    [House Hearing, 106 Congress]
    [From the U.S. Government Publishing Office]

               IS DRUG USE UP OR DOWN? WHAT ARE THE IMPLICATIONS?

    =======================================================================

                                    HEARING

                                   before the

                       SUBCOMMITTEE ON CRIMINAL JUSTICE,
                        DRUG POLICY, AND HUMAN RESOURCES

                                     of the

                                  COMMITTEE ON
                               GOVERNMENT REFORM

                            HOUSE OF REPRESENTATIVES

                           ONE HUNDRED SIXTH CONGRESS

                                 SECOND SESSION

                                   __________

                               SEPTEMBER 19, 2000

                                   __________

                               Serial No. 106-265

                                   __________

           Printed for the use of the Committee on Government Reform

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

                                   ----------

                       U.S. GOVERNMENT PRINTING OFFICE
    74-707                     WASHINGTON : 2001

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                         COMMITTEE ON GOVERNMENT REFORM

                         DAN BURTON, Indiana, Chairman
    BENJAMIN A. GILMAN, New York         HENRY A. WAXMAN, California
    CONSTANCE A. MORELLA, Maryland       TOM LANTOS, California
    CHRISTOPHER SHAYS, Connecticut       ROBERT E. WISE, Jr., West Virginia
    ILEANA ROS-LEHTINEN, Florida         MAJOR R. OWENS, New York
    JOHN M. McHUGH, New York             EDOLPHUS TOWNS, New York
    STEPHEN HORN, California             PAUL E. KANJORSKI, Pennsylvania
    JOHN L. MICA, Florida                PATSY T. MINK, Hawaii
    THOMAS M. DAVIS, Virginia            CAROLYN B. MALONEY, New York
    DAVID M. McINTOSH, Indiana           ELEANOR HOLMES NORTON, Washington,
    MARK E. SOUDER, Indiana                  DC
    JOE SCARBOROUGH, Florida             CHAKA FATTAH, Pennsylvania
    STEVEN C. LaTOURETTE, Ohio           ELIJAH E. CUMMINGS, Maryland
    MARSHALL ``MARK'' SANFORD, South     DENNIS J. KUCINICH, Ohio
        Carolina                         ROD R. BLAGOJEVICH, Illinois
    BOB BARR, Georgia                    DANNY K. DAVIS, Illinois
    DAN MILLER, Florida                  JOHN F. TIERNEY, Massachusetts
    ASA HUTCHINSON, Arkansas             JIM TURNER, Texas
    LEE TERRY, Nebraska                  THOMAS H. ALLEN, Maine
    JUDY BIGGERT, Illinois               HAROLD E. FORD, Jr., Tennessee
    GREG WALDEN, Oregon                  JANICE D. SCHAKOWSKY, Illinois
    DOUG OSE, California                             ------
    PAUL RYAN, Wisconsin                 BERNARD SANDERS, Vermont
    HELEN CHENOWETH-HAGE, Idaho              (Independent)
    DAVID VITTER, Louisiana

                          Kevin Binger, Staff Director
                     Daniel R. Moll, Deputy Staff Director
                         James C. Wilson, Chief Counsel
                            Robert A. Briggs, Clerk
                     Phil Schiliro, Minority Staff Director
                                     ------

       Subcommittee on Criminal Justice, Drug Policy, and Human Resources

                        JOHN L. MICA, Florida, Chairman
    BOB BARR, Georgia                    PATSY T. MINK, Hawaii
    BENJAMIN A. GILMAN, New York         EDOLPHUS TOWNS, New York
    CHRISTOPHER SHAYS, Connecticut       ELIJAH E. CUMMINGS, Maryland
    ILEANA ROS-LEHTINEN, Florida         DENNIS J. KUCINICH, Ohio
    MARK E. SOUDER, Indiana              ROD R. BLAGOJEVICH, Illinois
    STEVEN C. LaTOURETTE, Ohio           JOHN F. TIERNEY, Massachusetts
    ASA HUTCHINSON, Arkansas             JIM TURNER, Texas
    DOUG OSE, California                 JANICE D. SCHAKOWSKY, Illinois
    DAVID VITTER, Louisiana

                                   Ex Officio

    DAN BURTON, Indiana                  HENRY A. WAXMAN, California
               Sharon Pinkerton, Staff Director and Chief Counsel
                       Steve Dillingham, Special Counsel
                               Ryan McKee, Clerk
                        Sarah Despres, Minority Counsel

                                C O N T E N T S

                                  ----------
                                                                       Page
    Hearing held on September 19, 2000...............................     1
    Statement of:
        Alumbaugh, Mr. and Mrs., private citizens....................    11
        Raub, William, Deputy Assistant Secretary, Scientific
          Research, Health and Human Services; Julie Samuels, Acting
          Director, National Institute of Justice, Department of
          Justice; Lloyd Johnston, Monitoring the Future Project,
          University of Michigan; Donald Vereen, M.D., Deputy
          Director, Office of National Drug Control Policy [ONDCP],
          accompanied by Terry Zobeck, Chief, Research Programs
          Branch, Office of National Drug Control Policy [ONDCP].....    22
    Letters, statements, etc., submitted for the record by:
        Alumbaugh, Mr. and Mrs., private citizens, prepared statement
          of.........................................................    15
        Johnston, Lloyd, Monitoring the Future Project, University of
          Michigan, prepared statement of............................    47
        Mica, Hon. John L., a Representative in Congress from the
          State of Florida, prepared statement of....................     6
        Raub, William, Deputy Assistant Secretary, Scientific
          Research, Health and Human Services:
            Information concerning youth risk behavior trends........    88
            Prepared statement of....................................    25
        Samuels, Julie, Acting Director, National Institute of
          Justice, Department of Justice, prepared statement of......    34
        Vereen, Donald, M.D., Deputy Director, Office of National
          Drug Control Policy [ONDCP], prepared statement of.........    65

               IS DRUG USE UP OR DOWN? WHAT ARE THE IMPLICATIONS?

                                  ----------

                          TUESDAY, SEPTEMBER 19, 2000

                      House of Representatives,
    Subcommittee on Criminal Justice, Drug Policy, and
                                       Human Resources,
                                Committee on Government Reform,
                                                        Washington, DC.
        The subcommittee met, pursuant to notice, at 10 a.m., in
    room 2203, Rayburn House Office Building, Hon. John L. Mica
    (chairman of the subcommittee) presiding.
        Present: Representatives Mica, Ose, and Mink.
        Staff present: Sharon Pinkerton, staff director and chief
    counsel; Steve Dillingham, special counsel; Charley Diaz,
    congressional fellow; Ryan McKee, clerk; and Sarah Despres,
    minority counsel.
        Mr. Mica. Good morning. I would like to call the hearing to
    order. The order of business this morning will be first, I will
    proceed with an opening statement. Then we have two panels we
    will be hearing from today, and Mrs. Mink would like to move
    that we leave the record open for a period of 2 weeks for
    additional statements for Members or interested individuals
    who, through the Chair, would like their statements or
    information made part of the official record of these
    proceedings. With that we will begin, and this morning I will
    start with my opening statement.
        This morning our subcommittee will focus on the question of
    drug use trends in the United States. Over the past few weeks,
    administration officials have attempted to put a happy face on
    what appears, from the information that our subcommittee has
    received, an increasingly sad situation.
        Unfortunately, even information that will be presented by
    the Office of National Drug Control Policy today, that
    information indicates that overall drug use has grown from some
    6.4 percent in 1997 to 7 percent in 1999.
        While marijuana and crack use has decreased slightly among
    youth, methamphetamine, ecstasy and designer drug use has
    skyrocketed both for youth and for adults. Our subcommittee
    must report with great sadness that today, for the first time
    in the history of the United States, drug-induced deaths have
    exceeded homicides in our country. This, in fact, is a
    startling statistic and, in fact, a national tragedy.
        I have some charts that I brought with me. This one shows
    again that sad statistic. For the first time, drug-induced
    deaths have exceeded murder in the United States of America.
    Just an unbelievable tragedy.
        What is interesting is that data supported by information
    we received--this is a headline from last week in the Baltimore
    Sun--the Baltimore Sun said last week they released figures
    that in 1998 there were 290 overdose victims and 313 homicides,
    and that they have now reported for the succeeding year that
    324 people died of illegal drug overdose in Baltimore as
    compared to 309 homicides. So overdose deaths exceeds slayings.
    And this same headline in this urban area has been reported in
    my suburban area of central Florida.
        This is, in fact, a startling statistic and a national
    tragedy. As chairman of the House Subcommittee on Criminal
    Justice, Drug Policy, and Human Resources, I open this hearing
    with a simple message regarding drug use trends. Drug use
    remains as great a danger today as it has ever been. In fact,
    since 1998, America is losing more lives each year to drug-
    induced deaths than to murder. From 1992 to 1998, drug deaths
    have increased an astounding 45 percent in this country.
    Unfortunately, law enforcement officials have told me that the
    death statistic for drug deaths would be even worse if it were
    not for improvements in emergency room treatments for
    overdoses. Our hospitals and treatment facilities are being
    deluged with record numbers of drug overdose admissions. This
    is in spite of a nearly 52 percent increase in prevention
    funding over the same period and a 34 percent increase in
    treatment funding. This is also in spite of a $1 billion
    national media campaign that we have undertaken and it has been
    supported by this subcommittee.
        Why are we experiencing such an incredible onslaught of
    drug deaths and drug abuse? First, let me cite these reasons I
    believe--a lack of national leadership. Second, an
    unprecedented supply of deadly drugs. Three, high-purity
    levels. Four, a lack of successful treatment, education and
    prevention programs. And five, harm and risk from drugs is not
    understood and the use of drugs is in fact in our society today
    glorified.
        Although we may take some comfort in a declining murder
    rate, drug-induced deaths are rising. It is critical that we
    not be complacent in this fight against drugs and drug abuse as
    progress we have made may soon be lost. In many critical
    aspects, drug use remains at the highest levels ever.
    Furthermore, the threat is taking new forms after posing
    greater and less apparent danger such as popular but deadly
    club drugs. Accordingly, we must remain committed and work
    harder and smarter to protect our children, families, and
    communities from the dangers associated with the drug use
    trends that we study and will discuss today.
        Today's hearing will examine drug trends, consequences, and
    implications for policies and programs. Yesterday I chaired a
    hearing in Atlanta, GA that focused on the explosion of so-
    called club drugs across America. We examined the degree to
    which the threat is known and being experienced in communities
    in and around the city of Atlanta. Last week, we saw on the
    front page of the Baltimore Sun the headlines that drug
    overdose deaths had surpassed murders in Baltimore. As we will
    hear today, these trends reflect rising drug-related deaths
    nationally. Yesterday, I learned from families about tragedies
    they experienced. Today, we will hear and learn more.
        This hearing will focus on two important topics: (1), drug
    use trends as measured by national surveys and research; and
    (2), what is being done and should be done by the
    administration to respond to the drug scourge that continues to
    wreak destruction across America.
        We will hear from the White House Office of National Drug
    Control Policy [ONDCP], over which this subcommittee has
    oversight responsibility. ONDCP is responsible for examining
    data trends, identifying needs, and revising Federal policies
    and programs to respond to these needs. As the recently
    released year 2000 ONDCP Performance Measurement Report points
    out, the information is to be used to hold agencies
    accountable, including altering their budgets.
        This subcommittee is committed to ensuring that the
    administration takes its responsibility seriously and that
    reforms are made and actions are taken where needed. Today's
    hearing is the first opportunity that we have had to examine
    the performance report and implications for administration
    policies and programs.
        In all candor, the recent performance report, agency press
    releases, and comments by senior administration officials have
    highlighted what they consider to be good news and possible
    progress. I will be the first to state that positive trends are
    welcomed and desired by everyone. We are very supportive of the
    hard work being done by the committed individuals on the front
    line who risk their lives each and every day at Federal, State,
    and local levels. I commend law enforcement officers,
    prosecutors, judges, corrections officials, and drug treatment
    professionals at all levels.
        I remain concerned, however, that wrong and misleading
    messages are being sent regarding the dangers and extent of
    drug use in America. It is critical that we set the record
    straight and proceed with the business of working harder and
    smarter. We cannot afford to lose time, or to squander much-
    needed Federal resources.
        One survey that has received much attention is the National
    Household Survey on Drug Abuse, or Household Survey. This
    survey is sponsored by the Substance Abuse and Mental Health
    Services Administration [SAMHSA], at HHS.
        Recently, the administration has highlighted the Household
    Survey, finding a reported drop in drug use among teens aged 12
    to 17 from 1997 to 1999. While this limited decline might be an
    indication of positive movement, it should be considered in
    context of other findings. Since 1992, the same household
    survey shows that from 1992 to 1998, past month drug use by
    teens in this age group had almost doubled, from approximately
    5 to 10 percent. The relevant policy questions are: Why do many
    more teens now use drugs than 7 years ago? And, how can we get
    the levels of drug use back down again?
        Second, we will look at the findings of the Monitoring the
    Future [MTF] project, and make comparisons to findings of the
    Household Survey. MTF is a federally sponsored national survey
    of students conducted by the University of Michigan's Survey
    Research Center. Its findings also are examined by ONDCP. The
    MTF data and trends give us reasons to be alarmed. Looking at
    the ONDCP Performance Report numbers and graph, reported
    increases in teen drug use for 8th, 10th and 12th graders are
    obvious and dramatic. Since 1992, 8th grade past month drug use
    more than doubled; 10th grade drug use has almost doubled; and
    there was an increase of almost two-thirds, or 62 percent,
    among 12th grade drug users.
        What are the implications of this continuing high rate of
    drug use across America, and what does it mean for our agencies
    and programs?
        Another source of valuable information that we will examine
    is the data from the Arrestee Drug Abuse Monitoring [ADAM],
    program, supported by the National Institute of Justice [NIJ],
    at the Department of Justice. This data is collected from 35
    sites in 25 States and the District of Columbia, with plans for
    expansion.
        The data is obtained through drug testing and interviews of
    arrestees. ADAM's 1999 research data indicates rising drug use
    among male and female arrestees. More than 60 percent of adult
    male arrestees tested positive for the presence of illegal
    drugs. The city figures range from 50 percent in San Antonio to
    77 percent in Atlanta. What the data clearly shows is the
    linkage between crime and drugs continues. That is one reason
    that I have submitted H.R. 4493--the Drug Treatment Alternative
    to Prison Act--to meet the treatment needs of eligible
    nonviolent offenders. I hope the administration supports this
    bill.
        Finally, we will examine other HHS research related to drug
    use and abuse. As I mentioned, drug-induced deaths continue to
    climb, surpassing murders. ONDCP's drug policy strategy
    indicates that drug-related deaths exceed 50,000 annually, that
    there are more than one-half million emergency department drug-
    related episodes, and almost a million drug mentions.
        These are some of the trends that we will explore today,
    and that ONDCP must analyze and recommend changes to policies
    and practices. By most measures, drug use has worsened over the
    past 7 years. We are also seeing changes in drug preferences
    and potencies, as well as emerging challenges with dangerous
    club drugs.
        The implications for the administration are now the focus
    of our attention. What is being done to address these findings?
    In past hearings, we have identified serious deficiencies in
    the bureaucratic practices of SAMHSA in areas of management,
    evaluation, and research.
        Now we learn that the Department of Justice bureaucracy has
    quadrupled in size as a result of increased funding that we
    approved for State and local assistance. We are receiving
    reports of grant delays, waste, and deficient evaluations, in
    addition to less priority being given to drug efforts. In its
    1989 discretionary grant programs, the DOJ Bureau of Justice
    Assistance designed almost every grant to fight drug use. That
    grant program was named after police officer Edward Byrne, who
    died fighting drug traffickers. Today, it is difficult to find
    discretionary drug initiatives at DOJ that are considered to be
    priorities. How did this happen?
        Finally, the many problems we previously identified at the
    Department of Education in administering the Safe and Drug-Free
    Schools program appear to continue.
        As we will hear from our first witness, the consequences of
    drug use are enormous. Our efforts to combat it must remain a
    top priority, and our practices must improve. ONDCP has the
    central role in this challenge, and we must oversee the effort.
    I look forward to hearing from our witnesses today on this
    important topic.
        I am pleased at this time to yield to the gentlelady from
    Hawaii, our ranking member, Mrs. Mink.
        [The prepared statement of Hon. John L. Mica follows:]

        [GRAPHIC] [TIFF OMITTED] T4707.001

        [GRAPHIC] [TIFF OMITTED] T4707.002

        [GRAPHIC] [TIFF OMITTED] T4707.003

        [GRAPHIC] [TIFF OMITTED] T4707.004

        Mrs. Mink. Thank you very much, Mr. Chairman.
        The subject area that we have been dealing with for the
    past 2 years, drug consumption in the United States and its
    devastating consequences, is always a very depressing scene,
    and the difficulty that we have on this committee is that it
    does not appear that the massive efforts that we have
    undertaken, not only through this committee but in other
    committees in funding various programs, has not made
    demonstrable successes. We keep hearing the very deplorable
    rates of consumption among school children and teenagers, and
    as the chairman pointed out, the increasing numbers of users
    who end up dead.
        One of the things that I think troubles me most is the lack
    of emphasis on all of the agencies and those committed to this
    issue in really coming forward with a program that can work. We
    have tried everything and still the figures are very
    depressing. And even more depressing, when we talk about people
    dying from the use of these drugs, and to have it referenced as
    club drugs, as though it is something fashionable, sociable,
    and useful. Instead they should be referred to as ``killer
    drugs'' or something which characterizes the impact that these
    drugs have on our society.
        Not only are these people dying from the use of drugs, but
    the implications in the crime statistics are also something
    that we should pay attention to. Drug users are involved in all
    sorts of criminal violations in the pursuit of these drugs and
    trying to find money, stealing and so forth, so the problem is
    enormous and the progress that this country is making is very
    discouraging.
        And it is not for the lack of interest, I don't believe, on
    the part of the administration, or the Congress. We simply have
    not come up with the tools that can produce effective results
    to lower the usage and to enable the community to deal with it.
    It is not only a law enforcement problem, it is a community
    problem, and we have to put our best minds together,
    particularly with the school children and the teenagers that
    find themselves hopelessly addicted to these drugs.
        So I am very supportive of the chairman's efforts in this
    regard in trying to enlarge our capacity to understand the
    nature and scope and size of this problem, and hope that in
    engaging ourselves in hearings like this that we can come up
    with useful endeavors that can help this Nation end this
    scourge.
        Thank you very much, Mr. Chairman.
        Mr. Mica. I thank the gentlelady.
        I am pleased to recognize the gentleman from California,
    Mr. Ose, for an opening statement at this time.
        Mr. Ose. Thank you, Mr. Chairman.
        One of the interesting things that I have found in my short
    tenure here is that the things that are probably the most
    important that we deal with are those that are not going to get
    a lot of headlines. Maybe it is because the subject is
    difficult or ugly or trying or troubling. This is one of those
    subjects that rarely gets a lot of attention.
        In California we are dealing with any number of things, the
    most current of which is a proposal to further legalize or
    actually decriminalize the use or possession of illegal
    narcotics. And the headline on the committee hearing today ``Is
    Drug Use Up or Down? What are the Implications?'' I think are
    apropos to what I am about to say. And that is that the
    proposal on our ballot, Prop. 36, is crafted in such a sense as
    to suggest to the voters that the initiative will provide
    treatment or counseling, or what have you; but exactly the
    opposite. What the initiative does is reduce the treatment and
    reduce the options for people who want to eliminate the scourge
    of drugs from their lives.
        We have a number of things going on at the Federal level,
    and I know your bill, which I agreed to be a cosponsor of
    yesterday afternoon, to provide further treatment options, is
    one of those that we are working on. But that kind of thing is
    happening across the country at State and local levels to give
    people the options. The reality is until those of us from
    Florida or Hawaii or California or wherever say the truth,
    which is that drug use amongst our youth is a deadly, deadly
    exercise, until we say that in terms that our kids understand
    and explain to them that what they are using is not their
    father's pot or father's crack or their mother's crack or pot,
    that is not what it is, it is 10 times stronger, and the
    pharmacological impact on your body is that much worse also.
        Mr. Chairman, I don't know of a more important issue that
    this country faces than the challenge of abuse of drugs. Prop.
    36 is just the most current iteration of the politicization of
    this issue. I would hope that in the course of the debate that
    Prop. 36 is exposed for the fraud that it is and is voted down
    in California, and I will do everything that I can to make sure
    that information is in the public domain. I appreciate you
    having this hearing. I look forward to the testimony that we
    are about to hear.
        Mr. Mica. I thank the gentlelady and the gentleman for
    their opening statements, and now we will proceed with our
    first panel.
        Our first panel has two private citizens, Mr. and Mrs.
    Alumbaugh. They are from Fort Pierce, FL. I just explain again,
    I think you testified before our subcommittee in Orlando, this
    is an investigation and oversight subcommittee of the House of
    Representatives, and in that regard we do swear in our
    witnesses. If you will stand, please, to be sworn.
        [Witnesses sworn.]
        Mr. Mica. The witnesses have answered in the affirmative. I
    am pleased to welcome them to Washington to testify today,
    because I think it is important that we put a human face on
    these statistics and figures that we are announcing today;
    that, in fact, one of those who died in 1988 was their son,
    Michael, and he was a living, breathing, loved, human being.
    And this isn't just about bean counting or statistics, it is
    about people losing their lives in a tragedy beyond belief for
    parents.
        With that, I recognize Debbie Alumbaugh, who is the mother
    of Michael, for her comments and testimony. Thank you.

         STATEMENTS OF MR. AND MRS. ALUMBAUGH, PRIVATE CITIZENS

        Mrs. Alumbaugh. Thank you, Mr. Mica. We feel it is an honor
    to be asked to testify before you again. Again, my name is
    Debbie Alumbaugh, and I am the surviving mother of Michael
    Tiedemann. He was 15 years old when he died. That was 23 months
    ago. The cause of Michael's death was aspiration vomitus and
    GHB toxicity. GHB, or gamma hydroxybutyrate, is one of the club
    drugs that we have in our Nation now.
        Michael was a sophomore at Westwood High School in Ft.
    Pierce, FL. He was a black belt in karate and he was also an
    instructor. He had won several academic awards for reading,
    mathematics, music, and spelling. He was on the honor roll. He
    was not a street kid.
        On October 1, Michael went to school as any normal day;
    during his break between second and third periods, he
    complained to a friend that he had a headache. Another student
    overheard this and offered Michael, ``I have these pills. They
    will make your headache go away and make you feel better.'' We
    believe that since Michael was suffering with a headache, he
    didn't realize or didn't think this was taking drugs. We found
    out from the autopsy that he was given methadone in school. He
    didn't know what he got and the student who gave it did not
    know what she had.
        When Michael came home from school that day, he asked to go
    to the show with some friends. It was unusual to let him out on
    a school night, but he was doing well, A's and B's. Before he
    left, a friend came to the house and they went directly into
    Michael's room. This was one of his best friends. They were
    only in his room for 5 minutes, and this is where the
    transaction of GHB occurred. When Michael came home from the
    movies, his father looked at him: ``Are you on something, son?
    Did you take something?'' Michael denied this. Brad kept asking
    him and asking him. Finally, Michael admitted they had smoked
    some pot. Again, some pot. Brad said that he wouldn't lecture
    him that evening. He was high. It was 1 a.m. He would discuss
    it in the morning. He never got that chance. Michael died that
    night in the safest place, alone in his bed.
        The next morning the phone rang. The voice on the phone
    said Michael is not at the bus stop. As Brad walked across our
    home, he could hear the alarm ringing. Michael did have
    intentions of getting up to go to school. When he opened the
    door, he knew our son was dead. The scene was horrendous. Our
    son was on his back, eyes wide open and glassy. His mouth hung
    open, his tongue swollen so much his father couldn't shut his
    mouth. He had vomited from the chemicals in these drugs. GHB is
    mixed with floor stripper, degreaser and, most recently, red
    devil lye. His hands were in a clawed position where he tried
    to roll himself over to save himself and he couldn't because
    the chemicals in these drugs paralyzed the motor skills.
        We didn't know why our son had died and they had to do an
    autopsy. It took 12 weeks for us to learn why our son had died.
    GHB leaves the body quickly and it was not in his blood or his
    urine. They took our son's brain, and that is where they found
    this deadly drug.
        We go to schools and we tell the kids this story. We
    believe we leave nothing out. There is no antidote for GHB
    overdose. If you pass out and go into a coma, you will die,
    unless your body's constitution is strong enough to bring you
    out. Most are not. There is nothing the doctor or anyone can do
    to fix you. In the last 3 years in Florida alone, we have lost
    174 young people to these drugs. That is 173 tragedies just
    like ours.
        After several months, Michael came to his father in a dream
    and said, ``Dad, it is wrong to destroy the body the way I did.
    You and mom must tell my story. You don't have a clue about the
    drugs that my friends and my generation are faced with daily.''
    This put a burden on our hearts until we gathered up enough
    courage and strength to make the first call. We called St.
    Andrews where Michael had attended. We went to the school, and
    as I stood in front of all those beautiful young faces, I
    started, we are not here to lecture or accuse any of you of
    being bad kids. We are here to share our experience of losing a
    good kid to drugs. And that is when Michael's Message
    Foundation was born.
        We tell the students what took our son's life, and then I
    tell them a little bit about Michael. He was not only a great
    son but a very loving son. On June 1 of this year, Michael
    would have been 17 years old. And I testified before
    Congressman Mica at a hearing in Orlando, FL and today I stand
    here. It is an honor and a privilege. We have devoted our lives
    to this.
        We have chosen to take our tragedy and to educate our
    Nation. We have turned our grief into something positive and
    constructive. Michael's Message Foundation is a nonprofit
    organization. We do travel to schools. We go from 6th grade
    through 12th and up into college, sharing our son's story. We
    also speak at churches, rehab centers, and we speak a lot to
    at-risk youth activities. Our goal is to take Michael's message
    nationwide in the hopes of saving another family the heartache
    these drugs caused our family.
        Our children are our future. We feel that Michael's message
    should be heard by parents and grandparents also, and Michael's
    voice must be heard, that these drugs kill.
        We have been told by students at a charter school that they
    appreciate drug testing. It gives them a tool that can assist
    them with peer pressure. We do agree that cameras in school
    should be used as a tool or deterrent. Kids are not going to
    tell on the drug dealer.
        We just found out recently that many children knew what our
    son had taken that day. Yet no one came forward, no one was the
    hero and said anything. Their lives are at risk. They are
    afraid of being hurt or killed. Again, education plays a key
    role not only in informing the kids that it is wrong, but death
    is the major consequence to these drugs.
        I am here today in the hopes that laws will be made to
    punish the individuals who make and distribute these deadly
    drugs. No one was arrested for our son's death.
        After sharing Michael's message, students come up and ask
    what happened to the person that supplied the drugs. Well, in
    July, this young man who allegedly gave the GHB was arrested on
    school grounds with a half pound of marijuana, pills, and
    paraphernalia, yet again endangering the lives of our students.
    Did this young man learn nothing from our son's death? Our kids
    are begging for help. They often share with us that they are
    scared, telling this with tears rolling down their faces, and
    this echoes in our minds.
        Thank you again for asking us here today. Let's unite and
    make our schools, communities, and our Nation safer and better
    for everyone. Thank you.
        Mr. Mica. Thank you for your testimony, Mrs. Alumbaugh. Mr.
    Alumbaugh, did you have comments that you wanted to make? You
    are recognized.
        Mr. Alumbaugh. We do feel that the schools would be better
    for everyone, instead of the old saying that our school is drug
    free, we feel that they do make a major bust at a school, that
    the school be rewarded in some way via a camera to set up in
    their school. Or after a few years after this, sometimes we get
    the schools cleared out from the drug problem. Eventually there
    could be computers put in the schools. But right now we
    definitely need some cameras in there because they are not
    going to tell on Johnny.
        Mrs. Alumbaugh. And the people who run the schools turn a
    blind eye because they don't want their school to be labeled a
    bad school.
        [The prepared statement of Mr. and Mrs. Alumbaugh follows:]

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        Mr. Mica. Maybe I can start with some questions, if I may.
    You said in July of this year, the person who sold your son
    drugs was that this year--was selling them again a few years
    later?
        Mrs. Alumbaugh. Yes, sir.
        Mr. Mica. After your son was literally murdered?
        Mrs. Alumbaugh. Yes.
        Mr. Mica. No enforcement?
        Mr. Alumbaugh. We were told by the detective, due to the
    fact that the drug was given without intent to harm our son,
    there was no harm committed.
        Mr. Mica. Well, unfortunately, you know, I have heard this
    over and over. We heard it again yesterday. We had a picture of
    a beautiful young lady that her father brought to the
    subcommittee, and he described his daughter's horrible death on
    the same drug, except she lingered for 2 years.
        Mrs. Alumbaugh. Oh, my.
        Mr. Mica. And she ended up in a nursing home. She had
    convulsions that were beyond description. Her body temperature
    at some point--he said rose to 107. Her heartbeat was 170 and
    dropped at one point to 25, and their family went through hell
    for 2 years. She finally died.
        One of the problems that we have is that we are being
    inundated with a supply, not only these designer drugs, but
    also they are very difficult to detect for enforcement. The
    only way they can tell on some of these drugs now is after
    death, through an autopsy, unfortunately. We have spent--you
    heard Mrs. Mink. We supported a $1 billion ad campaign, media
    campaign. We are reviewing the results of that. It has only
    been around for less than 2 years. What else can we do at the
    Federal level to address this problem?
        Mrs. Alumbaugh. Newsletters.
        Mr. Alumbaugh. We feel that there should be a special task
    force developed for clearing out our neighborhoods. You are
    going to have to be tough on crime and drug dealers.
        Mr. Mica. Have you seen the ads that have been put out by
    the Office of National Drug Control Policy?
        Mrs. Alumbaugh. Yes.
        Mr. Mica. What is your evaluation? Are these effective?
    Unfortunately, the statistics are from 1998, the year your son
    died. I have not seen 1999, but I am sure that they have
    increased in 1999. The trends are just dramatic.
        Mrs. Alumbaugh. I saw one of the ONDCP commercials. I have
    seen them on TV, but I witnessed one on the Internet that I
    would like to see more of on the TV, and by all means my son be
    a poster child for this. And it is the funeral director talking
    about bringing the body past the school yard one last time on
    its way to the cemetery.
        I believe this is what our kids need. They need to know
    that they are going to die from these drugs, and more of that
    needs to be seen. They need to witness this. They need to hear
    this.
        Again, I saw the commercial on the Internet. I have not
    seen it on TV yet. But those type of commercials, they need to
    know the reality of the drugs.
        Mr. Mica. Mrs. Mink.
        Mrs. Mink. Thank you, Mr. Chairman.
        The comments you have made today are absolutely
    representative, I think, of the families who have suffered as
    you have with your son's involvement in this incident. I am not
    sure it was one incident or several, but it ended in this
    terrible tragedy. The point you make about young people not
    really comprehending the possibility of death from use of these
    drugs, I think, contributes to their general frivolous
    viewpoint about these drugs.
        Now, in the school that your son attended, I am sure
    throughout the campus, throughout the school, there was
    knowledge and a shared grief about this incident. So as a
    consequence of that, is there any statistic that you can point
    to that in this particular school that your son attended that
    there is greater awareness and less incidents like this?
        Mr. Alumbaugh. The school does seem to be a lot better
    school today than it was 2 years ago.
        Mrs. Alumbaugh. Yes, we visited it just the beginning of
    this month. It is more stringent. The school resource officers
    is there and the whole atmosphere of the school is different.
        Mrs. Mink. So when that young person who was your son's
    friend came back to the same campus----
        Mrs. Alumbaugh. It was summer school.
        Mrs. Mink [continuing]. To the same campus with the intent
    to distribute these drugs again, what did the school do to this
    individual?
        Mrs. Alumbaugh. He was arrested on felony charges. He was
    released to his parents.
        Mrs. Mink. How old is he?
        Mrs. Alumbaugh. He is 17 now.
        Mrs. Mink. And what charges have been brought against him?
        Mrs. Alumbaugh. Possession to distribute, possession to
    sell, because he had baggies, scales, pills, money. So they
    arrested him with possession of narcotic, possession with
    intent to distribute and to sell.
        Mrs. Mink. So why couldn't they levy the same charges in
    the incident that involved your son?
        Mrs. Alumbaugh. Those are answers that I would like.
        Mrs. Mink. Thank you, Mr. Chairman.
        Mr. Mica. Mr. Ose.
        Mr. Ose. I am most curious, when you meet with groups of
    kids, how is it that you communicate your message? It would
    seem to me that talking to adults about drugs is different than
    kids. Different words, different things that you visit with
    them about.
        Mrs. Alumbaugh. Well, we have given Michael's message to
    students and to adults.
        Mr. Ose. It is the same message, but is it delivered the
    same way?
        Mrs. Alumbaugh. No.
        To the parent we deliver it more on how to watch your
    child. I add in that I thought my child was safe in my own
    home.
        Mr. Ose. For the benefit of those of us in Congress, some
    of the tell-tale signs of a child who is abusing drugs are?
        Mrs. Alumbaugh. What you saw that night. I didn't have a
    clue myself that night.
        Mr. Alumbaugh. When Michael came home that night and I
    confronted him and was talking to him, he had eye contact like
    we do now. But when he was sitting on the sofa and nobody was
    confronting him, he was comatose. He was in the ozone. He was
    sitting with his mouth hanging open, staring at the floor. I
    knew that there was something wrong with him that night. I
    could tell that he had taken something.
        Mrs. Alumbaugh. Yet when he questioned the kids that he was
    with, they all denied it, one of which was my nephew. He asked
    point blank, Did Michael take something? No, Uncle Brad,
    honest, he just smoked some pot. Like that is not bad. Just
    smoked some pot.
        Mr. Alumbaugh. A few months later, Michael's friends came
    by the house and they shared with me that they were--they were
    buddies, and they shared with me that they were going to smoke
    pot but they would do nothing else, and that day was different.
    That day they decided to take these pills. The old saying goes,
    you know, when they start smoking pot, that is the start of
    their drug activity.
        Mrs. Alumbaugh. But the young boy who brought the drug
    didn't take it. He not only gave it to our son, he gave it to
    another child there also, but he didn't take this drug, but he
    is also the one who called our home the next morning to awaken
    Brad to tell him that Michael wasn't at the bus stop.
        Mr. Ose. When you have meetings with young people, what are
    their questions? The phrase is ``I don't want to rat somebody
    out.'' Obviously they have a fear of the consequence once the
    adults are out of the room kind of thing.
        Mrs. Alumbaugh. A lot of them we have a book over there cry
    and they are worried. They are not worried so much about
    themselves. Some of them are worried about their parents and it
    is not just the young people that are doing these drugs. They
    are afraid. They don't know who to go to and they ask where can
    we go, you know.
        Mr. Alumbaugh. They seem helpless and scared.
        Mr. Ose. They are 12 to 17 and they don't have a lot of
    life experiences.
        Mrs. Alumbaugh. True.
        Mr. Ose. Thank you, Mr. Chairman.
        Mr. Mica. Well, I appreciate so much your coming up from
    Florida. You testified before us in Orlando. When we learn
    these statistics, it confirms that we have drug-induced deaths
    exceeding homicides in this country. I thought it was important
    to have a human face on it. That is a 15-year-old kid; that is
    not a hardened drug dealer that died after a lifetime of abuse.
    And those individuals shouldn't die or be lost, and I
    appreciate your coming before the subcommittee today, trying to
    make something positive out of what has to be every parent's
    absolute worst nightmare.
        Unfortunately, this death was repeated and this tragedy for
    16,925 families the same year. So we appreciate again your
    coming and thank you for the message that you are giving to
    students and to communities and now to our country. Thank you
    so much, and I will excuse you at this time.
        Mrs. Alumbaugh. Thank you.
        Mr. Alumbaugh. Thank you.
        Mr. Mica. Let me call our second panel. Our second panel
    consists of William Raub, who is the Deputy Assistant
    Secretary.
        Mr. Ose. Could I interrupt? Could we have Mr. and Mrs.
    Alumbaugh stick around?
        Mr. Mica. Dr. Raub is Senior Scientific Adviser to the
    Secretary for Science Policy, Department of HHS; Ms. Julie
    Samuels, Acting Director, National Institute of Justice,
    Department of Justice; Dr. Lloyd Johnston, Monitoring the
    Future Project, University of Michigan; and we have the
    Honorable Donald Vereen, who is the Deputy Director of the
    Office of National Drug Control Policy.
        As I indicated before to our first panel, this is an
    investigations and oversight subcommittee. We do swear in our
    witnesses.
        [Witnesses sworn.]
        Mr. Mica. We actually have five witnesses at the table, if
    you can introduce yourself.
        Mr. Zobeck. I am Terry Zobeck. I am Chief of the Research
    Programs Branch at ONDCP.
        Mr. Mica. Dr. Zobeck, thank you.
        Let me first recognize Dr. William Raub who is with
    Scientific Research, HHS. Dr. Raub, welcome and you are
    recognized.

        STATEMENTS OF WILLIAM RAUB, DEPUTY ASSISTANT SECRETARY,
    SCIENTIFIC RESEARCH, HEALTH AND HUMAN SERVICES; JULIE SAMUELS,
     ACTING DIRECTOR, NATIONAL INSTITUTE OF JUSTICE, DEPARTMENT OF
        JUSTICE; LLOYD JOHNSTON, MONITORING THE FUTURE PROJECT,
     UNIVERSITY OF MICHIGAN; DONALD VEREEN, M.D., DEPUTY DIRECTOR,
    OFFICE OF NATIONAL DRUG CONTROL POLICY [ONDCP], ACCOMPANIED BY
       TERRY ZOBECK, CHIEF, RESEARCH PROGRAMS BRANCH, OFFICE OF
                  NATIONAL DRUG CONTROL POLICY [ONDCP]

        Mr. Raub. Thank you, Mr. Chairman, and Representative Mink
    and Representative Ose. My name is William Raub, and I am the
    Science Advisor to the Secretary for Health and Human Services.
    I am pleased to come before the subcommittee today to highlight
    efforts undertaken by the Department of HHS during the past
    decade to monitor and track trends in youth drug use.
        Mr. Chairman, with your permission I will submit my full
    statement for the record and make some brief statements.
        Mr. Mica. Without objection, so ordered. Please proceed.
        Mr. Raub. Research methodology relevant to the study of
    complex social problems generally does not produce absolute
    results, nor are those results 100 percent precise. Thus, in
    seeking to understand the nature and scope of issues such as
    youth drug use, one is well advised not only to collect data
    from multiple sources but also to analyze such data from
    multiple perspectives. Although synthesizing and interpreting
    data gathered in different ways in different contexts is
    invariably challenging, such efforts often are essential to
    ensure confidence in the results. Moreover, assembling such a
    multifaceted knowledge base often is a prerequisite to
    developing effective prevention strategies.
        With respect to the subject of this hearing, HHS conducts
    several surveys that provide estimates of the percentage of
    youth who use illegal drugs, alcohol or tobacco. I will
    describe each of these surveys briefly and then discuss recent
    trends in youth substance use.
        Since 1990, the CDC has operated the Youth Risk Behavior
    Surveillance System to provide information on specific
    behaviors that underlie the most important health problems
    among youth in the United States. The YRBSS reports on behavior
    in six risk areas: (1) tobacco use; (2) alcohol and other drug
    use; (3) behaviors resulting in unintentional injury and
    violence; (4) sexual behaviors contributing to unintended
    pregnancy and sexually transmitted diseases, including HIV
    infection; (5) unhealthy dietary behaviors; and (6) physical
    inactivity.
        The national Youth Risk Behavior Survey is a national
    component of the YRBSS. This survey, conducted during the
    spring semester among national samples of high school students,
    provides data that are representative of all students in grades
    9 through 12 in public and private schools in the 50 States and
    the District of Columbia. In 1999, 15,359 questionnaires were
    completed in 144 schools. Schools are selected using a
    scientifically based sampling process, and schools with a large
    percentage of African American and Hispanic students are
    oversampled to generate stable estimates each year for these
    subgroups of youth.
        Since 1975, the National Institute of Drug Abuse has
    sponsored the Monitoring the Future Survey through a succession
    of grants to the University of Michigan's Survey Research
    Center. The purpose of the survey is to assess the attitudes
    and behaviors of high school youth in a variety of areas,
    including and most notably the areas of drug, alcohol, and
    tobacco use. The survey covers 45,000 to 50,000 students
    annually and provides unique data on both youth substance use
    and the attitudes and beliefs that may contribute to such
    behaviors. The survey has been conducted among high school
    seniors since its inception and, since 1991, has included 8th
    and 10th graders as well.
        Since 1971, the Substance Abuse and Mental Health Services
    Administration has sponsored the National Household Survey on
    Drug Abuse. NHSDA is the primary source of statistical
    information on the use of illegal drugs by the U.S. population.
    Moreover, the Household Survey provides the only source of
    nationally representative data on adult substance use in this
    country.
        The NHSDA is conducted with a nationally representative
    sample of the population through face-to-face interviews at the
    subjects' place of residence. The population covered by the
    survey is the civilian, noninstitutional population age 12 and
    older in the United States, including all 50 States and the
    District of Columbia. In 1999, the survey underwent a major
    redesign, moving from a paper questionnaire to computer-
    assisted administration and dramatically expanding the sample
    to almost 70,000 individuals, including approximately 25,000
    youth between the ages of 12 and 17, to permit State-level as
    well as national-level prevalence estimates of substance use.
        Taken together, these three surveys provide a rich array of
    information to monitor and attempt to understand trends in
    substance use and abuse. Each survey provides unique and
    important information that is useful to local, State and
    national decisionmakers attempting to address problems of
    substance use and abuse. All three surveys recently were
    reviewed by a panel of outside experts, which concluded that
    each survey is methodologically strong, well designed for its
    intended purpose, and well administered.
        I am pleased to report that these three surveys--
    individually and collectively--provide data that can help to
    resolve the central question posed in today's hearing: ``Is
    drug abuse going up or down?'' In particular, all three surveys
    indicate that use of illegal drug and tobacco among youth has
    leveled and, in some cases, declined over the last 3 years.
    However, the data also indicate that the success of the last 3
    years hardly is cause for complacency, for youth use of illegal
    drugs and tobacco remains higher than that observed in 1991,
    the historical low point. In particular, all of the Department-
    sponsored surveys that track youth substance use show that the
    rates increased during the early to mid parts of the 1990's and
    then leveled off or declined somewhat since.
        The data make clear that far too many of our Nation's young
    people and their families continue to experience the risks, and
    often fatal consequences, that attend the use of illegal drugs
    and other substances. Nevertheless, recent trends in youth use
    of illegal substances provide a basis for cautious optimism
    that the joint efforts of parents, teachers, counselors, and
    public officials to educate youth about the dangers of illegal
    drug, alcohol, and tobacco use are bearing fruit. The Nation
    must buildupon the momentum gained in recent years against this
    major public health and social problem.
        The Department welcomes the continuing interest of the
    subcommittee. I will respond as best I can to whatever
    questions you may have.
        Mr. Mica. We will get to you in a few minutes. I would
    dispute some of your testimony.
        [The prepared statement of Mr. Raub follows:]

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        Mr. Mica. Let me recognize now Julie Samuels, acting
    director, National Institute of Justice.
        Ms. Samuels. Mr. Chairman, Congresswoman Mink, and
    Congressman Ose, I appreciate the opportunity to participate in
    the subcommittee's review of drug use trends in America. The
    National Institute of Justice operates the Arrestee Drug Abuse
    Monitoring the Future Program, known as ADAM. I would like my
    prepared statement to be accepted for the record.
        Mr. Mica. Without objection, your entire statement will be
    made part of the record. Proceed.
        Ms. Samuels. NIJ is the Department of Justice's independent
    research and development agency. Our mandate is to build
    knowledge to meet the challenges of crime and drug use. NIJ
    developed ADAM to build knowledge about drugs, crime, and
    related social issues and to support local and national
    policymakers. ADAM's primary purpose is to provide timely
    information about drugs and crime, patterns of drug use and
    treatment, emerging drug trends, the effect of law enforcement
    on drug use, treatment needs, and a wide range of related
    issues and it does this by focusing on people who are arrested
    and booked into local lockups.
        ADAM's data are collected in 35 different U.S. Counties
    every quarter. Within 48 hours of arrest, local ADAM staff
    interview arrestees and collect urine samples for drug testing.
    Participation in this program is voluntary and anonymous.
        Four things distinguish ADAM from other surveys as a source
    of information about drug use in America: One, ADAM focuses on
    communities. From ADAM, we develop detailed use of drug use
    among arrestees in specific areas.
        Two, ADAM focuses on arrestees. ADAM focuses on people who
    have been arrested, so the program provides a firsthand look at
    the connection between drugs and crime. These arrestees also
    represent a group of great concern.
        Three, ADAM includes a drug test. In addition to asking
    each respondent questions about his or her drug use and drug
    treatment experiences, respondents also provide a urine sample
    that is laboratory tested for a variety of drugs. The
    scientific testing supplements the interview responses.
        Four, ADAM offers a research platform. Building on the core
    ADAM program, NIJ has established a cost-effective way to
    undertake specialized studies on a broad range of public safety
    and public health issues related to drug use in the arrestee
    population, such as domestic violence or the dynamics of drug
    markets.
        Consistently, ADAM's data have shown that about two of
    every three arrestees who participate in the program test
    positive for at least one of five drugs: cocaine, opiates,
    methamphetamines, marijuana, or PCP. In recent years our data
    have shown little overall decline in the level of drug use
    among arrestees. Perhaps the most important thing we have
    learned is that the drug problem is different in different
    communities around the Nation. For example, methamphetamine use
    among arrestees remained low in most ADAM communities in 1999
    but continued to vary by region, with use clearly higher in the
    ADAM communities in the western part of the Nation.
        As I mentioned earlier, ADAM is primarily designed to
    provide data on drug use among arrestees on the local level. In
    that sense it helps communities nationwide to understand their
    particular problems of drugs and crime from a local
    perspective.
        At present, ADAM data do not readily lend themselves to
    national estimates of drug use among arrestees. Nonetheless, in
    the same way that ADAM can help local communities shape local
    responses to drug and crime, it can help inform national
    policymakers about trends and patterns in various regions in
    the United States.
        We hope to expand ADAM to 75 sites. As part of our
    expansion, we would routinely collect data on arrestees not
    only in urban metropolitan centers, but also in rural,
    suburban, and Indian country. In addition to extending the ADAM
    program and its benefits to other communities, this expansion
    and the improved methodology would enable us to make national
    estimates of drug use among the arrestee population. Our
    expanded plan would also allow us to increase the specialized
    studies that can inform both local and national concerns about
    the problem of drugs and crime in the United States.
        Mr. Chairman, that concludes my opening remarks. I would be
    pleased to answer any questions.
        Mr. Mica. Thank you. We will hold questions until we have
    heard from all of the panel witnesses.
        [The prepared statement of Ms. Samuels follows:]

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        Mr. Mica. Next we will hear from Dr. Johnston who is with
    Monitoring the Future Project, the University of Michigan.
        Mr. Johnston. Thank you, Mr. Chairman and members of the
    committee. I appreciate this opportunity to testify. My name is
    Lloyd Johnston. I am a research scientist and principal
    investigator of the Monitoring the Future study at the
    University of Michigan. That study, as Mr. Raub mentioned, is
    now in its 25th year, and we have tracked American high school
    seniors for that entire period on an annual basis. In 1991, we
    added younger adolescents, 8th and 10th graders, fortunately at
    a point where it was helpful in interpreting what was going on.
        This is an investigator-initiated research grant, which
    means that the scientists responsible came up with the idea,
    brought it before NIH for competitive review and must bring it
    back every 5 years for continued competitive review. The
    surveys involve in-school student-based samples as opposed to,
    for example, people in a household. They are large and
    nationally representative at each of the three grade levels.
    Each is a separate national survey independently selected;
    altogether we have close to 50,000 students per year located in
    some 430 secondary schools.
        A less well known feature of the design is that we also
    follow some of each year's graduating high school class into
    adulthood by use of mail surveys, sent through the mail, and
    these give us a very nice national sample of American college
    students and eventually young adults of various ages who are
    high school graduates. We have people who are 40 years old whom
    we initially surveyed when they were high school seniors.
        We have over the years given great priority to consistency
    of methods in this study so that we don't confuse
    methodological changes with real underlying changes in the
    phenomenon understudy.
        As far as timeframe, our data are collected in the spring,
    primarily in March through May, and therefore we have a
    somewhat different time reference in the year than the National
    Household Survey which you will hear more about.
        The content coverage is broad. We go into a great many
    substances, in excess of 30 categories and subcategories of
    substances, as well as many characteristics of the person and
    surrounding attitudes and beliefs that may help explain the use
    of these individual drugs.
        As for recent trends, the most recent data are from the
    spring of 1999. The 2000 survey, while complete, is not ready
    for release and will not be until December. The results of the
    study are provided in a blue book of which I hope there are
    enough copies for all the committee members--called Overview of
    Key Findings, which gives a brief synopsis for each of the
    categories of drugs.
        Several things to mention, one of which is that it is clear
    that the peak of the American epidemic was in the last third of
    the 20th century, the late seventies, beginning of the
    eighties. There was a long period of decline in use in all age
    groups, including the ones that we monitor, and that decline
    ended in the beginning of the 1990's. There then was a period
    of increase again, among adolescents only, a rather interesting
    development. Up to that point, almost all of the age groups
    were moving in parallel, and then suddenly adolescents began to
    show an increase in the 1990's that was not observed even among
    young adults.
        You have alluded to the scale of that change, and what we
    saw was that by 1996, the 8th graders reached a peak level and
    there was an inflection point and use has been declining since
    then. The older adolescents reached an inflection point a year
    later in 1997, and the 12th graders thereafter have remained
    level in their use, and the 10th graders have shown some
    decline, although there was not much decline in any of these
    groups in 1999 specifically.
        I might note that the eighth graders, the youngest of the
    students that we looked at, were the first to show the increase
    in the 1990's and also the first to show the decrease in the
    1990's, which suggests to me that the younger children who
    really haven't established attitudes and patterns in this area
    yet are the most susceptible to the forces of change, whatever
    those forces might be--good or bad.
        It also helps to explain why there are some differences in
    the results of the surveys, since our surveys cover somewhat
    different age bands. The Household Survey was down to age 12,
    and we start at 13 and 14.
        Since those peaks, as I say, there has been some change,
    mostly in the younger children. And in 1999, only the eighth
    graders showed any further decline in overall illicit drug use.
    But nevertheless all groups showed some decline in some
    specific drugs. We saw some divergence of different classes of
    drugs. While heroin and marijuana and amphetamines remain
    fairly stable in 1999, a number did decline. Inhalants, crystal
    methamphetamine, crack cocaine, a very important drug, showed a
    decline for the first time among the eighth graders.
        So there was some good news in that year, and there were
    two pieces of bad news. One was the increase of ecstacy, a
    sharp increase among the 10th and 12th graders. Ecstacy is also
    called MDMA, and we know from our surveys of young adults that
    ecstacy use has been climbing among those in the first half of
    the 20's through age 26. So we have clearly seen the emergence
    of an epidemic of use among those in the late teens, early
    20's, of so-called club drugs.
        Steroids also bumped up in 1999 among the younger children,
    8th to 10th graders, perhaps for some very specific reasons. So
    in fact there has been a divergence, which I think helps to
    illustrate the point that different drugs to some degree march
    to their own drummers. As youngsters learn about the hazards of
    a drug, they are less likely to use. As peer disapproval
    emerges, they are less likely to use. With ecstasy or GHB and
    others which always are coming along, I think they enjoy a
    certain period of suspended judgment, as it were, what I call a
    ``honeymoon period,'' where their alleged benefits are
    circulated among youngsters, but their effects are not yet well
    documented and convincingly communicated to youngsters. And I
    think that was the case with GHB related to the tragic story
    that we heard earlier from the first panel.
        Another thing to note is that cohort effects have emerged,
    and the teens of the early 1990's are continuing to carry with
    them into young adulthood higher rates of drug use. The kids
    who were entering teenagehood in the late 1990's have lower
    rates of drug use, which is the good news part of the story. We
    have not always seen these cohort effects in the past, but it
    clearly occurred, and I think it was because the kids who grew
    up in the late 1980's and the early 1990's saw so much less
    drug use around them, they saw much less of the consequences,
    the tragic consequences of use, and they came to see these
    drugs as less dangerous than their predecessors who had more
    direct observation of what happened.
        Finally, you noted the increase in death rates, and that,
    of course, is a tragic fact. Death rates and some other
    consequences such as entering treatment do tend to occur on a
    lagged basis from when we actually see an increase in the
    prevalence of using the drugs. For example, cocaine use spread
    considerably in the late seventies, but it wasn't until the
    early eighties that we began to see a rise in deaths in people
    calling emergency hotlines and in people entering treatment and
    various other kinds of effects. So some of these indicators are
    what I call lagged indicators. And I think the spread of heroin
    earlier in the decade is probably one of the contributing
    factors to the death rates that are now rising because many of
    those people are still using heroin, and through a natural
    process of involvement, have become more involved and more
    susceptible to overdose.
        Thank you, Mr. Chairman.
        [The prepared statement of Mr. Johnston follows:]

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        Mr. Mica. We will now recognize Dr. Vereen, who is the
    Deputy Director of the Office of National Drug Control Policy.
        Dr. Vereen. Thank you, Mr. Chairman, Chairman Mica,
    Representative Mink, and Representative Ose and to the other
    members of the subcommittee.
        The Office of National Drug Control Policy welcomes this
    opportunity to discuss illegal drug use trends in America. The
    annual report on the National Drug Control Strategy which is
    submitted to Congress every winter is a data-based
    comprehensive 10-year report that includes an assessment of
    Federal success in achieving the goals and objectives of the
    strategy. And the data presented in that 2000 report are valid,
    and they demonstrate that we are moving in the right direction
    to achieve the goals that we have identified for that strategy.
        I would like to submit the full written testimony for the
    record and just give a brief oral statement.
        Mr. Mica. Without objection, your entire statement will be
    made part of the record. Please proceed.
        Dr. Vereen. As my colleague from HHS has explained already,
    to assess trends in drug use, the government examines the
    results from a number of different surveys, three in
    particular, three nationally representative population studies.
    One is the HHS National Household Survey that has been
    presented. I will just add that is a study that is conducted
    through face-to-face interviews each year, using computer-
    assisted self interviews, and it covers a host of drugs that
    are used, including lifetime use, past-year use and past-month
    use.
        You have just heard from Dr. Johnston on the Monitoring the
    Future study. This is a school-based study that surveys
    students in the 8th, 10th and 12th grades. These data are
    released every year in December, and the most recently
    available data are for 1999.
        The third is the Center for Disease Control and
    Prevention's Youth Risk Behavior Study. That is also a school-
    based survey for students 9th through 12th grade. The data are
    released for that particular study every other year. That is
    important--an important point to make.
        Let me refer you to a visual because it is very difficult
    to talk about data sometimes without getting some sense of what
    it looks like over time. Here is a slide that shows the trend
    lines from all three studies that have been presented to you,
    and what we have done here is to select out marijuana, the most
    commonly used drug by young people. The main point that we want
    to make from all of this data is that there is a remarkable
    consistency in the trends of the data. The actual numbers will
    change as a reflection of methodology and other factors, which
    we can go into if you would like, but the trends are
    consistent. So while the absolute prevalence rates may vary,
    the trends are consistent.
        Of great concern to us is that even though recently we
    reported that there has been a 21 percent decline over the last
    2 years in illicit drugs use in 12 to 17-year-olds, we are
    concerned as well about the increase, apparent increase in drug
    use in the 18 to 25-year-old group. The current use of any
    illicit drug among this group increased 28 percent from 1997 to
    1999. This may capture some of the club drug use, as Dr.
    Johnston mentioned earlier, those in the lower end of their
    20's. Club drugs are becoming a drug of increasing use.
        Past month use of marijuana in this group followed a
    similar trend, also increasing 28 percent. Overall drug use
    remains level, as you can see from these trend lines. According
    to the National Household Survey, the rate of illicit drug use
    in the population ages 12 and older is statistically unchanged
    over the past 2 years, if you look just at the statistics, and
    it is represented here visually. But as Dr. Johnston stated,
    the latest findings from the Monitoring the Future Study for
    the school year 1998 to 1999 indicate that we are holding the
    line against drug use; that we have turned a corner. He
    referred to it as--I am forgetting the word that he used
    before. But the data from the 1999 Monitoring the Future Study
    show that the use of illicit drugs among 8th, 10th and 12th
    graders remains pretty much unchanged from 1998 to 1999.
        With regard to emerging drugs, there has been an increase
    in ecstacy or MDMA use among 10th and 12th graders which is of
    great concern. The documented increase in these drugs
    corroborates other recent indicators. As you have probably
    noted, these are huge studies with a 6-month to a 1-year lag
    time.
        We have a couple of other mechanisms that allow us to get
    at local trends in a slightly faster fashion. ONDCP has a pulse
    check mechanism, and the Department of HHS, through the
    National Institute on Drug Abuse has a community epidemiology
    working group report that allows us to get a little closer to
    these local trends. And approximately a year ago, we were able
    to note the use in trends of club use drugs as that data was
    taken into account.
        On the next slide I would like to briefly illustrate the
    methamphetamine problem. It has been of great concern to us,
    and we are going to illustrate the ADAM data here to give you a
    visual of that data set to show two main points. These are the
    blood tests or the drug test results of booked male arrestees,
    as was explained by my colleague earlier. But you will notice
    in the cities where methamphetamine was found, there are huge
    variations in the amount of methamphetamine use. We think of
    the drug problem in the country is a collection of local
    epidemics, as the past director of NIJ was wont to describe.
    Just so you get a picture of what the female arrestee rates
    look like, you will see a similar set of patterns, and I won't
    go into the specific changes from city to city.
        The second point that I want to make about this data set is
    that you will notice that all of the cities are west of the
    Mississippi. This is a drug phenomenon that as it creeps across
    the country in its local fashion, has at this point stopped or
    hovered around the Mississippi River, and drug trends follow
    such patterns. So when you hear us announce national trends for
    methamphetamine, we are really talking about the western part
    of the country for the most part. In conclusion, Mr. Chairman,
    the trends among the 12 to 17-year-old age group are positive
    and encouraging. Adolescents increasingly disapprove of illegal
    drugs. But despite this good news, we face an increasingly
    difficult challenge to our abilities to detect, monitor and
    track emerging drug trends that pose a grave and dangerous
    threat to our children.
        All of us at ONDCP are grateful to Congress for your
    efforts in this subcommittee. And now I would like to just say
    a couple of words about our performance measure system.
        Our strategy, as you know, is attached to performance
    measures of effectiveness system. This system makes extensive
    use of many of the data sources that you have seen here for
    tracking our success or where we need areas of help in
    achieving our goals and objectives for the strategy. The system
    is complex. It involves an interagency effort, those of us
    sitting across this table as well as others. The performance
    measure community recognizes that such systems have to change
    and adjust, just like our national strategy. It is a 10-year
    plan based on data, but has flexibility built in to respond to
    new and local epidemics. This PME system has been favorably
    reviewed by the National Academy of Public Administration, the
    National Partnership for Reinventing Government, and the GAO.
        At this point, I will end my comments.
        Mr. Mica. Thank you.
        [The prepared statement of Dr. Vereen follows:]

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        Mr. Mica. Let me first turn to Julie Samuels of DOJ. You
    noted in your testimony, as a result of the urine testing of
    arrestees, it was revealed that the actual number of drug users
    was twice as high as the level that had been previously
    reported; is that correct?
        Ms. Samuels. Yes, sir.
        Mr. Mica. So some of the statistics we are looking at,
    unless there was drug testing, urine testing, may be even worse
    than what is being presented?
        Ms. Samuels. It is unclear whether you can draw that
    conclusion. I think what we have learned with respect to doing
    both the interviews and the drug tests is there are times when
    what the arrestee tells us with respect to his drug use is not
    consistent with the confirmed drug test. I don't know whether
    you can necessarily generalize that to the rest of the
    population.
        Mr. Mica. You said that the actual number of drug users was
    twice as high?
        Ms. Samuels. Yes. Clearly for this population, they are not
    always admitting as much use as the drug tests indicated.
        Mr. Mica. And that most of the testing that we have talked
    about is self-reported; is that correct, Dr. Johnston?
        Mr. Johnston. Yes. The national surveys are all self-
    reported. But I should note that the in-jail situation is a
    very extreme situation where people are there because of
    breaking the law and they are under charges.
        Mr. Mica. Have you given any consideration in your
    reporting to finding a sample that would also look at some
    verification of the statistics that you are compiling, Dr.
    Johnston?
        Mr. Johnston. It is, unfortunately, the case that, short of
    doing actual hair or urine testing, there is no gold standard;
    and even those are not a gold standard.
        Mr. Mica. Is there a comparison where they have conducted
    hair or urine testing and then compared it to the statistics?
        Mr. Johnston. Not in this country. I have seen it done in
    other countries, and the results were pretty good. But what we
    do is a number of what I call ``triangulations'' on validity
    and look at quite a host of things which should come out a
    particular way if the data are valid. We look for consistency
    among the answers that an individual gives about various drugs.
    And if it is a high rate of inconsistency, we throw the case
    out. And we look at their reports of friends' use about which
    there would be less motivation to conceal, presumably, since
    they are unnamed friends. We get both prevalence and trends, I
    might add, because sometimes it is asserted that maybe the
    willingness to be honest changes over time, but I think we have
    pretty good evidence to suggest that hasn't been the case, at
    least in the school surveys.
        Mr. Mica. Dr. Vereen, we are trying to get measures of
    performance, and get some hard data on the success or failure
    that we have incurred in these programs. I guess you have a
    couple of targets, a 5-year target, 2002 or 2003, and that
    would be our closest target. What is the overall drug use
    percentage of the population that you are trying to achieve in
    2003?
        Dr. Vereen. Overall, as we state in the national strategy,
    we want to cut past-month use in half. When you look at the
    whole population which the strategy deals with, there is
    approximately a 6.4 percent across the country drug use, and we
    want to cut that in half by 2004.
        Mr. Mica. And you are trying to get to 3 percent; that is
    the goal?
        Dr. Vereen. Yes.
        Mr. Mica. According to the report given to us in 1997, we
    were at 6.4 percent. In 1998 we have dropped slightly to 6.2
    percent. However, this past year we are back at 7 percent. So
    instead of getting closer to the 3 percent of the population,
    we are now 4 full percentage points away. While we had 1 year
    where there was a slight decrease, it appears that the trend,
    in fact, for overall drug use remains increasing; is that
    correct?
        Dr. Vereen. That is 1 data point that----
        Mr. Mica. From 6.4 to 7, and our goal is 3; 7 is higher
    than 3.
        Dr. Vereen. It is, but 1 point doesn't define a----
        Mr. Mica. It doesn't appear that we are heading in the
    right direction. We use the chart here of marijuana. I don't
    know if you have charts of some of the other uses, but we have
    got ecstacy reaching cocaine and heroin proportions. Do we have
    a chart for ecstacy? I know that you testified that it is on
    the increase, and Dr. Johnston said that we are seeing a
    substitution. Rather than crack, rather than seeing other drugs
    we have seen in the past, that they are shifting use; is that
    correct?
        Dr. Vereen. That's correct.
        Mr. Mica. The other problem is we are seeing death and also
    increase in hospital emergency admissions; is that correct?
        Dr. Vereen. Yes.
        Mr. Mica. And I attribute this to two things: One, an
    incredible supply. There is an incredible supply of heroin
    coming in from Colombia. A 20 percent increase in production in
    black tar heroin from Mexico. And not only are we seeing a
    larger amount of heroin and cocaine coming into the country, we
    are also seeing the highest purity levels that we have ever
    confiscated or seized; is that correct?
        Dr. Vereen. Yes, but you are seeing exactly how the drug
    problem preys on the United States. It takes advantage of
    communities and----
        Mr. Mica. We are seeing a regional problem. We see
    methamphetamines, and we held hearings in Mr. Ose's district up
    and down the West Coast. We were in Iowa, and they had captured
    something like 1,000 meth labs between local, State and Federal
    law enforcement sources. We were in Dallas, TX, Mr. Sessions'
    district, and the DEA that covers Oklahoma and Texas told us
    that there are almost 1,000 labs in that area producing meth;
    people, literally by the thousands, being addicted.
        In Mr. Ose's district we had testimony from one social
    worker where several hundred children had been abandoned in one
    county of 100,000 population, and they could only get about 30
    reunited with the family because the people were either
    incoherent or so damaged by meth. We are seeing a new
    phenomenon of death and destruction, I think unlike anything
    that we have experienced; would you agree?
        Dr. Vereen. Yes, and that occurs with each new drug. Each
    one has a new and different profile. The challenge is to react
    as quickly as possible to that new drug.
        Mr. Mica. One of the things that we have is a gap in our
    survey. We had the people from the Center for Disease Control,
    and some of the drugs that are now in vogue are not even on the
    charts for bean counting.
        Dr. Vereen. The CDC study is an every-other-year study. The
    other two studies are starting to capture that. We have two
    other local mechanisms, the CEWG and our pulse check, that gave
    us information about these other phenomena within the last 2
    years.
        Mr. Mica. I have to dispute some of Dr. Raub's testimony,
    too; again, the leveling off. And I think if we look at long
    term, or we take some of these individual drugs, we can dispute
    that we have seen, as Dr. Johnston and Dr. Vereen have
    testified, that we are seeing, unfortunately, a continued use
    overall. We are seeing dramatic increases in adult population,
    we will say 18 to 25, in that range, because some of those are
    young adults, and we have seen still dramatic increases; even
    in drugs that are perceived as a lesser risk, like marijuana,
    only some minor leveling off.
        Do you want to respond, Dr. Raub?
        Mr. Raub. Only that the thrust of my statement was not to
    declare victory; rather, to identify where there are some
    positive signals, but also to acknowledge that there are some
    disconcerting negative developments. This country cannot lower
    its guard, and I agree completely with your concerns.
        Mr. Johnston. We do have crystal methamphetamine for some
    years in the Monitoring the Future study, and for the first
    time in 1999 it showed a significant drop, roughly a 40 percent
    drop. So there was some good news on that front. I hope it
    holds.
        Mr. Mica. Let me yield now to Mrs. Mink.
        Mrs. Mink. Thank you, Mr. Chairman.
        I am somewhat distressed by the tone of the testimony that
    all of you have presented, because I don't happen to agree that
    there is anything to celebrate. The trends that are developed
    by these individuals studies, I don't think relate to the real
    world that we have to face. While studies are very valuable to
    help people determine where the emphasis ought to be in law
    enforcement or treatment I think that the context in which they
    are sometimes read and presented turns people off guard into
    thinking, well, somebody must have a handle on all of this
    because such-and-such a report indicates that the trends are
    going down in consumption.
        I happen to agree with the testimony and tone of the first
    panel where the witnesses said they had such extreme
    difficulty, even among family members, to get the teenagers to
    disclose the truth of what is happening in a school situation.
    And so I take a very jaundiced view about the studies that
    depend upon the teenagers themselves relating honestly their
    30-day practices or 14-day practices or the year practices. And
    I think that our job really is to examine the veracity of this
    evidence that you have collected and test it to make sure that
    these are accurate phenomenon that are going on.
        The first question I have is, while this chart, Dr. Vereen,
    is dismissed as indicating as the trends are similar, there is
    still a wide range between the top line and the bottom line.
    How do you interpret that for a layperson like myself looking
    at this chart saying, why the differences?
        Dr. Vereen. That is an excellent question and I perhaps
    should invite you to some of our staff meetings.
        Mrs. Mink. No, no, no.
        Dr. Vereen. I can partially explain the answer, and my
    colleagues can add what they would like.
        The CDC study, the top line, has a slightly older
    population which we know has a higher drug rate use. The bottom
    line, the red line, is the National Household Survey which
    surveys people as young as 12 which have a----
        Mrs. Mink. They have no business being on one chart.
        Dr. Vereen. Well, we made the judgment, since the studies
    were going to be presented and compared, we would show that.
    Yes, there are discrepancies in the prevalence rate, but we as
    scientists, we as policymakers, look at the trend. I can tell
    you as a physician, we do that as well. Sometimes when you get
    a series of blood tests, the absolute numbers are not as
    important as the trends sometimes.
        So what we have here are multiple views of the drug problem
    to get as clear a picture as possible. That is what we attempt
    to do and that is why we have multiple studies. We don't just
    rely on one.
        Mrs. Mink. The top line is what age group?
        Dr. Vereen. That is the 9th, 10th, 11th and 12th grades.
    The Monitoring the Future we have split out. That is 8th, 10th,
    and 12th.
        Now, on the bottom line you have 12 and over, so you have
    young people who have a low rate of drug use, and then you have
    many older people who are not using drugs at all in a
    household, because that is where the study grabs it, and that
    is why it is important to understand what each of those lines
    mean.
        Mrs. Mink. So they offer no conclusive evidence. They don't
    look at the chart and say, oh, I am a policymaker and now I
    know what to do.
        Dr. Vereen. The data tell us that the trends are consistent
    and move in the same direction.
        Mrs. Mink. Do you have a similar chart for the 18 to 25,
    because in your testimony you point out in this age group there
    is a significant increase in users. Do you have a chart?
        Dr. Vereen. We have one that we can provide for you,
    certainly.
        Mrs. Mink. So your testimony is corroborated by the other
    studies?
        Dr. Vereen. Yes. I can offer that we can take any of these
    numbers and any of the data that the U.S. taxpayer pays for and
    put it in any form. We have a copy of this here, if you would
    like a closer look at it.
        Mrs. Mink. So if the rates of consumption, addiction,
    however you want to say, increase after age 18 up to 26 in the
    studies----
        Dr. Vereen. Not necessarily. What we may have is a cohort
    that had been using at a high rate before and are continuing to
    use at a high rate. When we select out that age group, it
    doesn't necessarily mean that they started at that age group.
        Mrs. Mink. But they are continuing. Why the huge variance
    in use to the next group, Mr. Johnston?
        Mr. Johnston. We have very similar results and it is more
    detailed by age. What we see is the youngsters who were the
    teenagers in the early 1990's when drug use among teens was
    going up, as they enter the post-high school years, those same
    class cohorts or birth cohorts are showing higher rates than
    their predecessors in older ages as well. They are carrying
    with them the habits they established back in the early 1990's.
    That is an unusual pattern here. We see that all of the time
    with cigarettes. If a particular class cohort had a high rate
    of smoking, even in their early teens, they will carry with
    them those habits. We have not seen that with illicit drug use:
    this is the first occasion where we have actually seen a cohort
    effect, and that shows up in the later ages as those
    youngsters, become the people in their 20's and perhaps even
    into their 30's.
        Dr. Vereen. And as Dr. Johnston pointed out, the 20's are
    when many young people are using some of the club drugs for the
    first time.
        Mrs. Mink. Who came up with the term ``club drug?''
        Dr. Vereen. I am not sure.
        Mrs. Mink. Your agency?
        Dr. Vereen. No.
        Mrs. Mink. And ``designer drug,'' who came up with that
    name?
        Dr. Vereen. One of the things that we try to do is speak to
    the American people. We try to get educated by them. So we try
    to keep tabs on all of the latest lingo on the drugs. If we
    want to get messages out to young people, we try to meet them
    halfway by speaking their lingo so that they know that we have
    listened to them and we can report back to them, reflect back
    to them: We are concerned; this thing that you think is not
    very harmful is.
        We have been able to react very quickly to ecstacy, for
    example. We can now show with the latest technology that
    ecstacy, in fact, causes brain change, perhaps permanent brain
    change, and we are able to get that information back to young
    people who are engaging in the club drug scene.
        A part of the initiative by the National Institute on Drug
    Abuse is to actually present those very clinical pictures and
    postcards distributed in batches of thousands to young people
    so they can see for themselves what this drug that they think
    won't harm them could actually do to their brains.
        Mrs. Mink. Thank you, Mr. Chairman.
        Mr. Mica. I thank the gentlelady.
        I yield to the gentleman from California, Mr. Ose.
        Mr. Ose. Thank you, Mr. Chairman. I want to go back to Dr.
    Raub. I want to make sure that I understand something. On page
    5 of your written statement at the bottom paragraph, you
    indicate that there is a change in the methodology by which the
    data for the study was collected, and that there can only be
    limited comparisons made between the data from the 1999 survey
    and the data obtained from surveys prior to 1999; is that
    correct?
        Mr. Raub. Yes, that's correct.
        Mr. Ose. If I also understand your testimony on page 4, the
    survey that we are referring to in that testimony I just cited
    is the primary source of statistical information on the use of
    illegal drugs by the U.S. population? That is the bottom line
    there?
        Mr. Raub. Yes.
        Mr. Ose. The question I have, I am up here trying to
    decide, as compared to Dr. Vereen, I am trying to decide as a
    policymaker what is the data that we are supposed to be using.
    If the methodology had not been changed, do you have any
    indication what the results of the survey would have been so we
    can tie apples to apples, for instance?
        Mr. Raub. In fact, your point is well taken, and the
    language here and the approach here was a cautionary one. This
    is a Household Survey based on direct interview, which is a
    very powerful type of method. Most surveys of this type over
    the last several years have been making the transition from
    pencil and paper questionnaire approaches to computer-assisted
    devices. These are generally more favorable in terms of both
    the accuracy and the efficiency of following up on the data,
    but there is also the risk of introducing a different
    methodology that may alter the reporting. Therefore, as a
    cautionary step, the people doing the Household Survey, while
    introducing the computer method for the first time, also
    maintained a parallel pencil-and-paper approach as a subset, as
    a way of testing that transition.
        Mr. Ose. That is the 13,000 sample?
        Mr. Raub. That's correct. I don't think that the language
    here or from my colleagues from SAMHSA means to suggest that
    the new results are invalid, but rather it is a cautionary,
    upfront signal.
        Mr. Ose. Is there a difference between the results in the
    13,000 sample and the new modality sample?
        Mr. Raub. The analyses are underway. My understanding is
    that to date they seem to be consistent--that there does not
    seem to be a major quirk introduced by the change in the
    methodology. We will know better after another cycle.
        Mr. Ose. When do you except the analysis on the current
    sample, the comparative analysis on the current two samples, to
    be finished?
        Mr. Raub. I don't know precisely, but I expect that to be
    in the near future.
        Mr. Ose. I would appreciate having that information when
    you get it.
        [The information referred to follows:]
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        [GRAPHIC] [TIFF OMITTED] T4707.059

        Mr. Raub. May I also add on the methodological front the
    question that came up before about the use of urine or
    regarding hair testing. As part of the continuing evolution of
    this survey, there is a subset of people in the 2000 Household
    Survey that will have urine and hair testing as well as a
    movement toward some further verification of this information,
    but this is just a natural part of the methodological evolution
    in these studies.
        Mr. Ose. Ms. Samuels, how would you describe ADAM in terms
    of its value as a research tool?
        Ms. Samuels. Well, I think that----
        Mr. Ose. First, ADAM is the statistical process you use
    to----
        Ms. Samuels. ADAM is the program by which we are working in
    these 35 communities across the country, conducting interviews
    and then collecting the drug test information. So from that we
    gain information about the picture of the drug problem in a
    particular community, and that information can then be the
    basis or analytic tool for folks living in that community so
    they understand exactly what the sorts of problems are that we
    are seeing, the types of drugs being used by this population,
    the age effects, the differences by gender.
        Mr. Ose. So it is a pretty comprehensive look into a
    community's practices?
        Ms. Samuels. Yes. With respect to research as well, we also
    have the opportunity because we are doing this periodically to
    go in and ask supplemental questions that might be of
    particular relevancy to communities that we can provide as part
    of the ADAM process, so that we can elicit this information
    from the arrestees in the lockups during part of our
    quarterly----
        Mr. Ose. Is the quality of the information gleaned from
    ADAM high quality, low quality, medium quality? How would you
    characterize it?
        Ms. Samuels. I hope it is high quality. I think we have put
    into place a number of checks to ensure that we are conducting
    the interviews using a consistent instrument across the
    country, to ensure that the drug tests that are taken are sent
    to a central laboratory so they are all analyzed under the same
    set of circumstances, and over time we are also working to
    improve the methodology to ensure that the information that we
    get from a particular county is in fact representative of that
    county.
        Mr. Ose. The 35 communities in which ADAM is currently at
    work, were they statistically selected or did you just pull
    them out of a hat? Do they reflect the country at large?
        Ms. Samuels. The 35 communities that are involved now
    evolved from an earlier part of this program. We had a program
    that was called the Drug Use Forecasting Program that goes back
    more than a decade. We were testing the question as to whether
    or not drug use testing could inform us about drug use among
    arrestees, and from there we have expanded to a number of other
    cities. Currently the program is not and cannot provide a
    national representative estimate of drug use among arrestees,
    but we do have a vision and a plan for expanding to 75 cities,
    and as part of that plan we would be able to provide
    representative and statistically valid data on the drug use in
    the arrestee population as a whole.
        Mr. Ose. That is exactly where I want to focus my question,
    so I appreciate you getting to that. That was not set up, Mr.
    Chairman, but that just happened.
        On page 3 of your testimony, you say ADAM is the only
    national drug survey that routinely provides data on hard-core
    drug users. Then in the last paragraph, you say ADAM is the
    only national drug data system that includes a routine drug
    test as part of the data collection. I presume by your
    inclusion of that specific statement you are trying to
    differentiate ADAM as a scientifically quantifiable survey as
    opposed to one that might just be verbal?
        Ms. Samuels. I think what we are trying to show is that
    there are two parts of it. There is the interview that is
    supplemented by the drug test, so we will ask the arrestee, Are
    you using drugs? What types of drugs are you using? And by
    getting the results of the drug test, we can validate and look
    at the answers that they have provided to us.
        Mr. Ose. Do you find a higher validity in the responses on
    the verbal side from those who know that they are going to have
    their urine or hair samples taken as opposed to those that
    don't? Dr. Johnston, you are kind of smiling.
        Mr. Johnston. That is a reasonable question. I was smiling
    because of what it says about human motivation. But the--I
    don't know whether ADAM has tested that. I know in the
    cigarette research literature, it has been found that if kids
    know that they are going to have saliva tests, they report
    higher rates of smoking, but it is not a consistent finding. It
    is depends on the situation that kids are presented with.
        Mr. Ose. In California we have this Proposition 36 that
    purports to be something to address an inadequacy in our drug
    treatment and drug programs, but the actual initiative
    eliminates the opportunity to perform a urine or drug test. And
    it just seems to me that why would you put into law, in an
    actual referendum that is going to be the law of the State, why
    would you put into that position a preclusion, the inability to
    actually hold someone accountable for their actions so that you
    can get the truth? Our objective here is to provide treatment
    for people. Yet, we are going to put into law or at least
    control--what is the phrase, controlling legal authority--an
    inability to hold them accountable for what they tell us.
        I was reading your testimony, and I can't say that it is in
    here explicitly, but implicitly at least in your testimony,
    that you have to have some means of verifying what you collect
    verbally, and that drug testing urine, blood, hair, is the most
    effective way of doing that.
        I didn't set this up, Mr. Chairman, but it is absolutely so
    precisely targeted on the basic dilemma we face in California
    that I would have flown on three red-eyes, 3 days in a row,
    just to get that in the public record, and I appreciate Ms.
    Samuels doing that.
        Who was it that testified on the Centers for Disease--Dr.
    Raub. You indicated that use levels had flattened or leveled
    and in some cases improved. I am a little bit confused about
    something. I have a copy of the basic data from the Center for
    Disease Control study, and it talks about risk behaviors that
    worsened; and it has got tobacco use frequently, alcohol and
    other drug use, episodic, current, sexual behaviors and the
    like, and it goes from 1991 to 1997 following the 2-year
    implement pattern that Dr. Vereen mentioned. It indicates to me
    that over the five tests that would have been occurring in the
    1990's, that being 1991, 1993, 1995, 1997, and 1999, lifetime
    marijuana use has gone from a risk factor of--I have to make
    sure that I understand this--31.3 to a comparative 47.2 in
    1999. Is that percent? I can't tell if that is percent. It is a
    50 percent increase over an 8 or 9-year period. Current cocaine
    use has gone from a risk behavior rating of 1.7 in 1991 to 4 in
    1999, which is basically a 100 percent increase. Frequent
    cigarette use has gone from a risk behavior rating of 12.7 in
    1991 to 16.8 in 1999.
        If you look at trends, which I believe is what we are
    looking at here, either in that chart or most any others that
    we have seen here, the trend is not positive. The trend is
    showing an increase in the risk behaviors, at least as it
    relates to this chart, and I am wondering whether that
    corresponds to a decline in usage that is indicated in your
    testimony?
        Mr. Raub. On that specific line, sir, I would not
    characterize it as decline in usage. Compared to 1991, there is
    an increase. Compared to 1997, there is a leveling.
        Mr. Ose. I would agree on a comparative basis.
        Mr. Raub. But we need additional years of evidence to
    determine whether we have turned a corner or whether that is
    just a momentary pause.
        Mr. Ose. I am trying to deal with the trend. I am hoping
    that it is not a momentary pause and that it is the peak, so
    that it goes down. And that is as it relates to the marijuana
    use, the 47.1 to the 47.2 risk behavior rating; but in current
    cocaine use, it goes from 3.3 to 4, which is a 25 percent
    increase.
        Mr. Raub. Right.
        Mr. Ose. Now, I am not here to argue about the other
    things, but whether you take it in segmented markets, depending
    on what designer drug of the day we are talking about, or
    otherwise, while there may be some indication from 1997 to 1999
    as it relates to lifetime marijuana use that there is a
    leveling, I don't see the indication that there is a trend here
    that has been set of a leveling. And that is what I am trying
    to get at: whether or not these risk behaviors that are
    highlighted here indicate usage patterns.
        If I understand your testimony correctly, it is that as it
    relates to lifetime marijuana use, as it relates to these
    numbers, there seems to be a leveling from 1997 to 1999; but
    that the trend from 1991 to 1999 indicates significant
    increases?
        Mr. Raub. That is the way that I interpret it, yes, sir.
    And it is a pattern that is consistent in the trend in the
    other two surveys.
        Mr. Ose. The 1997 to 1999 change, or the 1991 to 1999?
        Mr. Raub. The recent year change. Depending when they do
    the measurement, the last few years have changed in the other
    surveys and are showing in general a leveling or a slight
    decline, but we are showing an increase compared to the early
    1990's.
        Mr. Ose. Can you explore with me a little bit, it is
    interesting to me that the difference between lifetime risk
    behavior reports and current risk behavior reports. For
    instance, in 1997, the risk behavior report here for lifetime
    marijuana use indicated a reporting level of 47.1, and in 1999
    it indicated a reporting level of 47.2. That would suggest to
    me that the same people who had reported a lifetime marijuana
    use in 1997 basically reported it also in 1999? I mean if they
    used it by the time they got to 1997, they would have used it
    by the time they got to 1999 on a lifetime basis. But if you go
    to the current report on cocaine use, which I guess would stand
    for one or more times during the 30 days preceding the survey,
    in 1997 you had a risk behavior rating of 3.3, and in 1999 you
    had a risk behavior rating of 4, which going back to my earlier
    comments indicates a 25 percent increase in the usage of one or
    more times during the 30 days preceding the survey.
        So I am a little bit confused on the difference between
    lifetime and current usage and how it can get analyzed for
    those of us who are responsible for making policy so we can
    keep kids like this from, frankly, suffering what we don't want
    them to suffer.
        Mr. Raub. I think that is one that we might best submit for
    the record with detailed explanation of how the various terms
    are used.
        Mr. Ose. I appreciate that. That would be helpful.
        Mr. Mica. Just in conclusion, we have again what I consider
    the attempt to put a happy face on this situation. Both Mrs.
    Mink and I am dismayed by what we have heard today. The death
    statistics are frightening and that is 1998. We haven't seen
    1999. I see no reason why there would be any change in the
    trend that we have seen at least from deaths. This chart that
    was brought in by ONDCP doesn't show the 18-to-25, which put
    another dramatic rise there. There is only one statistic that
    shows any possible trend and possible decline or leveling out
    of what is going on. All three of the top three measures
    include, and if we take the fourth measure, it also shows a
    scary little turn for the worse. So 1 year does not a trend
    make, and we are concerned with the overall picture, which
    again is pretty glum, combined with the new phenomenon of drug-
    induced deaths that we see reported here today. I guess that
    really isn't a question, it is more of a statement.
        We would also appreciate if there is something the
    subcommittee could do in making certain that we properly
    address the evaluation and statistics-gathering to make these
    trends and this information more accurate. We would appreciate
    working with each of you in that regard, and we welcome your
    suggestions and recommendations in that vein.
        Mr. Ose.
        Mr. Ose. Thank you, Mr. Chairman. I have collected my
    thoughts. I want to go back to something. Dr. Vereen, I am a
    little bit confused on the statistical sample that was used to
    report the improvement in drug use over the last 3 years. I
    have in my possession here the 1998, 1999, and 2000 annual
    reports on the National Drug Control Strategy Performance
    Measures of Effectiveness. While I am looking for this article
    that I read which I seem to have misplaced, the question arises
    as to whether or not the sample on which the performance
    measurement or the performance metrics were based is 12th grade
    usage or 8th grade usage.
        If I understand correctly, from the years leading up to
    1999 and included in the 1999 annual report, the performance
    metric was the 12th grade usage, and in the current year the
    performance metrics is the 8th grade level usage. My question
    obviously arises, is that apples versus apples or apples versus
    oranges? And I would appreciate any input you might have on
    that.
        Dr. Vereen. It is apples and apples or apples versus
    oranges depending on the question that is being asked in
    general. I brought along the expert, Dr. Zobeck, to explain
    some of the technical reasons why that was changed. It depends
    on what age group you are looking at and what program we
    administer. So, for example, in our media campaign, we want to
    know what is happening with the youngest set. When we are
    talking about overall drug trends for the Nation, which we are
    required to report every year in February, we use the higher
    numbers. But I will let Dr. Zobeck run through the details.
        Mr. Zobeck. The article and the issue that you refer to
    relates to our Objective 2 under Goal 1 of the PME, which deals
    with implementing a media campaign as a prevention tool for
    youth.
        About this time last year when we were beginning to prepare
    the report, we did our review of the various measures. I also
    worked closely with our media campaign people. I oversee the
    evaluation there. And I said, based on the refinements to the
    media campaign, where they decided that the primary focus of
    the campaign would be on what they call ``tweens,'' 11 to 13-
    year-olds, I said that the better measure for seeing if that
    has any impact would be using the 8th grade sample rather than
    the 12th grade sample. If you are looking for the most
    immediate impact of the program, which would be the media
    campaign, that would be the most direct measure. So I made the
    recommendation that we switch it from 12th to 8th graders.
        Mr. Ose. If it had stayed at 12th graders, what would have
    been the results?
        Mr. Zobeck. I think you would have had a similar picture.
    Let me go back. The issue that the article made was that by
    changing it to 8th graders, it made it look like we were
    accomplishing things. There was a misunderstanding in the
    article. The chart that came in question was our Progress at a
    Glance chart, if I can find it here.
        This chart on page B-4 was designed to give the reader a
    quick idea based on a color-coding scheme as to whether we were
    making progress, not making progress, or had no data to assess
    it. That is on page B-4.
        Mr. Ose. It looks like a health care plan to me.
        Mr. Zobeck. It is a very complicated system dealing with
    100 measures. However, you notice up here it says, This
    progress is measured as of 1998 relative to 1996, and the
    increase or the change that the article focused on was the 1999
    data which is relevant to this chart, the 1998 data.
        The baseline for the media campaign was 1998 so we actually
    only had 1 year of data. So we coded this green because we had
    the data and it was right on target.
        If you go back to page E-4, I believe it is--no, page E-
    10, you have the chart for that specific measure. And you see
    1998, the red line here is what we call our glide path, where
    we want to be by 2002 and 2007, our two targets. You can see
    that the 1999 data reported it because we had--it was at 73.3
    percent, which is below the glide path. However, that red and
    green chart is not reflecting that data year, it is reflecting
    the 1998 one.
        This coming report, we already know that is going to be a
    red color on there because we know we are low, below the glide
    path. If we had stayed with 12th graders, it would have been
    the same result. It would have been green for 1998 because that
    is the baseline year; but the 12th graders, also in 1999, would
    have been below the glide path. So for the next year's report,
    that is going to be red--either one.
        Mr. Ose. Just to satisfy my curiosity as to whether or not
    we are getting the straight scoop, are you saying that the
    results on page E-10, whether you use 8th or 12th graders as
    the proxy, would have been the same?
        Mr. Zobeck. The 12th graders would have had a lower
    perception of risk, so they would have been--it would have been
    lower, so I guess it would have been a worse case.
        Mr. Ose. That would have put them below the glide path?
        Mr. Zobeck. Below the glide path. You want to increase
    their perception of risk rather than decrease it.
        Mr. Ose. So the 8th graders perceive a higher level of risk
    in marijuana use than 12th graders?
        Mr. Zobeck. A slightly higher.
        Mr. Ose. So using the 8th grade cohort would have improved
    the results of the report?
        Mr. Zobeck. They still would have been below the glide
    path. They wouldn't have changed the color code.
        Mr. Ose. If you project that out a couple, 3, 4 years to
    the dates on which the program is supposed to adhere to certain
    goals, do you get there using the 12th grade cohort or the 8th
    grade cohort, or both?
        Mr. Zobeck. We could get there using both. We have a
    separate evaluation of the media campaign to track this very
    closely, very specifically. This is really a very broad-brush
    way--indicator. It is just one specific variable perception of
    risk of using marijuana regularly. Our in-depth evaluation is
    looking at hundreds of different variables and the complex
    relationship between them. Risk itself is not the most--it
    doesn't explain all of the variations that you are going to
    get.
        Mr. Ose. Prior to the decision to use the 8th grade cohort,
    was there a discussion amongst the people who had the
    responsibility for selecting which cohort to be used and as to
    what its ultimate appearance would be in these reports?
        Mr. Zobeck. At the time we had the discussion, we didn't
    have the 1999 data. We didn't know where it was going to go. It
    was based solely on my recommendation that 8th graders are a
    better source to track the effectiveness of the media campaign
    than 12th graders.
        Mr. Ose. So if we change the media campaign, we may very
    well need to change the cohort that we look at in future years?
        Mr. Zobeck. If we change the media campaign to aim at older
    individuals, yes.
        Mr. Ose. I will say that I can imagine our interest in this
    issue in terms of changing the cohort from the 12th to 8th
    grade sample without having been advised accordingly, because I
    can tell you that the members of this panel travel to a lot of
    different districts, for obvious reason.
        My final question, Mr. Chairman, if I may: What steps are
    you taking so that in the future when the cohorts get changed,
    you advise the appropriate congressional committee of such
    changes?
        Mr. Zobeck. We are going to include a section in the PME
    report that says ``Changes.'' For this one, we just viewed this
    as a technical change rather than a change to any of the goals,
    objective or targets. We changed a measure. We made a call
    thinking, well, this is a minor technical thing; we are not
    going to report it. We realize that we should have, and in the
    next report there will be a section of any changes to this
    report.
        Mr. Ose. Thank you, Mr. Chairman.
        Mr. Mica. I thank the gentleman. We do have a vote that has
    been called, and it looks like possibly a series of votes. I
    don't have any further questions of the panelists at this time.
    We may submit in writing some additional questions for you to
    respond to.
        We appreciate your participation in our hearing today and
    your willingness to work with us to try to find some answers to
    some pretty difficult questions and bring what we see as a very
    serious situation under control.
        There being no further business to come before the
    subcommittee at this time, this meeting is adjourned.
        [Whereupon, at 12:21 p.m., the subcommittee was adjourned.]
        [Additional information submitted for the hearing record
    follows:]

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