U.S. GOVERNMENT PRINTING OFFICE

63–121 CC WASHINGTON : 2000

OVERSIGHT OF AGENCY EFFORTS TO PREVENT

AND TREAT DRUG ABUSE

HEARING

BEFORE THE

SUBCOMMITTEE ON CRIMINAL JUSTICE,

DRUG POLICY, AND HUMAN RESOURCES

OF THE

COMMITTEE ON

GOVERNMENT REFORM

HOUSE OF REPRESENTATIVES

ONE HUNDRED SIXTH CONGRESS

FIRST SESSION

MARCH 18, 1999

Serial No. 106–94

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

DAVID M. MCINTOSH, Indiana

MARK E. SOUDER, Indiana

JOE SCARBOROUGH, Florida

STEVEN C. LATOURETTE, Ohio

MARSHALL ‘‘MARK’’ SANFORD, South

Carolina

BOB BARR, Georgia

DAN MILLER, Florida

ASA HUTCHINSON, Arkansas

LEE TERRY, Nebraska

JUDY BIGGERT, Illinois

GREG WALDEN, Oregon

DOUG OSE, California

PAUL RYAN, Wisconsin

JOHN T. DOOLITTLE, California

HELEN CHENOWETH, Idaho

HENRY A. WAXMAN, California

TOM LANTOS, California

ROBERT E. WISE, JR., West Virginia

MAJOR R. OWENS, New York

EDOLPHUS TOWNS, New York

PAUL E. KANJORSKI, Pennsylvania

PATSY T. MINK, Hawaii

CAROLYN B. MALONEY, New York

ELEANOR HOLMES NORTON, Washington,

DC

CHAKA FATTAH, Pennsylvania

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

ROD R. BLAGOJEVICH, Illinois

DANNY K. DAVIS, Illinois

JOHN F. TIERNEY, Massachusetts

JIM TURNER, Texas

THOMAS H. ALLEN, Maine

HAROLD E. FORD, JR., Tennessee

JANICE D. SCHAKOWSKY, Illinois

———

BERNARD SANDERS, Vermont

(Independent)

KEVIN BINGER, Staff Director

DANIEL R. MOLL, Deputy Staff Director

DAVID A. KASS, Deputy Counsel and Parliamentarian

CARLA J. MARTIN, Chief Clerk

PHIL SCHILIRO, Minority Staff Director

SUBCOMMITTEE ON CRIMINAL JUSTICE, DRUG POLICY, AND HUMAN RESOURCES

JOHN L. MICA, Florida, Chairman

BOB BARR, Georgia

BENJAMIN A. GILMAN, New York

CHRISTOPHER SHAYS, Connecticut

ILEANA ROS-LEHTINEN, Florida

MARK E. SOUDER, Indiana

STEVEN C. LATOURETTE, Ohio

ASA HUTCHINSON, Arkansas

DOUG OSE, California

PATSY T. MINK, Hawaii

EDOLPHUS TOWNS, New York

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

ROD R. BLAGOJEVICH, Illinois

JOHN F. TIERNEY, Massachusetts

JIM TURNER, Texas

EX OFFICIO

DAN BURTON, Indiana HENRY A. WAXMAN, California

ROBERT B. CHARLES, Staff Director and Chief Counsel

MARGARET HEMENWAY, Professional Staff Member

AMY DAVENPORT, Clerk

MICHEAL YEAGER, Minority Counsel

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C O N T E N T S

Page

Hearing held on March 18, 1999 ............................................................................ 1

Statement of:

Autry, Joseph H., III, M.D., Deputy Administrator, Substance Abuse

and Mental Health Services Administration .............................................. 26

Millstein, Richard A., Deputy Director, National Institute on Drug Abuse,

National Institutes of Health ....................................................................... 39

Schecter, Daniel, Acting Deputy Director for Demand-Reduction, Office

of National Drug Control Policy .................................................................. 9

Verdeyen, Vicki, Psychology Services Programs, Federal Bureau of Prisons, U.S. Department of Justice .................................................................. 52

Letters, statements, et cetera, submitted for the record by:

Autry, Joseph H., III, M.D., Deputy Administrator, Substance Abuse

and Mental Health Services Administration:

Information concerning FTEs ................................................................... 75

Prepared statement of ............................................................................... 29

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

Florida, prepared statement of .................................................................... 4

Millstein, Richard A., Deputy Director, National Institute on Drug Abuse,

National Institutes of Health, prepared statement of ............................... 42

Mink, Hon. Patsy T., a Representative in Congress from the State of

Hawaii, prepared statement of .................................................................... 7

Schecter, Daniel, Acting Deputy Director for Demand-Reduction, Office

of National Drug Control Policy:

Information concerning use of media campaign funds ........................... 86

Letter dated May 21, 1999 ....................................................................... 72

Prepared statement of ............................................................................... 14

Verdeyen, Vicki, Psychology Services Programs, Federal Bureau of Prisons, U.S. Department of Justice, prepared statement of ........................... 54

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OVERSIGHT OF AGENCY EFFORTS TO

PREVENT AND TREAT DRUG ABUSE

THURSDAY, MARCH 18, 1999

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

The subcommittee met, pursuant to notice, at 1 p.m., in room 2247, Rayburn House Office Building, John L. Mica (chairman of

the subcommittee) presiding. Present: Representatives Barr, Gilman, Shays, Ros-Lehtinen, Souder, LaTourette, Hutchinson, Ose, Mink, Towns, Cummings,

Kucinich, Blagojevich, Turner, and Tierney. Staff present: Robert Charles, staff director; Margaret Hemenway, professional staff member; Amy Davenport, clerk; Michael Yeager, minority counsel; and Courtney Cook, minority staff

assistant.

Mr. MICA. I would like to call this meeting of the House Subcommittee on Criminal Justice, Drug Policy, and Human Resources

to order; we are pleased to now have with us, Mrs. Mink, our ranking member and other members who have joined us.

We do want to go ahead and get started. We have a full schedule

of witnesses. What I would like to do is start with an opening

statement and then yield to our ranking member.

Fist of all, I want to thank the ranking minority member, Mrs.

Mink, for requesting and helping to facilitate today’s hearing. She

and her staff have assisted in securing the witnesses that we have

here and worked with the majority in preparing for today’s hearing.

Again, this is part of, hopefully, a bipartisan effort to deal with

a very difficult national issue. We have a wide range of matters to

review today with a full panel to discuss a number of critical problems facing our Nation relating to drug abuse and illegal narcotics.

As I have stated many times before, I believe we cannot tackle

the problems of drug abuse and the concurrent social problems of

crime and significant cost to our country without an approach that

addresses simultaneously education, treatment, prevention, enforcement, interdiction, and eradication.

Today’s hearing will focus on several key elements that are critical to our total effort. In the past few years, the new majority started its national commitment to solve our growing drug problem.

I believe we have renewed our efforts at education, prevention,

and in building effective community coalitions to prevent drug

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abuse. While we have dramatically increased spending, any questions relating to effectiveness of programs and results remain.

The administration’s drug message, unfortunately, has been

marked by ambivalence at the very best. It has supported Needle

Exchange Programs. It has downgraded law enforcement and interdiction.

It has, in my opinion, white washed the Mexican Government’s

drug and corruption problems. It has often fought Congress’ efforts

to provide proper counternarcotics equipment, which is so important to Columbia.

It has also failed to come to grips with a legalization agenda.

Meanwhile, drug use among our young people has doubled over the

levels before this administration took office.

In Florida, we have a heroin epidemic. In 1997, 136 Floridians

died from heroin overdoses; up from 84 in 1995. The proportion of

our Nation’s 8th graders who said they have tried heroin doubled

between 1991 and 1996.

The administration’s answer to the heroin epidemic is not to destroy the crops on the ground in Columbia, which is our major

source now of heroin. This is, in my opinion again, the simplest and

most cost effective remedy, rather than spend more funds for methadone for heroin addicts.

We will never really win the war against drugs by only treating

the wounded. Many of whom will succumb again and again to their

addiction and some who will not survive it at all.

Finally, I want to say today how disappointed I am that another

$1 million was spent on yet another study of marijuana for medicine. This study has resulted in disappointing news.

The Institute of Medicine report calls for more research, while

acknowledging that smoked marijuana should generally not be recommended for medical use, admitting that crude marijuana contains, in fact, very harmful substances.

I am more bothered by the fact that the IOM report seems to be

the administration’s only response to the medical marijuana ballot

initiatives, the assault on Federal Controlled Substances Act, and

the FDA approval process for medicines which are deemed safe and

effective.

We also know that the potency of today’s marijuana is about 10

times greater than what we had around in the 1960’s. Between

1992 and 1997, the percentage of 6th, 7th, and 8th graders using

marijuana tripled from 4.8 percent to 14.7 percent, according to a

PRIDE survey.

I look forward to hearing from NIDA on this, especially because

of NIDA’s research which has shown that marijuana cigarettes

‘‘prime the brain’’ for other illicit drugs. Those drugs often turn out

to be cocaine and heroin, as well as from ONDCP’s Dan Schecter.

I am concerned because we are witnessing the onset of drug use

among younger and younger children. We know from studies that

the earlier the onset of use, the longer a drug abuse lasts, the more

serious the consequences, and the more addicts we end up seeing

on our streets.

Our children are being exposed to a resurgent drug culture,

which is much better funded and much more organized than it was

30 years ago. Worse, in my opinion, since many of us believe parVerDate 11-SEP-98 11:44 May 19, 2000 Jkt 000000 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 C:\DOCS\63121.TXT HGOVREF1 PsN: HGOVREF1
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ents are the most important factor in a child’s decision to experiment with illegal drugs.

Almost half the parents today expect their kids to use illegal

drugs, and 40 percent believe they have little influence over a

child’s decision to use drugs. These are some pretty startling statistics.

We have many issues to examine today. I look forward to hearing

from our witnesses on how we can improve our Federal programs,

how we can provide better services to our States and localities who

are struggling with substance abuse, and the staggering cost on individuals, families, schools, and businesses.

Hopefully, our hearing today will provide us with new answers,

new solutions, and new hope for what I consider to be one of the

most serious problems facing this Nation.

Again, I am pleased with the cooperation of our ranking member,

which has allowed us to put together this hearing today and address these issues.

I am delighted at this point to yield to the ranking member, Mrs.

Mink for as much time as she may consume.

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

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Mrs. MINK. I thank you, Mr. Chairman, for yielding to me to

make a few opening remarks. I want to especially acknowledge the

invitation which you extended to me when I joined this subcommittee to take an active role in helping to put together a substantive

discussion about any issue.

Specifically, to help organize this particular hearing today. I appreciate the confidence and courtesy that you have extended to me.

In the process of organizing this hearing, I learned a great deal

about the whole issue.

Looking to the goals that are posted there on the bulletin board,

we see that what we are about to discuss today constitutes a very

important part of the overall strategy.

We are talking about demand reduction. We are talking about,

in that context, education, prevention, and treatment. Those subject areas are going to be discussed by this panel. The budget request for this strategy is at $17.8 billion. About one-third of it is

allocated for activities to reduce the demand.

So, the areas that you will be covering are very, very important

and crucial. We do not only want to hear an explanation of what

you are doing in your program services in meeting the goals, but

we want specifically to find out how effective the programs are,

under your administration, and have been or will be with respect

to the accomplishment of the goals that are listed in the drug strategy. The people of this country are very concerned about the drug

problem.

In my opinion, it is worsening. Much of the problem is within our

own communities in terms of the cultivation of marijuana, and the

manufacturing of methamphetamine, and other very serious drug

substances.

So, the efforts in terms of prevention, treatment, and education

are very, very critical. I thank you all for coming. I hope that we

will be able to engage in a meaningful discussion this afternoon on

this overall subject.

Thank you, Mr. Chairman.

[The prepared statement of Hon. Patsy T. Mink follows:]

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Mr. MICA. Thank you.

I am pleased now to recognize the gentleman from Massachusetts, Mr. Tierney.

Mr. TIERNEY. Thank you, Mr. Chairman.

I have no particular opening remarks. I came for the hearing. I

appreciate folks showing up and sharing their thoughts with us.

Mr. MICA. OK. Thank you.

We will proceed with our panel this afternoon. Our panel, if I

may introduce them, first we have Daniel Schecter, who is the Deputy Director for Demand-Reduction, acting in that position, in the

Office of National Drug Control Policy.

Mr. Richard Millstein, who is the Deputy Director of the National Institute on Drug Abuse. He is with the National Institutes

of Health.

We have Joseph H. Autry III, M.D., Deputy Administrator of

Substance Abuse and Mental Health Services Administration. We

have H. Westley Clark, with an M.D., J.D., and M.P.H, Director of

the Center for Abuse Treatment, Substance and Mental Health

Services Administration.

We have Karol Kumpfer, Ph.D., Director of the Center for Substance Abuse Prevention; and Vicki Verdeyen. She has—is it an

educational doctorate?

Ms. VERDEYEN. Yes.

Mr. MICA. OK; good. That is a program I started but never finished, Psychology Services Programs, Federal Bureau of Prisons,

with the U.S. Department of Justice.

I would like to welcome our panelists this morning. Ladies and

gentlemen, this is an investigations and oversight subcommittee of

Congress. So, it is customary that we swear in all of our panelists.

So, if you would please stand, and if you would raise your right

hands.

[Witnesses sworn.]

Mr. MICA. They answered in the affirmative. The record will

show that. So, pleased to have you with us. We look forward to

your testimony this afternoon.

Now, the rules of the game are this in this subcommittee, if you

have a long statement, and since we have many witnesses, we will

use the clock today. You can submit reams and reams full of information for the record.

We do create a record of this hearing. I would ask that you try

to summarize lengthy statements and try to get it into 5 minutes

so we can then get into an exchange of questions and discussion.

With that, I am pleased to recognize Daniel Schecter as our first

witness, Deputy Director for Demand-Reduction, acting in that position, with the ONDCP.

You are recognized, sir.

STATEMENT OF DANIEL SCHECTER, ACTING DEPUTY DIRECTOR FOR DEMAND-REDUCTION, OFFICE OF NATIONAL DRUG

CONTROL POLICY

Mr. SCHECTER. Thank you Chairman Mica, Congresswoman

Mink, and other members of this subcommittee. On behalf of all

my colleagues, I greatly appreciate the opportunity to have this

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hearing on demand reduction. I think we have a good story to tell

and all of us are anxious to tell it.

If I could begin on a personal note, I came to ONDCP in 1989

when then the first Director, Bill Bennett, asked me to help him

prepare what was then the first National Drug Control Strategy.

As you might imagine, since that time, I have seen, of course, all

of the strategies developed; all of the Directors come and go. And

I have seen a great deal of progress in demand reduction.

I would like to highlight for you today just a few of the areas

that we are quite excited about and to identify what we think are

some of the major challenges that lie ahead.

The first point I want to make, which probably almost goes without saying, is that demand reduction has been and will continue to

be critical to achieving our goal of lowered drug use in the United

States.

It is the cornerstone of the National Drug Control Strategy which

Director McCaffrey testified about last month. As you will see, the

blue chart lists the five goals of that strategy. Certainly, three of

those goals pertain to demand reduction, and various individuals

will be referring to those in the course of their testimony.

[Chart shown.]

Mr. SCHECTER. Demand reduction is the cornerstone of our strategy because it works. There is a substantial body of research out

there that demonstrates this. We know much more now than we

did 10 years ago.

I call your attention in the prevention area, to the little red book

that NIDA has produced that identifies research-based prevention

strategies.

I urge every member of the subcommittee to take a look at it.

We will certainly provide you with copies, if you do not have it.

Drug treatment also works. We have a tremendous body of research now that shows that it is effective in reducing drug use, reducing crime, reducing homelessness, and reducing the cost burden

to the American public of drug abuse.

We know demand reduction works because over the last 15 years

or so, drug use in this country has been cut substantially. The 1979

household survey shows that 14.1 percent of the population 12 and

over were current, active drug users. That is down to 6.4 percent

in the 1997 household survey; about a 60 percent reduction in

terms of the percentage of the population.

Clearly, this is a substantial achievement and demand reduction

strategies have a lot to do with that. Our goal in the Strategy is

to cut this by yet another 50 percent by the year 2000.

Now, there are concerns, of course: teen drug use, as you point

out Mr. Chairman, has risen through the 1990’s. We are gratified,

however, that it seems to have stabilized the last 2 years.

We are confident that with some of the new programs being

brought on line, teen drug use will be driven down further in the

years ahead. There are many reasons for this, but I will cite four.

First, parents are getting more involved and civic and service

groups are becoming energized about the drug prevention issue. I

note the prevention through Service Civic Alliance that we started

with HHS and other agencies, representing about 100 million of

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our citizens and, of course, community coalitions sprouting up

throughout the country.

Second, Federal resources for demand reduction have increased.

In the $17.8 billion fiscal year 2000 request for the entire drug

area, there is about $6.04 billion earmarked for demand reduction

programs; $2.47 billion for prevention; and $3.57 billion for treatment. Since 1996, treatment funding is up about 26 percent and

prevention funding up by over 50 percent.

Third, Federal agencies are working cooperatively better than

ever. I can speak with some authority on this; again, having been

at ONDCP since 1989.

I have never seen a higher or more effective degree of interagency cooperation. There are many ways I could illustrate this.

Certainly, the strategy itself is probably the best indication of that.

It is a true team effort.

We have interagency demand reduction working groups at the

senior policy level, working on important demand reduction issues.

The performance measures of effectiveness [PME] was truly an

interagency effort. Over the course of 3 months, we had something

like 100 interagency meetings that took place to develop those

standards. I will also note the Drug Free Communities Program,

which is unusual in that its implementation is a true interagency

team effort.

That is something I do not know that I have ever seen in a Federal program. It is interesting that the program itself was created

to create partnerships at the local level. We have a partnership at

the Federal level with the Justice Department, HHS, and ONDCP

implementing that program.

So far, I think this team approach has really proven its worth.

The whole is greater than the sum of its parts.

The fourth point I would make is that some important new demand reduction tools are now coming on line, and they are starting

to show results. I think over the next couple of years, we will succeed in further driving down rates of teen drug use. The first of

these new tools would mention is the media campaign.

I am sure there will be more about this later. This is a historic,

unprecedented campaign, more ambitious certainly than anything

I have seen in my 27 years of government service.

I think it is changing the face of the drug problem in the U.S.

and will continue to do so. We project that by the end of this fiscal

year, by the end of September, there will have been 14 million antidrug messages shown in this country that would not otherwise

have been shown to our teens; again, 14 million messages.

We are exceeding the goals that we set for audience reach and

message frequency. We are right now reaching over 95 percent of

all American teens on an average of once every day with an antidrug message.

Through the ‘‘pro bono match’’ there have been 47,000 30-second

PSAs created by other groups, not created as a part of this campaign, but shown free of charge.

As a result of this campaign, we have major Hollywood television

shows now devoting their series programs to anti-drug themes.

Home Improvement, ER, Dawson’s Creek, and other shows.

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I just learned yesterday, that on Channel one, which is a public

affairs program piped into American classrooms across the country,

they are today showing a town meeting on drugs that was taped

yesterday in Los Angeles with General McCaffrey. Over 7 million

kids will be watching that today.

Finally, of course I note the superb team of contractors that has

been assembled to help the Federal Government implement this

campaign; Fleishman Hillard, Ogilvy Mather, Porter Novelli—some

of the best people in this business.

A second important new tool is the Drug Free Communities Program. This, again, is an extremely important undertaking. Congress came together in 1997, in a bipartisan fashion, worked with

ONDCP and produced what we regard as a flagship piece of legislation.

The first 92 communities were awarded grants last year in 46

States. They are now hard at work. We just completed technical assistance workshops around the country with about 520 prospective

new applicants coming and learning how they can put together a

good application. We will make a second round of awards later this

summer. The final and I think most important new tool, speaking

of ONDCP of course—my colleagues will mention some other

areas—is the Drug Free Prison Zones Demonstration Program. The

$6 million came to ONDCP last year in the appropriations process.

We provide $1.5 million to the Bureau of Prisons for Federal correctional institutions and $4 million to eight States to develop new,

more effective, innovative ways of keeping drugs out of prisons.

This, of course, is a tremendous problem in jails and prisons

throughout the country. These funds are being used to put ion

scanners on-line to scan people coming into the prisons for drugs,

to train staff, for drug testing of inmates, and a range of other purposes.

Let me mention just a couple of things about the IOM study. Mr.

Chairman, you raised it in your opening statement. This was indeed released yesterday. We asked the IOM to do this study back

in late 1997.

The reason we asked them to do it was because, at that time, we

were in the midst of a series of State referenda which were using

the ballot box to make medical policy. We thought that was a bad

idea and said so.

To try to refocus the discussion around this issue back onto

science where it belongs, we asked the National Academy of

Sciences; Institute of Medicine to assemble a blue ribbon team to

submit all of the available research on marijuana to the highest

possible standards, and then draw some conclusions.

They did, we think, a pretty good job. The study is rigorous. They

looked only at peer reviewed literature. They have a distinguished

advisory panel.

The first point I would make is—you do not always get these

points in reading the news accounts about this study—they distinguished clearly between the cannabinoid compounds in marijuana

and smoked marijuana.

Concerning the former, they said, yes, there is definitely some

evidence that for certain conditions, some of these compounds show

promise of alleviating certain symptoms.

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With regard to smoked marijuana, they were quite discouraging

about its potential as ever being any kind of useful medication. In

fact, they said there is little future for smoked marijuana as medicine.

I would think this would come as bad news for all of those who

pushed these State referenda. Finally, they suggest that it might

be useful to conduct some clinical trials to develop a more rapid delivery system, including some limited clinical trials of smoked marijuana, but again not for the purpose of proving marijuana is medicine, but to gather important data under very short-term, highly

controlled conditions that could be used to develop more rapid and

effective delivery systems for the cannabinoid compounds, not for

smoked marijuana itself.

Finally, I’d like to identify some future challenges, things which

we are eager to work on with the Congress in the months ahead

and that we think are very important to the demand reduction effort.

One is we have got to close the treatment gap. We have got to

do a better job providing effective treatment to those who need it.

Is that my buzzer or your buzzer?

Mr. MICA. Your buzzer went off some time ago. You can wrap

that up.

Mr. SCHECTER. I am almost done. We suggest that taking a look

at parity legislation might be helpful in this regard. So many people right now are going into the publicly funded treatment system

who, quite honestly, probably could have been taken care of by private health insurance, if it were available.

Drug Free Schools Reauthorization is another important challenge coming up. The administration is making some proposals to

try to tighten up that program and try to focus it better on the programs that research shows are going to be effective in reducing

drug use.

Finally, better integration of drug treatment in the criminal justice system. There is a proposal for a Drug Intervention Program

at the Justice Department, which we think is very important. Of

course, Bureau of Prisons will have more to say on that later.

Again, I apologize for taking so much time. We look forward to

working with the Congress in all of these areas.

[The prepared statement of Mr. Schecter follows:]

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Mr. MICA. Thank you. I understand we have two witnesses who

will not be giving opening statements.

So, what we will do now is hear from Dr. Joseph Autry, Deputy

Administrator of the Substance Abuse and Mental Health Services

Administration.

There will be another buzzer in about 4 minutes. You can go

about 2 minutes after that, Dr. Autry. Then we will recess for a

vote and come back and hear from the others.

Mr. SCHECTER. Mr. Chairman.

Mr. MICA. Yes.

Mr. SCHECTER. I forgot to mention that I do have a statement for

the record I would like submitted.

Mr. MICA. Without objection, that will be made a part of the

record.

You are recognized, Dr. Autry.

STATEMENT OF JOSEPH H. AUTRY III, M.D., DEPUTY ADMINISTRATOR, SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Dr. AUTRY. Let me start by thanking the subcommittee and you,

Mr. Chairman, and Congresswoman Mink. We really appreciate

this opportunity of coming before you.

I am accompanied today by Dr. Westley Clark, whom you mentioned earlier heads our Substance Abuse Treatment Program; and

Dr. Karol Kumpfer, who heads our Substance Abuse Prevention

Program.

Although they are not making presentations today, they are

available to answer questions. We felt, in the interest of trying to

get the fullest possible information to the subcommittee, that it

was best to have the people who deal with this on a day-to-day

basis with us.

I would like to submit my testimony for the record.

Mr. MICA. Without objection, that will be made a part of the

record.

Dr. AUTRY. I also want to apologize that Dr. Nelba Chavez, who

is the Administrator, cannot be here today. This is a subcommittee

before whom she was very much looking forward to testifying.

She is unfortunately involved in other activities that she can do

and I cannot. So, that is why I am here. Let me just say that we

concur with what Dan Schecter has said.

Our mission focuses primarily on goals 1 and 3, which are educating America’s youth to reject illegal drugs, alcohol, and tobacco,

and reduce health and social costs to the public of illegal drug use.

I, like Dan, have been around a long time. We were debating a

little bit earlier which one of us had been here the longest. Despite

the fact that I am the grayest, I think he actually beats me by a

little bit.

I have never seen a drug control strategy or any other major

Federal program that has the degree of collaboration, coordination,

development, implementation, and insured responsibility.

I think I can say that without exception in all of my years of

service here. We are all aware, as you have said in your opening

statement, of the devastation of substance abuse; not only on individuals, families, and communities, but how it also dovetails with

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other social problems, such as unintended pregnancy, HIV/AIDS,

crime, welfare, violence, school dropout, suicide, homelessness, and

injuries.

It is clearly one of our most pressing public health problems. We

did a recent survey of American adults and found that 56 percent

of them listed drugs as the top priority that was facing their American children.

Crime was second at 24 percent. This is a relationship that is

well-known to this subcommittee and I will not go into it in my

verbal testimony. We also know that prisons and punishment are

not sufficient in and of their own right to deal with the problem

of substance abuse in this country.

It takes, prevention, intervention, and education to augment

those efforts. We concur with this subcommittee that it takes a

comprehensive approach that cuts across all of the goals of the

strategy in order to make a dent in the substance abuse problems

that face our Nation.

I would like to highlight a couple of programs that we fund in

SAMHSA to show you how we actually put this kind of information

to the test. We have programs that are focused more on a comprehensive, coordinated, community approach that address family,

school, and mental health problems that may lead to substance

abuse and other destructive behaviors.

We know many times in adolescence that there are mental

health problems that develop prior to substance abuse problems.

We have the opportunity of intervening early and heading off the

substance abuse problems that may develop.

We also know that there are tremendous gaps in our States in

terms of both prevention and treatment needs. One of our programs is the State incentive—Grant Program in which we fund 19

States, through the Governor’s Office, to provide a comprehensive,

integrated approach identifying, and filling gaps, and leveraging resources to address the prevention needs.

We work collaboratively while colleagues at the Department of

Education, Department of Justice, Bureau of Prisons, Department

of Transportation, Office of National Drug Control Policy, HUD,

and others in helping them implement a range of programs.

We have six regional centers that provide technical assistance to

a range of programs that cut across the Federal and State programs. You mentioned earlier your concern about the devastation

on families.

We have a specific initiative that focuses on strengthening families and teaching better parenting skills; teaching parents how they

can help their kids, not only say no, but say no thank you; that is

not for me. It interferes with my future that is too bright to have

it clouded by the drugs that you are trying to get me to use.

We have also worked with the National Media Campaign. I will

just highlight one thing that has happened as a result of the campaign that Dan mentioned. Since this campaign went into effect,

we have increased our National Clearinghouse Hotline to a 7-day

operation, 24 hours a day.

We have received approximately 2,000 phone calls a day since

the media campaign has been implemented. We have distributed

over 636,000 copies of Keeping Youth Drug Free, which is a guide

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to help parents learn how to talk with their kids. We put a copy

of that in your package for your information.

I also want to talk about treatment. Dan mentioned that treatment is effective. That is true. We know that it does a whole variety of things.

There are studies that show that people who have been through

treatment can remain drug free or substantially reduce their substance abuse following treatment.

We have people who actually go to work, who pay taxes, who actually decrease crime, who decrease their drug use and become the

kinds of citizens that we would all like for them to be.

They reduce their criminal activity and they reduce their risky

sexual behavior. We are working with the National Institute on

Corrections and the Office of Justice Programs in helping develop

treatment and management programs for the dually diagnosed persons in the criminal justice system.

We also have a Targeted Capacity Expansion Program in addition to our Block Grant Program. These are funds that are aimed

at specific communities who have emerging drug problems or who

have specific emerging needs for treatment services that cannot be

met within the Existing Block Grant Funds.

We are also in the process of developing new knowledge and implementing knowledge on effective prevention and treatment interventions; working with our States, mayors, town and county officials, the Congressional Black Caucus, and Indian Tribal Governments.

We have also mounted a recent major initiative on HIV/AIDS.

Let me close with two things. One is, you asked about how accountable are we?

Every program that we implement requires not only that evaluation of the program for the specific grantees, but also for the overall program as a whole. We have GPRA measures that cut across

our entire agency, as well as specific program measures.

We have recently expanded our household survey that will be

sampling about 70,000 households a year, including 25,000 kids between the ages of 12 and 17. For the first time, this will allow us

to make State-level estimates of the drug use in this country, so

we can better pinpoint the distribution of our resources and the

kinds of treatment and prevention programs that we need to put

on the ground.

Last, you asked are we going to be able to meet the goals that

we have set out for the Strategy? I think, quite honestly, given the

kind of cooperation and teamwork that we have across the Federal

Government with our colleagues in the regions, the States, and the

communities the answer to that question is yes.

Thank you.

[The prepared statement of Dr. Autry follows:]

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Mr. MICA. Thank you for your testimony.

We are going to recess the subcommittee at this time. We will

reassemble here in about 15 minutes.

Thank you.

[Recess.]

Mr. MICA. The subcommittee will come to order.

We have heard from Daniel Schecter and from Joseph Autry. We

will now hear from Richard Millstein, Deputy Director from the

National Institute on Drug Abuse, the National Institutes of

Health.

You are recognized, sir. Did you have a lengthy statement for the

record?

STATEMENT OF RICHARD A. MILLSTEIN, DEPUTY DIRECTOR,

NATIONAL INSTITUTE ON DRUG ABUSE, NATIONAL INSTITUTES OF HEALTH

Mr. MILLSTEIN. I do have a formal statement for the record that

I would like to be entered.

Mr. MICA. Without objection, that will be made a part of the

record.

Mr. MILLSTEIN. Thank you.

Mr. MICA. You are recognized, sir.

Mr. MILLSTEIN. Mr. Chairman and members of the subcommittee, I am pleased to share with you what science has shown about

drug abuse, its prevention, and treatment, and how we can use this

research information to educate the public and practitioners about

this complex problem, through research that the National Institute

on Drug Abuse [NITA], supports and conducts.

We now know that drug abuse is a preventable behavior and that

drug addiction is a treatable disease. We have learned that although initial drug use is a voluntary and therefore preventable behavior; drug addiction is a chronic illness and is characterized for

many people by occasional relapse. At its core, the state of addiction comes about because prolonged drug use has modified the

brain’s functioning in ways that last long after the individual stops

using drugs. These brain changes essentially are what make addiction and brain disease.

The good news is that addiction is treatable, though it is never

a simple disease to treat. As addiction affects all aspects of a person’s life.

An individual’s treatment program must address not only the individual’s current drug use, but help with the maintenance of a

drug free lifestyle through a sure projected function in the family,

at work, and in society.

Fortunately, just as with other illnesses, drug abuse professionals have at their disposal an array of tools to treat addicted individuals. Among these are medications and promising sciencebased behavioral therapies, proven to be efficacious in some settings, but not yet tested on a large scale or in diverse patient populations. That is why we are launching the National Drug Abuse

Clinical Trials Network.

The Network will form partnerships between university-based

medical and research centers and community-based treatment providers to test and deliver a wide array of treatments and real life

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settings, while simultaneously determining the conditions under

which the treatments are most successfully adapted.

The Network will also serve to transfer knowledge into the community setting. In addition, with research and practitioner organizations, and our Federal colleagues, including those on this panel,

we will disseminate the research findings. Thus, moving sciencebased treatment into practice.

The other encouraging news is that drug addiction treatment can

be very effective. In fact, surprisingly, it works just as well as medical treatments for other chronic illnesses like asthma, hypertension, and diabetes that also have major medications and behavioral compliance issues.

Treatment effectiveness has been confirmed by a number of studies, including one sample of 10,000 patients in terms of decreased

drug use, reduced involvement in illicit acts, and preventing the

spread of HIV and Hepatitis C.

As with all medical conditions, science will lead the way as we

develop more effective approaches to treat addiction. Science already has shown that there is one common area—in the brain

where all drugs that are abused act.

This seems to hold true for heroin, cocaine, nicotine, marijuana,

and one of our country’s most serious emerging drug problems,

methamphetamine. We have mounted a major science-based initiative focusing on methamphetamine public education and prevention

campaigns, and the development of more effective behavioral treatments, and new medications to treat methamphetamine addiction

and overdose.

We have developed and disseminated widely a Community Drug

Alert Bulletin on methamphetamine. Ultimately, we know that our

best treatment is prevention. We also know that we must provide

the public with the necessary tools to play an active role in preventing drug use in their own local communities.

This is likely one of the reasons why NIDA is preventing drug

use among children and adolescents. The red book that Dan

Schecter showed you has become one of our most requested publications since its release last year, with over 200,000 copies distributed.

We also continue to support town meetings across the Nation to

disseminate our research findings and to educate the American

public about what science is teaching us about addiction.

We also have a strong science education program to ensure that

our Nation’s youth have accurate science-based information to

make healthy lifestyle choices. For those who have access to the

Internet, we have placed many of our materials on NIDA’s Home

Page, which last month received 23,600 page hits a day.

We have also set-up a Fax-on-Demand Service called NIDA InfoFax which provides fact sheets on drugs and abuse that can be

faxed, mailed, or read over the phone to a requester. Since we

debuted this system in December 1997, we have distributed more

than 250,000 fact sheets.

Because addiction is such a complex and pervasive health issue,

research is a part of a comprehensive public health approach. It

also includes education and prevention, and treatment and after

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care service. These are all areas addressed by the concerted Government effort to reduce drug use in this country, as outlined in

the National Drug Control Strategy.

Thank you for the opportunity to testify at this hearing.

[The prepared statement of Mr. Millstein follows:]

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Mr. MICA. Thank you for your testimony.

I am pleased to recognize Vicki Verdeyen, Psychology Services

Programs, Federal Bureau of Prisons, U.S. Department of Justice.

Welcome and you are recognized.

STATEMENT OF VICKI VERDEYEN, PSYCHOLOGY SERVICES

PROGRAMS, FEDERAL BUREAU OF PRISONS, U.S. DEPARTMENT OF JUSTICE

Ms. VERDEYEN. Thank you, Mr. Chairman and members of this

subcommittee. I appreciate the opportunity to go over the Bureau

of Prisons Drug Abuse Treatment Programs with you today.

Since 1990, every inmate who has been committed to the Bureau

of Prisons, their record has been reviewed to determine whether or

not their instant offense involved drug or alcohol, whether or not

the Judge recommended that they have treatment while they are

incarcerated, and whether or not they are being re-committed for

a violation involving drugs or alcohol.

The folks who meet any of these elements or criteria are moved

into our drug education course, which is a 40-hour course that provides them information about the psychological, social, and physical affects of drug abuse.

We provide that program in all of our institutions. In fiscal year

1998, a little bit over 12,000 inmates went through that course.

Since its inception in 1990, over 98,000 inmates have gone through

our drug education course.

Additionally, for inmates who have diagnosable substance abuse

problems, we provide at 42 of our institutions a Residential Treatment Program. These programs are 6 to 12 months in length.

There is a minimum of 500 hours of treatment provided. During

this time, the treatment components really try to target inmates’

criminal thinking patterns so that we are working toward reducing

any future criminal activity, as well as reducing any tendency to

use drugs again.

In fiscal year 1998, we treated a little bit over 10,000 inmates

in our Residential Programs. We also offer in all institutions what

we call Non-Residential Treatment Programs for inmates who may

not otherwise be eligible for the Residential Programs.

These counseling services are coordinated through the Psychology Services Department at the institution. When an inmate completes our program and is being ready to be released back to the

community, either through a half-way house, community corrections center, or back to supervision under U.S. probation, we provide that entity with a treatment plan and treatment summary

prior to their release so that they can arrange treatment and support services to ease the transition of the inmate back to the community.

Since the inception of our programs, we have been working with

NIDA to evaluate their overall effectiveness. We did get some good

news last year. In February 1998, we published the first interim

report that indicated for inmates who complete our Residential Programs, and for the first 6 months they are in the community, they

were 73 percent less likely to be re-arrested, and 44 percent less

likely to relapse into drug use.

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Additional analysis of this same data has shown us that inmates

who go through our treatment programs, while they remain in the

institution, also engage in significantly less misconduct. So, this

helps us ensure safe, secure institutions as well.

This concludes my formal statement. I will be happy to answer

any questions you or other members of this subcommittee may

have.

[The prepared statement of Ms. Verdeyen follows:]

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Mr. MICA. Thank you. We will start some questioning. I will lead

off. First, I want to ask Mr. Schecter with ONDCP a couple of

questions.

We have had the report that was released yesterday on the Institute of Medicine’s findings on marijuana as a medicine. I think we

have had dozens of other studies that have already demonstrated

that smoking marijuana is dangerous and lacks any medical utility.

It is also my understanding that a recent Canadian journal said

that the United States might start clinical trials of medical marijuana. I think in the report there is some indication that might be

the next step.

Subsequently, the FDA has said that it has approved clinical

trials. Can you tell us about that report or the status of what the

next step might be that is anticipated?

Mr. SCHECTER. Mr. Chairman, I have not seen that journal. I

would really probably have to defer to NIDA on what their plans

are for clinical trials.

Mr. MICA. Does your office have a position on clinical trials? Are

they recommending that as the next step?

Mr. SCHECTER. No. I think General McCaffrey’s position on this

is that they have gone through a great deal of time and trouble to

assemble and review the scientific evidence. They have presented

their findings. The ball is now really in the court of NIH and other

agencies to determine what, if any, next step is appropriate, given

their own research priorities and the needs for developing this.

Mr. MICA. So, your recommendation would be against further

clinical studies?

Mr. SCHECTER. Well, again, I would defer to HHS on that question.

Mr. MICA. Mr. Millstein, do you want to comment?

Mr. MILLSTEIN. If you are talking about the clinical trials, sir?

Mr. MICA. Right.

Mr. MILLSTEIN. That is the province of the Food and Drug Administration. The role of the National Institute on Drug Abuse specifically is by international treaty, we hear, the only organization

that can supply marijuana for research use in this country. That

is a rule formally held by the DEA and by NIDA.

Mr. MICA. What would be your recommendation; that you want

to go forward with that or do you have a position regarding clinical

trials?

Mr. MILLSTEIN. If you are speaking, sir, about the recently released report by the Institute of Medicine, of course, that has just

been released yesterday and it has been received by the Department. It will be reviewed there. The Food and Drug Administration, the National Institutes of Health, and the Surgeon General

will advise the Secretary.

Specifically, as to NIDA’s role, it is only in providing the marijuana after others make a determination that a study should

be——

Mr. MICA. So, you will not get involved in either recommending

for or against any trials?

Mr. MILLSTEIN. The Director of the National Institutes of Health

might have a different role than we do. Because the National Institute on Drug Abuse has, as its mission, solely the use of dollars for

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drug abuse, we have no role in any so-called medicinal or medical

use of marijuana.

Anything that would be for any particular disease entity would

be the province of a different institute and the National Institutes

of Health.

Mr. MICA. Does this Substance Abuse and Mental Health Services Administration, Dr. Autry, have a position?

Dr. AUTRY. Let me answer that for the department as a whole,

rather than for any one of our given agencies. The department really has not analyzed the IOM report and come to a decision on that

issue yet.

This will be a high priority policy issue that we will have to have

discussions across all of the agencies that might be involved in this.

We will certainly keep the subcommittee informed on those decisions. We do not have a position at this point.

Mr. MICA. Mr. Schecter, you spoke about some reports that indicate that we have fewer users. I guess that is primarily an adult

group. But we have more deaths and we have more use by teenagers or our youth population.

How is ONDCP trying to address the problems of the additional

deaths and the use with our younger population?

Mr. SCHECTER. Well, you raise a very good point. We have, I

think in this country today, an increasingly two-sided drug problem.

We have a situation where there are fewer individuals using

drugs, yet at the same time, almost paradoxically, the number of

drug-related medical emergencies has been rising.

The number of drug-related deaths has been rising. The economic

impact of drug abuse on American society has been rising, despite

the drop in the number of drug users.

Mr. MICA. And we have more people in our prison than ever before.

Mr. SCHECTER. That is true too.

Mr. MICA. And more there because of some drug-related offense.

Mr. SCHECTER. The reason for this seems to be that what is not

decreasing commensurately is the number of chronic or hard-core

drug users. Their number is difficult to gauge with accuracy, and

we have been trying to do a better job of doing this with the Chicago study and so forth. The number of chronic users seems to be

holding rather steady and, at the same time, aging. So, consequently you get people who are much more likely to be overdosing, to be developing medical problems which get them into hospital emergency rooms, causing crimes, and so forth.

Now, the answer to this I think lies in a couple of areas. One is

closing that treatment gap—particularly, doing a better job targeting the treatments to where it is needed. SAMHSA has a Targeted

Capacity Expansion Treatment Initiative, which we think will be

very successful in getting those hard-core users into treatment.

Another way to do that is using the criminal justice system more

effectively, because that is where so many of these individuals end

up.

You also mentioned the problem of young people. That is yet another facet of this drug situation which is becoming increasingly

complex.

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The number of overall drug users has been going down and then

holding steady for the last several years. Teen drug use has, during

the 1990’s, increased and now apparently is starting to level off.

What you have, as you pointed out in your statement, is more

teens now starting to get involved in some of the extremely dangerous drugs like heroin. So, you have the situation that occurred

in south central Florida, in the past year or so, where there was

a number of drug-related deaths due to heroin. One of the ways

that we have got to deal with that issue over the short-run is to

get the word out to these kids about how dangerous heroin is.

Heroin has not really been a high visibility drug problem in this

country for probably 20 or 30 years. That was the last real heroin

epidemic we had.

So, certainly the younger generation has tended to, not be aware

of how dangerous heroin is; particularly, now that you have got the

high-purity heroin. You do not have to inject it. You can take it nasally, pop it through the skin; other means of administration which

do not appear to be so threatening as injection. So, we are using

our media campaign to get some effective anti-heroin messages out

there.

Mr. MICA. Well, one of the things that concerns me is that this

administration has spent more time talking about tobacco from the

beginning. I think the recent statistics that I just heard within the

last week is that we may even have an increase among youth, the

use and probably addiction to tobacco.

Within the last 2 weeks, I sat down with a group of young people, all who were committed either by court sentence to a drug

treatment program or I think there were several in there who had

volunteered.

They did not have much of a choice. It was either volunteer or

be sentenced. Two were there because of alcohol-related felonies,

but the balance of maybe 25 were all there because of drug abuse.

I asked them specifically had they seen any of the ads that have

been put on of late, which you all have been touting and we financed? They all shook their heads, yes. Then I asked them what

they thought of them.

They all just started laughing. I asked them about the ads. They

thought they were completely useless. They said that in today’s

media barrage and barrage of violence and other things that they

are exposed to, that they had no impact.

They thought they were almost a waste of money. Now, I am not

going to spend the rest of the hearing on that. We are going to

have a specific hearing. We have questions to you examining what

is going on with the sizable amount of taxpayer dollars we are putting into that.

I have no problem putting $1 billion every week into it, if we had

to, to solve the problem. But we want to make sure it is effective.

What is your response? For example, there is no 800 number on

the ads.

Then I understand in your program where you do have an 800

number, that you get an automated response. That you do not talk

to an individual. Maybe you could just respond to the points I have

raised.

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Mr. SCHECTER. Yes. First, let me respond to your point about the

kids. I am not completely surprised that they had that reaction.

The goal of the campaign is not so much to change the minds of

kids who are already starting to get involved with drugs or who are

already in trouble with the law.

It is really targeted to a somewhat younger group; the kids who

are just on the verge of that kind of activity to try to shift their

attitudes before drug use behavior begins.

Mr. MICA. All right. But now, go back and do another focus

group. Thank you. The balance of the response; the 800 number.

Mr. SCHECTER. I believe most of the print ads do have an 800

number on them, except for the matching ads which may not.

Sometimes, it is hard to distinguish which is a pro bono match ad

and which is an ad paid for directly by the campaign.

As far as the automated response, a part of that problem is we

are victims of our own success. We are trying to deal with that to

make sure that everybody does talk to an individual. That there is

as short a wait as possible.

Mr. MICA. Thank you. I would like to yield now to our ranking

member, Mrs. Mink.

Mrs. MINK. Thank you very much.

There is considerable discussion about the youth media campaign

and a hope and expectation that it will be effective. How much

money actually is being spent on that program in terms of it being

out there actually in it commercials on television, excluding the administrative production costs?

Mr. SCHECTER. Of the $185 million appropriated for this past

year, my recollection is the amount of money that is devoted to ads

is something like, I could be wrong, but it is on the order of $157

or $158 million.

The rest of the funding is for other types of media. It is a multimedia, not just an ad, campaign. We have a major Internet component, for example, that will be announced next week, which is very

exciting.

Of course, some money goes to the contractors who place the ads

and handle the other administrative requirements, but that is a

very, very small percentage.

Mrs. MINK. So, most television programs and others make a survey or conduct a poll to see what the reach is in terms of the targeted population. Do you have any information as to whether you

are reaching that age group that those ads are targeted to?

Mr. SCHECTER. Yes, we do have tracking surveys that our contractors conduct.

That is how we know and can speak with confidence that we are

reaching at least 95 percent of the teen target audience, an average

of about 6.7 times per week, which averages out to about once a

day.

Mrs. MINK. Now, if we are spending $165 million on the ad program, what is the value of the pro bono contributions that you are

receiving in the form of PSA’s?

Mr. SCHECTER. Again, we are exceeding our projections. When we

first began this campaign and predicated it on a dollar-for-dollar

match, we frankly had no idea whether that was going to happen;

whether the industry would really be able to match to that level.

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What is happening is we are exceeding that projection—about

107 percent matching. In other words, we are more than matching

dollar-for-dollar. In addition to that, there is about another $40

million in other contributions from private industry that have come

along as a part of this campaign.

Now, later this summer, we will be letting a contract for a new

corporate participation program which will vastly increase still further the level of corporate contributions to the campaign.

Mrs. MINK. So, what is your expectation in terms of the outcome,

in terms of reducing the young people turning to drugs and becoming persistent drug users?

Mr. SCHECTER. There is a graph in the strategy which really

shows what we are trying to do. It plots teen drug use.

[Chart shown.]

Mr. SCHECTER. You can see that line coming down through the

1980’s and then turning up again during the 1990’s, and leveling

out the last couple of years. Then you have got two other lines

which are absolutely perfectly inversely proportionate to that line.

In other words, as drug use is going up, the perception of risk

is going down. The perception of social disapproval is going down.

This is measured on Dr. Lloyd Johnston’s Monitoring the Future

survey at the University of Michigan.

You have perception of risk going down. This campaign is targeting those two attitudes, trying to again shift those trend lines back

in another direction.

What the research shows is that when those attitudes start heading the other way, teen drug use, within 1 to 2 years, starts heading downward. That is what the campaign is trying to achieve.

Mrs. MINK. Just one final question because I have a second

round. You talked about the Drug Free Community Program and

the partnership and how effective it is. Why is it that in the administration’s budget or your office budget you have reduced the funding of that program?

Mr. SCHECTER. The authorized ceiling for that program is $30

million for fiscal year 2000. The administration’s request is $22

million. We would, of course, welcome discussion with the Congress

about different funding levels.

I think it is probably no secret that General McCaffrey initially

proposed both to OMB and to the President a higher level. But $22

million is the administration’s position.

Mrs. MINK. The other aspect of that is the maximum amount of

funding for the Community-Based Coalitions. You also have set

very low caps in the next 3 or 4 succeeding years. What is the reason for that?

Mr. SCHECTER. The law says that the Administrator and the Director of ONDCP is authorized, to award continuation grants in the

2nd, 3rd, 4th, and 5th years of the grants. It prohibits any up-front

multi-year funding.

So, the decision before the Director, first of all, was whether to

award continuation grants. That was an open question. Second, if

so, what would the policy be, keeping in mind two goals that we

have and that the Congress had with this program.

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One goal is to support strong, healthy, vibrant coalitions that

will be able to stand on their own feet, both financially and otherwise, with strong local support.

Second, our goal is to increase the number of such coalitions

around the country. Based on recommendations from the Department of Justice and after discussion with the Advisory Commission, this is the Presidentially-appointed Advisory Commission on

Drug Free Communities that met back in November, the Director

made a decision to award continuation grants. But he decided to

reduce the amount of funding in the 2nd and 3rd year, and commensurately increase matching to provide a strong incentive for

communities to increase, broaden, and strengthen their base of

local support.

Mrs. MINK. Thank you, Mr. Chairman.

Mr. MICA. I thank the gentle lady. I now recognize the gentleman from Indiana, Mr. Souder.

Mr. SOUDER. I want to say for the record that was an unacceptable answer. Mr. Schecter, I am not used to seeing you in America.

We were in Mexico the last time we talked.

I would think that those of us in Congress who worked on the

bill, who helped put that bill together, who put that language in,

who worked with community groups to try to get the processes in,

would have been consulted in that process as well.

We were specifically not consulted in any work there. Furthermore, you said you talked to them in November. Did the Advisory

Commission know, at that point, that you were not going to seek

additional funding, and it was not going to be fully funded?

In other words, did the Commission get told that if in fact, the

people who already had the grants and already submitted a plan,

while I understand that it was not locked in, that it was going to

be there?

I do not know of very many grants that you do not assume that

the funding is going to flow, unless something—in other words,

that there is going to be a sea change in the middle of your process.

I am not arguing that they were not told up-front that this is not

guaranteed. But when you present a multi-year plan, and here is

the amount of money, it is not an illogical jump to conclude that

it is going to be a continuation, unless you do something wrong.

Furthermore, you certainly do not assume that you are going to

get the size in draconian cuts that were there. You said that the

Advisory Commission, based on their input, that the Director made

the decision to reduce this.

Did they know the size of these cuts? Did they know what the

budget was going to be? Were they given the impression that there

would be minimal and additional groups added in the process? Besides, we were not consulted.

Mr. SCHECTER. I take your point, sir.

At the November meeting of the Advisory Commission, going

back, I am looking over the minutes of Shay Bilchik—who is our

Grants Administrator, head of the Office of Juvenile Justice and

the Delinquency Prevention at Justice—we put into play for the

commission’s consideration a policy of a reduction of about 25 percent in the next year.

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They discussed that and on through lunch. In fact, one committee member at one point said, ‘‘Well, we will let you, the staff, work

out the details. We could talk about this endlessly.’’

What they were very clear on, put in their minutes, and recommended to the Director, was that there be a clear policy of reducing the Federal share of the budget in each succeeding year.

They then left to the Director his best judgment of what exactly

those levels should be. Again, of course, they were aware of this

proposal on the table for a 25 percent reduction and did not view

that as out of line.

Mr. SOUDER. It may put us in the position of having to make

more clear direction, rather than leaving discretion, because rural

groups, for example, and some urban groups who are many of the

targets of this program do not have the flexibility to go out and

raise the private sector match as easily as a suburban group would.

I, myself, am not sure. I have a fundamental distrust of whether

this is not a budget gimmick where the administration in fact

comes in with a lower budget request by altering existing grants.

Although I agree, it was not mandated, but the understanding of

those groups, certainly in my District, that was not how they understood the process. I am not saying they did not jump to a conclusion, but that was not their understanding.

Then putting political pressure on us to do something in the

budget that the administration did not have the courage to do. It

does not breed trust in the relationships when it was a project that

was bipartisan and one that we are trying to put together.

I also have a similar concern on drug free work places. You

talked in your testimony about the Drug Free Work Place bill

which came originally through my subcommittee that I Chaired at

the time.

I Chaired that bill and worked it through, but the President’s

budget, I believe, does not have any funding in it for drug free

work places. Is that correct?

Mr. SCHECTER. I believe it does. I will have to check on that. I

believe that is in there.

Mr. SOUDER. My understanding is that——

Mr. SCHECTER. It should be in the Small Business Administration budget. It would not be in ONDCP.

Mr. SOUDER. Yes, it would be in the Small Business budget because it was under the Small Business Committee that we funded

that. I will double check that.

Mr. SCHECTER. Let me check on that, too, sir.

Mr. SOUDER. OK.

Mr. SCHECTER. I will provide an answer.

[The information referred to follows:]

72

73

74

Mr. SOUDER. I wanted to follow up too on the media campaign.

By the way, I want to say first off, I think this is a comprehensive

campaign in prevention and treatment. I want to applaud you with

that.

We are here in an oversight function and I am asking aggressive

questions. First off, I want to say to all of you, this is the type of

thing we need. It does not mean that I do not have a lot of fundamental questions underneath that to fine tune it.

I do have some concerns as you are hearing from a number of

our members. I believe that if we do not get ahold of the medicinal

use of marijuana question, all other questions are pretty well defeated.

I wanted to zero in, if I could just briefly, Mr. Chairman, on the

concern about the media campaign. On Monday, I am at the Education Committee, where we are working on the Elementary and

Secondary Education Act.

We have been going to a lot of different schools. I asked a group

of students if they had heard about the medicinal use of marijuana

debate. The answer was uniformly yes.

What did they think? They uniformly thought it should be used

for medicine. I asked them if they realized that there were, I think,

270 different chemicals in marijuana and it is just one that is in

fact the critical chemical?

Here you do not have to have marijuana to find that chemical.

They said they had never heard that before. Now, that was particularly troubling.

How can we have a media campaign, and how can we have a national effort that does not in fact speak to the fundamental challenge we are having right now in the 8th and 12th grades?

As you all have eloquently pointed out, we are making headway

in college students. We are going to make more with our drug testing and student loan criteria which every university is going berserk about right now, but which is putting the pressure on at the

college level.

We are making at least stabilization and some headway among

adults, and 8th graders generally do not start with heroin or cocaine. They are starting with marijuana, tobacco, and alcohol.

If they believe that marijuana is medicinal, how in the world are

we going to win this battle? Do you not believe that our materials

actually ought to be focused, first and foremost, at the primary

point where the growth in the drug abuse is occurring? Why would

that not be a part of our national media campaign?

Mr. SCHECTER. Well, we reached very much the same conclusion.

Right now, we are in phase II of this campaign. This means that

it is a national campaign, but it is essentially using media spots

that had already been created through the Partnership For Drug

Free America—essentially off-the-shelf ads.

The problem with this is that the inventory of good anti-marijuana ads targeted to the age group you just referred to—which

really is the critical age group was very, very small.

We are having to make do with what we’ve got. However, we told

PDFA that our top priority for new ad development was exactly

those kinds of ads; ads that dealt with marijuana for middle school

aged kids.

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We have now previewed in the last several weeks a number of

new ads that they are developing which are absolutely superb.

They are some of the best spots I have ever seen and that General McCaffrey has ever seen. Those will be coming on-line in the

next couple of months.

Mr. SOUDER. I hope we will see a focus beyond just the students

and reach beyond that point. I want to say, first of all, bravo for

doing that. That is the at-risk market. We need to see an aggressive effort there.

Then moving to the high school market and see where we are

going in the general public. Clearly, this advent of opening the door

to drug legalization is a disaster in this country.

Thank you for letting me go over my time.

Mr. MICA. I thank the gentleman.

I would like to recognize the gentleman from Maryland. Would

you allow me one 30-second question? Joseph Autry, the Substance

Abuse and Mental Health Services Administration, I think you put

in our packet these, I guess, how much funds flow into each State.

Is that correct?

Dr. AUTRY. We developed specific State data for each one of the

members.

Mr. MICA. Can you provide me that information by next week,

I want to know how many people administer this program?

Dr. AUTRY. Sure, we can do that.

Mr. MICA. I want to know how many Federal folks administer

that program. If you would followup and get me that information?

[The information referred to follows:]

SAMHSA has approximately 26 FTEs assigned to administration of the Substance

Abuse Prevention and Treatment Block Grant. This number represents all staff involved in administration of the grant including those responsible for providing technical assistance to the States.

Mr. MICA. Thank you. I yield now to Mr. Cummings.

Did you get one, too? I think your goodie bag is in there. I am

pleased to recognize the gentleman who has the distinction of officially having 39,000 heroin addicts.

The unofficial figures he tells me are much higher; the gentleman from Maryland, Mr. Cummings.

Mr. CUMMINGS. That is certainly not a good thing.

Thank you, Mr. Chairman. I want to thank you and our ranking

member, Mrs. Mink, for having this hearing because it is a subject

that is near and dear to me.

First of all, let us note that most of the questions have been directed to you, Mr. Schecter. I have just a few. I must tell you, there

is not a lot that I agree with my friends on the other side.

One thing I am concerned about is the Drug Free Communities

Act and this reduction of funding. The reason I say that is because

there are so many community groups that are trying to fight this

drug problem.

In my area of Baltimore, it takes a lot of nerve for people to do

what they do. Literally, their lives are threatened daily. I have said

it before, I live in fear everyday. Every night when I sleep, I am

in fear because I see what is happening in my community with regard to drugs.

76

So, whenever you have a program where community groups are

willing to band together and to stand-up to fight the drug element,

I think we need to be doing more and not less. It concerns me. I

wanted to ask a question of our friend from the Bureau of Prisons,

Dr. Verdeyen. One of the things that has always concerned me,

having practiced criminal law for 18 years and talking to the criminal element in the State prisons.

It seemed as if you could get drugs just as easy in prison as you

could get them out of prison. I could never figure that out. It concerns me that just this past week or two we had a show on local

television in Baltimore where they are talking about trying to help

people who were in prison, and still on drugs.

The drug problem got worse in prison, and trying to figure out

a way to help them was difficult. See, there is something wrong

with that picture. I mean, maybe I am missing something.

I thought prisons were supposed to be pretty much air-tight and

definitely drug-tight. Then when I think about our Federal prisons,

they are supposed to be tighter. I am wondering what your view

is on that?

Do we have major drug problems in our prisons? When I say

‘‘drug problem’’ I want to be real clear. I mean, drugs coming into

our prisons.

Ms. VERDEYEN. I have the most recent information. Actually, it

is information for this past year on the random drug testing that

we do on offenders in Federal prisons. Our screens came up as 1.1

percent of those tests were positive.

So, while it is not air-tight, it is not a huge problem. We have

a number of approaches to prevent drugs from coming in, having

to do with surveillance in the visiting rooms.

We have introduced the ion scanners in 28 of our institutions.

That seems to be effective in deterring people from even trying to

bring drugs into the visiting areas.

Mr. CUMMINGS. Maybe we need to try to do some of that in the

State prisons. Do we have somebody here from the State prisons?

Ms. VERDEYEN. I believe so.

Mr. SCHECTER. Sir, this is exactly the purpose of Drug Free Prison Zone demonstration project that I was talking about in my opening statement.

Mr. CUMMINGS. I apologize. I was in another hearing.

Mr. SCHECTER. Oh, I am sorry. That is true.

This was a $6 million appropriation that came to ONDCP last

fiscal year. We entered into an agreement with the Justice Department to divide that among the Federal prisons to put ion scanners

into some of these Federal facilities so that when people are trying

to bring drugs into the prison, they will get detected.

Then $4 million was awarded competitively to 8 States to implement different types of procedures and programs, including better

training for staff on how to intercept drugs coming into prisons,

and also to institute drug testing.

Mr. CUMMINGS. Did he just pass you a note that Maryland is one

of them?

Mr. SCHECTER. Maryland is one.

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Mr. CUMMINGS. I know staff. I mean, you have got to get that

in. I did not know that, but I am glad to know that, brother staff

member.

So, how long have those grants been out there?

Mr. SCHECTER. They were just awarded, I think, in January.

Mr. CUMMINGS. January; OK, good.

Let me ask you something. What are we doing with regard to

sales persons of drugs? Let me just tell you. In my community, a

part of the problem is that young men, and there are a lot of

women, they do not use drugs but they sell them because they cannot find jobs, so they claim.

When I came home last night, literally within a block of my

house, I got home around 12 o’clock. There were about 14 or 15

young people standing on the corner within a block of my house,

which is right near downtown Baltimore, selling drugs.

I am just wondering, I mean, do we aim anything at dealing with

these sales people?

[No response.]

Mr. CUMMINGS. Hello. Anybody?

Mr. SCHECTER. Yes. There are a number of programs like that.

Karol Kumpfer may have some examples from CSAP. There are

media campaign spots that target that kind of activity. There are

some other prevention programs.

It is very difficult to reach these kinds of kids. What you are

really talking about are not so much programs targeted at selling

drugs, but programs targeted at a whole range of negative, high

risk, and counter productive behaviors in the school systems.

I might ask Karol to speak to that.

Mr. CUMMINGS. While you are pulling the microphone closer, one

of the interesting things that we’ve seen, and heard about drug

sales in the black communities.

You turn on the 6 o’clock news and people, if you just looked at

the television, you would assume that most of the people on drugs,

using, and selling drugs are black. Well, dah. They are not. They

are white.

I think all of you all know that, but the picture is thrown out

there that they are black. One of the interesting phenomenons that

I have seen here lately is how in our suburban schools, where you

have these majority white populations like 90 percent to 95 percent, they are now discovering major sales persons in the schools

with big time corporate activity selling drugs to our youngsters.

So, I am not just aiming it at my street. I am also looking at the

streets outside of my neighborhood.

Ms. KUMPFER. One of the things that I wish is that we could

market prevention as well as they market drugs. That is one of the

things that we are working on at the Center for Substance Abuse

Prevention.

You are right about being concerned about that for a number of

reasons: in terms of youth selling because, not only do they sell

but, eventually, most of the data shows that they eventually get

into using drugs.

They think they are only going to start making some money, but

they get involved in the whole drug culture. Eventually, the stress,

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the pressures, the money, and all that, they end up using quite

often as well.

What we are doing at the Center for Substance Abuse Prevention

is: we recognize that it takes a coordinated, comprehensive, community-based approach to be able to help youths not to use drugs—

which involves working with the whole community, changing the

atmosphere and the environment, helping kids to have productive

lives—in other ways that they are not going to want to use or not

want to sell drugs.

Effective programs that would deal with this more directly are

going to start right in the home, very early, with having a strong

family: where the kids understand that this is not within the family values and norms that they should be selling drugs.

The parents monitor their children and are close enough and connected to their children that they know what their children are

doing and where they are.

Then also when you get to the junior high and high school level,

you can start working on having the children be involved in positive activities so that they are involved in community service activities through their schools, through their churches.

They start learning that there are more effective ways for them

to make money and develop skills and competencies in this world.

We have also been working with one of our grant programs. It is

Project Youth Connect, which is to involve those youth with mentors.

We have funded a number of grants around the country this last

year through the High Risk Youth Grant Program to train mentors

to work with youth to then support their communities through

doing a number of different kinds of activities with youth in the

community. It would also involve community service projects as

well.

Mr. CUMMINGS. What is the average amount of those grants? I

am just curious.

Ms. KUMPFER. The average amount is around $400,000 to

$500,000. They are funded at a pretty good size level.

Mr. CUMMINGS. Do you know if Maryland got one?

Ms. KUMPFER. They were incredibly popular, I might say also.

We had a huge number of applications for a very small amount of

money. We only had $7 million this year. Excellent grants, we

could not even fund, though they were very, very popular.

Mr. CUMMINGS. Thank you.

Mr. MICA. My friend from Hawaii has questions.

I am going to yield the floor.

Mr. OSE [presiding]. This is the first time this junior member has

sat in the chair.

Mrs. MINK. Oh, you want to sit there awhile.

Mr. OSE. I am terrified I am going to screw it up.

Mrs. MINK. For my colleagues’ benefit, we are going to have another hearing on the law enforcement end, where the questions

that you are pursuing, which I am very much interested in, also

can be pursued at that time with the law enforcement agencies. I

have a question to Ms. Verdeyen.

Ms. VERDEYEN. Yes.

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Mrs. MINK. The prison population that you referred to in your

testimony is basically the Federal prisons; correct?

Ms. VERDEYEN. That is correct.

Mrs. MINK. That is a very small number when you consider the

1.8 million that are in our prisons throughout the country, local

jails, State prisons, and so forth.

Now, to what extent is the program that you described also in

place in the State prison systems so that what you are doing to

identify the prisoners that are drug-dependent and putting them

into a treatment program?

To what extent is that happening in the State prison populations? We are talking about 100,000 Federal prisoners, as compared to 1.6 million prisoners in the other systems. These are the

individuals who are going to be released and eventually come back

to our communities.

If treatment in the prisons is going to make any difference, we

have to find a program that relates to that population. Can you

comment on that?

Ms. VERDEYEN. Our programs are available to States through the

National Institute of Corrections. Our curriculum that we use—I do

not have information on——

Mrs. MINK. How do you get it out to them? Are there grants to

States? Is there financial support? We talk about partnerships in

the communities. Is there partnering in terms of what you are

doing with our local prisons so that the practices that you find successful are translated to them? Perhaps we have to enlarge the program and make sure those are funded as well.

Ms. VERDEYEN. That information would be from the Office of

Justice Programs. I would be happy to see that you get that information.

Mrs. MINK. Meaning that they have money that they allocate to

the States for that purpose?

Ms. VERDEYEN. Yes.

Mrs. MINK. Do you have any idea how much that is?

Ms. VERDEYEN. No, I am sorry.

Mr. SCHECTER. Mrs. Mink, there are some programs in the Justice Department, although not in the Bureau of Prisons areas that

do this. For example, there is, as I mentioned earlier, the Drug

Intervention Program, which is unfunded. It is a $100 million request.

That would institute system-wide drug intervention and treatment programs throughout all aspects of the criminal justice system in an area. There is also, of course, the Break the Cycle Program, which you may be aware of.

There are a limited number of demonstration sites around the

country. Again, through a similar kind of systemic approach to

drugs in the criminal justice system.

Mrs. MINK. Why has that remained unfunded; because the funds

were not requested or that the Congress refused to fund it?

Mr. SCHECTER. The funds were requested last year. I believe the

request was $85 million. That was unfunded.

Mrs. MINK. What about in this year’s budget?

Mr. SCHECTER. This year, the request is $100 million.

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Mrs. MINK. So, it is before the Appropriation Committee now on

both sides?

Mr. SCHECTER. Yes.

Mrs. MINK. What are the prospects of getting that money? It

would seem to me that it is a terribly important area.

Mr. SCHECTER. It is certainly one of our high priorities. We are

going to fight very hard for it, as is Attorney General Reno.

Mrs. MINK. Is it a correct statement that of the 1.8 million persons who are in the prisons that 60 percent of that population in

some way got into prison because of their drug use, or drug dependency, or selling of drugs, or related in some way to the drug

traffick? Is that a correct figure.

Mr. SCHECTER. There are various figures and they are all pretty

high. It is hard to know which one is most accurate. It depends

upon how you define it I guess.

Mrs. MINK. Is there a higher figure than 60 percent?

Mr. SCHECTER. I am sorry?

Mrs. MINK. Is there a higher figure than 60 percent drug related?

Mr. SCHECTER. That is about as high as I have seen.

Mrs. MINK. It seems to me that this population is going to get

out. They are not going to be in prison, you know, for life, I do not

think so. Although some of the sentences are pretty stiff.

This population is going to get out, go back into the communities,

and unless we have adequate treatment of these prisoners in the

State system, we are just going to compound the problem for ourselves when they get back in.

So, it seems to me this has to be a priority in terms of the demand situation.

Mr. SCHECTER. We agree 110 percent.

Let me cite one other program that I neglected to mention; the

Residential Substance Abuse Treatment Program; $62 million at

the Justice Department to support Residential Treatment Programs in State prisons.

Mrs. MINK. I just have one other area that we were talking about

earlier. That is the medicinal use of marijuana. It is a very controversial subject. I differ with my colleagues on the majority on

that subject.

It, nevertheless, I think, requires some scrutiny in terms of how

we deal with the subject area. You have made the distinction that

the Institute of Medicine did not indicate that smoked marijuana

had any particular medicinal value. That the emphasis is going to

be on the chemical compounding of it. Now, is there some way that,

that kind of information can be extracted and formulated in a way

that the people will accept that distinction?

Are we talking about a general topic of marijuana being something that has value and therefore completely compromise the efforts that you are making to indicate that it is not a suitable item

for anyone, not only the youth, to be using?

Mr. SCHECTER. I think one of the real strengths of the IOM report is that they took great pains to distinguish between the two.

Mrs. MINK. Could you distinguish the two for this hearing so

that it would be as clear as possible, given the limitations of language?

81

Mr. SCHECTER. Absolutely. Again, what the IOM is recommending is that there be further research into the various cannabinoid

compounds contained within the raw marijuana plant.

There are a great many compounds. They are very complex. Most

of them are not very well researched yet, but there is promising

evidence, including some very new research showing how

cannabinoids affect the brain, that suggest that there may be some

potential uses.

One of the compounds has already been developed for commercial

use. It is called marinol. It was developed in the 1980’s. The IOM

is suggesting there may be some other potentially useful compounds as well. As you have said, with regard to smoked marijuana, the raw plant that you roll up and light, their finding is: little to no medical potential.

Mrs. MINK. In dealing with this subject matter, is it necessary

to go back to the marijuana plant for the manufacture and creation

of the compounds that they are dealing with?

Is it a chemical compound that can be found distinct in the

chemical laboratories without having to make a reference to marijuana? That is really my question.

Mr. SCHECTER. These compounds can potentially be synthesized.

This is getting beyond my level of scientific knowledge.

Mrs. MINK. I read that explanation in a newspaper. It seemed

perfectly clear, but nobody has said it today. So, I am somewhat

mystified as to whether that is an accurate distinction in that report. If so, why that has not been utilized by any of you in clarifying the subject.

Mr. MILLSTEIN. Mrs. Mink, if I can answer your question.

Mrs. MINK. Yes.

Mr. MILLSTEIN. The substance drenavenol marketed as marinol

is a synthetic substance. It is the psychoactive ingredient of marijuana, zeltinyne tetrahydrocanavanol. It is a synthetic substance,

not made from the plant material.

Mrs. MINK. So, why are we in this discussion at all when we are

talking about drug abuse, then, if it is like any other prescription;

something that is synthesized chemically and sold as a prescriptive

drug?

Why do we have to relate it in any shape or form to clarify as

to whether there is any value to marijuana consumption?

Mr. SCHECTER. My understanding is that these compounds, of

course, exist naturally in the marijuana plant. So, that is where

you would first attempt to isolate them.

Mrs. MINK. But they are non-existent in any other circumstance.

Mr. SCHECTER. Apparently, they are quite rare otherwise. I think

there are possibly some other plants that may exist.

Mrs. MINK. So, that you cannot get out of the discussion then.

Mr. SCHECTER. Once you do isolate them from the raw plant,

then it is possible to synthesize it in the laboratory.

Mrs. MINK. But you need to have the plant.

Mr. SCHECTER. Initially.

Mrs. MINK. ‘‘Initially’’ meaning what? In every instance?

Mr. SCHECTER. Initially to identify and isolate what the compound is.

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Mrs. MINK. Only for research purposes, but for the manufacturing as well?

Mr. SCHECTER. For manufacturing, you do not need the plant.

You can manufacture it.

Mrs. MINK. It can be synthesized in a laboratory. Is that correct?

Mr. MILLSTEIN. The fact is that there are androgenous, that is

within the body itself, cavanoids and canabidials. There is, I guess

in theory at least, the possibility that there can be a derivation.

Mrs. MINK. Do you mean taking my body?

Mr. MILLSTEIN. In theory one could say that because——

Mrs. MINK. Well, this is far too complicated for me.

I yield the floor.

Mr. OSE. I heard that last exchange. In California, we have recently had the opportunity to vote on the use of marijuana for medicinal purposes.

What I failed to understand, particularly given my colleagues’

questions, is that if we have the ability to synthesize marinol, for

instance, and we have not yet been able to identify these other

compounds that might come from smoking marijuana, why are we

spending $1 million to study the use of smoked marijuana?

I do not grasp this. I want to come back to that point. I know

Mr. Mica has spent some time on it. I am hopeful someone can explain it to me. My concerns are pretty straightforward.

There are enough clinical studies to establish that smoked marijuana lowers someone’s immune system. It causes DNA, lung,

heart, and epidemiological damage, that is according to some European studies.

It is a Schedule I Narcotic, according to U.S. Code. It has psychologically damaging affects. I mean, I know friends who have used

it, former friends I must say. I do not have to have a doctor tell

me about it.

Somebody needs to explain this to me.

Mr. SCHECTER. Common sense would suggest that you are absolutely right. However, we have an environment in which a number

of States, including your own, were embarking on these public

referenda where marijuana was the subject of intense debate about

its medicinal properties.

Our view was that what we needed was a rigorous, up-to-date,

state-of-the-art, unimpeachable review of exactly what the science

said. As you say, there are a number of studies out there in various

places, in various journals.

Different people will cite different studies. What we did not have

was somebody that actually brought them all together, assessed

them, peer-reviewed them, and determined exactly what the bottom line was, and reported back to the American public. That is

what the IOM has done.

Mr. OSE. Let me back-up a minute. I have a hard time not being

argumentative on this. So, be patient with me, if you would. It is

my understanding that the Food and Drug Administration has that

role.

What I am trying to understand is why are we branching out

into ONDCP with that same role of studying the use of marijuana?

Mr. SCHECTER. Again, we do not normally do this kind of thing.

We got into this simply because this was becoming a national pubVerDate 11-SEP-98 11:44 May 19, 2000 Jkt 000000 PO 00000 Frm 00085 Fmt 6633 Sfmt 6633 C:\DOCS\63121.TXT HGOVREF1 PsN: HGOVREF1
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lic policy debate. We did not see anybody else out there convening

a blue ribbon group of scientists to review all of the existing research.

So, we thought that there was a need. It had not been done for

a number of years. There was a fair amount of recent research that

was worth looking at, including some very important research that

Mr. Millstein alluded to on the natural cannabinoid in the brain

and how cannabinoids affect the isolation of receptors in the brain.

So, somebody needed to take a look at that. It simply was not

being done.

Mr. OSE. Let me go on to another question. If I understand correctly, ONDCP believes there are legal restrictions to developing

and using advertisements that debunk the notion of marijuana as

medicine. Is that correct?

Mr. SCHECTER. Well, the advertisements produced under our ad

campaign do not directly address the issue of marijuana as medicine. What they address is the use of marijuana by kids because

that is the target of the campaign.

Clearly, they communicate the idea that marijuana is a dangerous, harmful substance. That is the basic attitude that we wanted to instill.

Mr. OSE. Does the ONDCP believe that there are legal impediments to developing and using advertisements that debunk the notion of marijuana as medicine?

Mr. SCHECTER. No. I do not think there are legal impediments.

I think there are statutory restrictions on using the campaign for

a partisan political purpose. The problem is when you get into

marijuana as medicine.

There are these various referenda in the States. They start getting into the area of public policy issues. What we wanted to target

this campaign on was reducing teen drug use. So, everything in the

campaign is focused on achieving that end.

Mr. OSE. I yield.

Mrs. MINK. Will the gentleman yield?

Mr. OSE. Yes.

Mrs. MINK. In the strategy book that I read, the executive summary; I have not really gone through the huge volumes. Repeatedly

it suggests that one of the reasons why the whole issue of marijuana is so important is that, that is the beginning of the young

person’s experiment into drug use. Once they get into marijuana,

it is quite likely that they will expand into other more difficult

drugs like heroin, cocaine, and methamphetamine.

Therefore, in structuring an approach that will nip this potential

growth of drug use among young people it is very important to hit

the marijuana issue. Is that correct? Is my reading of the report

accurate?

Mr. SCHECTER. Absolutely. In fact, the IOM points out in their

report that the use of marijuana usually precedes the use of any

other illicit drug.

Mrs. MINK. So, if that is true, and my reading is accurate then,

I have a followup question. What impact will the validation of

marijuana as a medicine have upon your overall media efforts to

try to get young people to stay off of it?

84

Mr. SCHECTER. This was one of the things that has always concerned us about these ballot referenda and one of the reasons why

we conducted this study. Indeed, the study now does say smoked

marijuana is not beneficial.

Mrs. MINK. Suppose your clinical studies validate it as a useful

relief from pain in terminal illnesses, no matter how it is structured?

Supposing it validates that, what impact will that have on our

ability as a country to take hold of this whole issue of marijuana

and get it under a controlled situation for our young people?

Mr. SCHECTER. We have long been concerned about the message

that the whole medical marijuana movement, which is in many respects a thinly disguised legalization of drug movement is sending

to our young people. There is no question about that.

Mrs. MINK. Thank you.

Mr. OSE. You are welcome.

Mrs. MINK. The microphone is yours.

Mr. OSE. Mr. Schecter, going back to the advertising issue on the

use of marijuana and the comment about whether or not there are

legal impediments to targeting advertisements to debunk the notion of marijuana as medicine.

If there are no legal impediments to that, and we have States

that are considering referenda that would authorize such, why

would we not target our advertisements in the immediate timeframe into those States. If we could, I would like to have you all

come back to California and target California again.

Mr. SCHECTER. I wondered if, for the sake of wondering, whether

if we were to do that, whether the other side on that public policy

referenda would then demand equal time from the media.

Mr. OSE. They should come and ask Congress for funding.

Mr. SCHECTER. Again, I think the main reason for not doing that

is that it is not central to the campaign’s primary objectives. If you

go back and take a look at the strategic plan for the media campaign, it states very clearly what the goals are.

What we wanted to avoid was having this campaign and the

funds appropriated for it lose focus. There are various purposes

that may be important and useful, but not central to the campaign.

The central purpose of the campaign, again, is to reduce rates of

teen drug use. The campaign goes about that in the most direct

way possible—in the ways in which research tells us are most likely to be effective.

Mr. OSE. How much clearer a message could one send than to

go into States where they are actually considering the question of

marijuana’s medicine and make the case that it is not?

Mr. SCHECTER. My own view is that if you have effective ads out

there showing the negative impact of marijuana on kids—and if I

were a voter in that State and I saw those ads day in and day

out—I think I would have a very different point of view when

somebody came to me and suggested marijuana is medicine.

So, I think there is a connection. Again, what we want to do is

keep the campaign focused on its initial goal: to reduce teen drug

use.

Mr. OSE. Does ONDCP have the authority to concentrate ads in

the States that are having referendums?

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Mr. SCHECTER. I would have to talk to our lawyers to take a look

at that to see looking at State laws, looking at the laws governing

the campaign itself, the authorizing statute. I would have to get

back to you on that. My impression is that would be a problematic

exercise.

Mr. OSE. What does ‘‘problematic’’ mean?

Mr. SCHECTER. Meaning not necessarily legal, but I am not sure.

Let me check on that and get back to you, sir.

Mr. OSE. We are going to leave the record open for a couple of

weeks. So, we will take that feedback.

[The information referred to follows:]

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Mr. OSE. Let me go back for a minute. I want to make sure I

understand on the smoked marijuana question whether or not we

are doing clinical trials on smoked marijuana. Are we or are we not

doing clinical trials on smoked marijuana for medical purposes?

Mr. SCHECTER. I am not aware of any plans in HHS to do that.

In fact, they indicated yesterday that they probably would not go

in that direction.

Mr. MILLSTEIN. The National Institutes of Health is supporting

one study, a clinical study, looking at the affects of smoked marijuana.

It is a phase I safety study supported by five NIH Institutes,

with Dr. Donald Abrams of the University of California at San

Francisco; looking at the affects of smoked marijuana as it interacts with AIDS medications and protease inhibitors.

Mr. OSE. I am not a clinical diagnostician or anything like that,

but I do read some. From what I read of smoked marijuana, it is

a suppressant to the body’s natural immune systems. Am I correct

in my understanding?

Mr. MILLSTEIN. Yes.

Mr. OSE. What would be the purpose of a study that introduces

a suppressant to immune systems in conjunction with the protease

inhibitors that might be an enhancer? Are we talking about nullification of impact?

Mr. MILLSTEIN. There are a number of periods with marijuana

in the smoked form; not only including the one you mentioned, Mr.

Chairman, but also pulmonary effects. The study is looking at, as

I said it is a phase I safety study.

If it turns out there is no safety, this would be a message that

would go back to other people in your State about the negative effects of smoked marijuana.

Mr. OSE. There is information about the adverse impact of marijuana, as you say, for pulmonary reasons?

Mr. MILLSTEIN. Yes.

Mr. OSE. Well, if we know that, why are we studying it again?

Mr. MILLSTEIN. The fact is that many people are using marijuana because of, not scientific evidence, but anecdotal reports that

it is effective.

Dr. Abrams is trying to show by having comparisons of different

subjects using and not using; some using marijuana; some using

the synthetic product, marinol, the zeltinyne tetrahydrocanavanol.

That is the one most psychoactive ingredient of marijuana and

a placebo group to be able to make comparisons of the effects of all

three groups.

Mr. OSE. I must say I do not understand why we have to do a

study about something we already seem to know about.

Mr. MILLSTEIN. A lot of people do not believe what science says.

They do not believe Government. Since I have decided that nothing

is helping them and this will be actual activity, scientifically, to say

what are the results in each group.

Mr. OSE. Are we advertising the results of the previous study

that established the connection between adverse pulmonary impact

and the use of marijuana as much as we are these other things

within the ONDCP’s advertisements? Are we relying on anecdotal

transfer of the information?

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Mr. MILLSTEIN. I do not know if that specific information is released in the ONDCP. In NIDA’s own materials, including those

targeted to middle school students, and in our brochures, Marijuana Affects Appearance and Marijuana Affects Routines, we

speak about marijuana and its negative effects.

We have people who are saying that nothing helps them. That

they are terminally ill. That they do not care about certain affects

on their body because of the alternatives that they are facing. This

will be the first ever scientific study that will show differences.

This is in an AIDS population.

Mr. OSE. I have one more question on the marijuana aspects of

this. Mr. Cummings, do you have a question?

Mr. CUMMINGS. Yes.

Mr. OSE. I will gladly yield to you.

Mr. CUMMINGS. Thank you very much.

Mrs. MINK. Your time is up.

Mr. OSE. My time is up?

Mrs. MINK. Yes.

Mr. OSE. OK.

Mr. CUMMINGS. I was just looking at this document of grants.

First of all, thank you. It is nice to know that Maryland is getting

money.

Mrs. MINK. How much?

Mr. CUMMINGS. Quite a bit. I am just curious. When I look at

these grants, I am trying to figure out if they have proposals and

they present them to you? Is that it? They do not look like something that you sort of put an RFP out for. Is that how it goes?

Dr. AUTRY. There basically are two types of grants. One are what

are called Block Grants or Formula Grants. These are given on a

capitation basis to the States, both in the mental health and substance abuse, treatment, and prevention area.

In the substance abuse, treatment, and prevention area, that

money goes directly to the State, the Single State Authority, working with the Governor who then dispenses that; 80 percent for

treatment, 20 percent for prevention.

In addition to the Block Grants, there are what are called Discretionary Grant Programs which are competitively awarded where

we solicit ideas in certain areas based on input from the field, put

out what are called GFAs or Guidance For Applicants, who apply

for the funds. They are competitively reviewed and then hopefully

awarded. Those are the two basic types of grant programs.

Mr. CUMMINGS. I mean are there some goals that you have?

Dr. AUTRY. You were not here at the opening statement. One of

the things that I said is that every time we have a program that

we start, we have not only specific evaluation outcome and process

goals for the individual projects that are funded in these programs,

but also for the overall program as a whole.

So, we look at how effective it was, say, a new substance treatment intervention program, as a case in point.

Mr. CUMMINGS. OK. Mr. Schecter, Chairman Mica, when he was

here, was talking about his little focus group; talking about the

ads. It is interesting. When General McCaffrey first instituted this

program, he came to Baltimore.

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He spoke at a high school which is located in the inner city. Most

of these kids are very street-wise. Most of them have either had a

relative, or they know of someone who was close to them, who have

died indirectly or directly because of drugs.

So, this is a pretty street-wise group. One of the interesting

things is that they played several of the ads. The one which seemed

to really hit them hard was the frying pan ad, where the woman

takes an egg and she is splattering stuff all over the place. Are you

familiar?

Mr. SCHECTER. Yes. In fact, that is a heroin ad.

Mr. CUMMINGS. Is it heroin?

Mr. SCHECTER. Yes.

Mr. CUMMINGS. I am just wondering, how do you all rate those

ads? It was so interesting. When I talk to kids about these ads, out

of all of the ads that they see on television, I will bet you that one

rates about 95 percent.

That is the one they seem to remember and say has some impact

on them. There are a lot of them. I mean I have seen so many of

them. I was just wondering how you rate them.

Mr. SCHECTER. Mr. Cummings I have to share with you that

‘‘frying pan’’ is my personal favorite among the ads. But we do not

want to run this campaign based on what ads you, I, or anybody

else thinks are most effective.

One of the unusual things about this campaign is that we have

set-up a very rigorous ad testing process that involves focus groups

put together by people whose business it is to test ads much the

way General Motors would before launching a $500 million ad campaign.

They do not want to spend money on ads if they are not going

to work. So, we are doing the same thing. We want to make sure

that any ad that is aired, before it will air as a part of this campaign, has undergone a rigorous ad testing process. It has to be

shown to be effective with its particular target audience.

Mr. CUMMINGS. About how many ads do you have out there? Do

you have any idea?

Mr. SCHECTER. I am not sure what the number is. Right now it

is probably 50 or 60 different ads.

Mr. CUMMINGS. I guess what I am trying to get to is as I understood the program, they were trying to figure out, they were doing

little testing and they were trying to figure out in the first quarter

or whatever, what kind of effect they were having.

I am just wondering, do you then pick like the top 10, or top 15,

or something like that. I mean how does that work or do you just

continue. I am going to what you just said. I agree with you.

I mean we, in Government, I think on both sides of the aisle

want taxpayers’ money to be spent effectively and cost efficiently.

So, I am just wondering do you take your top 10 or your 15, or do

you just keep—staff gave you something.

Do you keep just running ads that do not even—I guess what I

am thinking about is the way they do the television ratings. If a

show does not do well——

Mr. SCHECTER. Either it is effective or it is not effective.

Mr. CUMMINGS. Right.

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Mr. SCHECTER. That is really the threshold. If it is not effective,

it is not used anywhere in our campaign. In fact, when we subjected the first round of available ads produced through the Partnership For Drug Free America, and they are the best in the business in this kind of thing, what we found was that some of the ads

did not work.

You or I may not have guessed that. It may have seemed to you

or I like a great ad, but this was an ad targeted to a 10 or 12 year

old kid. It is not important whether you or I think it is a good ad.

Does it achieve the desired effect with that young person? So,

some of the ads were discarded. I would also mention that, particularly now that we are starting to approach phase III which will

begin this summer, we are going to have much more targeted and

differentiated kinds of ads.

We are developing ads in 11 different foreign languages; ads targeted to all sorts of different ethnic groups so that no matter what

the community is, we will have tested ads that will be effective

with that particular group.

Mr. CUMMINGS. One last question. It is so interesting. I notice

that a lot of times they will run two or three of these ads right in

a row. Why is that?

Maybe this is not a national thing. In Maryland, I have noticed

that a lot of times, they will run them and they will run them right

behind each other. I thought maybe that was one of your theories

of effectiveness or something.

Mr. SCHECTER. No. I do not think there is any particular purpose

there. Sometimes what that means is that you have got a paid ad

and then maybe a pro bono matching ad right behind it.

So, the network of the local station will simply just tag those together. I have seen that done, incidently, for other product ads as

well, not just our campaign.

Mr. CUMMINGS. Thank you.

Mr. OSE. Mrs. Mink.

Mrs. MINK. So, which is the most effective ad you have produced?

Mr. SCHECTER. I do not think I could answer that. Again, it is

not a ranking. It is a threshold of effectiveness that must be met.

Mrs. MINK. Does the fried egg make it?

Mr. SCHECTER. Oh yes, absolutely. That is why you see it. As I

said, it is my own personal sentimental favorite.

Mrs. MINK. Thank you.

Mr. OSE. One last observation. I am not all that skilled at the

legislation that this subcommittee has jurisdiction over.

I would wager that the legislation that this subcommittee did authorize does not include a restriction on targeting of ads into specific areas in such a way as to off-set what might be a concentration of pro-marijuana use in a political campaign.

I just have a hint or an inkling of that. The reason I keep coming

back to this is No. 1, I have been the beneficiary of some very creative advertising and the subject of some other creative advertising. I know it works.

While I am not in any way, shape or form suggesting that this

gentleman should be noted for anything else, but Pat Buchanan

said, you know, when you hear the gun fire, do not call headquarters. Mount up and ride to the sound of the gun fire.

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We have five States right now, if not more who are considering

referenda to legalize the use of marijuana for medicinal purposes,

if not otherwise. I do not see any reason not to go and engage in

that debate.

I thank my colleagues. You have been very patient to this rookie.

Mr. CUMMINGS. I know a lot about marijuana, Mr. Chairman. I

have heard more about marijuana today than I have heard in

years, Mr. Chairman.

Mr. OSE. I thank the witnesses.

We would like to leave the record open for 2 weeks for members’

submission of questions.

I look forward to future briefings.

We are adjourned.

[Whereupon, at 3:15 p.m., the subcommittee was adjourned.]

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