U.S. GOVERNMENT PRINTING OFFICE

74–707 DTP WASHINGTON : 2001

IS DRUG USE UP OR DOWN? WHAT ARE THE

IMPLICATIONS?

HEARING

BEFORE THE

SUBCOMMITTEE ON CRIMINAL JUSTICE,

DRUG POLICY, AND HUMAN RESOURCES

OF THE

COMMITTEE ON

GOVERNMENT REFORM

HOUSE OF REPRESENTATIVES

ONE HUNDRED SIXTH CONGRESS

SECOND SESSION

SEPTEMBER 19, 2000

Serial No. 106–265

Printed for the use of the Committee on Government Reform

(

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http://www.house.gov/reform

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Mail: Stop SSOP, Washington, DC 20402–0001

(II)

COMMITTEE ON GOVERNMENT REFORM

DAN BURTON, Indiana, Chairman

BENJAMIN A. GILMAN, New York

CONSTANCE A. MORELLA, Maryland

CHRISTOPHER SHAYS, Connecticut

ILEANA ROS-LEHTINEN, Florida

JOHN M. MCHUGH, New York

STEPHEN HORN, California

JOHN L. MICA, Florida

THOMAS M. DAVIS, Virginia

DAVID M. MCINTOSH, Indiana

MARK E. SOUDER, Indiana

JOE SCARBOROUGH, Florida

STEVEN C. LATOURETTE, Ohio

MARSHALL ‘‘MARK’’ SANFORD, South

Carolina

BOB BARR, Georgia

DAN MILLER, Florida

ASA HUTCHINSON, Arkansas

LEE TERRY, Nebraska

JUDY BIGGERT, Illinois

GREG WALDEN, Oregon

DOUG OSE, California

PAUL RYAN, Wisconsin

HELEN CHENOWETH-HAGE, Idaho

DAVID VITTER, Louisiana

HENRY A. WAXMAN, California

TOM LANTOS, California

ROBERT E. WISE, JR., West Virginia

MAJOR R. OWENS, New York

EDOLPHUS TOWNS, New York

PAUL E. KANJORSKI, Pennsylvania

PATSY T. MINK, Hawaii

CAROLYN B. MALONEY, New York

ELEANOR HOLMES NORTON, Washington,

DC

CHAKA FATTAH, Pennsylvania

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

ROD R. BLAGOJEVICH, Illinois

DANNY K. DAVIS, Illinois

JOHN F. TIERNEY, Massachusetts

JIM TURNER, Texas

THOMAS H. ALLEN, Maine

HAROLD E. FORD, JR., Tennessee

JANICE D. SCHAKOWSKY, Illinois

———

BERNARD SANDERS, Vermont

(Independent)

KEVIN BINGER, Staff Director

DANIEL R. MOLL, Deputy Staff Director

JAMES C. WILSON, Chief Counsel

ROBERT A. BRIGGS, Clerk

PHIL SCHILIRO, Minority Staff Director

SUBCOMMITTEE ON CRIMINAL JUSTICE, DRUG POLICY, AND HUMAN RESOURCES

JOHN L. MICA, Florida, Chairman

BOB BARR, Georgia

BENJAMIN A. GILMAN, New York

CHRISTOPHER SHAYS, Connecticut

ILEANA ROS-LEHTINEN, Florida

MARK E. SOUDER, Indiana

STEVEN C. LATOURETTE, Ohio

ASA HUTCHINSON, Arkansas

DOUG OSE, California

DAVID VITTER, Louisiana

PATSY T. MINK, Hawaii

EDOLPHUS TOWNS, New York

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

ROD R. BLAGOJEVICH, Illinois

JOHN F. TIERNEY, Massachusetts

JIM TURNER, Texas

JANICE D. SCHAKOWSKY, Illinois

EX OFFICIO

DAN BURTON, Indiana HENRY A. WAXMAN, California

SHARON PINKERTON, Staff Director and Chief Counsel

STEVE DILLINGHAM, Special Counsel

RYAN MCKEE, Clerk

SARAH DESPRES, Minority Counsel

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C O N T E N T S

Page

Hearing held on September 19, 2000 ..................................................................... 1

Statement of:

Alumbaugh, Mr. and Mrs., private citizens ................................................... 11

Raub, William, Deputy Assistant Secretary, Scientific Research, Health

and Human Services; Julie Samuels, Acting Director, National Institute of Justice, Department of Justice; Lloyd Johnston, Monitoring

the Future Project, University of Michigan; Donald Vereen, M.D., Deputy Director, Office of National Drug Control Policy [ONDCP], accompanied by Terry Zobeck, Chief, Research Programs Branch, Office of

National Drug Control Policy [ONDCP] ..................................................... 22

Letters, statements, etc., submitted for the record by:

Alumbaugh, Mr. and Mrs., private citizens, prepared statement of ............ 15

Johnston, Lloyd, Monitoring the Future Project, University of Michigan,

prepared statement of ................................................................................... 47

Mica, Hon. John L., a Representative in Congress from the State of

Florida, prepared statement of .................................................................... 6

Raub, William, Deputy Assistant Secretary, Scientific Research, Health

and Human Services:

Information concerning youth risk behavior trends ............................... 88

Prepared statement of ............................................................................... 25

Samuels, Julie, Acting Director, National Institute of Justice, Department

of Justice, prepared statement of ................................................................ 34

Vereen, Donald, M.D., Deputy Director, Office of National Drug Control

Policy [ONDCP], prepared statement of ..................................................... 65

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IS DRUG USE UP OR DOWN? WHAT ARE THE

IMPLICATIONS?

TUESDAY, SEPTEMBER 19, 2000

HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON CRIMINAL JUSTICE, DRUG POLICY, AND HUMAN RESOURCES, COMMITTEE ON GOVERNMENT REFORM, Washington, DC.

The subcommittee met, pursuant to notice, at 10 a.m., in room

2203, Rayburn House Office Building, Hon. John L. Mica (chairman of the subcommittee) presiding.

Present: Representatives Mica, Ose, and Mink.

Staff present: Sharon Pinkerton, staff director and chief counsel;

Steve Dillingham, special counsel; Charley Diaz, congressional fellow; Ryan McKee, clerk; and Sarah Despres, minority counsel.

Mr. MICA. Good morning. I would like to call the hearing to

order. The order of business this morning will be first, I will proceed with an opening statement. Then we have two panels we will

be hearing from today, and Mrs. Mink would like to move that we

leave the record open for a period of 2 weeks for additional statements for Members or interested individuals who, through the

Chair, would like their statements or information made part of the

official record of these proceedings. With that we will begin, and

this morning I will start with my opening statement.

This morning our subcommittee will focus on the question of

drug use trends in the United States. Over the past few weeks, administration officials have attempted to put a happy face on what

appears, from the information that our subcommittee has received,

an increasingly sad situation.

Unfortunately, even information that will be presented by the Office of National Drug Control Policy today, that information indicates that overall drug use has grown from some 6.4 percent in

1997 to 7 percent in 1999.

While marijuana and crack use has decreased slightly among

youth, methamphetamine, ecstasy and designer drug use has skyrocketed both for youth and for adults. Our subcommittee must report with great sadness that today, for the first time in the history

of the United States, drug-induced deaths have exceeded homicides

in our country. This, in fact, is a startling statistic and, in fact, a

national tragedy.

I have some charts that I brought with me. This one shows again

that sad statistic. For the first time, drug-induced deaths have exceeded murder in the United States of America. Just an unbelievable tragedy.

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What is interesting is that data supported by information we received—this is a headline from last week in the Baltimore Sun— the Baltimore Sun said last week they released figures that in 1998

there were 290 overdose victims and 313 homicides, and that they

have now reported for the succeeding year that 324 people died of

illegal drug overdose in Baltimore as compared to 309 homicides.

So overdose deaths exceeds slayings. And this same headline in

this urban area has been reported in my suburban area of central

Florida.

This is, in fact, a startling statistic and a national tragedy. As

chairman of the House Subcommittee on Criminal Justice, Drug

Policy, and Human Resources, I open this hearing with a simple

message regarding drug use trends. Drug use remains as great a

danger today as it has ever been. In fact, since 1998, America is

losing more lives each year to drug-induced deaths than to murder.

From 1992 to 1998, drug deaths have increased an astounding 45

percent in this country. Unfortunately, law enforcement officials

have told me that the death statistic for drug deaths would be even

worse if it were not for improvements in emergency room treatments for overdoses. Our hospitals and treatment facilities are

being deluged with record numbers of drug overdose admissions.

This is in spite of a nearly 52 percent increase in prevention funding over the same period and a 34 percent increase in treatment

funding. This is also in spite of a $1 billion national media campaign that we have undertaken and it has been supported by this

subcommittee.

Why are we experiencing such an incredible onslaught of drug

deaths and drug abuse? First, let me cite these reasons I believe— a lack of national leadership. Second, an unprecedented supply of

deadly drugs. Three, high-purity levels. Four, a lack of successful

treatment, education and prevention programs. And five, harm and

risk from drugs is not understood and the use of drugs is in fact

in our society today glorified.

Although we may take some comfort in a declining murder rate,

drug-induced deaths are rising. It is critical that we not be complacent in this fight against drugs and drug abuse as progress we

have made may soon be lost. In many critical aspects, drug use remains at the highest levels ever. Furthermore, the threat is taking

new forms after posing greater and less apparent danger such as

popular but deadly club drugs. Accordingly, we must remain committed and work harder and smarter to protect our children, families, and communities from the dangers associated with the drug

use trends that we study and will discuss today.

Today’s hearing will examine drug trends, consequences, and implications for policies and programs. Yesterday I chaired a hearing

in Atlanta, GA that focused on the explosion of so-called club drugs

across America. We examined the degree to which the threat is

known and being experienced in communities in and around the

city of Atlanta. Last week, we saw on the front page of the Baltimore Sun the headlines that drug overdose deaths had surpassed

murders in Baltimore. As we will hear today, these trends reflect

rising drug-related deaths nationally. Yesterday, I learned from

families about tragedies they experienced. Today, we will hear and

learn more.

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This hearing will focus on two important topics: (1), drug use

trends as measured by national surveys and research; and (2),

what is being done and should be done by the administration to respond to the drug scourge that continues to wreak destruction

across America.

We will hear from the White House Office of National Drug Control Policy [ONDCP], over which this subcommittee has oversight

responsibility. ONDCP is responsible for examining data trends,

identifying needs, and revising Federal policies and programs to respond to these needs. As the recently released year 2000 ONDCP

Performance Measurement Report points out, the information is to

be used to hold agencies accountable, including altering their budgets.

This subcommittee is committed to ensuring that the administration takes its responsibility seriously and that reforms are made

and actions are taken where needed. Today’s hearing is the first

opportunity that we have had to examine the performance report

and implications for administration policies and programs.

In all candor, the recent performance report, agency press releases, and comments by senior administration officials have highlighted what they consider to be good news and possible progress.

I will be the first to state that positive trends are welcomed and

desired by everyone. We are very supportive of the hard work being

done by the committed individuals on the front line who risk their

lives each and every day at Federal, State, and local levels. I commend law enforcement officers, prosecutors, judges, corrections officials, and drug treatment professionals at all levels.

I remain concerned, however, that wrong and misleading messages are being sent regarding the dangers and extent of drug use

in America. It is critical that we set the record straight and proceed

with the business of working harder and smarter. We cannot afford

to lose time, or to squander much-needed Federal resources.

One survey that has received much attention is the National

Household Survey on Drug Abuse, or Household Survey. This survey is sponsored by the Substance Abuse and Mental Health Services Administration [SAMHSA], at HHS.

Recently, the administration has highlighted the Household Survey, finding a reported drop in drug use among teens aged 12 to

17 from 1997 to 1999. While this limited decline might be an indication of positive movement, it should be considered in context of

other findings. Since 1992, the same household survey shows that

from 1992 to 1998, past month drug use by teens in this age group

had almost doubled, from approximately 5 to 10 percent. The relevant policy questions are: Why do many more teens now use drugs

than 7 years ago? And, how can we get the levels of drug use back

down again?

Second, we will look at the findings of the Monitoring the Future

[MTF] project, and make comparisons to findings of the Household

Survey. MTF is a federally sponsored national survey of students

conducted by the University of Michigan’s Survey Research Center.

Its findings also are examined by ONDCP. The MTF data and

trends give us reasons to be alarmed. Looking at the ONDCP Performance Report numbers and graph, reported increases in teen

drug use for 8th, 10th and 12th graders are obvious and dramatic.

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Since 1992, 8th grade past month drug use more than doubled;

10th grade drug use has almost doubled; and there was an increase

of almost two-thirds, or 62 percent, among 12th grade drug users.

What are the implications of this continuing high rate of drug

use across America, and what does it mean for our agencies and

programs?

Another source of valuable information that we will examine is

the data from the Arrestee Drug Abuse Monitoring [ADAM], program, supported by the National Institute of Justice [NIJ], at the

Department of Justice. This data is collected from 35 sites in 25

States and the District of Columbia, with plans for expansion.

The data is obtained through drug testing and interviews of

arrestees. ADAM’s 1999 research data indicates rising drug use

among male and female arrestees. More than 60 percent of adult

male arrestees tested positive for the presence of illegal drugs. The

city figures range from 50 percent in San Antonio to 77 percent in

Atlanta. What the data clearly shows is the linkage between crime

and drugs continues. That is one reason that I have submitted H.R.

4493—the Drug Treatment Alternative to Prison Act—to meet the

treatment needs of eligible nonviolent offenders. I hope the administration supports this bill.

Finally, we will examine other HHS research related to drug use

and abuse. As I mentioned, drug-induced deaths continue to climb,

surpassing murders. ONDCP’s drug policy strategy indicates that

drug-related deaths exceed 50,000 annually, that there are more

than one-half million emergency department drug-related episodes,

and almost a million drug mentions.

These are some of the trends that we will explore today, and that

ONDCP must analyze and recommend changes to policies and

practices. By most measures, drug use has worsened over the past

7 years. We are also seeing changes in drug preferences and potencies, as well as emerging challenges with dangerous club drugs.

The implications for the administration are now the focus of our

attention. What is being done to address these findings? In past

hearings, we have identified serious deficiencies in the bureaucratic

practices of SAMHSA in areas of management, evaluation, and research.

Now we learn that the Department of Justice bureaucracy has

quadrupled in size as a result of increased funding that we approved for State and local assistance. We are receiving reports of

grant delays, waste, and deficient evaluations, in addition to less

priority being given to drug efforts. In its 1989 discretionary grant

programs, the DOJ Bureau of Justice Assistance designed almost

every grant to fight drug use. That grant program was named after

police officer Edward Byrne, who died fighting drug traffickers.

Today, it is difficult to find discretionary drug initiatives at DOJ

that are considered to be priorities. How did this happen?

Finally, the many problems we previously identified at the Department of Education in administering the Safe and Drug-Free

Schools program appear to continue.

As we will hear from our first witness, the consequences of drug

use are enormous. Our efforts to combat it must remain a top priority, and our practices must improve. ONDCP has the central role

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in this challenge, and we must oversee the effort. I look forward

to hearing from our witnesses today on this important topic.

I am pleased at this time to yield to the gentlelady from Hawaii,

our ranking member, Mrs. Mink.

[The prepared statement of Hon. John L. Mica follows:]

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Mrs. MINK. Thank you very much, Mr. Chairman.

The subject area that we have been dealing with for the past 2

years, drug consumption in the United States and its devastating

consequences, is always a very depressing scene, and the difficulty

that we have on this committee is that it does not appear that the

massive efforts that we have undertaken, not only through this

committee but in other committees in funding various programs,

has not made demonstrable successes. We keep hearing the very

deplorable rates of consumption among school children and teenagers, and as the chairman pointed out, the increasing numbers of

users who end up dead.

One of the things that I think troubles me most is the lack of

emphasis on all of the agencies and those committed to this issue

in really coming forward with a program that can work. We have

tried everything and still the figures are very depressing. And even

more depressing, when we talk about people dying from the use of

these drugs, and to have it referenced as club drugs, as though it

is something fashionable, sociable, and useful. Instead they should

be referred to as ‘‘killer drugs’’ or something which characterizes

the impact that these drugs have on our society.

Not only are these people dying from the use of drugs, but the

implications in the crime statistics are also something that we

should pay attention to. Drug users are involved in all sorts of

criminal violations in the pursuit of these drugs and trying to find

money, stealing and so forth, so the problem is enormous and the

progress that this country is making is very discouraging.

And it is not for the lack of interest, I don’t believe, on the part

of the administration, or the Congress. We simply have not come

up with the tools that can produce effective results to lower the

usage and to enable the community to deal with it. It is not only

a law enforcement problem, it is a community problem, and we

have to put our best minds together, particularly with the school

children and the teenagers that find themselves hopelessly addicted to these drugs.

So I am very supportive of the chairman’s efforts in this regard

in trying to enlarge our capacity to understand the nature and

scope and size of this problem, and hope that in engaging ourselves

in hearings like this that we can come up with useful endeavors

that can help this Nation end this scourge.

Thank you very much, Mr. Chairman.

Mr. MICA. I thank the gentlelady.

I am pleased to recognize the gentleman from California, Mr.

Ose, for an opening statement at this time.

Mr. OSE. Thank you, Mr. Chairman.

One of the interesting things that I have found in my short tenure here is that the things that are probably the most important

that we deal with are those that are not going to get a lot of headlines. Maybe it is because the subject is difficult or ugly or trying

or troubling. This is one of those subjects that rarely gets a lot of

attention.

In California we are dealing with any number of things, the most

current of which is a proposal to further legalize or actually decriminalize the use or possession of illegal narcotics. And the headline on the committee hearing today ‘‘Is Drug Use Up or Down?

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What are the Implications?’’ I think are apropos to what I am

about to say. And that is that the proposal on our ballot, Prop. 36,

is crafted in such a sense as to suggest to the voters that the initiative will provide treatment or counseling, or what have you; but exactly the opposite. What the initiative does is reduce the treatment

and reduce the options for people who want to eliminate the

scourge of drugs from their lives.

We have a number of things going on at the Federal level, and

I know your bill, which I agreed to be a cosponsor of yesterday

afternoon, to provide further treatment options, is one of those that

we are working on. But that kind of thing is happening across the

country at State and local levels to give people the options. The reality is until those of us from Florida or Hawaii or California or

wherever say the truth, which is that drug use amongst our youth

is a deadly, deadly exercise, until we say that in terms that our

kids understand and explain to them that what they are using is

not their father’s pot or father’s crack or their mother’s crack or

pot, that is not what it is, it is 10 times stronger, and the pharmacological impact on your body is that much worse also.

Mr. Chairman, I don’t know of a more important issue that this

country faces than the challenge of abuse of drugs. Prop. 36 is just

the most current iteration of the politicization of this issue. I would

hope that in the course of the debate that Prop. 36 is exposed for

the fraud that it is and is voted down in California, and I will do

everything that I can to make sure that information is in the public

domain. I appreciate you having this hearing. I look forward to the

testimony that we are about to hear.

Mr. MICA. I thank the gentlelady and the gentleman for their

opening statements, and now we will proceed with our first panel.

Our first panel has two private citizens, Mr. and Mrs.

Alumbaugh. They are from Fort Pierce, FL. I just explain again, I

think you testified before our subcommittee in Orlando, this is an

investigation and oversight subcommittee of the House of Representatives, and in that regard we do swear in our witnesses. If

you will stand, please, to be sworn.

[Witnesses sworn.]

Mr. MICA. The witnesses have answered in the affirmative. I am

pleased to welcome them to Washington to testify today, because

I think it is important that we put a human face on these statistics

and figures that we are announcing today; that, in fact, one of

those who died in 1988 was their son, Michael, and he was a living,

breathing, loved, human being. And this isn’t just about bean

counting or statistics, it is about people losing their lives in a tragedy beyond belief for parents.

With that, I recognize Debbie Alumbaugh, who is the mother of

Michael, for her comments and testimony. Thank you.

STATEMENTS OF MR. AND MRS. ALUMBAUGH, PRIVATE

CITIZENS

Mrs. ALUMBAUGH. Thank you, Mr. Mica. We feel it is an honor

to be asked to testify before you again. Again, my name is Debbie

Alumbaugh, and I am the surviving mother of Michael Tiedemann.

He was 15 years old when he died. That was 23 months ago. The

cause of Michael’s death was aspiration vomitus and GHB toxicity.

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GHB, or gamma hydroxybutyrate, is one of the club drugs that we

have in our Nation now.

Michael was a sophomore at Westwood High School in Ft. Pierce,

FL. He was a black belt in karate and he was also an instructor.

He had won several academic awards for reading, mathematics,

music, and spelling. He was on the honor roll. He was not a street

kid.

On October 1, Michael went to school as any normal day; during

his break between second and third periods, he complained to a

friend that he had a headache. Another student overheard this and

offered Michael, ‘‘I have these pills. They will make your headache

go away and make you feel better.’’ We believe that since Michael

was suffering with a headache, he didn’t realize or didn’t think this

was taking drugs. We found out from the autopsy that he was

given methadone in school. He didn’t know what he got and the

student who gave it did not know what she had.

When Michael came home from school that day, he asked to go

to the show with some friends. It was unusual to let him out on

a school night, but he was doing well, A’s and B’s. Before he left,

a friend came to the house and they went directly into Michael’s

room. This was one of his best friends. They were only in his room

for 5 minutes, and this is where the transaction of GHB occurred.

When Michael came home from the movies, his father looked at

him: ‘‘Are you on something, son? Did you take something?’’ Michael denied this. Brad kept asking him and asking him. Finally,

Michael admitted they had smoked some pot. Again, some pot.

Brad said that he wouldn’t lecture him that evening. He was high.

It was 1 a.m. He would discuss it in the morning. He never got

that chance. Michael died that night in the safest place, alone in

his bed.

The next morning the phone rang. The voice on the phone said

Michael is not at the bus stop. As Brad walked across our home,

he could hear the alarm ringing. Michael did have intentions of

getting up to go to school. When he opened the door, he knew our

son was dead. The scene was horrendous. Our son was on his back,

eyes wide open and glassy. His mouth hung open, his tongue swollen so much his father couldn’t shut his mouth. He had vomited

from the chemicals in these drugs. GHB is mixed with floor stripper, degreaser and, most recently, red devil lye. His hands were in

a clawed position where he tried to roll himself over to save himself

and he couldn’t because the chemicals in these drugs paralyzed the

motor skills.

We didn’t know why our son had died and they had to do an autopsy. It took 12 weeks for us to learn why our son had died. GHB

leaves the body quickly and it was not in his blood or his urine.

They took our son’s brain, and that is where they found this deadly

drug.

We go to schools and we tell the kids this story. We believe we

leave nothing out. There is no antidote for GHB overdose. If you

pass out and go into a coma, you will die, unless your body’s constitution is strong enough to bring you out. Most are not. There is

nothing the doctor or anyone can do to fix you. In the last 3 years

in Florida alone, we have lost 174 young people to these drugs.

That is 173 tragedies just like ours.

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After several months, Michael came to his father in a dream and

said, ‘‘Dad, it is wrong to destroy the body the way I did. You and

mom must tell my story. You don’t have a clue about the drugs

that my friends and my generation are faced with daily.’’ This put

a burden on our hearts until we gathered up enough courage and

strength to make the first call. We called St. Andrews where Michael had attended. We went to the school, and as I stood in front

of all those beautiful young faces, I started, we are not here to lecture or accuse any of you of being bad kids. We are here to share

our experience of losing a good kid to drugs. And that is when Michael’s Message Foundation was born.

We tell the students what took our son’s life, and then I tell them

a little bit about Michael. He was not only a great son but a very

loving son. On June 1 of this year, Michael would have been 17

years old. And I testified before Congressman Mica at a hearing in

Orlando, FL and today I stand here. It is an honor and a privilege.

We have devoted our lives to this.

We have chosen to take our tragedy and to educate our Nation.

We have turned our grief into something positive and constructive.

Michael’s Message Foundation is a nonprofit organization. We do

travel to schools. We go from 6th grade through 12th and up into

college, sharing our son’s story. We also speak at churches, rehab

centers, and we speak a lot to at-risk youth activities. Our goal is

to take Michael’s message nationwide in the hopes of saving another family the heartache these drugs caused our family.

Our children are our future. We feel that Michael’s message

should be heard by parents and grandparents also, and Michael’s

voice must be heard, that these drugs kill.

We have been told by students at a charter school that they appreciate drug testing. It gives them a tool that can assist them

with peer pressure. We do agree that cameras in school should be

used as a tool or deterrent. Kids are not going to tell on the drug

dealer.

We just found out recently that many children knew what our

son had taken that day. Yet no one came forward, no one was the

hero and said anything. Their lives are at risk. They are afraid of

being hurt or killed. Again, education plays a key role not only in

informing the kids that it is wrong, but death is the major consequence to these drugs.

I am here today in the hopes that laws will be made to punish

the individuals who make and distribute these deadly drugs. No

one was arrested for our son’s death.

After sharing Michael’s message, students come up and ask what

happened to the person that supplied the drugs. Well, in July, this

young man who allegedly gave the GHB was arrested on school

grounds with a half pound of marijuana, pills, and paraphernalia,

yet again endangering the lives of our students. Did this young

man learn nothing from our son’s death? Our kids are begging for

help. They often share with us that they are scared, telling this

with tears rolling down their faces, and this echoes in our minds.

Thank you again for asking us here today. Let’s unite and make

our schools, communities, and our Nation safer and better for everyone. Thank you.

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Mr. MICA. Thank you for your testimony, Mrs. Alumbaugh. Mr.

Alumbaugh, did you have comments that you wanted to make? You

are recognized.

Mr. ALUMBAUGH. We do feel that the schools would be better for

everyone, instead of the old saying that our school is drug free, we

feel that they do make a major bust at a school, that the school

be rewarded in some way via a camera to set up in their school.

Or after a few years after this, sometimes we get the schools

cleared out from the drug problem. Eventually there could be computers put in the schools. But right now we definitely need some

cameras in there because they are not going to tell on Johnny.

Mrs. ALUMBAUGH. And the people who run the schools turn a

blind eye because they don’t want their school to be labeled a bad

school.

[The prepared statement of Mr. and Mrs. Alumbaugh follows:]

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Mr. MICA. Maybe I can start with some questions, if I may. You

said in July of this year, the person who sold your son drugs was

that this year—was selling them again a few years later?

Mrs. ALUMBAUGH. Yes, sir.

Mr. MICA. After your son was literally murdered?

Mrs. ALUMBAUGH. Yes.

Mr. MICA. No enforcement?

Mr. ALUMBAUGH. We were told by the detective, due to the fact

that the drug was given without intent to harm our son, there was

no harm committed.

Mr. MICA. Well, unfortunately, you know, I have heard this over

and over. We heard it again yesterday. We had a picture of a beautiful young lady that her father brought to the subcommittee, and

he described his daughter’s horrible death on the same drug, except

she lingered for 2 years.

Mrs. ALUMBAUGH. Oh, my.

Mr. MICA. And she ended up in a nursing home. She had convulsions that were beyond description. Her body temperature at some

point—he said rose to 107. Her heartbeat was 170 and dropped at

one point to 25, and their family went through hell for 2 years. She

finally died.

One of the problems that we have is that we are being inundated

with a supply, not only these designer drugs, but also they are very

difficult to detect for enforcement. The only way they can tell on

some of these drugs now is after death, through an autopsy, unfortunately. We have spent—you heard Mrs. Mink. We supported a $1

billion ad campaign, media campaign. We are reviewing the results

of that. It has only been around for less than 2 years. What else

can we do at the Federal level to address this problem?

Mrs. ALUMBAUGH. Newsletters.

Mr. ALUMBAUGH. We feel that there should be a special task

force developed for clearing out our neighborhoods. You are going

to have to be tough on crime and drug dealers.

Mr. MICA. Have you seen the ads that have been put out by the

Office of National Drug Control Policy?

Mrs. ALUMBAUGH. Yes.

Mr. MICA. What is your evaluation? Are these effective? Unfortunately, the statistics are from 1998, the year your son died. I have

not seen 1999, but I am sure that they have increased in 1999. The

trends are just dramatic.

Mrs. ALUMBAUGH. I saw one of the ONDCP commercials. I have

seen them on TV, but I witnessed one on the Internet that I would

like to see more of on the TV, and by all means my son be a poster

child for this. And it is the funeral director talking about bringing

the body past the school yard one last time on its way to the cemetery.

I believe this is what our kids need. They need to know that they

are going to die from these drugs, and more of that needs to be

seen. They need to witness this. They need to hear this.

Again, I saw the commercial on the Internet. I have not seen it

on TV yet. But those type of commercials, they need to know the

reality of the drugs.

Mr. MICA. Mrs. Mink.

Mrs. MINK. Thank you, Mr. Chairman.

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The comments you have made today are absolutely representative, I think, of the families who have suffered as you have with

your son’s involvement in this incident. I am not sure it was one

incident or several, but it ended in this terrible tragedy. The point

you make about young people not really comprehending the possibility of death from use of these drugs, I think, contributes to their

general frivolous viewpoint about these drugs.

Now, in the school that your son attended, I am sure throughout

the campus, throughout the school, there was knowledge and a

shared grief about this incident. So as a consequence of that, is

there any statistic that you can point to that in this particular

school that your son attended that there is greater awareness and

less incidents like this?

Mr. ALUMBAUGH. The school does seem to be a lot better school

today than it was 2 years ago.

Mrs. ALUMBAUGH. Yes, we visited it just the beginning of this

month. It is more stringent. The school resource officers is there

and the whole atmosphere of the school is different.

Mrs. MINK. So when that young person who was your son’s

friend came back to the same campus——

Mrs. ALUMBAUGH. It was summer school.

Mrs. MINK [continuing]. To the same campus with the intent to

distribute these drugs again, what did the school do to this individual?

Mrs. ALUMBAUGH. He was arrested on felony charges. He was released to his parents.

Mrs. MINK. How old is he?

Mrs. ALUMBAUGH. He is 17 now.

Mrs. MINK. And what charges have been brought against him?

Mrs. ALUMBAUGH. Possession to distribute, possession to sell, because he had baggies, scales, pills, money. So they arrested him

with possession of narcotic, possession with intent to distribute and

to sell.

Mrs. MINK. So why couldn’t they levy the same charges in the

incident that involved your son?

Mrs. ALUMBAUGH. Those are answers that I would like.

Mrs. MINK. Thank you, Mr. Chairman.

Mr. MICA. Mr. Ose.

Mr. OSE. I am most curious, when you meet with groups of kids,

how is it that you communicate your message? It would seem to

me that talking to adults about drugs is different than kids. Different words, different things that you visit with them about.

Mrs. ALUMBAUGH. Well, we have given Michael’s message to students and to adults.

Mr. OSE. It is the same message, but is it delivered the same

way?

Mrs. ALUMBAUGH. No.

To the parent we deliver it more on how to watch your child. I

add in that I thought my child was safe in my own home.

Mr. OSE. For the benefit of those of us in Congress, some of the

tell-tale signs of a child who is abusing drugs are?

Mrs. ALUMBAUGH. What you saw that night. I didn’t have a clue

myself that night.

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Mr. ALUMBAUGH. When Michael came home that night and I confronted him and was talking to him, he had eye contact like we do

now. But when he was sitting on the sofa and nobody was confronting him, he was comatose. He was in the ozone. He was sitting

with his mouth hanging open, staring at the floor. I knew that

there was something wrong with him that night. I could tell that

he had taken something.

Mrs. ALUMBAUGH. Yet when he questioned the kids that he was

with, they all denied it, one of which was my nephew. He asked

point blank, Did Michael take something? No, Uncle Brad, honest,

he just smoked some pot. Like that is not bad. Just smoked some

pot.

Mr. ALUMBAUGH. A few months later, Michael’s friends came by

the house and they shared with me that they were—they were buddies, and they shared with me that they were going to smoke pot

but they would do nothing else, and that day was different. That

day they decided to take these pills. The old saying goes, you know,

when they start smoking pot, that is the start of their drug activity.

Mrs. ALUMBAUGH. But the young boy who brought the drug

didn’t take it. He not only gave it to our son, he gave it to another

child there also, but he didn’t take this drug, but he is also the one

who called our home the next morning to awaken Brad to tell him

that Michael wasn’t at the bus stop.

Mr. OSE. When you have meetings with young people, what are

their questions? The phrase is ‘‘I don’t want to rat somebody out.’’ Obviously they have a fear of the consequence once the adults are

out of the room kind of thing.

Mrs. ALUMBAUGH. A lot of them we have a book over there cry

and they are worried. They are not worried so much about themselves. Some of them are worried about their parents and it is not

just the young people that are doing these drugs. They are afraid.

They don’t know who to go to and they ask where can we go, you

know.

Mr. ALUMBAUGH. They seem helpless and scared.

Mr. OSE. They are 12 to 17 and they don’t have a lot of life experiences.

Mrs. ALUMBAUGH. True.

Mr. OSE. Thank you, Mr. Chairman.

Mr. MICA. Well, I appreciate so much your coming up from Florida. You testified before us in Orlando. When we learn these statistics, it confirms that we have drug-induced deaths exceeding homicides in this country. I thought it was important to have a human

face on it. That is a 15-year-old kid; that is not a hardened drug

dealer that died after a lifetime of abuse. And those individuals

shouldn’t die or be lost, and I appreciate your coming before the

subcommittee today, trying to make something positive out of what

has to be every parent’s absolute worst nightmare.

Unfortunately, this death was repeated and this tragedy for

16,925 families the same year. So we appreciate again your coming

and thank you for the message that you are giving to students and

to communities and now to our country. Thank you so much, and

I will excuse you at this time.

Mrs. ALUMBAUGH. Thank you.

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Mr. ALUMBAUGH. Thank you.

Mr. MICA. Let me call our second panel. Our second panel consists of William Raub, who is the Deputy Assistant Secretary.

Mr. OSE. Could I interrupt? Could we have Mr. and Mrs.

Alumbaugh stick around?

Mr. MICA. Dr. Raub is Senior Scientific Adviser to the Secretary

for Science Policy, Department of HHS; Ms. Julie Samuels, Acting

Director, National Institute of Justice, Department of Justice; Dr.

Lloyd Johnston, Monitoring the Future Project, University of

Michigan; and we have the Honorable Donald Vereen, who is the

Deputy Director of the Office of National Drug Control Policy.

As I indicated before to our first panel, this is an investigations

and oversight subcommittee. We do swear in our witnesses.

[Witnesses sworn.]

Mr. MICA. We actually have five witnesses at the table, if you

can introduce yourself.

Mr. ZOBECK. I am Terry Zobeck. I am Chief of the Research Programs Branch at ONDCP.

Mr. MICA. Dr. Zobeck, thank you.

Let me first recognize Dr. William Raub who is with Scientific

Research, HHS. Dr. Raub, welcome and you are recognized.

STATEMENTS OF WILLIAM RAUB, DEPUTY ASSISTANT SECRETARY, SCIENTIFIC RESEARCH, HEALTH AND HUMAN

SERVICES; JULIE SAMUELS, ACTING DIRECTOR, NATIONAL

INSTITUTE OF JUSTICE, DEPARTMENT OF JUSTICE; LLOYD

JOHNSTON, MONITORING THE FUTURE PROJECT, UNIVERSITY OF MICHIGAN; DONALD VEREEN, M.D., DEPUTY DIRECTOR, OFFICE OF NATIONAL DRUG CONTROL POLICY

[ONDCP], ACCOMPANIED BY TERRY ZOBECK, CHIEF, RESEARCH PROGRAMS BRANCH, OFFICE OF NATIONAL DRUG

CONTROL POLICY [ONDCP]

Mr. RAUB. Thank you, Mr. Chairman, and Representative Mink

and Representative Ose. My name is William Raub, and I am the

Science Advisor to the Secretary for Health and Human Services.

I am pleased to come before the subcommittee today to highlight

efforts undertaken by the Department of HHS during the past decade to monitor and track trends in youth drug use.

Mr. Chairman, with your permission I will submit my full statement for the record and make some brief statements.

Mr. MICA. Without objection, so ordered. Please proceed.

Mr. RAUB. Research methodology relevant to the study of complex social problems generally does not produce absolute results,

nor are those results 100 percent precise. Thus, in seeking to understand the nature and scope of issues such as youth drug use,

one is well advised not only to collect data from multiple sources

but also to analyze such data from multiple perspectives. Although

synthesizing and interpreting data gathered in different ways in

different contexts is invariably challenging, such efforts often are

essential to ensure confidence in the results. Moreover, assembling

such a multifaceted knowledge base often is a prerequisite to developing effective prevention strategies.

With respect to the subject of this hearing, HHS conducts several

surveys that provide estimates of the percentage of youth who use

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illegal drugs, alcohol or tobacco. I will describe each of these surveys briefly and then discuss recent trends in youth substance use.

Since 1990, the CDC has operated the Youth Risk Behavior Surveillance System to provide information on specific behaviors that

underlie the most important health problems among youth in the

United States. The YRBSS reports on behavior in six risk areas:

(1) tobacco use; (2) alcohol and other drug use; (3) behaviors resulting in unintentional injury and violence; (4) sexual behaviors contributing to unintended pregnancy and sexually transmitted diseases, including HIV infection; (5) unhealthy dietary behaviors; and

(6) physical inactivity.

The national Youth Risk Behavior Survey is a national component of the YRBSS. This survey, conducted during the spring semester among national samples of high school students, provides

data that are representative of all students in grades 9 through 12

in public and private schools in the 50 States and the District of

Columbia. In 1999, 15,359 questionnaires were completed in 144

schools. Schools are selected using a scientifically based sampling

process, and schools with a large percentage of African American

and Hispanic students are oversampled to generate stable estimates each year for these subgroups of youth.

Since 1975, the National Institute of Drug Abuse has sponsored

the Monitoring the Future Survey through a succession of grants

to the University of Michigan’s Survey Research Center. The purpose of the survey is to assess the attitudes and behaviors of high

school youth in a variety of areas, including and most notably the

areas of drug, alcohol, and tobacco use. The survey covers 45,000

to 50,000 students annually and provides unique data on both

youth substance use and the attitudes and beliefs that may contribute to such behaviors. The survey has been conducted among high

school seniors since its inception and, since 1991, has included 8th

and 10th graders as well.

Since 1971, the Substance Abuse and Mental Health Services

Administration has sponsored the National Household Survey on

Drug Abuse. NHSDA is the primary source of statistical information on the use of illegal drugs by the U.S. population. Moreover,

the Household Survey provides the only source of nationally representative data on adult substance use in this country.

The NHSDA is conducted with a nationally representative sample of the population through face-to-face interviews at the subjects’

place of residence. The population covered by the survey is the civilian, noninstitutional population age 12 and older in the United

States, including all 50 States and the District of Columbia. In

1999, the survey underwent a major redesign, moving from a paper

questionnaire to computer-assisted administration and dramatically expanding the sample to almost 70,000 individuals, including

approximately 25,000 youth between the ages of 12 and 17, to permit State-level as well as national-level prevalence estimates of

substance use.

Taken together, these three surveys provide a rich array of information to monitor and attempt to understand trends in substance

use and abuse. Each survey provides unique and important information that is useful to local, State and national decisionmakers

attempting to address problems of substance use and abuse. All

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three surveys recently were reviewed by a panel of outside experts,

which concluded that each survey is methodologically strong, well

designed for its intended purpose, and well administered.

I am pleased to report that these three surveys—individually and

collectively—provide data that can help to resolve the central question posed in today’s hearing: ‘‘Is drug abuse going up or down?’’ In particular, all three surveys indicate that use of illegal drug and

tobacco among youth has leveled and, in some cases, declined over

the last 3 years. However, the data also indicate that the success

of the last 3 years hardly is cause for complacency, for youth use

of illegal drugs and tobacco remains higher than that observed in

1991, the historical low point. In particular, all of the Departmentsponsored surveys that track youth substance use show that the

rates increased during the early to mid parts of the 1990’s and

then leveled off or declined somewhat since.

The data make clear that far too many of our Nation’s young

people and their families continue to experience the risks, and

often fatal consequences, that attend the use of illegal drugs and

other substances. Nevertheless, recent trends in youth use of illegal

substances provide a basis for cautious optimism that the joint efforts of parents, teachers, counselors, and public officials to educate

youth about the dangers of illegal drug, alcohol, and tobacco use

are bearing fruit. The Nation must buildupon the momentum

gained in recent years against this major public health and social

problem.

The Department welcomes the continuing interest of the subcommittee. I will respond as best I can to whatever questions you

may have.

Mr. MICA. We will get to you in a few minutes. I would dispute

some of your testimony.

[The prepared statement of Mr. Raub follows:]

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Mr. MICA. Let me recognize now Julie Samuels, acting director,

National Institute of Justice.

Ms. SAMUELS. Mr. Chairman, Congresswoman Mink, and Congressman Ose, I appreciate the opportunity to participate in the

subcommittee’s review of drug use trends in America. The National

Institute of Justice operates the Arrestee Drug Abuse Monitoring

the Future Program, known as ADAM. I would like my prepared

statement to be accepted for the record.

Mr. MICA. Without objection, your entire statement will be made

part of the record. Proceed.

Ms. SAMUELS. NIJ is the Department of Justice’s independent research and development agency. Our mandate is to build knowledge to meet the challenges of crime and drug use. NIJ developed

ADAM to build knowledge about drugs, crime, and related social

issues and to support local and national policymakers. ADAM’s primary purpose is to provide timely information about drugs and

crime, patterns of drug use and treatment, emerging drug trends,

the effect of law enforcement on drug use, treatment needs, and a

wide range of related issues and it does this by focusing on people

who are arrested and booked into local lockups.

ADAM’s data are collected in 35 different U.S. Counties every

quarter. Within 48 hours of arrest, local ADAM staff interview

arrestees and collect urine samples for drug testing. Participation

in this program is voluntary and anonymous.

Four things distinguish ADAM from other surveys as a source of

information about drug use in America: One, ADAM focuses on

communities. From ADAM, we develop detailed use of drug use

among arrestees in specific areas.

Two, ADAM focuses on arrestees. ADAM focuses on people who

have been arrested, so the program provides a firsthand look at the

connection between drugs and crime. These arrestees also represent a group of great concern.

Three, ADAM includes a drug test. In addition to asking each respondent questions about his or her drug use and drug treatment

experiences, respondents also provide a urine sample that is laboratory tested for a variety of drugs. The scientific testing supplements the interview responses.

Four, ADAM offers a research platform. Building on the core

ADAM program, NIJ has established a cost-effective way to undertake specialized studies on a broad range of public safety and public health issues related to drug use in the arrestee population,

such as domestic violence or the dynamics of drug markets.

Consistently, ADAM’s data have shown that about two of every

three arrestees who participate in the program test positive for at

least one of five drugs: cocaine, opiates, methamphetamines, marijuana, or PCP. In recent years our data have shown little overall

decline in the level of drug use among arrestees. Perhaps the most

important thing we have learned is that the drug problem is different in different communities around the Nation. For example,

methamphetamine use among arrestees remained low in most

ADAM communities in 1999 but continued to vary by region, with

use clearly higher in the ADAM communities in the western part

of the Nation.

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As I mentioned earlier, ADAM is primarily designed to provide

data on drug use among arrestees on the local level. In that sense

it helps communities nationwide to understand their particular

problems of drugs and crime from a local perspective.

At present, ADAM data do not readily lend themselves to national estimates of drug use among arrestees. Nonetheless, in the

same way that ADAM can help local communities shape local responses to drug and crime, it can help inform national policymakers about trends and patterns in various regions in the United

States.

We hope to expand ADAM to 75 sites. As part of our expansion,

we would routinely collect data on arrestees not only in urban metropolitan centers, but also in rural, suburban, and Indian country.

In addition to extending the ADAM program and its benefits to

other communities, this expansion and the improved methodology

would enable us to make national estimates of drug use among the

arrestee population. Our expanded plan would also allow us to increase the specialized studies that can inform both local and national concerns about the problem of drugs and crime in the United

States.

Mr. Chairman, that concludes my opening remarks. I would be

pleased to answer any questions.

Mr. MICA. Thank you. We will hold questions until we have

heard from all of the panel witnesses.

[The prepared statement of Ms. Samuels follows:]

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Mr. MICA. Next we will hear from Dr. Johnston who is with Monitoring the Future Project, the University of Michigan.

Mr. JOHNSTON. Thank you, Mr. Chairman and members of the

committee. I appreciate this opportunity to testify. My name is

Lloyd Johnston. I am a research scientist and principal investigator

of the Monitoring the Future study at the University of Michigan.

That study, as Mr. Raub mentioned, is now in its 25th year, and

we have tracked American high school seniors for that entire period on an annual basis. In 1991, we added younger adolescents,

8th and 10th graders, fortunately at a point where it was helpful

in interpreting what was going on.

This is an investigator-initiated research grant, which means

that the scientists responsible came up with the idea, brought it before NIH for competitive review and must bring it back every 5

years for continued competitive review. The surveys involve inschool student-based samples as opposed to, for example, people in

a household. They are large and nationally representative at each

of the three grade levels. Each is a separate national survey independently selected; altogether we have close to 50,000 students per

year located in some 430 secondary schools.

A less well known feature of the design is that we also follow

some of each year’s graduating high school class into adulthood by

use of mail surveys, sent through the mail, and these give us a

very nice national sample of American college students and eventually young adults of various ages who are high school graduates.

We have people who are 40 years old whom we initially surveyed

when they were high school seniors.

We have over the years given great priority to consistency of

methods in this study so that we don’t confuse methodological

changes with real underlying changes in the phenomenon understudy.

As far as timeframe, our data are collected in the spring, primarily in March through May, and therefore we have a somewhat

different time reference in the year than the National Household

Survey which you will hear more about.

The content coverage is broad. We go into a great many substances, in excess of 30 categories and subcategories of substances,

as well as many characteristics of the person and surrounding attitudes and beliefs that may help explain the use of these individual

drugs.

As for recent trends, the most recent data are from the spring

of 1999. The 2000 survey, while complete, is not ready for release

and will not be until December. The results of the study are provided in a blue book of which I hope there are enough copies for

all the committee members—called Overview of Key Findings,

which gives a brief synopsis for each of the categories of drugs.

Several things to mention, one of which is that it is clear that

the peak of the American epidemic was in the last third of the 20th

century, the late seventies, beginning of the eighties. There was a

long period of decline in use in all age groups, including the ones

that we monitor, and that decline ended in the beginning of the

1990’s. There then was a period of increase again, among adolescents only, a rather interesting development. Up to that point, almost all of the age groups were moving in parallel, and then sudVerDate 11-MAY-2000 11:21 Sep 14, 2001 Jkt 000000 PO 00000 Frm 00048 Fmt 6633 Sfmt 6633 C:\DOCS\74707.TXT HGOVREF1 PsN: HGOVREF1
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denly adolescents began to show an increase in the 1990’s that was

not observed even among young adults.

You have alluded to the scale of that change, and what we saw

was that by 1996, the 8th graders reached a peak level and there

was an inflection point and use has been declining since then. The

older adolescents reached an inflection point a year later in 1997,

and the 12th graders thereafter have remained level in their use,

and the 10th graders have shown some decline, although there was

not much decline in any of these groups in 1999 specifically.

I might note that the eighth graders, the youngest of the students that we looked at, were the first to show the increase in the

1990’s and also the first to show the decrease in the 1990’s, which

suggests to me that the younger children who really haven’t established attitudes and patterns in this area yet are the most susceptible to the forces of change, whatever those forces might be—good

or bad.

It also helps to explain why there are some differences in the results of the surveys, since our surveys cover somewhat different

age bands. The Household Survey was down to age 12, and we

start at 13 and 14.

Since those peaks, as I say, there has been some change, mostly

in the younger children. And in 1999, only the eighth graders

showed any further decline in overall illicit drug use. But nevertheless all groups showed some decline in some specific drugs. We saw

some divergence of different classes of drugs. While heroin and

marijuana and amphetamines remain fairly stable in 1999, a number did decline. Inhalants, crystal methamphetamine, crack cocaine, a very important drug, showed a decline for the first time

among the eighth graders.

So there was some good news in that year, and there were two

pieces of bad news. One was the increase of ecstacy, a sharp increase among the 10th and 12th graders. Ecstacy is also called

MDMA, and we know from our surveys of young adults that

ecstacy use has been climbing among those in the first half of the

20’s through age 26. So we have clearly seen the emergence of an

epidemic of use among those in the late teens, early 20’s, of socalled club drugs.

Steroids also bumped up in 1999 among the younger children,

8th to 10th graders, perhaps for some very specific reasons. So in

fact there has been a divergence, which I think helps to illustrate

the point that different drugs to some degree march to their own

drummers. As youngsters learn about the hazards of a drug, they

are less likely to use. As peer disapproval emerges, they are less

likely to use. With ecstasy or GHB and others which always are

coming along, I think they enjoy a certain period of suspended

judgment, as it were, what I call a ‘‘honeymoon period,’’ where

their alleged benefits are circulated among youngsters, but their effects are not yet well documented and convincingly communicated

to youngsters. And I think that was the case with GHB related to

the tragic story that we heard earlier from the first panel.

Another thing to note is that cohort effects have emerged, and

the teens of the early 1990’s are continuing to carry with them into

young adulthood higher rates of drug use. The kids who were entering teenagehood in the late 1990’s have lower rates of drug use,

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which is the good news part of the story. We have not always seen

these cohort effects in the past, but it clearly occurred, and I think

it was because the kids who grew up in the late 1980’s and the

early 1990’s saw so much less drug use around them, they saw

much less of the consequences, the tragic consequences of use, and

they came to see these drugs as less dangerous than their predecessors who had more direct observation of what happened.

Finally, you noted the increase in death rates, and that, of

course, is a tragic fact. Death rates and some other consequences

such as entering treatment do tend to occur on a lagged basis from

when we actually see an increase in the prevalence of using the

drugs. For example, cocaine use spread considerably in the late

seventies, but it wasn’t until the early eighties that we began to

see a rise in deaths in people calling emergency hotlines and in

people entering treatment and various other kinds of effects. So

some of these indicators are what I call lagged indicators. And I

think the spread of heroin earlier in the decade is probably one of

the contributing factors to the death rates that are now rising because many of those people are still using heroin, and through a

natural process of involvement, have become more involved and

more susceptible to overdose.

Thank you, Mr. Chairman.

[The prepared statement of Mr. Johnston follows:]

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Mr. MICA. We will now recognize Dr. Vereen, who is the Deputy

Director of the Office of National Drug Control Policy.

Dr. VEREEN. Thank you, Mr. Chairman, Chairman Mica, Representative Mink, and Representative Ose and to the other members of the subcommittee.

The Office of National Drug Control Policy welcomes this opportunity to discuss illegal drug use trends in America. The annual report on the National Drug Control Strategy which is submitted to

Congress every winter is a data-based comprehensive 10-year report that includes an assessment of Federal success in achieving

the goals and objectives of the strategy. And the data presented in

that 2000 report are valid, and they demonstrate that we are moving in the right direction to achieve the goals that we have identified for that strategy.

I would like to submit the full written testimony for the record

and just give a brief oral statement.

Mr. MICA. Without objection, your entire statement will be made

part of the record. Please proceed.

Dr. VEREEN. As my colleague from HHS has explained already,

to assess trends in drug use, the government examines the results

from a number of different surveys, three in particular, three nationally representative population studies. One is the HHS National Household Survey that has been presented. I will just add

that is a study that is conducted through face-to-face interviews

each year, using computer-assisted self interviews, and it covers a

host of drugs that are used, including lifetime use, past-year use

and past-month use.

You have just heard from Dr. Johnston on the Monitoring the

Future study. This is a school-based study that surveys students in

the 8th, 10th and 12th grades. These data are released every year

in December, and the most recently available data are for 1999.

The third is the Center for Disease Control and Prevention’s

Youth Risk Behavior Study. That is also a school-based survey for

students 9th through 12th grade. The data are released for that

particular study every other year. That is important—an important

point to make.

Let me refer you to a visual because it is very difficult to talk

about data sometimes without getting some sense of what it looks

like over time. Here is a slide that shows the trend lines from all

three studies that have been presented to you, and what we have

done here is to select out marijuana, the most commonly used drug

by young people. The main point that we want to make from all

of this data is that there is a remarkable consistency in the trends

of the data. The actual numbers will change as a reflection of

methodology and other factors, which we can go into if you would

like, but the trends are consistent. So while the absolute prevalence rates may vary, the trends are consistent.

Of great concern to us is that even though recently we reported

that there has been a 21 percent decline over the last 2 years in

illicit drugs use in 12 to 17-year-olds, we are concerned as well

about the increase, apparent increase in drug use in the 18 to 25-

year-old group. The current use of any illicit drug among this group

increased 28 percent from 1997 to 1999. This may capture some of

the club drug use, as Dr. Johnston mentioned earlier, those in the

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lower end of their 20’s. Club drugs are becoming a drug of increasing use.

Past month use of marijuana in this group followed a similar

trend, also increasing 28 percent. Overall drug use remains level,

as you can see from these trend lines. According to the National

Household Survey, the rate of illicit drug use in the population

ages 12 and older is statistically unchanged over the past 2 years,

if you look just at the statistics, and it is represented here visually.

But as Dr. Johnston stated, the latest findings from the Monitoring

the Future Study for the school year 1998 to 1999 indicate that we

are holding the line against drug use; that we have turned a corner. He referred to it as—I am forgetting the word that he used

before. But the data from the 1999 Monitoring the Future Study

show that the use of illicit drugs among 8th, 10th and 12th graders

remains pretty much unchanged from 1998 to 1999.

With regard to emerging drugs, there has been an increase in

ecstacy or MDMA use among 10th and 12th graders which is of

great concern. The documented increase in these drugs corroborates other recent indicators. As you have probably noted, these are

huge studies with a 6-month to a 1-year lag time.

We have a couple of other mechanisms that allow us to get at

local trends in a slightly faster fashion. ONDCP has a pulse check

mechanism, and the Department of HHS, through the National Institute on Drug Abuse has a community epidemiology working

group report that allows us to get a little closer to these local

trends. And approximately a year ago, we were able to note the use

in trends of club use drugs as that data was taken into account.

On the next slide I would like to briefly illustrate the methamphetamine problem. It has been of great concern to us, and we

are going to illustrate the ADAM data here to give you a visual of

that data set to show two main points. These are the blood tests

or the drug test results of booked male arrestees, as was explained

by my colleague earlier. But you will notice in the cities where

methamphetamine was found, there are huge variations in the

amount of methamphetamine use. We think of the drug problem in

the country is a collection of local epidemics, as the past director

of NIJ was wont to describe. Just so you get a picture of what the

female arrestee rates look like, you will see a similar set of patterns, and I won’t go into the specific changes from city to city.

The second point that I want to make about this data set is that

you will notice that all of the cities are west of the Mississippi.

This is a drug phenomenon that as it creeps across the country in

its local fashion, has at this point stopped or hovered around the

Mississippi River, and drug trends follow such patterns. So when

you hear us announce national trends for methamphetamine, we

are really talking about the western part of the country for the

most part. In conclusion, Mr. Chairman, the trends among the 12

to 17-year-old age group are positive and encouraging. Adolescents

increasingly disapprove of illegal drugs. But despite this good news,

we face an increasingly difficult challenge to our abilities to detect,

monitor and track emerging drug trends that pose a grave and

dangerous threat to our children.

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All of us at ONDCP are grateful to Congress for your efforts in

this subcommittee. And now I would like to just say a couple of

words about our performance measure system.

Our strategy, as you know, is attached to performance measures

of effectiveness system. This system makes extensive use of many

of the data sources that you have seen here for tracking our success or where we need areas of help in achieving our goals and objectives for the strategy. The system is complex. It involves an

interagency effort, those of us sitting across this table as well as

others. The performance measure community recognizes that such

systems have to change and adjust, just like our national strategy.

It is a 10-year plan based on data, but has flexibility built in to

respond to new and local epidemics. This PME system has been favorably reviewed by the National Academy of Public Administration, the National Partnership for Reinventing Government, and

the GAO.

At this point, I will end my comments.

Mr. MICA. Thank you.

[The prepared statement of Dr. Vereen follows:]

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Mr. MICA. Let me first turn to Julie Samuels of DOJ. You noted

in your testimony, as a result of the urine testing of arrestees, it

was revealed that the actual number of drug users was twice as

high as the level that had been previously reported; is that correct?

Ms. SAMUELS. Yes, sir.

Mr. MICA. So some of the statistics we are looking at, unless

there was drug testing, urine testing, may be even worse than

what is being presented?

Ms. SAMUELS. It is unclear whether you can draw that conclusion. I think what we have learned with respect to doing both the

interviews and the drug tests is there are times when what the arrestee tells us with respect to his drug use is not consistent with

the confirmed drug test. I don’t know whether you can necessarily

generalize that to the rest of the population.

Mr. MICA. You said that the actual number of drug users was

twice as high?

Ms. SAMUELS. Yes. Clearly for this population, they are not always admitting as much use as the drug tests indicated.

Mr. MICA. And that most of the testing that we have talked

about is self-reported; is that correct, Dr. Johnston?

Mr. JOHNSTON. Yes. The national surveys are all self-reported.

But I should note that the in-jail situation is a very extreme situation where people are there because of breaking the law and they

are under charges.

Mr. MICA. Have you given any consideration in your reporting to

finding a sample that would also look at some verification of the

statistics that you are compiling, Dr. Johnston?

Mr. JOHNSTON. It is, unfortunately, the case that, short of doing

actual hair or urine testing, there is no gold standard; and even

those are not a gold standard.

Mr. MICA. Is there a comparison where they have conducted hair

or urine testing and then compared it to the statistics?

Mr. JOHNSTON. Not in this country. I have seen it done in other

countries, and the results were pretty good. But what we do is a

number of what I call ‘‘triangulations’’ on validity and look at quite

a host of things which should come out a particular way if the data

are valid. We look for consistency among the answers that an individual gives about various drugs. And if it is a high rate of inconsistency, we throw the case out. And we look at their reports of

friends’ use about which there would be less motivation to conceal,

presumably, since they are unnamed friends. We get both prevalence and trends, I might add, because sometimes it is asserted

that maybe the willingness to be honest changes over time, but I

think we have pretty good evidence to suggest that hasn’t been the

case, at least in the school surveys.

Mr. MICA. Dr. Vereen, we are trying to get measures of performance, and get some hard data on the success or failure that we

have incurred in these programs. I guess you have a couple of targets, a 5-year target, 2002 or 2003, and that would be our closest

target. What is the overall drug use percentage of the population

that you are trying to achieve in 2003?

Dr. VEREEN. Overall, as we state in the national strategy, we

want to cut past-month use in half. When you look at the whole

population which the strategy deals with, there is approximately a

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6.4 percent across the country drug use, and we want to cut that

in half by 2004.

Mr. MICA. And you are trying to get to 3 percent; that is the

goal?

Dr. VEREEN. Yes.

Mr. MICA. According to the report given to us in 1997, we were

at 6.4 percent. In 1998 we have dropped slightly to 6.2 percent.

However, this past year we are back at 7 percent. So instead of getting closer to the 3 percent of the population, we are now 4 full percentage points away. While we had 1 year where there was a slight

decrease, it appears that the trend, in fact, for overall drug use remains increasing; is that correct?

Dr. VEREEN. That is 1 data point that——

Mr. MICA. From 6.4 to 7, and our goal is 3; 7 is higher than 3.

Dr. VEREEN. It is, but 1 point doesn’t define a——

Mr. MICA. It doesn’t appear that we are heading in the right direction. We use the chart here of marijuana. I don’t know if you

have charts of some of the other uses, but we have got ecstacy

reaching cocaine and heroin proportions. Do we have a chart for

ecstacy? I know that you testified that it is on the increase, and

Dr. Johnston said that we are seeing a substitution. Rather than

crack, rather than seeing other drugs we have seen in the past,

that they are shifting use; is that correct?

Dr. VEREEN. That’s correct.

Mr. MICA. The other problem is we are seeing death and also increase in hospital emergency admissions; is that correct?

Dr. VEREEN. Yes.

Mr. MICA. And I attribute this to two things: One, an incredible

supply. There is an incredible supply of heroin coming in from Colombia. A 20 percent increase in production in black tar heroin

from Mexico. And not only are we seeing a larger amount of heroin

and cocaine coming into the country, we are also seeing the highest

purity levels that we have ever confiscated or seized; is that correct?

Dr. VEREEN. Yes, but you are seeing exactly how the drug problem preys on the United States. It takes advantage of communities

and——

Mr. MICA. We are seeing a regional problem. We see

methamphetamines, and we held hearings in Mr. Ose’s district up

and down the West Coast. We were in Iowa, and they had captured

something like 1,000 meth labs between local, State and Federal

law enforcement sources. We were in Dallas, TX, Mr. Sessions’ district, and the DEA that covers Oklahoma and Texas told us that

there are almost 1,000 labs in that area producing meth; people,

literally by the thousands, being addicted.

In Mr. Ose’s district we had testimony from one social worker

where several hundred children had been abandoned in one county

of 100,000 population, and they could only get about 30 reunited

with the family because the people were either incoherent or so

damaged by meth. We are seeing a new phenomenon of death and

destruction, I think unlike anything that we have experienced;

would you agree?

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Dr. VEREEN. Yes, and that occurs with each new drug. Each one

has a new and different profile. The challenge is to react as quickly

as possible to that new drug.

Mr. MICA. One of the things that we have is a gap in our survey.

We had the people from the Center for Disease Control, and some

of the drugs that are now in vogue are not even on the charts for

bean counting.

Dr. VEREEN. The CDC study is an every-other-year study. The

other two studies are starting to capture that. We have two other

local mechanisms, the CEWG and our pulse check, that gave us information about these other phenomena within the last 2 years.

Mr. MICA. I have to dispute some of Dr. Raub’s testimony, too;

again, the leveling off. And I think if we look at long term, or we

take some of these individual drugs, we can dispute that we have

seen, as Dr. Johnston and Dr. Vereen have testified, that we are

seeing, unfortunately, a continued use overall. We are seeing dramatic increases in adult population, we will say 18 to 25, in that

range, because some of those are young adults, and we have seen

still dramatic increases; even in drugs that are perceived as a lesser risk, like marijuana, only some minor leveling off.

Do you want to respond, Dr. Raub?

Mr. RAUB. Only that the thrust of my statement was not to declare victory; rather, to identify where there are some positive signals, but also to acknowledge that there are some disconcerting

negative developments. This country cannot lower its guard, and I

agree completely with your concerns.

Mr. JOHNSTON. We do have crystal methamphetamine for some

years in the Monitoring the Future study, and for the first time in

1999 it showed a significant drop, roughly a 40 percent drop. So

there was some good news on that front. I hope it holds.

Mr. MICA. Let me yield now to Mrs. Mink.

Mrs. MINK. Thank you, Mr. Chairman.

I am somewhat distressed by the tone of the testimony that all

of you have presented, because I don’t happen to agree that there

is anything to celebrate. The trends that are developed by these individuals studies, I don’t think relate to the real world that we

have to face. While studies are very valuable to help people determine where the emphasis ought to be in law enforcement or treatment I think that the context in which they are sometimes read

and presented turns people off guard into thinking, well, somebody

must have a handle on all of this because such-and-such a report

indicates that the trends are going down in consumption.

I happen to agree with the testimony and tone of the first panel

where the witnesses said they had such extreme difficulty, even

among family members, to get the teenagers to disclose the truth

of what is happening in a school situation. And so I take a very

jaundiced view about the studies that depend upon the teenagers

themselves relating honestly their 30-day practices or 14-day practices or the year practices. And I think that our job really is to examine the veracity of this evidence that you have collected and test

it to make sure that these are accurate phenomenon that are going

on.

The first question I have is, while this chart, Dr. Vereen, is dismissed as indicating as the trends are similar, there is still a wide

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range between the top line and the bottom line. How do you interpret that for a layperson like myself looking at this chart saying,

why the differences?

Dr. VEREEN. That is an excellent question and I perhaps should

invite you to some of our staff meetings.

Mrs. MINK. No, no, no.

Dr. VEREEN. I can partially explain the answer, and my colleagues can add what they would like.

The CDC study, the top line, has a slightly older population

which we know has a higher drug rate use. The bottom line, the

red line, is the National Household Survey which surveys people as

young as 12 which have a—— Mrs. MINK. They have no business being on one chart.

Dr. VEREEN. Well, we made the judgment, since the studies were

going to be presented and compared, we would show that. Yes,

there are discrepancies in the prevalence rate, but we as scientists,

we as policymakers, look at the trend. I can tell you as a physician,

we do that as well. Sometimes when you get a series of blood tests,

the absolute numbers are not as important as the trends sometimes.

So what we have here are multiple views of the drug problem to

get as clear a picture as possible. That is what we attempt to do

and that is why we have multiple studies. We don’t just rely on

one.

Mrs. MINK. The top line is what age group?

Dr. VEREEN. That is the 9th, 10th, 11th and 12th grades. The

Monitoring the Future we have split out. That is 8th, 10th, and

12th.

Now, on the bottom line you have 12 and over, so you have

young people who have a low rate of drug use, and then you have

many older people who are not using drugs at all in a household,

because that is where the study grabs it, and that is why it is important to understand what each of those lines mean.

Mrs. MINK. So they offer no conclusive evidence. They don’t look

at the chart and say, oh, I am a policymaker and now I know what

to do.

Dr. VEREEN. The data tell us that the trends are consistent and

move in the same direction.

Mrs. MINK. Do you have a similar chart for the 18 to 25, because

in your testimony you point out in this age group there is a significant increase in users. Do you have a chart?

Dr. VEREEN. We have one that we can provide for you, certainly.

Mrs. MINK. So your testimony is corroborated by the other studies?

Dr. VEREEN. Yes. I can offer that we can take any of these numbers and any of the data that the U.S. taxpayer pays for and put

it in any form. We have a copy of this here, if you would like a closer look at it.

Mrs. MINK. So if the rates of consumption, addiction, however

you want to say, increase after age 18 up to 26 in the studies—— Dr. VEREEN. Not necessarily. What we may have is a cohort that

had been using at a high rate before and are continuing to use at

a high rate. When we select out that age group, it doesn’t necessarily mean that they started at that age group.

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Mrs. MINK. But they are continuing. Why the huge variance in

use to the next group, Mr. Johnston?

Mr. JOHNSTON. We have very similar results and it is more detailed by age. What we see is the youngsters who were the teenagers in the early 1990’s when drug use among teens was going up,

as they enter the post-high school years, those same class cohorts

or birth cohorts are showing higher rates than their predecessors

in older ages as well. They are carrying with them the habits they

established back in the early 1990’s. That is an unusual pattern

here. We see that all of the time with cigarettes. If a particular

class cohort had a high rate of smoking, even in their early teens,

they will carry with them those habits. We have not seen that with

illicit drug use: this is the first occasion where we have actually

seen a cohort effect, and that shows up in the later ages as those

youngsters, become the people in their 20’s and perhaps even into

their 30’s.

Dr. VEREEN. And as Dr. Johnston pointed out, the 20’s are when

many young people are using some of the club drugs for the first

time.

Mrs. MINK. Who came up with the term ‘‘club drug?’’ Dr. VEREEN. I am not sure.

Mrs. MINK. Your agency?

Dr. VEREEN. No.

Mrs. MINK. And ‘‘designer drug,’’ who came up with that name?

Dr. VEREEN. One of the things that we try to do is speak to the

American people. We try to get educated by them. So we try to

keep tabs on all of the latest lingo on the drugs. If we want to get

messages out to young people, we try to meet them halfway by

speaking their lingo so that they know that we have listened to

them and we can report back to them, reflect back to them: We are

concerned; this thing that you think is not very harmful is.

We have been able to react very quickly to ecstacy, for example.

We can now show with the latest technology that ecstacy, in fact,

causes brain change, perhaps permanent brain change, and we are

able to get that information back to young people who are engaging

in the club drug scene.

A part of the initiative by the National Institute on Drug Abuse

is to actually present those very clinical pictures and postcards distributed in batches of thousands to young people so they can see

for themselves what this drug that they think won’t harm them

could actually do to their brains.

Mrs. MINK. Thank you, Mr. Chairman.

Mr. MICA. I thank the gentlelady.

I yield to the gentleman from California, Mr. Ose.

Mr. OSE. Thank you, Mr. Chairman. I want to go back to Dr.

Raub. I want to make sure that I understand something. On page

5 of your written statement at the bottom paragraph, you indicate

that there is a change in the methodology by which the data for

the study was collected, and that there can only be limited comparisons made between the data from the 1999 survey and the data

obtained from surveys prior to 1999; is that correct?

Mr. RAUB. Yes, that’s correct.

Mr. OSE. If I also understand your testimony on page 4, the survey that we are referring to in that testimony I just cited is the

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primary source of statistical information on the use of illegal drugs

by the U.S. population? That is the bottom line there?

Mr. RAUB. Yes.

Mr. OSE. The question I have, I am up here trying to decide, as

compared to Dr. Vereen, I am trying to decide as a policymaker

what is the data that we are supposed to be using. If the methodology had not been changed, do you have any indication what the results of the survey would have been so we can tie apples to apples,

for instance?

Mr. RAUB. In fact, your point is well taken, and the language

here and the approach here was a cautionary one. This is a Household Survey based on direct interview, which is a very powerful

type of method. Most surveys of this type over the last several

years have been making the transition from pencil and paper questionnaire approaches to computer-assisted devices. These are generally more favorable in terms of both the accuracy and the efficiency of following up on the data, but there is also the risk of introducing a different methodology that may alter the reporting.

Therefore, as a cautionary step, the people doing the Household

Survey, while introducing the computer method for the first time,

also maintained a parallel pencil-and-paper approach as a subset,

as a way of testing that transition.

Mr. OSE. That is the 13,000 sample?

Mr. RAUB. That’s correct. I don’t think that the language here or

from my colleagues from SAMHSA means to suggest that the new

results are invalid, but rather it is a cautionary, upfront signal.

Mr. OSE. Is there a difference between the results in the 13,000

sample and the new modality sample?

Mr. RAUB. The analyses are underway. My understanding is that

to date they seem to be consistent—that there does not seem to be

a major quirk introduced by the change in the methodology. We

will know better after another cycle.

Mr. OSE. When do you except the analysis on the current sample,

the comparative analysis on the current two samples, to be finished?

Mr. RAUB. I don’t know precisely, but I expect that to be in the

near future.

Mr. OSE. I would appreciate having that information when you

get it.

[The information referred to follows:]

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Mr. RAUB. May I also add on the methodological front the question that came up before about the use of urine or regarding hair

testing. As part of the continuing evolution of this survey, there is

a subset of people in the 2000 Household Survey that will have

urine and hair testing as well as a movement toward some further

verification of this information, but this is just a natural part of the

methodological evolution in these studies.

Mr. OSE. Ms. Samuels, how would you describe ADAM in terms

of its value as a research tool?

Ms. SAMUELS. Well, I think that——

Mr. OSE. First, ADAM is the statistical process you use to——

Ms. SAMUELS. ADAM is the program by which we are working

in these 35 communities across the country, conducting interviews

and then collecting the drug test information. So from that we gain

information about the picture of the drug problem in a particular

community, and that information can then be the basis or analytic

tool for folks living in that community so they understand exactly

what the sorts of problems are that we are seeing, the types of

drugs being used by this population, the age effects, the differences

by gender.

Mr. OSE. So it is a pretty comprehensive look into a community’s

practices?

Ms. SAMUELS. Yes. With respect to research as well, we also have

the opportunity because we are doing this periodically to go in and

ask supplemental questions that might be of particular relevancy

to communities that we can provide as part of the ADAM process,

so that we can elicit this information from the arrestees in the

lockups during part of our quarterly——

Mr. OSE. Is the quality of the information gleaned from ADAM

high quality, low quality, medium quality? How would you characterize it?

Ms. SAMUELS. I hope it is high quality. I think we have put into

place a number of checks to ensure that we are conducting the

interviews using a consistent instrument across the country, to ensure that the drug tests that are taken are sent to a central laboratory so they are all analyzed under the same set of circumstances,

and over time we are also working to improve the methodology to

ensure that the information that we get from a particular county

is in fact representative of that county.

Mr. OSE. The 35 communities in which ADAM is currently at

work, were they statistically selected or did you just pull them out

of a hat? Do they reflect the country at large?

Ms. SAMUELS. The 35 communities that are involved now evolved

from an earlier part of this program. We had a program that was

called the Drug Use Forecasting Program that goes back more than

a decade. We were testing the question as to whether or not drug

use testing could inform us about drug use among arrestees, and

from there we have expanded to a number of other cities. Currently

the program is not and cannot provide a national representative estimate of drug use among arrestees, but we do have a vision and

a plan for expanding to 75 cities, and as part of that plan we would

be able to provide representative and statistically valid data on the

drug use in the arrestee population as a whole.

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Mr. OSE. That is exactly where I want to focus my question, so

I appreciate you getting to that. That was not set up, Mr. Chairman, but that just happened.

On page 3 of your testimony, you say ADAM is the only national

drug survey that routinely provides data on hard-core drug users.

Then in the last paragraph, you say ADAM is the only national

drug data system that includes a routine drug test as part of the

data collection. I presume by your inclusion of that specific statement you are trying to differentiate ADAM as a scientifically quantifiable survey as opposed to one that might just be verbal?

Ms. SAMUELS. I think what we are trying to show is that there

are two parts of it. There is the interview that is supplemented by

the drug test, so we will ask the arrestee, Are you using drugs?

What types of drugs are you using? And by getting the results of

the drug test, we can validate and look at the answers that they

have provided to us.

Mr. OSE. Do you find a higher validity in the responses on the

verbal side from those who know that they are going to have their

urine or hair samples taken as opposed to those that don’t? Dr.

Johnston, you are kind of smiling.

Mr. JOHNSTON. That is a reasonable question. I was smiling because of what it says about human motivation. But the—I don’t

know whether ADAM has tested that. I know in the cigarette research literature, it has been found that if kids know that they are

going to have saliva tests, they report higher rates of smoking, but

it is not a consistent finding. It is depends on the situation that

kids are presented with.

Mr. OSE. In California we have this Proposition 36 that purports

to be something to address an inadequacy in our drug treatment

and drug programs, but the actual initiative eliminates the opportunity to perform a urine or drug test. And it just seems to me that

why would you put into law, in an actual referendum that is going

to be the law of the State, why would you put into that position

a preclusion, the inability to actually hold someone accountable for

their actions so that you can get the truth? Our objective here is

to provide treatment for people. Yet, we are going to put into law

or at least control—what is the phrase, controlling legal authority—an inability to hold them accountable for what they tell us.

I was reading your testimony, and I can’t say that it is in here

explicitly, but implicitly at least in your testimony, that you have

to have some means of verifying what you collect verbally, and that

drug testing urine, blood, hair, is the most effective way of doing

that.

I didn’t set this up, Mr. Chairman, but it is absolutely so precisely targeted on the basic dilemma we face in California that I

would have flown on three red-eyes, 3 days in a row, just to get

that in the public record, and I appreciate Ms. Samuels doing that.

Who was it that testified on the Centers for Disease—Dr. Raub.

You indicated that use levels had flattened or leveled and in some

cases improved. I am a little bit confused about something. I have

a copy of the basic data from the Center for Disease Control study,

and it talks about risk behaviors that worsened; and it has got tobacco use frequently, alcohol and other drug use, episodic, current,

sexual behaviors and the like, and it goes from 1991 to 1997 followVerDate 11-MAY-2000 11:21 Sep 14, 2001 Jkt 000000 PO 00000 Frm 00095 Fmt 6633 Sfmt 6633 C:\DOCS\74707.TXT HGOVREF1 PsN: HGOVREF1
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ing the 2-year implement pattern that Dr. Vereen mentioned. It indicates to me that over the five tests that would have been occurring in the 1990’s, that being 1991, 1993, 1995, 1997, and 1999,

lifetime marijuana use has gone from a risk factor of—I have to

make sure that I understand this—31.3 to a comparative 47.2 in

1999. Is that percent? I can’t tell if that is percent. It is a 50 percent increase over an 8 or 9-year period. Current cocaine use has

gone from a risk behavior rating of 1.7 in 1991 to 4 in 1999, which

is basically a 100 percent increase. Frequent cigarette use has gone

from a risk behavior rating of 12.7 in 1991 to 16.8 in 1999.

If you look at trends, which I believe is what we are looking at

here, either in that chart or most any others that we have seen

here, the trend is not positive. The trend is showing an increase

in the risk behaviors, at least as it relates to this chart, and I am

wondering whether that corresponds to a decline in usage that is

indicated in your testimony?

Mr. RAUB. On that specific line, sir, I would not characterize it

as decline in usage. Compared to 1991, there is an increase. Compared to 1997, there is a leveling.

Mr. OSE. I would agree on a comparative basis.

Mr. RAUB. But we need additional years of evidence to determine

whether we have turned a corner or whether that is just a momentary pause.

Mr. OSE. I am trying to deal with the trend. I am hoping that

it is not a momentary pause and that it is the peak, so that it goes

down. And that is as it relates to the marijuana use, the 47.1 to

the 47.2 risk behavior rating; but in current cocaine use, it goes

from 3.3 to 4, which is a 25 percent increase.

Mr. RAUB. Right.

Mr. OSE. Now, I am not here to argue about the other things,

but whether you take it in segmented markets, depending on what

designer drug of the day we are talking about, or otherwise, while

there may be some indication from 1997 to 1999 as it relates to

lifetime marijuana use that there is a leveling, I don’t see the indication that there is a trend here that has been set of a leveling.

And that is what I am trying to get at: whether or not these risk

behaviors that are highlighted here indicate usage patterns.

If I understand your testimony correctly, it is that as it relates

to lifetime marijuana use, as it relates to these numbers, there

seems to be a leveling from 1997 to 1999; but that the trend from

1991 to 1999 indicates significant increases?

Mr. RAUB. That is the way that I interpret it, yes, sir. And it is

a pattern that is consistent in the trend in the other two surveys.

Mr. OSE. The 1997 to 1999 change, or the 1991 to 1999?

Mr. RAUB. The recent year change. Depending when they do the

measurement, the last few years have changed in the other surveys

and are showing in general a leveling or a slight decline, but we

are showing an increase compared to the early 1990’s.

Mr. OSE. Can you explore with me a little bit, it is interesting

to me that the difference between lifetime risk behavior reports

and current risk behavior reports. For instance, in 1997, the risk

behavior report here for lifetime marijuana use indicated a reporting level of 47.1, and in 1999 it indicated a reporting level of 47.2.

That would suggest to me that the same people who had reported

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a lifetime marijuana use in 1997 basically reported it also in 1999?

I mean if they used it by the time they got to 1997, they would

have used it by the time they got to 1999 on a lifetime basis. But

if you go to the current report on cocaine use, which I guess would

stand for one or more times during the 30 days preceding the survey, in 1997 you had a risk behavior rating of 3.3, and in 1999 you

had a risk behavior rating of 4, which going back to my earlier

comments indicates a 25 percent increase in the usage of one or

more times during the 30 days preceding the survey.

So I am a little bit confused on the difference between lifetime

and current usage and how it can get analyzed for those of us who

are responsible for making policy so we can keep kids like this

from, frankly, suffering what we don’t want them to suffer.

Mr. RAUB. I think that is one that we might best submit for the

record with detailed explanation of how the various terms are used.

Mr. OSE. I appreciate that. That would be helpful.

Mr. MICA. Just in conclusion, we have again what I consider the

attempt to put a happy face on this situation. Both Mrs. Mink and

I am dismayed by what we have heard today. The death statistics

are frightening and that is 1998. We haven’t seen 1999. I see no

reason why there would be any change in the trend that we have

seen at least from deaths. This chart that was brought in by

ONDCP doesn’t show the 18-to–25, which put another dramatic

rise there. There is only one statistic that shows any possible trend

and possible decline or leveling out of what is going on. All three

of the top three measures include, and if we take the fourth measure, it also shows a scary little turn for the worse. So 1 year does

not a trend make, and we are concerned with the overall picture,

which again is pretty glum, combined with the new phenomenon of

drug-induced deaths that we see reported here today. I guess that

really isn’t a question, it is more of a statement.

We would also appreciate if there is something the subcommittee

could do in making certain that we properly address the evaluation

and statistics-gathering to make these trends and this information

more accurate. We would appreciate working with each of you in

that regard, and we welcome your suggestions and recommendations in that vein.

Mr. Ose.

Mr. OSE. Thank you, Mr. Chairman. I have collected my

thoughts. I want to go back to something. Dr. Vereen, I am a little

bit confused on the statistical sample that was used to report the

improvement in drug use over the last 3 years. I have in my possession here the 1998, 1999, and 2000 annual reports on the National Drug Control Strategy Performance Measures of Effectiveness. While I am looking for this article that I read which I seem

to have misplaced, the question arises as to whether or not the

sample on which the performance measurement or the performance

metrics were based is 12th grade usage or 8th grade usage.

If I understand correctly, from the years leading up to 1999 and

included in the 1999 annual report, the performance metric was

the 12th grade usage, and in the current year the performance

metrics is the 8th grade level usage. My question obviously arises,

is that apples versus apples or apples versus oranges? And I would

appreciate any input you might have on that.

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Dr. VEREEN. It is apples and apples or apples versus oranges depending on the question that is being asked in general. I brought

along the expert, Dr. Zobeck, to explain some of the technical reasons why that was changed. It depends on what age group you are

looking at and what program we administer. So, for example, in

our media campaign, we want to know what is happening with the

youngest set. When we are talking about overall drug trends for

the Nation, which we are required to report every year in February, we use the higher numbers. But I will let Dr. Zobeck run

through the details.

Mr. ZOBECK. The article and the issue that you refer to relates

to our Objective 2 under Goal 1 of the PME, which deals with implementing a media campaign as a prevention tool for youth.

About this time last year when we were beginning to prepare the

report, we did our review of the various measures. I also worked

closely with our media campaign people. I oversee the evaluation

there. And I said, based on the refinements to the media campaign,

where they decided that the primary focus of the campaign would

be on what they call ‘‘tweens,’’ 11 to 13-year-olds, I said that the

better measure for seeing if that has any impact would be using

the 8th grade sample rather than the 12th grade sample. If you are

looking for the most immediate impact of the program, which

would be the media campaign, that would be the most direct measure. So I made the recommendation that we switch it from 12th to

8th graders.

Mr. OSE. If it had stayed at 12th graders, what would have been

the results?

Mr. ZOBECK. I think you would have had a similar picture. Let

me go back. The issue that the article made was that by changing

it to 8th graders, it made it look like we were accomplishing things.

There was a misunderstanding in the article. The chart that came

in question was our Progress at a Glance chart, if I can find it

here.

This chart on page B–4 was designed to give the reader a quick

idea based on a color-coding scheme as to whether we were making

progress, not making progress, or had no data to assess it. That is

on page B–4.

Mr. OSE. It looks like a health care plan to me.

Mr. ZOBECK. It is a very complicated system dealing with 100

measures. However, you notice up here it says, This progress is

measured as of 1998 relative to 1996, and the increase or the

change that the article focused on was the 1999 data which is relevant to this chart, the 1998 data.

The baseline for the media campaign was 1998 so we actually

only had 1 year of data. So we coded this green because we had

the data and it was right on target.

If you go back to page E–4, I believe it is—no, page E- 10, you

have the chart for that specific measure. And you see 1998, the red

line here is what we call our glide path, where we want to be by

2002 and 2007, our two targets. You can see that the 1999 data reported it because we had—it was at 73.3 percent, which is below

the glide path. However, that red and green chart is not reflecting

that data year, it is reflecting the 1998 one.

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This coming report, we already know that is going to be a red

color on there because we know we are low, below the glide path.

If we had stayed with 12th graders, it would have been the same

result. It would have been green for 1998 because that is the baseline year; but the 12th graders, also in 1999, would have been

below the glide path. So for the next year’s report, that is going to

be red—either one.

Mr. OSE. Just to satisfy my curiosity as to whether or not we are

getting the straight scoop, are you saying that the results on page

E–10, whether you use 8th or 12th graders as the proxy, would

have been the same?

Mr. ZOBECK. The 12th graders would have had a lower perception of risk, so they would have been—it would have been lower,

so I guess it would have been a worse case.

Mr. OSE. That would have put them below the glide path?

Mr. ZOBECK. Below the glide path. You want to increase their

perception of risk rather than decrease it.

Mr. OSE. So the 8th graders perceive a higher level of risk in

marijuana use than 12th graders?

Mr. ZOBECK. A slightly higher.

Mr. OSE. So using the 8th grade cohort would have improved the

results of the report?

Mr. ZOBECK. They still would have been below the glide path.

They wouldn’t have changed the color code.

Mr. OSE. If you project that out a couple, 3, 4 years to the dates

on which the program is supposed to adhere to certain goals, do

you get there using the 12th grade cohort or the 8th grade cohort,

or both?

Mr. ZOBECK. We could get there using both. We have a separate

evaluation of the media campaign to track this very closely, very

specifically. This is really a very broad-brush way—indicator. It is

just one specific variable perception of risk of using marijuana regularly. Our in-depth evaluation is looking at hundreds of different

variables and the complex relationship between them. Risk itself is

not the most—it doesn’t explain all of the variations that you are

going to get.

Mr. OSE. Prior to the decision to use the 8th grade cohort, was

there a discussion amongst the people who had the responsibility

for selecting which cohort to be used and as to what its ultimate

appearance would be in these reports?

Mr. ZOBECK. At the time we had the discussion, we didn’t have

the 1999 data. We didn’t know where it was going to go. It was

based solely on my recommendation that 8th graders are a better

source to track the effectiveness of the media campaign than 12th

graders.

Mr. OSE. So if we change the media campaign, we may very well

need to change the cohort that we look at in future years?

Mr. ZOBECK. If we change the media campaign to aim at older

individuals, yes.

Mr. OSE. I will say that I can imagine our interest in this issue

in terms of changing the cohort from the 12th to 8th grade sample

without having been advised accordingly, because I can tell you

that the members of this panel travel to a lot of different districts,

for obvious reason.

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My final question, Mr. Chairman, if I may: What steps are you

taking so that in the future when the cohorts get changed, you advise the appropriate congressional committee of such changes?

Mr. ZOBECK. We are going to include a section in the PME report

that says ‘‘Changes.’’ For this one, we just viewed this as a technical change rather than a change to any of the goals, objective or

targets. We changed a measure. We made a call thinking, well, this

is a minor technical thing; we are not going to report it. We realize

that we should have, and in the next report there will be a section

of any changes to this report.

Mr. OSE. Thank you, Mr. Chairman.

Mr. MICA. I thank the gentleman. We do have a vote that has

been called, and it looks like possibly a series of votes. I don’t have

any further questions of the panelists at this time. We may submit

in writing some additional questions for you to respond to.

We appreciate your participation in our hearing today and your

willingness to work with us to try to find some answers to some

pretty difficult questions and bring what we see as a very serious

situation under control.

There being no further business to come before the subcommittee

at this time, this meeting is adjourned.

[Whereupon, at 12:21 p.m., the subcommittee was adjourned.]

[Additional information submitted for the hearing record follows:]

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