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Dissenting view of Reps. David Obey and Nancy Pelosi in House Committee Report 106-521 on H.R. 3908, March 14, 2000
DISSENTING VIEWS OF HON. NANCY PELOSI AND HON. DAVID OBEY

Along party lines, the Committee voted 23 31 (rollcall vote No. 2) in rejecting an amendment offered by Ms. Pelosi that would have invested $1.3 billion for domestic drug demand reduction services. This amount equals the amount included in this bill for international source-country cocaine supply reduction. The Pelosi amendment would have provided an additional $1,300,000,000 over four years for state and local substance abuse prevention and treatment services funded through the Substance Abuse and Mental Health Services Administration at the Department of Health and Human Services.

The Majority has included funds in this bill to support a ``comprehensive strategy to combat the flow of drugs from Colombia and the region into the United States.'' However, it is not a comprehensive strategy to reduce overall cocaine and other illegal drug consumption in the United States, which is the ultimate policy objective of our national war on drugs. By rejecting the Pelosi amendment, the Committee failed to recognize that our national drug control strategy must focus on demand reduction, as well as supply reduction--especially since a large portion of illegal drugs consumed in the United States is domestically produced.

Substance abuse is a critical and persistent public health problem facing the Nation's major cities and smallest communities. The impact of substance abuse on families, public safety, employment and productivity is deep and well documented. While drug treatment is proven to work, cities and towns still have waiting lists for treatment services. In fact, there is a large ``treatment gap'' identified by public surveys and acknowledged by the Office of National Drug Control Policy in its reports. Our public treatment systems are able to serve only 2.1 million out of an estimated 5.7 million people in need of treatment--leaving 3.6 million people in severe need of substance abuse treatment. As a result, people working to overcome their addictions cannot get into treatment. While Federal funding for these programs has increased in recent years, it has not come close to covering the need.

A Rand Corporation study on reducing cocaine consumption, sponsored by the U.S. Army and the Office of National Drug Control Policy, found that achieving a one percent reduction would cost $723 million for source-country control, or $366 million for interdiction, or $246 million for domestic enforcement, or $34 million for treatment. In other words, funds spent on domestic drug treatment were 23 times more effective than source-country control, 11 times more effective than interdiction, and 7 times more effective than law enforcement.

An even greater crisis awaits us if we fail to reach millions of today's youth experimenting with drugs or reaching a vulnerable age with effective substance abuse prevention services. Effective model prevention programs have been identified by the Substance Abuse and Mental Health Services Administration, the National Institute on Drug Abuse within the NIH, and other agencies. For every dollar invested in prevention, communities can save four to five dollars in costs for drug treatment and counseling; and estimated treatment needs are projected to increase by 57% by 2015 if current initiation rates continue without prevention intervention.

The Pelosi amendment would have provided treatment for an additional 303,000 addicted individuals and proven prevention services to an estimated 2.4 million youth. It would provide help to those who need it most, by establishing a priority for high-need populations such as youth, minority and rural communities, pregnant and postpartum women, and individuals who are homeless, at-risk for HIV infection, or have co-occurring mental illness and substance abuse disorders.

The amendment would have increased the Substance Abuse Prevention and Treatment Block Grant by $650,000 over the next years, and guaranteed that all states receive at least a 6.25% increase this year over the current allotments. An additional $650,000 would have been awarded competitively to local providers in three-year grants to implement or expand proven drugs treatment and prevention programs at the community level. Most of these funds would be dedicated to Targeted Capacity Expansion grants to boost local treatment capacity. Some of the additional funds, when combined with current funding, would also allow SAMHSA to support State Incentive Grants in all states to fill gaps and improve quality through the development of comprehensive, state-wide plans to coordinate all prevention services and funding streams within the state. A portion of the funds would also be competitively awarded to local providers under the research-based Knowledge Development and Application program to develop and test new strategies for providing opioid treatments for injection drug users, and support the existing Family Strengthening Initiative to provide parenting skills to high-risk parents such as those addicted to drugs whose children are at greater risk of substance abuse.

We are facing a true public health crisis in this country. Illicit drugs make their way into our communities, our schools, our places of work. While rates of drug use among teens have leveled off after a rapid increase since 1992, over half of all high schools seniors are still using illicit drugs; and rates among young adults age 18 25 have continued to rise. Regular abuse of illicit drugs is rising among certain minority populations. Drug use has increased 40% in the past five years among African-Americans and 17% among Hispanics. Substance abuse costs the nation about $246 billion a year. These figures do not even capture the lost potential, wrecked families and other human costs resulting from substance abuse.

While cocaine is a prevalent drug among adults, and deserving of special eradication efforts, it is worth noting that it is used far less frequently by our nation's youth than other drugs. Fifty percent of the nation's high school seniors have used marijuana, 15% have used inhalants, and 14% have used hallucinogens, while 10% have used cocaine and 5% have used crack. Even if were to succeed at reducing the foreign supply of drugs, drugs with rising popularity are often produced here at home. Cocaine consumption peaked in 1993 and has leveled off, while abuse of other drugs such as methamphetamines and marijuana has been rising. In many communities, methamphetamines have risen to epidemic proportions. According to the United States Drug Enforcement Agency, methamphetamines are rampant in the Western and Midwestern states. In 1998 in San Diego, California, one in every three arrestees tested positive for methamphetamines. Production and trafficking have risen in the Northeast and Southeast regions as well. The point of considering these usage statistics is that a balanced approach must take measure of the entirety of our national drug problems.

The Majority's refusal to support an equivalent increase for domestic drug abuse treatment and prevention ignores the reality that these are the most effective tools available to reduce the burden of drug abuse on our society. A five-year evaluation of SAMHSA substance abuse treatment services found treatment has significant and lasting benefits. Patients receiving treatment reported 50% decrease in drug and alcohol use 1 year after completing treatment, 53% decrease in alcohol/drug related medical visits, 43% decrease in criminal activity, 56% decrease in sexual encounters for money or drugs, 51% decrease in sexual encounters with an injection drug user, 43% decrease in homelessness, and a 19% increase in employment. A $1 investment in drug abuse prevention will likely save $15 in reduced health, justice, and other costs to society, according to a SAMHSA-sponsored study that used findings from the National Household Survey on Drug Abuse.

Stopping imported drugs like cocaine and heroin before they reach our borders is an important and difficult endeavor. But it is only a part of what is needed to prevent and control the human and economic cost of substance abuse. The Pelosi amendment would have addressed the abuse of all drugs, including those abused most by our nation's youth, with proven effective prevention and treatment services. The Majority's refusal to support this amendment means that, even if the Colombia strategy proves effective, we will continue to ignore the needs of millions of Americans and get far less return for our investment.

Nancy Pelosi.

Dave Obey.

As of March 17, 2000, this document is also available at ftp://ftp.loc.gov/pub/thomas/cp106/hr521.txt

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