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84–447 PDF 2003

BENEFITS OF INTEGRATED DRUG DEMAND-REDUCTION STRATEGY: EFFECTS OF TREATMENT

FUNDING ON PUBLIC HEALTH AND PUBLIC

SAFETY IN BALTIMORE

HEARING

BEFORE THE

SUBCOMMITTEE ON CRIMINAL JUSTICE,

DRUG POLICY AND HUMAN RESOURCES

OF THE

COMMITTEE ON

GOVERNMENT REFORM

HOUSE OF REPRESENTATIVES

ONE HUNDRED SEVENTH CONGRESS

SECOND SESSION

MARCH 5, 2002

Serial No. 107–150

Printed for the use of the Committee on Government Reform

(

Available via the World Wide Web: http://www.gpo.gov/congress/house

http://www.house.gov/reform

(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

MARK E. SOUDER, Indiana

STEVEN C. LATOURETTE, Ohio

BOB BARR, Georgia

DAN MILLER, Florida

DOUG OSE, California

RON LEWIS, Kentucky

JO ANN DAVIS, Virginia

TODD RUSSELL PLATTS, Pennsylvania

DAVE WELDON, Florida

CHRIS CANNON, Utah

ADAM H. PUTNAM, Florida

C.L. ‘‘BUTCH’’ OTTER, Idaho

EDWARD L. SCHROCK, Virginia

JOHN J. DUNCAN, JR., Tennessee

——— ———

HENRY A. WAXMAN, California

TOM LANTOS, California

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

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

JANICE D. SCHAKOWSKY, Illinois

WM. LACY CLAY, Missouri

DIANE E. WATSON, California

STEPHEN F. LYNCH, Massachusetts

———

BERNARD SANDERS, Vermont

(Independent)

KEVIN BINGER, Staff Director

DANIEL R. MOLL, Deputy Staff Director

JAMES C. WILSON, Chief Counsel

ROBERT A. BRIGGS, Chief Clerk

PHIL SCHILIRO, Minority Staff Director

SUBCOMMITTEE ON CRIMINAL JUSTICE, DRUG POLICY AND HUMAN RESOURCES

MARK E. SOUDER, Indiana, Chairman

BENJAMIN A. GILMAN, New York

ILEANA ROS-LEHTINEN, Florida

JOHN L. MICA, Florida,

BOB BARR, Georgia

DAN MILLER, Florida

DOUG OSE, California

JO ANN DAVIS, Virginia

DAVE WELDON, Florida

ELIJAH E. CUMMINGS, Maryland

ROD R. BLAGOJEVICH, Illinois

BERNARD SANDERS, Vermont

DANNY K. DAVIS, Illinois

JIM TURNER, Texas

THOMAS H. ALLEN, Maine

JANICE D. SCHAKOWKY, Illinois

EX OFFICIO

DAN BURTON, Indiana HENRY A. WAXMAN, California

CHRISTOPHER DONESA, Staff Director

NICHOLAS P. COLEMAN, Professional Staff Member and Counsel

CONN CARROLL, Clerk

JULIAN A. HAYWOOD, Minority Professional Staff Member

(III)

C O N T E N T S

Page

Hearing held on March 5, 2002 .............................................................................. 1

Statement of:

Beilenson, Peter, M.D., M.P.H., Baltimore City health commissioner and

chairman of the board of directors of Baltimore Substance Abuse Systems [BSAS], Inc. .......................................................................................... 51

Cummings, Hon. Elijah E., a Representative in Congress from the State

of Maryland ................................................................................................... 5

Hickey, John, director, Tuerk House Drug Treatment Center ..................... 65

Johnson, Jeannette, Ph.D., professor, School of Social Work, University

of Buffalo ....................................................................................................... 55

Norris, Edward T., commissioner, Baltimore City Police Department ........ 20

O’Malley, Martin, mayor, city of Baltimore .................................................... 16

Robinson, Renee, treatment and criminal justice program manager,

Washington, DC–Baltimore HIDTA ............................................................ 31

Seward, Elizabeth, graduate and program coordinator, Tuerk House Drug

Treatment Center ......................................................................................... 69

Townsend, Kathleen Kennedy, Lt. Governor of Maryland ............................ 8

Weitzman, Jamey, judge, Baltimore City Drug Treatment Court, and

Chair, Maryland State Drug Courts Commission ...................................... 38

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

Beilenson, Peter, M.D., M.P.H., Baltimore City health commissioner and

chairman of the board of directors of Baltimore Substance Abuse Systems [BSAS], Inc., prepared statement of ................................................... 54

Hickey, John, director, Tuerk House Drug Treatment Center, prepared

statement of ................................................................................................... 67

Johnson, Jeannette, Ph.D., professor, School of Social Work, University

of Buffalo, prepared statement of ................................................................ 57

Norris, Edward T., commissioner, Baltimore City Police Department, prepared statement of ........................................................................................ 22

O’Malley, Martin, mayor, city of Baltimore, prepared statement of ............ 18

Robinson, Renee, treatment and criminal justice program manager,

Washington, DC–Baltimore HIDTA, prepared statement of ..................... 34

Seward, Elizabeth, graduate and program coordinator, Tuerk House Drug

Treatment Center, prepared statement of .................................................. 72

Souder, Hon. Mark E., a Representative in Congress from the State

of Indiana, prepared statement of ............................................................... 3

Townsend, Kathleen Kennedy, Lt. Governor of Maryland, prepared statement of ........................................................................................................... 11

Weitzman, Jamey, judge, Baltimore City Drug Treatment Court, and

Chair, Maryland State Drug Courts Commission, prepared statement

of ..................................................................................................................... 40

(1)

BENEFITS OF INTEGRATED DRUG DEMANDREDUCTION STRATEGY: EFFECTS OF

TREATMENT FUNDING ON PUBLIC HEALTH

AND PUBLIC SAFETY IN BALTIMORE

TUESDAY, MARCH 5, 2002

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON CRIMINAL JUSTICE, DRUG POLICY AND

HUMAN RESOURCES,

COMMITTEE ON GOVERNMENT REFORM,

Baltimore, MD.

The subcommittee met, pursuant to notice, at 10:02 a.m., in War

Memorial Building, 101 North Gay Street, Baltimore, MD, Hon.

Mark E. Souder (chairman of the subcommittee) presiding.

Present: Representatives Souder and Cummings.

Also present: Christopher Donesa, staff director and chief counsel; Nicholas P. Coleman, professional staff member and counsel;

and Conn Carroll, clerk.

Mr. SOUDER. The subcommittee will come to order. Good morning

and thank you for coming.

It is a great pleasure to be here in Baltimore today at the invitation of our Ranking Member Congressman Cummings and to be

joined by Lt. Governor Townsend, Mayor O’Malley and so many

other leaders to discuss the successes of drug treatment programs

in Baltimore.

Drug treatment is possibly the most essential component of an

integrated national drug strategy. The events of last year prevented us from spending as much of the subcommittee’s time as we

would have liked on drug treatment issues, so I welcome the opportunity presented today to return to and accelerate the discussion.

Two of the three main goals set forth in the National Drug Control

Strategy recently announced by President Bush and Director Walters are related to prevention and treatment: ‘‘Stopping Use Before

It Starts’’ through education and community action, and ‘‘Helping

America’s Drug Users’’ by getting treatment resources where they

are needed.

As part of the second goal, both the administration and the subcommittee will be seeking better information about fundamental

questions: what works in drug treatment, why it works, and where

there are shortages of capacity. We are looking at significant increased in budget support for the Substance Abuse and Mental

Health Services Administration [SAMHSA], but the Government

cannot invest those funds wisely until we know how best to provide

those services. The Office of National Drug Control Policy is redouVerDate 11-MAY-2000 10:55 Jun 04, 2003 Jkt 000000 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 D:\DOCS\84447.TXT HGOVREF1 PsN: HGOVREF1
2

bling its efforts to address those fundamental questions, and we

look forward to working with them.

One thing we do know is that effective drug treatment programs

can make a meaningful difference. Drug treatment can reduce use

of both hard drugs and marijuana, illegal behavior by addicts and

improvement in employment status. The Drug Abuse Treatment

Outcome Study found that, nationally, use of the primary drug of

choice by addicts dropped 48 percent and that the number of health

visits related to substance abuse declined by more than 50 percent.

Five years after treatment there was a 21 percent reduction in the

use of illegal drugs. While these statistics and successes do not

themselves hold the key to all treatment issues, we must for example, also find out how to encourage addicts to enter and stay in

treatment, as well as how to make it more available. They speak

to the plain fact that a good treatment program can clearly have

an impact on the lives, health and future of individual users and

their families.

[The prepared statement of Hon. Mark E. Souder follows:]

3

4

5

Mr. SOUDER. Today we are in Baltimore to hear about the findings of the ‘‘Steps to Success’’ drug and alcohol treatment outcomes

study, reviewing the many successes of treatment programs in Baltimore. We will be joined on our first panel by Baltimore Mayor

Martin O’Malley, Lt. Governor Kathleen Kennedy Townsend, and

Police Commissioner Edwin Norris. On our second panel we will

hear testimony from Ms. Renee Robinson, Treatment and Criminal

Justice Program Manager for the Baltimore/Washington HIDTA,

and Judge Jamey Weitzman from the Baltimore City Drug Treatment Court. On our third panel we will focus directly on the ‘‘Steps

to Success’’ report with Dr. Peter Beilenson, Baltimore City health

commissioner, Dr. Jeannette Johnson of SUNY-Buffalo, Mr. John

Hickey of the Tuerk House Drug Treatment Center, and Elizabeth

Seward, a graduate of the Tuerk House program. Thanks to all of

you for coming, and to Congressman Cummings and his staff for

organizing the excellent panels of witnesses today. I look forward

to your testimony.

Now I would like to recognize Mr. Cummings for his opening

statement.

STATEMENT OF HON. ELIJAH E. CUMMINGS, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MARYLAND

Mr. CUMMINGS. Mr. Chairman, I want to thank you for agreeing

to my request for today’s field hearing of the House Government

Reform Subcommittee on Criminal Justice, Drug Policy and

Human Resources. I truly appreciate both your willingness to come

to Baltimore City, and your sincere interest in the issue of drug

treatment.

I also want to thank all of our witnesses for being here to share

their diversion of individual perspectives toward Baltimore’s

progress in providing effective drug treatment. I might add that

when the subcommittee came here before in which Chairman Mica

was then the chairman, it was no doubt that it did have some effect, because of the fact that we saw a greater attention after that

given to drug treatment. And I am sure with your commitment to

treatment we will see similar benefits from today’s hearing.

As we all now, America’s war on drugs has generated another

equally intense war of conflicting opinions. While there is consensus around the premise that the problem of illegal drug consumption inflicts enormous harm on America and society, there also has

been a sharp disagreement as to how to go about eradicating it. As

is the case in most public disputes, the issue boils down to how to

allocate finite resources. We can all agree that we must do something about stopping the flow of drugs into the United States from

abroad, that we must enforce the law, that we must provide treatment, that we must try to prevent and discourage drug use, and

so on. But in what order?

Budgetary realities dictate that we must make choices. Every expenditure, therefore, must be justified in terms of benefits to the

public that it supports. In the minds of some policymakers, the extent to which we can establish that treatment actually works is

central to the debate over increasing Federal funding. We have

heard that over and over again now in Washington where the question has raised, does treatment work and how do we make sure

6

that it does work. And I noticed in the Lt. Governor’s testimony,

she talks about that. I look forward to hearing your testimony.

While there has been ample research on the subject of drug

treatment outcomes, large differences in methodology focus, scope

and rigor of the studies make evaluating the accuracy of the data

very difficult. A March 1998 report by the U.S. General Accounting

Office surveyed the available research on drug treatment outcomes

in order to determine the effectiveness of Federal drug treatment

funding. The report concluded that, ‘‘While studies conducted over

nearly three decades consistently show that treatment reduces

drug use and crime, current data collection techniques do not allow

accurate measurement of the extent to which treatment reduces

the use of illicit drugs.’’ Now that report was from 1998.

Opponents of increased funding cite the lack of definitive proof

of treatment effectiveness as justification for their position. At the

same time, the proponents of making drug treatment available on

demand stress the abundance of data that shows that drug treatment is in fact beneficial. The opponents of increased treatment

funding have tended to focus upon the absolute abstinence as a

measure of treatment effectiveness. Meanwhile, proponents of the

expanded heed the advice of the institute of medicine. The institute

has found that, ‘‘An extended abstinence, even if punctuated by

slips and short relapses, is beneficial in an of itself, and may serve

as a critical intermediate step toward lifetime abstinence and recovery.’’

In the context of this debate I welcome the fact that policymakers within Congress and the administration are now seeking to

identify a common ground on this important issue. We may be seeing the emergence of a new pragmatic consensus that recognizes

the need for effective treatment, programs and good law enforcement practices to function as two complimentary arms of the same

successful strategy. In this environment, the need for new and better research on treatment effectiveness cannot be more clear.

The recently completed Baltimore Drug and Alcohol Treatment

Outcome Study, ‘‘Steps to Success’’ comes at an opportune time. As

we will hear from those who commissioned ‘‘Steps to Success’’,

those who conducted the research and those who cooperated, the

study is the largest and most rigorously conducted scientific study

of drug treatment outcomes to focus on a single city. There is none

like it in this country. The unequivocal conclusion is that treatment

does work to reduce drug and alcohol abuse. And treatment also reduces the range of other maladies that flow from drug use, including drug related crime, overdose deaths, emergency room presentments, risky health behaviors and depression.

Mr. Chairman, Baltimore City’s devastating drug problem has

become well known to the Nation. For the benefit of communities

around the country that are similarly besieged by drug abuse, it is

very, very important that Baltimore’s recent progress of addressing

the drug plague and the challenges that remain to be overcome

should also be well known. That I think is the main reason why

we are here today. For the benefit of individuals, families and communities throughout the United States, we need to carefully consider what Baltimore has learned from its experience with expanded drug treatment funds.

7

I again thank the chairman. I want to thank all of the staff of

the—the chairman’s staff and all of my staff, and every—and the

committee’s staff that took time to pull all this together. I really

appreciate it. It took a phenomenal amount of work to take the

hearing out of Washington and bring it to any locale, just puts a

tremendous burden on the staff. And I want to thank all of you for

your cooperation and your hard work. With that, Mr. Chairman, I

look forward to hearing from our witnesses.

Mr. SOUDER. Thank you very much. And, hopefully, today will

help us. We have had difficulty moving Congressman Ramstad’s

bill on insurance to make sure that insurance companies will help

provide the coverage for drug and alcohol treatment. Because so

many times people lose their coverage and get kicked out of a program because their moneys run out. And that has been one of our

long-standing problems.

I also want to say, it is good to be back in Baltimore. In my earlier lives when I was public and staff director on the Children Family Committee, we visited the Johns Hopkins in the mid-80’s who

was a pioneer in dealing with crack babies, trying to identify family

problems there. I have been up in Sandtown looking at the Community Health Center there years ago as well in that work. Because as we realize, and then when I chaired the Empowerment

Subcommittee that was created when the republicans first took

over Congress, we had Mr. Mafumy, your predecessor, in to talk

about some of the economic development things that need to be

done. Because a lot of these problems are interrelated. And we all

realize that. Baltimore has been a creative center. We also worked

with, when I was with the Children Family Committee with one of

the distinguished Lieutenant Governors relatives, Eunice Schriver,

on a number of problems, teen pregnancy. And your family has

been very active. And we appreciate you coming today.

First, let me take care of a couple of procedural matters. I ask

unanimous consent that all Members have 5 legislative days to

submit written statements and questions for the hearing record.

Then the answers to written questions provided by the witnesses

also be included in the record. Without objection, it is so ordered.

Second, I ask unanimous consent that all exhibits, documents

and other materials referred to by Members and the witnesses may

be included in the hearing record. And that all Members may be

permitted to revise and extend their remarks. Without objection it

is so ordered.

Since this is an oversight committee, it is our standard practice

to ask all of our witnesses to testify under oath. So if you would

rise and swear the other witnesses in as they come.

[Witness sworn.]

Mr. SOUDER. Thank you very much. Let the record show that the

witness has answered in the affirmative.

It is our honor today to have the distinguished Lt. Governor

Kathleen Kennedy Townsend here. We appreciate you coming, and

you are recognized for 5 minutes.

8

STATEMENT OF KATHLEEN KENNEDY TOWNSEND, LT.

GOVERNOR OF MARYLAND

Ms. KENNEDY TOWNSEND. Thank you very much, Chairman

Souder. And thank you for your kind words that you have said

about our city and our creativity. We really appreciate it. It is great

to be here with Congressman Cummings who has been a leader in

making our community safer. And has been a real partner in our

state’s effort to make sure that we are doing all we can to help our

communities and to help our families and our citizens in this city.

Thank you, Congressman Cummings.

As Lieutenant Governor, I have been in the unique position to

direct Maryland’s substance abuse and law enforcement efforts

over the last 71⁄2 years. In fact, I chair Maryland’s Drug and Alcohol Council. And we made recommendations 2 years ago that we

should increase the amount that is spent on drug treatment by

$300 million over the next 10 years. I was glad to hear you say

that part of that should come from private insurance. Our council

said that $200 million should come from the state funds. But that

$100 million should come from private insurers who, as you pointed out, very well often do not want to fund drug treatment or mental health treatment. So I wish you the best, I wish you luck in

making sure the law passes as you have described it.

I also oversee as Lieutenant Governor the Departments of Public

Safety and Corrections, Juvenile Justice, and the Maryland State

Police. I am chair of the Cabinet Council on Criminal and Juvenile

Justice. With help from many partners throughout the state, state

agencies, local jurisdictions, research based programs, we have

steered Maryland toward dramatic reductions in crime. In fact, the

lowest reductions in a generation. This would not have happened

without our integrated approach of effective treatment and smart

policing. What we have achieved has not been easy. But with leadership and vision, and I have to tell you, help from the Federal

Government, we have found the right road. And the Federal Government has been an essential partner in all that we are doing in

Maryland and in Baltimore City. And we are very, very grateful

that you have come here to listen to what we have done. And I

hope to help us in the coming session.

Let me just take a few minutes to frame this issue in a broad

view. Let me say, and I think this is what Congressman Cummings

said and Congressman Souder as well, for a long time we were

stuck in a fruitless debate about false choices. Should we spend

more money on treatment, or should we spend more money on enforcement. After a long time of self-doubt, we also we were wondering if this treatment work, do prosecutors, probation officers, police

actually make a difference. So there was always a question, what

is effective, what will really help communities, what will help citizens.

I would say that in Maryland we have learned some important

lessons over these last few years. And I would like to welcome this

opportunity to tell you what we have learned. One, we have

learned that effective law enforcement with smart policing, involving parole and probation officers and prosecutors, works. That drug

treatment works. And that getting communities involved to improve the quality of our lives works. We can improve the quality

9

of life in our communities. We can provide and must provide both

effective law enforcement and effective drug treatment.

We have invested in fighting crime in these ways and we have

seen consistent reductions in crime. It has been a partnership of

the Federal Government, state government, local government, and

countless citizens who simply refused to give up.

Let me just touch briefly on what we have done at the state

level. The State has invested in law enforcement in Baltimore City.

In the past 2 years, for example, we have doubled the capacity of

the State’s Attorney’s Office to prosecute the violet gun crimes. The

result, more convictions of violet felons who terrorize our streets.

We have provided millions of dollars to support policing in Baltimore City. And the results, better trained police force, better equipment to investigate crimes and track down criminals. We have supported community strategies in 12 hot spot communities in Baltimore that account for almost a third of the city’s violent crime. And

the result, we have had a 40 percent reduction in violent crime in

our city’s most challenged neighborhood.

We have also begun to invest fundamentally in how offenders are

supervised. Particularly, drug addicted offenders. When I first became Lieutenant Governor, an average parole probation officer

would have enough money to do seven drug tests per month for a

case load of over 100 offenders. That is seven per month for a case

load of over 100 offenders. Obviously, they had no idea who was

doing drugs, how often they were doing drugs, and what drugs they

were doing. And this is a time that we knew from national research

that over between 50 and 60 percent of all the cocaine and heroin

used in the United States are used by people on parole or probation. In other words, the very people that were under our supervision were those that were fueling the drug trade. And this did

not make any sense at all. And so we decided to change it.

In 1996 under Judge Weitzman’s leadership we started a Drug

Court. And in 1999 building on the lessons of the Drug Court we

began to implement Break the Cycle, Maryland’s path-breaking effort to change behavior of people on parole and probation. This

combines a regular drug test with treatment and the scheduled

sanctions. Today over 11,000 offenders are under community supervision. Drug use has dropped by more than half in the first 4

months among offenders who are being tested twice a week. And

recidivism dropped by 29 percent among the sample on Baltimore

City. In other words, it worked.

In the last few years the State of Maryland has doubled the

amount of money that we are spending in drug treatment in Baltimore City. We have invested another $16 million. And this year in

this year’s budget, we are asking for another $13 million, which

may not sound like a lot to Congressman, but for our state it is

substantial. And $9 million to go to Baltimore City. We are working to make sure we get that budget funded. And I know you have

been very helpful, and as well, Commissioner Norris. And I want

to thank you for it.

But let me just tell you about the results in the last 2 years.

Emergency room admissions are down, overdose deaths are down,

crime is down, and behavior that spreads the deadly AIDS virus is

down. Let me just say, it works, it is effective, it can be done well.

10

But I am not just talking rhetoric. We have also launched first

in the state, first state to do effectiveness evaluation. We are working with John Carnavali, who used to be at HIDTA, to ask him to

work throughout the state to see which kind of treatment works for

which kind of offender, or which kind of drug abuser so that we are

not just talking about how many slots we have. We are talking

about what slot, what is needed for which kind of person. And I

am telling you it has been effective, it works. And the good thing

about it is that as we work with treatment programs throughout

the state, each one is saying, we want to work with you. We want

to know what works. We want to be here to help people get off of

drugs. We do not just want to receive more dollars. We want to

make sure those dollars are used well.

I thank you so much that you have come and heard this this

morning. You will soon hear from the mayor and the commissioner

of police who I think share that same message. Drug treatment

works. You need smart law enforcement. And you treat drug treatment and you can really make a difference. Thank you very much.

[The prepared statement of Ms. Townsend follows:]

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Mr. SOUDER. Thank you. As I said earlier, as an oversight committee we swear in our witnesses. So therein, police commissioner,

if you could rise and take the oath.

[Witness sworn.]

Mr. SOUDER. Let the record show that both witnesses answered

in the affirmative. And we appreciate you coming today. Mayor

O’Malley, would you like to give your testimony next?

STATEMENT OF MARTIN O’MALLEY, MAYOR, CITY OF

BALTIMORE

Mr. O’MALLEY. Sure. Absolutely. And I appreciate your coming.

My trip was a lot shorter than yours, I suspect. Mr. Chairman,

members of the committee, I want to welcome you, first of all, to

the greatest city in America. And I appreciate the opportunity to

speak with you about some of the success we have been having

here in Baltimore, which would not have been possible without

Federal help. On both sides of the political aisle, across the United

States, I think there is a growing consensus that effective drug

treatment has to be part of any serious effort to reduce crime. You

cannot talk about criminal justice, you cannot talk about safer

streets without also talking about, and more importantly, without

funding drug treatment.

For years many of us were engaged in this pointless debate pitting law enforcement dollars against drug treatment dollars. And

what we have proven here over the last couple of years in Baltimore is that we can move past that debate, we can do more of both.

And we can do it in a way that makes our streets a much safer

place. We have done that in Baltimore.

One, just 2 years ago Baltimore was No. 1 among major cities in

terms of drug, in terms of violent crime. No. 1 in terms of drug addiction. I am glad to report now that over these last 2 years Baltimore has been No. 1 among major cities in the reduction of violent

crime. A double-digit, back-to-back reductions of about 21 or 23

percent. Baltimore was No. 1 among major cities in reducing drug

related emergency room admissions, according to the Federal Government Health and Human Services report, down by 19 percent.

One of only two cities that was actually going down. The one that

followed us was San Francisco, which had about a 12 percent reduction.

And by making progress on both of these fronts, we have dramatically reduced the number of citizens in our city who have died

from drug related deaths, whether it is from homicides or

overdoses. If you combine the murders and the overdoses in 1999,

628 of our fellow citizens died from overdoses and murders combined. Last year that number was 502. Still 502 too many, but 126

lives saved in two short years of working hard on this problem.

This progress has required significant investments. It has required an unprecedented partnership between Baltimore City, the

State of Maryland, and our Federal Government. Congressman

Cummings, I want to thank you and your colleagues for your leadership you have shown, and that investment in Baltimore’s turnaround.

On the law enforcement front city government has been the lead

investor, as well we should be, increasing city spending by $32 milVerDate 11-MAY-2000 10:55 Jun 04, 2003 Jkt 000000 PO 00000 Frm 00020 Fmt 6633 Sfmt 6633 D:\DOCS\84447.TXT HGOVREF1 PsN: HGOVREF1
17

lion in 2 years. And this investment has been supplemented by a

$9 million COPS grant.

On the drug treatment front, the State of Maryland, under Governor Glendening/Townsend administration, has been the lead investor in increasing its level of treatment by funding by $16 million

with a promise of an additional $9 million. I have my finger

crossed because Legislature is in session.

The rise in state treatment funds since 2000 has been accompanied by an increase in local, private and Federal funding from

$11 million to $14 million over that same time period. Just last

month Hopkins and the University of Maryland and Morgan State

issued a report on the effectiveness of drug treatment, noting that

after 1 year in Baltimore City, heroin use dropped 69 percent

among those that were in treatment, cocaine use dropped 48 percent, criminal activity dropped 64 percent. We have also become

very much a performance driven organization as local government.

We track a lot of, and each of our departments through CityStat

or the police department through Comstat. CityStat, by the way, is

just an expanded use of Comstat. We deploy our resources to where

the problems are. We measure for results. And programs have

shown that they are getting results get the increased funding.

We do this now with regard to drug treatment programs. Dr.

Beilenson joining us here, our health commissioner, who chairs

DrugStat where we measure retention rates, recidivism, all sorts of

indicators as to whether or not a person is actually moving out of

that self-destructive cycle of drug addiction.

Two weeks ago John Walters, Director of the Office of National

Drug Policy, came to Baltimore to talk about national goals that for

the very first time targets specific reductions in drug use. Ten percent in 2 years and 25 percent in 5 years. Director Walters was

very familiar with our efforts here. And we intend to do our share

to meet that national goal. And I think it was encouraging to him

to see a city like ours turning things around and making those

sorts of dramatic strides. The citizens of our city and state have

benefited greatly from this partnership. We move beyond the zero

sum debate.

With your leadership, the people of our Nation can benefit from

a similar approach. We cannot arrest our way out of this drug

problem. We cannot only treat our way out of this crime problem.

We have to do both. We have to disrupt the supply by jailing dealers and reduce demand by showing their customers a better way

to live.

And I thank you all very much for your leadership and for hearing me out.

[The prepared statement Mr. O’Malley follows:]

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Mr. SOUDER. Thank you for your testimony. Commissioner Norris.

STATEMENT OF EDWARD T. NORRIS, COMMISSIONER,

BALTIMORE CITY POLICE DEPARTMENT

Mr. NORRIS. Gentlemen, I want to thank Congressman

Cummings and everyone else for this opportunity, because this is

extremely important to the police department. One thing that both

the Lieutenant Governor and the mayor touched on was the fact

that in the past this was mostly mutually exclusive. People thought

that the police chiefs would not be in support of drug treatment

and we have a different goal or agenda. And nothing could be further from the truth. Because the fact is what we have been saying

since we got here was you cannot arrest your way out of this problem. You don’t arrest your way out of a crime problem bringing a

city back to where it needs to be. We have been saying for several

years.

When I got here, you know, I got my initial brief on the standard

of the city. And the picture was not very bright. And we were No.

1 in every crime category in America at the per-capita rate. And

the DEA came in and they spoke to me. And my briefing was even

more chilling. We were No. 1 in emergency room admissions for

both heroin and crack cocaine. Not good.

In 2 years this has come down and come down dramatically. We

may have one of the sharpest declines in America, if not the sharpest crime decline in the last 2 years in violent crime, which did not

happen by accident. And did not happen by police intervention. But

we are a much more effective police department, I believe. We are

doing a better job at what we do, and that is you know, our deployment, our investigations. We are a real police agency again. And

we are very proud of that.

But the fact is, is the hard work of all the people in this room,

from Annapolis, from the Mayor’s Office, the health commissioner,

and the people on your side of the table that this has happened.

Because what people do not realize or they do not think about initially is at first we talk about the nexus between drug usage and

the drug problem with the crime rate, people automatically get

homicide rate and the murder rate. Which is, it is an obvious connection because just about—we estimate about 80 percent of all

murders are connected to the drug trade. Hard to know, but that

is what we assume because of what data we do get from our victims, victim’s families and the like. That is where our focus is on.

What people forget is that the rest of the rate, the overall crime

rate of your city is mostly by your property crime. People talk

about homicides in any city, it is a terrible one, it is the one you

should focus on because it is the most serious crime, but is by far

the smallest number.

We are talking about property crime, you think how is this

fueled. I mean, when people have $50 to $100 a day drug habits,

they have to get the money from somewhere. And where they get

that money from very often is breaking into cars, breaking into

homes, stealing small items, robberies on the street, selling their

bodies. Whatever they may be doing they got to come up with the

money. And by doing this, and this meaning providing treatment

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and treatment dollars to help people get off their addiction, you are

helping us, you are helping us all. And you make my job a whole

lot easier.

And the one thing that I am very happy to report today is that

not only do we have this very substantial violent crime drop in the

past 2 years at approximately 23 percent, but this year our overall

crime is down dramatically about 21 percent for part-one crime,

which includes all the crime, murder rate, robbery, burglary, auto

theft, and the like. That is what I am really encouraged by.

The murder rate is coming down and it is coming down every

year. And we are very, very happy with that. But what people have

to look at is our overall crime is coming down. And I am convinced

that this has to do with it. Because in the last 2 years, as you have

heard from the Lieutenant Governor and the mayor, we have had

a tremendous drop in emergency room admissions. I think, and I

believe you will hear from Dr. Beilenson later, we may be leading

the country. And I am convinced this is way we have been so successful. This is a partnership between the police and the health

community. We cannot do it alone. And we have been saying that

since we got here. You are not going to arrest your way out of the

crime problem in any city. It is part of what I do. That is the side

of the business I am in is the enforcement side. But without the

intervention of the health community and all of the things that

they are doing, we would not be nearly as successful.

So I would just like to say as the head of the police agency for

the city that we are very much in support of drug treatment. And

I just want to get on the record by saying so. I have said in the

past the smaller venues but they are not mutually exclusive. And

the police department is very, very much in support of drug treatment dollars coming this way.

I just want to thank everyone for hearing me out today.

[The prepared statement of Mr. Norris follows:]

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Mr. SOUDER. I want to thank each of you for your testimony. I

am going to yield to Congressman Cummings for the first 5 minutes of questions.

Mr. CUMMINGS. Thank you very much, Mr. Chairman. And I

want to thank all of you for being with us today. And I want to

thank all of you for being about the business of building lives and

not just sending people that got into trouble and let us just sort

of throw them away and move on. And that means a lot.

Commissioner Norris, one of the things that when the drugs

hearing at the Tuerk House 2 weeks ago and the mayor and Lieutenant Governor were there, afterwards I did a little survey of

some of the people that were in the room, 12 people. And of the

12 people I asked what was their average when they were using

drugs, how much money did they spend during a period when they

were unemployed. And the average person was $110 per day. That

is a lot of money.

So it goes back to what you said about the property crimes. If you are not employed then you, you know, you spend $110 a day,

I mean, even us to spend $110 a day, that is a lot of money. And

so it has got to come from somewhere And I, you know, I was just

thinking as you were talking, probably a better barometer, a measurement, measuring tool of effectiveness in regard to crime would

be the property crimes.

Because, and I have said this to you, Mr. Mayor, I think it is

when I look at the murder situation, it is hard. I mean, because

you have got to have some—the only way I can see you really getting to the murder situation most effectively is intelligence. I mean,

if someone wants to harm somebody, then they are going to do it.

I mean, and unless you know it, it is kind of rough. But I mean,

I applaud you. And I really mean that for doing what you have

done.

Let me just ask you, Lieutenant Governor, about this whole

thing of working with people after they get out of prison. The chairman and I would guess most of the members of our subcommittee

are very impressed with this New York Program. And you all may

want to comment on this, too. The VTAP Program where one of the

elements of the program is that they finds job for these folks. Because one of the things that they noticed that people go right back

to the same corners.

Ms. KENNEDY TOWNSEND. That is correct.

Mr. CUMMINGS. I think the mayor was talking about this the

other day, they go right back to the same corners. And the next

thing you know they are back in jail or they are back dealing drugs

or whatever. And we see this revolving door.

Ms. KENNEDY TOWNSEND. Right.

Mr. CUMMINGS. And one of the things that apparently, assuming

that you have counseling and then treatment and all that kind of

stuff, and if you can help them find jobs, it seems that would be

one of the key elements that so many programs do not have.

Ms. KENNEDY TOWNSEND. That is exactly right. Thank you for

asking that, Congressman Cummings. As you may know, the State

of Maryland has launched three initiatives to help stop the recycling of prisoners back into prisons, to help offenders get their lives

together.

25

One of the things we have learned is that one of the biggest challenges is in fact housing. That people come out of prison and they

do not have a place to live. And so one of our efforts has been to

focus on housing. Combined with that is obviously job training,

some of which occurs in the prison, some of it occurs when they are

on parole and probation under supervision. Drug treatment, very

critical.

As you know and as you said, 11,000 of the people on parole and

probation are in our Break the Cycle Program. They are in a drug

treatment program. And so what they need is housing, they need

roots in the community, they need job training. We have launched

a number of efforts to connect people who are getting out of prison

with mentors in the community, with job interviews. We have done

a number of, you know, efforts to make sure that they learn how

to have a job interview, as well as drug treatment.

If you combine those three aspects, I think you can really make

an impact. In fact, the Justice Department has highlighted one of

our programs already. And we hope in the coming years that we

will grow them based on what we learn from these three initiatives.

But each is really crucial, the housing, the drug treatment and

the job training. As well as, helping the person get the job.

Mr. CUMMINGS. Mr. Mayor and Commissioner Norris, what have

we learned that from your experiences that we could transfer to

other cities as far as effectiveness of bringing down the crime rate

with regard to drugs? I mean, we are always talking about looking

at other places. It seems like we have been very effective here. And

I am sure you all have learned some things since you have been

in office. And I was just wondering what kind of things, because

we are always trying to figure out what we can take from one place

and take it to a higher level, more or less national. And I am just

wondering what have you learned in this process? I know it has

only been a short time.

Mr. O’MALLEY. I think the most important thing that we have

learned here, Congressman, is that it is not an either/or proposition. You have got to do both. The former Drug Czar said, you

know, in Washington we have these debates all the time about

whether we move enforcement dollars into treatment, or whether

we move treatment and interdiction dollars into enforcement. He

said, and the truth of the matter is, it is like pouring a half-full

glass back and forth thinking that sometime, you know, it might

fill up one of the two glasses. The truth of the matter is we need

to do more of both. That is the most important lesson that I think

has come out of Baltimore.

Commissioner Norris is far more expert at the enforcement end

of things. And Dr. Beilenson is here. Speaking just briefly for him,

I do not know if he testifies later, but the wraparound services we

found has been critically important.

You can create a whole bunch of additional slots. Or you can improve the quality of the treatment you are providing in terms of the

random urinalysis or the job placement or helping people get stable

homes. And I think those things are thing that he will probably tell

you have we have learned ourselves over these last couple of years

as we ramp up with the additional dollars. That more slots does

26

not necessarily mean that you are more effective. But more effective slots mean you are able to treat more people in a more lasting

way.

Mr. CUMMINGS. Before we get to you, Commissioner, I met yesterday with the Enterprise Foundation, Mr. Mayor. And they were

telling me that they are coming up with this program to help people when they come out of prison, to try to, you know, do a lot of

things for them. Basically, it was what the Lieutenant Governor

and you just said, give them the kind of support system. And I was

wondering are there entities to your knowledge that are doing the

same thing that is outside of government? And I mean, is that

something that we should look forward to more folks doing?

Mr. O’MALLEY. I know that the, maybe Dr. Beilenson might be

able to speak more to this. I know that the Open Society Institute

had some initiatives that they were starting to roll out.

I think this is a battle for all of us. You know, too often we think

that it is up to government, everything is up to government. Well,

it is true that only government can swear police officers and give

them the badge and the gun and those arrest powers. While it may

be true that government has a big role to play in providing treatment for those who are uninsured, the fact of the matter is, this

battle is everybody’s battle.

So I would hope that as we progress and as we start establishing

this track record as a national leader, that success will become contagious. And the churches will realize that indeed there is a calling

and there is a mission for every church to be involved in the lives

of people coming out of prison and helping them become more stable, productive members of society by reaching out. But Dr. Beilenson may be able to know more of the other program.

Ms. KENNEDY TOWNSEND. And just on that, I would say that we

have a productivity council at the State of Maryland. And it was

chaired by Jack Kingsley, private industry. And he started this effort to recruit businesses to be mentors and to do job training and

to do—helping with people coming out of prison.

Because he understood, first of all, we had a job shortage for a

long period of time, as you know. And they wanted to make sure

that they were getting as many people employed as possible. So

there was a lot of self-interest on the part of the business community to make sure that they were working with people coming out

of prison. And it has been productive so far. As you know, it is one

of the three initiatives that we have launched.

But and I would say one other thing, and I just add on to what

the mayor said about what works. I think there was an article in

the New York Times a couple of weeks ago that said very clearly,

the longer somebody is in treatment, the better chance they have

to get off of drugs. And so to the extent that we do not focus just

on slots but how long somebody can stay in the slot and what incentives we can get to somebody who stays in treatment I think the

better off we are.

And I think that is why Break the Cycle has been effective. But

that is why other programs work the best, if you can get them to

stay in the program for a longer period of time. Because that is

really what works the best.

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Mr. CUMMINGS. Mr. Beilenson, I mean, Norris, I am sorry. I

apologize.

Mr. NORRIS. That is all right, Congressman. Just to reiterate

what the mayor and Lieutenant Governor just said again and give

you a brief description of how we run the Police Department now.

The basic philosophy in our police and strategy is that here as

in other cities, you have got small core criminals that cause you all

your grief. And you are focusing in on that small core. And the better you do addressing them the faster your crime rate goes down.

The same philosophy applies to the drug treatment. And I will explain why.

The violent criminals are obvious. The predatory criminals that

shoot people, they do not commit one shooting, one murder, get a

square job and go drive a truck the next day. They made a decision

at this point in their lives very often as adults. But we catch these

people and very often they go to prison and for long periods of time.

What is helpful about having people in effective drug treatment,

and this is again just to back up 1 second, as you stated before

with the murder rate, people always focus on the tie between the

drug problem in America and the murder rate. And it obviously is

tied but at a different level. It is how you have to deal at the top.

The people that are providing this poison for our streets are the

ones that are shooting each other for business purposes. And they

always kind of confuse the two.

Where the overall crime rate that we are talking about here is

driven by the people who are abusing the drugs and being fed this

stuff than the drugs dealers. And they are two very distinct things.

The very serious violent problem we focused on, they are all these

business wars going out there. The fighting over turf, product that

may be sold and may be missing, moneys and the like. For the

junkies on the street, the people that are using and are caught in

this addictive cycle, as we talked about before, it is about $100 a

day, $110 when you spoke to these folks. That is what we hear.

The point is, the way we run the Police Department, you got a

person who is committing a series of crimes in every neighborhood,

be it robberies, burglaries and the like. The quicker you identify

them and bring them to the bar of justice, your crime rate goes

down because they do not commit all the crimes they would had

they been left out there.

It is in the drug treatment. If you got people who are in need

of treatment and are unemployed, and they are going to be unemployed if they have a drug problem. They are not going to hold onto

their jobs if they are addicted to any kind of alcohol, drugs, whatever. They are going to be unemployed sooner or later. They are

going to get the money somehow. And that is going to be by the

petty crimes we talked about.

The more people get into drug treatment and get back on track

and get their lives back in order, get them housing, get them jobs,

get them off this terrible addictive cycle they are in, again, that is

going to bring your crime rate down. And that is the business I am

in, is looking at the bottom line of crime reduction every day. And

that is why I am such an advocate for treatment.

Because it is very helpful for us as we look at the whole crime

picture in the city. If you take, even if you cannot address, you are

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never going to get everybody off drugs in any city. But the more

people you help incrementally, you bring people off, you get their

lives back, make them productive citizens again, you reduce your

crime rate by that much because each one of those people is back

at work, hopefully, not committing crimes to feed their habit. And

all those victims that would, you know, ordinarily be victimized no

longer are.

Because if it is, you know, if it is 100, if it is 1,000, you just multiply that by crimes they would need to feed their habits. They are

not committed in the future and your crime rate goes down substantially.

And that is what we have learned.

Mr. CUMMINGS. Thank you.

Mr. SOUDER. Commissioner Norris, one of the interesting steps

that I was recently told, I have always assumed that 60 to 75 percent of all crime is related to narcotics and alcohol abuse. But I had

a civil judge come up to me and tell me that in his court cases he

felt it was also true in child support, divorce cases. And in the civil

side, usually we talk the criminal side, but it is interesting that

drug and alcohol abuse is the No. 1 reason, by as you mentioned,

people do not hold jobs, they can’t pay the support to take care of

their kids. And it is even more than just a violent crime.

I had a kind of—let me ask, I have two questions. One relates

to what is actually being done while people are incarcerated. That

I heard you say that juveniles have a probation program targeted

for that in Drug Court.

Ms. KENNEDY TOWNSEND. And for adults.

Mr. SOUDER. And for adults for probation.

Ms. KENNEDY TOWNSEND. And parole.

Mr. SOUDER. And parole. Is anything done while they are in prison to anticipate? One of the things that happened a number of

years, excuse me, a number of years ago was we increased the

number of people who were locked up. Now many of them are

starting to come back out on the streets. Part of our decline in

crime around America is because we simply took the criminals off

the street.

Now we are faced with they are coming back out. In Indiana the

law states they have to go back into the neighborhood they were

originally arrested, which means that neighborhoods that have respectively been cleaned up are now about to get another wave in.

Have you started to anticipate that, have you worked in the prisons and what are you doing in that area?

Ms. KENNEDY TOWNSEND. Yes. We do have drug treatment in the

prisons. We could clearly have more in the prisons. But we have

also made a choice to put most, many of our drug treatment dollars

for the people that are on parole and probation.

Because as I said earlier, 60 to 70 percent of cocaine use and heroin use is used by these individuals. These are the individuals who

are already out in the streets and in the neighborhood. So they are

most—they use the drugs on one hand, and they are most dangerous to the community on the others. And very frankly, if we get

them off of drugs, we will reduce the need for cocaine and heroin,

you know, on one hand. And we will reduce the crime rate on the

other.

29

So it was the choice, very frankly, of where we put our treatment

dollars. We do have drug treatment in the prisons. But we have focused mostly on those who are going to be greatest harm to those

on the streets.

Mr. NORRIS. From the city side, I am not really the person to

speak for this. It is not a police issue. But I do know from the mayor’s strategy at the cabinet meetings, one of the things we have

done is there is, embarrassed to say, they provide jobs for folks in

the city. They get the job training and actually find employment for

people who need it in Baltimore City. Bonnie Siepel runs the program. And one of the things they have done is they have asked us

for releasees and the like who were getting, you know, coming back

to neighborhoods who just recently were released from prison. And

they have gotten businesses to agree to take these folks on board.

So in response they will actually provide employment for them once

they come back to the city.

And so the short answer is yes. There is a program and strategy

in place to actually get people jobs when they came out.

Mr. SOUDER. So that process starts 3 to 6 months before they are

to be released?

Mr. NORRIS. That is right.

Ms. KENNEDY TOWNSEND. That is exactly right.

Mr. SOUDER. And also, Governor Townsend, maybe you can address this. Do you see differences in the—we are always in a dilemma in Congress and everybody who talks about drug treatment

has this, or drug abuse has this same problem. On the one hand,

we say everybody uses drugs, it is equally spread around the country. Yet when we normally look at the violence figures they are

greatest in the lowest income.

We talk about housing needs, we talk about job need, which generally implies that the problem is predominately in low income.

Certainly, the criminal side is because often that is where people

come in and wreck the neighborhoods in the low income area where

the dealers are.

What I wonder is, do you see differences in suburban, rural

trends from urban Baltimore, are you nuanced in the strategy in

Maryland? What kind of pressures do you see? Because I assume

that in Maryland, as it elsewhere, drug usage is not just concentrated in the urban center.

Ms. KENNEDY TOWNSEND. No, no. It is not.

Mr. SOUDER. And what are the patterns that are similarly——

Ms. KENNEDY TOWNSEND. No.

Mr. SOUDER [continuing]. Economic or, and then how do you adjust when you are looking at drug treatment?

Ms. KENNEDY TOWNSEND. That is a very good question. In fact,

we have the University of Maryland something called the DEWS

system. The Drug Early Warning System, which has showed us

what kind of drugs are used in different parts of the state. And

very frankly, I would love to submit as part of my testimony a description of who uses what drugs where. And it changes.

As you have heard, Baltimore uses a lot of heroin. In the suburban areas ecstasy has become more popular. There are other parts

of the state that really focus more on alcohol. And I think down to

30

Washington, if my memory serves me right, this is from looking at

this about 6 months ago, cocaine has been more used.

So we do have different strategies. And that is why we have this

evaluation system that says what kind of treatment is best for

what kind of user. I would say, however, that I think a lot of people

use drugs wherever they are, you know, some of our toughest

neighborhoods, as you may know. And I say this before, my brother

who clearly did not grow up in that tough of a neighborhood, died

of a drug overdose. My other brother was a heroin addict for 15

years. So I think it is important.

And on the radio this morning on an ad that says drug treatment

works, they were talking about a neurologist who had been overdosing on prescription drugs. So I think—and which is also a terrible abuse. So I think it is important for us all to understand that

drug abuse hits everybody in some place or another. It could be alcoholism, it could be heroin overdose. And what we are doing at the

state level is evaluating what works in what places because we do

have very different profiles of who is taking the drugs and what

drugs they use..

Mr. SOUDER. Congressman Cummings, do you have——

Mr. CUMMINGS. Just one other thing, Lieutenant Governor.

There is a program which the State had something to do with. And

they—which has been very effective in getting jobs for Preston—

and the reason why I know so about it is his office is literally

across from our office. But the State Department of Economic and

Employment Development worked with them and the unions. It is

an amazing situation. And they are—the unions are helping to

train folks who are coming right out of prison.

Ms. KENNEDY TOWNSEND. Right.

Mr. CUMMINGS. Starting them at $9 to $11 an hour. And this

agency actually monitors their conduct and whatever. So and they

just told me, Mr. Daley just told me the other day that they have

gotten Wyatt and Turner, one of our big contractors in this area,

well, across the country really, just guaranteed them 300 jobs. So

this thing can be done.

Ms. KENNEDY TOWNSEND. It can be done.

Mr. CUMMINGS. Yeah.

Ms. KENNEDY TOWNSEND. We are now much more focused on the

transition into civilian life than we had previously. We had been

focusing on other issues. But now that we are putting more drug

treatment, we are going to do the wraparound services.

And I am glad you focused on it because it has been—I think we

need that. We also need in prison, besides drug treatment, education. Because there is a strong correlation between how educated

people are and whether they are recidivate.

So if you are looking at ways that Congress could help, more

money for drug treatment, more money for education in the prisons

I think would make a big difference. And more help with training.

And I know that in the President’s budget he cut some of the

drug treat—he cut some of the training dollars, you know, job

training dollars. And I would ask that you look at that. Because

that could be very useful as well.

Mr. CUMMINGS. I think by the time the budget finishes it may

be quite different than what the—what we started out with.

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Ms. KENNEDY TOWNSEND. That is why you get to be elected to

Congress.

Mr. CUMMINGS. Yeah, yeah. Thank you. So I want to thank both

of you, and of course, the mayor, for being with us today. I know

your schedules are very busy. And I just encourage you all to stay

on the path. Because the people that you are affecting every day

in a very, very positive way that will never come up to you and say,

thank you.

As a matter of fact, some of them may be upset with you. But

the fact is, that a lot of good things are being done to help lift them

up and their families. And so we really do thank you.

Ms. KENNEDY TOWNSEND. Thank you, Congressman.

Mr. SOUDER. Thank you. And I want to assure you too, that in

the budget process that it is like labor negotiations, an opening

offer. And it always embarrasses the President if some Member

from the other side puts their budget up. I think Reagan’s budget

got two votes when he was in. Clinton got one vote, the person who

is steadfast. And I am sure a similar thing would happen here. In

fact, one of the things I am not doing this morning was speaking

to a job training conference. And Welsh and I sit on that subcommittee also.

Ms. KENNEDY TOWNSEND. Oh, good.

Mr. SOUDER. And I can assure that the job training money never

goes down. It is questionable whether it is going to be flat or how

much it is going to go up. Because it is so, particularly with the

softness of the economy. But I do want to thank you——

Ms. KENNEDY TOWNSEND. Thank you.

Mr. SOUDER [continuing]. For your efforts. And understand that

these problem are very complex. Often when we see exciting new

programs like Drug Court and some of these programs the expectations can outstrip reality.

Ms. KENNEDY TOWNSEND. Right.

Mr. SOUDER. The truth is is that people’s—the reason people get

involved with this is very complex. And it is not like they are all

going to suddenly be turned around. And as the general public understands that when we work with drug treatment or drug prevention, it is incremental. And hopefully, we can all be successful.

And thank you for your efforts.

Ms. KENNEDY TOWNSEND. Thank you very much. I appreciate it.

Mr. SOUDER. If the second panel could come forward. Ms. Renee

Robinson, the Honorable Jamey Weitzman. And maybe you can

just remain standing so we can do the oath.

[Witnesses sworn.]

Mr. SOUDER. Let the record show that both witnesses responded

in the affirmative. Ms. Robinson, could you go ahead with your testimony.

STATEMENT OF RENEE ROBINSON, TREATMENT AND CRIMINAL JUSTICE PROGRAM MANAGER, WASHINGTON, DC–BALTIMORE HIDTA

Mr. ROBINSON. Good morning. I would like to thank everyone for

the opportunity to come in to share about the work that we are

doing at the Washington Baltimore HIDTA.

32

I am the Treatment and Criminal Justice Program Manager at

the HIDTA. I am responsible for the 12 initiatives that are part of

the Treatment Criminal Justice Project. And those 12 initiatives

are spread throughout the region and the State of Maryland, northern Virginia, as well as, the District of Columbia.

And what HIDTA provides—what actually HIDTA is funded

through the Office of National Drug Control Policy. And we are

now affiliated with the University of Maryland, who is our fiduciary. So subsequently, the University of Maryland provides subcontracts to these jurisdictions to expand or enhance their treatment services continuum.

HIDTA funds are very flexible in that we have opportunities to

support the Break the Cycle effort. Our model and our philosophy

is very similar to Break the Cycle. So subsequently, while HIDTA

funds will provide additional treatment slots in the Break the

Cycle jurisdictions, we stress a continuum of care for the offenders

who are involved in the HIDTA Project. We require that they are

extensively supervised. We also want them to be drug tested on a

frequent and regular basis. And we try to retain them in treatment

as long as we possibly can. So subsequently, the outcomes for the

offenders who are involved in HIDTA funded treatment are very

good.

We had at our last evaluation a 70 percent reduction in recidivism over the 12 jurisdictions that were involved in the Treatment

and Criminal Justice Initiative. And I think that is pretty outstanding considering the rate of recidivism that you find in most

programs.

One of the things that HIDTA does is stress accountability and

responsibility for the offenders who are involved in our program.

That is a cornerstone. I have been involved in providing treatment

services in jails and prisons throughout my entire adult career.

And one of the things that I found to be most problematic was the

fact that offenders often times slip through the cracks while they

are involved in supervision. And subsequently, were not held accountable for long periods of time after they committed crimes

against the communities.

And what HIDTA wants to do is to approach treatment not from

a hug-a-thug mentality, but one of responsibility. One, to make

sure that these offenders, if they commit crimes against the communities, are held accountable for our sanctioning process. That

the drug use stops, that they are tested to insure that they are

drug-free and that they are crime-free while they are involved in

our projects.

And we focus on best practices. We fund programs that have

been proven to be effective with the offender population. We are

not specifically based on a medical model. Although we have an eclectic, we allow the program to have an eclectic approach to the

treatment services that they offer. But what we want them to

stress is addressing the criminality. Addressing the criminal thinking pattern, the criminal behaviors that continue to allow these offenders to commit crimes in our communities. And once we have

an opportunity to address these issues with these offenders, superVerDate 11-MAY-2000 10:55 Jun 04, 2003 Jkt 000000 PO 00000 Frm 00036 Fmt 6633 Sfmt 6633 D:\DOCS\84447.TXT HGOVREF1 PsN: HGOVREF1
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vise them closely while they are an offender, and excuse me, while

they are in the programs, then we see significant reductions in

their criminal behavior while they are involved in HIDTA funded

treatment.

[The prepared statement of Ms. Robinson follows:]

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Mr. SOUDER. Thank you very much. Judge Weitzman.

STATEMENT OF JAMEY WEITZMAN, JUDGE, BALTIMORE CITY

DRUG TREATMENT COURT, AND CHAIR, MARYLAND STATE

DRUG COURTS COMMISSION

Judge WEITZMAN. Good morning, Chairman Souder and Congressman Cummings. It is nice to see you. Thank you so much for

allowing me to talk to you about one of my favorite subjects which

is Drug Court. I know that from the state and local perspective

they are concentrating on coordinated delivery of services. And

they have a large perspective. They are looking at the forest. But

I draw on trees.

Every day in my criminal court in part two, I see the face of drug

addiction. I see the devastation that drug addiction brings. The

dysfunctional families, countless children, people who have lost

jobs, lost hope, lost self-respect. That is where the rubber meets the

road in my courtroom.

And we have been the victim, so to speak, of lack of services and

coordinated services for many, many years. That was the basis for

the creation of the Drug Treatment Court. It was born out of the

frustration of the criminal justice community. That what we were

doing just is not working. We were not really addressing the longterm needs that the folks who were committing crimes to support

their drugs habits. That voila, we have Drug Court, which apparently I have heard from your comments, you know, quite a bit

about, and certainly, Congressman Cummings intimately is familiar with it.

Drug Court is an extremely intensive, it is intensive everything.

We provide intensive treatment, intensive supervision, probationary supervision twice a week, as well as, urine testing twice a

week. They even get to see me monthly so that I can monitor their

services. Perhaps that is one of the hallmarks of Drug Court is the

traditional oversight. So through a system of incentives and sanctions, a carrot and stick approach, if you like, we are able to monitor, shape, cajole, encourage, if you will, positive behavior of our

addicts. So in 8 years, almost 9 years now of our operation, I am

proud to boast that I think this Drug Court, at least in Baltimore

City, works.

It is important though that in addressing the problems of addicts

that you do not just address the addiction per say. So which is why

I think the Drug Court is so successful. Is because we embrace the

entire defendant and the needs that they have. We address the

issues that they have which contribute to their drug addiction. So

in Drug Court we provide housing, we try to address their housing

needs. We provide job training and placement, GED training. We

have a Drug Court Support Group. We also provide and teach the

meditation techniques. And we have developed a community

church support group to hook one of our Drug Court addicts up

with somebody in the church community to try to help build the

bridges that they have so destroyed. It is a very holistic approach.

And it is coordinated. It is coordinated between us and treatment. So while all the components of Drug Court, I would like to

think I am a critical component, but actually it does not work without treatment. Because as much nurturing as I can give and fingerVerDate 11-MAY-2000 10:55 Jun 04, 2003 Jkt 000000 PO 00000 Frm 00042 Fmt 6633 Sfmt 6633 D:\DOCS\84447.TXT HGOVREF1 PsN: HGOVREF1
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wagging, without the education, without the information, without

the counseling that is provided by treatment, it is just not going

to work.

And our folks are in dire need of help. To give you just a face

of how needy our folks are, the average person who enters into

Drug Treatment Court in Baltimore City has been addicted 10, 20,

30 years. They enter into our program with daily heroin, cocaine

habits, $40 to $200 a day. Can you imagine the crimes that are

being committed to support that? And their criminal records, their

criminal history is quite healthy. Now they are not violent. But if

it was not for Drug Court, these folks would be heading to jail.

And so we surround them immediately with very intensive programmatic support. And we get them on the right track. And most

individuals entering Drug Court attend a 6-week treatment acupuncture program, which is in Baltimore City Detention Center.

Ideally after that we like to send them to transition living. Why?

Because our folks are in such need of structured living environment that we have found that with the double-punch of the acupuncture program and transitional living, that those who receive

those things by far succeed more than those who do not.

But that comes with a cost. Because transitional or inpatient

treatment is one, is the most expensive treatment modality. And

unfortunately, we do not have the funding ability to treat all of the

need. So what we have done to skin the cat, is we have partnered

with non-certified transitional houses. And while I am so grateful

to the generosity of those folks, it is not ideal. Because we do not

have the necessary coordination with a treatment oversight. We

have to send those folks to an outpatient program. So it is helpful,

it is useful, but it is not ideal.

And so those folks who do not get into Drug Court, we only have

900 slots. That is only the tip of the iceberg in a city of 60,000 addicts. And almost 100,000 criminal cases last year. So the rest of

the criminal courts are the ones who have to deal with the overflow. When I do not sit in Drug Court I sit in criminal court. And

one only needs to sit in a criminal court or violation of probation

docket to notice that we are lacking continued, a continuity of longterm sustained treatment for our folks. So money, of course, additional funding is always the issue. Judge Bell, our chief judge of

Maryland, is so convinced of the ethicality the treatment court

merits that he established a Drug Court Commission. And as chair

of that commission it is my job now to develop a coordinated approach to develop Drug Courts throughout the system and make

sure that we have robust and continued treatment for the needy

folks in the city, as well as throughout the state.

So I think our path is clear, Congressman.

[The prepared statement of Judge Weitzman follows:]

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Mr. SOUDER. Thank you very much. Congressman Cummings.

Mr. CUMMINGS. Yeah, Judge. First of all, thank you both for

being here. And, Judge, I was just wondering just one thing. If jail

is a turn do you think for, in other words, you are talking about

the carrot and the stick. Do you find that the threat of being imprisoned to be something that people—would cause them not to use

drugs?

Judge WEITZMAN. In a Drug Court it is surprising. Folks who can

do jail standing on their head do not—they avoid it in Drug Court.

Because we only give them 1, 2, 3 day sanctions, maybe a week

sanction. It is just enough to make their life miserable. They have

been out there long enough to establish a pattern. It just is very

disruptive. And I have had long-term addicts and criminals tell me

the reason they are clean now is because they are not going back

to jail. So, yes, I think it is extremely effective.

Mr. CUMMINGS. In the President’s budget, if I recall correctly, I

think it is—there was $2 million increase for Drug Courts. And it

is already at $52 million. It was, I mean, he increased it just slightly. But it could have been level funded, or some would say it is

level funded because of inflation and what have you. But certainly,

it could have been reduced. So it seems as if the Drug Czar and

the administration have some confidence in Drug Courts. And that

is good, especially considering the fact that we are spending the

kind of money that we are spending now in the war on terrorism.

And I was just wondering, you know, when you say you have 900

now, first of all, how do they get to you? I mean, how do they get

to Drug Court? What is the qualifications?

Judge WEITZMAN. We do have a screening process through the

State’s Attorney’s Office to identify the right people. The right people for us are long-term, chronic addicts who would be heading for

a period of incarceration if it is not for our intervention. We take

the worst.

Mr. CUMMINGS. Well, I think it works, too. And as far as jobs are

concerned, are you able to find them jobs?

Judge WEITZMAN. We do. We have a coordinated effort with a

program in the Probation Department. And we are now partnering

with the Enterprise Foundation as well to provide more jobs. But

the reality is they need living wages as well. The majority of our

folks enter the program unemployed. And we have about 90 percent employment rate upon graduation. So we are creating quite a

few tax payers. But long-term living wages is something that is always at issue.

Mr. CUMMINGS. Before this you were State’s Attorney?

Judge WEITZMAN. Yes.

Mr. CUMMINGS. And before that, the State’s Attorney was your

first job as a lawyer?

Judge WEITZMAN. Well, my first real job, I used to work in Mexico as lawyer. But that did not count.

Mr. CUMMINGS. The reason why I am asking you that is I am

just wondering, you know, I am wondering what whether there is

any real surprises to you when you came and got involved in the

criminal justice system. It seems as if, you know, in listening to

your testimony you were talking about you see. And it sounds like

it has a profound impact on you. And there is just so many people,

44

like I said to the mayor a little bit earlier, who see folks in these

predicaments and they have a tendency to devalue them.

Judge WEITZMAN. Right.

Mr. CUMMINGS. And say, you know, they got in trouble. Not they

it would be, it seems like it would be easy for a judge to do that.

When you see all these people coming at you and they are committing crimes and, you know, to say, OK, let us just lock them up and

throw away the key. Not throw away the key, but lock them up.

Judge WEITZMAN. Right.

Mr. CUMMINGS. And I was just wondering, you know, and there

is so many people that lack the compassion. And I am just wondering, I mean, how does that come about? Because, see, that is part

of our problem in trying to educate people that people still have

value. And that maybe they did make a mistake, but that they may

have fallen but they can get up if we help them get up. And I was

just wondering was there something in your career that caused you

to, I mean, maybe you were already like that. But I was just—it

affected you.

Judge WEITZMAN. Yeah. As the State’s Attorney, actually I was

the Chief of the Drug Prosecution Unit. And I used to go after king

pins. But I used to do a lot of community work. And getting into

the community you really get to see face-to-face what it is, the drug

involvement is doing to the families.

What stresses me the most is as one is chasing drugs what are

they doing to the children that they have left behind. And that is

probably the single most motivating factor I have is trying to get

these families back together. Because the social welfare costs for us

to do nothing or to do a job poorly is devastating on the generations

to come. We have generational uses, addicts, poverty. And there

has to be an end to that. If I can get our folks off of these drugs

they become reunited with their families. For one Drug Court defendant is now running the PTA, is the coach of a little league, and

has—is raising their children. Is that not worth all the money in

the world.

Ms. ROBINSON. Congressman, I would like to address that also.

I can tell you where it first impacted me most significantly. And

that was when I was working in the prisons. And I started off as

a correctional counselor and I worked on the weekends. And what

I saw was exactly what Judge Weitzman said. I saw the faces of

the families that were impacted. I saw generations of families that

were incarcerated in the facility. You had the fathers, you had the

sons, you had the grandsons. And you had a whole cast of children

that were fatherless, that had no male role models that could potentially help them to break the cycle. And then it became to me

a mission to want to at some point impact the population significantly enough so that I would be in a position to help with policies

that would impact the population. And at some point, put some closure to the addiction process.

Now that is a tall order. Because in order to do this it has to be

a systematic approach. And one of the things that HIDTA tries to

do is assist these programs in building infrastructure. Because the

infrastructure is important. You have to have collaboration and

communication among the agencies. If the Drug Courts and HIDTA

and Break the Cycle are managing a common client and commuVerDate 11-MAY-2000 10:55 Jun 04, 2003 Jkt 000000 PO 00000 Frm 00048 Fmt 6633 Sfmt 6633 D:\DOCS\84447.TXT HGOVREF1 PsN: HGOVREF1
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nicating progress on this client and holding this person accountable, then you give them an opportunity to stop the behavior. Because that is the first thing that you want them to do. You want

them to stop using the drugs. You want them to stop committing

the crimes. Then you want to address the problems that brought

them to the system.

Now sometimes you are not able to do all of that. But if you can

at least get them to the point where they stop committing crimes,

using drugs, and become productive tax payers, with continued

wraparound services you give this opportunity, this person a better

opportunity to reintegrate successfully back into the community.

And that is what we have got to do with these folks.

They stay incarcerated for years on end, some of them. But inevitably they have got to come out. And once they come out we have

got to be able to address their needs from a systems perspective.

And systems can no longer function as single entities. We have a

tremendous demand for services. I mean, we are funding programs,

like I said, in 12 jurisdictions. But we could probably serve every

locality up and down the east coast and still not begin to address

the needs for services.

So we have to become smarter in the way that we use the resources that we have available to us. And make sure that when we

are providing these services that it is the appropriate level of service for that individual. Because drug use is a continuum.

You have offenders who have been in the system for only short

periods of time. They do not need the same level of structure, same

level of supervision as someone as Judge Weitzman was speaking

of who has had an addiction and criminality for 20 or 30 years. So

the system needs to respond to that particular individual’s needs

and address those needs at that level. And all of it again takes collaboration. All of it takes coordination. And all of it requires that

we are compassionate about the population that we serve.

Mr. CUMMINGS. Mr. Chairman, when the Drug Czar was here 2

weeks ago, one of the interesting things that, you know, that we

observed is that he had a chance to talk to 12 people from the

Tuerk House and they will be testifying shortly. But at least three

of the people said that they began their drug habits when they

were 11 or 12 years old. And so these are people who are like probably in their thirties.

So that is kind of scary. And I would imagine the kind of environment, when you are talking about generations to come, you

know, it seems as if we have no other incentive, you know, when

you see little kids as I see going into elementary school, playing

hop-scotch and hide-and-go-seek in the kindergarten, and the

thought that there is a detention center which has just been built

that I am sure will hold at least 1,000 children, and know that detention center is being built, has been built for the very children

that you talk about, that is rather frightening. It really is. Thank

you, Mr. Chairman.

Mr. SOUDER. Thank you. Judge Weitzman, I wanted to just ask

you a couple of followup questions on your screening process. Is it

for the long-term chronic addicts, is it voluntary to be in the program and they can withdrawal?

Judge WEITZMAN. Once they are in, they are mine.

46

Mr. SOUDER. In other words, if they—unless you kick them out

they cannot voluntarily withdrawal if it is near the end of their

term?

Judge WEITZMAN. I will not let them. Once they volunteer to get

in the program they are my captives. And I am going to hold on

to them until they absolutely give me no alternative but to violate

them.

Mr. SOUDER. Because I thought under the law they are allowed

to withdrawal if they are near the end of their term. In other

words, if it is the intent of the program was voluntary. I understand that the ideal is to keep them in.

Judge WEITZMAN. Well, when we run out of probationary time

and they have not successfully graduated then it will be their

choice whether they want us to extend it or whether we will just

go probation. But a few get there. They are either terminated out

or they are graduates. So we do have a group in that category.

Mr. SOUDER. And that for the followup when you have the wraparound services that do that continue after the period they are in

Drug Court and that is also voluntary?

Judge WEITZMAN. Yes. It is voluntary.

Mr. SOUDER. What percentage of your people that you have

worked with continue in those services for, say, 2 years and how

long have you had the program?

Judge WEITZMAN. I have not done a study on the longevity of the

graduates in aftercare. We have an aftercare program that is set

up for them that usually begins while they are still under supervision for us. And then continues, hopefully, and throughout. Our

recidivism study suggests that they are still doing very well. So

they must be maintaining good aftercare plans. Additionally, we

have our support group. And some of them come back and assist

us with that.

Mr. SOUDER. It has been a real struggle, one of my good friends

from college, in fact, we ran in the student government election together. He was my vice-Presidential candidate. He was democrat

and I was a republican. He is now the judge for our Drug Court

in Fort Wayne. It was one of the first ones that they established,

I don’t know, it is probably getting close to 8, 10 years ago. And

I have gone to the graduations of the different people from the program.

But it is a real battle. Because that is what I was mentioning

earlier, the expectations sometimes are greater than can be done

because these people are struggling with a lot of issues in their

lives, and you try to do the best you can to——

Judge WEITZMAN. Yeah. I can clean the drugs out of the system.

It is changing the behavior which is a struggle. It is getting them

to understand that there are other ways of approaching their lives.

And that is why the church mentoring program that we have, I

think, is critical. By the way, I think the myth of the magic bullet

here is spirituality. I find that at least with our group that those

who have a spiritual connection, of course, with everything else

that we are providing, do much better. And so if I am able to provide different tools through meditation, through support groups,

through the church group, then we can enhance their success.

47

Mr. SOUDER. I am not overly enthusiastic about the potential for

tremendous success out of Drug Court. But if it does not, the question is what else would. Because it has all the earmarks of the only

things that absolutely can work. I mean, these are chronic people

who have a drug problem. Yet they are voluntarily choosing to go

into the program.

Judge WEITZMAN. That is——

Mr. SOUDER. Yes, it is a carrot and stick. But that is No. 1 is

that somebody voluntarily choose to try to address something. So

we have already done that. The second thing is you have got wraparound services with it. You have a judge who is checking with

them regularly. You are doing the drug testing with it. You are

holding them accountable. If this does not work, it is not like we

have another option here.

So just because I say I have concerns about how well it will work

does not mean that it won’t achieve success. But I do not see how

anything else can work better. Because you have all the combination of different issues.

Judge WEITZMAN. In my lengthy judicial career, which is no more

than a decade, I have sat in regular criminal courts and drugs

courts, and I must tell you that I find that this is the most worthwhile thing I have done in my career. And that, no, we do not have

total success. This population is just too tough. But we are by far

succeeding better than the normal, than the norm.

So I do not know what the magic potion is to get everyone to succeed. I do not think there is such a thing. Because people are at

different levels at different times. But I am convinced that a holistic, coordinated approach greatly enhances the opportunities for

success.

Ms. ROBINSON. And, Congressman Souder, also there are different points of intervention for this population. And though Drug

Court may be a particular point in intervention continuum, there

is also services available for this population in jail, in prison. And

that is where they are the most captive audience.

If we are providing services appropriate to their need within the

confines of the institution, then we are also addressing this problem from that particular perspective. And once they parole out,

then you will have another point of intervention. And that is the

supervision part in terms of parole and probation. And that is one

that HIDTA addresses.

So and then there is the other point that I think no one really

has mentioned since I have been here, and that is to prevent the

prevention piece. So we have got to address this problem from a

multi-task perspective. We cannot just look to any one, as Judge

Weitzman said, magic bullet to address it. We have got to put resources to intervene at different points with this population, with

the type of services that they need so that we are addressing it everywhere they are.

So that the juvenile facility that you mentioned is going to decrease in population. Because we have got funds that are available

for preventing. If we can get these kids to recognize that they do

not want to end up where their parents have, where their uncles,

their mothers, their cousins and brothers have. Then we are doing

48

a tremendous job to impact the future level of service across the

entire continuum.

You are talking about medical services. You are talking about

educationally. You are talking about the entire gamut of the life experience for that juvenile You can arrest him right then, right

there with the proper level of services provided right where they

are.

Mr. SOUDER. In your HIDTA you have 43 different initiatives.

And 12 in the Washington/Baltimore HIDTA are treatment and

three are prevention. Do you know what the approximate dollar is

that is given to treatment?

Ms. ROBINSON. Sure. $4.5 million to treatment. And I think it is

about $300,000 or $400,000 to prevention.

Mr. SOUDER. And that is out of what size budget?

Ms. ROBINSON. I believe it was $11.2 million.

Mr. SOUDER. Do you know how that compares to other HIDTA’s?

Because most, I think only five HIDTA’s are allowed to do treatment.

Ms. ROBINSON. Well, from my last understanding it was only one

other that specifically funded treatment in the manner, or similar

manner, that we do in Washington/Baltimore. Washington/Baltimore allows the jurisdiction to actually fund treatment that the

continuum of services from residential, to intensive outpatient, to

transitional living.

Whereas the other HIDTA, which is in Seattle, provides prevention services for the lion’s share of their money. And also provides

supplemental funding for the Drug Court. So they have approached

it from a different perspective than Washington/Baltimore HIDTA

has.

Now the other HIDTA that you mentioned may be providing

money for DARE Programs, which are prevention programs.

Mr. SOUDER. Do you target drug traffickers in your prevention

and treatment in particular, or do you target more users?

Ms. ROBINSON. We are targeting the—it depends on the jurisdictions. One of the great things about HIDTA dollars is that we allow

them the flexibility to use the funds in the manner that is most expeditious for their particular locality. So some of them are targeting traffickers.

But the majority of them are actually targeting the hard-core

substance abusing offender population. And those are the ones that

are continuing to commit crimes in the communities and are continuing to use drugs at a prevailing rate on a daily basis.

Mr. SOUDER. But do you distinguish whether they are trafficking

as opposed to large uses?

Ms. ROBINSON. Yes. And the interventions that are utilizing

those individuals in those programs, they do. The mentality of that

type of offender is different than a street user. So you have got to

intervene again, as I mentioned earlier, at the level where they

are. You cannot—there is no really such one thing as one-size-fitsall treatment. That everybody can be put in the same kind of treatment and you expect that the outcomes for that individual are

going work. Because it does not.

Those who are traffickers are persuaded by the lifestyle. They

want the fast money, they want all of the material trappings. So

49

they are not interested so much in the personal usage, although

some of them are. But most of them want a piece of the pie. And

they do not want to use the legal means to gain it.

Mr. SOUDER. We are looking, this committee has oversight over

the Drug Czar, actually authorizing and oversight. And we are

looking at the HIDTA’s in the reauthorization because one of the

problems we have in the Federal Government is that when there

is kind of consensus, everybody moves toward consensus and all of

a sudden we are paying three to five different grant structures to

do the same thing.

That earlier Lieutenant Governor referred to the state efforts on

drug and alcohol like we have in Indiana where we fund the Governor’s office to reach out to coordinate community efforts on prevention and treatment. And elsewhere we have treatment dollars

that go in toward treatment. We have Drug Courts dollars that are

going directly to that. We now have, we have really through our

subcommittee, boosted up the authorized dollars and the appropriating dollars are following for community anti-drug efforts. And

everybody is coordinating the general effort.

The HIDTA program which is probably, it has evolved for past

intentions of the HIDTA program and the question now, how do we

change it. It is almost like every state is developing a coordinate

effort through their HIDTA which is what you referred to as coordinating among groups, which was not the intent of a HIDTA. The

HIDTA’s intent was to be for where the trafficking was going

through to focus on the trafficking per say. That is not to say that

the goals are not really good. We met with the Seattle people, too,

as well as Detroit where other, and other cities where the HIDTA’s

are trying to address it. But we have got to sort through not a

change necessarily in how a community is approaching it, or even

the number of dollars, but that the dollars are going toward what

they were intended to go for. Maybe we reduce the dollars for

HIDTA’s and put more into treatment and into a different community infrastructure. Target the HIDTA’s back more what they originally intended to do, which was to pick the highest drug trafficking

areas and zero in on breaking up the networks. That is what we

are trying to work through.

And that was beyond my question. And we will be talking to you

more directly because you are the primary, I mean, you are basically saying close to 40 percent of your funding has gone to treatment. Certainly, 40 to treatment and prevention. Seattle is the

most far along with that. Clearly, trying to figure out how to coordinate that with the dollars we are putting into the states and

the big boost up in the community groups. We need to make sure

because that was one of our questions. Excuse me, I am really battling a cold. To the community organizations was how do we avoid

paying for coordinators three times. How do we make sure that the

maximum dollars are actually getting to the street level. And it is

one of the things we will be working through. Do you have any

other?

Mr. CUMMINGS. Yeah, just two things. Ms. Robins, just piggyback on what the chairman just said. The President’s budget cuts

HIDTA by $20 million. And I think we have checked and it does

appear that our HIDTA here will be affected this time. But that

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is something that we really do have to deal with. Because I can see

what will happen. They will look at this HIDTA and say, OK, what

he just said. Where can we make these cuts. And the cuts will

come in those programs that are unique, like this one.

The problem with that is is that the funds that are now being

used out of the HIDTA piece for drug treatment may not ever get

back to those individuals who need the treatment. And that is a

real problem. The only other thing I wanted to say, I want to thank

both of you, first of all, for being with us. And, Judge, you know,

as you were talking I was saying to myself that, you know, it is

so said in this country that so often people do not get to the—you

all see the faces, both of you. You see the faces of these folks and

reality. And there is just a gap so often with the Congress and the

policymakers everywhere. Sometimes there is a big gap between

the reality and the policies that we are making, you know.

And when you said, Judge, that, you know, out of all the things

you do as a judge, this is the most meaningful thing that you do,

whatever you said. I mean, I wish, you know, the whole Congress

could hear that, you know. Because I mean, that is the bottom line.

I mean, apparently this is something that is effective. And I am

sure you feel the same way, Ms. Robinson. Something that is effective and it works.

And this is the first time I have heard testimony, and we have

heard a lot of testimony over the years, where there is actually talk

about future generations. This is the first time. And we all know

it. But it is the first time I have heard it talked about in a hearing

setting. And so, you know, we—and perhaps that kind of focus is

what will bring policymakers more in line with what is actually

happening in our neighborhoods.

I think that we have made a tremendous, made tremendous

progress with regard to our community anti-drug program where

we give community associations dollars to help them fight drugs.

I mean, I think we have—that is more in line with what is happening out there. I think the drug treatment, there is still more that

needs to be done. Unfortunately, we have limited resources.

And one of the things that I am sure the chairman agrees with,

and that is that all of these programs because there is now such

a great competition for the dollars, have to able to show effectiveness and efficiency. I mean, it is—that is just real. And one of the

things that we have been looking at and the Drug Czar talked

about, not only when he was at the Tuerk House, but also when

he appeared before our committee to lay out his plans, was that he

really wants to see the programs are effective. And those programs

that are not effective are going to fall by the wayside.

And so, you know, I think that we have just have to keep all that

in mind. And you all have to keep letting people know what you

know works. And thank you very much.

Judge WEITZMAN. Congressman, to convince you of the effectiveness, come to the graduation, which just happens to be tomorrow.

You are all welcome to join us.

Ms. ROBINSON. And one final comment also, Congressman

Souder, although I understand the need to separate and garner our

resources expeditiously, again, I would want you to keep in mind

that we have to approach this from a three-prong perspective.

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Although the HIDTA’s may have initially been designated to just

address the trafficking, the outcomes that the treatment and prevention initiatives have been able to produce since we have been

involved in that HIDTA far, far exceed I think some of the outcomes that you would see with some of the trafficking initiatives.

Because we are able to put quantitative measures on what we do.

We are not specifically just looking at—well, we are specifically

looking at the numbers of people that we are impacting, and the

social costs for those offenders in those communities. So I think

that what we are doing is truly outstanding. And I just want to

leave with that.

Mr. SOUDER. Well, thank you for your work. We appreciate all

your efforts to help the kids and families and the communities that

are so devastated by the drug and alcohol abuse. And we appreciate you coming today and giving your testimony.

Ms. ROBINSON. Thank you.

Mr. SOUDER. If the third panel could come forward. Dr. Beilenson, Dr. Johnson, Mr. Hickey and Ms. Seward. As soon as you all

get comfortable and seated I am going to have you stand again. So

just—as you may have heard me say earlier, we are an oversight

committee so we swear in all of our witnesses.

[Witnesses sworn.]

Mr. SOUDER. Let the record show that all the witnesses responded in the affirmative. Dr. Beilenson, you are recognized for 5

minutes.

STATEMENT OF PETER BEILENSON, M.D., M.P.H., BALTIMORE

CITY HEALTH COMMISSIONER AND CHAIRMAN OF THE

BOARD OF DIRECTORS OF BALTIMORE SUBSTANCE ABUSE

SYSTEMS [BSAS], INC.

Dr. BEILENSON. Thank you, Mr. Chairman. And Congressman

Cummings, thank you for having the folks come up to hear about

Baltimore. I do not want to reiterate too much because people have

been talking about our successes and the mayor and Lieutenant

Governor and the police commissioner talked about some of what

I was going to talk about. I want to touch on two things. One is

accountability, the other is effectiveness.

I have just passed out something, this template that you all

should have. You have heard about DrugStat and Comstat. This is

what we use. We used outcome measures. Not how many people

are seen but actual outcomes in our treatment programs to show

their effectiveness, just as Congressman Cummings was talking

about. Because we want to know—there is competition for dollars

and we want to know which programs work the best. Every Friday

myself and two of our staff folks who do the stat analysis, along

with a lot of people from Baltimore Substance Abuse Systems, including Bonnie Sieple, our president, meet with the directors of the

treatment programs. We have a hammer over them because we

fund them all. They must show up. And have usually ten. We do

it by modality. So for example, this sheet is the method on treatment programs, and this is actually from about 9 months ago.

But we hold them accountable for meeting benchmarks. These

benchmarks were set and suggested by a national scientific advisory committee. They are based on national data. And all the

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benchmarks were set above national averages. So we are holding

our treatment programs to a higher standards of the country’s. And

it is very simple. We go around, if there is someone who is an

outlier, we ask them, depending on my mood, either the outliers on

the positive side or the negative side, why are you doing so well

compared to other programs, or what is the problem here. And they

must respond. If they cannot respond with a reasonable explanation they have 2 weeks to respond in writing.

If their numbers consistently do not meet the benchmarks they

get decreased funding and eventually defunded. So we are truly,

truly doing accountable-based management, or whatever you want

to call it.

As I think Judge Weitzman or Lt. Governor Townsend was saying, the length of stay in treatment is very important. So we do

look at retention rates. And at least 3 months retained in treatment are a good marker for how effective treatment is going to be.

So that is one of the things we look at. We also look at arrest during treatment. There is a typo at the bottom on the arrest column

there which is toward the middle that says 70 percent is the benchmark. Actually it is a 10-percent or less getting arrested during

treatment.

We also look at employment statistics. How many are employed

at admission and how they did at discharge.

And we look at housing statistics as well. Some of those are not

on there, they are on the secondary sheet.

What kinds of things do we do? Well, here is an example of how

DrugStat actually works. Mr. Souder, since he is the majority I will

let him do better, if you do not mind, Congressman Cummings. The

chairman’s, Mr. Souder’s residential treatment program. This is an

actual example of what has happened in DrugStat, only not Souder

and Cummings, of course.

Mr. Souder’s treatment program and Mr. Cummings treatment

program both have very similar clinical outcomes. But Mr. Souder’s

had a much better employment increase over admission than Mr.

Cummings. So we asked Mr. Souder, what are you doing. Well,

they all had the similar wraparound services. And I will maybe

have time to talk about enhanced services. You cannot treat treatment, you cannot treat drug abuse in a vacuum. As people have

been saying over and over a slot alone does not do it. You got to

have wraparound services. We have mental health services, medical services, housing, jobs, etc. All those services are at many of our

treatment programs, including childcare. But in this case, Mr.

Cummings program was sending people offsight to a job training

program, who then maybe did some placement. But, of course,

many of our folks do not have transportation. Every time you have

to go offsight it makes it harder to get some place.

Mr. Souder’s program, again this is an actual example, had developed a pipeline to three different employers who were willing to

take a flyer initially on Mr. Souder’s statement that this guy who

was a former incarceree, who has been clean now for 4 months, he

is a good guy, take a flyer on him. Hired him and now there is a

good pipeline. So what we have done is now initially recommended

in all of our contracts with our treatment providers that they have

these direct pipelines, actual employers who will take their clients,

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and similarly requiring them in contracts. Not that every client has

to go to these employers. But at least there are some pipelines.

Those are some of the things, the lessons that we have learned

from DrugStat and that come out from getting everybody to meet.

Each modality meets about every 4 weeks. But every Friday we

have these meetings. And we have driven the system forward. That

has resulted, this accountability has resulted in the effectiveness

that you have heard from the smart, what is it called, Steps for

Success, that Jeannette is going to talk about a little bit more.

To show you some of the global effects, these graphs. The yellow

bars are the number of treatment spots. They have increased over

the last couple of years. The red line is the violent crimes that you

heard about from the commissioner and the mayor. The blue line

is the drug related emergency room visits. 2001 is not out yet. That

just shows some direct correlations that as you increase treatment

and make it more effective and have enhanced services, you reduce

the crime and drug related emergency room visits.

Let me—the only other one I am going to touch on here of the

graphs, because I do not have too much time, is that the cost of,

and Jeannette Johnson is going to talk a lot more about this, for—

you heard briefly that $9 million that was pledged in the Governor’s budget would serve about 4,000 more clients. What does

that mean in actual people terms? It means approximately 700,000

fewer days of heroin use in Baltimore City. It means about 240,000

fewer days of crime being committed in Baltimore City. That is

how important just treating 4,000 folks are.

And the important point to make is that this investment is not,

it is not one of these long-term investments. Although I am hugely

in favor of reducing tobacco usage, you will see 20 years down the

road you will see less cancer. Within a year, actually within a

month, as you will hear shortly, drug treatment dollars start paying dividends in terms of reduced crime, increased employment,

getting back with their families. I guess I have to end.

But I would be happy to give you some personal evidence that

this works and more from the city’s perspective when you have

questions. Thank you.

[The prepared statement of Dr. Beilenson follows:]

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Mr. SOUDER. Thank you. Dr. Johnson.

STATEMENT OF JEANNETTE JOHNSON, PH.D., PROFESSOR,

SCHOOL OF SOCIAL WORK, UNIVERSITY OF BUFFALO

Dr. JOHNSON. Thank you very much for having me speak today

on behalf of the effectiveness of substance abuse treatment. There

are generally two major questions that are always asked of history,

and that is, what did we know and when did we know it. And the

history of the systematic efforts to identify and empirically validate

treatments is a long one. And for the past several decades we have

known a great deal about the effectiveness of substance abuse

treatment.

From several federally funded nationally surveys and studies we

have been able to show that when substance abusers stay in treatment they reduce their incidence of substance use, they reduce

their involvement in criminal activity, and they increase their involvement in legal and normal day-to-day activities.

The city of Baltimore has once again provided strong evidence

that substance abuse treatment works to benefit the individual and

the communities in which they live. In an unprecedented 3 year

study, Baltimore has not only shown that substance abuse treatment reduces heroin use, reduces alcohol use, dramatically reduces

cocaine use, and reduces crime, but the Baltimore study has shown

that the substance abuse treatment also helps the non substanceabusing resident. Because substance abuse treatment decreases the

frequency in which substance abusers commit crimes for profit.

Participants in methadone treatment, for example, decrease their illegal income from $480 per month prior to entering treatment to

just $101 per month 1 year after entering treatment. And although

participants remained at very low income levels, we found that

they worked more and earned more legal income 1 year after entering treatment than they had before treatment began.

Substance abuse treatment also helps America’s public health.

Because the Baltimore study showed that methadone treatment decreases risky behaviors, such as going to shooting galleries, reducing the risk of transmitting or contracting HIV, hepatitis B or C,

and other sexually transmitted diseases. Baltimore substance

abuse treatment study shows that after 12 months the study participants in study abuse treatment reduce their illegal income by

a total of $3.2 million. And reduce their total number of days of

heroin use alone by 164,000 days.

As members of families and communities, we know that we need

substance abuse treatment. The National Institute on Alcohol and

Alcoholism conducted an epidemiological survey and showed that

48 percent of all Americans are related to somebody with an alcohol problem. As healthcare professionals we see the social and cultural disintegration results from untreated substance abuse disorders. This disintegration travels from generation to generation.

By not treating substance abuse now you almost guarantee the fate

of future generations of the children of substance abusers to another life of drugs, crime and social, cultural and familial disintegration.

The data on the transmission of alcohol and drug abuse from

parent to child is fairly clear. We know, for example, that sons of

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alcoholics are more likely to become alcoholic than the sons of non

alcoholics.

As scientists we are committed to evidence and not opinion. It is

not merely our opinion that substance abuse treatment works for

the benefits of all Americans. It is decades of accumulated evidence

from federally funded surveys and studies that shows the effectiveness of treatment.

Now the city of Baltimore has provided the strongest evidence to

date. This is not our opinion, this is not our guess, and it is not

our political view. The data shows that substance abuse treatment

really works.

In conclusion, I can answer two of those historical questions.

What did we know? We know that substance abuse treatment reduces heroin and cocaine use. We know that substance abuse treatment reduces drinking. We know that substance abuse treatment

reduces criminal activity. We know that substance abuse treatment

reduces the risky behaviors related to HIV.

And when did we know it? We have known it for a long time.

But now with the Baltimore study we know it again. We now have

the strongest evidence to date that shows us that we know how to

stop the demand for drugs. We know how to treat alcohol and drug

addiction. We can do it effectively. People shouldn’t have to wait

or be turned away.

And in conclusion, substance abuse is a problem we know how

to treat. And we save money, children, and countless lives by doing

so.

[The prepared statement of Dr. Johnson follows:]

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Mr. SOUDER. Thank you. Mr. Hickey.

STATEMENT OF JOHN HICKEY, DIRECTOR, TUERK HOUSE

DRUG TREATMENT CENTER

Mr. HICKEY. Good morning. It’s a pleasure to be here. It certainly

is compared to going to the regular DrugStat meetings. I am John

Hickey, Director of Quarterway Houses, Inc., which includes Tuerk

House, the 76 bed, abstinence-based residential treatment center

here in Baltimore.

While Tuerk House treats many people involved in the criminal

justice system, I will be focusing my remarks today on two groups

in particular. The first group is composed primarily of men referred

by the Department of Parole and Probation. The second group is

composed of women referred by Alternative Directions, a private

agency funded by the Department of Corrections to facilitate the

release of women from prisons and jails.

The experience with Parole and Probation has produced a rather

dramatic outcome. Of the last 50 clients referred by the Department of Parole and Probation and admitted to Tuerk House, 44, 88

percent, have completed the 28-day residential program.

The second program, Alternative Directions, moves women from

jails and prisons to the Tuerk House residential program, and then

to continuing care in the Quarterway Outpatient Clinic. All the

while Alternative Directions is providing case management and

wraparound services. Last Friday, 11 women referred by Alternative Directions were included in a class of 38 men and women

graduating from the outpatient clinic. Each of these women had to

participate actively in the outpatient program and achieve a minimum of 7 months drug free in order to graduate.

It is clear that both of these criminal justice programs are very

successful at identifying people involved in the criminal justice system who are in fact receptive to treatment. Because we cannot effectively identify those whose criminal behavior is the result of

their addiction, and are in fact amenable to treatment, we would

be well advised to divert drug dependent people from jails and prisons. And if they are already in jails and prisons, we need to get

them out and into treatment. We cannot afford as a society to imprison those who would respond to treatment and become contributing members of society.

I must call to your attention, however, that the existing resources are not capable of treating all those in need. We provide

a support group for people waiting for a treatment bed to become

available in Tuerk House. Recently, there were 29 men in attendance. Since 70 percent of our residents are heroin dependent, the

men in the holding group are at great risk every day that we simply release them to the street. We actually lose about 30 percent

prior to admission. This is not a paper waiting list. This is a group

of our fellow human beings with a life-threatening condition and

we need to respond to their cries for help in a more expeditious

manner.

I would like to call your attention to what I believe are three key

treatment issues.

First, I would like to mention that while Tuerk House is abstinence-based, we use Buprenorphine for detoxification from heroin.

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We know that people have stayed away from treatment in the past

because they are afraid of withdrawal. Our experience is that

Buprenorphine offers a substantial relief, reduces the fear, and increases admissions.

Next, I would like to point out that while we define alcoholism

and addiction as chronic relapsing conditions, we provide abstinence-based treatment only in time limited models. Ultimately, everyone is discharged. I believe the universal practice of discharge

is the most fundamental flaw in abstinence-based treatment in the

United States today.

We have made a beginning to deal with this issue by establishing

a peer support program at Tuerk House. Peer support is a self-help

relapse prevention strategy for people that have received treatment. The key idea is to stay connected to the treatment agency

and to stay connected to those who have had the benefit of treatment and are now striving to live in recovery.

Finally, it must be stated that a 28-day treatment program like

Tuerk House is just the beginning of treatment. No one leaves

Tuerk House without a referral to an outpatient program or halfway house. For many people, Tuerk House is essentially phase one

of the Baltimore Substance Abuse Systems, Inc. continuing of care.

Thank you for inviting me to share with you this morning.

[The prepared statement of Mr. Hickey follows:]

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Mr. SOUDER. Thank you very much. Ms. Seward.

STATEMENT OF ELIZABETH SEWARD, GRADUATE AND PROGRAM COORDINATOR, TUERK HOUSE DRUG TREATMENT

CENTER

Ms. SEWARD. Good afternoon. Thank you for allowing me to come

to speak to you today. My name is Elizabeth Seward. I am a recovering addict and a graduate of the 28-day program and outpatient

program at Tuerk House.

I will tell you briefly a little bit about my story. I began using

drugs to fit in. I guess I began about 20, in my early 20’s. And it

started out as fun, you know. I was a functional addict, I considered myself a functional addict for a number of years. I worked as

a factory worker and trained other workers on machinery. I know—

a lot of us would be using drugs in the workplace, you know, alcohol, marijuana. And that is where I started.

And it kept me from understanding I was an addict. I did not

know I was an addict at that time. At 39 I started sniffing cocaine,

which led me to using crack. That crack devastated my life for 7

years.

In 1997 one of the worst things that happened to me in my addiction was the lose of my daughter to the disease of addiction. She

had started using and she used crack before I did. And she told me,

mommy, do not pick that up. But I always had a mind-set that

anything that I used I controlled. It was a mind over matter thing.

So I knew, did not think that I would have a problem because I

had been using for a number of years. And working and doing all

the things that I am used to doing. And I picked up crack, picked

up a rock. And I never thought anything that small could bring me

to my knees. Seven years of pain.

For 2 years after my daughter’s death I was still on a downward

spiral with the crack. I isolated, cut myself off from everybody. I

worked, used and, you know, that was it. You know, I had two sons

and two grandsons. But I thought I was being a mother too because, like I said, most of my addiction I worked. But basically, I

was not being a mother to them because I could not even take care

of me. My oldest grandson is blind, he has been blind since he was

3 years old. So he was 13 when his mother passed. And he saw the

devastation of my daughter’s disease and my disease. So I allowed

him to move out of my house.

There is a lot of things that I could tell you that I could not write

down, you know. You all said to me, we have 5 minutes. But I want

you to feel what an addict feels, you know.

I did everything, stopped going to corners. I would go—I did not

know that I was an addict because I was not out there on the corners, I was not using dope, I did not have the big hands and all

of that, you know. So being a functional addict, you know, I

worked. You know, I did not sell my body, I did not do the things

that they did out there. So I was not an addict.

I continued until I fell on my knees. And I asked God for some

help. That is how I was led to the Tuerk House. I did not know

what Tuerk House was. When I stepped up those stairs at the

Tuerk House. I did not know Tuerk House was a treatment center.

I thought it was a halfway house dealing with people coming from

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jails or somewhere that they needed a place to go. But I knew I

needed some help. And I did not know what to do. So I went up

those stairs and I went into the outpatient side and I asked for

some help.

And they told me I was dealing with grief—or I was not dealing

with my grief. I was not dealing with my depression. The higher

I went up on cocaine the harder I crashed on cocaine. I knew nothing about the drug. A drug that I was sending through my body,

I knew nothing about. I was actually killing myself.

And Tuerk House saved my life. Tuerk House brought me in on

the day of my daughter’s death. It was my lifegate. My daughter

died like August 25, 1997. I came to August 25, 1999, exactly 2

years to the day of my daughter’s death. So I considered my

lifegate to her death day today.

I did a 28-day treatment program where I got information on the

disease of addiction. Went through the continuing care program

where I continued to get more information on my disease, because

it is an ongoing process. I also got with people just like me to help

each other, who help each other to get better a day at a time.

By getting through these two programs at Tuerk House I had

gotten better with me. By going through the recovery process I was

allotted the opportunity to give back in a special way. I now am

a staff member at the place where I got my help. I coordinate a

group called the peer support group. This group is a tool for relapse

prevention. It is a self-help support group. The members of this

group were clients in the Tuerk House program and joined this

group on a voluntary basis, volunteer basis to help—get extended

help.

Members of the peer support group are allowed to come as long

as they want. The disease of addiction is for a lifetime. So we have

to continue to do work on our recovery. That is what the peer support group allows its members to do.

We help each other by sharing our stories and commitments,

such as the Baltimore City Detention Center, the Johns Hopkins/

Bayview CAP Program which helps pregnant women, most of who

are addicts, the Maryland Youth Center and the Mountain Manor

Youth Center where a lot of our youths are in there have the problem due to the fact of parents and family members being on drugs.

And that is the only lifestyle they know. Also we go in and we try

to give them some help to guide them back to the right path.

At our weekly peer support meetings we use topics that help us

deal with different things we go through on a daily basis such as

relationships, let go and let God, change you must or die you will,

anger problems, steps and traditions that are dealt with through

the fellowship.

We let group members know that they must network together,

go to meetings, share, and reach out to others to help in their recovery process. We share information with others that may not

know that they have a problem, or know that there is help for

them. All these are important tools to help each of us to recover,

in our recovery and to help others in their way, to find their way

to recovery.

And the final thing I would like to say is, I am doing this to let

you know that we do recover. My daughter’s birthday would be

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Sunday. She would have been 32 years old. If she had some information, if I had had some information about the disease of addiction, that we had a disease and not just—did not know—wanted to

get high. When we wanted to get high. We had a disease that was

uncontrollable. And a lot of people have died because they do not

have this information. That is why it is so important for the treatment and the educational part to get to these people that are still

out here using.

I thank you for giving me the opportunity to speak to you.

[The prepared statement of Ms. Seward follows:]

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Mr. SOUDER. Thank you for being willing to speak out. And we

appreciate the information from each of you. Congressman

Cummings.

Mr. CUMMINGS. Thank you, Mr. Chairman. Mr. Johnson, Dr.

Johnson, I am sorry, the Steps to Success report, it seems like

something like this would have been before somewhere. Why do

you think that has not happened?

Dr. JOHNSON. There is a long, there is a huge commitment from

Mayor Schmoke in the very beginning to the city of Baltimore. And

the city officials as well as Peter Beilenson were really invested in

finding out how Baltimore was doing. And it took a very coordinated effort on their part to start it. And then they worked in collaboration with the universities.

So it took a long time to think about doing it, to get the political

support to find the money to do it. And we have had these program

evaluation techniques for a long time. We know how to do it. But

we have the backing of the city to really explore the status of Baltimore’s substance abuse treatment system.

Mr. CUMMINGS. Perhaps you and Dr. Beilenson may want to respond to this. When you do a—you all know research and how you

validate research. I was just wondering, when you have a study in

which a lot of the information is self-reported, I mean, does that

effect the outcome? I mean——

Dr. JOHNSON. Well, we——

Dr. BEILENSON. A lot of it was not self——

Mr. CUMMINGS. OK.

Dr. JOHNSON. We actually have urine data to corroborate the

self-report findings.

Mr. CUMMINGS. OK.

Dr. JOHNSON. And we have archival data which is from the

criminal justice system to corroborate the self-report findings as

well. So the criminal data that you see there is not self-report. It

is from the criminal justice system of Baltimore, actual arrest

records.

Mr. CUMMINGS. Dr. Beilenson, when you read the report was

there anything that surprised you?

Dr. BEILENSON. No. You know, we have been talking about this,

I have been in this job for 10 years. It is clear to me, as it is I know

to you from hearing you in the many venues, that this is the most

significant problem facing Baltimore. You know, it affects the economy of the city, it affects the educational system, it affects the

housing system, and it clearly affects health and obviously crime.

And we, I mean, it is lovely to have this study. But there is nothing

surprising in it because we know treatment works.

Mr. CUMMINGS. Ms. Seward, thank you. I thank all of you for

your testimony. But I was just wondering when you went from cocaine to crack, you in your testimony it sounds like that was a

major move. I mean, as far as your life, devastating your life was

concerned. Is that true?

Ms. SEWARD. Yes.

Mr. CUMMINGS. Why?

Ms. SEWARD. I lost a 17-year job within a year-and-a-half of picking up crack. I knew I had a problem that something was wrong,

but I did not know what the problem was.

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Mr. CUMMINGS. So you were, I think you used, you said you were

a functional addict.

Ms. SEWARD. Yes.

Mr. CUMMINGS. So in other words, with cocaine you could function.

Ms. SEWARD. But I only used cocaine maybe about 6 months before I picked up crack.

Mr. CUMMINGS. And so when you picked up crack then——

Ms. SEWARD. The crack was, it was just an ongoing thing, you

know, where I would go to work normally. Sometimes I would go

to work after being up all night long smoking. And I would go in

and I would be trying to do paperwork and going the things that

I would normally did. I was going to put myself and other people’s

lives in danger, you know, because I could not focus. My focus was

getting through that 8 hours or 10 hours or whatever I would have

to do to get back home to go back to crack.

Mr. CUMMINGS. If you had had insurance then that covered drug

problems would you had taken advantage of it? Or did you?

Ms. SEWARD. I am not sure. Well, let me put, they had just started I think with treatment, sending people to treatment on my job

at that time. And because I did not know that I had a problem, I

did not—it would have never even crossed my mind at that time.

As a matter of fact, I had a friend of mine that was in recovery

for 3 years. I put him in danger because of about 6 months of my

addiction I hid it from him. And understanding today that what

you can do to a person that is in recovery if you were using, you

know.

I know that today. But then I had no information. I knew nothing about recovery. You know, I did not understand it, the concept

of recovery.

Mr. CUMMINGS. And how long were you on crack?

Ms. SEWARD. Seven years.

Mr. CUMMINGS. And so just a short period of that time you

worked or——

Ms. SEWARD. I worked most of my addiction. I did a geographical

change. As a matter of fact, after I lost the—my 17-year job and

moved because I do not have family here. So I moved back to where

my family was. My family put me back on the right track. Now understanding that I am an addict so I take it with me. So when I

went to move back to Virginia, I just moved—I just found crack

there then. I was getting high all over again.

Mr. CUMMINGS. Now you offer a very unique perspective and

probably is a good person to answer this question. One of the

things that we are always concerned about and we try to figure out

is how do we provide effective treatment. Effective. Now you have

been on the addict side and now you are on the treatment side.

And you might want to also answer this, Mr. Hickey. What are the

elements that you believe have to be in an effective drug treatment

program?

Ms. SEWARD. Well, for me, the 28-day treatment is fine. But once

you come out of there, the information in those 28 days with comparing that to being out there on the street for 20 years getting

high, that is not enough. So we need to focus on is the outpatient

part of treatment.

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Because like I said, it is a lifetime disease, just like any other

disease. I had to have continuous care. Or if you do not, you are

going to end up relapsing or go right back.

So one, continued care at the Tuerk House, we had 36 sessions

that they go through. But my group which is the peer support

group is an ongoing group of self-report, self-help supporters. We

support each other. And we have been pushing for to make this in

other facilities because we all came out of the Tuerk House, did the

28-day, did the continuing care. But we know we need more. We

need to keep in contact with each other as well as the facility we

came out of if you are continuing care going.

Mr. CUMMINGS. What happens when somebody that you have

been real close to in the group and who has been a real, I mean,

doing a good job and of course, like you said, you are supporting

each other, and somebody then relapses? I mean, how does that affect you?

Ms. SEWARD. That is kind of hard. But I understand that some

people have to have a relapse in their story. So we are still there

for them. We do not go and pull you out of the crack house and

pull you out of the—but when you decide to come back we are there

for you. We just continuously give each other support.

Dr. BEILENSON. By staying connected what we see is that you

can minimize what the slip, you can keep it from becoming a total

relapse. When we graduate people and discharge people and we

give them the idea, now kind of we have taught you everything you

need to know to survive out there, what happens when they have

a slip is they are very embarrassed to come back. They are

ashamed and say, I am in trouble. So you will see them try to manage the slip on their own. And they will—when they finally come

back it is 6 months later and they are a mess, you know.

So what we really try to do is, and trying to do on a larger level,

is keep people connected and to feel comfortable and saying, I am

in trouble. Can you help me, you know. The definition is it is a

chronic relapsing condition. Certainly for the folks we see that have

ten, 20, as Judge Weitzman said, 10, 20, 30 years. They are in latestage addiction.

If you come into Tuerk House, you are in late-stage addiction.

You are not experimenting with drugs. You are drug dependent.

And you may well experience a relapse. So we have to make sure

they know if they are in trouble, even before they pick up, that is

the key. Before you pick up and you are thinking, hey, are you in

trouble, you need to know you have friends that you can come back

and talk to that have been through it. And you need to know you

can walk up to a counselor and there is no judgment about, oh, you

failed or you are a bad person or any of that. And that is kind of

what this peer support effort is about.

But we see it with case management. If you leave Tuerk House

we send you to an outpatient program somewhere in the city. But

we, from a small case management project we did in the last year,

you could see that when people would be falling out of that outpatient treatment, a good chance the case manager would have

been actually tracking them to make contact to get them back in.

So what you ultimately do by investing on a kind of a long-term

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community-based support system is you maximize what you have

invested in this residential treatment, which is expensive.

Mr. CUMMINGS. Thank you.

Mr. SOUDER. Dr. Beilenson, I had a few requests on your chart.

That one, the effective increased treatment on drug use and crime.

Could you provide us with a list of, for the record, of where you

got the—which hospitals you used on the ER’s and what—and

which crimes were combined together to get violent crimes? Do you

have a chart that takes us back 10 years?

Dr. BEILENSON. I am sure we could. We have not done that but

I am sure——

Mr. SOUDER. OK. If you do not have it we could try to assemble

that, too, if just make sure we compare it apples to apples. Also,

do you know whether the numbers of arrest went up during these

years or prior to it, which also would take people off the street?

Dr. BEILENSON. The arrests went up slightly the last year or two.

But and that may or may not have played into it. One, on your request, if we could do it 7 years. Because the blue data, that emergency room data, comes from DAWN, which I think is only 7 years

old. So——

Mr. SOUDER. Try to get apples to apples we will do that.

Dr. BEILENSON. So that would make it 1994.

Mr. SOUDER. Yeah, something like that. And did you pick 1999

because that was the year——

Dr. BEILENSON. The year the mayor started.

Mr. SOUDER. OK. I understand that. Do you know whether the,

because we will also look at this data, whether other around counties had the ER and violent crime rates go down?

Dr. BEILENSON. They would not know that because the DAWN

study which that is based on the national study, was the top 21

cities in the country. So no other city in Maryland would fall in

that. It would be comparing, you know, Indianapolis, Washington,

DC, Chicago, those kinds of cities.

Mr. SOUDER. But there is a—and you have compared to those

other cities?

Dr. BEILENSON. Correct. That is what the mayor and Lieutenant

Governor, the single biggest drop in this, in DAWN data, in this

emergency room data, was in Baltimore of the 21 big cities.

Mr. SOUDER. What about in the violent crime?

Dr. BEILENSON. We have the largest drop, 2 year drop in the last

couple of years in America.

Mr. SOUDER. Now the violent crime data, one of the reasons to

get the crime—the fundamental problem we have in Congress and

each of us as a member is the crime rate, generally speaking, has

been coming down everywhere.

Dr. BEILENSON. Right.

Mr. SOUDER. And that different people attribute different programs for that. For example, one area may have boosted their education. One area may have boosted their job training. One area

may have new—they have reduced dramatically the number of kids

who are assigned to probation officers. And then they say that is

the reason that the crime dropped. There is no arguing that individually the treatment programs help the individual.

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What is the harder argument is to make the collective argument.

And we have to make sure that the data is in fact the classic studies on this. And in fact, Baltimore was in this, and Minneapolis on

teen pregnancy, that where certain programs are put into the

schools the teen pregnancy rate dropped in Minneapolis. But nationally dropped greater in the areas around it where they did not

put the programs in.

And so we have to make sure that we—that this is not a question of a——

Dr. BEILENSON. A trends data.

Mr. SOUDER. Yeah. It is not—well, it is not just trends. It is that

when we see a change in society’s behavior patterns, we have to

make sure which variables were causing the change on a collective

basis as opposed to an individual basis. Because the truth is is

that, as you have pointed out, not that many people are able to get

into the intensive treatment programs in proportion to the number

of people who are——

Dr. BEILENSON. We are getting about 22,000 folks out of our

50,000 to 55,000 addicted individuals in treatment each year. So it

is a sizable percentage of them.

Mr. SOUDER. And that presumably would cause a reduction when

you are reaching that many. But that is why I wanted to see

whether there were other trends that were helping more of those

people be willing to come in, whether there are other trends. And

one way you measure that is compared to other cities like you attempted to do. And then also to the communities in the immediate

adjacencies which may or may not have the ER rates but they

would have the violent crime rates. And we have the mix of what

crimes they were.

Miss Seward, first I want to than you for your willingness to

speak out. And certainly express our praise for you in changing

your life and sorry that we were not able to reach your daughter.

That individuals ultimately have to bear responsibility, but society

should do everything they can to help individuals to try to overcome those problems and provide that assistance.

You mentioned that, have you talked with other people, obviously

you are as a peer counselor, who have dealt with cocaine and heroin addictions. You said that you started with marijuana and alcohol. Do you know anybody who did not start with marijuana?

Ms. SEWARD. Most addicts have started with alcohol or marijuana. Marijuana is considered the gateway drug. We start out

smoking it for fun, you know. And ends up leading us to the next

one and the next one and the next one.

Mr. SOUDER. Did you use any kind of cocaine besides crack?

Ms. SEWARD. I sniffed cocaine for about 6 months.

Mr. SOUDER. And the crack made it more difficult for you to function at work than the cocaine did?

Ms. SEWARD. Yes. Yes, because the crack, the chemicals in the

crack, that is why I sniffed so bad. Not because of the chemicals—

I mean, that is all it is now, is chemicals. But back then it was less

chemical. And I functioned but I did not function to what I normally was able to function. Because I stayed up. Crack keeps you

up all night, you know.

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You stay going out and buying, going out and buying. And by the

time you look up the sun is coming up, it is time for you to go to

work, you know. And you may really like crash unless you got another bag. If you got another bag you might choose not to go to

work, you know. That is how devastating that is. Or it was for me.

Mr. SOUDER. One of the most difficult problems that we are trying to sort through in Congress is how to deal with this difference

in penalties between crack and powder. Because it is disproportionately impacted in the African-American community on crack. Now

Congressman Rangel originally introduced the stiffer penalties for

crack because of that impact particularly on youth. Now I do not

know whether we will wind up probably splitting the difference,

raising one. But it has become an inequity. But it is helpful to understand how the inequity originally occurred. Because it does have

a disproportionate impact.

You also mentioned in your testimony that you asked God for

help. Do you say in your peer support group that you go through

let go and let God work in your life. Also, Judge Weitzman said

that spirituality was undergirding many of the people who recover.

What percentage of the people who you work with would you say

that is a key component if they have had a recovery?

Ms. SEWARD. The majority of have asked God—have found spiritual connections again. Because once you put a drug for me, we

always keep it in our statements for me, once you put a drug in

your system you are dead in the spirit. That is why you do not

have no conscious. The more you use the less conscious you have,

right.

You are removing yourself from God’s world and going to your

world. And that is why you have to get your spiritual connection

back. Once I fell on my knees and said, God, please help me. He

guided me where I had let my world go, you know. Because I had

beat myself up so badly that I thought that God was there. But

God was there for me all the time. I just left him. So I found my

way back to him. And he has helped me in this process from 21⁄2;

2-years and 7-months I have been in this process.

So and that is the way most of the group members feel. If it was

not for God’s intervention through the courts, through the police,

the cops picking them up off the street, through the judges,

through a counselor at Tuerk House or another treatment facility.

We look at them as our guardian angel. They led us back, you

know. They gave us the information to help us save our lives, you

know, working through people.

Mr. SOUDER. Thank you for offering your testimony. Mr.

Cummings.

Mr. CUMMINGS. Just to close out again, I want to thank all of you

for being here. Ms. Seward, I want to go back to something that

the chairman said. I too congratulate you for what you have been

able to accomplish. And I too wish that we had been in a position

to save your daughter.

And I was just thinking about how depending on when we are

born and where we are born and the environment we are in really

kind of dictates in any instances what our lives will be like. And

so a lot of people may ask, what is, you know, what are these hearings all about. It is an effort, first of all, to gather information so

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that we can then take that information and mold policy that can

help people. That is what it boils down to.

And so our, is sort of trying to figure out what works. And it is

good to have the testimony of people who deal with this up front

and personal so that we can then, hopefully, come up with the solutions that will save people like your daughter, and provide the opportunities like you are, you have been provided at Tuerk House,

and so that we can be effective with what you the tax payers are

paying every dime of, you know, various programs.

And so we want to just make sure that we spend that money effectively and efficiently. And the more effectively and efficiently

that money is spent, the more likely it is that we will be able to

get more funds to do the same kinds of things. And so, you know,

as being a legislator for now 20 years, I realize that you do things

1 day at a time, just like the—you know, you have a hearing there,

you bring the Drug Czar in there, you do something here. And,

hopefully, you gather enough information and bring enough people

together who are thinking somewhat the same. You have the research done and whatever.

The people begin to say, wait a minute. This is what we need to

be doing just like Judge Weitzman. I think if somebody saw, somebody like her come up and say, you know, this is the most effective

thing I do. And so you get a combination of people, black and

white, all colors, races and old, young, whatever, and bring them

together. Then society, finally a lightbulb goes off and says, you

know, we need to do this. We need to address this. And I think

saw, Peter, from testimony like yours. We are slowly seeing the society say, this is all of our problem and not just throwing people

away and saying, they made a mistake and we will see you later.

Let us move on.

But, you know, the President and others talk about leave no

child behind. I think what we are trying to do is get to the point

where we say we leave no person behind. So I thank everybody for

everything you have done. And thank you, Mr. Chairman, for holding this hearing in Baltimore today.

Mr. SOUDER. Thank you very much. We appreciate getting your

input into the global picture as we try to tackle it. But ultimately,

you are down on the street too winning each soul one by one. I remember years ago and when I was with the Children Family Committee I spent a number of different times up in Newark. And I

met this man who worked with Intervarsity Fellowship. He said

when he first started in the volunteer work, which is basically 24

hours a day, had not taken a vacation in I think something like 10

or 20 years, had got involved in his community. And often it is the

people who are there. The problems do not usually occur 9 to 5.

And he was around the clock. And he said, I came here. And when

I first decided the street ministry and work with the kids and he

said, I thought I could save all of Newark. And then it was South

Newark. Then it was my neighborhood. Then it was my block. Now

if I can just reach one kid at a time.

And we appreciate your work doing in that and inputting us as

we try to tackle the global. But ultimately, it is the people down

in the street talking to the individuals who are doing the yeoman’s

work. And we appreciate that.

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With that, our subcommittee stands adjourned.

[NOTE.—The report entitled, ‘‘Office of the District Attorney Drug

Treatment Alternative-to-Prison Eleventh Annual Report, 2001,’’

may be found in subcommittee files.]

[Whereupon, at 12:23 p.m., the subcommittee was adjourned.]

[Additional information submitted for the hearing record follows:]

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