[Congressional Record Volume 141, Number 26 (Thursday, February 9, 1995)]
[Senate]
[Pages S2423-S2425]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                           IT'S DRUGS, STUPID

 Mr. SIMON. Mr. President, one of the finest public servants in 
my years in Congress was Joseph Califano, who headed what was then 
known as Health, Education and Welfare for President Carter. He wrote a 
story in the Sunday New York Times on the drug problem that makes 
eminent good sense.
  Recently, the Chicago Sun-Times had a front-page story saying that 95 
percent of those who apply for drug treatment are being turned down. I 
visited Cook County jail with 9,000 inmates. In a minimum security 
barracks, with about 45 men sleeping on cots, one of the prisoners told 
me he wanted to get into drug treatment. I turned to the assistant 
warden who was with me and asked why he could not get in, and the 
warden said they had only 120 spots for drug treatment for 9,000 
prisoners. I turned to the rest of the men and asked how many of them 
would like to get into drug treatment and about 30 raised their hands.
  Our failure to provide drug treatment for people who need it is 
short-sighted. We demagog on the crime issue and pretend we are really 
doing something when we create 60 new causes for capital punishment and 
set more mandatory minmums. The reality is, we are 
[[Page S2424]]  doing nothing through those things to reduce the crime 
rate.
  Senator Kennedy uses the figure that 75 percent of those who do 
receive drug treatment while in prison do not come back, and 75 percent 
of those who do not, do come back. I don't know if those statistics are 
precisely accurate, but the general principle is clearly accurate. I am 
grateful to Joe Califano for providing sensible leadership once more.
  At this point, I ask that his statement be printed in the Record.
  The statement follows:
                [From the New York Times, Jan. 29, 1995]

                           It's Drugs, Stupid

                          (By Joseph Califano)

       Despite all the Republican preening and Democratic pouting 
     since Nov. 8, neither political party gets it. If Speaker 
     Newt Gingrich is serious about delivering results from his 
     party's ``Contract With America'' and if President clinton 
     means to revive his Presidency, each can start by recognizing 
     how fundamentally drugs have changed society's problems and 
     that together they can transform Government's response.
       For 30 years, America has tried to curb crime with more 
     judges, tougher punishments and bigger prisons. We have tried 
     to rein in health costs by manipulating payments to doctors 
     and hospitals. We've fought poverty with welfare systems that 
     offer little incentive to work. All the while, we have 
     undermined these efforts with our personal and national 
     denial about the sinister dimension drug abuse and addition 
     have added to our society. If Gingrich and Clinton want to 
     prove to us that they can make a difference in what really 
     ails America, they should ``get real'' about how drugs have 
     recast three of the nation's biggest challenges.
       Law, Order and Justice--In 1960 there were fewer than 
     30,000 arrests for drug offenses; in 30 years, that number 
     soared beyond one million. Since 1989, more individuals have 
     been incarcerated for drug offenses than for all violent 
     crimes--and most violent crimes are committed by drug 
     (including alcohol) abusers.
       Probation and parole are sick jokes in most cities. As 
     essential first steps to rehabilitation, many parolees need 
     drug treatment and after-care, which means far more 
     monitoring than their drug-free predecessors of a generation 
     ago required, not less. Yet in Los Angeles, for example, 
     probation officers are expected to handle as many as 1,000 
     cases at a time. With most offenders committing drug- or 
     alcohol-related crimes, it's no wonder so many parolees go 
     right back to jail: 80 percent of prisoners have prior 
     convictions and more than 60 percent have served time before.
       Congress and state legislatures keep passing laws more 
     relevant to the celluloid gangsters and inmates of classic 
     1930's movies than 1990's reality. Today's prisons are wall 
     to wall with drug dealers, addicts, alcohol abusers and the 
     mentally ill (often related to drug abuse). The prison 
     population shot past a million in 1994 and is likely to 
     double soon
      after the year 2000. Among industrialized nations, the 
     United States is second only to Russia in the number of 
     its citizens it imprisons: 519 per 100,000, compared with 
     368 for next-place South Africa, 116 for Canada and 36 for 
     Japan.
       Judges and prosecutors are demoralized as they juggle 
     caseloads of more than twice the recommended maximum. In 1991 
     eight states had to close their civil jury trial systems for 
     all or part of the year to comply with speedy trial 
     requirements of criminal cases involving drug abusers. Even 
     where civil courts remain open, the rush of drug-related 
     cases has created intolerable delays--4 years in Newark, 5 in 
     Philadelphia and up to 10 in Cook County, Ill. In our 
     impersonal, bureaucratic world, if society keeps denying 
     citizens timely, individual hearings for their grievances, 
     they may blow off angry steam in destructive ways.
       Health Care Cost Containment.--Emergency rooms from Boston 
     to Baton Rouge are piled high with the debris of drug use on 
     city streets--victims of gunshot wounds, drug-promoted child 
     and spouse abuse, and drug-related medical conditions like 
     cardiac complications and sexually transmitted diseases. AIDS 
     and tuberculosis have spread rapidly in large part because of 
     drug use. Beyond dirty needles, studies show that teen-agers 
     high on pot, alcohol or other drugs are far more likely to 
     have sex, and to have it without a condom.
       Each year drugs and alcohol trigger up to $75 billion in 
     health care costs. The cruelest impact afflicts the half-
     million newborns exposed to drugs during pregnancy. Crack 
     babies, a rarity a decade ago, crowd $2,000-a-day neonatal 
     wards. Many die. It can cost $1 million to bring each 
     survivor to adulthood.
       Even where prenatal care is available--as it is for most 
     Medicaid beneficiaries--women on drugs tend not to take 
     advantage of it. And as for drug treatment, only a relatively 
     small percentage of drug-abusing pregnant mothers seek it, 
     and they must often wait in line for scarce slots. Pregnant 
     mothers' failure to seek prenatal care and stop abusing drugs 
     accounts for much of the almost $3 billion that Medicaid 
     spent in 1994 on impatient hospital care related to drug use.
       The Fight Against Poverty.--Drugs have changed the nature 
     of poverty. Nowhere is this more glaring than in the welfare 
     systems and the persistent problem of teen-age pregnancy.
       Speaker Gingrich and President Clinton are hell-bent to put 
     welfare mothers to work. But all the financial lures and 
     prods and all the job training in the world will do precious 
     little to make employable the hundreds of thousands of 
     welfare recipients who are addicts and abusers.
       For too long, reformers have had their heads in the sand 
     about this unpleasant reality. Liberals fear that admitting 
     the extent of alcohol and drug abuse among welfare recipients 
     will incite even more punitive reactions than those now 
     fashionable. Conservatives don't want to face up to the cost 
     of drug treatment. This political denial assures failure of 
     any effort to put these welfare recipients to work.
       The future is not legalization. Legalizing drug use would 
     write off millions of minority Americans, especially children 
     and drug-exposed babies, whose communities are most under 
     siege by drugs. It has not worked in any nation where it's 
     been tried, and our own experience with alcohol and 
     cigarettes shows how unlikely we are to keep legalized drugs 
     away from children.
       Drugs are the greatest threat to family stability, decent 
     housing, public schools and even minimal social amenities in 
     urban ghettos. Contrary to the claim of pot proponents, 
     marijuana is dangerous. It devastates short-term memory and 
     the ability to concentrate precisely when our children need 
     them most--when they are in school. And a child 12 to 17 
     years old who smokes pot is 85 times as likely to use cocaine 
     as a child who does not. Cocaine is much more addictive than 
     alcohol, which has already hooked more than 18 million 
     Americans. Dr. Herbert D. Kleber, a top drug expert, 
     estimates that legalizing cocaine would give us at least 20 
     million addicts, more than 10 times the number today.
       It's especially reckless to promote legalization when we 
     have not committed research funds and energies to addiction 
     prevention and treatment on a scale commensurate with the 
     epidemic. The National Institutes of Health spend some $4 
     billion for research on cancer, cardiovascular disease and 
     AIDS, but less than 15 percent of that amount for research on 
     substance abuse and addiction, the largest single cause and 
     exacerbator of those diseases.
       Treatment varies widely, from inpatient to outpatient, from 
     quick-fix acupuncture to residential programs ranging a few 
     weeks to more than a year, from methadone dependence to drug-
     free therapeutic communities. Fewer than 25 percent of the 
     individuals who need drug or alcohol treatment enter a 
     program. On average, a quarter complete treatment; half of 
     them are drug- or alcohol-free a year later. In other words, 
     with wide variations depending on individual circumstances, 
     those entering programs have a one-in-eight chance of being 
     free of drugs or alcohol a year later. Those odds beat many 
     for long-shot cancer chemotherapies, and research should 
     significantly improve them. But a recent
      study in California found that even at current rates of 
     success, $1 invested in treatment saves $7 in crime, 
     health care and welfare costs.
       Here are a few suggestions for immediate action to attack 
     the dimension drugs have added to these three problems:
       Grant Federal funds to state and Federal prison systems 
     only if they provide drug and alcohol treatment and after-
     care for all inmates who need it.
       Instead of across-the-board mandatory sentences, keep 
     inmates with drug and alcohol problems in jails, boot camps 
     or halfway houses until they experience a year of sobriety 
     after treatment.
       Require drug and alcohol addicts to go regularly to 
     treatment and after-care programs like Alcoholics Anonymous 
     while on parole or probation.
       Provide Federal funds for police only to cities that 
     enforce drug laws throughout their jurisdiction. End the 
     acceptance of drug bazaars in Harlem and southeast Washington 
     that would not be tolerated on Manhattan's Upper East Side or 
     in Georgetown.
       Encourage judges with lots of drug cases to employ public 
     health professionals, just as they hire economists to assist 
     with antitrust cases.
       Cut off welfare payments to drug addicts and alcoholics who 
     refuse to seek treatment and pursue after-care. As employers 
     and health professionals know, addicts need lots of carrots 
     and sticks, including the treat of loss of job and income, to 
     get the monkey off their back.
       Put children of drug- or alcohol-addicted welfare mothers 
     who refuse treatment into foster care or orphanages. Speaker 
     Gingrich and First Lady Hillary Rodham Clinton have done the 
     nation a disservice by playing all-or-nothing politics with 
     this issue. The compassionate and cost-effective middle 
     ground is to identify those parents who abuse their children 
     by their own drug and alcohol abuse and place those children 
     in decent orphanages and foster care until the parents shape 
     up.
       Subject inmates, parolees and welfare recipients with a 
     history of substance abuse to random drug tests, and fund the 
     treatment they need. Liberals must recognize that getting off 
     drugs is the only chance these individuals (and their babies) 
     have to enjoy their civil rights. Conservatives who preach an 
     end to criminal recidivism and welfare dependency must 
     recognize that reincarceration and removal from the welfare 
     rolls for those who test positive is a cruel Catch-22 unless 
     treatment is available.
       [[Page S2425]] Fortunately, the new Congress and the new 
     Clinton are certain not to legalize drugs. Unfortunately, it 
     is less clear whether they will recognize the nasty new stain 
     of intractability that drugs have added to crime, health 
     costs and welfare dependency, and go on to tap the potential 
     of research, prevention and treatment to save billions of 
     dollars and millions of lives.
       If a mainstream disease like diabetes or cancer affected as 
     many individuals and families as drug and alcohol abuse and 
     addiction do, this nation would mount an effort on the scale 
     of the Manhattan Project to deal with it.
     

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