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1 1 2 THE ASSOCIATION OF THE BAR OF THE CITY OF NEW YORK 3 ----------------------------------------------X 4 DRUG POLICY HEARINGS 5 ----------------------------------------------X 6 DATE: OCTOBER 11, 1995 7 TIME: 9 a.m. 8 9 Drug Policy Hearings, held at THE 10 ASSOCIATION OF THE BAR OF THE CITY OF NEW YORK, 42 11 West 44th Street, New York, New York before a 12 Notary Public of the State of New York. 13 14 15 16 17 18 19 20 21 22 23 24 25 DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 2 1 2 THE PANEL: 3 4 KATHY ROCKLEN, CHAIRPERSON 5 ELEANOR JACKSON PIEL 6 DAVID FISCHER 7 CHARLES KNAPP 8 NANCY BRESLOW 9 DAVID AFFLER 10 LEO KAYSER 11 12 * * * 13 14 15 16 17 18 19 20 21 22 23 24 25 DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 3 1 2 SCHEDULED TESTIMONY BY: 3 4 5 MR. ARNOLD TREBACH 6 DR. LESTER GRINSPOON 7 MR. ROBERT GANGI 8 MR. WILLIAM F. BUCKLEY, JR. 9 DR. WILLIAM M. LONDON 10 DR. DIANA GORDON 11 DR. JOYCE LOWINSON 12 13 14 15 16 17 18 19 20 21 22 23 24 25 DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 4 1 DRUG HEARING 2 MS. PIEL: We thank you Diamond Reporting 3 Service for your pro bono work today and we are now 4 underway. 5 Our first speaker is Dr. Arnold 6 Trebach, who is the chairman and president of the 7 Drug Policy Foundation in Washington and for more 8 than 25 years, he's been an advocate of fundamental 9 drug policy change and he is a professor in the 10 Department of Justice, Law and Society at the 11 School of Public Affairs at American University in 12 Washington. He's written books on the subject and 13 he is a national figure in the field. 14 Without more, I introduce Dr. Arnold 15 Trebach. 16 TESTIMONY BY DR. ARNOLD TREBACH: 17 Thank you very much, Ms. Piel, and it's 18 a pleasure to be here. I remember years ago as a 19 very young lawyer working with other lawyers such 20 as Robert Von Mayo (sic.) and Emory Bounell (sic.) 21 on a committee to the endeavor systems. I think 22 the work of your committee is historic and I want 23 you to know that I want to help and the foundation 24 wants to help you as you pursue further work in 25 this area. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 5 1 DRUG HEARING 2 I'm in very strong agreement with your 3 conclusion ending prohibition of drugs would indeed 4 be the wiser course of direction for the nation. 5 It's a fundamental point that many good people 6 agree on and there are many people who disagree and 7 we respect their opinion. But, there are many 8 reasons for my opinion which are laid out in my 9 extensive statement which I sent you for your 10 records. 11 Mainly, it is my view and the view of 12 so many other people that the current situation is 13 so horrible that when you look at the cost of the 14 current situation, I think most sensible people 15 would say it's terrible and we have to seek a 16 change. For many years moreover, I was among those 17 people who felt that however bad the situation now 18 is from drug prohibition, there must have been good 19 reasons for commencing with drug prohibition around 20 the turn of the century. Recently, I have gone 21 back and looked at that earlier era and what I 22 found was -- and I'm speaking now as a lawyer and 23 even though I'm social scientist and a lawyer, I 24 tend to approach this as a lawyer. I look for 25 evidence. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 6 1 DRUG HEARING 2 I recently went back and looked at the 3 evidence at the turn of the century about the need 4 for criminal laws prohibiting the use of drugs and 5 I found no reliable evidence on the need for such 6 drastic legislation. So, I concluded that the 7 original basis for the drug prohibition laws was 8 faulty. 9 Now, that to me, had a profound effect 10 on my thinking. It pushed me even further into 11 being a reformer and seeking change. I think there 12 are many people, many lawyers, many government 13 officials, who are surprised when you tell them 14 that drug prohibition is relatively new in our 15 history relatively. It came into effect on March 16 1st 1915. I mean that's just a little older then I 17 am and I don't consider myself that old and I'm 18 capable of learning new tricks and the country is 19 capable of learning new tricks. 20 Drug prohibition is not something 21 written in the tablets of the bible. It is not 22 written in the constitution. It is not something 23 that is an immunable part of the American life. 24 I'm sure you've spoken to many people who have 25 testified here, who have said if you take away drug DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 7 1 DRUG HEARING 2 prohibition, the sky will fall. Addiction will go 3 through the roof. Crime will be rampant. We'll be 4 a nation of drug zombies. They may believe that 5 from the information they see, but when I look at 6 the information, I don't find any evidence of that, 7 any reliable evidence. 8 When I was speaking to Ms. Rocklen, I 9 said that I would concentrate in my presentation on 10 the early years because I don't think many people 11 have spent time on that. I certainly have not 12 until a few years ago. So, when I went back, I 13 looked at some of the leading scholars such as 14 David Miusto (sic.) or Cartwright, who are very 15 good writers and very good scholars and their 16 research is often used to provide a buttress to the 17 concept. 18 In the old days we had rampant 19 prohibition. Thank God, we got the prohibition 20 laws that repealed prohibition. It's simply not in 21 the records. I used to think it was. It's not in 22 the records. I went back oh, about three years ago 23 with the help of a lot of young people, mainly 24 unpaid interns at the foundation, and I said find 25 me evidence of what was wrong around the 1870's, DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 8 1 DRUG HEARING 2 1880, and we couldn't come up with anything. What 3 we come up with was this. A large number of people 4 were using drugs and a large number of people were 5 getting in trouble with drugs, but on a comparative 6 basis, they were a finite portion of the 7 population. There was no definitive evidence at all 8 that Navy ships didn't sail, that factories closed 9 down, that neighborhoods were destroyed by the 10 process of drugs and as if it were written in 11 stone, the idea of Civil War because of the 12 presence of drugs. Although, information from on 13 the battlefields -- we had battalions of addicted 14 soldiers. As far as I'm concerned, it was a myth 15 which we all accepted. 16 So, what did we have back then? We had 17 a situation where you could buy the drugs sometimes 18 from the Sears, Roebuck catalogue for a very low 19 price. As it also happens, you could buy a cure 20 for a couple of bucks. The cure didn't work, the 21 drugs did. There were many places where it was 22 bought over-the-counter. There were opium dens. 23 We believe it was a custom brought by Chinese 24 workers to do the work that white people wouldn't 25 and in those opium dens, people went and smoked DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 9 1 DRUG HEARING 2 opium and around at the 1870's or 1880's, perfectly 3 decent white folks, men and women of tender ages, 4 went there to enjoy the smoking. 5 This caused enormous resentment and I 6 believe that was the start of prohibition movements 7 in this country. And, if you look at opium and its 8 habits, smoking opium is dangerous. It was 9 generally a peaceful vice. There was no evidence 10 that out of those opium dens people spewed and 11 attacked the neighborhood. Opium was a problem for 12 the people who smoked it and was a problem for 13 families of people who got addicted, but there was 14 no evidence that this disrupted the society, but I 15 believe this was the start of the process of 16 prohibition and once they started that, they 17 realized that those laws didn't work. People get 18 high doing it. 19 Well, the result was, we've got to get 20 tougher. So, they got tougher and then we got the 21 Harrison Act which was passed on December 17, 1914 22 as an amendment to one of the anti-opium statutes. 23 It went into effect on March 1st 1915. That was 24 our first national anti-prohibition law. It's 25 never worked and we keep saying we've got to get DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 10 1 DRUG HEARING 2 tougher, we've got to get tougher. Now people 3 forget this history and they will sit here and 4 appear before Congress and right backs and say 5 national prohibition saved us and I find now no 6 evidence of that. 7 I summarized all of this in my 8 statement and we'll make it available to you. I 9 want to point out one part of my statement which I 10 think was very new for me. I mobilized these young 11 people and said let's see if we can create at least 12 some comparative data -- because there is none -- 13 of crime before and after prohibition and I viewed 14 that that was one evidence of a major social 15 problem that could flow from the easy availability 16 of drugs. 17 We found 10 cities -- and we worked 18 like the dickens to find them -- that had records 19 that would be comparative. Ten cities had arrest 20 records in 1918 and 1919. We picked two days 21 essentially apart and we looked at three crimes, 22 homicide, robbery and burglary. Remember our 23 questions was that is there evidence of the 24 presence of easily available drugs a century ago 25 that had the side effects of creating a vast amount DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 11 1 DRUG HEARING 2 of crime. We worked on this quite a deal. 3 It's in my statement on Page 16 and if 4 you look at the table, you realize in almost every 5 case a century ago crime was significantly lower. 6 We did it by rate. We did a rate in population. 7 We didn't look at absolute numbers, but I will just 8 pick up Manhattan and start my questions until, I 9 assume, my time is up. 10 In 1989, whereas far as I can tell, 11 drugs were easily available there and by the way, 12 there were local pharmacy laws, but you would and 13 could get drugs quite easily in Manhattan. It had 14 a population of a million-and-a-half. It had 119 15 homicides and 659 burglary arrests. Clearly, there 16 was more, but I was looking for comparatives and 17 the rates were 7.9 for homicide, 12.2 for robbery 18 and 21.3 for burglary and by 1989, the population. 19 Of Manhattan went down slightly. It was a 20 1,400,000, 1,408,000, but the homicides were 338, 21 robberies were 9,051. In other words, the rise in 22 rates is not something, but the rise in rate per 23 100,000 was 3400. In other words, it went up 34 24 times. 25 Now, what do you conclude from all this DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 12 1 DRUG HEARING 2 data? What I conclude is this. I am not making a 3 cause and effect connection that the advent of 4 drugs prohibition jammed this attendant crime. It 5 may have, but I'm talking very carefully like a 6 lawyer here, I am saying there is an answer absent 7 of evidence that there were a reduction in related 8 crimes problems back before prohibition and there 9 is some indication that crime is much worse now by 10 rate then it was then. 11 Where does this all lead me or I hope, 12 where it leads you? It should strengthen your 13 resolve because while the past cannot foretell the 14 future clearly, we have one test case here as to 15 how the American people react to the presence of 16 relatively, freely available drugs and we can say 17 they behaved quite well, thank you. Some of them 18 got into trouble, but even through the most 19 pessimist text scenarios, the number of people 20 addicted was like .4 percent or .3 percent, and I 21 would say that it should give us hope as we move 22 forward that the American people can do well 23 without your friendly, local policeman telling them 24 what chemicals to put in their own bodies. 25 Thank you very much. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 13 1 DRUG HEARING 2 MS. PIEL: We're going to start 3 questioning with the panel. Should we start with 4 you Mr. Fischer? 5 MR. FISCHER: Sure. 6 QUESTION BY MR. FISCHER: If the rate 7 of addiction was .4 percent, is that something that 8 I heard correctly -- 9 DR. TREBACH: I went over and invite 10 you to do and by the way a lot of this is included 11 in some of my reports and a lot of my section of 12 book which I wrote with Jim Sines (sic.), "Legalize 13 It." It's debate book put out by the American 14 University Press. I went back and looked at the 15 data that these scholars such as Musto (sic.) and 16 Corrad (sic.) used. 17 I concluded first of all, if you took 18 them at their worst -- I will tell you the number 19 exactly -- it's the number itself about -- we had 20 the most. It was either 99.59 percent or 99.67 21 percent of the American population was not 22 addicted. These are figures at their worst, but I 23 went beyond that. My next step was to go back and 24 look at and see is there a basis for their 25 estimates which are widely credited and you find -- DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 14 1 DRUG HEARING 2 by the way, the best place you can go for this? 3 Terry Palisi's (sic.) book, "The Opium Problem," 4 which came out in '28, and they reviewed all the 5 drugs in our surveys that had been done on them and 6 if you read them, it will boggle your mind, 7 especially as lawyers and as social scientists. 8 Their estimates vary so widely. The town of 9 Monroe, Michigan the doctor reported one opium, 10 either as they called them in the town and the 11 pharmacist reported 60. How do you use that as a 12 basis for calculation? 13 So, the conclusion was I made widely 14 available data now responsible. An expert or 15 lawyer can say we have reliable data to compare. 16 MR. FISCHER: Opium is not one of the 17 drugs that's considered much of a problem these 18 days. I believe heroin was developed late in the 19 19th century because it was hoped or expected to be 20 non-addictive and turned out to be much more 21 addictive then opium is; is my recollection 22 correct? 23 RESPONSE BY DR. TREBACH: Well, there 24 were many other drugs available then. Opium as I 25 said, was an emotional thing because there was DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 15 1 DRUG HEARING 2 opium smoking by aliens, but there were many other 3 drugs were available. Information means available 4 and needles were available and on heroin -- if I 5 can talk about that for just a second -- it was 6 widely believed that heroin was developed in the 7 19th century by Bayer Company and it was developed 8 as a cure for mentalism. This field is full of 9 myths. That's another myth. In fact, heroin was 10 discovered by C. Oral Wright (sic.). He published 11 it in an English journal. It was also joined by 12 Antole Dresser (sic.), a fellow physician in 13 Germany. They experimented with it and found it 14 was a wonderful cough medicine. It was never 15 marketed for a cure for morphine addiction. It was 16 used primarily as a sedative for coughs, which was 17 very effective. 18 MR. FISCHER: I guess just to leave the 19 microphone, my question is the extent to which 20 information we have about opium 100 years ago which 21 is not really an abused drug today or certainly not 22 one of the leading abused drugs today. Can you 23 really give us much guidance to current policy 24 where I think heroin and cocaine are probably 25 considered the major problem drugs? DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 16 1 DRUG HEARING 2 RESPONSE BY DR. TREBACH: What I'm 3 getting at is, what I was looking at were all of 4 the drugs available to them then and there were 5 many drugs available then. I simply say that opium 6 was the one that drew the most attention, but other 7 drugs did as well. By the turn of the century 8 heroin was being used and abused and other drugs 9 were being used and morphine was always being 10 abused. 11 So what I am saying is, there is no 12 reliable evidence in the surveys which covered all 13 the drugs that there was a problem of such 14 dimension that we were justified in creating an 15 army of police and prisonkeepers to control our 16 drug appetites. 17 MS. PIEL: Thank you. We have another 18 question from a member of our panel, Mr. Knapp. 19 MR. KNAPP: You mentioned the existence 20 of certain pharmacies in the 19th century? 21 DR. TREBACH: Yes. 22 QUESTION BY MR. KNAPP: Can you give 23 the committee a brief synopsis? 24 RESPONSE BY DR. TREBACH: These were 25 all state laws as opposed to national laws. There DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 17 1 DRUG HEARING 2 were some national laws and, as a matter of fact, I 3 think Musto (sic.), who I criticized, gives an 4 excellent summary of many of the state laws. They 5 put controls on the manner in which drugs could be 6 dispensed and they put internal controls on purity 7 and how the businesses could be run, but there was 8 some restrictions on sales in some states, but it 9 was very easy to get around them and there was no 10 national fabric of control and you could easily 11 order them through the mail. In one of my books, 12 "The Heroin Solution," many people have published 13 it, there is an ad from the Bayer Company saying 14 please send away for aspirin and heroin and one 15 other drug. So, that the controls -- you do order 16 the stuff and I have Sears, Roebuck catalogs with 17 all the drugs listed and you could find many ways 18 of getting that, but if you wish I'd be glad to 19 provide you with information. 20 QUESTION BY MR. KNAPP: But, your 21 overall conclusion in the historical records was 22 that those pharmacy laws proved to be ineffective? 23 RESPONSE BY DR. TREBACH: But mind you, 24 I am not at all against a whole series of new laws 25 that we put together. In fact, I talk about this DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 18 1 DRUG HEARING 2 in some of my work in this book, but I think the 3 task of the future is to create a new set of laws 4 that do not start and end with prohibition. 5 You look at the alcohol laws and I've 6 dealt with that on some occasions and some of you 7 perhaps have, there are a vast array of laws 8 regulating the sale of alcohol, the use of alcohol, 9 penalties for drunk driving, and I think they ought 10 to be the task I recommend as one place to start is 11 right here in New York, and I believe you probably 12 heard from Senator Joseph Gallagher. His law for a 13 new way of regulation is very intriguing and I 14 think worthy of attention. 15 I am not at all recommending that we 16 throw away the laws, but where we -- 17 post-prohibition laws, for example, you'd want age 18 limits, you'd want purity standards, you'd want 19 label standards. You would want a requirement that 20 people who sell these drugs not have criminal 21 records. I would hope that they're trained 22 properly. 23 In fact, one of the proposals I made 24 and I would make to you, is that in the future we 25 would consider creating two channels for obtaining DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 19 1 DRUG HEARING 2 these drugs. One would be the tradition channel we 3 now have. If you want to get codeine -- I just got 4 a prescription for antibiotic yesterday -- I called 5 my pharmacist. I went to my doctor and got advice 6 and I think people who want that route should have 7 it. It should still be there. It would be the one 8 I would prefer and there should be a nonmedical 9 route. If you are an adult and you want to 10 purchase these drugs and you have been given some 11 basic education and perhaps, have obtained a drug 12 license, you can go to a nonmedical drug store and 13 buy the drugs you want. 14 I think most people wouldn't go the 15 current route. You want a doctor, a pharmacist. 16 You want advice, but if you are an adult, I think 17 the future ought to hold that you could go to the 18 store and obtain it and with the label saying if 19 you are pregnant, don't use this drug, etcetera, 20 etcetera. I think that's where the challenge is 21 and I think lawyers should take up the challenge of 22 that. 23 MS. PIEL: Maybe our next question is 24 Mr. Kayser. Mr. Kayser would like to question. 25 QUESTION FROM MR. KAYSER: Most you've DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 20 1 DRUG HEARING 2 responded to in advance, which is what I had asked 3 witnesses yesterday, which was their comment with 4 respect to license and pharmacies to sell drugs 5 generally with warning labels and so forth, but 6 there is one other element I would like to ask you 7 about which has to do with the issue of taxes that 8 would have to be collected on the legal sale of 9 drugs under some regulation and if you levy tax 10 commiserate with tobacco and alcohol-type taxes, do 11 you have any estimate as to the type of revenue 12 that might be raised and also whether that revenue 13 might be put into a dedicated fund for purposes of 14 treatment? 15 RESPONSE FROM DR. TREBACH: As a matter 16 of fact, Senator Gallagher's bill recommends that 17 the -- first of all, this is a cardinal rule. They 18 should not be confiscatory. They should not be out 19 of the ballpark. They should not push the drugs to 20 the point where a black market develops. So, the 21 taxes should be reasonable and again your advice, 22 the advice of a group like this -- and again, we'd 23 be willing to work with you on that-- is paramount 24 here. Reasonable taxes-- we had funds in the 25 reform movement estimating how much money we'd DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 21 1 DRUG HEARING 2 gain. It would be a lot. It would be billions 3 there's no doubt about it. I have heard estimates 4 on marijuana in the eight billion range and that's 5 probably in the ballpark, but I think that would be 6 something you want to revisit, but clearly though, 7 I could see those funds. And this, I believe, the 8 Gallagher bill recommends being educated to 9 education prevention and treatment. 10 Remember my feeling would be and I 11 don't like the idea of people using drugs. I'm 12 square in that regard and let's assume many people 13 are squares, but I don't want them made criminals 14 if someone disagrees with me -- some of my friends 15 vote republican for God's sake -- but if some of 16 them want to use drugs, why should I say to them 17 they're bad people? As long as they don't hurt 18 anybody else, I would certainly uphold the right of 19 people who use drugs, but I would not in any way 20 use the criminal law. I would use persuasion and 21 use education and everything in my power to 22 convince them that when you do use drugs, there is 23 danger, but I would not use the panelling rate the 24 danger. 25 QUESTION FROM MR. KAYSER: One other DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 22 1 DRUG HEARING 2 question with your lawyer hat on; do you have an 3 opinions as to whether or not it would be best to 4 repeal the Federal regulatory scheme with view to 5 leaving it to the states, the laboratories of 6 states, to experiment with different kinds of drug 7 regulation at the state level as opposed to having 8 a Federal policy? 9 RESPONSE FROM DR. TREBACH: I dealt 10 with that again, as it happens, in this book, and 11 there's a good book. I won't look it up, but it's 12 in here, but in brief, a law professor and 13 economist dealt with us and they literally drafted 14 statutes which I think are pretty good and I would 15 be in favor of a statute not a constitutional 16 amendment. Thank God we don't need that. I think 17 I could see a Federal statute merely following a 18 very conservative principle, let the states handle 19 it. This has a lot of support for this. You get 20 it from prestigious national committees that have 21 stated this and I would simply say that it could be 22 like the -- the amendment repeal prohibition saying 23 that the Federal government will support states in 24 the way they deal with this. So, I would frame 25 this statute in a very conservative fashion and it DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 23 1 DRUG HEARING 2 shudders me, come to think of it, if the current 3 party stays in power in Washington, it will meet 4 their philosophy which is get the Federal 5 government out of the business and speaking as a 6 lawyer, I view the Federal government and Federal 7 police agencies presumptively incompetent in the 8 drug arena. 9 MS. PIEL: Thank you. Kathy Rocklen, 10 our chair, has a question. 11 QUESTION FROM MS. ROCKLEN: I want to 12 return to the subject that we talked a little bit 13 about before, drug related crime, and I think we 14 are pretty well satisfied that crime related to 15 trafficking and crime related to drug traffic and 16 to people trying to support their habits is likely 17 to be vastly diminished by some sort of 18 decriminalization program and the area of main 19 concern to people is drug-induced crime and I guess 20 the question is, do you think that there are 21 particular drugs that are likely to induce crimes 22 whether domestic, violent crimes or crimes to the 23 third parties and if so, what are these drugs and 24 how do we deal with this problem in the context of 25 legalization? DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 24 1 DRUG HEARING 2 RESPONSE BY DR. TREBACH: I recommend 3 to you on page 1818 of "Legalize It," Goldstein and 4 Brownstein in 1990 they studied 414 homicides right 5 here in New York City with the help of the police. 6 They went over them to see whether or not they were 7 drug related and how you could work up a text on 8 the way to describe them. They came up with 9 classic psychological pharmacological, systemic and 10 economic compulsive. And the one thing we are 11 concerned about is crack because you hear that 12 crack is just destroying our city and in my view, I 13 view crack as a bad drug. It is a dangerous drug 14 that can hurt a lot of people. But, what they 15 concluded was and I'm just looking for the date 16 here quickly, and if he found one case and mind 17 you, they worked with the police on this, they say 18 what do you think happened here? They found one 19 case out of these 414 homicides that they randomly 20 selected in New York City that where an 18-year old 21 man beat his daughter to death while high on 22 crack. That's what you hear about and that's 23 horrible and they found out about 106, I believe it 24 is, were involved in the crack trade. So you had 25 one, you know, psychopharmacological induced DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 25 1 DRUG HEARING 2 homicide and 106 in the crack trades for the 3 future. 4 What would happen? I think you would 5 find all of the drugs have some danger of an impact 6 on a human being towards violence that they may 7 push a person toward violence, but in almost every 8 case, the potential is small. It would depend on 9 the particular psychopharmacological of their 10 social situation. 11 The death of that little baby was 12 horrible, but I would say the single drug that 13 would continue to have the most criminal effect 14 hands downs dead and based upon all the research 15 antidotal data is alcohol. There is no drug I can 16 find where there is more evidence of crimogenic 17 impact then alcohol, and I think all the -- by the 18 way, with some prescribed medication there is a 19 danger that a person would take it and have a bad 20 episode. You know, would act badly and cause harm, 21 but I think that danger is at the level of .1 22 compared to a level of 10 for dangers from the 23 prohibition of the crack trade, the cocaine trade. 24 By the way, for reasons I don't 25 understand, the cocaine and crack trade and I will DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 26 1 DRUG HEARING 2 put on my criminologist hat for a moment, is one of 3 the most violent we've ever seen. I've asked cops 4 this and I've asked other people this and I can't 5 figure it out. I think there is a tradition of 6 violence among the people who traffic in it, but 7 that's the business. I can come up with the 8 dangers of prohibition in terms of violence are 9 much higher then the dangers of pharmacological 10 impact. 11 MS. PIEL: Thank you very much. We are 12 not taking questions from the audience because of 13 time considerations and we thank you very much. 14 Our next speaker to testify is Dr. 15 Lester Grinspoon, a distinguished psychiatrist who 16 has written over 200 theses and books. Here is his 17 CV and one that has caught my eye. In 1969 he 18 wrote a piece for my husband's magazine Scientific 19 American on marijuana and I think he can answer in 20 more details some of the answers to the questions 21 of Professor Trebach concerning the effect of drugs 22 on persons, but in any event, Dr. Grinspoon. 23 TESTIMONY FROM DR. GRINSPOON: 24 Thank you. I'm going to talk about 25 just one part of the prohibition. Namely, the DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 27 1 DRUG HEARING 2 marijuana prohibition and I'm going to be even more 3 specific then that. Of all of the harmful effects 4 of prohibition against marijuana, no part is more 5 harmful and more tragic than the proscriptions 6 against using marijuana as a medicine. 7 Now, you know, in 1928, Alexander 8 Fleming (sic.) returned from his vacation to 9 discover that a petri dish, which had become 10 covered with staphylococci, except for one little 11 island where a mold had formed and to make a long 12 story short, this was the serendipitous discovery 13 of penicillin. I published this in 1929 and it 14 wasn't until 1944 when two investigators using just 15 six patients demonstrated its efficacy as an 16 antibiotic. Why did it not happen until 10 years? 17 But, it was at the pressure of World War II which 18 made it necessary to find antibiotics other than 19 sulfonamides, and very rapidly. 20 In 1941, penicillin became known as the 21 wonder drug of the 40's. Why was it considered a 22 wonder drug? It seems to me there are three 23 reasons. One, it was remarkably nontoxic. You 24 could give large doses and no harm would result. 25 Two, once it was produced on an economy of scales, DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 28 1 DRUG HEARING 2 it was remarkably inexpensive and three, it was 3 very versatile. It would a challenged positive to 4 have coccus and various pneumonias and even 5 syphilis. It proved to be vulnerable to this 6 antibiotic. It was truly a wonder drug. 7 Now, if you consider those three 8 criteria, I would make the case that cannabis is a 9 wonder drug which we have been foolishly 10 overlooking for some time. The first criteria, 11 toxicity, well, cannabis is remarkably nontoxic. 12 When you think that this drug has been used for 13 thousands of years by countless millions of people 14 and that there has not been a single recorded death 15 from cannabis alone, that states that considering 16 the most toxic effect of all, death, it makes it 17 the least toxic substance in the armamentarium and 18 that is to say, once cannabis -- and I can go into 19 this in more detail in a question -- but once 20 cannabis resumes or regains its place in the United 21 States pharmacopeia, a place lost in 1941 paramount 22 to the Man Wantague (sic.) Act in 1941, once it 23 regains that place, it will be among the least 24 toxic substances in that pharmacopeia -- no, two, 25 like penicillin, cannabis will be when it's made DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 29 1 DRUG HEARING 2 remarkably inexpensive. 3 It now costs about 200 to $600 an ounce 4 on the street, but if it were available as a 5 medicine, it will cost something on the order of 6 $10 an ounce, maybe $20 an ounce. When you 7 consider post scaling costs a marijuana cigarette 8 weighs about .4 tenths of a gram, so there are 9 about 70 marijuana cigarettes in an ounce, so 10 therefore, one marijuana cigarettes will cost 11 something in the order of 26 cents. 12 So, consider its use in the treatment 13 of nausea and vomiting of a cancer chemotherapy 14 patient. Nowadays, many patients will get relief 15 from the conventional anti-nausea drugs, like one 16 of the newer ones, Dancpon (sic.) or Zofran (sic.) 17 as it's called. This drug, however, costs $20 for 18 an eighth of a milligram pill and then the patient 19 usually ends up paying about $40 for that pill. 20 That pill will give most people relief from that 21 nausea and vomiting, but the 26 cent marijuana 22 cigarette will generally give better relief with 23 fewer side effects and for people who can not get 24 relief from the any of the conventional anti-nausea 25 medicines, marijuana is the substance that will do DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 30 1 DRUG HEARING 2 it for them. 3 For example, there was an investigator 4 by the name of Vince Scura (sic.), who found 48 5 patients who couldn't get relief from the nausea 6 and vomiting of cancer chemotherapy with 7 conventional medicines. These people -- mind you, 8 this nausea is so powerful you feel it right down 9 to your fingernails and many of these people 10 protest that they won't go on with the therapy 11 because it's just so uncomfortable -- and in 48 of 12 these people who could get relief from these 13 medicines, he found that 78 percent got complete 14 relief by smoking marijuana and it will eventually 15 be an exceedingly effective medicine, relative to 16 the medicines whose place it will displace. 17 The third criteria for a wonder drug is 18 versatility. Now, marijuana has a growing list of 19 symptoms and syndromes from which it's useful and 20 for many people, it is the most peaceful substance 21 just to give you a partial list. I forgot to know 22 what time I started, but -- 23 MS. PIEL: You've been speaking for 24 about seven minutes. 25 THE WITNESS: Thank you. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 31 1 DRUG HEARING 2 -- as I mentioned one of the greatest 3 advancements in cancer treatment is the development 4 of these cancer therapeutics, but nausea and 5 vomiting is very discouraging to people. Marijuana 6 is a boom for millions of people. There is a 7 question of glaucoma. There are two kinds of 8 glaucoma. The most common one is called side-angle 9 or open-angle glaucoma. There are conventional 10 medicines since -- this is a decreased intraocular 11 pressure inside the eye which will eventually 12 destroy eyesight if pressure is not brought down. 13 The conventional medicines are difficult to take. 14 They often cause blurring of vision and people 15 don't like them. On the other hand, many people 16 have found that one, not just that they are able to 17 preserve their eyesight because these conventional 18 medicines don't work, but that marijuana will, and 19 they preserve their eyesight. But, for many other 20 people who could use conventional medicines, it's 21 just so much more comfortable and allows them to go 22 about their work so much more efficiently, that 23 eventually they prefer to use cannabis in the 24 treatment of their glaucoma pain. 25 When marijuana first reemerged in DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 32 1 DRUG HEARING 2 western literature in the mid-19th century, one of 3 the most important uses was as an analgesic. It's 4 knots as powerful as the opiates and it takes a 5 little longer for the effect to come on, but for 6 people, particularly dealing with chronic pain, 7 it's much more important then morphine because the 8 opiates are not necessary for that kind of pain and 9 there is no risk of addition with cannabis. And 10 then you take some specialized kind of pain, for 11 example, migraine. As late has his last textbook 12 on medicines, 1914, Sir William Osler (sic.) said 13 the single best drug for the treatment of migraine 14 is cannabis. And given the fact that about 20 to 15 25 percent of people with migraine fail to get 16 relief from the orgotamines (sic.), calcium channel 17 blockers and so forth, cannabis is still very 18 important in the treatment of migraines and then 19 there is multiple sclerosis, and in this disorder 20 people suffer muscle spasms and this is a rather 21 severe kind of pain. Anyone whose had a cramp 22 while swimming knows what a muscle spasm is like 23 and these people get supplemental relief from the 24 muscle spasm with cannabis and furthermore, another 25 often socially debilitating symptom of multiple DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 33 1 DRUG HEARING 2 sclerosis is that people lose bladder control and 3 cannabis very often will restore that control. 4 Similarly, the muscle spasm of 5 paraplegics and quadriplegics are relieved by 6 cannabis. In fact, if you go into some of the 7 paraplegic wards in Virginia hospitals you can 8 smell cannabis. The doctors know that the patients 9 have discovered that cannabis is much better than 10 the conventional medicines for muscle spasms which 11 is doctors' -- called Bactroban and Dantrolene has 12 very significant levels of toxicity and the third 13 one is Valium, but you have to take it in a dose of 14 about 40 milligrams a day, which means you are just 15 about zonked out. So, these doctors pretend that 16 it doesn't happen, that these veterans are smoking 17 cannabis. And furthermore, a number of them have 18 discovered that cannabis restores their ability to 19 get and maintain an erection and they can then go 20 on to have a sexual life. 21 The list is very long, but perhaps 22 given the time, I should just mention one more 23 disease I think which is really pushing -- just as 24 World War II pushed the development finally of 25 penicillin, I think AIDS is the disease which is DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 34 1 DRUG HEARING 2 really pushing cannabis as a medicine at this 3 point. AIDS patients find cannabis useful in a 4 number of ways. First of all, they suffer from 5 nausea, not just from the disease itself, but as 6 well from side effects of AZT and some of the other 7 drugs that we see, and it's very helpful with 8 that. Many others get muscle spasms and it's 9 helpful with that, but the thing that it is most 10 important for is critical in some of these patients 11 has to do with the weight loss syndrome. Many 12 people lose weight. They lose large amounts of 13 weight. Conventional medicine has not been 14 successful in retarding this weight loss. People 15 with AIDS smoke marijuana and they not only -- they 16 can either slow down the level at which they are 17 losing weight or -- and many of them, they turn it 18 around and they begin to gain weight. And, for 19 example, I have one patient who, as a matter of 20 fact, is a graduate of Harvard Medical School who 21 went on to later on get AIDS and once he learned 22 about this, he was so concerned about being 23 apprehended by the law that he moved to Amsterdam 24 and he wrote to me that for the first time in his 25 life with AIDS, he felt he was living with AIDS DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 35 1 DRUG HEARING 2 rather then dying with it. Then he called two 3 months later, "what will I do? I've run out of 4 money. I've got to come back to the United States. 5 What can I do about this?" 6 Now, there are a number of other 7 disorders and as time goes on, we are discovering 8 more and more of these and yet we are unable to 9 find the way to make this substance available to 10 patients. There is a subterranean way known as the 11 Bias Clubs. These are clubs -- the largest one 12 being in San Francisco -- where in defiance of the 13 law, people -- originally just AIDS people but now 14 people with other disorders -- come into the Bias 15 Club and if they have a note from their doctor 16 saying that marijuana would be useful to them in 17 the treatment of the AIDS reduction syndrome and 18 what have you, they are given seven grams of 19 marijuana, which is enough for two marijuana 20 cigarettes per day for a week. 21 The number of these clubs are growing, 22 but the efforts to get the government to even move 23 it from Schedule I to Schedule II and I first 24 testified on this in 1972, and it has made no -- it 25 wasn't until 1986 that the DEA finally agreed to DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 36 1 DRUG HEARING 2 have hearings. The administrative law judge who 3 heard these hearings, thousands of pages of 4 testimony of many patients and doctors, he 5 concluded that indeed, it should be moved to 6 Schedule II, but it was among one of the safest -- 7 in his words, the safest therapeutic substances 8 known to man, but yet they did choose to ignore the 9 advice of their own administrative law judge. 10 MS. PIEL: Dr. Grinspoon, the time is 11 up, but we're ready for questions and I would ask 12 the panel first? Kathy Rocklen, did you have 13 questions? 14 QUESTION BY MS. ROCKLEN: Thank you. 15 Could we just talk for a moment about 16 the deleterious effect of marijuana, diminished 17 capacity, diminished productivity, the high 18 associated with it. 19 RESPONSE BY DR. GRINSPOON: Well, when 20 you talk about diminished productivity and 21 diminished capacity, I really don't know what 22 you're talking about. 23 QUESTION BY MS. ROCKLEN: You think 24 those are myths. 25 RESPONSE BY DR. GRINSPOON: Yes. I DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 37 1 DRUG HEARING 2 started my work in marijuana in 1967. I started 3 because I had a little extra time. I had finished 4 my part of a three author book and was waiting for 5 the others and idea struck me to look into 6 marijuana a bit because I was concerned that so 7 many young people were using this terribly 8 dangerous drug and if I could present a 9 scientifically sound statement on this, maybe they 10 would pay attention. They weren't paying attention 11 to what the government was saying. 12 I soon learned several things. One, 13 that while marijuana wasn't addicting, studying it 14 was, I found. I spent three years full-time 15 working on this and the reason I call this 16 "Marijuana, Reconsider,", which was the first of 17 the books I published on this, was because I had to 18 record -- because I realized I had been brainwashed 19 by just about any other sentiment. In this country 20 it is not to say it's harmless. There is no such 21 thing as harmless psychoactive drugs, but the 22 United States government has spent tons of millions 23 of dollars trying to prove its toxicity which would 24 provide some basis for this prohibition and it's 25 failed miserably. And when it takes its place in DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 38 1 DRUG HEARING 2 the pharmacopeia, it will be in the top 10 drugs of 3 limitation of toxicity. The only area that I have 4 real doubts about aside from the fact that I don't 5 want children using it, young people, the only 6 areas I have real concerns about, are the pulmonary 7 effects. Marijuana smoke contains as much and up 8 to some reports, four times as much matter as the 9 cigarette smoke and the lungs were not constructed 10 to take any kind of burned plant matter. 11 However, even there, you have to 12 consider several things. First of all, people 13 don't smoke the equivalent of a pack of marijuana 14 cigarettes a day. That would be outrageous for a 15 whole bunch of reasons. It doesn't happen. For 16 one thing, you don't get anything out of it if you 17 do. Two, the government says marijuana is more 18 dangerous now because it is more potent, which is 19 the opposite of truth. The fact of the matter is, 20 the more potent marijuana is, the more safer it is 21 at -- a person stated when marijuana just as 22 marijuana -- they will only take as much as it is 23 required to get the high and there is indeed, a 24 study which demonstrates they should give people 25 marijuana cigarettes with very little potentate and DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 39 1 DRUG HEARING 2 they will do an awful lot of puffing of it. If 3 they receive a more potent cigarette they will and 4 just take a few puffs of the more potent one. And 5 the third thing is, that there are ways of 6 separating the cannabinoids from the particular 7 matter. For example, the water pipe. The lowly 8 water pipe does some of this, but of course, the 9 governments in its wisdom -- many states have ruled 10 out paraphernalia. So people can't do that, but I 11 am assured that the technology exists now when we 12 talk about cannabis for patients in the future we 13 won't be talking about smoking. We'll be talking 14 about vaporizing cannabinoids. 15 MS. ROCKLEN: Thank you very much. 16 MS. PIEL: Do we have another 17 question? 18 MR. FISCHER: I have a couple. 19 QUESTION BY MR. FISCHER: My first 20 question is really more an observation of a list of 21 uses. I'm aware of antidotal evidence of its being 22 used for Irritable Bowel Syndrome, which I think 23 fits into some of the other kind of symptoms, also 24 as an insect repellant, and I'd like to follow up 25 on Kathy's questions, though I think perhaps what DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 40 1 DRUG HEARING 2 she was suggesting was that the marijuana high 3 itself is disabling and during the period of the 4 marijuana high, that a person really shouldn't be 5 driving. I don't think he should be writing 6 contracts for clients and there are a lot of 7 things. It's a very psychoactive drug. 8 So, my question is, to what extent on a 9 comparable basis, are there other substitute drugs 10 that don't have temporary psychological disabling 11 effect. 12 RESPONSE FROM DR. GRINSPOON: Well, 13 first of all, I would agree with you that people 14 should not drive automobiles when they are high on 15 marijuana, but they shouldn't drive automobiles 16 when they are on Valium or any of the tricyclic 17 antidepressants and so forth and so on. Marijuana 18 as medicine will not be different from these other 19 substances. Secondly, there is, you know, just as 20 there is clearly some work which shouldn't be done 21 with marijuana, there are people who claim that 22 some kinds of work are facilitated to marijuana. I 23 am limiting myself to the medicinal aspect of that 24 because it is the most urgent part of it, but, in 25 fact, marijuana has some other utilities besides DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 41 1 DRUG HEARING 2 medicinal which we needn't go into those today. In 3 fact, the last three people that I present in my 4 book, "Marijuana, The Forbidden Medicine" are two 5 scientists and a musician who believe this 6 substance has been useful in their work. But like 7 as I say, Valium or any other benzodiazepine, 8 people have to learn that there are circumstances 9 in which these drugs can be used and other 10 circumstances in which they cannot be used. 11 QUESTION FROM MR. AFFLER: I'd like you 12 to briefly address the feasibility or efficacy or 13 if there's an alternative of separating the active 14 ingredient in cannabis or the medically beneficial 15 ingredient particularly in light of the three 16 criteria you used at the beginning. 17 RESPONSE FROM DR. GRINSPOON: Well, in 18 fact, that's already been done with respect to one 19 of the cannabis. First, let me say that whole, 20 smoked marijuana there are at least 60 -- probably, 21 we think, about 61 cannabinoids. Of these 61 of 22 these chemicals that have slight variations, the 23 most active is one called Delta-9 or Delta-1 24 tetrahydrocannabinol. In 1985 the government in 25 response to a growing pressure to make this drug DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 42 1 DRUG HEARING 2 available as a medicine, allowed the production of 3 what is called Dronabinol or the propriety name is 4 Marinol and Marinol is pure THC. It's a useful 5 drug. However, the fact is that the more we learn 6 about cannabis, the more we know that the 7 therapeutic utilities of cannabis do not lie solely 8 in tetrahydrocannabinol in the delta of 9 tetrahydrocannabinol. And again, if one looks 10 through our book, "Marijuana, The Forbidden 11 Medicine," almost invariably the patient who has 12 had the opportunity to use both smoked cannabis and 13 Marinol, almost to every person the whole smoked 14 cannabis itself is more effective then Marinol. 15 And then, there is the particular problem that if 16 you take it by ingestion -- first of all, people 17 who suffer from a lot of nausea have trouble 18 ingesting anything and questions of viability 19 arise. If I take a 10 milligram tablet today, four 20 milligrams are absorbed tomorrow, there may be six 21 and there is that kind of variation within 22 individuals and between individuals. And thirdly, 23 there is no way of titrating it, whereas with 24 smoking, one can get the effect right away. 25 Now, one could imagine that we could go DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 43 1 DRUG HEARING 2 through the whole spectrum of cannabinoids and I 3 think that the particular facts of cannabis, whole 4 smoked cannabis, why it's better then THC is 5 because some of these cannabinoids act 6 synergistically. It's not just THC. But, now, 7 it's theoretically possible we could isolate each 8 and every one of them. That would cost a fortune. 9 Then we could try different combinations of these 10 things so we could get the best combination for the 11 treatment of glaucoma and that would cost another 12 fortune. And then, you know, I mention the fortune 13 because, you see, the problem here, and one of the 14 problems of making this available as a drug in our 15 country -- the way these drugs come about, here's 16 chemical "X. " Let's say Merck Company buys 17 chemical "X" or buys the patent to it and then it 18 puts the money into all of the steps that it takes 19 to get it on the shelf as a medicine. The Phase 1 20 study, the Phase 2 study and so forth. It costs -- 21 for the average drug it cost 231 million dollars to 22 do that. The drug companies are willing to do that 23 because the patent allows them to charge whatever 24 they want for 17 years, soon to be expanded to 20 25 years. There is no patent on the planet -- no drug DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 44 1 DRUG HEARING 2 company is going to do the work that I just 3 mentioned -- is going to isolate these cannabinoids 4 and put them together and so forth and so on. 5 The only source of this kind of 6 resource to do this would be the United States 7 government and of course, the United States 8 government is doing everything it can to prevent 9 the development of this substance as a medicine. 10 Right now, the best way to use cannabis as a 11 medicine is to smoke it. 12 MS. PIEL: Mr. Knapp? 13 MR. KNAPP: One quick question. In a 14 recent document produced by the United States 15 Department of Justice Drug Enforcement 16 Administration entitled "Speaking Out Against Drug 17 Legalization," referring to the American Medical 18 Association, the American Glaucoma Society, 19 American Academy of Opthamology, the International 20 Federation of Multiple Sclerosis Society and the 21 American Cancer Society, they say that not one 22 American health association accepts marijuana as 23 medicines. Statements issued by these 24 organizations express concerns over the harmful 25 effects of the drugs and over the lack of solid DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 45 1 DRUG HEARING 2 research demonstrating that they might do more good 3 then harm. 4 I'd ask you in light of your testimony 5 today and the research you've conducted, if you 6 could comment on first of all, the status of 7 marijuana as medicine within all these 8 organizations and two, you've just started to 9 allude to it, since it's a Schedule I drug, the 10 United States government's role in allowing it to 11 be used for the creation of solid research one way 12 or the other. 13 RESPONSE BY DR. GRINSPOON: Well, now, 14 that is absolutely true. These various medical 15 organizations are not supportive of medical 16 marijuana yet, but this is going to change. I 17 think the harbinger of this was the decision of the 18 Journal of the American Medical Association to 19 publish, I think they call it a commentary, that 20 Mr. Becklyer (sic.) and I wrote this past June, in 21 which we made the point that these physicians 22 really should reconsider their position on this 23 drug. That more and more of them are coming to 24 understand that marijuana has an important role in 25 this and the position should no longer be the DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 46 1 DRUG HEARING 2 reason why the government won't support this. One 3 is always hearing no, we can't. But look at the 4 American Cancer Society. It says no, it's not 5 useful and so forth. But, on the other hand, there 6 was recently, a couple of years ago, a survey of 7 oncologists by Mr. Gobler (sic) and Mr. Kleinman 8 that demonstrated that oncologists are better 9 educated about this then most physicians because 10 they see a lot of patients who have to go through 11 cancer chemotherapy and 44 percent of them said 12 that and that was a few years ago. I'd wager it's 13 much higher now that they would recommend cannabis 14 to a patient. 15 Now, you see, why are the physicians 16 lagging behind here? Physicians get their drug 17 education in three ways. One, they read journals. 18 There are no journal articles about marijuana as a 19 medicine and two, they listen to the detail men and 20 women. These are the drug salespeople that come 21 into the doctor's office and ply them with samples 22 and gifts and listen to their spiel about drugs and 23 third, there are various promotional devices and 24 advertisements from the drug companies, but there 25 is none. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 47 1 DRUG HEARING 2 Physicians are learning about 3 cannabis. How are they learning? A most unusual 4 way to learn about drugs for physicians. They're 5 learning from their patients. There is a patient in 6 San Francisco who comes to his physician who knows 7 he's losing weight very rapidly and he has not seen 8 him in three weeks and he comes in and he says 9 "doctor, I want to get on your scale and show you 10 something. " He gets on the scale and lo and 11 behold, not only has he not been losing weight over 12 the last three weeks, but he gained some and he 13 goes on to tell the doctor he goes to the Buyers 14 Club in San Francisco and getting cannabis and 15 smoking it. This doctor is astonished. He's 16 beginning to pay some attention to this. This is 17 happening very rapidly today and that list that you 18 read, I would be willing to wager that's going to 19 change very shortly. As I said, I think the fact 20 that Gammer (sic.) published that article suggests 21 that something is going on in terms of what 22 physicians are coming to understand about the 23 usefulness of this substance as medicine. 24 MS. PIEL: Unfortunately, we are again 25 out of time, but we thank you very much, Dr. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 48 1 DRUG HEARING 2 Grinspoon, for your knowledge. 3 MS. PIEL: Our next performer is Robert 4 Gangi, whom I believe is here from the smile that I 5 saw and exchanged with him. He is the executive 6 director of the Correctional Association of New 7 York where he has -- thank you, doctor. You can 8 have your tray back. Glad to have had you with us 9 -- 10 DR. GRINSPOON: My pleasure. 11 MS. PIEL: Back to Robert Gangi. He's 12 held the post there for 13 years. It's an 13 organization that advises and analyzes problems in 14 the criminal justice system in New York with 15 special attention to the conditions of the prisons, 16 and Mr. Gangi is a critic of the Rockefeller Drug 17 Laws and he is going to tell us a little bit about 18 them and what the position of the association is 19 and what his opinion is and what some of the facts 20 are concerning the Rockefeller Drug Laws today. 21 TESTIMONY BY ROBERT GANGI, DIRECTOR OF THE 22 CORRECTIONAL ASSOCIATION OF NEW YORK: 23 Thanks alot. I have some literature, a 24 position paper, that I'll be following along with 25 some fact sheets that are relevant to the question DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 49 1 DRUG HEARING 2 of imprisonment in New York State and the 3 Rockefeller Drug Laws. 4 Like the good doctor before me, I began 5 studying marijuana in the late 60's also, and came 6 to a very similar conclusion that he has about the 7 basic benign quality of the drug, although without 8 all the scientific research that he obviously 9 engaged in. 10 As I said, following along the position 11 paper that the Correctional Association has 12 prepared on the Rockefeller Drug Laws, the laws 13 were passed in 1973 with the active support of 14 Governor Rockefeller. The common wisdom about the 15 passage of the laws -- it was right around the time 16 that Rockefeller had decided that in order to 17 advance his political career effectively, he could 18 no longer be perceived as a kind of Javits liberal 19 within the republican party and he had to adopt a 20 more conservative political posture, and he did a 21 number of things in order to advance that agenda. 22 One of the things was the way he 23 handled the prison uprising in Attica and another 24 thing that he did was push through some very harsh 25 mandatory sentencing laws in 1973, the most well DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 50 1 DRUG HEARING 2 known of which are the New York Drug Laws, which 3 have become known as the Rockefeller Drug Laws. 4 Talking about marijuana, the law was 5 amended in 1979, mainly to reduce the penalties for 6 offenses involving marijuana. The punishments 7 required by this law, though at this time for the 8 possession or sale of heroin, cocaine and other 9 hard drugs, are still amongst the most severe in 10 the nation. For example, this statute mandates 11 that a judge impose a prison term of no less than 12 15 years to life for anyone convicted of selling 13 two ounces or possessing four ounces of a narcotic 14 substance. The penalties apply without regard to 15 the circumstances of the offense or the 16 individual's character or background. Whether the 17 person is a first time or repeat offender, for 18 example, is irrelevant. 19 I'd like to sort of quickly run through 20 what we see as the principal problems created by 21 the implementation of this law. The first is 22 simply the expense of it. As of December 31st, at 23 the end of last year there were 8,433 drug 24 offenders locked up in New York State prisons under 25 the Rockefeller Drug Laws. It cost nearly 850 DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 51 1 DRUG HEARING 2 million dollars for the state to construct prisons 3 to house these people and the operating expenses 4 for confining them on an annual basis comes to 5 about 253 million dollars. 6 Another problem helped created by these 7 laws is prison overcrowding. To accommodate the 8 tremendous growth in the inmate population caused 9 in part by the application of the Rockefeller Drug 10 Laws, New York State has spent extraordinary sums 11 each year on building new prisons. Since 1981 the 12 state has added nearly 40,000 beds to its prison 13 system at an average construction cost of $100,000, 14 not counting debt service. So, the total cost of 15 this prison expansion program simply for the 16 construction, comes to nearly four billion 17 dollars. 18 Despite these enormous expenditures, 19 New York City prison expansion has not kept pace 20 with the increase in the number of inmates. The 21 state's correctional system is hobbled by crisis 22 conditions. The prisons are overcrowded. There are 23 not enough programs to productively occupy 24 prisoners and idleness and tension levels are 25 high. The system has been forced to double-bunk or DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 52 1 DRUG HEARING 2 double-cell about 9,000 inmates and especially has 3 to this arrangement, given the presence of 4 tuberculosis and its potential to spread among 5 inmates and staff. The state has also been forced 6 to rush a large number of prisoners out the back 7 door of the system to work-release and day 8 reporting programs and have not been able to 9 provide participants with adequate support or 10 supervision. 11 The third problem, and this is 12 probably, I think, the most significant, and that's 13 the skewed effect on law enforcement. These 14 statutes result too often in the arrest, 15 prosecution and long-term imprisonment of minor 16 dealers or persons only marginally involved in the 17 drug trade. Major traffickers usually escape 18 sanctions. 19 The problem -- and this is a key point 20 -- the problem is the Rockefeller Drug Laws place 21 the main criteria for culpability on the weight of 22 the drugs and the person's possession when he or 23 she is apprehended, not on the actual role that he 24 or she plays in the drug transaction. Aware of the 25 law's emphasis, drug kingpins will rarely, if ever, DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 53 1 DRUG HEARING 2 be foolish or reckless enough to be caught carrying 3 narcotics. Whereas, a teenage mother employed as a 4 drug courier by the same kingpin, may very well be 5 picked up on the street and charged with a serious 6 felony for having in her possession a small amount 7 of drugs. 8 Another criticism of the law that's 9 relevant is that major dealers often take advantage 10 of one of its provisions permitting lifetime 11 probation sentences in exchange for cooperation in 12 turning other drug offenders over to the 13 authorities. Less culpable persons generally do 14 not possess information that would be useful to 15 prosecutors. These people often decline to 16 plea-bargain and insist on a trial instead. If 17 these persons are found guilty, they frequently 18 must be sentenced to the mandatory minimum term of 19 15 years to life in prison. 20 Our overriding point here is that this 21 statue as a principal weapon of and as implemented 22 in the so-called "War Against Drugs," results 23 directly in the following misguided practices: 24 Law enforcement agencies focus their 25 efforts on the minor actors in the trade who are DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 54 1 DRUG HEARING 2 the most easily arrested, prosecuted and penalized, 3 rather then on the middle and high-level criminals 4 who are drug dealings' true masterminds and 5 profiteers. 6 The injustices is another problem 7 caused by this statute. The Rockefeller Drug Laws 8 result in many individual cases of injustice where 9 people with no histories of violent or predatory 10 behavior, who function barely on the margins of 11 outlaw drug markets, are slammed with the harshest 12 punishments our criminal justice system can 13 dispense. 14 For example, the Correctional 15 Association's research shows that in New York that 16 95 percent of the women charged with drug couriers 17 in our sample, had no previous criminal 18 involvement. In New York, murderers, arsonists and 19 kidnappers face the same penalty as drug mules. 20 Rape, the sexual abuse of a child and armed robbery 21 carry lesser punishments. 22 Our research showed also that many drug 23 mules are often poor and uneducated women who are 24 coerced by threats of violence or tricked into 25 transporting drugs, and are therefore, highly DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 55 1 DRUG HEARING 2 culpable of the charges against them. However, 3 many of them facing 15 years to life in prison, 4 plead guilty to a lesser offense in exchange for a 5 much shorter term of incarceration. Some who are 6 mothers and primary caretakers of children say they 7 are afraid to risk long-term separation from their 8 families by presenting their cases at trial. In 9 effect and in a mockery of the justice system, the 10 Rockefeller Drug Laws are being used to bludgeon 11 guilty pleas from people who are facing long prison 12 sentences and do not have the resources or savvy to 13 defend themselves. 14 The reform that we propose is, 15 basically, to repeal the Rockefeller Drug Laws so 16 the prison terms would no longer be mandated for 17 drug offenders convicted of less serious crimes. 18 Flexibility in sentencing would allow judges to 19 utilize less costly and more productive punishments 20 for many of the minor drug offenders who are taking 21 up increasing amounts of valuable prison space 22 because of the impact of the Rockefeller Drug 23 Laws. 24 It is important to note that many 25 persons sentenced under the statue are locked up DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 56 1 DRUG HEARING 2 merely for possession of narcotics. At the end of 3 last year, about 3,000 people were incarcerated in 4 New York for drug possession under these laws. It 5 costs the state about 90 million dollars a year 6 simply to keep these people confined. 7 The alternative punishment that we 8 propose, that we think would be the most effective 9 as an alternative to this law, would be intensive 10 supervised probation that includes such features as 11 day reporting, community service, job training and 12 mandatory participation in drug treatment 13 programs. Implemented properly, this program can 14 closely monitor the offenders' behaviors while 15 simultaneously providing them with support services 16 and making sure, where appropriate, that they repay 17 the community and/or the victim for the property 18 stolen or the damage done. The added value of a 19 well-run alternative punishment is that it gives 20 selected offenders a critical opportunity to become 21 more abiding members of society. Under current 22 practices, too many people are unnecessarily 23 relegated to the grim and crimogenic world of state 24 prison. 25 I'd like to make a couple of other DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 57 1 DRUG HEARING 2 points that are not included in the position 3 paper. One is to refer you to the fact sheet that, 4 basically, reflects the trends in New York State 5 prison commitments just to show the extraordinary 6 shift there's been in law enforcement practices in 7 New York State. 8 In 1980, for example, 57 percent of the 9 people sent to New York State prisons were sent for 10 violent offenses. In 1994 it was only 33 percent. 11 1n 1980, 11 percent of the people sent to New York 12 State prisons were for drug offenses. By 1994, it 13 had risen to 45 percent. So, there's been an 14 extraordinary shift in the way we apply our law 15 enforcement resources and in part, that's driven by 16 the presence on the books of the Rockefeller Drug 17 Laws. 18 I'd like to make one other important 19 point. There's been a lot of publicity lately 20 about the sort of confluence of race and the 21 criminal justice system. The OJ Simpson trial was 22 one obvious example of this and also, last week an 23 organization based in Washington called the 24 Sentencing Project, published a report that showed 25 that on any given day in the United States about DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 58 1 DRUG HEARING 2 one-third of young African American men are under 3 the custody of the criminal justice system. That's 4 either from jail or prison or on probation or 5 parole. And in large part, that extraordinary 6 disproportion of young black men under the controls 7 of the criminal justice system is due to the way we 8 enforce the Rockefeller Drug Laws. Because again, 9 the people in the inner-city communities in terms 10 of their activities in the drug trade are much more 11 arrestable, since so often the drug trade is done 12 out in the open and in the street. That's where 13 law enforcement concentrates its resources even 14 though all the research shows apparently that more 15 than half the people who use and even sell drugs 16 are white. And the results of that decision by the 17 law enforcement authorities, again backed up by the 18 presence on the books of the Rockefeller Drug Laws, 19 is that the so-called "War Against Drugs" is 20 carried out, if you will, in a discriminatory 21 fashion. 22 So, although again, over half of the 23 people who use drugs and sell drugs are white, in 24 New York State, for example, over 90 percent of the 25 people who are in State Prison on a drug offense, DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 59 1 DRUG HEARING 2 that is the sale or possession of narcotics, are 3 African American or Latino. The exact figure 4 actually, the end of 1994, was 93.8 percent of the 5 people in New York State Prison on a drug offense 6 were African American or Latino. 7 So, those are the major points I wanted 8 to make on the Rockefeller Drug Laws. 9 MS. PIEL: Thank you. Now, this time 10 we're going to have questions from the -- Mr. 11 Kayser has a question and then we'll turn to the 12 audience. 13 QUESTION FROM MR. KAYSER: Mr. Gangi, 14 I'm particularly interested in your testimony in 15 that it does -- what you do is move back towards -- 16 you maintain a criminal system with respect to drug 17 regulations. As I understand it, you simply relax 18 the rules and, therefore, the reasons as I 19 understood it, that people move toward more 20 stringent criminal penalties initially, is the idea 21 that you're going to either -- the idea for the 22 people who moved in that direction initially, was 23 they felt that you needed stricter penalties to 24 stamp out drugs and of course, you know, it didn't 25 occur, but to maintain our criminal system, you DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 60 1 DRUG HEARING 2 still have no consumer protection in terms of 3 labeling or substance of drugs when they're sold. 4 There is no reason to think that relaxing criminal 5 penalties would do anything less to keep drugs from 6 being in society. I don't think you contend that. 7 We still would not have the revenues from adequate 8 treatment for people who have drug problems by 9 relaxing drug laws, per se, even though that's the 10 direction we want to go, but we don't have 11 resources for that under your proposal and we are 12 still subsidizing drug sales by not collecting 13 taxes, because we have a black market still in the 14 sale of drugs. 15 Would you oppose or would you think it 16 would be compared to our current system, support in 17 the sale of drugs legally through licensed outlets, 18 like pharmacies, in which we collect taxes, 19 allocate the tax money for treatment and, 20 basically, remove from the criminal arena the sale 21 and distribution of drugs in that manner, at least 22 as to adults? 23 RESPONSE BY MR. GANGI: A couple of 24 responses to your question and to your point. One, 25 is that our view is and this is the position of the DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 61 1 DRUG HEARING 2 Correctional Association, is that the Rockefeller 3 Drug Laws and other mandatory sentencing laws that 4 result in the wide -- broad-based imprisonment of 5 many low-level drug offenders should be repealed. 6 We think that would result in significant savings 7 of money because it would necessarily result in 8 many fewer people going to prison. It would also 9 result in our refocusing of our law enforcement 10 resources. So much of the time and resources of the 11 police and the courts are spent in apprehending and 12 prosecuting these low-level drug offenders. 13 So, our full proposal would be to take 14 the resources that would be saved and that would 15 result in literally hundreds of millions of dollars 16 a year from the dismantling of the mandatory 17 sentencing laws and put that into drug treatment 18 programs and family support programs and job 19 creation and development programs in the inner 20 cities as a way of addressing the crime problems 21 and the other problems that afflict the inner city, 22 including the use of drugs. 23 So, we think that the overall strategy 24 would begin through education, treatment and 25 prevention to help deal with the drug issue. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 62 1 DRUG HEARING 2 Now, in terms of your question about 3 the decriminalization of the legal -- 4 MR. KAYSER: The collection of taxes, 5 the millions of dollars of taxes. 6 MR. GANGI: -- the Correctional 7 Association does not have a formal position. My 8 personal position based on looking at this problem 9 from a number of different angles over the years, 10 is that decriminalization and licensing of some 11 sort does make sense, makes eminent sense, but 12 again, it's not the formal position of the 13 Correctional Association. 14 Let me make another point. I think 15 that critical from our standpoint is that sort of a 16 larger question is of how we use the criminal 17 justice system today and what in our judgement 18 what's happened goes beyond the drug or issue of 19 the drugs and as a critical part of this, is that 20 because of the significant changes in our society 21 and our economy, hundreds of thousands, if not 22 millions of people, that we commonly refer to as 23 the underclass have been disenfranchised and 24 marginalized in our society. There is no 25 institutional role in our economy and our societies DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 63 1 DRUG HEARING 2 for these people and the criminal justice system 3 steps in, apprehends them, criminalizes them and 4 locks them up. If we are going to address that 5 problem, not only do we have do things like 6 dismantle the drug laws, if that's all we did or if 7 we legalized drugs and didn't then address the 8 tremendous economic and social problems that 9 afflict those communities, we would not, in my 10 judgment, be making a major step forward in terms 11 of whatever social progress or improvement for the 12 quality of life in our cities. 13 MS. PIEL: Thank you. Now we're going 14 to ask people in the audience if they would like to 15 ask questions and would you come up and take the 16 microphone and bring it back. 17 Any questions? No questions. 18 Any members of the panel have any 19 questions? Oh, all right, please come up. 20 QUESTION FROM AUDIENCE MEMBER: It's a 21 friendly question. We often hear estimates of how 22 much drug abuse costs Americans in the "X" number 23 of billions of dollars lost in the workplace, etc. 24 What is the average cost to a family where a family 25 member has been in contact with the criminal DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 64 1 DRUG HEARING 2 justice system? Obviously, if your child is going 3 before a court you have to take off from work, you 4 have to hire a lawyer. Very few cases of drug abuse 5 other than the worst cases would destroy someone's 6 life the way an extended prison term would; is 7 there any quantified estimate of what this is 8 costing on that level? 9 RESPONSE FROM MR. GANGI: No, none that 10 I know of. We have not done that kind of analysis 11 and I'm not aware of anyone who has, but I think 12 that you raise an important point though, which is 13 -- and there are more and more social analysts and 14 academics looking at the issue of the unintended 15 consequences of incarceration, if you will. I 16 didn't refer to this, but I think probably most of 17 us know, there's been an extraordinary increase in 18 the use of imprisonment in the last 20 years. Much 19 of it around or driven by the mandatory sentencing 20 laws that I've discussed today. 21 For example, in New York State we had 22 12,500 people in prison in 1973. Today we have 23 nearly 70,000. In the country over that same 24 period of time, the prison population went from 25 about 250,000 to now, 1,500,000. So there's been DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 65 1 DRUG HEARING 2 an extraordinary explosion. I think that's not too 3 dramatic a term to use in the use of incarceration 4 in the prison population. 5 There's an extraordinary shift in our 6 public policy and I think it has had what are now 7 being referred to as unintended consequences that I 8 think policymakers have not considered, and one way 9 when you look at this, to look at the effect on the 10 family and obviously, there are so many more 11 families now who are impacted by the use of 12 incarceration. So many more families where young 13 men have been taken out and so many more 14 communities where young men are virtually missing 15 in action because they are doing time in upstate 16 prison facilities. 17 So again, there has been, as far as I'm 18 aware of, no quantifiable analysis of what the 19 monetary effect of that is, but there is beginning 20 to be some kind of analysis of what the social and 21 economic effects to those particular communities 22 are. It's primarily, as you might imagine, people 23 are seeing it as -- given that prisons are 24 warehouses and they are often criminogenic, that 25 the effect is deleterious to those communities DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 66 1 DRUG HEARING 2 where so many young men who go through those 3 communities experience the prison system. 4 MS. PIEL: Thank you. Mr. Knapp has a 5 question on our committee. 6 QUESTION FROM MR. KNAPP: I have a 7 question concerning the fact sheet. If you look at 8 1985, the percentage of violent felonies with 9 respect to total commitments is 56 percent. The 10 percentage of drug arrests is 17 percent. 11 RESPONSE FROM MR. GANGI: To correct 12 the record, this is prison commitments, not 13 arrests. 14 QUESTION FROM MR. KNAPP: Excuse me, 15 commitments. I stand corrected. That focuses the 16 question even more then. If you go from 56 and 17 17 in 1985 and three years later in 1988, your 18 statistics indicate that the percent of violent 19 felony commitments has dropped from 56 to 38 and 20 the percent of drug commitments has risen from 17 21 percent to 37 percent, do you have any explanation 22 for the dramatic shift which seems to have occurred 23 during those five years, economic, social, any 24 explanation at all? 25 RESPONSE FROM MR. GANGI: Two primary DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 67 1 DRUG HEARING 2 explanations. One was the more widespread use of 3 crack and the effects that was having on the 4 communities and then, basically, the government's 5 response to that problem. The primary response was 6 a law enforcement response so that in New York City 7 under Mayor Koch and Police Commissioner Ben Ward, 8 we instituted what was referred to as the TNT 9 Squad, Tactical Narcotic Teams. Whose primary job 10 was to target drug-infested communities and do buy 11 and bust operations and drug sweeps and arrest lots 12 more people. There was an extraordinary increase 13 during those years in the number of arrests of 14 people for low-level drug offenses. 15 So, the primary reason for the shift in 16 those numbers, was the change in public policy. 17 Although, it was in response to a real problem, 18 which was the great increase in the use of crack. 19 MS. PIEL: Thank you. Thank you very 20 much, Mr. Gangi. We have one more question and then 21 this will be the last question. 22 QUESTION FROM AUDIENCE MEMBER: Mr. 23 Gangi, I have frequently seen in national justice 24 documents and other papers a justification of the 25 prison system as a way of providing treatment for DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 68 1 DRUG HEARING 2 individuals with substance abuse problems and I 3 believe that cuts across the board, not just people 4 who are arrested on narcotics charges, but everyone 5 in prison. 6 I was wondering if you have a comment 7 on the rationale of re-enforcing the prison systems 8 as a means of funneling people into treatment and I 9 am curious if there are any figures on the efficacy 10 of treatment in prison for reducing those numbers. 11 RESPONSE FROM MR. GANGI: I think it is 12 a good question and again, sort of raises a larger 13 issue of how prison systems have in a way become 14 extensions of our welfare and social services 15 system. Because now many people locked up get 16 services, frequently inadequate services, in prison 17 that probably we would have been better off and 18 they would have been better off, if they got them 19 in their community. That's where they get 20 educated. Frequently, that's where they get 21 vocational training, that's where they get 22 healthcare, that's where they get shelter, three 23 meals a day, and that's where they get drug 24 treatment. 25 There has been across the country in DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 69 1 DRUG HEARING 2 some states experiments with different kinds of 3 drug treatment programs, although recently there's 4 been a cutback in the amount of resources set aside 5 for that as sort of a more right-wing philosophy of 6 government that has taken hold in many places. 7 There is some evidence that drug 8 treatment in prisons can work. Frequently, for the 9 first year or two or three somebody is out of 10 prison, but will not work out over the long term at 11 least in terms of recession rates, unless there is 12 some aftercare and some backup in the community. 13 Our view is that drug treatment can be 14 very useful for many people who are addicts and 15 that the criminal justice system has a role to 16 play, but we would prefer to see drug treatment not 17 done in prison. We think it's more difficult in 18 that environment to do effective drug treatment. 19 In fact, drug treatment done in the community and 20 perhaps, the criminal justice system held as a 21 hammer over someone's head -- in other words, we 22 have no problem with the person being forced into 23 drug treatment and to stay in drug treatment and if 24 they fail in drug treatment, a possible consequence 25 of that would be them going to jail or prison. And, DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 70 1 DRUG HEARING 2 the evidence seems to show that that type of 3 approach increases the retention rate of the drug 4 treatment programs that people participate in. As 5 you might easily understand, the longer someone 6 stays in a drug treatment program and the higher 7 retention rate the drug treatment program has, the 8 more likely that person is to have a more 9 successful experience with treatment and finally 10 leave the program and be able to stay out of crime, 11 stay away from crime and hold a decent job. 12 MS. PIEL: Thank you very much, Mr. 13 Gangi. 14 MR. GANGI: Thank you. 15 MS. PIEL: We now have Mr. William 16 Buckley. Mr. Buckley is a distinguished television 17 personality. We know him from the Firing Line. We 18 know him as the editor of the National Review and 19 we know him also as an novelist and we understand 20 also he plays the harpsichord, but he isn't going 21 to do that today. He has also written in the New 22 York Post a favorable review of our committee's 23 report and he is here today to give us his views. 24 I'm a strict taskmistress and I will 25 call your time a little after 15 minutes and then DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 71 1 DRUG HEARING 2 we'll have questions. 3 TESTIMONY FROM MR. WILLIAM F. BUCKLEY, JR.: 4 Thank you, I've never done this before, 5 so tell me if I have the drill wrong. 6 MS. PIEL: You're going to talk and I 7 know you know how to do that. 8 MR. BUCKLEY: I have a brief 9 statement. I've been given 15 minutes to make a 10 statement on a plague that consumes an estimated 75 11 billion dollars a year of public money. Exact 12 estimates is 70 billion dollars a year from 13 consumers and is responsible for nearly 50 percent 14 of those 1.3 million Americans who are today in 15 jail, and consumes an estimated 50 percent of the 16 trial time of our judiciary, and occupies the time 17 of 400,000 policemen -- a plague for which no cure 18 is at hand, nor in prospect. In 15 minutes, on 19 such a subject, I can only offer you a haiku. 20 Perhaps you will understand if I 21 chronicle my own itinerary on the subject of public 22 policy with respect to those drugs that are 23 illegal. When I ran for mayor of New York, the 24 political race were jocular, but the thought given 25 to municipal problems was entirely serious, and in DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 72 1 DRUG HEARING 2 my papers on drugs and in my post-election book, I 3 advocated their continued embargo on unusual 4 grounds. 5 I had read, and I think the evidence 6 continues to affirm it, that drug taking is a 7 gregarious activity. What this means, I reason, 8 that an addict is in pursuit of social company and, 9 therefore, tends to entice others to share with him 10 his habit. Under the circumstances, I've reasoned, 11 it can reasonably be held that drug taking is a 12 contagious disease and for that reason entitled to 13 the police protection extended to shield the 14 innocent from Typhoid Mary. 15 Some sport was made of my position by 16 the Libertarians, including Professor Milton 17 Friedman, who asked whether the police might 18 legitimately be summoned if it was established that 19 keeping company with me was a contagious activity. 20 I recall this reasoning in search of 21 philosophical perspectives. Back in 1965, I sought 22 to pay due deference to Libertarian presumptions 23 against outlawing any activity potentially harmful 24 only to the person who engages in that activity. I 25 cited John Stewart Mill and, while at it, opined DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 73 1 DRUG HEARING 2 that there was no warrant for requiring 3 motorcyclists to wear a helmet. I was seeking and 4 I found it a reason to override the presumption 5 against inviting the intercession of the state. 6 About 10 years later, I deferred to a 7 different allegiance, this one not opposition to 8 state intervention, which opposition is properly 9 superordinated, not as an absolute, but as a 10 presumption. A Conservative should evaluate the 11 practicality of a legal constriction, as for 12 instance, those states tend to do whose statute 13 books continue to outlaw sodomy, which interdiction 14 is unenforceable, making the law nothing more than 15 print on paper. 16 I came to the conclusion that the 17 so-called "War Against Drugs" was not working, that 18 it would not work absent a change in the structure 19 of the civil rights to which we are accustomed to 20 and for which we cling to as a part of our 21 patrimony. And that if that war was not working, 22 we should correctly explore the casualties 23 resulting in its failure to work. 24 That consideration encouraged me to 25 weigh two occurring principles; the calculus of DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 74 1 DRUG HEARING 2 pain and pleasure introduced by the illegalization 3 of drugs. A year or so ago, I thought to attempt 4 to calculate a ratio, however roughly arrived at, 5 towards an elaboration of which I'd attempt to 6 place a dollar figure on matters that do not lend 7 themselves to quantification. 8 Even so, the law, lacking any other 9 recourse, every day countenances to such 10 quantifications, as when asking a jury, for 11 example, to put a dollar figure on the damage done 12 by the loss of a plaintiff's right arm, amputated 13 by defective machinery in the factory. My 14 enterprise, in fact, became allegorical in 15 character, but the model, I think, proved useful in 16 sharpening perspectives. 17 Professor Steven Duke of the Yale 18 University Law School in his valuable book and 19 scholarly essays, reminds us that it isn't the use 20 of the illegal drugs that we have any right to 21 complain about, but it is the abuse of such drugs. 22 It is acknowledged that tens of million of 23 Americans -- I have seen the figure of 85 million 24 -- at one time or another consumed or in whatever 25 manner exposed themselves to an illegal drug. But, DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 75 1 DRUG HEARING 2 the estimate authorized by the Federal agencies 3 charged with such explorations is that there are 4 only one million regular cocaine users, defined as 5 those who use the drug at least once in the 6 preceding week. There are again, an informed 7 estimate of five million Americans who regularly 8 use marijuana, and again, an estimated 80 million 9 who once upon a time or even twice upon a time, 10 inhaled marijuana. 11 From the above, we reasonably deduce 12 that the American who abuses the drug, here defined 13 as the American who became addicted to the drug, or 14 even habituated to it, is a very small percentage 15 of those who have experimented with the drug or who 16 have continued to use the drug without any 17 observable distraction in that person's life or 18 career. 19 About such users one might say that 20 they are the equivalent of those Americans who 21 drink liquor, but do not become alcoholics, or 22 those Americans who smoke cigarettes, but do not 23 suffer a shortened life span because of that drug's 24 effects. 25 Curiosity naturally causes us to ask DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 76 1 DRUG HEARING 2 next how many users of the illegal drugs, in fact, 3 die from the use of them? The answer is 4 complicated in part because marijuana finds itself 5 lumped together with cocaine and heroin, and nobody 6 has ever found dead from marijuana. The question 7 of deaths from cocaine is complicated by the fact 8 of impurity. 9 It would not be useful to draw any 10 conclusions about alcohol consumption, say for 11 instance, by observing that in 1931, 1,000 12 Americans died from alcohol consumption. If it 13 happened that half or more than one half of those 14 deaths were the result of drinking alcohol with 15 toxic ingredients extrinsic to the drug as 16 conventionally used. When alcohol was illegal, the 17 consumer could never know whether he had been given 18 relatively harmless alcohol to drink -- such 19 alcoholic beverages as we find today in the liquor 20 store -- or whether the bootleggers' distillery had 21 come up with paralyzing rot gut. 22 By the same token, purchasers of 23 illegal cocaine and heroin cannot know whether they 24 are consuming a drug that would qualify for 25 regulated consumption after clinical analysis. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 77 1 DRUG HEARING 2 But, we do know this, and I approach 3 the nexus of my inquiry, which is that more people 4 die every year as a result of the "War Against 5 Drugs" then die from what we call, generically, 6 overdosing. These fatalities include, perhaps most 7 prominently, drug agents who compete for commercial 8 territory, but include also people who are robbed 9 and killed by persons desperate for money with 10 which to buy the drugs to which they have become 11 addicted. 12 This is perhaps the moment to note that 13 the pharmaceutical cost of cocaine and heroin is 14 approximately one percent of the street price of 15 those drugs. In as much as a cocaine addict can 16 spend as much as $1,000 per week to sustain his 17 habit, he needs to come up with that $1,000. The 18 approximate fencing cost of stolen goods is 80 19 percent, so that to come up with $1,000 in which to 20 pay a narcotic dealer can require stealing $5,000 21 worth of whatever -- jewels, cars, cash. We can 22 see that at free market rates, $10 per week would 23 be sufficient to provide the addict with the 24 cocaine he now needs to procure in our wartime drug 25 situation to come up with $1,000 worth of cocaine DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 78 1 DRUG HEARING 2 to support his habit. 3 My mind turns, then, to auxiliary 4 expenses -- auxiliary pains, if you wish, the crime 5 rate whatever its modest little curtsey last year 6 towards diminution, continues brave and, probably, 7 will continue to rise; indeed, serious crime is 480 8 percent higher than it was in 1965. The 9 correlation is not absolute, but it is helpful. 10 Namely the crime is reduced by the number of 11 available enforcers of law and order, namely 12 policemen. 13 The heralded new crime legislation, 14 passed last year and proclaimed so boisterously by 15 President Clinton, would provide for 100,000 extra 16 policemen, even if only for a limited amount of 17 time. But 400,000 policeman would be free to 18 pursue criminals engaged in other activities than 19 the sale and distribution of drugs if such sale and 20 distribution, at a price that pursues no profit, 21 were it be done by say, a Federal drugstore? 22 So then, we attempt to put a value on 23 the goods stolen by addicts, the figure arrived at 24 by Professor Duke being 10 billion dollars. But we 25 need to add to this pain of stolen property, DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 79 1 DRUG HEARING 2 surely, the pain suffered by victims of robbers. 3 If someone breaks into your house at night, perhaps 4 holding you at gunpoint while taking your money and 5 your jewelry and whatever, I think it is reasonable 6 to assign a "higher cost" to the episode then the 7 commercial value of the money stolen and the 8 missing jewelry to what you have suffered. 9 If we were modest, we might reasonably, 10 if arbitrarily, put at $1,000 the value of the 11 victim's pain. But then the hurt, and 12 psychological trauma, might be evaluated by a jury 13 at ten times or even 100 times that sum. 14 But, we must consider other factors, 15 not readily quantifiable, but no less tangible. 16 Fifty years ago to walk at night across Central 17 Park was no more adventurous than to walk down 18 Fifth Avenue. But walking across the park is no 19 longer done, save by the kind of people who climbed 20 the Matterhorn. 21 Is it fair to put a value on a lost 22 amenity? If the Metropolitan Museum were to close, 23 might we, without fear of distortion, judge that we 24 have been deprived of something valuable? If it is 25 valuable, how valuable is it? What value might we DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 80 1 DRUG HEARING 2 assign to confidence that, at night that one can 3 sleep without fear of intrusion by criminals 4 seeking money or goods exchangeable for money? 5 Pursuing the Utilitarian analysis, we 6 ask: What are the relative costs of on the one 7 hand, medical and psychological treatment for 8 addicts, and on the other, incarceration for 9 drugs? It transpires that treatment is seven times 10 more cost effective. By this is meant that one 11 dollar spent on the treatment of an addict reduces 12 the probabilities of continued addiction seven 13 times more than one dollar spent on incarceration. 14 Looked at another way: Treatment for 15 addicts is not now available for 40 percent of 16 those who would benefit from such treatment. Yet, 17 we are willing to build more and more jails in 18 which to isolate more and more drug users, even 19 though at one-seventh the cost of building and 20 maintaining jail space, we would subsidize 21 commensurately effective medical care and 22 psychological treatment. 23 I have spared you, even as I have 24 spared myself, an arithmetical consummation of my 25 inquiry, but the data here cited instruct us that DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 81 1 DRUG HEARING 2 the cost of the drug war is many times more 3 painful, in all these manifestations, then would be 4 the licensing of drugs combined with intensive 5 education to nonusers and intensive education 6 designed to warn those who experiment with drugs. 7 We have seen a substantial reduction in 8 the use of tobacco over the last 30 years, and this 9 is not because tobacco became illegal, but because 10 the sentient community began in substantial numbers 11 to apprehend the high cost of tobacco to human 12 health. 13 If Ninety-five percent of the American 14 people can experiment with drugs and resist 15 addiction, using their own resources and profiting 16 from information publicly available, we can 17 reasonably hope that approximately the same number 18 would resist the temptation to purchase such drugs 19 even if they were available at a public or Federal 20 drugstore at minimal cost. 21 Added to the above is the point of 22 civil rectitude. Those who suffer from the abuse 23 of drugs have themselves to blame for it. This 24 does not mean that society is absolved from active 25 concern for their plight. It does mean that their DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 82 1 DRUG HEARING 2 plight is subordinate to the plight of those 3 citizens who do not experiment with drugs, but 4 whose life, liberty and property are substantially 5 jeopardized by the illegalization of the drugs 6 sought after by the minority. 7 I have not spoken of the cost to our 8 society of the astonishing legal weapons available 9 now to policemen and prosecutors of the use of the 10 penalty of forfeiture of one's home and property, a 11 violation of laws which, though designed to advance 12 the "War Against Drugs," could legally be used -- 13 I've learned from learned counsel -- as penalties 14 for the neglect of one's pets. 15 I leave it at this, that it is quite 16 simply outrageous to live in a society whose laws 17 tolerate sending young people to life in prison 18 because they grew or distributed a dozen ounces of 19 marijuana. I would hope that the good offices of 20 your vital profession would mobilize at least to 21 protest such excesses of wartime zeal, the legal 22 equivalent of a My Lai massacre. Perhaps you might 23 succeed in recommending experimentally the 24 legalization of the sale of marijuana, except to 25 minors. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 83 1 DRUG HEARING 2 And perhaps what is primarily needed is 3 to encourage our political representatives to 4 reject any suggestion that to permit traffic in a 5 drug is to condone the consumption of it. We are 6 free to view "Deep Throat" on television, but it 7 does not follow that those who interpret the First 8 Amendment as making that legal, endorse the 9 enterprise. It is humiliating to suppose that the 10 distinction cannot be communicated to adult voters 11 who are to be distinguished from those adults who 12 encourage adult movies. 13 Thank you. 14 MS. PIEL: We have questions from the 15 panel. 16 QUESTIONS FROM MR. KAYSER: Mr. 17 Buckley, good morning. The question I've asked a 18 number of witnesses is what their position would be 19 on a scheme of things which -- first the issue of 20 should drugs sales and legalization be left to the 21 state as opposed to the Federal policy on it? 22 RESPONSE FROM MR. BUCKLEY: I would 23 favor a movement in any such direction as we have 24 in over 11 states who have here and there played 25 with marijuana. Alaska went quite far, but at the DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 84 1 DRUG HEARING 2 this strenuous insistence of Federal agencies, they 3 repealed that particular law. So, if you say let's 4 inform by urging the states to exercise their 5 authority, I think we are moving in the correct 6 direction. 7 QUESTION FROM MR. KAYSER: And 8 secondly, in terms of what your position might be 9 in the state that you live, what your position 10 would be if the state favored licensing pharmacies 11 to sell drugs and collect taxes on those drugs and 12 proper labeling and distribution and consumer 13 protection and dedicating the tax money to 14 treatment, what was your position on that? 15 RESPONSE FROM MR. BUCKLEY: I think 16 that would be very prudent and pervasive and 17 positive. It's important not to tax them to the 18 extent that would encourage the revival of the 19 black market. 20 QUESTION FROM MR. FISCHER: Mr. 21 Buckley, could you comment on the effect that our 22 drug policies has, as a matter of foreign policy, 23 with regard to, for example, our Latin American 24 neighbor? 25 MR. BUCKLEY: We have a technical DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 85 1 DRUG HEARING 2 problem. It states most directly who will and who 3 doesn't want to repeal its ratification of that 4 treaty, that covenant, that requires an individual 5 country not to do anything that promotes the use of 6 drugs. So, what they do is simply permit the use 7 of drugs and say nothing about it. We are not good 8 at that kind of thing because we are too exposed. 9 However I am advised by authorities that a 10 rescission of that commitment provided as an 11 agreement of an attempt ultimately to reduce the 12 ill effect which in the first instance were adduced 13 as a reason for that covenant would be persuasive 14 to International counsel. 15 QUESTION FROM MS. ROCKLEN: Thank you 16 very much. I want to explore a little further 17 something you touched on at the end of your 18 speech. One of the frequently thrown up questions 19 is what are we going to tell our children, and I 20 guess the question is do you have any thoughts on 21 how we legalize drugs without legitimizing them or 22 whether that's even a useful concern? 23 RESPONSE FROM MR. BUCKLEY: Well, I 24 think a concern -- it has to be a constant by 25 individuals who over the course of experience have DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 86 1 DRUG HEARING 2 decided how their children respond to different 3 forms of persuasion. One thing we absolutely need, 4 of course, is that the illegalization of drugs has 5 had practically no effect on the consumption, say 6 in the college population of marijuana. I was told 7 by students at Harvard at it is much easier to get 8 marijuana in Cambridge then booze. But if you bust 9 the person who sells it to you illegally because 10 you are a minor, he stands to forfeit his license. 11 Where there is no cap tap plan and I've run into 12 nobody who says it is any problem in doing so. 13 As far as parents exercising any kind 14 of authority over their children, it's of two 15 kinds, morals and issues with respect. The moral 16 information says don't do it because it's harmful 17 and self-mutilation. It doesn't in the long run 18 pay off and inform in the sense that you are 19 entitled to say the percentage of people who 20 experiment with marijuana end up with about 78 21 percent addicted and there is a certain aspect of 22 Russian roulette, therefore, if you played with 23 it. That fact I think we simply know from 24 experience that the overwhelming majority of 17, 25 18, 19 year olds do experiment with it and do to DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 87 1 DRUG HEARING 2 some point put it to one side. But I'm not -- I 3 have a son who smoked marijuana. I'm simply not 4 informed on any magical way in which to communicate 5 the authority, moral and instructional, that 6 individual parents have over their children. 7 MS. PIEL: Thank you. Mr. Knapp. 8 QUESTION FROM MR. KNAPP: Mr. Buckley, 9 taking advantage of your political acumen, I'd like 10 to post the following question: Your views in this 11 area as you speak them have evolved to what extent 12 in life as a an example of failure of the plan to 13 disband the drug enforcement administration and 14 place its functions with the Federal Bureau of 15 Investigation; in light of failure of that, have 16 you been able to identify any governmental interest 17 in at least exploring a change in the drug 18 policies? 19 RESPONSE FROM MR. BUCKLEY: Well, 20 there's an interest, but it's pretty much in the 21 closet. It's extremely difficult to find, but you 22 do occasionally find it despite those who speak 23 about it overtly, but we have to also remember that 24 there enormous lobby in fear of continued 25 enforcement. A lot of people lose their jobs if we DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 88 1 DRUG HEARING 2 legalize drugs. On the intramural question further 3 injuries resulting from agency A to agent I is 4 simple. I am neither informed or particularly -- I 5 haven't had, but that to the extent that those 6 discussions happen and they illuminate the basic 7 questions which you are considering here then I 8 would well tell them. 9 MS. PIEL: Thank you. 10 Now we have questions from the 11 audience. Anyone here? Come up and take the 12 microphone and place it back, please. 13 QUESTION FROM AUDIENCE MEMBER: I'd 14 like to follow up on the questions of policy of 15 change. I'm a reporter from Channel 9 and it seems 16 that I've witnessed a good deal of mileage 17 politically covering events on the issues of the 18 "War On Drugs," and I'm wondering if there have 19 been any mileage gotten politically out of changing 20 that position and moving more towards legalization 21 and more towards your point of view? 22 RESPONSE FROM MR. BUCKLEY: Not quite 23 yet. The reason they haven't is because the other 24 person is going to say is that what you have really 25 in mind is a general side for blacks and Hispanics DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 89 1 DRUG HEARING 2 and you're indifferent to the suffering you have 3 Congressman Gephardt or my dear friend, Charlie, 4 that I ran against, that does make light of it 5 every day. That's why the way it has to be 6 prepared for absolving the crime and an 7 enterprising candidate to say it's simply incorrect 8 to suppose by espousing this measure indicates my 9 approval of drug experimentation. That can only be 10 done by education. You know, Jefferson told us 11 that "laws are merely a confluence of public 12 opinion," and public opinion has to be changed by 13 people like you. 14 RESPONSE FROM AUDIENCE MEMBER: Thank 15 you. 16 QUESTION FROM AUDIENCE MEMBER: I was 17 very moved by your talk. I just wanted to say -- 18 RESPONSE FROM MR. BUCKLEY: Thank you. 19 QUESTION FROM AUDIENCE MEMBER: I have 20 been working for years to try to support the 21 medical use of marijuana and democratic 22 administrators failed if they approve it and they 23 will place a ban on drugs and recently, Pat 24 Buchanan has come out in favor of the use of 25 marijuana and other republican candidates or the DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 90 1 DRUG HEARING 2 president asks if you think there is a way we might 3 approach them about it. 4 RESPONSE FROM MR. BUCKLEY: There's an 5 identifiable movement that is taking us in that 6 direction saying if the doctors say marijuana would 7 actually help you or help your nausea after 8 exposure to various therapy, it's okay. A habit 9 that I spot here and there and the probability is 10 that change would come and as you know, there was a 11 very active movement for a few years to authorize 12 the use of heroin for terminal cancer patients. It 13 was narrowly defeated on the grounds that you would 14 use in coping with the marijuana problem, but it 15 came close enough, and finally, went down only when 16 doctors who served as witnesses persuaded the 17 congressional committees that you could, in fact, 18 contrive a series of drugs and call them cocktails 19 in Great Britain that would have an effect as 20 powerful as heroin, but the general sympathy that 21 is given to people who are sick and can benefit 22 from marijuana is I think growing increasingly. I 23 had a sister who had radiation -- no, who had 24 chemotherapy and she wrote me and said that I'm 25 trying to get some marijuana because I'm told it DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 91 1 DRUG HEARING 2 would help me. So I wrote a column about it and I 3 became briefly the marijuana center of the United 4 States and everybody sent it to me. She, in fact, 5 did try it, but it didn't help her simply because 6 she reacted to the inhalation, but anyway, my point 7 is that it is a widespread acknowledgment that it 8 is used. Richard Brickheiser (sic.) here in New 9 York City wrote a piece on it for the New York 10 Observer and he had the same problems and his wife 11 who is a medical professional brought it to him and 12 simply did so, and I think that it's creeping in 13 the direction of quite general acceptance. 14 MS. PIEL: One more question and then 15 we have to go on. 16 QUESTION FROM THE AUDIENCE: The effect 17 of drugs -- Richard Bennett said on an ABC 18 television special recently that any form of 19 legalization of drugs would almost immediately make 20 50,000,000 hard-core drug addicts in the United 21 States; I disagree with that, but I wonder what 22 your comment is? 23 RESPONSE FROM MR. BUCKLEY: My comment 24 is that is simply an extrapolation not based on any 25 evidence. We know for instance, that in Amsterdam DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 92 1 DRUG HEARING 2 where marijuana -- they have had a legal rate of 3 consumption higher then in Cambridge Massachusetts, 4 so there's evidence to the contrary, but Professor 5 Duke persuasively says that even if the consumption 6 of drugs was to increase tenfold, we would still 7 in the calculus that I attempted today, be better 8 off then we now are. 9 Fluctuations in the use of drugs have a 10 lot to do with experimentation circumstances. As 11 many as 35 percent of Americans used and when they 12 got back within a matter of months they were on 13 reduced use of four or five percent. Some people 14 would experiment simply fashionably to sell before 15 the fact of legality, but it's not probable. 16 When prohibition rolled in the 17 consumption of alcohol dropped very sharply at 18 first because people were afraid to violate the 19 law. It then went up to about 50 or 70 percent of 20 what the consumption had been pre-prohibition and 21 when prohibition was repealed, it didn't rise at 22 all. It was more than a decade, but it rose to the 23 pre-prohibition level and there we have a 24 distorting experience where it did not increase the 25 alcoholics by 50 million Richard Bennett and James DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 93 1 DRUG HEARING 2 Wilson are extremely committed intellectually and 3 emotionally and I don't think they were 4 sufficiently the calculations that I attempted to 5 interest you in. 6 MS. PIEL: Thank you so much, Mr. 7 Buckley. 8 We'll take a short recess. 9 Off the record. 10 (Whereupon a short recess was taken. 11 MS. PIEL: We're about to get started, 12 would you please take your seats. 13 Our next speaker we are happy to have, 14 Dr. William M. London, who is director of the 15 Public Health American Counsel on Science and 16 Health in New York and he is here to tell us the 17 top priorities of his organization which is to help 18 Americans distinguish between real and hypothetical 19 health risks. A number of questions were asked 20 today of the other speakers concerning this and 21 we'll be very happy to hear you. Dr. London, tell 22 us what we should know about this. 23 TESTIMONY BY DR. LONDON, DIRECTOR OF PUBLIC HEALTH 24 AMERICAN COUNSEL ON SCIENCE AND HEALTH: 25 Thank you. I'm very pleased to be here DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 94 1 DRUG HEARING 2 and absolutely thrilled to have read the 3 committee's report and I'm honored to be here with 4 so many distinguished speakers. I'm one of the few 5 speakers that I ever even heard of today. It's 6 very hard for me to comment on this report because 7 the report says many things that I would like to 8 have said myself and I can't say it any better. I 9 want to bring some other perspectives to the issue 10 that I think may be helpful to you. 11 I'm a health educator by training in 12 public health and people often ask me as a health 13 educator what do I coach and I tend to get 14 flustered when they do so. I'm actually somebody 15 who spends time promoting healthy life-styles and I 16 have been Professor of Kent State University for 10 17 years and a drug abuse prevention specialist and 18 receive funding from the United States Department 19 of Education to do training grants in drug 20 prevention. I want to bring some of those 21 perspectives alive today. It seems to me that Woody 22 Allen described the situation best, "We are in 23 America at any time in history mankind faces 24 crossroads and only one path leads to despair and 25 utter hopelessness, the other to total extinction. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 95 1 DRUG HEARING 2 Let us pray we have the wisdom to choose 3 correctly. " 4 It's amazing to me that people chose 5 utter extinction over utter despair and 6 hopelessness. Extinction is not nearly as nice. 7 Actually, I'm not so sure that that dichotomy 8 presents the only alternatives and the way we think 9 about things tends to narrow the possibilities of 10 solutions and often it distorts our perspectives on 11 our risks. So, I spend a lot of time trying to 12 place risk in perspective and dealing a lot with 13 how we think about things in our world and science. 14 So much of the time it's not the things we don't 15 know that get us in trouble, but the things we know 16 that ain't so. 17 One thing that fits along those lines 18 of this kind of thing and I'm very much interested 19 in, is the concept of addiction and this is how it 20 presented to us. There are two basic kind of ways 21 of looking at it. The drug addict as sick 22 requiring help, a treatment center and basically 23 viewed as some of kind of victim or criminal 24 stigmatized, jailed, and deviant. And, I think the 25 fact that we are having this session today suggests DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 96 1 DRUG HEARING 2 to us that the speakers on most sides of the issue 3 are tending to reject the criminal view of this and 4 you hear of criminals who are still advocates to 5 compassionate treatment. And compassion, I 6 certainly value, and I don't necessarily think the 7 sickness model is the only way we can look at the 8 question of addiction and I want to summarize the 9 point that I'd like to make. I'm sure I will not 10 have time to elaborate on all of them and please 11 cut me off when it's necessary. 12 Here's my basic summary in life of my 13 session, regarding addiction in particular: No. 1 14 is drugs do not have any special power to enslave 15 people to use them. It's a sickness model. Rather 16 some people organize their lives excessively and 17 destructively around activities to medicate for 18 what I like to call the unbearable heaviness of 19 being, the pain of life, the search for the meaning 20 in life. 21 Point two, addiction is something we 22 would like to try to prevent as well as drug abuse 23 and in doing so, requires that we litigate risk 24 factors and this is what I have been trying to 25 promote for years as a drug abuse prevention DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 97 1 DRUG HEARING 2 specialist. The risks factors that lead people 3 away from organizing one's life around responsible, 4 prudent moderation and health. 5 Three, is what I like people to 6 consider. I actually asked the questions of Dr. 7 Kleber yesterday and I don't think what is fact, of 8 does it mitigate risk factors for drug addiction or 9 is it possible for a climate of drug prohibition 10 that the risk factors are actually exacerbated? My 11 view is that they are exacerbated. 12 No. 4, we do allow almost everybody who 13 talks about policy reform to advocate education. I 14 think it is often a mistake. Any notion about what 15 education is, my point is anti-drug propaganda is 16 not from education. It's a big distinction from 17 what propaganda is and what education is. 18 My fifth point is that drug education 19 efforts are likely to produce significant benefits 20 only in the context of comprehensive, school, 21 community health programs, integrated with all as 22 aspects. The point is you need to take all health 23 very seriously and drug education is another list 24 not simply as some coined feeble efforts, but as 25 part of mission of education really is and that's DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 98 1 DRUG HEARING 2 my point six. The true mission of education should 3 be the empowerment of information, living, loving, 4 learning and liberty, along with responsibility and 5 I believe drug education, not drug propaganda is an 6 essential component to achieve this mission. 7 My first point about addiction is if 8 you got rid of drugs today, we would still have 9 addiction. There is nothing magical about drugs 10 that enslave people to behaviors and excess and 11 that's really what addiction is about. That's 12 where the term comes from. It comes from a Latin 13 word. Addiction means the surrender to give into. 14 It's very similar to the word abdicated with a 15 different prefix essentially, but similar root, and 16 if abdicated sort of give away from, we give up and 17 give away. With addiction people surrender and 18 they surrender to behaviors. Behaviors in excess. 19 The term addiction had been used in the 20 19th century for activities other than drug takings 21 and later on became much more frequently used and 22 associated with drug abuse. Addictive behaviors 23 are habitual. There is apparent limited personal 24 flexibility, feelings of compulsion, overwhelming 25 feelings for engaging in involvement, repetitive DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 99 1 DRUG HEARING 2 and chronic, and they frequently occur. There is 3 difficulty in quitting without lapses and without 4 full-blown relapses and rejoined power to the 5 report. I focused on that aspect that made a claim 6 that tobacco and alcohol weren't as addictive as 7 other drugs by two criteria, I disagree. The two 8 criteria of judging addictiveness is the percent of 9 people who use in the manner I just described and 10 the difficulty in quitting. And tobacco is hot in 11 hand down there. The approximately 75 to 80 12 percent of current smokers want to quit and are 13 having difficulties and by the same notion we have 14 and should recognize that millions of people have 15 quit smoking and the vast majority have done so 16 without any formal program. The news that we are 17 enslaved to these habits, I think, undermines your 18 approach to the problems and result in a 19 problematic, self-fulfilling prophecy and that's 20 all I have to say about addiction. 21 In dealing with prevention, we need to 22 consider what your goal is. For instance, 23 establish inner and at a glance or these are the 24 people behind the development project in the report 25 who talk about five particular broad conceptions of DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 100 1 DRUG HEARING 2 what the prevention deals with. What are we trying 3 to prevent? Are we trying to prevent drug abuse? 4 Let's be clear what we mean by drug abuse. I don't 5 think it should be socially acceptable use 6 deviating from legal or medical standards. I 7 believe it should be used and viewed as 8 self-administration without reasonable likelihood 9 of medical benefit that results in harm of medical, 10 physical, social or emotional nature. 11 Two, regular use of psychoactive drugs 12 is a broad conception of the times that people want 13 to focus on. I think that misses part of the 14 issue. If we're truly interested in the whole, we 15 want to take a view that takes into account how 16 people use a whole range of substances. We also 17 want to take into account how people relate to a 18 whole range of behaviors. 19 The television program "Dateline" 20 yesterday, they talked about shopping addiction. 21 Very, very destructive. We cannot ban shopping, 22 yet we still have addiction. If we ban shopping, 23 but people destroy their lives in all sorts of 24 ways. So focusing just on psychoactive drugs and 25 neglecting other drugs and also neglecting a whole DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 101 1 DRUG HEARING 2 range of behaviors in existence, I think misses the 3 boat. Any use of psychoactive drugs. No. 3, we 4 have had it with the mandate in drug education 5 programs. The clear message that drug use is wrong 6 and harmful, that's propaganda, not education. 7 No. 4 and five to me were more 8 propagandizing and that's what the Seattle 9 development project does. The people who get into 10 the most problems with drugs are those who start 11 young, particularly preadolescent use. Let's focus 12 on the risk factors there and how we can prevent 13 them and mitigate those risk factors. The use of 14 particular drugs, so-called gateway drugs like 15 tobacco and alcohol have been more obtainable even 16 as the prevention goal -- even as the Department of 17 Education shifted in its funding that way. The 18 trouble with the conventional gateway drugs that it 19 makes it seem like the real problem once you pass 20 on the gateway and drugs on the gateway themselves 21 are less significant. That, in my view, distorts 22 perception of risks. 23 When we focus on drugs as in terms of 24 their power to enslave us, we miss the whole 25 picture. In public health we focus on actual lives DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 102 1 DRUG HEARING 2 and the environment. The drug is the agent who is 3 the fact that we bring to it as individuals that 4 effect our vulnerability susceptibility and the 5 environment, the -- our social environment. We 6 need to focus on setting a total of an individual 7 at time a drug is administrated and physical, 8 mental and emotional characteristics are part of 9 that and setting the total external environment of 10 the individual at the time the drugs are 11 administered. Yesterday Dr. Kleber gave you the 12 example of availability as a setting related 13 factor. He cited Vietnam as where drugs were 14 available and where people used drugs to a great 15 extent. There was more to the setting of Vietnam 16 then simply that there were lots of drugs 17 available. And there was a setting where the 18 unbearable heaviness of being might have been quite 19 great and people might have wanted to medicate for 20 it. In other Southeast Asia countries where our 21 folks were, there was not the same type of use and 22 as I think Mr. Buckley says, when people returned 23 to the United States, soldiers returned to the 24 United States, the drug use was not nearly to the 25 same extent -- three more minutes I'm doing better DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 103 1 DRUG HEARING 2 then I thought I would. 3 Let me talk to you about my point of 4 addressing risk factors and how I think prohibition 5 may actually exacerbate that. Let me tell you what 6 the risk factors we need to address are 7 particularly when dealing with early onset. 8 Prevention. There is economic deprivation -- by 9 the way, none of these risk factors in an of 10 themselves will explain drug abuse, but let's look 11 at the whole. Particularly, economic deprivation 12 is a risk factor and consider whether the "War On 13 Drugs" has as an impact on that. Low neighborhood 14 attachment and community disorganization. I ask 15 you to consider to what extent does -- you know, we 16 can do programs that provide culturally relevant 17 rights of passage programs, community based utility 18 development programs and programs that orientate 19 communities to available services, but what kind of 20 impact does having vigorous enforcement on 21 neighborhood attachment and organization of 22 community have? Does it strengthen community ties 23 or does it bond community ties for the poor or 24 inconsistent management practices? Again, consider 25 what happened with the "War On Drugs" as who had -- DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 104 1 DRUG HEARING 2 that availability of drugs again is a risk factor. 3 In some communities you may want to consider that 4 the "War On Drugs" makes drugs more available 5 because you can buy it on the street and it's 6 really not too hard to find them. 7 On the other hand, if the "War On 8 Drugs" keeps drugs completely unavailable in other 9 communities and No. 5 is I think the most important 10 risk factor from my perspective is low commitment 11 to education, school and learning. I don't think 12 propaganda programs enhance that. I think we 13 enhance our educational programs by actually doing 14 education. I think I'm involved in doing education 15 and creating a stimulating environment for kids to 16 live in, not one where there is a grim, oppressive 17 environment. I think education is all about 18 promoting critical things. I don't think drug 19 education has drastically done. It means not 20 arguing when someone doesn't know something, but 21 knowing when someone needs more information to 22 answer a question. Knowing there is a difference 23 to a conclusion that might be truth and must be 24 truth knowing that people have been trying to avoid 25 common mistakes in his or her own reasoning of the DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 105 1 DRUG HEARING 2 meaning of words. 3 I disagree with Dr. Grinspoon who 4 referred to marijuana as not being addictive. I 5 think of many drugs as being addictive, as 6 behaviors being addictive, drug taking is 7 addictive, not the drugs itself. Drugs provide 8 experience people seek, but the addiction people 9 often equate addiction with some kind of physical 10 dependence reaction and that's not the nature of 11 the behaviors that we're talking about and you 12 don't need to have a physical withdrawal reaction 13 to demonstrate behaviors. 14 I'm getting cut off, right? 15 MS. PIEL: Time is up. Questions from 16 the panel? 17 QUESTION FROM MR. FISCHER: There was a 18 study done at the beginning of the year or at least 19 the result were announced at the beginning of the 20 year by the Henry Ford Hospital in Detroit which 21 showed a high correlation between an absence of 22 drug use and the level of parental supervision of 23 very young children. The study started with 24 children in grades three and four. Are you 25 familiar with the study and do you have any DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 106 1 DRUG HEARING 2 particular opinion of it. 3 RESPONSE FROM DR. LONDON: I am not 4 familiar with the study. 5 QUESTION FROM MR. AFFLER: I'd like you 6 to elaborate a little more on the distinction 7 between addictive behavior rather then physical 8 addiction. My understanding is there are some 9 drugs that can be physically addictive, but at 10 least the majority -- if I'm wrong, correct me -- 11 but the majority of abuse is more behavior other 12 than that and I am just curious what percentage of 13 that breaks down -- 14 RESPONSE FROM DR. LONDON: This is the 15 issue in critical thinking that I'm raising for 16 us. How we use language is very, very important. 17 This isn't the issue that has not been resolved, 18 but I take a very firm stand here. I'm sort of a 19 purist, that I go back to how we originally use the 20 term and how in common language we use the term as 21 addiction referring to a behavioral pattern. 22 In the 60's, I think the 23 pharmacologists kind of took over and equated 24 addiction with withdrawal. They called it physical 25 dependence. I would suggest to you that physical DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 107 1 DRUG HEARING 2 dependence is a weak explanation of why people 3 engage in behaviors to excess. First of all, the 4 idea that people would engage in the behaviors to 5 express withdrawal reactions, but people don't 6 often wait around for a withdrawal reaction. They 7 don't really experience them. They don't need them 8 to have cravings for the drugs. Many people will 9 often go from a drug like cocaine to a drug like 10 heroin that are pharmacologically unrelated. That 11 has nothing to do with experiencing withdrawal and 12 in studies on relapse, negative and physical states 13 account for a very small percentage of precipitance 14 of relapse for gambling or for alcohol-related 15 alcohol use. 16 Addiction, as I like to refer to it -- 17 textbooks in the 1970's refer to cocaine as not 18 addictive because there wasn't a clinical 19 withdrawal action. The idea with withdrawal is 20 take more of the same drugs and repress the 21 physical reactions to the drugs. With cocaine, if 22 you try it to repress the withdrawal, you have a 23 depressed effect. What you do is you go on a run 24 and you produce a psychotic reaction. You can't 25 repress it cleanly. I would suggest to you that DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 108 1 DRUG HEARING 2 these are completely different concepts and I 3 overstate it. These are different concepts and 4 that the real issue that we should focus on is a 5 relationship to how one is living once life starts 6 and that most activity people engage in, they can 7 again engage in destructively and to excess. 8 Raising shopping addiction as an example is 9 minimizing the horror of drug addiction. I think 10 it may be the other way around. People have all 11 sorts of ways of destroying themselves with or 12 without drugs and with or without withdrawal 13 symptomatology. 14 QUESTION FROM MR. KAYSER: Dr. London, 15 from your testimony so far, I'm not exactly sure 16 what you would support in terms of a regulatory 17 scheme. I know that you're not satisfied with the 18 way it is now, but I'm not sure what you would 19 support. The question I have asked other witnesses 20 is, is what their position with respect to licensed 21 various pharmacies or some other appropriate outlet 22 for sale of drugs properly labeled collecting taxes 23 on these drugs commensurate with alcohol and 24 tobacco-type taxes and dedicating those taxes to 25 funds for research and for prevention and for DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 109 1 DRUG HEARING 2 treatment, also leaving it to the -- getting the 3 Federal government out of the issue because we 4 would be going back to the state level to 5 experiment for results in these hearings and I'd 6 like your reaction? 7 RESPONSE FROM DR. LONDON: That's where 8 the real debate needs to be with respect to those 9 questions. I'm not real firm on all my ideas in 10 this area, but let me give you a few. Regarding 11 labeling, I'm skeptical about the merits of a 12 government mandated label on drugs and I'm telling 13 you why. It seems to have insulated tobacco 14 companies from liability in these cases, that there 15 is a government mandated label. I would like to 16 see whoever manufactures drugs to be firmly 17 accountable and have as much incentive as possible 18 to insure there is as low a risk as possible. I 19 think they should be responsible for labeling 20 accordingly. So, that's one area and if they are 21 not responsible, there will be plenty of public 22 outcry and outrage and I think it would be to their 23 detriment to not be as responsible as possible. 24 So, I think that civil law is a very good way of 25 handling many of these problems. I'm not sure that DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 110 1 DRUG HEARING 2 -- I'm not sure that those particular kind of sin 3 taxes are necessary, but I think it will be very 4 beneficial simply to be able to collect income tax 5 from people selling drugs as legitimate business 6 people rather then not being able to collect 7 anything from them as they are hiding their assets 8 now. I don't know if licensure is the way to go or 9 not, this is where I want to hear more. 10 MS. PIEL: Any more questions from the 11 panel? From the audience? 12 QUESTION FROM AUDIENCE MEMBER: I'd 13 like to thank you for being the only person who 14 used the term abuse to actually give the 15 definition. By my way of thinking, I really like 16 eating. But seriously though, I'd like you, taking 17 your definition of abuse, to run through various of 18 the subjects which we would be dealing with 19 cannabis, cocaine, whatever, and say have those in 20 the United States, what would be your estimate 21 these days of the fraction of users whose primary 22 use of these materials is abuse. 23 RESPONSE FROM DR. LONDON: I'm not 24 really prepared to answer that going through all 25 those drugs. What I can do for you though and I DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 111 1 DRUG HEARING 2 think I even have it on an overhead. If I take 3 this up with me. I don't know if you can read this 4 or not, but the numbers I want you to see on the 5 top of Table 2 reflect cocaine, cocaine in terms of 6 millions of people who annually use cocaine, and in 7 1985 it was 12 million and in 1988 it was the eight 8 million from the National Institute on Drug Abuse. 9 Then you have weekly cocaine users reported the 10 same years and I think of weekly cocaine use as a 11 rough indicator of addictive use. Not everyone who 12 uses drugs once a week are addicted. Some people 13 may be addicted and use it less frequently. It 14 depends on one's relationship to the drug, but it's 15 a fairly rough indicator with what you see there, 16 which is $647,000 and less than one in 12 in 1985 17 were weekly users and in 1988 it was one in 10 18 there, and it also shows the effects of any kind of 19 intervention or trends in drug use which may differ 20 somewhat from trends in terms of how harmful the 21 use of drugs is. And setting factors are very 22 important in that regard. Compare these numbers to 23 tobacco where about 75 percent to 80 percent of 24 users would like to quit and think of it also -- 25 the other point in terms of difficulty quitting, DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 112 1 DRUG HEARING 2 smokers have a much more difficult time and there's 3 several lines of evidence for it, including a study 4 from the Addiction Research Foundation which asked 5 addicts which do you prefer; which gives you more 6 pleasure, your cocaine or the tobacco? What do 7 they say? Cocaine, which is harder to quit and 8 people are more likely to say that the tobacco was 9 more difficult to give up and we've seen this in 10 many ways. To get in treatment facilities you 11 often have to be drug free, but an exception is 12 often made for tobacco there. So, I think it's a 13 very important reference point in terms of 14 difficulty of quitting and the percentage of users 15 who use addictively. I'm not prepared to answer 16 your questions on drugs, but much less than 17 tobacco. 18 QUESTION FROM AUDIENCE MEMBER: I 19 wanted to ask, given your model of addiction as 20 excessive behavior, what does that say as to the 21 effectiveness of different types of effectiveness 22 or ineffectiveness of different approaches to 23 treatment. 24 RESPONSE FROM DR. LONDON: I think the 25 question of the effectiveness or ineffectiveness of DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 113 1 DRUG HEARING 2 various approaches of treatment doesn't necessarily 3 -- I don't see how it relates necessarily to how I 4 conceive of addiction. However, I think I'm a 5 critic of many treatment programs that I think are 6 promoting some sort of a self-fulfilling prophecy 7 in viewing drugs as things that can totally take 8 over people and that being sort of the person that 9 sort of extremely radical resolution is necessary. 10 I think that creates a self-fulfilling prophecy 11 that tends to grow against trends in psychology to 12 promote self-efficacy, the sense of people that 13 they can perform various types of behaviors. 14 That's my business though, and I can't really 15 defend it one way or the other that that's the 16 case, but that undermines programs, but it's a 17 controlling trend for me to see that in treatment 18 programs and I think it could be improved by 19 approaches that take a view that addiction is sort 20 of a pitfall of human existence and recovery can be 21 sort of a journey out of that pitfall, and that 22 tools can be learned to do that. That's my 23 preference, but I think there's some promising 24 aspect to that. I can't give you any firm 25 conclusion about mine is the right way to go. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 114 1 DRUG HEARING 2 MS. PIEL: Thank you, Dr. London. Dr. 3 Gordon, an author of a book which is entitled "The 4 Return Of The Dangerous Classic Drug Prohibition 5 and Politics." It's all yours. 6 TESTIMONY FROM DR. DIANA GORDON: 7 Thank you, very much. I'm delighted to 8 be here. I've had a long experience in analyzing 9 the policies of criminal justice and I've sort of 10 moved on now to looking at policies of drug 11 prohibition and I'd like to talk first about a 12 little bit about the report and some of my 13 reactions to the report, and talk about a little 14 bit about my works. I would think the sources are 15 important as we try to reform drug policy to deal 16 with the sources of our commitment to prohibition 17 which I think are much more complicated then we 18 sometimes admit. 19 I'd like to congratulate and compliment 20 the Committee on Drugs and Law of the Bar 21 Association for an extraordinarily intelligent and 22 sensible synthesis of many of the problems, rigid, 23 but selective, of prohibition of mind-altering 24 drugs, and I'd like to go beyond the comments on 25 drug historic effectiveness, which I think are DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 115 1 DRUG HEARING 2 incontrovertible and I think the public knows 3 almost as well as the experts. To talk about -- to 4 comment on some points that I think the committee's 5 report makes particularly strongly. 6 First, it provides an accurate 7 description of the distortion of the priority 8 occasioned in the huge increase in the drug arrests 9 and convictions beginning in the early and mid 10 80's. Drug prohibition can sort of be said to be 11 the lump in the boa constrictor in the crime 12 controls direction in the past decade or 13 decade-and-a-half, and in the State Prison 14 convictions in 1990 as in 1980 where property 15 crimes and violent crimes were only slightly -- 16 arrest, etcetera -- were only slightly more likely 17 to result in conviction. Secondly, I think the 18 report does a fine job of predicting the cost of 19 prohibition to civil liberty, the due process of 20 1970 and 1980, hence all the theorizing, and 21 advocacies of most vigorous law and order promote 22 lawyers wide-eyed refer to the drug exception, does 23 prohibition unreasonable search and seizures -- and 24 I think that's not an inaccurate characterization 25 and finally, I'd like to congratulate the committee DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 116 1 DRUG HEARING 2 on its recital of the dangers to public health of 3 the drug prohibition policy itself. The 4 development of more concentrated and dangerous 5 forms of drugs is being attributed to prohibition 6 and I believe that injuries and deaths caused by 7 transactional violence, that is the buying and 8 selling of drugs, far exceeds physical harm and 9 death from serious pharmacological damage done by 10 illegal drugs. 11 Now, I'd like to talk a little bit 12 about my work which tries to trace the sources of 13 our commitment as a nation to prohibition. The 14 research that I did for three years leading up to 15 the book that Ms. Piel referred to really was 16 conceived around two principal questions. Why is 17 the conventional definition of the drug problem so 18 inconclusive of encompassing so much violence and 19 suffering and attributed to harmful, social, urban 20 disenchantment and things like that. And secondly, 21 why has it became more intense and substantive as 22 evidence has mounted with its declared goals. We 23 have a strongly prohibitionist or strongly punitive 24 strain in American culture going back a very long 25 way and it's important to note here that while drug DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 117 1 DRUG HEARING 2 policymaking is dominated by law enforcement 3 measures, that it does enjoy still very wide public 4 support. 5 Yet, the political demands that 6 sustains what appears to be a popular and political 7 consensus has many concerns about many sources 8 besides concern about reducing the physical and 9 social harm that can occur as a result a 10 experimenting with psychoactive drugs. The variety 11 and depth of wants and needs that sustain 12 prohibition is extraordinary. A concern for 13 personal safety which gives government elites a 14 chance to determine straight, social, control 15 capability of state and an interest in going what 16 are increasingly seen as dangerous classes in 17 society, minority male youth. Sometimes I am in 18 agreement with the sometimes so-called cultural 19 liberals and the chance to advocate a policy about 20 which people have great fear and, therefore, convey 21 the extensive protectiveness which supports 22 political candidates and bureaucratic growth in the 23 area of law enforcement and sometimes in the area 24 of social welfare. I argue that the weight and 25 profusion of all the national functions of our drug DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 118 1 DRUG HEARING 2 policy -- current prohibition drug policies are at 3 least as equivalent in the medical and some social 4 harm caused by drugs and, therefore, if we are 5 going to address the drug prohibition policy and at 6 least mitigate it partially, if not change it 7 entirely, we are going to have to address these 8 political sources of support for drug prohibition 9 as well as the substantive issues of physical and 10 social harm that drug abuse or the consumption of 11 illegal drugs. Because, of course, it's not always 12 drug abuse that is punished in this system. So, I 13 maintain that there is a kind of shadow agenda in 14 drug policy as in some other areas of social 15 policy. By think, I don't mean a hidden agenda. 16 It's often quite open, but a sort of dark and 17 volatile shadow which accompanies the concern about 18 physical and social harms of dangerous drugs. I 19 don't mean by any means to suggest that there isn't 20 a serious public health and other kinds of sorts of 21 family communication problems and things like that 22 caused by drugs. I don't mean to say that they 23 don't cause significant problems, but rather that 24 there's an agenda shadowing the agenda of reducing 25 those harms which reflect rational and generational DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 119 1 DRUG HEARING 2 conflicts. Prospects of political and material 3 gain and bureaucratic devotion to or commitment to 4 bureaucratic growth. 5 In order to route my exploration of my 6 basic questions in the flesh and blood of the 7 contest over drug policy, I studied five cases of 8 drug politics in action in a variety of arenas. 9 They included: 10 One, the development of a congressional 11 consensus supporting the death penalty for drug 12 kingpins even where no murder is committed. 13 The adoption and revision of a Michigan 14 law mandating life imprisonment without parole for 15 people convicted of possession of more than 650 16 grams of opiates or cocaine derivatives. 17 The decriminalization in Alaska by a 18 citizens' iniative of possession of small amounts 19 of marijuana for personal use after 15 uneventful 20 years of decriminalization. 21 The passage of an anti-drug sales tax 22 in the era of taxpayers' revolt also in the part of 23 the country most committed to the taxpayers' revolt 24 to fight drugs. 25 In Jackson County, Missouri, which is DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 120 1 DRUG HEARING 2 Kansas City, the adoption of a Seattle ordinance 3 making it illegal to loiter with intent to engage 4 in an illegal drug transaction. 5 The results of these actions, these 6 legislative actions, taken of a prohibitionist sort 7 are quite interesting and illustrative. In 8 Michigan, the legislators who voted for the 650 9 plus law in 1978, did so because they thought it 10 would ensnare the big heroin dealers, but the 11 evidence is overwhelming that the law has served up 12 a different kind of defendant. The bulk of people 13 sentences to life imprisonment -- I think there are 14 about 160 of them now under the law -- are merely 15 couriers in the trade. Autoworkers laid off, who 16 do two or three jobs and get caught in this web. 17 More than half of the defendants who have these 18 life sentences have no prior records whatsoever not 19 just no drug record, but no record of kind. 20 The recriminalization of marijuana 21 possession in Alaska has produced virtually no 22 defendants. The police and the public apparently 23 share a lack of interest in arresting people in 24 their homes and prosecuting them for possessing 25 small amounts of the drug and the criminal law has DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 121 1 DRUG HEARING 2 always covered more problematic situations. 3 With respect to the Jackson County 4 anti-drug drug sales tax, adding 14 million dollars 5 of tax money annually to the "War on Drugs" in 6 Kansas City, initially failed to drive up arrests 7 and prosecutions for drug offenses, although that's 8 no longer true, but two years after the tax went 9 into effect, neither officials, including law 10 enforcement people, nor anti-drug activists, 11 believe that illicit drugs were less available on 12 the streets of Kansas City. 13 The Seattle Loitering Law has not 14 resulted in the large number of arrests that could 15 be relied upon to produce solid convictions. 16 Furthermore, the deployment of 100 police officers 17 appointed since the law went into effect has more 18 impact on the downtown open air markets then the 19 loitering law has. The perception that the law 20 contributes to police harassments of young minority 21 males persists and has been buttressed by a local 22 affiliate ACLU study, which found that something 23 like 92 percent of the arrests under the drug 24 loitering law were of young minority males and that 25 over half of those were never charged for -- were DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 122 1 DRUG HEARING 2 such poor arrests that they never amounted to real 3 criminal cases. 4 This, of course, doesn't mean that -- 5 it doesn't mean that there wasn't something 6 accomplished at the political level with these 7 prohibitionist contacts. Supporting and voting for 8 the death penalty presumably helps furnish images 9 of some members of Congress as leaders in securing 10 security to their constituents. 11 Positioned at the extreme end of the 12 range of Federal penalties, the proposal lends 13 legitimacy to other more conventional designations 14 of capital crimes -- and I think we'll see the 15 expansion of capital crimes in Federal anti-crime 16 legislation in the next few years -- 17 Recriminalizing pot in Alaska made some 18 parents feel empowered to effect their children's 19 futures and to exert their own authority and it's 20 kind of a symbolic strand in the tightening 21 cultural bond between the last frontier and the 22 lower 48. Alaska doesn't want to be seen as the 23 outlying roughneck place that appealed to its early 24 residents. 25 The drug sales tax program in Kansas DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 123 1 DRUG HEARING 2 City has insured organizational and fiscal health 3 for criminal justice. It was clear that the city 4 and county law enforcement people needed new 5 computers and new walkie-talkies and new technology 6 for the normal function, ordinary functions, of 7 criminal justice and they were hard to get in an 8 era of taxpayer concern, so this campaign provided 9 a kind of -- I don't want to say cover or excuse 10 because that sounds too conspiratorial, but 11 provided them with an alternative route which put 12 the emphasis on the drug problem of Kansas City and 13 not on the larger issue of providing adequate 14 assistance to law enforcement and criminal 15 justice. 16 In the cases of both the Michigan 650 17 Plus law and the Seattle Drug Loitering Law, the 18 most important effect however unintended or 19 inadvertent it may have been, was to foster and 20 reinforce for many the association between young 21 inner city black males and the drug problem. Both 22 in the Midwest and the northwest, drug prohibition 23 has helped to focus, target and label the often 24 effuse threats of dangerous classes. 25 I'm not, I would say, a proponent of DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 124 1 DRUG HEARING 2 legalization in the same way that I'm not a 3 proponent of prohibition. I think the legal 4 advisors and prohibitionists make some of the same 5 mistakes in assuming that the larger problems of 6 the cities of our social and criminal malaise will 7 be solved by either legalization or by 8 prohibition. But, I think, in order to move toward 9 a set of reforms we are going to have to address 10 the more complex supports for prohibition that 11 exist both among the public and among 12 professionals. 13 MS. PIEL: Thank you, Dr. Gordon.. 14 MS. PIEL: We are now going to have 15 some questions and your conclusion, I think, will 16 provoke quite a few. Members of the panel? 17 QUESTION BY MR. KAYSER: Actually your 18 conclusion -- is it professor or doctor? 19 RESPONSE BY DR. GORDON: Professor. 20 QUESTION BY MR. KAYSER: -- is 21 interesting to me is -- actually a question I was 22 going to ask you as a political scientist, is that 23 it seems to me that one -- I'd like your comment on 24 this. 25 Is one of the problems in getting the DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 125 1 DRUG HEARING 2 reform of the system as you say, is the consensus 3 that it's not working? 4 RESPONSE BY DR. GORDON: I think one of 5 the problems with getting reform -- 6 QUESTION BY MR. KAYSER: I think you're 7 saying the consensus is that the current system is 8 not working. Is one of the problems in getting 9 reforms on the system is that there is no consensus 10 of what the reform might be and that, just as your 11 conclusion seems to leap up in the air with no 12 definitive place to move, and of course, I have 13 been asking witnesses what their position is with 14 respect to if you did have a legalized system, 15 would you leave it to the states and then debate it 16 at the state level a system in which you could 17 license pharmacies to sell drugs and collect taxes 18 and use the taxes for some dedicated ways for 19 prevention and treatment and so forth; at least 20 until there is a model that people can respond to 21 in terms of a system that might be an alternative 22 system. 23 RESPONSE BY DR. GORDON: I hear two 24 questions there and I'll answer the second one. I 25 think your scenario of a regulated system probably DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 126 1 DRUG HEARING 2 makes a good deal of sense. I would think you 3 would need to do it in a gradual sort of way. Now 4 we're not talking about politics, we're just 5 talking substance. Because I think one of the 6 things that we need to do is test for substitution 7 effects. One of the criticisms that is made of 8 legalization and decriminalization proposals is 9 that if you legalize or decriminalize, you'll 10 suddenly have lots of new users or lots of new hard 11 users and there is some evidence that that's just 12 not going to be true because there are other ways 13 you can substitute a less dangerous form of the 14 drug, for instance, for what you're now taking or 15 if you have -- you know, if you can drink cocaine 16 tea or smoke opium or find less concentrated 17 forms. It may be that you are able to produce 18 substitution effects, but I would want to do that 19 gradually. I wouldn't do it all at once. 20 There is only one example I can think 21 of where that's been quite successful and that is 22 with the prohibition of absinth in France in the 23 19th century. When I was working on this book I 24 got fascinated by that example of drug prohibition 25 that actually worked. But, it worked, I think, DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 127 1 DRUG HEARING 2 because there were plenty of substitutes for 3 absinth and, in fact, what was generally done was 4 that clear liquors were dyed Grinspoon to look like 5 absinth so people could pretend they were still 6 drinking absinth. I think we need to test this 7 substitution fairly gradually. 8 What I heard as the first question, a 9 different question, has to do with the difficulty 10 of persuading people below the -- beyond the 11 medical uses of marijuana for example. You're 12 really going to have to convince Americans that not 13 just that drug prohibition is ineffective. I think 14 they already believe that, but that we shouldn't 15 hold on to it for other reasons. I mean drug 16 prohibition gives people the chance to express 17 their frustrations and concerns with the 18 rebelliousness of youth and the conditions in the 19 ghettos and participating in anti-drug neighborhood 20 watch patrols which gives people a sense of 21 participation that they don't have in a lot of 22 areas that maybe they used to have with their 23 political parties or unions or wards. 24 I think we really have to address the 25 attitudes of Americans that drug prohibition has DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 128 1 DRUG HEARING 2 moral -- conveys moral values that are important to 3 uphold and I mean that I think the fact that people 4 believe that drug prohibition is ineffective as a 5 substantive matter, doesn't mean they're going to 6 easily relinquish it as political matter. 7 MS. PIEL: Questions? Mr. Knapp? 8 QUESTION BY MR. KNAPP: Professor 9 Gordon, with respect to the experience in Alaska, 10 are you aware of any studies investigating at the 11 time of decriminalization of small amounts of 12 marijuana for personal use, the effect, if any, on 13 the consumption other any harder drugs or on 14 alcohol; is there any change in the rates? 15 RESPONSE BY DR. GORDON: Alaska has not 16 had much of a hard drug problem. When I was 17 interviewing in Alaska in 1990 and '91, I was told 18 nobody had ever seen crack, but they expected it to 19 come up from the lower 48 at any moment, but this 20 was five years after crack had been a major problem 21 in the big cities in the lower 48. Well, mostly 22 Alaska is a place where people drink and then there 23 is a small marijuana-using culture and it's going 24 to be very difficult to change that because 25 marijuana is easily grown -- easily and invisibly DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 129 1 DRUG HEARING 2 grown along the banks of Alaskan rivers. So I 3 don't think there was a hard drug problem before 4 and there wasn't a hard drug problem afterwards. 5 When I talked to the Attorney General 6 of Alaska about the significance of marijuana as a 7 criminal problem of decriminalization, whether 8 decriminalization had created more problems of 9 other criminal sorts, he said we just have not 10 noticed any difference. 11 MS. PIEL: Any more questions? 12 QUESTION FROM THE AUDIENCE: In terms 13 of the five models, sort of, different drug laws, 14 in particular the Michigan one which seems harshest 15 that you studied and which all seem to either have 16 not reach their intended results, what is the 17 perception of the public at large in those 18 jurisdictions; does the public at large realize 19 that these have not reached their intended results 20 and if so, what is their reaction? 21 RESPONSE BY DR. GORDON: Well, I can't 22 really tell you about the public at large, but I 23 can tell you about their representatives. For 24 example, in Michigan after the ineffectiveness of 25 this and the fact that the 650 Plus Policy was DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 130 1 DRUG HEARING 2 netting only these little fish, rather than the big 3 heroin dealers, after there was some publicity 4 about that, people in the state legislature -- 5 representatives in the state legislature began to 6 feel empowered to try to change it and there has 7 been a effort, unsuccessful thus far, but there has 8 been an effort. Which I think could not have been 9 possibly mounted 10 years earlier to make the law 10 less harsh. 11 The Supreme Court of Michigan finally 12 threw out one tiny aspect of this law. Now, you 13 can't be -- if you can show that you had no intent 14 to sell, you can't be given a life sentence. But 15 still, most of the possession cases are, I think, 16 probably situations in which the defendant did 17 intend to sell and, you know, it's very difficult 18 to prove otherwise, and there was no -- when this 19 modification of the law was made, the principal 20 reaction as I could gauge it from the newspapers, 21 was that it didn't go far enough. I can't tell you 22 more about the public. 23 MS. PIEL: All right. We're going to 24 take one question from the audience and maybe 25 another and then our time will be up. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 131 1 DRUG HEARING 2 QUESTION FROM AUDIENCE MEMBER: I am 3 wondering from a political science standpoint, what 4 do you think is the origin and essence of the 5 historic distinction made between the possessor and 6 the person who provides that possession to the 7 possessor; why it is that we have always made such 8 a strong distinction? 9 If the possession and consumption of 10 the drug constitutes a serious danger to society, 11 he ought to be punished severely. If it doesn't, 12 why is the person who gives the drug to that person 13 subject to serious penalty. 14 RESPONSE FROM DR. GORDON: I'm afraid I 15 really don't know the answer to that, but I do know 16 that in Holland, the relaxation -- it really isn't 17 legalization in Holland, but the relaxation of drug 18 laws has been sharply divided between -- there's 19 reform with respect to possession laws, but not 20 reform with respect to dealing laws. 21 My sense is that even in that much more 22 relaxed, pragmatic society, there's still a sense 23 of moral turpitude associated with purveyors that 24 is not so terribly different from what it is, 25 qualitatively at least, from what it is here. I DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 132 1 DRUG HEARING 2 think that would be extremely difficult to counter 3 from a political point of view. 4 QUESTION FROM AUDIENCE MEMBER: 5 Professor Gordon, I don't know whether you are 6 aware that this committee invited several 7 representatives of the Federal government to 8 participate in the current dialogue and all the 9 invitations were declined. 10 I wonder if you could comment on the 11 prospect for a wide-ranging debate of a wide 12 variety of policy options considering the current 13 political situation and this administration? 14 RESPONSE BY DR. GORDON: I think it's 15 going to be very difficult. I think, you know, 16 there have been on occasion at the Federal level 17 reformers who have gotten their wrists slapped and 18 I sort of assumed that that's not going to change 19 in the immediate future. 20 In Germany there is a huge gap and to 21 some extent in the United Kingdom, between the 22 rhetoric at the center and local iniatives and on 23 the continent there's something called the Hamburg 24 Resolution, which now must have 3035 signatories. 25 Each city is a signatory to a resolution to adopt DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 133 1 DRUG HEARING 2 the policy of harm reduction as the principal focus 3 of drug control rather then law enforcement. 4 There are lots of little local programs 5 and it's fascinating to be in Germany studying 6 this, because you go from one little local program 7 to another. For instance, one local program I saw 8 also in Hamburg, was teaching heroin addicts to 9 shoot up safely so they don't hit the arteries of 10 the femoral artery, and of course, that's mixed 11 with concern about shared needles. 12 So, here you go and you go see these 13 shooting-up rooms with a public health nurse 14 present all the time and then you listen to or you 15 see German television and there's Chancellor Cole 16 waving his drug treatment and enforcement plans and 17 it looks exactly like the national strategy for 18 drug control that is put out by successive 19 administrations in this country. 20 So, I think it may be that one approach 21 is not to deal with it -- not to try even to deal 22 with it at the national level at this point, but 23 rather to work on small local reform efforts and 24 find a few more brave mayors like the mayor of 25 Baltimore -- I think there are a few more brave DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 134 1 DRUG HEARING 2 mayors -- and to also explore the weakness of 3 support for drug prohibition in law enforcement. 4 There are a lot of people in American 5 law enforcement now who say this is a terrible, 6 terrible failure and we don't want to spend our 7 time on these kinds of things and we see kids who 8 need families and social supports and that's what 9 they have to have first before you get them off the 10 drugs. I think that's a much more profitable route 11 then making it a national political issue at this 12 point. 13 MS. PIEL: Thank you, Professor Gordon, 14 very much. We now have one more speaker this 15 morning. Her name is Dr. Joyce Lowinson and she is 16 going to bring a very special kind of knowledge to 17 this committee and this group having to do with 18 methadone. 19 Professor Dr. Lowinson is a 20 psychiatrist and she has been for many years a 21 professors on the staff of Albert Einstein School 22 of Medicine and for the last 25 years has headed 23 the Division of Substance Abuse there and she has 24 had personal experience with knowledge of the 25 methadone program which was instituted in New York DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 135 1 DRUG HEARING 2 not long ago. 3 I don't believe we've had anyone 4 telling us about methadone, which is both legal and 5 a controlled drug, but has its problems both 6 politically -- I don't know if she'll tell you 7 whatever problems there are medically, but 8 politically it still has a lot of problems. 9 Dr. Lowinson? 10 TESTIMONY BY DR. LOWINSON: 11 Thank you very much and thank you for 12 inviting me to speak here and I want to pay a 13 tribute to the Committee on Drugs and Laws for this 14 excellent report which I find challenging and I'm 15 dismayed to hear that we don't have Federal 16 officials who are interested in commenting on 17 this. 18 This report deals in part with public 19 health conditions which are caused by our punitive, 20 puritanical, prohibitionist attitudes and laws and 21 I, as a physician, am going to confine my remarks 22 to the role of methadone maintenance treatment in 23 reducing harm reduction and reducing harm and risk 24 to intravenous drug users. That is, the 25 transmission of HIV, Hepatitis and other infectious DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 136 1 DRUG HEARING 2 diseases, including Tuberculosis. 3 In the mid-80s it became increasingly 4 apparent that intravenous drug users were 5 exceedingly at risk for HIV and AIDS and that's 6 really what surfaced the great concern to the care 7 of intravenous drug users. This was because of 8 needle sharing and risky sexual behavior. 9 Methadone is perceived as one means of helping to 10 curb the spread of HIV among this group. We have 11 studies from Norway by Blitzenal (sic.), from the 12 Bronx by Diana Hartel (sic.) and from the Institute 13 of Medicine which support this. 14 Now, although expansion was recommended 15 by several prestigious bodies and that includes the 16 Executive Office of the President, it was known it 17 would take several years at least to expand 18 treatment to set up clinics in a customary manner 19 and for this reason, Dr. Robert Newman at Beth 20 Israel Medical Center proposed interim care which 21 he felt would help reduce the risk of HIV to this 22 population. In 1985 he opened a pilot, interim, 23 methadone clinic which proved to be moderately 24 successful. It was funded by the Federal 25 Government and then in 1988 it was approved by the DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 137 1 DRUG HEARING 2 FDA. But, it also faced a lot of opposition from 3 the professional methadone providers who felt this 4 would undermine their efforts to provide extensive 5 needed comprehensive services to patients who had 6 huge medical and social needs. And so, as a 7 consequence of this, the plan never really went 8 through. 9 Another way of extending or expanding 10 treatment was considered to be to allow the private 11 practitioners to treat intravenous drug users, to 12 accept them into their practice the way they do 13 other individuals with chronic disease. It's 14 important to go back to some of the other earlier 15 studies that were on the outgrowth of research at 16 Rockefeller University where I had the privilege of 17 participating with Dawn Eislender (sic.), Lori Jo 18 Crete (sic.), working with them, did studies on 19 Hepatitis and demonstrated that patients who were 20 on methadone and who remained on methadone had a 21 reduction in the incidence of Hepatitis B which at 22 that time was a serious medical problem. Beyond 23 reducing it in this population, it was demonstrated 24 that in the general population there was a similar 25 decrease, so that there was this public health DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 138 1 DRUG HEARING 2 reform. 3 In 1966 while I was still a resident of 4 Einstein, I had interrupted my residency to do the 5 research with Dawn Eislender (sic.) and I returned 6 to Einstein, where they had a TB program and we had 7 been told that if heroin addicts who were infected 8 with TB could be kept in the hospital until their 9 sputum turned negative, that TB would disappear. 10 So, I went to the head of the chest 11 disease program and made a proposition that I would 12 treat those patients in the hospital who were 13 addicts and treat them with methadone for a year 14 and see what the outcome was. Now, prior to the 15 introduction of methadone, 95 percent of the 16 patients left the hospital against medical advice 17 with positive sputum. After one year, the results 18 were reversed. In 95 percent of the patients were 19 remained in the hospital until their sputum had 20 turned negative and moreover, they continued to 21 come into the hospital on a regular basis where 22 they got their follow-up anti-TB therapy. 23 This was probably the first experiment 24 where a methadone program was providing directly 25 observed therapy, DOT, which is the treatment known DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 139 1 DRUG HEARING 2 today. It has really special relevance due to the 3 reemergence of TB, because TB never really went 4 away, but there was a myth that with all the 5 wonderful knew drugs, the TB hospitals could 6 closed, but it persisted and began to reemerge long 7 before HIV due to declining socioeconomic 8 conditions. But, with the appearance of HIV we had 9 double trouble. HIV and TB and multiple-drug 10 resistance TB. 11 Don DeJaLais (sic.) who is an 12 epidemiologist now working at Beth Israel heading 13 their chemical dependency unit has shown that 14 methadone patients have significantly lower rate of 15 HIV infection. Those who have been in treatment 16 then those who are currently entering treatment. 17 Those who have in treatment 10 years or more have 18 an insignificant incidence of HIV, whereas 40 to 50 19 percent of those entering treatment today are 20 infected. 21 Now, I'm sure you often hear that 22 methadone is just substituting one narcotic for 23 another, but the important difference between 24 methadone and heroin is that methadone can be taken 25 once daily, orally, and it markedly diminishes the DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 140 1 DRUG HEARING 2 craving for narcotics and as a consequence, it 3 allows IDUs, intravenous drug users to assume or 4 resume a normal way of life. Moreover, it moves 5 patients into the mainstream of medicine and it 6 turns out to be cost effective because patients get 7 regular medical care keeping them out of emergency 8 rooms. There is no good actuarial studies on this 9 which I think should be done, especially as we 10 enter the age of managed care. 11 At Einstein as elsewhere, women of 12 childbearing age have their urine tested on a 13 regular basis to determine whether or not-- that is 14 on a monthly basis -- to determine whether or not 15 they are pregnant and if they are, they receive 16 early prenatal care. Those women who are HIV+ -- 17 although though there is a law in New York which 18 prevents you from examining anyone against her will 19 -- most patients are willing to do that and those 20 who are HIV+ during the last trimester of their 21 pregnancies are able to receive AZT, which has had 22 a dramatic effect on reducing the transmission of 23 this virus to the fetus. 24 So, whereas, prior to this approach, 25 25 percent of the children, the babies, were HIV+, DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 141 1 DRUG HEARING 2 only eight percent -- only eight percent, but still 3 it's a marked reduction. 4 I want to get back to the issue of 5 expanding treatment and some of the ideas that have 6 been put forth by Dr. Newman. Patients are 7 reluctant to enter these major methadone clinics 8 because of all of the controls that are placed upon 9 them. In addition to the regulatory controls, 10 patients, like programs, superimpose their own 11 conditions, and it makes it difficult. It's not 12 easy to be a methadone patient. 13 In terms of the interim methods, we 14 found that patients who might have been reluctant 15 to go into a standard clinic, are willing to go 16 into a clinic where they get minimal services and a 17 physical examination and they get HIV education. 18 They do not get counsel and counseling is one of 19 the services about which I have serious 20 reservations. I'm never quite sure what counseling 21 means. I think social services are necessary, but 22 not counseling. 23 But, one of the important things to 24 know about these interim clinics is that according 25 to the regulations, they have to be integrated into DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 142 1 DRUG HEARING 2 a program that has comprehensive services with the 3 goal of moving patients into standard treatment 4 where they get the services they need. 5 We are also currently pursuing other 6 ways of expanding treatment. Now, in Australia, 7 New Zealand, Western Europe and other parts of the 8 world, private practitioners are seeing patients, 9 intravenous drug users and providing methadone 10 where necessary. In Australia they are about 11 15,000 patients in treatment with somewhat over 200 12 private physicians and this is the way of 13 destigmatizing treatment of methadone patients. You 14 never hear a methadone patient boldly announce "I 15 am on methadone." Even staff don't have that 16 feeling because of the stigma attached. I think 17 part of the stigma derives from the fact that the 18 patients are not seeing any regular medical care. 19 They are seen in a clinic where they receive 20 methadone. It doesn't happen if you have 21 hypertension or cardiac disease. You are seen in a 22 practice with other patients who have a variety of 23 diseases. 24 Some of the other things I wanted to 25 talk about have really been fully covered and they DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 143 1 DRUG HEARING 2 don't -- they are not related to methadone, but we 3 certainly are aware of the great costs that are 4 placed on the prohibition system -- the criminal 5 justice system and this report outlines beautifully 6 how our courts are cluttered with IDUs and Federal 7 judges are refusing to see these cases and prisons 8 are flooded with them and there is no education, 9 there is no treatment, there is practically no 10 healthcare in our prison system. It's a source of 11 social and medical illness for our society. 12 With the public health problems in 13 general, which were created by prohibition cannot 14 be overestimated and I think the report does bring 15 that out. 16 MS. PIEL: Thank you, doctor. Members 17 of the panel, any questions? 18 QUESTION BY MR. KNAPP: I recall when 19 methadone treatment first came about in the 60's 20 and 70's and that there were stories in the press 21 about how a black market had developed in methadone 22 and this was now a new problem; was that a myth or 23 did there in fact exist a black market and what is 24 the current situation with respect to a black 25 market for methadone. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 144 1 DRUG HEARING 2 RESPONSE BY DR. LOWINSON: Well, you're 3 talking about diversion which is a major concern of 4 the DEA and I think if there were adequate 5 treatment for all who needed it, diversion wouldn't 6 take place. There is selling of methadone, but it 7 is sold to patients or individuals who need the 8 methadone because they are dependent on narcotics 9 and they can't get into a program because of the 10 long waiting list and/or they don't want to get 11 into a program because of all of the social 12 controls. 13 I think the DEA did a study which 14 showed that there was something less than a gram of 15 methadone that was bought in the South Bronx which 16 might amount to something like 10 doses. 17 MS. PIEL: Mr. Davis and then we'll take 18 from the audience. 19 QUESTION BY MR. DAVIS: Dr. Lowinson, I 20 wonder if you could address whether you think there 21 are any prospects for using some of the models that 22 you described, perhaps the interim methadone 23 maintenance model, for the distribution of drugs 24 that are currently illegal in safe doses at some 25 point in the future through the medical system. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 145 1 DRUG HEARING 2 RESPONSE BY DR. LOWINSON: Well, there 3 are examples in Switzerland of the clinics where 4 heroin, morphine, methadone are available. We have 5 an example in the Netherlands where marijuana bars 6 exist and people can go and have marijuana and not 7 fear being arrested. Their laws are a little less 8 clear than ours, but certainly, they don't have as 9 heavy a hand in regard to marijuana as we do. 10 Should such a possibility exist? 11 That's one of issues that we are faced with and I 12 think the question was asked earlier could 13 pharmaceutical companies prepare medications and 14 could they be made available either in the 15 pharmacies or the way alcohol is readily available 16 under license. Should they be taxed? I think we 17 would run into greater risks and see fewer side 18 effects and I don't subscribe to the idea that we 19 have we would have more or significantly more 20 people using drugs, if that were the case. 21 QUESTION FROM AUDIENCE MEMBER: Dr. 22 Lowinson, you are aware that the Federal sentencing 23 scheme with respect to sale of the long list of 24 prescribed substances is based upon the weight of 25 the substance sold, and these weights are DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 146 1 DRUG HEARING 2 translated by an equivalency to marijuana, which is 3 the common denominator. 4 I am going to ask you about a situation 5 with respect to methadone in particular. I 6 recently became aware of a case where a person was 7 arrested for selling five doses of methadone and 8 they come in 70 gram vials, that's 350 gram total, 9 which I gather was sold -- 10 DR. LOWINSON: Milligram. 11 QUESTION FROM AUDIENCE MEMBER: Well, 12 actually grams, I think, because they did it in 13 terms of weight rather than volume and it was sold 14 for something less than $100. The equivalency was 15 174.5 kilograms of marijuana, which would amount to 16 presumably something over a million doses if it 17 were translated that way and certainly close to a 18 million dollars. 19 I just wondered about your comment on 20 the equivalency of five doses of methadone to 175 21 kilograms of marijuana in the sentencing scheme. 22 RESPONSE FROM DR. LOWINSON: I can only 23 say I think that's a ridiculous comparison and you 24 certainly couldn't buy that amount of marijuana for 25 $100. DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 147 1 DRUG HEARING 2 QUESTION FROM AUDIENCE MEMBER: Well, 3 it's really a clarification of that. The statutes 4 are written to say a substance containing any 5 amount of X, Y, Z, so the solvent, the carrier, the 6 blotter paper for LSD, all that counts because it's 7 a substance containing any amount of etc., so 8 that's how it must have been figured. He really 9 did mean grams because it was milliliters of water. 10 MS. PIEL: Thank you, Dr. Lowinson. 11 We've now come to the end of our 12 morning session. Thank you very much. And I have 13 been asked to announce that the committee will be 14 in recess now for a half an hour and resume again 15 for the afternoon session at 1:30. 16 (Whereupon, at 1:00 p.m., the testimony 17 of these witnesses was concluded.) 18 19 I, MARYBETH E. MUIR, a Notary Public 20 for and within the State of New York, do hereby certify that the above is a correct transcription 21 of my stenographic notes. ____________________________ 22 MARYBETH E. MUIR 23 24 25 DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 148 1 DRUG HEARING 2 I N D E X 3 4 WITNESS TESTIMONY Q/PANEL Q/AUDIENCE 5 DR. TREBACH 4 13 6 7 DR. GRINSPOON 26 36 8 9 DR. ROBERT GANGI 48 59, 66 63, 67 10 11 MR. W.J. BUCKLEY 71 83 88 12 13 DR. LONDON 93 105 110 14 15 DR. GORDON 114 124 129 16 17 DR. LOWINSON 135 143 145 18 19 20 21 22 23 24 25 DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY 149 1 DRUG HEARING 2 DOG SHEET - MARYBETH MUIR - OCTOBER 11, 1995 3 CASE: 4 DRUG POLICY HEARINGS 5 CLIENT: GARBARINI SCHER 6 TIME: 9 AM am 7 8 TIME: 9 AM - 1:00 pm 9 10 BILL: 11 *** AS PER FRAN, PAY REPORTER HEARING RATE & 12 APPEARANCE, DO NOT BILL CLIENT *** 13 14 SEND 3 1/2 INCH ASCII TO: 15 KENNETH BROWN 16 2 PARK AVENUE 17 MASSAPEQUA, NY 11758 18 19 * SEND CONDENSED TRANSCRIPT TO: 20 KATHY ROCKLEN 21 515 MADISON AVENUE SUITE 130 22 NY, NY 10022 23 24 25 DIAMOND REPORTING -718-624-7200- 16 COURT ST., B'KLYN, NY