ORGANIZATIONS REPRESENTED AT THE HEARINGS-Continued Narcotic addict rehabilitation agency program, Tulane University: Clark, June, drug addiction research team. Cohen, Dr. Gary, head. Goldsmith, Bernard, systems analyst, drug abuse team. Heath, Dr. Robert G., head, department of social psychiatry. Narcotic Service Council (NASCO)-St. Louis: Harvey, William M., Ph. D., director of psychological services. National Council of Community Mental Health Centers: Levin, Gilbert, Ph. D. Morris, Jonas V., executive director. National Loss Control Service Corp. (NATLSCO), Lewis F. Presnall, manager, corporate alcoholism and other behavioral problems department; and director of rehabilitation, Kemper Insurance Group. New Orleans, La.: Landrieu, Hon. Moon, mayor. Thompson, Dr. Doris, director, city health department. New York City: Finney, Graham S., commissioner, addiction services agency. Lacey, Miss Diane, mayor's office. Lindsay, Hon. John V., mayor. New York State Narcotic Addiction Control Commission: Chambers, Dr. Carl. Hesse, Ray. Jones, Howard, chairman. Parents Foundation Against Drug Abuse: Rembish, Mrs. Helen. Tarantino, Mrs. Mary. Pharmaceutical Manufacturers Association: Adams, Dr. John G., vice president for scientific and professional relations. Brennan, Bruce J., vice president and general counsel. Cavallito, Dr. Chester J., executive vice president, Ayerst Laboratories. Gadsden, Henry W., chairman, board of directors. Stetler, C. Joseph, president. Richmond Regional Planning District Commission, M. Miles Matthews, director, council on drug abuse control (CODAC). Rubicon, Inc., Richmond, Va., Edmund Menken, project director. Smith Kline & French Laboratories, Thomas M. Rauch, chairman of the board and president. State Department, Nelson Gross, Senior Adviser to the Secretary of State and Coordinator for International Narcotics Matters. Treasury Department, Eugene T. Rossides, Assistant Secretary (Enforcement, Tariff and Trade Affairs, and Operations. Veterans' Administration: Bronaugh, A. T., Associate General Counsel. Johnson, Donald E., Administrator of Veterans' Affairs. Kaim, Dr. Samuel, Director, Alcohol and Drug Dependence Service. Lee, Dr. Lyndon, Assistant Chief Medical Director for Professional Services. Musser, Dr. Marc J., Chief Medical Director. Peckarsky, J. C., Deputy Chief Benefits Director. Virginia Commonwealth University, Richmond, Va.: Brandt, Dr. Warren W., president. Bright, Dr. George M., director, Adolescent Medicine Medical College of Virginia. Harrison, Willard I., M. Sc., director, department of pharmacy services, and project director, methadone treatment program, Medical College of Virginia. Mathis, Dr. James, professor of psychiatry, Medical College of Virginia. Virginia Council on Narcotics and Drug Abuse Control, F. John Kelly, executive director. 66-841 0-72-pt. 1- -2 SPECIAL ACTION OFFICE FOR DRUG ABUSE PREVENTION FRIDAY, JULY 30, 1971 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON PUBLIC HEALTH AND ENVIRONMENT, Washington, D.C. The subcommittee met at 10 a.m., pursuant to notice, in room 2123, Rayburn House Office Building, Hon. Paul G. Rogers (chairman) presiding. Mr. ROGERS. The subcommittee will come to order. We are continuing hearings on bills to establish a special action office of drug abuse prevention, as well as on congressional proposals to help meet the drug abuse problem of our Nation. We are honored today to have the distinguished Secretary of Health, Education, and Welfare, Hon. Elliot Richardson, to testify, along with his associates, Mr. Stephen Kurzman, Assistant Secretary, Dr. Charles C. Edwards, Food and Drug Administration, Dr. Vernon E. Wilson, Head of Health Services and Mental Health Administration, and Dr. Bertram S. Brown, Director of the National Institute of Mental Health and other associates I see in the room. We are pleased to have you before the committee again, Mr. Secretary. We welcome you and will be pleased to receive your testimony. STATEMENT OF HON. ELLIOT L. RICHARDSON, SECRETARY, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE; ACCOMPANIED BY STEPHEN KURZMAN, ASSISTANT SECRETARY FOR LEGISLATION; DR. CHARLES C. EDWARDS, ADMINISTRATOR, FOOD AND DRUG ADMINISTRATION; DR. VERNON E. WILSON, ADMINISTRATOR, HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION; AND DR. BERTRAM S. BROWN, DIRECTOR, NATIONAL INSTITUTE OF MENTAL HEALTH Secretary RICHARDSON. Thank you very much, Mr. Chairman and members of the subcommittee. My colleagues and I are delighted to have the opportunity to appear before you today to testify in support of H.R. 9264, the bill proposed by President Nixon in his message on June 17, 1971, to establish the Special Action Office for Drug Abuse Prevention within the Executive Office of the President. In accordance with the Chairman's invitation, my testimony will also cover related bills pending before the subcommittee. NATURE OF THE DRUG ABUSE PROBLEM As the President stated in his message on drug abuse, "the problem has assumed the dimensions of a national emergency." In keeping with that assessment, it is most appropriate that this subcommittee has so promptly taken up this legislation. In the past decade, this Nation has experienced an alarming increase in the use of drugs. The precise dimensions of drug use and its effect are still not fully known. But we do know, for example, that in New York City, the number of deaths caused each year by narcotics use has risen from 200 to 1,000. More people between the ages of 15 and 35 die as a result of narcotics in New York City than from any other cause. Our best estimate is that there are now approximately 250,000 persons addicted to heroin in the United States. To deal with this emergency, the administration has sought an amendment to the fiscal year 1972 budget requesting an additional $155 million to mount a comprehensive attack on drug abuse. Of this $155 million, $105 million will be earmarked for rehabilitation of drug addicts and $10 million for drug abuse education. Another $14 million has been requested to support expanded treatment programs in Veterans' Administration facilities. These additional funds will raise the total available for fiscal year 1972 for such activities to $271 million. Much more is necessary to meet the drug abuse problem, however, than financial resources alone. A coordinated Federal response is also essential in order to maximize the impact of the substantial resources we are investing in the solution of this problem. Much progress in this regard has already been made in the field of law enforcement by the transfer of the Bureau of Narcotics to the Department of Justice. But much more needs to be done to coordinate the non-law-enforcement activities of the Federal Government. At present, nine Federal departments and agencies are involved in the various non-law-enforcement aspects of drug abuse such as research, treatment, rehabilitation, and drug education. Treatment programs alone are supported by at least three domestic agencies. One result is that State and local officials and private groups have often found it difficult, if not impossible, to obtain adequate information about Federal antinarcotics programs. Another result is that duplicative and overlapping projects are mounted in some localities while other areas with similar needs are underserved. Effective coordination at the Federal level involves, first, ordering the relationships between Federal departments and, second, ordering the relationships of agencies within each department, such as HEW, which has a number of agencies working on these problems. INTERDEPARTMENTAL COORDINATION Effective interdepartmental coordination involves at least four major elements: (1) Rational allocation of funds among various Federal departments and agencies and among various State and local, public and private grantees, and contractors: (2) Uniform and accurate information to the public and to nonFederal officials regarding the dangers of drug abuse and the avail. ability of Federal resources; (3) Rapid application of research findings to operating preventive and treatment programs; (4) Development and utilization of comprehensive social indicators for more precise identification of nature and extent of drug abuse. To achieve coordination of the Federal effort, the President has proposed in H.R. 9264, to establish a Special Action Office of Drug Abuse Prevention located within the Executive Office of the President and headed by a director accountable directly to the President. This proposal reflects the President's personal commitment to combat the national drug emergency effectively. Since this proposal is a response to an emergency, the Office will be established, not permanently, but for 3 years from the date of enactment of the bill. Provision is made for a 2-year extension if the President determines that an extension would be appropriate. The Special Action Office will assume overall responsibility for all major nonenforcement drug abuse programs, including those for prevention, education, treatment, training and research. It will develop a comprehensive Federal strategy to deal with these critical aspects of the drug abuse efforts and will set goals for the individual programs in accordance with that overall strategy. The Director of the Special Action Office will prepare budget requests for all programs over which he has authority and will determine funding priorities. He will maintain general supervisory authority over the operations of such programs. He will also coordinate research, evaluation, and information activities. In short, H.R. 9264 will provide the Director with all the tools necessary for effective coordination of the Federal drug abuse effort. In his appearance before this subcommittee on June 28, Dr. Jerome Jaffe, Special Consultant to the President for Narcotic and Dangerous Drugs, outlines in considerable detail how the Special Action Office will function. I will, therefore, not go into greater detail about the functions of that Office at this point. However, it might be noted that, before the President's proposal was made, alternative means of achieving much needed Federal interdepartmental coordination were carefully considered and were judged less effective than the Special Action Office now proposed. It would be at least theoretically possible for example, to achieve a similar result by placing all Federal activities relating to drug abuse within a single existing department. This alternative was rejected on the ground that many of the programs to be coordinated are integrally related to other activities of the agencies now managing those programs. For example, drug education is so clearly an important school function that it would be unwise to remove it from the Office of Education, the Federal agency with the closest ties to school systems throughout the Nation. Similarly, the drug prevention and treatment programs funded by the Office of Economic Opportunity are an important aspect of the antipoverty functions of community action agencies at the neighborhood level. Similar nonenforcement examples can be found in the Departments of Labor, Justice, Transportation, Defense, and in the Veterans' Administration. Another alternative would have been to assign to one department the leadership role in coordinating the drug abuse activities of all other Federal departments and agencies. This alternative was rejected |