A. Background
CITA Biomedical, Inc. (the "Company" or "CITA(R)"), was incorporated in Colorado on June 9, 1981, under the name "Blue Grass Breeders, Inc." The Company was originally formed for the purpose of engaging in the business of acquiring, breeding, racing and selling thoroughbred horses. The Company completed an initial public offering of its $.0l par value common shares in February 1983, receiving net proceeds of approximately $2,134,000. From March 1987 to May 1989, the Company engaged in the business of breeding and selling horses. The Company was dormant from May 1989 through 1997.
On December 15, 1997 a special meeting of shareholders of the Company was held at which Joseph Dunn and Michael Hinton were elected to serve as Directors of the Company. On August 12, 1998 the Company purchased 100% of the outstanding capital stock of CITA Americas, Inc. (a Nevada corporation) from Aviation Industries, Inc. for 1,000 Shares of the Company's Series A Convertible Preferred Stock, par value $0.01 per share.
A dispute arose between the Company and Aviation Industries, Inc. concerning the conversion formula as well as other matters relating to the original Stock Purchase Agreement relating to the acquisition of CITA Americas, Inc. from Aviation Industries, Inc. In reporting its fully diluted Common Stock, the Company has previously reported 2.2 million shares issuable upon the conversion of the Preferred Stock. However, the Company reached an agreement with Aviation Industries, Inc. as of May 1, 2001 whereby the all outstanding shares of the Preferred Stock were converted to 400,000 shares of Common Stock.
CITA Americas, Inc. operates as a wholly owned subsidiary of CITA Biomedical, Inc. and is in the business of providing the technology, information, and administrative services necessary to the treatment and rapid detoxification of persons addicted to opiate based drugs whether natural or synthetic (i.e., Methadone, Heroin, Codeine, Demerol, and Percocet).
The Company currently has an agreement with Centinela Hospital in Los Angeles, California whereby Centinela Hospital is licensed to treat patients using proprietary UROD(R) (Ultra Rapid Opiate Detoxification) technology. The Company is currently negotiating with other hospitals and medical facilities to establish additional treatment centers both for UROD treatments and a new set of treatments for cocaine and alcohol dependency, as described below, although it has not yet received full Federal regulatory approval of those treatment programs.
In November, 2001, the Company entered an agreement with CITA S.L., a Spanish company operated by Dr. Juan Jose Legarda, the developer of CITA's UROD opiate addiction treatment program, whereby CITA acquired from CITA S.L. a license to certain technology, known as Detoxification and NeuroAdaptation ("DNA"),developed for the purpose of detoxifying persons habituated to alcohol and cocaine, as well as a neuron adaptation process designed to "reset" the nervous system of a habituated alcohol or cocaine user to its pre-habituation state. The Company believes that, provided it can obtain capital to permit it to implement the new technology, this license represents a major step in the Company's efforts to become a leading provider of products and services for the treatment of a wide variety of chemical addictions.
B. The Business of the Company
Products
The Company's current product offering consists primarily of UROD(R), which stands for Ultra Rapid Opiate Detoxification. This revolutionary procedure offers successful detoxification from heroin, methadone and other opiate based drugs, including pharmaceuticals, to addicted individuals without the typical elongated painful withdrawal discomfort. The UROD procedure has been approved as an accepted treatment method by the American Society of Addictive Medicine. Through year end 2001, over six thousand addicted persons have been successfully treated with the UROD procedure. Patients are successfully detoxified in 4 - 6 hours with a typical hospital stay of 24 hours. Patients are put under anesthesia and are given FDA approved opiate antagonist drugs, which displace the opiates at the receptor level. The UROD(R) procedure helps to reset the natural state of the body's receptors.
In November 2001 the Company announced a new family of treatments based on the DNA process, a new technology that provides revolutionary treatment for people who are substance dependent. The DNA process establishes a new treatment regiment in the fight against the disease of substance dependency. Historically the disease of addiction has been treated only through behavioral intervention, but the DNA process provides a solution for treating the physiological and psychological components of this devastating condition. By providing successful detoxification solutions that reduce the time, severity, pain and cost associated with withdrawal, DNA process allows the patient to concentrate on returning to a productive level of functioning in just hours.
Substance abuse impedes normal neural functioning of the brain and body systems as a whole, not only resulting in cravings but potentially serious or even life-threatening withdrawal symptoms. The DNA process reduces or eliminates cravings while regulating the neural functioning. PET scans taken within days of the DNA process demonstrate metabolic normalization of frontal, parietal and temporal lobes of the brain. Completion rates for the DNA process far exceed standard detoxification solutions; approaching a 100% completion rate. In its first nine months of use the DNA for Addictions treatments have had a relapse rate that averages less than half of the relapse rates for people treated for substance dependence by other means.
The following treatments from the DNA for Addictions family have been announced and are described below: DNA for Alcohol, DNA for Cocaine, DNA for Crack Cocaine, and DNA for Alcohol and Cocaine.
DNA for Alcohol: Currently, over 735,000 patients in the United States seek medical assistance for alcohol abuse every year. the Company has developed a Detoxification and NeuroAdaptation for Alcohol (DNA for Alcohol) process that cleanses the body in a 2 day period, during which time alcohol is purged from the patient's body under rigorous and intensive medical supervision. Withdrawal symptoms are treated and suppressed during the detoxification procedure and immediately after it, ensuring the most comfortable transition for the patient possible. In its first nine months of use DNA for Alcohol has a relapse rate of less than 25%, this is in contrast with the close to 75% relapse rate for people treated for alcoholism by other means. $8,000 per treatment. Patents pending.
DNA for Cocaine and Crack Cocaine: There are over 237,000 patients in the United States who seek medical assistance for cocaine abuse every year. the Company has developed a Detoxification and NeuroAdaptation for Cocaine (DNA for Cocaine) offering that cleanses the body in a 2 day period, during which time cocaine is purged from the patient's body under rigorous and intensive medical supervision. Withdrawal symptoms are treated and suppressed during the detoxification procedure and immediately after it, ensuring the most comfortable transition for the patient possible. In its first nine months of use DNA for Cocaine and Crack Cocaine has a relapse rate of less than 25%. This is in contrast to the close to 70% relapse rate for people treated for cocaine and crack cocaine addiction by other means. Crack cocaine use makes up about one third of all cocaine use yet it constitutes over 67% of all cocaine users who seek treatment for substance abuse. $10,000 per treatment. Patents pending.
DNA for Poly-drug: Over half of all people who seek treatment for substance dependency are poly-drug users. DNA for Alcohol and Cocaine is the first poly-drug treatment to be released in our new family of treatments, DNA for Addictions. In the past successful treatment of poly-drug use has been difficult and most treatment programs have not been designed to address poly-drug use. With DNA for Poly-drug the patient treated derives all the benefits of the single drug user in the same treatment time. A significant percent of patients treated for substance dependency are dependent on multiple substances. For instance 43% of patients treated for alcohol dependency have a secondary drug dependency. This procedure is an inherent part of any DNA procedure and it can also be administered during a UROD procedure. In the past many patients using other substances, like cocaine were ineligible for UROD. This procedure eliminates the opiates only requirement and therefore increases the UROD market. Patents pending.
Flexible Intensity Treatment (FIT): Following the DNA and UROD procedures, the patient is initiated into continuing care, a long-term program consisting of flexible intensity treatment based on The American Society of Addiction Medicines Patient Placement Criteria and the patient's ongoing needs in the areas of his/her physical, mental, and spiritual life. By providing the patient with a relapse-prevention medication (UROD patients only) and an aftercare program built on the solid foundation of an abstinence-based "twelve-step" model of recovery, the patient is offered the best possible chance at ongoing, continued persistent recovery.
The Company is in discussions with several hospitals regarding the provision of DNA treatments for alcohol and cocaine dependency. The latter program offers dual benefits insofar as it may be used as a standalone procedure, or in conjunction with UROD to treat patients dependent both on cocaine and opiate drugs. The Company's licensed facilities are currently unable to treat opiate addicts who test positive for cocaine as well.
The market for an effective alcohol treatment program is far larger than that for either opiates or cocaine. The principal advantage of the Company's alcohol treatment program over existing programs is that it can "reset" the brain's neurological function in order to prevent or ease the cravings experienced by many recovering alcoholics.
Staff
The Company currently has a total of eleven staff members. These include two Certified Addiction Counselors, and one person with a Masters Degree in Psychology and significant work completed for her Doctorate.
The Market
Opiates occur naturally as alkaloids in the opium poppy, or they can be imitated synthetically. Collectively, all of these highly addictive drugs are known as opioids. Of the twenty alkaloids contained in opium, only morphine and codeine remain in clinical use. Heroin (diacetylmorphine), the other major natural opiate-derived drug, was first introduced 1898, and it was widely prescribed as a cure for morphine addiction. Since the 1960's, synthetic methadone has been heralded as a cure or palliative (depending upon point of view) for heroin addiction. Most recently, a two-drug substitute for methadone has evolved using Orlaam and buprenorphine in combination. Both of these are longer acting, and unlike the required daily intake of methadone (Dolophine), this combination needs to be taken only three times per week.
Shown here are various other synthetic opioids that have been developed for various medical applications, most notably as analgesic or cough suppressants, wherein both generic and registered trade names (which are capitalized) are given:
o hydrocodone: Lorcet, Lortab, Vicodin o hydromorphone: Diluadid o levorphanol: Levo-Dromoran o meperidine o oxycodone: OxyContin, Percocet, Percodan o oxymorphone: Numorphan.
These drugs can be prescribed by physicians, dentists, veterinarians, etc. "Medical addiction" occurs when a patient becomes addicted under medical supervision using legally prescribed drugs. Black markets also exist for these drugs.
In 1999, National Institute on Drug Abuse (NIDA) studies identified hydrocodone, hydromorphone, and oxycodone as emerging narcotic drugs of abuse, noting that hospital admissions for hydrocodone, primarily Vicodin, increased from 6,115 in 1993 to 14,639 in 1999, an increase greater than 139%.
Consequently, the opiate detoxification market is growing. Opiate addiction affects 0.7% of adult Americans sometime during their lifetime1. In 1998, total spending for all detoxification services amounted to approximately $10.5 billion in the U.S. alone. This represented a 6% growth over the prior two years2. Heroin and other opiate addiction is currently at an epidemic state both nationally as well as internationally. Between 1988 and 1995, according to NIDA, American users spent between $9 billion and $18 billion yearly on the purchase of opiate drugs. Recent studies estimate that there are almost two million heroin users in the U.S.3, and indications show the number is rising. Worldwide estimates are significantly greater. More importantly, and likely greater, is the population of prescription opiate abusers, which has yet to be quantified by researchers. It is estimated, for example, that as many as 4 million people in the U.S. may be abusing prescription drugs obtained, in most cases, for legitimate medical purposes. Of this number, roughly 2.5 million people misused opioid and other narcotic pain relievers.4 This number does not take into account abuse of prescription drugs obtained from black market sources. Additionally, there are over 180,000 registered methadone addicts in the U.S.5 There are an estimated 1.5 million opiate addicts in the U.S. with only 600,000 treatment slots currently available. In New York state alone, almost 30,000 opiate detoxification procedures are performed each year6 and an additional 40,000 methadone patients are addicted. The State spends almost $140 million a year on maintaining methadone addicts and $130 million for opiate detoxifications.7
Recent U.S. government data on nationwide hospital admissions for substance abuse issues has been obtained through the Office of Applied Studies, Substance Abuse and Mental Health Services Administration from its published 1998 Treatment Episode Data Set. There were 1,560,915 such admissions in that year of which opioid addiction accounted for approximately 234,000, or approximately 14% of the total. Of this approximately 234,000, about 216,000, roughly 92%, were due to heroin alone.
1 Robbins LN, Regier DA (eds): Psychiatric Disorders in America, New York, Free Press, 1991. 2 National Institute on Drug Abuse: National Household Survey on Drug Abuse, Washington DC, US Government Printing Office, 1998. 3 American Psychiatric Association: Practice Guidelines for Treatment of Patients With Substance Abuse Disorders: Alcohol, Cocaine, Opioids, Washington DC American Psychiatric Association, 1995. 4 "Prescription Drug Abuse Said to be on the Rise," Reuters/Yahoo! News, April 12, 2001. 5 National Institute on Drug Abuse: Washington DC. 6 New York State Department of Social Services, DHLTC FFY 1995, Longitudinal Inpatient (E) 807D Report. 7 Rettig RA, Yarmolinski J (eds): Federal Regulations of Methadone Treatment, Washington D.C., National Academy Press; New York State Department of Services, Longitudinal Inpatient (E) 807D Report.
Other statistics published by NIDA confirm that addiction risk is rising in youthful populations. Specifically,
o A 1998 Monitoring the Future (MFT) study showed that heroin use among high school seniors nationwide had doubled since 1991.
o A 1997 MFT study found that 2.1% of 12th graders had used heroin at least once and that 1.2% had used it once within the last thirty days.
o A Community Epidemiology Work Group study concluded that emergency room admissions for heroin within the 18 to 25-age category increased 51.4% from 1997 to 1999.
Competition
The Company's primary competition for rapid opiate detoxification comes from two distinct forms of treatment: (i) traditional in-patient methods of detoxification; and (ii) methadone maintenance or methadone taper detoxification.
A. Traditional In-Patient Methods of Detoxification
Traditional forms of detoxification are generally conducted in an in-patient setting, in a hospital facility. Examples of such treatment centers include the following:
1. Hazelden Foundation: A 28 day program, which costs more than $20,000. 2. The Betty Ford Center: A 28 day program, which costs more than $20,000. 3. Cornerstone in New York: A 7-day detoxification treatment at an estimated cost of $4,000, with no outpatient follow up. (This is the most typical form of conventional detoxification treatment). Aftercare is billed separately, totaling approximately $7,000. 4. National Recovery Institute: A 14 to 28 day program costing approximately $250 per day (average total cost $5,000). This program uses group therapy and medication, including methadone. No follow up care after detoxification is complete is included in the cost of the program. 5. Methadone Maintenance: $4000-$8000 per year with patient remaining addicted.
Most centers for treatment of opiate addiction refer the patients out to a local hospital to do the detoxification portion of the treatment, then bring the patient into an outpatient rehabilitation program. These hospital detoxifications generally cost between $4,500 and $13,000, depending on daily hospital rates, length of stay, any additional substances, etc. The main advantage these programs have over CITA is that they are generally covered by third party payors, such as insurance companies and managed care entities. However, this may change in the future if the CITA program authorized for reimbursement by private insurance companies, and managed care groups. The Company is currently working with two organization to provide first third-party reimbursement arrangement for CITA procedures, Creative Care Management in Chicago, Illinois, and The Promises Foundation, in Malibu, California.
In terms of quality and strength, CITA has several distinct advantages over the conventional methods of the competition, including the following:
O Success rates - traditional forms of detoxification currently have a documented 7-17% average success rate; CITA consistently enjoys a documented 60% average success rate8. O The usual 6-28 days for detoxification is reduced to just 24 to 36 hours. O UROD is a guaranteed and 100% effective detoxification: all traces of opiates are removed. O Trained and board-certified UROD anesthesiologists oversee and monitor the entire detoxification process, offering an even more controlled and safer environment than conventional centers. O No painful withdrawal symptoms are experienced while under anesthesia. O Hospital stay is reduced to 23 to 36 hours: UROD frees hospital space for more efficient use of the facilities. O No traumatic transition experienced between detoxification and rehabilitative treatment, thereby increasing the chances the patient will continue to go on to further therapy and rehabilitation. O UROD allows for an earlier return to work and home. O No addictive medications are used as opiate substitutions. O UROD accelerates repair of the body's cells and increases regeneration of the natural opiates. O The CITA program reduces insurance requests for re-treatment. O The CITA program is the only viable treatment for methadone addicts.
B. Methadone
Developed in Germany around World War II, methadone was brought into use in the United States in the mid 1960's as a method of treating those addicted to heroin and other illegal substances. It was endorsed by the government as a daily maintenance dose of synthetic opiates to produce a pharmacological cross-tolerance, or "blockade," so that patients would not feel any narcotic or euphoric effects if they were to self-administer a normal dose of a short acting narcotic (e.g., heroin).
Methadone's intended use was four fold: (1) to counter the problem of addicts' highs and lows (severe sickness and mood swings), allowing this population to go back to work and normal daily functions; (2) to control issues surrounding disease transmission through needle use; (3) to reduce criminal activity related to obtaining the substance; and (4) to contribute to the reduction of illegal drug trafficking.
Methadone's intended goal was to safely taper addicts off of opiates, such as heroin, in a controlled environment, while offering counseling and support on the psychological end. The problem with methadone has become apparent in the increasing number of methadone patients, the increasing amounts per dosage that the patients are receiving, and the increasing number of methadone facilities. Many patients report that their guidance counselors at the clinics have no intention of weaning the patients off methadone, and rarely offer counseling or help to get them detoxified.
Methadone clinics have become a place patients visit each and every morning, stand in line, pay their fees, take their doses, and go on with their day. There is little attempt at helping the patients overcome the addiction or work on other areas of their lives, and the clinics have no economic incentive to begin reducing memberships. It has become a prison for many, as they are told that there is no other solution. These clinics perpetuate the very problem they were set up to solve.
8 Rabinowitz J, Cohen H, Kotler M: One Year Outcomes of Ultra Rapid Opiate Detoxification Combined with Naltrexone Maintenence, Journal of Drug Abuse, 1996.
The CITA Method of detoxification is a superior solution, and CITA believes that it is the only method in existence today that can effect a rapid release of methadone addicts from their addiction. CITA's research shows that approximately 70% of the addicts receiving methadone maintenance are treatable and are capable of leading normal and functional lifestyles, with detoxification and aftercare.
C. Other Rapid Detoxification Programs
Although there are a few other small and little known clinics, small hospitals and sole practitioners performing one form or another of one-day opiate detoxification, their impact is not deemed significant for several reasons outlined below. The individual hospitals (CITA has identified three) that provide this treatment do so in the $6,000 - $10,000 price range, and have done such a small number of patients that CITA does not believe they will be able to continue operations indefinitely. These hospitals have no opportunity for regional or national reach, and have no capabilities of absorbing any of CITA's prospective patients or market share due to CITA's own name branding. In addition, none appear to combine the detoxification treatment with the long-term counseling necessary to relieve the patient from psychological addiction.
The small clinics and individual doctors that compete in the one-day opiate detoxification market charge competitive prices in the upper $4000 to lower $6000 price range, but are based in free-standing, and often times dangerous, clinic settings, with no regional or national reach.
CITA has several distinct advantages over the other rapid detoxification centers, including the following:
O CITA's patented technology and proprietary program combines rapid detoxification with long-term aftercare for relapse prevention.
O CITA has the only method of rapid detox that is affiliated with major hospitals.
O CITA's method of rapid detox is the only method that is clinically proven to be safe and effective - based on over a decade of research.
O CITA's Ultra Rapid Opiate Detoxification has been successful on over 6,000 patients worldwide, and is the only such method with no mortality, morbidity or insurance claims.
Conventional Detoxification
One of the serious limitations of conventional detoxification is that many patients do not complete it. In single center studies, dropout rates have been as high as 80% for outpatient detoxification9 and between 15% to 30% for inpatient detoxification10.
9 Stark M: Dropping Out of Substance Abuse Treatment: A Clinically Oriented Review, Clin Psychol Rev 1992; 12:93-116. 10 Gossop M, Green L, Phillips G, Bradley B: Lapse, Relapse, and Survival Among Opiate Addicts After Treatment: A perspective follow-up study. Br J Psychiatry 1989; 154:348-353.
Multi-center studies report inpatient dropout rates without distinguishing between opiates and other substances11. In the CATOR (Comprehensive Assessment and Treatment Outcome Research) study, based on 6,000 patients from 19 treatment centers in 13 states, the dropout rates for all inpatient substance abuse programs was 16%12. In perhaps the only national study reporting dropout rates from detoxification and treatment, which was conducted in Israel, almost half of the patients abandoned inpatient detoxification during the first week of the standard 30-day stay13. In New York State, 26% of Medicaid clients drop out of inpatient detoxification14. This amounts to an expenditure of almost $30 million per year for dropouts in New York State alone. Under the CITA program, patients cannot drop out during detoxification.
Another limitation of conventional detoxification is that many patients are averse to detoxification. Stark, for example, found that 34% of methadone maintenance patients do not detoxify due to detoxification phobia.15 Thus, another possible advantage of anesthesia aided detoxification is that it may facilitate the detoxification of addicted persons who are afraid to approach conventional detoxification.
CITA Aftercare
It is well recognized that while detoxification is an important first step, relapse prevention requires an aftercare program. The Drug Abuse Reporting Program (DARP), a national treatment outcome study conducted in the United States on several thousand patients from 52 different substance abuse programs, found that 75% to 85% of patients treated in detoxification-only programs relapsed within one year. As noted previously, completing detoxification is a barrier to treatment for many patients. Of those patients who completed conventional detoxification without dropping out and who subsequently entered an aftercare program, 50% to 80% of them returned to routine use of opiates within the first year. For example, in the DARP study, relapse rates for patients in aftercare programs ranged from 60% to 75% during the first year. Another major national study of treatment outcomes, TOPS (Treatment Outcome Prospective Study), found that of 2,280 select clients who had successfully completed detoxification and then enrolled and started after care treatment, 57.2% had relapsed during the first year.
CITA requires that all prospective UROD treatment patients commit to a comprehensive aftercare program. CITA's aftercare program consists of six months of an opiate antagonist such as Naltrexone, up to six months of group and individual counseling and the support of a spouse or significant other during and immediately following UROD treatment. Persons who are unable to commit to all of these steps are ineligible to receive UROD detoxification.
11 Stark M: Dropping Out of Substance Abuse Treatment: A Clinically Oriented Review. Clin. Psychol. Rev 1992; 12:93-116. 12 Harrison PA, Hoffman NG, Steed SG. Drug and Alcohol Addiction Treatment Outcome, Miller NS, ed. Comprehensive Handbook on Drug and Alcohol Addiction, New York, 1991, Maecel Dekker Inc. 1163 - 1197. 13 Levinson D: Comparisons of Outcomes Among Graduates of Various Detoxification Programs, Jerusalem IL, State of Israel Ministry of Health, 1993. 14 In 1995, Medicaid paid for 28,921 detoxifications in New York State. In 7,474 cases, patients left against medical advice after an average of 4.4 days. Since detoxification takes 7 days and these patients left against medical advice, they apparently dropped-out prior to completing detoxification. 15 Stark M: Droping Out of Substance Abuse Treatment: A Clinically Oriented Review. Clin. Psychol. Rev 1992. 16 Hubbard RL, Rachel JV, Craddock SG, Cavanaugh ER, Treatment Outcome Prospective Study (TOPS), NIDA Res. Monogr., 1984;51:42-68.
Methadone Treatment
According to Federal guidelines, while the eventual goal of methadone programs is abstinence, it is recognized that some patients may need long-term methadone treatment. In practice, most programs encourage long-term methadone maintenance and do not encourage detoxification17. Not surprisingly, it is rare to find patients who have successfully detoxified from methadone without relapsing to opiate use18. In the TOPS study discussed above, which included almost 2,700 methadone maintenance patients, by 13 weeks, 32% of patients had dropped out of treatment, and by 26 weeks 48% had dropped out. Only 34% of patients remained in methadone program for over one year. Similar results were obtained in the DARPS study 19.
Thus, as compared to conventional detoxification, methadone appears to have a higher dropout rate. After taking into account the higher drop out rate, and the dollars spent, it is evident that the CITA treatment is far more effective and cost efficient than methadone treatment of persons addicted to opiates.
The CITA Treatment Program Success Rates
After adjusting for dropout rates during detoxification or methadone treatment, the literature reviewed above suggests that, of all patients who enter opiate detoxification or methadone treatment, fewer than 30% are opiate free a year later. In contrast to the relapse rates of patients treated with conventional methods, a study of patients who completed the CITA treatment program found that after 1.5 years following UROD Procedure, 57% of 113 randomly selected patients remained drug-free20. Despite the fact that the UROD study allowed more time for relapse (1.5 years vs. 1 year), the results are considerably better than most other studies. Considering that 15% to 50% of conventional inpatient detoxification patients drop out before completing the detoxification process, the success rate of the CITA treatment program in this study appears to be four times that of conventional detoxification programs.
Advertising and Promotion
CITA recognizes that the key to continued success and growth at this time is extensive promotion. This must be done aggressively and on a nationwide scale. Responses and success rates based on patients treated indicate that the CITA program for detoxification and rehabilitation has earned an excellent reputation among both the addicted population and substance abuse professionals. CITA intends to use this earned reputation as an important part of its advertising and promotion program. Relationships with third party payers, hospitals and community leaders are as important as traditional forms of advertising in reaching CITA's goals.
CITA's strategy is to enhance, promote and support the quality of its products and services, as it continues to increase its share of the market for the treatment of opiate addiction, and to enter the market for the treatment of dependency on cocaine, alcohol, nicotine and other substances. Upon licensing medical institutions, CITA participates in the development of a comprehensive promotion plan designed to educate the public about CITA, create demand for its product, and add value to the medical institution's name and image.
18 Kleber HD: Detoxification From Methadone Maintenance; The State of the Art, International Journal of Addiction 1977; 12:807-820. 19 Hubbard RL, Mardsen ME, Rachel JV, Harwood HJ, Cavenaugh ER, Ginzburg HM: Drug Abuse Treatment: A National Study of Effectiveness, Chapel Hill, NC, The University of North Carolina Press, 1989. 20 Rabinowitz J, Cohen H, Kotler M: One Year Outcomes of Ultra Rapid Opiate Detoxification Combined with Naltrexone Maintenance, Journal of Drug Abuse, 1996. 17 Hubbard RL, Mardsen ME, Rachel JV, Harwood HJ, Cavenaugh ER, Ginzburg HM: Drug Abuse Treatment: A National Study of Effectiveness, Chapel Hill, NC, The University of North Carolina Press, 1989.
During the years 2001 and 2002, CITA was hampered in its efforts to promote the UROD program due to insufficient working capital. Until sufficient additional capital is available to it, CITA will be constrained and unable to engage in intensive promotion of its products.
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