re~
spondent without any summary. out so many responses were of the ’yee'
and 'uo' variety, which seemed unreadable unless we provided text and
substance. This, Dick and I did. Perhaps, it is unfortunate that we
tended to quote the more complete responses, even when we disagreed
with them. Your comments led us to edit the answers, and I am enclosing
a revised text.

Should this text meet with your approval, we can make these
corrections in the gslleys. Should this correction not meet with your
approval, perhaps you would make other corrections, and we could edit
the galleys.

If there is another

course that

will serve your interests

and those of our readers, we should be pleased to hear from you. I
expect to use you in Mexico City, where we may be able to have an op-

portunity to resolve this question at leisure.

Again, we are grateful for your candor and c00perstion.

Sincerely yours,
ﬂax Fink, H.D.

Professor of Psychiatry

Hfzig
Enc.

�</text>
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                    <text>Hounnbcr 23, 1971

Mr. Karat Bosteman

Deputy Director
Division of Narcotic Addiction
&amp;

Drug Abuse

ﬁlﬂh

5600 Fishers Lane
Rockville, Maryland 20852

Dear Karst:
have been invited to participate in the Fourth
National Conference on ﬁethadone Treatment in San Francisco
in January. Dr. Ivan Bennett has asked that we present our
experiences with the antagonists and 1~alpha methadol. I
am writing to ask support for one investigator to attend
We

this meeting.

The

is

principal support for research for opiate

from the stata of ﬂow York. Last week the
commission cancollcd tho oxpcnditure of all travel funds,
making attendance at this stating unfaasible for us.

dependence

IIIth of

Ho

would

b: gratoful for financial support for

IV

staff to attend this routing.

Hy

beat with...
Sinccroly yours,
22:: Pink,

5.».

Professor of Psychiatry
83:13

8

�</text>
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                    <text>._.W_,..r... _. .1wh...

.

.

'vayvi- ..

.1.

v...—w...,._...y-v——

-

Hovaaber 23, 1971

Dr. R. Mechoulam

Laboratory of Hatural Producta
of Pharmacy
The ﬁchrew University of Jerusalem
Faculty of Medicine
Jerua elem , la rael
The School

Bear br. Mechoulam:

Separately I have sent you the import permit of

EA

1476.

There is much interest in the antagonists, and particularly in
a long acting formulation in this country. I have attended two meetings
focused on this problem during the past month. The immediate focus of
interest is in naloxona pamoate, which in animal trials releases naloxona
for 10—14 days. we will begin an assay of this material in January.
At present, the two best antagonists are naloxone and l—cyclarocinc,.
Naloxone is enclosed. For l-cyclaaocinc, samples would have to be ob—
tained from Dr. Sidney Archer, winthrop Laboratories. It is also probable
that ﬁ~5050 of Beckett &amp; Coleman may to useful, but neither lccylaaocina
or M—SOSO have racoivad touting in man. Therefore, for the present, nal~
ozone in the drug of choice. Should you believe the chemistry of cycleaocino would be a better choice, I would suggest you write Dr. Archer
for a sample of l-cyclazocino to test.

The testing is a problem. I recall that the Israeli pharmacologiata were able to assay the duration of action in animal subjects, uaing
morphine challenges. Ia that correct? Our facilities permit us to aaaay
the duration of antagonism in nan, using heroin challenges. Ha have not
been able to undertake toxicology studies in our laboratories, and have
been trying to obtain the funda to study M~5050 under a contract. Thio
it under review. Should you uaka some aanplaa available that you believe
has a long release rate, we will try to assess the animal duration (rclcaae) and if intaraating, arrange for the other trials.

�w
rrv ‘mII—u -m,.—,_..vwn—.J,u‘“

.“pwwﬁﬂ.”

.wu.n...,wm,wwwrvywvwﬁw,

November 23, 1971

Dr. R. Mechoulam

chare grateful for

E

'

be remembered to you.

your

interest,

and Dr. Freedman asks to

Sinceraly yours,
..W-wvv'ﬂ

Max

Fink ,

14.1).

Professor of Psychiatry

:ig
lie.

biF
mw—mmrmw

,w—rmm.

v
”.2.”

�</text>
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                    <text>\J

I"

ﬂovembcr 22, 1971

Harold Moisolao, 8.0.
Commissioner

Narcotic Addition Control Commission

1855 Broadway
New York, New York 10023
Dear Harold:

I have read the

list

of suggested examinations for methadone
was suggested for research
or as the basis for a more complete examination of methadone treated
patients. As a series of research issues, the suggestions are vague
and seem to reflect a general clinical neurologists' approach to a
problem, without appreciation of the complexity of tne interaction of
opiate dependence, its complications, and methadone.

effects. It is not clear whether this list

(1)

Clinical

exam:

by methadone.

routine medical,

Tue "mental

very detailed and

euphorigenic,

and usually unchanged
status”, of course, can be

is the basis for exhaustive studies of

memory,

perceptual.

Egg,

effects of methadone.

(2)

such a routine EEG is of very limited value. In the
studies that have dissected the EEG effects of methadone,
quantitative measurement: were necessary. These did not
show significant refusal differences and from our past exporionceg such differences are rare witn drugs.

(3)

Ancillary EEG: interesting theoretic speculation, with
little foundation. Despite many studies of drugs, the
AER shows changes only at vary high dosages, and these
have usually been non~contributing to our understanding.

(4)

EEG:

few

Bode:

interlacing, but probably of little relevance to

nothcdone's

mode of action. Again, only chnngcs at very
high doses of drugs or with that: which opecificolly affect

labyrinth: or vestibular nuclll (2.3.. barbiturates,
actuation).

an—

�Harold Mbisolnn, M.D.

Novonhot 22, 1971

similar to 3, 4.

(5)

Blood flow:

(6)

significant test, which is under study in many
laboratottes. Thar: at: at least 3 important issuau:
Rt undo: oinulntod conditions (9.3., drowsy); simple
R.T. and complex R.T. Also, intranodnlity and internodslity issuas are critical. If done preperly, such a
program could be of interest (oopecially simulated R.T.).

(7)

Conduction volocity: as prepared, a test of limited
value. This in a highly complex procedure that may (like
R.T.) warrant intensive study by exports, using sophis~

Rt:

A

ticated methods.

For each item, 1~7, there is
methadone treated aubject.

in each
I

ﬂy

trust those

comments

little

merit as a ”routine" test

are responsive.

If not, please call.

best.
Sincerely yours,
Max

Fink, H.D.

Professor of Psychiatry
MF:ig

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                    <text>E

Novamber 22, 1971

Dr.

J. 0.

Cole

Boston State Hospital
Boston, Massachusetts 02124
Dear Jon:
Should you wish to exoand yoor program to include EEG measures.
are pleased to couparato and analyze the tapes using our IBH 1800
systam. Our present recorder is a Hewlett Packard 3960 A (1 7/8, 3 31‘,
7 1/2 IPS, 6 track, 1/4 inch, PM) and your lab should have a compatible
recording system.

we

In addition, it is useful to have a sine wave oscillator
(similar to ﬁ.P. 2020c) and an oscilloscope monitor. We ”charga” users
according to the hours of computer time for EEG analysis and for such
statistical analyses as are required. For the usual studies you might
complete in a year, $4,000 should be very adequate.

Finally, should you need a new EEG, we have found the Grass
polygraph with 7P511 amplifiers stable and most satisfactory. For a
4-channel portable the coat is about $4,000; and an 8-chanaol about
$8,000.
We

would

to pleased to cooperate with your laboratory.
Sincerely yours,
Fink, M.D.
Protozoa: of Psychiatry

Max

MF:13

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                    <text>Novcmbcr 22, 1971

ﬁarold Mciselas, H.D.
Commissionor

Narcotic Addition Control Commission
1855 Broadway
York, ﬂew York 10323

New

Dear narold:

I

have road the

list

of Suggested examinations for methadone
was suggested for research
or as the basis for a more complete examination of methadone treatcd
patients. As a caries of research issues, the suggastions are vague
and seem to reflect a general clinical neurologists' approach to a
problem, without appreciation of tho complexity of the interaction of
opiate dependence, its complications, and methadone.

effects. It is not clear whether this list

(1)

Clinical exam: routine medical, and usually unchanged
by methadone. The "mental status”, of course, can be

very detailed and

euphorigunic,

(2)

(3)

(4)

is the basic for exhaustive studies of

memory,

perceptual, 355, effects of methadone.

ouch a routine EEG is of very limited value. In the
studies that have dissected the EEG effects of methadone,
quantitative measurlncnts were necessary. These did not
show significant regional differences and from our past cx~
variance, such differences are rare with drugs.
EEG:

few

Ancillary

interesting theoretic speculation, with
Despite many studies of drugs, the
changes only ct very high dosages, and tho-o
hcvc usually been non-contributing to our understanding.
EEG:

little foundation.
AER shows

20M: interesting, but probably of little relevance to
nothadonc‘s mode of action. Again, only changes at very
high doccc of drugs or with those which specifically affect

labyrinth: or vcstibulor nuclei (0.3., barbiturates,

esthctica).

an~

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                    <text>Howunbor 22, 1971

Dr. Donald

J. Jcnder

Department of Pharmacology
UCLA School of ﬁcdiciue
Los Angeles, California 90024
Dear Dr. Jender:

l was pleased to hour of your work and the techniques for
measuring low levels of acetylcholine, at the ﬁIHH meeting Friday.
Some years ago. in studying the electroshbck
process, the specificity
of anticnolinorgic drugs in reversing the ECT effect led me to poatulcte an elevation of acetylcholine as important to this effect. We
attempted some measures of CSF acetylcnoline, but our results were
unreliable. Recently, I approached the problem again, and sent some
fluids to Walter Essmau at Queen's College, ﬁew York, but he was cola
to measure other constituents, not acctylcholine.
Are the techniques yen describe ouitablc for CSF? is there
a way of stabilizing CSF~acetylcnolinc so that samples could be shipped?
Would your laboratory be interested in some samples of CSF in monkey.
and man, before and following ocizurca, to test the hypothesia
ccetylcholinc eiotation occurs and persists post~ECT7

any

I an enclosing a copy of my 1966 rcport,
relevant citations from your lnborctory.

and onould appreciate

Sincerely yours,
Fink, H.D.
Professor of Psychiatry

Max

ﬂF:ig
Inc.

that

�</text>
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                    <text>Novemher 19, 1971

Craig Burrell, M.D.

Sandor Pharmaceuticals

Hanover,

New

Jersey

Dear Craig,
Some

time ago you requested some information regarding our

regret that the letter
is enclosed. and should
allow
fate to this
same
the
wish
will
I
not
additional
data,
you
request.
studies of thioridazine

wee misplaced

until this

and thiothixane, and I
week. The information

I trust the information

may

be of

interest.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>November 19, 1971

Dr. R. Mechoulam
School of Pharmacy
Hebrew

Israel

University of Jerusalem

Dear Dr. Hechoulamm

I

am

pleased to enclose an import permit (#3273) for
air freight, and the permit should

1476. This may be shipped by
accompany the shipment.
EA

I have also received your letter regarding the antagonist.
I can and will send some naloxone, but would like to discuss your
letter with Professor Freedman first, as he may have some suggestions
as to the eventual testing of the antagonist.
you

I trust the lectures in Stockholm were interesting. I thank
copy of the program.

for a

my

best regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>'vmm'

Novenber 18, 1971

Dr.

Fritz Frcyhcn

St. Vincent's Hospital
153 West 11th

New

York.

Dear

New

Strﬂet

York 10011

Fritz;

Encloeed is a revised draft of our report ”Clinical
Experiences With Multiple Electroconvulsive Treatments".
We have reduced the
tett as suggested.
Again, our thanks for your consideration.

Sincerely yours,
Max

Fink,

24.1).

Professor of Psychiatry

MF:1g

Enc.

�</text>
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                    <text>.7...__

cavvr ,

.

w“..-r_._._._-

”us—1..

wwwww—v... Mr 3..“

-m ”aura-w.

.

.

.mwr-twwwm~mw .m.

my”,

W-..i....r.

Hovssbsr 18, 1971
Robert Rees. H.D.

Special Action Office For Drug
Abuse Prevention

White House

Hashington, D.C. 20506
Dear Bob:

Since the September meeting of SAODAP, we have reviewed our
programs in New York and Al Freedman and I are writing to acquaint you
with our immediate projects.

sured

We

plan to expand our studies of nsloxone.

We

have been

as—

by Ralph Jacobson that naloxone pamoate will be available for
by the end of the year. We have filed the necessary
clinical
forms for an IND, and will give this study our highest priority. We

trial

are also continuing our studies of high dose oral naloxone, and are t
testing dosages from 1.0 to 1.8 grams. This study will parallel the
psmoste. In both studies, we will assess the duration of antagonisiu
with heroin challenges and clinical acceptability.
Our interest in M—SOSO and BC 2605 has led us to file and
N.I.H.H. application for support of the antagonist studies. The applicstion requests funds for the necessary animal trials to obtain an
1RD for M-SOSO, and should we obtain this IND, we will
assess the du~
rstion of sntsgonisu sad sccsptsbility as an antagonist in our clinical
population. We have not made s psotocol for BC—2605 since our facilities
sre cousitted to thsss prior studies. To expand our facilities, how—
ever, so srs sstshlishing s clinicsl research unit at the Montroso V.A.
One of my students. Alexsnder Don, hss sgrssd to set up the unit and
hss joinsd thst staff this week.

�Robert Rees, M.D.

recently completed our comparison of l-slpha-acetylsethedol
that report was sent to your office. We
believe that this compound can be used more widely and further testing
should be done. We have urged Dr. Richard Brotnen of our College to
undertake a large scale clinical study, using the College methadone de~
toxificetion program as a base, and he is preparing the necessary doc—
unentation for city authorities.
We

and methadone, and a copy of

Bristol has requested that we assess the safety of naloxone:
in a ratio of 1:10, and one member of our staff. Dr. Richard
Resnick, has written a protocol for this study.

methadone
0

..'ervr-~

-:':'

'Ir'

Wutv'r‘n

wo‘rw.

November 18, 1971

chiatay;

Our latest cyclsxbcine report is in press in Comprehensive Rayand the report of our methadone—cyclesocine transfer study is

being revised following

editorial criticism.

Our trails with silsstic/naloxone are not funded beyond the
end of the month. The data are interesting, suggesting that
is fea-

it

sible to delay the release of naloxone, but are not sufficiently conclusive to warrant our enthusiasm.

heroin,

Under another program, we are continuing our EEG studies of
with one aim the development of an objective index of narcotic

antagonism. We are also studying the neurohumorel consequences of opiate
use; and our cannabis program is most active. But these issues are of
less immediate public concern.
Should your office obtain funding, two of these projects wer-

Iant your attention: animal toxicology of

M-SOSO

sufficient for

an IRD,

as described in our N.I.M.H. protocol; and a large scale comparison of
nethedol and methadone. While we have not prepared a protocol and bud~
get, this can be done.

wish to implement the recommendation that addiand pro-clinical testing of analgesics and
antagonists be establishdd, we have reviewed the facilities and personnel
available in New York, and believe that a viable program could be es—
Should

SADDAP

tional centers for clinical
tablished, capitalizing

facilities.

on

the affiliated college, city,

state,

and V.A.

Finally. there is one delicate matter that should be brought
to your attention. In discussions with Ralph Jacobson, he has repeat—
edly alluded to the support from your office for the naloxone studies
in this institution. We did discuss funding from Endo with his, in part,
for the special tests and reports that they usually require at the end of
each study. Also, in our discussions with Dr. Irwin Pechter of Bristol
Laboratories, we have indicated that support of our study programs is
essential to their vitality, and that transfer of this support to governmental agencies are not particularly useful. (You may recall that Ster-

�November 18, 1971

Robert Recs, M.D.

ling~w1nthrop provided us with funds for our cyclczocinc studios ~fundo that wcro used for oquipncnt. travel, and consulting not ordin—
arily available in governmental contracts). I would hope that the parof ncrcotic
allel, direct Iupport by Endo and Bristol, of then: studios
antagonists, will not be projudiccd by implied proniocs from SAODAP.

‘-

'H'srxw-"mro'ivv-uuv

v

We trust those
succcooful launching of

comments
SAODAP

are uscful, and look forward to tho
in tho near future.

programs

Sincerely yours,
Mu Fink,

,

at,

WIN“

V‘Rﬂ‘

"'

'-r"smm-

HOD.

Professor of Psychiatry

42v"

HF:ig

�</text>
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                    <text>November 16, 1971

Dr. Allen Berger

Pfizer Pharmaceuticals

Groton, Connecticut 06340

Dear Allen:

Enclosed are two copies of the behavorial data summary
of the comparison of doxepin hydrochloride (25 and 10 mg) and
doxepin pemoata (10 mg) in male volunteers. The behevoriel

data parallel: the EEG data quite well. It is this date that
clarified for us, the differences in behavorial data obtained
on a moment-to—moment basis compared to summary data at the
end of an experiment.
An

quested

My

extra

it.

capy

is enclosed for Dr. Beckett, as she re»

best regards.
Sincerely yours,
Pink, H.D.
Professor of Psychiatry

Hex
Wu".

MF:ig

Inc.

�</text>
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                    <text>November 16, 1971

Dr. William Bunney
Acting Director, Center for Studies of

Narcotic and Drug Abuse
Rockville, Maryland
Dear Dr. Bunney,

Thank you for the invitation to attend the meeting of
Advisory Committee on Friday, November 19 in Bethesda. I
look forward to attending, and will arrive that morning by 9:30 a.m.

the

Ad Hoc

The arrangements

and

for reimbursement are satisfactory.

I will bring some notes as suggested in your letter,
will plan to present a short overview of our studies in opiate

antagonieta and cannabis.

Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>Novsubsr 16. 1971

Barrett Scovills,
Deputy Director

M.D.

Department of Health, Education
&amp; Welfare
Food 5 Drug Administration
Rockville, Maryland 20852

Dear Dr. Sioville:

studios under

Vs
IND

progress report.

hsvs conplsted the snclossd summary of
4724, and are submitting this cepy so our

Sine-rely yours,
Fink, M.D.
Professor of Psychiatry
Max

Mrzig

�</text>
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                  <elementText elementTextId="103555">
                    <text>“w,

«arm—MW‘u—wvsv-

—~

nu.-..,..r..t.g—v—

.r

.

wv—.-— p

7”...— iv...- mw—wn-wvn—wmww—uu—w—u—u ~.w—.—...v~.,.»..._..m~~_-—nv—w

w.

—

fr...»

'I‘-«_-'- .

—-

&gt;~\W;L'ﬂn.m—«v-.. w... 3,...

n

v

,

. -~-

November 16, 1971

Dr. Robert C. Petersen

Center for Studies of Narcotic

&amp;

Drug Abuse

National Institute of Mental Health
5600 Fishers Lane
Rockville, ﬁaryland 20852
Dear Bob:

In response to your request, we are pleased to send this report and appendices, using as notations the numeric references of your

letter,

10/26/71.

With regard to the

last question,

we

have had unusual, and

to us, unnecessary delays in obtaining marijuana and THC. Our requests
require 3~4 months of processing, and in the 21 day study, the Committee's suggestions (interdictions?) as reported by Dr. oroude, were
not based on experience satisfactory to us. The delays resulted in a
loss of half our sample, who were available for study during the summer
only. Since research effort, if truly innovative, will be novel to the
Committee, it may not be possible to satisfy their anxieties, leading
to covert behavior on the part of investigators. Perhaps, investigators
who have passed the hurdles of institutional peer review, NIMH peer review, and

clinical

and research experience, warrant the same deference

to their judgment in regard to studies of cannabis is is accorded their
studies of other substances in the service of man. The present Commit—
tee or its spokesman seen to assume prerogatives not ordinarily accorded

advisory colnittaas. It would be a welcome breathe of moderation and
restraint for the Committee and 31MB authorities to exercise less demanding control over the minute details of experiments and experimenters
with regard to a drug as extensively studied as cannabis.
make

Should any additional data be required,

than available.

we

will

Sincerely yours,
Max

Fink, H.D.

Professor of Psychiatry

HF:ig
Enc.

he

slid to

~.

�</text>
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                    <text>Il

“mm_ﬂ_‘

WWW—w...

~W

November 9, l9?!

.w—u—v—"n—

v-W.w—w

Drs. Joyce &amp; Ivar Small
lndlana Unlverslly School of Medlclne
lndlanapolls, lndlana

v

VWW

«W

-—

—-

Dear Joyce and

lver,

varlous reporfs for +he ECT volume ln Seminars
In Psychiatry are now a+ fhe publlsher, and fhey have a planned Issue
am encloslng the llsf of authors, and
dale of February, l97l.
ldenflflcaflon/addresses. lf correcf, please do nolhlng. If lncorrecf,
please wrlfe me.
The

I

fhe Seminars.

You

should recelve The galleys within

6

You

wlll also recelve

subscrlpllon To

a complemanfary

weeks.

fhanks for your flne confrlbuflon. l fhlnk the
Issue wlll be a useful one, and your report ls most valuable.
My personal thanks for The fine cooperaflon.
Many

Slncerely yours,
Max

Flnk,

M.D.

Professor of Psychlafry

�</text>
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Miss Frances Morrall

Chronic Disease Management
801 Second Avenue

New

York,

New

York 10017

Dear Miss Morrall:
and I

letter

of July 9 was misplaced in my
regret not having answered it when received.
Your

files,

I am taking the occasion to enclose the report you
requested, and some background information, should you still
wish to use them.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry
Max

MF:ig
Enc.

�</text>
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                    <text>o-unr

WWrr-—w-—..._r,ww

~w-—mmm..wm, “WW
.

.

w

.

m.

.»-...r.

m.._..__...‘.

._

.s.7

..._,......;......___.7. “V.

.

.

.__... H.._~,~.w. ..

w,

..

.

.

a

November 8, l97l

Dear Turan,
IT was a pleasure To have you visiT.
ACNP
The
enjoyed
meeTlng, and voTed our friends in.

I

hope you

am enclosing a xerox of The page proofs of The
fenfluramine arTicle. have found 2 errors (noTed). if you find
any oThers, elTher wriTe me of To Springer Verlag, Heidelberg,
i

l

Germany.

Mr. Pavel has checked The cosT of The parTs for The
in
small
boxes-quanTiTies, $34. Should you wish him To build
These, he can do so. I would suggesT $75 each, paid To him.

How

many ?

Andy Don

clinical populaTion,

arrived This afTernoon, and

had

i

a good

could underTake some of The sTudies we discussed.
i will
Try To esTablish him aT The VA, and should he succeed, we
could do parallel sTudles, should The markeT call for such work.
i

Send us your Tapes-- as l suggesfed, iT would be
To
have a l0 minuTe run of an oscillatory signal
helpful
so ThaT we could check The sysTem before you record a loT of daTa.

mosT

My

besT To Ellen and The

children.
As

ever,

.w

�</text>
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                    <text>"WWW!“

~— -—.

m. wr‘m.‘ :mvﬂmwv—w-w ,»m~—wr—mwm.—~—va~———m-~~—
~—

-‘4-

November

8, l97l

Dr. Lothar Kaiinowsky

ll5 East

New

82

Street

York City

Dear Lothar,
i am
enclosing a draft of the Q &amp; A contribution to
the Special issue of seminars in Pbychiatry. Following your suggestion,
the contributions are summarized, and i am enclosing a copy for your
information. Any suggestions for changes will be appreciated.

that

it

issue will appear in February, and i am hopeful
will complement your text, which is the standard.
The
My

thanks for your cooperation.
Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiatry

———_ -«

�</text>
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                    <text>November

8, i97i

Dr. David impasfafo
46

New

Fiffthvenua
York iOOIi

Dear David,
i am
enclosing a draff of +he Q &amp; A sacfion of 1he
forihcoming Special issue on ECT of Shminara in Payahiatry, which is due
i0 appear in February. We have summarized the various answers and are
presanfing this digesf with some odiforiaiizing. Any suggesiions will

be appreciafad.

opinions.

Many

My

Thanks for your promo? cooperation and

franl

has? regards.

Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiafry

�</text>
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                    <text>November

8, I97!

Dr. Wiiiiam Kariiner
i749 Grand Concourse
Bronx, New York i0453
Dear

Bill,

enclosing a draf? of the Q &amp; A secfion of The
forfhcoming speciai issue on ECT of Seminars in Peychiatry which is
due To appear in February. We have digesied fhe various answers, and
are presenfing ihis 'digesf', wifh some ediforiaiizing. Any
suggesfions wiii be appreciafed.
i

am

van? *0 fake This opportunify to +hank you, no?
only for This confribufion, bu? The unsfin+ing supper? you gave our
sfudies a? Gracie Square.
i

My

best regards.
Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiatry

�</text>
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                    <text>November 8, l97l

Dr.

Ferris Plffs

Sf. Louis, Mlssourl
Dear Pefe,

varlous arflcles for The ECT Issues of Semlnars
of fhe publlshers. The Index and
Psychlafry are
Idenflflcaflon nofes for The aufhors are enclosed, and If fhere Is
an error, please lef me know.
The

In

The galley proofs should
In February.

fhe Issue Is due

arrlve wlfhln

6

The publlsher ls grateful, and will send
fhe journal.
fo
subscrlpflon
And,

—-

..

.quv—m»

In fhe hands

I

flnally,

hope fhe Issue Is wedl

be.

Many

fhanks.

I

weeks, and
you a

van? #0 fhank you for the fine arflcle.
know fhaf your reporf wIII

recelved, for

I

“awn-”am.

-v—v

Slncerely yours,

mm...

..
v
w-

n“

-.—.-

WW

~qu

vw-r

wwu—w—WWF—I'MEWFW

Max

Flnk,

M.D.

Professor of Psychlafry

�</text>
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                    <text>November

’Iw‘vlﬂ‘vr

Mm’

~

8, l97l

Dr. Walfer Essman
York

New

'smmr

ley

Dear Wall,
Many Thanks for your flne confrlbuflon lo The ECT
Issue of Seminars In Psychlafry. The reporfs are all In the hands of
the pibllsher, and you should recelve galleys In 6 weeks. The Issue
Is due In February.

call
+0

Your
me.

fhe Journal.

should recilve, as a

You

And,

and cooperaflon.

My

ldenflflcaflon Is Ilsfed,

please accepf

my

and If Incorrecf, please

glff of

+he

publisher,

3

subscrlpflon

fhanks for your fine confrlbullon

besl regards. (Please call

me

when you

refurn).

Slncerely yours,
Max

Flnk,

M.D.

Professor of Psychlafry

�</text>
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Wmmm—W

w-wmmmmmm

r-vrrrw

November 8, l97l
TO:

Richard Abrams,
Rhea Dornbush

Jan Volevke

The various reporfs for +he ECT issue of lhe
Seminars in Paychiatry are in The hands of the publisher, and we
should receive galleys wlfhin 6 weeks. The issue is due to appear
in February.

publisher has indicafed Thai he will give each
of you a subscriplion, in grafifude for your cooperafion.
The

enclosing a copy of The idenfificaflon
sheaf, as submifled. if incorrecf, please advise.
l

am

l van? #0
express my personal thanks for your splendid
I
know the? l would nof have undertaken
and
enfhusiasm.
cooperation
I
no?
had
This efforl, if
fell lhaf you would do as well as you did.
i
The confribufion to ECT undersfandlng fhaf
make
hope fhe issue does

is so sorely needed.
My

Thanks.

�</text>
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                    <text>_,,__

w

,7

“we...“.c—u—"r—n

m4 ..»Wuumw.w‘ W'ﬂrx-

‘

~ww‘"“wpu‘w v—nw—vawam

W...- ~mv&lt;~W—n’w-w' rpm...“

:-———Y-~=—n a. - 1—

.-

:_
—

..

“ppm,

w‘v-

November

v-

8, 1971

.mew'yq'ypwnwrm-v-w

Dr. ﬁichacl Sheard

Foi'w'y

.wr-vwzu

gyn-

&lt;

Department of Psychiatry
Yale University School of Hedicilo
34 Park Street
New Haven, Connocticut 06508
Dear Mike:

wv

«v-

A

a

w-nwmr

Juror-ww-

r—w‘v‘!‘

To add to the EEG~lithium data, you could write to
Joyce Sucall, Professor of Psychiatry, University of Indiana
School of Medicine. 1315 West 10th Street, Indianapolis for

her report.

Summary

is oncloaed.

""rnl':.ra3-1Summwu

Sincerely yours,
-

Fink, M.D.
Professor of Pyychiatry

Max
new

my,”

1....

m

4

i

k
S

s

Hrzig

�</text>
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".v.”

..

.. .W

MW“.-.

".7.

my"...

1..“ .7.

.._-_...,.._...,.\:r

..

Hovembet 8. 1971

Dr. Jon. Carrtnta~Acevodo
Kano, Clinical Pharmacology Section
Instituto Mexicano del Seguro Social
Division de Farmncologia
VJ

,.

Apartado postal 73~032
Mexico 73, D.P.

.-.-—wm-w

Dan: Jose:
.‘vf'!'AVV.‘

-m.-.

1972.

The

is meeting this your in Lao Vegas, January
hotel for the meeting is Caesar's Palace.

The ACE?

18~21,

wt

I havo already "used up” my one invitation; I would
suggest you do what so many others are doing ~ registering either
at Coolants Palace or a neighboring hotel (there are very many)
and attend the nesting as a visitor. So for, no one has ever been
proscribed from registering or attending.
As

o‘nar’wara-wrxm

rm.

3W

I plan to attend the W.C.P. at the
to toting you there.

and look forward
L'Wﬁrn‘u‘

My

and of tho month,

but wanes.

m~uwmr

Sine-rely yours,
:vwm

.W

Warren-74

Ir

w-w

'
'

nave;

Mu

-m‘,

M

ﬂak. ”and
m
Profcosor of Paychiotry

.rt

"qr.

mp

,

.

u...“ ,..

.

T,

�</text>
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                    <text>Hovember 5, 1971

William Tabor, 24.0.
A. E. Robins 00.
Richmond, Virginia

Dear

Bill,

for the

Enclosed are the completed
study, your number 1301.

AER-4118

It

was

My

best regards.

clinical data form

a pleasure to have the opportunity to

review this compound. Hazy thanks.

Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

�</text>
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                    <text>November

5, 1971

Grass Inetrunents Conpeny

101 Old Colony Avenue

Quincy, Meeeachueette 02169
7.‘

harm—Iv

Dear

Site:

are sending to
for repair.

We
-.,,—.-.

,.r

you the Cress

amplifier,

MOD

7P511,

Thank you

for your assistance.
Very

truly yours,

Fink, M.D.
Professor of Psychiatry

Mex

3?

J. Volevke.

“ﬁlm."

Wm

#731P1,

During the recording (approximately 1 1/2 hours) the gain decreeeod
to elmoet zero.

”noun—rm"

-

Seriel

m/Jvug
Enc.

K.D.

�</text>
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                    <text>November 4, 1971

Mr. Robert

Ubell

Plenum Publishing Corporation
227 West 17th Street
ﬁgs York, New York
Dear Bob:

In the course of our studies of heshish users in Greece,
across a monograph in German, "Die Easchischsucht" published
in 1939 by Dr. M. G. Stringaris. Not finding any translation, I
imposed on a friend to do the work, and I am taking the liberty of
enclosing the translation of the first chapter. The text is 66 pages
with 33 additional pages of case material.

I

came

Dr. Stringaris
Do

is alive in

Athens.

you think there is a market for a
do you wish to handle this?

this text? If yes,

translation of

I appreciate your advice.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

MF:ig

Ens.

�</text>
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                    <text>November

Mr.

4, 1971

Earl Ubell, Science Editor

CBS~TU

ﬂ.West 52nd Street
York, New York

New

Dear

Earl:

Enclosed is a report of our acetylemethaﬁol comparison
with lethadone, as submitted to the JAMA. The study provides good
evidence that methadol three times a week is equivalent to daily
methadone. While there is no therapeutic advantage, there is a
potential saving in diverted methadone.
and we are

studies of cannabis in Greece are progressing well,
starting parallel studies in Jamaica.

Our
As

for the antagonist, Endo has produced a long acting
tested early next year.

my

best regards.

panoate form of naloxone, to be

Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

Ming
Ihc.

�</text>
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                    <text>November 4, 1971

Dr. Louis Bozzetti
U.S. Commissioner Marijuana
801-19

Street

N.W.

&amp;

Narcotic Abuse

Washington, D.C. 20006
Dear Lou:
on the

It

was nice having you

visit

and

I

hope a

effects of chronic marijuana can be arranged.

presentation

Separately I have sent Dr. Henry Brill a proposal to undertake a study of chronic cannabis users in Jamaica, as well as a copy
of our Greek study interim report.

I am writing about another question. In working with
the Greeks, I was told about a prior study of hashish by Dr. M. G.
Stringaris, published in German. After much travail, I obtained a
copy of the original and asked a translator to make the text comprehensible in English. She has completed the first section (24
pages). I am enclosing a copy of her translation.
Is it within the Commissioner's activities to use such
a text and data, and can the Commissioner support the translation?
The text is 66 pages with an additional 33 pages of case histories.
My

best regards.
Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

MF:ig

inc.

�</text>
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                    <text>mu'mmv"'ﬁl‘

n-u

"Yr-1r"

-&lt;

«nnm-

“w..."—

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T

'nr-ng’wv-

w,—

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s-‘fa‘wwﬁw-"r

ll»

Hovenber 4, 1971

Dr. Lester
Editor

King

Jﬂml

535 North Dearborn Street
Chicago, Illinois 60610
Dear

Sir:

We are pleased to submit the report, "1~Alpha~Acetylemethadol
in Haintenence Treatment of Opiate Dependence“ for your consideration
for the Journal.

This etudy deacribee similar clinical reeulte for l-alphaacetylenethedol given three tines a week to daily methadone. Should
this prove generally applicable, the saving in illicit methadone and
its coneequencee can be great.
Thank you

for your consideration.
Sincerely yours,
Fink, H.D.
Professor of Psychiatry

Hex

erig
Enc
e

�</text>
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                    <text>”“1 “mu-mm,- W “M-.. w. Wm".

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mm

M

m

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r-r

November

Mr. Karl
CBS~TU

Ubell, Science Editor

5. West 52nd

New

York,

Dear

4, 1971

Stroot

New

York

Earl:

Enclosed is e report of our acetyleaothndol comparison
with nethadone. as submitted to the JAMA. The study provides good
evidence that methadol three times A week is equivalent to daily
nethndono. While there is no therapeutic advantage, there is a
potential saving in divorced nothedono.
and we are

Our

studies of cannabis in Greece are progressing well.

starting parellol studios in Joneicn.

for tho antagonist, Endo hes produced a long acting
panoete ﬂora of naloxone, to be tested early next your.
As

My

best regards.
Sincerely yourn,
Pink, H.D.
Professor of Psychiatry

Max

M3313

Inc.

.

..

--.-r~4

.

rm“

�</text>
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                    <text>Novonbor 4, 1971

Dr. Harold Moinola

NYS~NACC

1855 Broadway

Now

York,

New

York

Door Harold:

have just completed our conporison of methadone and
l-alpha~acaty1omothadol. The results show nothadol at 80 23., throo
tins: a wook, to ho equivalent to daily nothadono.
We

and

Condidoring the potential saving in diverted nothadono,
3 nor: extensive study ohould haw: a high

in personnel tins,

priority.
(we have

Additional copies for the Commissionor are oncloood.

sent the tort to
My

JAMA

for consideration).

best regards.
Sincoroly yours,
Fink, M.D.
Professor of Psychiatry

Mar

Hr:ig
Koo.

�</text>
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                    <text>~.»-

"-—

A
w

v..." -.—_r-— n

ku: ...n gymnw~m.mm..,_.w_.

W~n my... ”mow-r. nrw—utmw m:--Wu .n “Amy—w w—‘~...m 4—.v—n‘rl—ww'",
»

,

. 7‘

~.~_‘-V~.....V.._......vv. _........ .._.._-..._~.‘_.,v.~,..w~,r.r.r...,..z .—.~—....__..._..

Hovonbar 4. 1971

Dr. Clyde Strickland
Merck, Sharpe 8 Doha.
West Point, Pennsylvania 19486
Dear Clydo:

w-

,.
«aw-w

“WWW

34.."

m

w"

-..

Enclosed is a report of our comparison of l—alphaw
acetylemothadol with methadone. We found 80 m3. methadol three
times a weak equivalent to 100 mg. methadone daily. While the
therapeutic saving is small, the saving in illicit methadone and
parsonnel costs can be large.

WquﬁV—Wﬂ"

7
~

,;-;wr-w"‘

melmvnmtw~mwz

My

thanks for your cooperation.

Sincerely yours,
Fink, H.D.
Professor of Psychiatry

Max

Elsi;
Enc.

.‘r-—~..‘..

.

.

r

v...— _..

..

�</text>
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                    <text>=1—

mt‘wwsrﬂ

Hoveaber A, 1971

Dr. warren Glaser

Director

Out Patient Department (Medicine)
Kings County Hospital Canter
450 Clerkson Avenue
Brooklyn, New York 11203
Dear Dr. Glaser:

staff of the Division
of Biological Psychiatry of this department during the period of
July 5, 1967 to July 1, 1969. During this time she wen internist
in our Narcotic Addiction and Psychiatric Pharmacology Program.
Dr. Amelia 3. Banana was on the

When she began, her cxperinee with narcotic addicts
bed been limited but she was willing to assume responsibility for
their examination and nodical care. During the tine they were
given new drugs. she was dependable and did her work carefully.
Because she was Spanish speaking, she made a special contribution
to the care of a large segment of our patients.

She became so interested in clinical psychiatry
from
our program in order to become a psychiatric
resigned
She

is bright, enthusiastic

and

friendly.

Sincerely yours,
Fink, H.D.
Professor of Psychiatry

Max

H3213

that she
resident.

�</text>
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                    <text>November 3, 1971

Dr. Gerald L. Klernsn
Harvard Medical School
Hassachusetts General Hospital
2

Fruit Street

Boston, Massachusetts 02114
Dear Gerry:
membership
Award

w-

v.

.

.
v

,t

,
.

n....,....,.(.,.

m..."

for

For this work, he received the 1969 Clinical Research
of the Society of Biological Psychiatry.

During his residency, also, he carried out independent

verification of the lactate infusion test for anxiety neurosis,
firuing the

work of

Pitts

and McClure.

con~

Since returning from military service, he has established
a variety of independent studies at Metropolitan Hospital, in anxiety

and

in schisOphelits

I an pleased to

recommend him

for

membership.

Sincerely yours,
Max Pink, H.D.
Professor of Psychiatry

:

:71vr

Dr. Michael Alan Taylor
American Psychopathological Association.

As a resident physician, he use most industrious and
undertook independent research into the concomitants of post~partun
schizophrenia. Demonstrating that the sex of the offspring bore
a significant relation to illness in the nether, he subsequently
demonstrated that hormonal effects operated concurrently with the
staractic properties of drugs—- a conclusion derived from his data.

\,.,,.,‘v:..r.:.,,-.

awn...”

I an pleased to nominate

in the

83:13
Enc.

�</text>
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                    <text>m

wno

....,

...

. _

”ﬁrm—n.

.

rum—w."

.w

my.

mm ..—«-m—..m—W.W_,.—. ..m-&lt;'V—4——wwr ‘v’wwwu-

.

.

.

“w"’

Dr. Henry

Brill

National Marijuana

&amp; Drug Abuse Comriseion
”JV.
Street,
Washington, 0.0. 20006

801- 19

Dear Henry,
During the past two months,

busy with the problem

my

associates and

I have been

of chronic cannabis use. Enclosed are a few

products of those labors:
a)

An

b)

A

c)

A

proposed extension

interim report of the

of

Greek study; and a

the study as submitted to NINE;

report

’Cannabis Psychoais', prepared

held recently in Amsterdam

draft of the

for meetings

proposal to extend our study of chronic cannabis use
I am not sanguine that NIMH will fund this study
(or the Greek extension), I am hopeful that both studies can be done
since the Greek study is so interesting, and the Jamaica study will
complement this data, providing an independent validation or contrast
to the findings.

to Jamaica. Vhile

Would it be possible for the Cosmission to support this
In
study
your forthcoming visit to Jamaica, you will have the opportunity
to appraise this application. Should it be helpful for me to join you
during that visit to discuss the proposal, it can be arranged.
?

During Dr.

Bossetti's recent visit to

it

that the

my

laboratory, the

Commission may find
useth to review the
available chronic cannabis use data, by inviting presentations from Dre.
m'ras, Stefanie, Beaubrzm, Vera Rubin, and our laboratory. We could then
describe our chronic studies in New York. (The data of our 21 day study
are almost analysed add the report should be ready by early December).

suggestion

my,”

~

,,..

November 3, 1971

'm"vr"

«v

n... ”wan—.7».

My

was made

I am most

best regards.

grateful for your support, and await your advice.

m"

.
v...

Sincerely yours,

7A...

.'

rung-v—w-rnx

Vs

r'wvnw‘

Mas:

Fink,

M.D.

Professor of Psychiatry

�</text>
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                  <elementText elementTextId="103579">
                    <text>_.._.

. ..
.

.

‘7‘ .

,. —“»~~_—-=..~—

v—www.

u...

ww—umw—n—W..

m_.m__ ,(w, "w_,,( ,

_

,

W

w.-.

__.

W‘

,_

7r. _

_

_

,

November 2, 1971

J. Gradmll
Chief, Contracts Management Section
National Institute of Mental Health

Mr. R.

Rockville, Maryland
Dear Mr. Gradwell,
HSM—42- 70—98,

In conjunction with the extension application for
I am enclosing an application for the study, "Physiological
"
Jamaicans
It is our belief that this study will

Effects of Chronic Cannabis

Use

in

Male

complement the
observations in Greece, and provide the “formation of interest to
the public today.

This proposal has been discussed with Drs. william
and
Robert
Petersen of the Division of Narcotics and Drug Abuse,
Bunney
and copies are being sent to them for their consideration.
Thank you

for your consideration.
Sincerely yours,
Max

Fink,

M. D.

Executive Director

�</text>
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                    <text>-7.

._...._. .0...“— m—e—mw..m—m-rn

"W. W- -mw

“wmmm—“iwvaw. _.,__...___._A...,.._...v.“

-mm -mmv..._....w

. "-7 r.

71m- (WW...

-—.. ‘7

- r-

.. W

.w—.—...._

uW~—'.wVw—.——-—w.—.nw-

November 2, l97|

i

l

Dr. Wllllam Bunney, Dlrecfor

Dlvlslon of Narcoflcs

&amp;

Drug Abuse

Naflonal Ins+l+u+e of Mental Healfh

Rockvllle, Maryland
Dear Blf,

-——-rw

pleased To submlf an appllcaflon for fhe sfudy,
Physiological Effbots of’Chronia Cannabis use in Mhle Jamaicans, for
your conslderaflon. Thls appllcaflon complemenfs fhe s+udy of chronlc
cannabls use In Greece whlch Is now In progress, and for which an
I

s

am

exfended appllcaflon was submlfled last week.

have sen? a copy of fhls proposal to Mr. R. J. Gradwell
of The Confracfs Management Branch of the lnsflfufe, and fo Bob Pefersen.
I

My

Thanks for your cooperaflon and

lnleresf.

Sincerely yours,
Flnk, M.D.
Execuflve Dlrecfor

Max

_

,

,

_

V

n

.

W

‘

_........,

,

�</text>
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                    <text>November 2, l97l

E

Dr. Robert Petersen
Natlonal lnstltute of Mental Health

Rockvllle, Maryland

l

Dear Bob,
am pleased to enclose our appllcatlon for an
extension of the studles of chronlc cannabis users to a populatlon
ln Jamalca. The study, Physiological Effects of'Chronio cannabis use
in Male Jamaicans, ls planned to progress ln parallel wlth the
Greek study.
I

A copy of this proposal has been sent to Mr. R. J. Gradwell
of the Contracts Management Branch and to Dr. Bunney.
My thanks for your recommendatlon, and for the
opportunlty to conslder thls lnterestlng study.

Slncerely yours,
Flnk, M.D.
Executlve Dlrector

Max

"HI-WW

‘

.

,
.
.

'5-H’

�</text>
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                    <text>pun-m“.W‘w— ,w

awn"

-

'

,...-....

Dr. Michael Beaubrun

Professor

November 2, l97l

Chairman,
Department of Psychiatry
University of the West indies
Kingston, Jamaica
&amp;

Dear Dr. Beaubrun,

After considerable delay and consideration, the application
for the study of chronic cannabis use in Jamaica has been forwarded to
Washington. i have held prior consultations with various of the officers
in Washington, and have been told that this study, with the one in Greece,
has a high priority, but that funds for the l97l~i972 fiscal year for
these contracts haze not yet been approved. Approval is expected this
month, and these applications are in hand in time.

studies

have also requested the letter of interest
lnstitutem and this is under consideration.

i

by the

in such

It was most useful to have Mr. Beecher, and i trust he
do not know whether some funds are necessary from
enjoyed his stay.
our study program, but if there are some that may be useful, please
I

write to

me.

have asked Dr. Dornbush to write to Mr. Chevannes to
apprise him of the timetable and to enquire as to his cooperation, since
he indicated that there may be a change in his status atbthe end of the
year.
i

duplicate copy of the proposal is enclosed for Professor
told you, i did discuss his budget with him and
the budget as submitted includes his requests (modified) and your own.
i would
urge both of you to review the details, and assuming our NIMH
will support the study, will ask you to confirm that the summary includes
the items necessary.
A

Ward. As he may have

have also sent a copy of the proposal to Dr. Henry
U.S. Marijuana &amp; Drug Abuse Commission. I understand he
will be visiting you next week. i have asked him to present the prOposai
to his commission for support, for it may interest them as much as our
National Institute of Mental Health. Should he raise questions regarding
I

Brill of the

.W. .srw.r,_.7,m_,_

�z
‘

_-W——w——-——w—e—

Dr. Michael

'r-‘u'l-Iw

,

T—wv'vr'IW-‘m _——W_.._..._
.

Beaubrun..........November 2, l97l

wuss-aura:

m m.

....__w——.—..&lt;~v-_—-..e«ww

...........................2

w-«w—

this proposal, it would be helpful for you to be as candid as possible.
Brill was responsible for establishing our study in Athens, and has

Dr.

maintained a deep

use.

year,

i

am

interest

in the possible consequences of chronic cannabis

Anticipating a faborable response before the end of the
proceeding with orders for the additional equipment on a

contingency basis; and have scheduled visits to Jamaica immediately
after the New Year. it should be possible for one of these funding

agencies to indicate their position

by

early

December.

Meanwhile, should any data from the population survey
available, it would be helpful to provide these in support of this
application, and I would appreciate a copy as soon as possible.
be

shall be attending the World Congeess of Psychiatry
at the end of the month, and shall look for you. My
best regards to your wife.
i

in Mexico City

Sincerely yours,
Fink, M.0.
Executive Director

Max

�</text>
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November 2,

1.9 71

Prof. Henri Gastaut
Hopital de la Timone
Bd Jean—Moulin

13- Marseille, France

Dear Prof. Gas taut,

In response to your letter regarding supplies of
and cannabis for your research programs, I called :our National
Institute of Mental Health center for distribution of thesupplies,
and introduced your request. My letter to Dr. Monique Broude, the
THC

scientist responsible for the distribution of supplies, will serve

to begin the orderly process of making the materials you request available.
will write to you shortly to indicate the type and quality of the
material on hand, and ask for some additional information that her
Comittee may request.
She

usual processing time of requests has been 2 months,
fail to obtain some assurances within that time, please
again.

and should you

write to

me

The

My

n

best regards .
Sincerely yours,

J“wmmt'_wumr.wmwmwx

Max

Fink,

M. D.

Professor of Psychiatry

cc: Dr. Monique Broude
Dr.

W. C.

Bunney

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"'wmwm

WWW—"mm: w—wr—w:

av

November 3, 1971

Dr. Monique Brouds
Div. Narcotics and Drug Abuse

National Institute of Mental Health
5600 Fishers Lane
Rockville, Maryland 20852
Dear Monique,

At recent meetings on the subject of cannabis
research in Marseille, I was impressed with the variety and extent
of research into hashish (kif) and cannabis by Professor Henri
Gastaut and his colleagues. They have excellent facilities for
the evaluation of the central and systemic effects of various
cannabis derivatives, and were assessing compounds of high THC
activity, in dosages that were higher than those conventionally used
in the United States.

comparability between his findings and those
investigators, I suggested that he obtain some NIMII supplies
of
and use these in parallel with his own materials, providing in his
publications, some assessment of the changes induced by his materials
and the U.S. materials.
To provide

U.S.

is

a letter requesting some U. S. material
would
fbom Professor Gastaut. I
urge your office to make such supplies
he
may request available for him and his associates. Their findings
as
be
will
complementary to our own, both in New York and in Athens, and
be
should
of special interest to our scientists and the Marijuam
Conmrission.
Enclosed

Many

thanks

for your assistance.
Sincerely yours,
Fink, M. D.
Professor of Psychiatry
Max

cc:

H.
V.

Gastaut,
C.

14.0.
Huntley, 24.0.

.————m m ”may...“
w

m

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Wﬂwmn

November 2,

Dr.

W.

1.9

71

C. Bunney

Actind Director

Div. Narcotics &amp; Drug Abuse
National Institute of Mental Health
Rockville, Maryland 20852
Dear Bi f,

in Marseille in September at a meeting called

While

by the President of the University on the subject of cannabis research,
was impressed that they were doing excellent work with materials of
unknown potency. The dosages administered exceeded in THC content those
ordinarily given in the 0.5., and urged Dr. Gastaut to request some

I

I

materials from the National Institute of Mental Health, so that his
findings could be compared to those of our own and of other laboratories
in the 0.8.
A

copy

of his letter and

are enclosed for your information.
be

my

covering

letter to

Monique

Any assistance you can give these scientists should
in
repaid
fine, comparable data.
Many

thanks .

Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiatry

cc: Monique Brande, M.D.
Henri Gastaut, M.D.

�</text>
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                    <text>November 2, l97l

Dr. Michael Beaubrun

Professor

Chairman,

&amp;

DeparTmenT of Psych iaTry
Univers iTy of The Wesi indies

KingsTon, Jamaica

Dear Dr. Beaubrun,

for

AfT er

The sTudy of

considethle delay

chronic cannabis use in

and

considsraTion

The

eraica

applicaTion

has been forwarded To
have hel d prior consuiTaTions wiTh various of The officers
WashingTon
in “ashinnTon, and have been Told ThaT This s.udy, wiTh The one in Greece,
has a high priorlTy, buT ThaT funds for The l97l-l972 fiscal year for
These conTracTs hose noT yeT been approved. Approval is excecTed This
l

monTh, and These

applicaTions are in hand in Time.

have also requesTed The leTTor of inTaresT in such
lnsTiTuTem and This is under consideraTion.

l

sTudies by

The

lT was mos T useful To have Mr. Beecher, and l TrusT he
do noT know wheTher some funds are necessary from
enjoyed his sTay.
our sTudy propram, huT if There are some ThaT may be useful, please

i

wriTe To me.

l
have asked Dr. Dornbush To wriTe To Mr. Chevannes To
The
him
TimeTable and To enquire as To his cooperaTion, since
of
apprise
he indicaTed ThaT There may be a change in his sTaTus aTbThe
of The

.year.
A

duplicaTe copy of The proposal is enclosed

his

for Professor

Ward. As he may have Told you, i did discus
budgeT wiTh him and
*The budgeT as sulmiTTed includes his reques Ts (modified) and your own.
i
would urge boTh of you To review The deTails, and assuming our NlMH
will supporT The sTudy, will ask you To confirm ThaT The summary includes
The lTems necessary.

have also senT a copy of The proposal To Dr. Henry
The U.S. Marijuana &amp; Drug Abuse Commission. I undersTand he
be vlsiTing you nexT week. i have asked him To presenT The proposal
I

Brill of

will
To his commission for supporT, for iT
NaTlonal lnsTlTuTe of MenTal HealTh.

may

inTeresT

Should he

Them

as

much

as our

raise quesTions regarding

�h

Dr. Michael

Beaubrun..........November 2, l97l

...........................2

if wouid be helpful for you To be as candid as possible.
was
Brill
responsible for esieblishinq our siudy in Afhens, and has
mainfained a deep inferesf in iho possible consequences of chronic cannabis
This proposal,

Dr.

use.

year,

faborable response before The end of iho
proceeding wiih orders for fhe addiiional equipmen+~on.a
Anficipaiing

I

am

a

contingency basis; and have scheduled VisiTs To Jamaica immediafely
afier The New Year. if should be possible for one of fhose funding

agencies

+0

indicaie fheir posifion

by

early

December.

Meanwhile, should any daia from ihe populaflon survey
would be helpful To provide fhese in supporf of This
i would
appreciaie a copy as soon as possible.

available, if
applicafion, and
be

i

in Mexico Cify
_

bes? regards +0

shall be aiiending fhe World Congeess of Psychiatry
+he end of ihe monlh, and shall look for you. My
your wife.

ai

Sincerely yours,
Fink, M.D.
Exocufive Direcior

Max

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                  <elementText elementTextId="103587">
                    <text>A..,..

.A

....

.....

W...“

V.

—,

vmw.‘mwvmﬂmm
,

"mm-— W w w
.

&lt;

,,

- r:

memww’ww W n. m
..

r

,

. ....,_,

“Wm W’s—nab

Dr. Werner P. Xoella

Ciba-Geigy

Basle, Switzerland
Dear Werner,

written
Regretfully, there are no copies of the report
EEG
methods
analysis.
of
by Don Shapiro and myself on the quantitative
That report was written in 1.966 and described some of the basic
studies upon which we based our decisions to use period analysis,
epoch size, sanpling rates, filters, etc. Since then, we have

altered our programs considerable, based on our subsequent experiences,
and that issue is now outdated.
we have often spoken of a need for a revision of that
volume, but have not got to do anything about

it.

a number of occasions, we have been asked by some
laboratories about our pregrams, and in each instance we have suggestedand
that they would do best to send someone from their unit to our center,
we can discuss your needs and aims, and provide the backgroundin formation
you wish, either Don Shapiro
for a proper EEG analytic program. Or,
or I can visit your laboratories in Basel, and work with you to develop
the programs to your specifications.
On

if

Separately, I am sending you some of our recent preprints
which will describe the results of our present programs.
Incidentally. Dr. Jiri Roubicek, who was a student in
Basel with Sandos,
my laboratory for more than a year, is now resident in
the
qucmtification aspects,
and while he does not have the experience for
marvelous
he
is
a
person.
meeting
him
enjoy
for
may
you
My

best regards .

sum

-

w"

w

r

"lrrw-qu

wry-wan.

mpwvam—uw

”p.”

a.

November 1, 1971

w—u..«,.~w....—.

A—

.

Sincerely yours,
Mas:

Fink,

M.D.

Professor of Psychiatry

W

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                    <text>November 1, 1971

nun

wu~

Vw‘....a....-.~.m—n

5.....-"

Dr. Jean Paul Smith

Division of Narcotics &amp; Drug Abuse
National Institute of Mental Health
5600 Fishers Lane
Rockville, Maryland

mvvuvw'fv-

Dear Dr. Smith,
aw?

I am enclosing preprints of a number of our reports
regarding naloxone and cyclazocine, and the latest report on the
comparison of methadone and Z-alpha-acetylmethadol. The latter
report is being submitted to the JANA.

‘m

A

«Izslv'll'mn‘

Separately, Dr. Alfred Freedman has submitted a grant
application entitled Novel Narcotic Antagonists in Mhn for the
consideration of the appropriate committees of NINE. Included
that proposal is a sum of money for the subcontract to do the in
animal toxicity studies necessary for an IND for the antagonist,
MFSOSO. Any assistance you can give to that
application will
allow that agudy to progress rapidly.
Again, I regret missing the meeting on narcotic antagonists,
trust that we will be able to contribute our resources to this
interesting program.

and

Sincerely yours,
Max

gm.

;
‘77

~1‘lw‘v‘ww—

mf/
.

,‘ﬁkww,,“w.-wnr—.V

r6"

vaI-

2w:

wwwrw‘

“trap-535w.

.
r':

-.

Fink, M.D.

Professor of Psychiatry

4

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                    <text>v

,

Why-”W—WVW"my-n.

:I‘w'w

December 29, 1971

William Bunney, M.D.

National Institute of Mental Health
Rockville, Maryland
Dear Dr. Bunney,

In the course of our studies of cannabis. I became
acquainted with Dr. Rapael Mechoulam of the Hebrew University. Dr.
Freedman was able to interest him in the problem of the development
of a long acting narcotic antagonist. A copy of a recent letter from
him is enclosed for your information.
Should there be a list of potential laboratories capable
of studying the problem of a long acting antagonist, you may wish
to add his name, and consider his participation in any collaborative

program.

My

best regards.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>Dace-bar 28, 1971

Dr. ﬂush K. ﬁuaaay, M.D.

Jﬁwﬁi

535 N. Dcarborn

Chicago,

_

Illinoia

60610
RE:

REF:- HS #3163
7
:\.

Dear Dr. ﬁuaaay:
have reviewed the data in our study of ”i-AlphaAcetylmctoadol in Maintenance Treatment of Opiate Dependence"
and find that some of the interesting relationships can be pre—
sented in tabular form. We have made up such a table, and it
We

is attacﬁca.

seemed somewhat lengthy, we indicate a section
tables.
that can be separated, and toe data presented in two abide
by
As this is a matter of style and appearance, we will
As

it

your decision.

for your kind consideration. I trust that
high price of the base material for
excessively
the raputed
soon be roduced, so that more ex—
will
£-alpha~acotylmethadol
tanaiva clinical tests can ha dona. Publication of thisandexper—
in—
ionco may serve to stimulate a more rapid governmental
Thank you

duatrial raaponao.

Sincerely yours,

as: link, at».

Profaaaor of Psychiatry

anig
inc.

|

8152.

“£45,931

�a

10

Completad 6 Hal.

5

4

4

A

Mean A38 (yearn)

24.7

31.0

28.5

Your: Addiction

7.0

9.2

7'0

Methadone

Methadol
High 2233'

‘

Law Dqgg

t

Behavioral

9

Change Score

l
1
€

(Range 0%1)

+1.2

+1.4

i

+1.5

!

Opiate Withdrawal Symptonw

3/4

a

Secéndar/ Symptoms

t
3

lrritauility

1/5

Jerky Actor Jovements'

1/3

1/4

2/5

1/4

2.02

2.8%

16.9%

7.12

1.72

2.52

10/10

5/5

1/4

0/1

~

Constipation

4/8

i

2/4

Urine Testing
P05.

for

P03.

for Barb1Cutate

Morphine

or Amphetamine
Ho

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+24 ﬂour

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�</text>
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                    <text>December 28, 1971

Dr. Craig D.

Eurrell

Vice-President, Medical Affairs
Sandor Pharmaceuticals
Hanover, New Jersey 07936
Door Craig:

It is

not clear what additional information would
be useful, to the study was incomplete. But, I am pleased to
enclose xerox cepies of the summaries and behavorial ratings
on the subjects in this study in our files.
My

best wishes for 1972.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

Hr:ig
lhc.

�</text>
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                    <text>December 28, 1971

Dr. Turan

Itil

Missouri Institute of Psychiatry
5&amp;00

Arsenal Street

3t. Louis, Missouri

63139

Dear Turan:

received the tape from Istanbul, and found it comWe analyzed your “records” and
the range of values looks much like-tho EEG playback.
We

patible with our tape system.

Our difficulty is in identifying the “record” on the
tape. For example, our firtt EEG on playback looks like netthcr
of the two playbacks you sent. We have more ZO-aecond epochs
than your sample; the artifacts do not match, etc.
We

make

if

will

be pleased to analyze

available paper or card outputs, or

the data are complete.

similar tapes,
some

and can

statistical analyses

I an enclosing a summary outline of instruments we
used in another atuiy. This will give you one way of identifying
tho racord on tape, so no can find the correct record for each
subject.

My

beat for 1972.
Sinccrcly yours,
ﬂax Pink, H.D.

Professor of Psychiatry
33:13
But.

�</text>
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                    <text>December 27, 1971

Prof. Dr. H. M. van Praag
Div. Biological Psychiatry
Croningen, Holland

Dear Prof. van Praag,

lick forward to your visit to our laboratories on Friday,
I would like for you to meet with some of my associates,
discuss
to
your research interests, paricularly your experience with
the probenécid test. The meeting will be informal, and we are
equipped for the presentation of slides, should these be useful to
your presentation.
We

January 14.

If suitable to your schedule,

and the formal session can begin

at

we
2

should meet

p.m.

at 1:30 p.m.,

administration offices and my laboratory are at 5 East 102
Street, on the corner of Fifth Avenue. It may be best for you to call
my office the day before or the morning of the 14th: (212) 369—7900 x255,
or my home (516) 466 5444 the evening before.
The

useful.

I will be pleased to
My

best wishes for a

forward with

make

hotel arrangements, should this be

happy and successful 1972-— and

interest to your visit.

I look

Sincerely yours,
Max

link,

M.D.

Professor of Psychiatry

�</text>
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                    <text>December 23, 1971

Julian J. Lasky, Ph.D.
Executive Secretary
Department of Health, Education, &amp; Welfare
Health Services &amp; Mental Health Administration
National Institute of Mental Health
Mr.

Fishers Lane
Rochville, Maryland 20852
5600

RE:

MH18490—03

- Kurland

Dear Jack:

It

was kind of you to give me an Opportunity to see the menswand thus get a follow—up of the progress on this study. There
has been much effort eXpended in planning and equipping the EEG analytic

al request

portions of the study; the promised participation of an electroencephalographer. (Dr. Bohm) is no longer listed in the renewal or the progress
report; and 16 patients have had records analyzed on 3 or 4 occasions
during the ECT process. The principal focus seems to be on the EEG chang—
es induced by ECT and this is reflected in the large supplementary request of $36,000 for specialized EEG equipment.
A. Two observations have stimulated these workers. One is
the increase in podt—seizure alpha activity is related to a better clin—
ical evaluation, and increased theta/delta activity with lesser degrees
of improvement. This observation is reported as “contrary“ to that of
others. But, the study is not a replication, and many factors that influence the EEG expression are disregarded.

l.

The EEG

is recorded in the ten minutes before the

ECT

treat—

is given, presumably in the treatment room. This is a time when
anxiety may be intense and which may alter the EEG. Prior workers did
not use this method, probably because of its lack of stability. (Is it
ment

—

�ht. Julian

J.

Lasky, Ph.D.

December 23, 1971

not also likely that many of the patients will have received some anxiolytic therapy before the treatment
perhaps not for the psychotic
depressives, but surely for those rated as depressive neurotics?)
——

2.

any measure of
ing the amount

In the

EEG

evaluation, a difference score is used, without
The sample size is 10 minutes, and considerbe artefact filled, it would be a surprise if

variability.
that

must

the pre~sample, on which the results are highly dependent, is a reliable
estimate. (One should expect an awareness of the variablility of the
EEG and estimates of variance to be included in the
analyses).

3. The post—ECT assessment is at 43 hours. Rﬂilizing that
there is a decay in the amount of slow waves, and that this is most rapid in the early treatments, the authors now suggest estimates continuously
during and after the seizure for one hour; and again at 24 hours. Are
they implying that this pilot work was wasted? Would it not have been
useful to examine a few patients at various times and present this data
for a new study?
4. The records were evaluated for normality. By whom? With
what standards? One of the main reasons for the emphasis in the 1950's
on quantitative measures for EEG evaluation was a difficulty to achieve
agreement as to normality and abnormality among sophisticated EEG'ers.
The authors have more than adequate equipment to provide preetreatmeut
estimates of the amount of various frequencies, the amount of variability
in amplitudes, egg, « and to use statistical techniques to allow for the
relationship between these measures and change with ECT or with clinical
evaluations. But they eschew these techniques for an earlier technique,
which I would consider less reliable.
B. The second focus is the isoelectric period after the sei—
zure. This important observation follows the reports of Paul Blachly.
The observation here is contrary to those reported by Blachly, and inde—
pendently observed by my associates. Could it be that some of the isoelectricity that is measured is an artefact of the blockade of the amplifiers? This possibility is not mentioned. If the observation is valid,
what possible explanations do they have, and how do they propose to ex-

amine

it

further?

Perhaps the biggest disappointment is in the behavioral
In any correlation, the highly sophisticated analyses of
one variable (EEG) ought to be matched by equally detailed and time~re~
lated behavioral measures.
C.

observations.

1. There is one clinical psychiatrist assigned to the project,
so his observations must stand alone. He uses standard, gross measures
of behavior and the results are couched in the grossest estimate of 'im~
provement'. Improvement in what? Mood? Affect? Sleep? What of the
contamination of memory loss to the overall assessment?

�Hr.

Julian J. Lasky,

condition,
few.

December 23, 1971

Ph.D.

The authors use a fixed number of treatments. Under this
some patients may receive too many treatments and some too

2,

It is probable that psychotic depressives, the older patients, will

reapond to the extra treatments with memory loss. Hence, they hay be
evaluated poorly if memory is an integral part of the improvement evaluation. These patients may also show more slowing, for this correlation
increased EEG slowing and decay in memory function is well established.

~

3. Using their ratings for behavior, and assigning a value
of 2—3 eps from the graphs, we find the following:
amount
to the
Rating

LE;

1

7

23

l2

4
5

2
3

Mean

"delta"

5.7
2.0
3.0
7.5
7.4

I do not find their tentative conclusion, that delta increase
is associated with lack of improvement to be well grounded.
of the

Also, the behavioral measures are presented without making use
today.

statistical techniques available

is disappointing. xot uecause the authors have
presented little data, for they have made a good effort to get started
on an interesting problem. They have fulfilled some of the goals prom~
ised. But, the report shows a lacs of involvement by clinical psychie
This review

trists

with sophistication and hnowledge of the issue involved. The rem
newal focuses on gadgets ~ $36,000 of equipment for engineers, and no
funds for the researcners. Replacing some of the clinical funds and reducing the equipment would do little to improve the project, for it is

clear that the important investigators are beipcl and brown. If one had
much money, perhaps the $16,000 for each of 2 years may serve to keep
the project going at its present level. The electroencephalographic portions are also weak, and this may reflect the lace of someone with per~
sonal experience or involvement with this instrument (the promised ap~
pointment of a neurologistnelectroencephagrapher did not materialize).
I regret that I

cation. In

my

am

less than enthusiastic about this appli~
was optimistic that the problem may ex-

earlier review, I

cite the staff to a productive involvement ~ but this has not occurred,
and I am not sanguine that another two years would add much.
Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiatry

MF:ig

�</text>
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                    <text>December 22, 1971

Dr. Paul H. Blachly
Professor of Psychiatry
University of Oregon Medical School
3181 S.W. Sam Jackson Park Road

Portland, Oregon 97201
Dear Paul;

again, I find your questions thought—provoking and most
relevant to public issues. I accept your premise that ”those who are
physically dependent or have been so in the past” should be admitted to
methadone programs ~ and our program is limited to those males with at
least a Zwyear history and one confirmed treatment failure. In answer
to your questions:
Once

(1)

We

(2)

I

(3)

We

do

not use naloxone to screen routinely.

know of no program

that does.

do not use naloxone to screen, for we admit all patients
to the ward, observe for withdrawal symptoms, and then detoxify with methadone if symptoms are observed.

to run a large methadone program, I would use naloxone
give naloxone for test purposes auout 4m7 days post—withdrawal
(0.8 mg IV) 24 hours (or more) before we give heroin challenges. At various times, 3-6 days after the last does of methadone, our patients have
had chills, piloerection, irritability, and insomnia ~ sufficient for the
staff not to wish to do a naloxone challenge routinely.

tests.

Wereel

We

(4) About prisoners, your suggestion is interesting. In nor~
subjects, naloxone has no effect on behavior, pupils, heart rate, or
EEG. In the recent post~addict, symptoms are precipitated.
I do not know
what to expect in an addict, ”clean” for some weeks or months, although I
would anticipate he would be like our normals. Surely, a man claiming to
mal

be dependent - and using opiates within
easily by a naloxone test.

3—6

days

-

would be

identified

�(5)

The suggestion about naloxone's

availability to police and
objection would be the rare sadist who would enjoy the discomfort of precipitated abstinence - but this
is a miniscule risk compared to the possible saving in overdose deaths.
I would anticipate a coma from non~opiate cause would have no adverse consequences from the naloxone.

ambulance

drivers is brilliant.

On two

The only

occasions, in patients receiving

100 mg methadone

daily,

our heroin challenges (50, 75 mg) elicited euphoria, respiratory slowing,
and miosis
evidence of insufficient blockade (cross-tolerance). We gave
1 mg naloxone IV, and in each case, precipitated a severe abstinence
syndrome, unresponsive to additional heroin, methadone, and chlorpromazine,
and being relieved only by time (3-6 hours).
—

Note also, that naloxone IV is usually effective for
only and in overdoses, must be repeated frequently.

2—3

hours

I would support the suggestion that naloxone be freely available
to ambulances, police, physicians', and pharmacies; would not object to
an over—tne—counter availability; and would encourage studies of naloxone
in prison (or hospital) units as a test for eligibility for methadone maintenance.

Incidentally, our acetylmethadol study is completed and it coninitial optimism in 1969. It will appear in JAMA a copy is
enclosed for your interest. Also, Eur first trials with naloxone pamoate
firms your

—

began December 16.

My thanks for the good wishes
about these provocative questions.

—

and

for the opportunity to think

Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

MF:ig
Enc.

�</text>
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                    <text>December 22, 1971

Mr. John E.

Director

Ingersoll

United States Department of Justice
bureau of Narcotics &amp; Dangerous Drugs
Nashington, D.C. 20537
Dear Mr.

Ingersoll:

and find

have examined our summary records of methadone use,
that our clinic has diapensed the following amounts:
We

(1971)

152.8 gr 31113
169.1
155.8
142.3

July

August
September

g

October

1

Attached is a tabuiation of the number of applicants
for treatment to our clinic during the same period.

I trust these data are helpful.
Sincerely yours,
Fink, M.D.
Professor of Psychiatry

Max

Hing
Enc.

�</text>
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                    <text>December 21, 1971

Mr. Walter Essman Ph.D.

Queens College
Remson Hall
Room 14

Flushing,

New

York

Dear Walt:

Enclosed

past quarter.

I

am

is our check for consultation during the
sorry the check was delayed, - the next

should be more prompt.
My

best for a happy 1972.
Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

MF:ig
Enc.

�</text>
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                    <text>December 21, 1971
Dear Dr.

Kosterlitz,
In response to your questions regarding

my

report to the

Aberdeen symposium, I am pleased to submit the following:

1. International Conference on Drug Abuse: Published by the
University of Michigan Press. Page numbers are not available.

2. Wikler: pages 85—102.
3. Resnick et a1.: is to appear in Comprehensive Psychiatry,
in the issue of November—December 1971, which should be mailed to
subscribers in January.
The second report was not accepted for publication, and should
be reported as 'unpublished observations'.

4. Page 8, paragraph 2, line 4: reference should be 1968

for Fink, not
1972.

my

1969.

best wishes for

a happy holiday season and a healthy

Sincerely yours,
Max

Fink,

M.D.

�</text>
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                    <text>December 20, 1971

Dr. Honiqua Brande

Division Narcotics and Drug Abuse
National Institute of Mental Health

Fisharl

Lana
20852
Maryland
Rnckvillc,

5600

Dear Moniquo:

I as writing to yoqucst 200 grams nlnijuanc placebo
for our ongoing studio: of cannabis (In 18172) and our contract

or: expanding our sample in both populations
without altering the study protocol.
(62—70—98).

We

Enclosed

is

an opproptiato tequeat form.

Sinccrcly yours,
Max

Pink, H.D.

Praia-cor of Psychiatry

HP:13
Enc.

�</text>
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                    <text>December 18, 1971

Society for Neuroscience

Bethesda,

Md.

Dear Mrs. Wilson,

I had heard of the first meeting of the Society for
Neuroscience, but was unable to attend. Since then, I have been
told that the next meeting is scheduled to peecede the American
EEG Society meetings in Houston.

interested in any information that may be
available regarding this meeting and membership in the Society.
I

am

Many

thanks.
Sincerely yours,

Fink, M.D.
Professor of Psychiatry

Max

�</text>
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                    <text>Docember 17, 1971

Dr. Stanley Yolleo
Chairman and Professor

Department of Psychiatry
Stony Brook
Stony Brook, new York
SUNY

—

Dear Stan;
who

writing at the request of Joseph S.
is applying for appointment to the Department.
I

am

A.

Miller,

H.D.

Joe was the Hedical Director during my years at Hillsido
Hospital. He was a fine clinician and his conferences were well run.
he was most supportive of my research efforts. encouraging the Board
of Directors, and the Research Committee to approve the projects.
havo only seen him on fan occasiono since we both left
Hillside, so am less acquainted with the work of the past decade.
I am pleased to recommend him for a clinical appointment, knowing
it would be interesting to work with him.

I

Sincerely yours,
Max

Fink, M.D.

Professor of Psychiatry

Whig

�</text>
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                    <text>December 17, 1971

Professor Ian Oswald

Department Psychiatrist

University of Edinburgh
Royal Edinburgh Hospital
Edinburgh Ed lU~5
Great britain

HF

Dear Ian:

It was good to hear your report in Mexico City, and on my
nad
the occasion to re~read your report on fenfluramine
I
return,
and imipramine. As I understand your thesis, the abuse potential
is “blocked” by initial unpleasantness, or unpleasantness during
withdrlwal. This suggestion is descriptive enough, and is probably
accurate. Some years ago, we attempted a sudden withdrawal from
imipramine and found our subject to develop “withdrawal“ symptoms
(Withdrawal Symptoms Following Discontinuation of Imipramine Therapy, American

J. Psychiat.,

118:

549~550, 1961).

it

not true that ”dependence” develops to all drugs, given chronically? We have observed, and others
reported, withdrawal effects for phenotniazines and antihistamines,
and I would expect careful studies to show withdrawal to other drugs.
Using your model,

My

is

YOur suggestions are provocative, as was your presentation.
best wishes for a successful and nealthy 1972.

Sincerely yours,
Max

Fink,

M.D.

Professor of Psychiatry

Ming

�</text>
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