SPECIAL ACTION OFFICE FOR DRUG ABUSE

PREVENTION

TUESDAY, JULY 27, 1971

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON PUBLIC HEALTH AND ENVIRONMENT, COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE, Washington, D.C. The subcommittee met at 10 a.m., pursuant to notice, in room 2322, Rayburn House Office Building, Hon. Paul G. Rogers (chairman) presiding.

Mr. ROGERS. The subcommittee will come to order, please.

We are continuing hearings on proposed bills to establish a Special Action Office for Drug Abuse Prevention, as well as other approaches to help handle the drug abuse problem.

For our first witness today we have the honor to hear from our colleague from the State of Massachusetts, the Honorable Margaret M. Heckler.

Welcome, Mrs. Heckler, we are pleased to have you with us this morning.

STATEMENT OF HON. MARGARET M. HECKLER, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MASSACHUSETTS

Mrs. HECKLER. Mr. Chairman, members of the committee, I am grateful for this opportunity to comment on H.R. 6732, of which I am a cosponsor.

There is no question as to the need for this legislation. The Nation is confronted by a drug problem of increasingly alarming proportions. There are an estimated quarter of a million hard drug addicts in this country and one-tenth that many among our Armed Forces in Southeast Asia.

There is every indication that the sickening rise of crime, particularly assault, robbery, burglary, and murder, are directly attributable to drug habits that require criminal acts to support them.

Were not the sheer numbers disturbing in themselves, the fact that most of these addicts are young people constitutes a very grave threat to the equilibrium of America.

Much is being done now that the Nation's full attention is being focused on the problem. Health and welfare agencies, public and private, are all making some effort at treatment and rehabilitation.

The Defense Department has instituted a crash military program. The Veterans' Administration is gearing up to care for addicted ex

servicemen. The President won a significant concession from Turkey, one of the largest exporters of opium in the world, when it agreed to halt the planting of poppies after 1972.

There are bills pending in the Congress expanding and deepening programs for military addicts.

In providing for an Office of Drug Abuse Control, H.R. 6732 complements all these programs and all this effort and is therefore a desirable step forward.

It calls for much needed research into the pharmacological aspects of the problem, provides for international control of narcotics, and requires a plan for coordination of the disparate Federal effort in the whole field of drug abuse.

I feel that all these provisions will strengthen and expand what must be a national effort, making existing programs more effective and adding its own dimension.

Mr. Chairman, there is much need in this country for a broad effort to make whole and preserve the environment. Admittedly, this is an urgent matter that will demand a great deal of time and money.

But how much more urgent and important is our need to cure and prevent the personal pollution of drug addiction and to make whole and preserve the natural resource of our young people?

I respectfully urge the committee to act quickly and favorably on this legislation so not a minute nor a life will be lost to us. We cannot afford the squandering of either.

Mr. ROGERS. Thank you, Mrs. Heckler, for sharing your views with us today.

Mrs. HECKLER. Thank you, Mr. Chairman, it has been my pleasure. Mr. ROGERS. Our next witness today is the Honorable Frank Carlucci, Director, Office of Economic Opportunity, Executive Office of the President.

I understand he will be accompanied by Dr. Carl Smith, Acting Director of the Office of Health Affairs.

The committee welcomes you and will be pleased to receive your testimony at this time.

STATEMENT OF HON. FRANK CARLUCCI, DIRECTOR, OFFICE OF ECONOMIC OPPORTUNITY, EXECUTIVE OFFICE OF THE PRESIDENT; ACCOMPANIED BY DR. CARL SMITH, ACTING DIRECTOR, OFFICE OF HEALTH AFFAIRS; AND DR. LEON COOPER, DIRECTOR, COMPREHENSIVE HEALTH PROGRAM

Mr. CARLUCCI. Mr. Chairman, on my left is Dr. Carl Smith, the Director of our Office of Health Affairs, and on my right is Dr. Leon Cooper, the Director of our Comprehensive Health Program.

Mr. Chairman, I have a prepared statement which I can submit for the record, if you would like. There are several parts of that statement that I would like to cover orally. I will try to be brief.

Mr. ROGERS. This is a fairly brief statement, and it might be well to read it.

Mr. CARLUCCI. I appreciate the opportunity to discuss with you the approaches and activities of the Office of Economic Opportunity in the field of drug rehabilitation.

The OEO health program has been aiding local agencies and groups in low-income neighborhoods to develop pilot programs in the drug field since 1967. I understand this committee has previously considered data and reports on the severe impact of drugs among the poor and the substantial disruptive effect of narcotics-related problems in lowincome communities. Recognition of these facts and conditions resulted in amendments to the Economic Opportunity Act in 1967 and 1969 which called upon OEO to give increased emphasis to the development of drug prevention, treatment, and rehabilitation activities.

Section 222 (a) (9) of the Economic Opportunity Act authorizes a "special emphasis" program in Drug Rehabilitation. The law states, in part:

A Drug Rehabilitation program (shall be) designed to discover the causes of drug abuse and addiction, to treat narcotic and drug addiction and the dependence associated with drug abuse and to rehabilitate the drug abuser and drug adict... Such programs shall be community based, serve the objective of the maintenance of the family structure as well as the recovery of the individual drug abuser or addict, encourage the use of neighborhood facilities and the services of recovered drug abusers and addicts as counsellors, and emphasize the reentry of the drug abuser and addict into society rather than his institutionalization.... You will note this language provides a very broad and a very sound foundation for program development.

As a result, the thrust of the OEO program has been to help organize community-based services which are located in poverty areas and are readily accessible and acceptable to those in need. A mix of needed services have been made available, including methadone, outpatient services, day care and residential treatment. Sometimes the mix of service is available through one facility. In other cases, needed services are organized through a network of component activities, with coordinating mechanisms to facilitate the movement of patients from one type of treatment to another.

In the last 4 years, OEO grant funds have assisted 22 demonstration projects concerned with drug addiction and rehabilitation. These local projects involve strong community participation in planning and operations to insure that services are organized and offered in ways that are as responsive as possible to the needs and conditions of patients and their families. The training and employment of ex-addicts as staff members of these projects are most important features; more than 500 have been trained and employed to date.

About 25,000 addicts have been served by OEO-aided local projects. About 5,000 of them received services for a substantial period of time. Some 10,000 families have received supportive services and 4,000 youths have been served in special outpatient activities. It is estimated that over 100,000 adults and youths have been reached by prevention and education activities.

In June 1967, OEO grants were made to aid pilot projects in New York City, Los Angeles, Chicago, Washington, Tacoma, San Antonio, New Jersey, and Puerto Rico. These efforts emphasized the organization of outpatient services in poverty neighborhoods for heroin and other addicts. Local community action agencies sponsored and aided the development of these new efforts. Four of these projects are now supported almost entirely from other funds.

In fiscal year 1970, $4.5 million was made available in the OEO budget to fund narcotics control projects. In fiscal year 1971, $12.8

million was available. The development of six new community projects were assisted in 1970 and eight in 1971.

In the planning of OEO-aided projects, a deliberate effort has been made to help initiate services in a variety of poverty settings and environments. Through these different approaches, we have sought to help develop new resources and experiences of many different types and to build a broad foundation on which further efforts might be built. Thus, in addition to urban programs in New York City, Boston, Detroit, and elsewhere, we have aided rural efforts in Vermont. A youth program has been helped in Washington, D.C., as well as activities to relate State correctional systems to community programs in California and South Carolina. A multi-modality program is being supported in Atlanta and a methadone program is run jointly by the Community Action Agency and the local medical society in Chattanooga. Other projects in California and Arizona serve largely Chicano communities. A training institute is being implemented to train ex-addicts as counsellors, supervisors and administrators. Supporting technical assistance and evaluation activities have also been sponsored through contracts.

We would be pleased to give the committee detailed descriptions of all these efforts. At this time, though, I should like to describe a few programs to give you a more complete sense of the types of activities. that are being undertaken.

Mr. ROGERS. May I interrupt to say that the committee would appreciate receiving the details on your various programs, where they are located, the staffing, the number of people and any experience you may have in that area. That would be very helpful.

Mr. CARLUCCI. I have the data here and would submit it for the record. (See pp. 869-878.)

Mr. ROGERS. Thank you.

Mr. CARLUCCI. The OEO-assisted program in Richmond, Va., administered through the community action agency, has grown from a small residential program to a multimodality program with extensive community support. The central facility is Rubicon, a therapeutic community, which has now expanded to Peidmont State Hospital, part of which has been donated to the program by the State of Virginia. Methadone maintenance and withdrawal is supervised by staff of the Medical College of Virginia and outpatient counseling and support are provided. The families of addicts are involved in the treatment process on a continuing basis. The community has made substantial commitments to this program through donations, fundraising, volunteer, and recreational activities. Radio, television, and newspaper coverage has been extensive. A community advisory council has been active and a community corporation has been formed called Rubicon, Inc.. to manage the program in the future.

The OEO grant to Vermont has enabled the State Office of Economic Opportunity, through the Vermont Drug Rehabilitation Commission, to commence a variety of local efforts dealing with the prevention and treatment of drug abuse and addiction. These activities include a manpower program, relating to a concentrated employment program component of a community action agency, to train former drug abusers as mental health workers.