[Congressional Record Volume 148, Number 130 (Monday, October 7, 2002)]
[Senate]
[Pages S10034-S10035]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
21ST CENTURY DEPARTMENT OF JUSTICE APPROPRIATIONS AUTHORIZATION ACT
Mr. BIDEN. Mr. President, I rise today to call attention to Section
2202 of the 21st Century Department of Justice Appropriations
Authorization Act which directs the President--in consultation with the
Attorney General, the Secretary of Health and Human Services and the
Secretary of Education--to review all Federal drug and
[[Page S10035]]
substance abuse treatment, prevention, education and research programs
and make recommendations about how to ``streamline, consolidate,
coordinate, simplify, and more effectively conduct and deliver'' these
services.
Mr. HATCH. I understand that this provision is intended to allow the
administration to assess current treatment, prevention, education and
research programs. The conference report directs the President to
conduct the study. The President's logical choice to conduct this study
would be Drug Czar John Walters, the President's point person on the
drug issue, wouldn't you agree?
Mr. BIDEN. Yes, I would.
Mr. President, I want to make it clear that Section 2202 of the 21st
Century Department of Justice Appropriations Authorization Act was not
included because the Senate wants to cut substance abuse treatment,
prevention, education and research programs. After all, when the Senate
unanimously passed S. 304, the Drug Abuse Education, Prevention and
Treatment Act, which Senators Hatch, Leahy and I introduced, it went on
record supporting an increase in funding for demand reduction programs,
including providing treatment for some of the 3.9 million people in
this country who need it but are not receiving it. I know that the
President does not want to shrink these programs either. Recall that
when he announced Mr. Walters' nomination to be drug czar, he said that
``the most effective way to reduce the supply of drugs in America is to
reduce the demand for drugs in America'' and he pledged that his
administration ``will focus unprecedented attention on the demand side
of the problem.'' As I see it, the study is meant to assess current
programs in order to identify where there may be duplication of effort
and where we need to increase effort.
The belief that demand reduction programs are a valuable part of our
national drug policy needs to guide this report. That does not mean
that the authors should be afraid of recommending ways to deliver
services more efficiently or to suggest that there is duplication of
effort that needs to be streamlined. What it means is that the report
should not be interpreted as a directive from Congress to decrease the
level of effort dedicated to demand reduction.
Increasing access to treatment is critical. Drug addiction is a
chronic relapsing disease. And as with other chronic relapsing
diseases, such as diabetes, hypertension and asthma, there is no cure,
although a number of treatments can effectively control the disease.
According to the Journal of the American Medical Association, the rate
of adherence to treatment programs and relapse rates are similar for
drug addiction and other chronic diseases. That means that treatment
for addiction works just as well as treatment for other chronic
relapsing diseases. I hope these facts will be reflected in the drug
czar's report, particularly in terms of relapse. We should not be
skimping on the amount of time a patient spends in treatment because
someone thinks that would be more efficient. In truth, it would be less
efficient. Studies have shown that the longer a patient spends in
treatment the more likely that patient is to stay off drugs. But even
with the best treatment protocol, patients relapse. That does not mean
that treatment does not work, however.
Research is another area where returns on investment are not always
linear or predictable. But I believe that we need to be doing more
research on new forms of treatment, particularly when it comes to
developing new anti-addiction medications. In the last Congress, I
worked with Senators Levin and Hatch and former Senator Moynihan to
pass a law to allow qualified doctors to prescribe certain anti-
addiction medications from their offices rather than requiring patients
to pick them up at special clinics. The bill helps to move drug
treatment using anti-addiction medications into the medical mainstream.
And buprenorphine, the first medication that could be prescribed under
the system created by the bill, is expected to be approved any day now.
We need to develop additional medications for this new system to treat
cocaine and methamphetamine addiction as well as to curb the cravings
associated with addiction.
The last item that I would suggest that the drug czar keep in mind
when drafting his report is the importance of prevention, particularly
school-based prevention programs. After several years of a stable level
of drug use in the United States, this year drug use is up 11 percent
among 12 to 17-year-olds and 18 percent among 18 to 25-year-olds. It is
vital that we increase our current efforts at preventing drug use among
teens and young adults. After all, we know that if we can get a child
through age 21 without abusing drugs, they are unlikely ever to do so.
My goal is not to dictate what the drug czar writes in his report.
Rather, I want to make clear that when Congress directs that the drug
czar write a report on how to ``streamline, consolidate, coordinate,
simplify, and more effectively conduct and deliver'' Federal drug and
substance abuse treatment, prevention, education and research programs,
it does not mean that we are trying to minimize the importance of these
programs. We are merely looking for guidance on how they could be
delivered more effectively and more efficiently.
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