[Congressional Record (Bound Edition), Volume 148 (2002), Part 14]
[Senate]
[Page 19235]
[From the U.S. 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 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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