[Congressional Record Volume 144, Number 54 (Tuesday, May 5, 1998)]
[Senate]
[Pages S4376-S4377]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      CHEECH AND CHONG DRUG POLICY

  Mr. GRASSLEY. Mr. President, I spent much of the recent recess 
talking to constituents in my state about drug problems. It is clear to 
me after a field hearing, numerous town meetings, and many 
conversations that the public is deeply concerned about the drug issue. 
This impression is confirmed by recent pools. Again and again, the 
public have indicted an abiding concern about the presence of drugs in 
our society. Parents, community leaders, and young people have 
repeatedly indicated that the availability and use of illegal drugs is 
among the most important issues affecting them. They expect the 
government to help them in fighting back. They expect our policies and 
programs to support community efforts to keep drugs off the streets, 
out of our schools, and away from our kids. But what do they find?
  I am sorry to say that the Clinton Administration is simply not 
making a convincing case that it is serious about the war on drugs. If 
I had doubts about this before, events of the last several days have 
removed them. I learned during recess that the Administration was 
planning to endorse needle exchange programs. I found it hard to 
believe that this could be true, but I learned otherwise. Indeed, on 20 
April, Donna Shalala, the HHS Secretary, issued a statement saying that 
needle exchange programs were a good thing. That they stopped the 
spread of AIDS and did not encourage drug use. She encouraged 
communities to embark on programs giving needles to drug addicts. She 
did not go so far as to say that the Administration would back up this 
determination with federal dollars--a small blessing. But she has now 
put the authority of the Administration behind this idea. Exactly what 
is this idea? It is startling simple: The Administration has announced 
that it will now facilitate and promote others to facilitate making 
drug paraphernalia available to drug addicts in our communities.
  It will now use the voice of the Federal Government to facilitate 
drug use. What next, handing out the drugs themselves to addicts?
  This is voodoo science backing up Cheech and Chong drug policy. It is 
making the federal government a Head Shop.
  How does the Administration justify such a decision? It hides its 
move behind junk science. Secretary Shalala's argument is ``The science 
made me do it.'' At best, this is a half-truth. While there is science, 
of a sort, that claims that needle exchange programs work, there is no 
consensus science that establishes this as remotely the case. Still, we 
are being asked to endorse this vast experiment on the public based on 
a trust-me argument. This is not acceptable. It is irresponsible and 
risky.
  In order to understand what is at issue here, let me start at the 
beginning. One of the most effective delivery systems for illegal drugs 
is intravenous injection using needles. This is one of the most common 
methods for taking heroin and it also can be used in taking cocaine and 
methamphetamine. The addict uses injection because it means getting 
high quicker. The whole purpose of using needles is to facilitate drug 
use. Major addiction, which is risky business all by itself, also often 
leads to other, destructive behaviors. One of these is sharing the 
needles used for injection.
  Basically, what this means is that a number of addicts pass around or 
get together and share the same needle for numerous injections. In the 
age of AIDS, this means that if any of the sharing addicts has HIV or 
AIDS, anyone who shares the needle is at great risk of infection. Now, 
addicts already know this. It is not a secret. There are also quick and 
easy ways to disinfect these needles. Addicts know these too. They are 
not secrets here either.
  Despite this, addicts often don't bother with these easy steps. They 
don't bother even though they can do them with commonly available 
disinfectants in the comfort of their own preferred environment for 
injecting. Addicts are not the most rational of people when it comes to 
life decisions. Their lives are built around and based upon upon risky 
behavior. Our decisions on policy, however, should not be so cavalier.
  Now we come to the logic of needle exchange. The argument is, that a 
significant, or overwhelming proportion of HIV-positive cases are the 
result of using infected needles shared among addicts. Arriving at this 
conclusion, the next step in the logic is that stopping the use of 
infected needles will stop the spread of HIV and AIDS. Having reached 
this point, the next step is to argue that we must, therefore, keep 
addicts for sharing dirty needles. And now, in this breathless chain of 
argument, we arrive at this conclusion: To ensure that drug-using 
addicts only use safe needles, we, that is the government using public 
money or some similar deep-pocket institution, must hand out clean 
needles to addicts on demand.
  This is what the Secretary of Health and Human Services has now 
endorsed. But there is more to this story.
  Let us start again at the beginning. Drug addicts, particularly 
heroin users, depend upon syringes as the best vehicle for 
administering their drug of choice. This means that, for addicts, 
needles are essential drug paraphernalia. Just like crack pipes or 
other devices used to administer the drug, needles are part of the 
necessary equipment.
  During our last drug epidemic, one of the things that we learned we 
needed to do was to close the many ``Head Shops'' that specialized in 
selling drug equipment. We realized that pushing drug paraphernalia, 
making the equipment for drug use readily available, fostered drug use. 
It encouraged a climate of use. It was an indirect way for advertising 
drug use. Most states passed laws to prohibit the sale of drug 
paraphernalia.
  Many States included needles as part of this. Doing so was one of the 
things that helped us stop the drug epidemic. It helped us establish 
with kids that consistent no-use message that is essential if we are to 
keep drugs off our streets and out of our schools. Now, enter needle 
exchange.
  The Congress and most of the public have long opposed needle 
exchange. This is not because anybody wants to promote the spread of 
AIDS. Let's get that canard out of the way right up front. The concern 
is for whether or not handing out drug paraphernalia promotes drug use. 
Our past experience says yes, so it is a reasonable assumption that 
doing so in the present will cause a similar problem. Hence the 
opposition in many quarters to handing out needles. Thus, also part two 
of Secretary Shalala's announcement: Her claim that not only do needle 
exchanges stop AIDS, handing out needles will not, in her view, 
encourage drug use. Really?
  Just how do we know this? Just how do we know that handing our 
needles will also stop AIDS? The short answer is, we do not know any 
such thing.

[[Page S4377]]

  The response from HHS, from an anonymous source I might add, and from 
AIDS activists is that the science tells us so. As proof they quote in 
the HHS press release from Dr. Harold Varmus, Director of the National 
Institutes of Health, to the effect that needle exchanges can help. 
Well, so can chicken soup, but this is not the issue and is not what 
the law calls for.
  Being concerned about issues of public policy and public health, the 
Congress has been concerned not to be stampeded into irresponsible 
policies.
  In this light, it included specific guidance in law on using public 
money or government support for needle exchange. The intent was fairly 
clear: No money, no support. Full stop. It did provide for an exception 
if the science conclusively showed that needle exchange programs 
stopped AIDS and did not encourage use. That is a fairly high standard. 
And it should be. Otherwise, what we are doing is experimenting on the 
public, betting on a hope that things will turn out right. This may be 
a good strategy at the race track or at the roulette table, but it has 
no place in major policy.
  Yet, this casino mentality is what the Secretary of HHS has now 
proclaimed. And she is gambling with the public health. Secretary 
Shalala has announced that, ``a meticulous scientific review has now 
proven that needle exchange programs can reduce the transmission of HIV 
* * * without losing ground in the battle against illegal drugs.''
  In doing this, the chief health official of the country has endorsed 
a policy that is reckless and irresponsible. And she has done so on 
claims about scientific support for her position that is, at best, 
inconclusive. At the worst, science contradicts her arguments flatly. 
In either case, this is poor ground upon which to base such a 
significant change in public policy.
  As Dr. James Curtis notes in an oped piece in the New York Times of 
23 April, the idea of handing out needles to stop AIDS is ``simplistic 
nonsense that stands common sense on its head.'' Dr. Curtis, a 
professor of psychiatry at Colombia University and the director of 
psychiatry at Harlem Hospital, goes further. ``For the past 10 years,'' 
he writes, ``as a black psychiatrist specializing in addiction, I have 
warned about the dangers of needle-exchange policies, which hurt not 
only individual addicts but also poor and minority communities.''
  The lack or contradictory nature of the science referred to by 
Secretary Shalala is also laid bare by Dr. David Murray of the 
Statistical Assessment Service. In an oped in the Wall Street Journal 
of 22 April, he notes just how thin the science is and yet how 
activists try to skip over this fact.
  Even the drug czar opposed this decision. Thus, there is not even 
consensus within the administration on this policy. The reason for this 
lack of agreement is based on the fact that the science is not there to 
support the position. And the law is clear. It does not say the science 
must show that such programs ``might reduce'', or ``can reduce''. What 
it says is the science must show that they in fact do reduce AIDS and 
do not increase the chances for promoting illegal drug use. Even 
Secretary Shalala's press release hedges this with a ``can reduce'' 
comment.
  The only bright spot in the Secretary's announcement, and that light 
is a pretty dim bulb, is that no federal money will be used to support 
this policy. But this is a dodge. Even the advocates for exchange 
programs recognize it as such. This statement puts the authority of the 
administration behind this program. It does so on the thinnest of 
evidence.
  In my view, this decision is outrageous. I call upon Mr. Clinton to 
retract it. Whatever the outcome, it is clear that this administration 
simply doesn't get it when it comes to drug policy.
  Mr. AKAKA addressed the Chair.
  The PRESIDING OFFICER. The Senator from Hawaii, Mr. Akaka, is 
recognized.

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